Construction of an entrustable professional activities framework for medical undergraduates / 中华医学教育探索杂志

Objective:To construct an entrustable professional activities (EPAs) assessment framework for undergraduate medical students suited to the national conditions in China.Methods:The Delphi method was used to construct an EPAs assessment framework for medical undergraduates. Twenty-one clinical experts across China were invited to participate in two rounds of Delphi consultation.Results:All the 21 experts completed the two rounds of Delphi consultation. The effective questionnaire response rates of the two rounds of consultation were 100.0% (21/21). For the first-round expert consultation, the W values of importance and feasibility scores of EPAs were 0.182 and 0.173 (both P<0.05), respectively. For the second-round expert consultation, the W values of importance and feasibility scores of EPAs were 0.167 and 0.152 (both P<0.05), respectively. According to the second-round Delphi consultation, the importance and feasibility scores of all 14 EPAs indicators were >3.5 points, with the coefficients of variation <0.25 points. We preliminarily established 12 EPAs indicators and 42 key assessment points and determined the expected entrustment levels of each EPA at different stages for medical undergraduates. Conclusion:This study preliminarily constructed an EPAs assessment framework for medical undergraduates, which provides a new evaluation method for the cultivation of medical undergraduates in China.

Proteomic Analysis Reveals Resistance Mechanism Against Chlorpyrifos in Frankliniella occidentalis (Thysanoptera: Thripidae).

The western flower thrips is an economically important worldwide pest of many crops, and chlorpyrifos has been used to control western flower thrips for many years. To develop a better resistance-management strategy, a chlorpyrifos-resistant strain of western flower thrips (WFT-chl) was selected in the laboratory. More than 39-fold resistance was achieved after selected by chlorpyrifos for 19 generations in comparison with the susceptible strain (WFT-S). Proteome of western flower thrips (WFT-S and WFT-chl) was investigated using a quantitative proteomics approach with isobaric tag for relative and absolute quantification technique and liquid chromatography-tandem mass spectrometry technologies. According to the functional analysis, 773 proteins identified were grouped into 10 categories of molecular functions and 706 proteins were presented in 213 kinds of pathways. Comparing the proteome of WFT-chl with that of WFT-S, a total of eight proteins were found up-regulated and three down-regulated. The results from functional annotation and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses indicated that the differentially expressed protein functions in binding, catalyzing, transporting, and enzyme regulation were most important in resistance development. A list of proteins functioning in biological processes of metabolism, biological regulation, and response to stimulus was found in WFT-chl, suggesting that they are possibly the major components of the resistance mechanism to chlorpyrifos in western flower thrips. Notably, several novel potential resistance-related proteins were identified such as ribosomal protein, Vg (vitellogenin), and MACT (muscle actin), which can be used to improve our understanding of the resistance mechanisms in western flower thrips. This study provided the first comprehensive view of the complicated resistance mechanism employed by WFT-S and WFT-chl through the isobaric tag for relative and absolute quantification coupled with liquid chromatography-tandem mass spectrometry technologies.

Multi-factoral analysis on the flap thickness influenced by laser operation in situ keratomileusis / 中华流行病学杂志

Objective To investigate the various factors that influencing the flap thickness after laser operation in situ keratomileusis (LASIK). Methods 369 LASIK eyes (192 cases;among them, 15 patients for surgery monocular) with M2 130 microkeratome heads, grouped by left or right eye were analyzed by Chi-square test and logistic regression analysis based on age, sex, occupation, family history of myopia and ophthalmologic examination results before and after LASIK. The result of analysis of one-way variance which P＜0.05 as the variance to described with logistic regression analysis. Results Results from logistic regression analysis showed that the flap thickness after LASIK of right eye group was related to two factors: the preoperative refractive power (P = 0. 017, OR = 0. 832,95% CI : 0. 715-0. 968), and the corneal thickness ( P = 0. 000, OR = 1. 023,95% CI : 1.011-1. 036) while left eye group was related to three factors: the preoperative astigmatism power (P = 0.044, OR = 2.094, 95% CI: 1.021-4.294),negative pressure suction time ( P = 0. 019, OR = 1. 418,95% CI : 1. 059-1. 898) and the corneal thickness(P = 0. 000, OR = 1. 049, 95% CI : 1. 025-1. 073 ). Conclusion Corneal thickness, the preoperative astigmatism power and the negative pressure suction time tended to make the flap thicker while the preoperative refractive power tended to make the flap thinner. Results showed that the flap thickness performed at the first time was more obvious than at the second time.[ Key words] Laser in situ keratomileusis; Flap thickness; Multi-factor analysis