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Objective:To explore the effects of "2+1" PAD class based on online course in medical statistics undergraduate teaching.Methods:A total of 326 clinical undergraduates who took medical statistics in the spring term of 2017 were randomly divided into experimental group ( n=186) and control group ( n=140). Students in the experimental group were taught by "2+1" teaching method, which included self-study on line, classroom teaching, discussion and so on. While students in the control group were taught traditionally. Feedbacks about the teaching progress and effects from the students in the two groups were compared. SAS 9.4 was used for quantitative data description, t-test and rank sum test. Results:according to the students, the online-based "2+1" teaching method paid more attention to interdisciplinarity than traditional method ( P<0.01), and the new teaching method was more beneficial for the improvement of students' capacity ( P=0.008) and more conducive for students to engaging in scientific research ( P=0.012). Students in the experimental group had higher overall satisfaction scores ( P<0.01) and better ability for solving comprehensive problems ( P<0.01). Conclusion:The "2+1" PAD class teaching model based on online courses has more advantages than traditional teaching methods does, which should be recommended and adopted in undergraduate teaching.
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Objective@#The aim of the present study was to investigate the survival rate and its prognostic factors for patients with biliary tract cancer, and then a prognostic risk prediction model was constructed to predict the survival probability of patients.@*Methods@#A total of 14 005 patients with biliary tract cancer (including gallbladder cancer, extrahepatic bile duct cancer, and ampulla of Vater cancer), who were diagnosed between 2010 and 2015 in the US National Cancer Institute Surveillance, Epidemiology, and End Results Program (SEER) were included in the development cohort. The prognostic risk factors of biliary tract cancer were investigated using multivariate Cox regression models. The predictive nomograms were then constructed to predict the overall survival probability of 1, 3, and 5 years, and the predictive discrimination and calibration ability of the nomograms were further evaluated. Meanwhile, 11 953 patients who were diagnosed during 2004 to 2009 from SEER Program were then selected to validate the external predictive accuracy of the prediction models.@*Results@#The 1, 3 and 5-year cumulative survival rates of patients with biliary tract cancer were 41.9%, 20.4% and 15.3%, respectively, in the development cohort. Age greater than 50 years, African Americans and Native Americans and Alaska Natives, higher T, N and M stage and poor histological differentiation grade were risk factors for death, while married status, Asia-Pacific Islanders, insured status and surgery on primary site were protective factors. Gender was not significantly associated with the overall survival. The C statistic of the prediction model was 0.73 (95%CI: 0.72-0.74), and the calibration curve showed that the interaction curves of predictive and actual survival rates of 1, 3 and 5 years were close to the 45 degree diagonal. Results in the validation cohort were similar with those in the construction cohort, with a C statistic of 0.70 (95%CI: 0.69-0.72), indicating high external applicability of the prediction model. Findings from gallbladder cancer, extrahepatic bile duct cancer, and ampulla of Vater cancer are in consistent with the overall biliary tract cancer.@*Conclusions@#The survival rate of patients with biliary tract cancer is relatively poor, and the survival prediction model based on prognostic factors has high prediction accuracy. In the future, this prognostic prediction model could be applied to clinical practice to guide individualized treatment for patients with biliary tract cancer.
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Objective:To investigate the prevalence of post-traumatic stress disorder(PTSD)symptoms in middle school students after Wenchuan earthquake.Methods:The PTSD Checklist-Civilian version( PCL-C),which included three symptom groups(A,B,and C),was used to assess the PTSD symptoms in 1960 middle school students in the disaster region through self-questionnaire.Results:(1)The general positive rate of PTSD symptoms was 78.3%,and that of B group was the highest(68.9%).(2)The rates of general PTSD and three symptom groups of PTSD were higher in girls,high grade students,minority groups,rural students,injured in earthquake and those who lost family property than in boys,low grade students,the Han nationality,urban students,not injured in earthquake and those who did not lost family property[such as,the general positive rate of PTSD symptoms:girls 82.2%,boys 73.9%,P<0.05].(3)The rates of severe PTSD symptoms in girls and rural students were higher than that in boys and urban students(27.9% vs.19.9%,26.7% vs.21.4%,Ps<0.05).Conclusions:PTSD symptoms are common among middle school students in earthquake region.Targeted measures should be taken to protect middle school students from PTSD in earthquake region.