Objective To discuss some expectation on reform of classroom teaching method for eight-year program medical education, in order to provide a basis for the evaluation and reform of classroom teaching method. Methods Investigation that mainly included expectation on reform of classroom teaching method, classroom teaching method of most expected application, and ex-pected value of classroom teaching method was investigated and analyzed with self-made question-naire, to total 78 medical students (22 of Grade 2008, 20 of Grade 2009, 20 of Grade 2010, 16 of Grade 2011) of eight-year program who had completed the stage before medical education in the uni-versity, and related 32 teachers. Software of SPSS 20.0 was used to make statistical analysis. Results In the survey, 55.8% students and 78.1% teachers hoped to reform the current classroom teaching methods (χ2=4.782,P=0.029). 61%students and 90.6% teachers expected comprehensive application of diverse method(χ2=15.464,P=0.017), including instruction combined with writing on blackboard, teaching by multimedia, PBL, inversion-type class, independent learning, a lot of questions for exami-nation, and so on. The value expectation (>60%) of classroom teaching method was multivariate, in-cluding to stimulate students' interest in learning, to cultivate ability of finding and solving problems, conducive to understanding of knowledge and memory, conducive to comprehension and memory of knowledge, conducive to cultivation of learning method, able to improve ability of creativity and criti-cal thinking, conducive to strengthening interaction and communication of teachers and students, to improve the subject consciousness of student in classroom, helpful to cultivate the spirit of teamwork, to improve the efficiency of teaching, and able to make full use of information technology. Conclusions For the diversified value demand and the highly expectation on reform of current classroom teaching method, more attention should be paid to evaluation and guidance on reform of classroom teaching method for eight-year program medical education.

Objective To explore the relativity between clinical learning organization culture and core competency among registered nurses,to offer theoretic basis and practical advices for improving core competency among registered nurses.Methods 680 registered nurses in three tertiary hospitals in Ji'nan city were investigated with the general information questionnaire,Competency Inventory for Registered Nurses and the Dimensions of The Learning Organization Questionnaire.Results The total score and all the four subscales of learning organization were positively correlated with the core competency among registered nurses(P＜0.01),the dimension of overall situation senses and strategic leadership were the main influencing factors.Conclusions The cultivation of nurses' overall situation senses should be strengthened,providing strategic leadership for learning,strengthening cooperation and innovation,and promoting inquiry and communication.These will help increase core competency among registered nurses and improve their general competence.

Objective To evaluate the medium and long term safety and efficacy of sacrospinous ligament fixation (SSLF) performed with conventional instruments in treating stage Ⅲ-Ⅳ pelvic organ prolapse (POP).Methods A prospective cohort analysis was conducted in the Peking Union Medical College Hospital,between May 2007 and June 2015,enrolling 55 women with stage Ⅲ-Ⅳ POP who intended to receive SSLF.Primary end points were objective success rates using pelvic organ prolapse quantitation system (POP-Q) and subjective satisfaction rates with questionnaires after surgery according to vaginal examination and related questionnaires for all patients who received SSLF eventually.Exploratory outcomes included perioperative parameters and complications.Results Of these 55 POP patients enrolled,52 (95％,52/55) received SSLF using conventional surgical instruments,the other 3 cases converted to ischial spinous fascia fixation due to difficulty exposing.Medium blood loss during operation was 100 ml (20-300 ml) and operative time 60 minutes (20-165 minutes).Pelvic hematoma with diameters of 5 cm and 7 cm were observed in two patients,both recovered fully with conservative methods.All patients were able to micturate spontaneously after catheter withdrawal.One patient reported right thigh pain after operation which remained till 3-month follow-up and relieved after physiotherapy.The objective success rate was 100％ (52/52) at 3 months.With a medium follow-up time of 23.7 months,the objective success rate was 98％ (51/52),the recurrence rate was 2％ (1/52) and the satisfactory rate was 94％ (49/52).De novo urinary incontinence occurred in 6％ (3/52) of patients.Conclusion Most POP could be corrected with SSLF using conventional instruments which is a feasible,economic and effective procedure for Asian patients with medium compartment prolapse.

Objective To evaluate the effects of exercise therapy for patients with difficult weaning using mechanical ventilation.Methods A total of 63 patients with difficult weaning using mechanical ventilation were randomly divided into the experimental group(33 cases) and the control group(30 cases).The patients in the control group received routine respiratory care,however,the patients in the experimental group received gradual and individualized exercise therapy according to patients' condition and physical strength.The items such as the tidal volume,respiratory rate,PaO2/FiO2 were compared between two groups.Results Compared with the control group,the tidal volume,respiratory rate,PaO2/FiO2 and the score of APACHE Ⅱ were better in the experimental group on the 21th and 28th day after mechanical ventilation,the heart rate was better in the experimental group on the 28th day after mechanical ventilation.In addition,the duration of mechanical ventilation and ICU hospitalization was shorter in the experimental group.But the rate of complications showed no significant difference.Conclusions Exercise therapy has a positive effect on patients with difficult weaning using mechanical ventilation.

Objective To observe the change of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene expression during 3T3-L1 adipocyte differentiation as well as other reference gene expressions.Methods The mRNA expressions of several common reference genes were detected by real time-PCR on day 0,1,3,5,and 7 of 3T3-L1 adipocyte differentiation.Western blot was used to confirm the protein expressions of three common reference genes.Results (1) GAPDH and transferrin receptor(TFRC) mRNA expressions were significantly increased during adipocyte differentiation.GAPDH mRNA level was increased by 5.7,7.6,22.0,and 24.5 folds on day 1,3,5,and 7 after induction of adipocyte differentiation,but no apparent changes of β-actin,α-tubulin,peptidylprolyl isomerase A (PIPA),and 18S mRNA expressions were detected.The expression changes of key transcript factors for adipocyte differentiation such as PPARγ2,C/EBPα,and C/EBPβ were under-estimated by real time-PCR if GAPDH was chosen as the reference gene.Western blotting results showed that the GAPDH protein level increased gradually during adipocyte differentiation,especially on day 5 and 7 after adipocyte differentiation.There were no obvious changes of β-actin and α-tubulin protein expressions.(2) Berberine significantly inhibited mRNA and protein expressions of GAPDH in the process of adipocyte differentiation.GAPDH mRNA levels were reduced by 68.1％ and 66.3％ on day 5 and 7 after induction of adipocyte differentiation,but with no significant change in other reference genes.Conclusion It is not suitable for GAPDH to be used as an endogenous reference gene during 3T3-L1 adipocyte differentiation.

Objective To investigate the effect of individualized weight management on pregnancy outcomes of obese pregnant women.Methods A total of 130 obese pregnant women with regular check-ups and hospital delivery of single fetus and without medical complications were randomly divided into observation group and control group with 65 cases in each group.Preg-nant women in control group were given antenatal examination and health education by convention-al methods,while those in observation group were given individualized weight management based on methods of control group.Weight gain,pregnancy complications,overweight newborns,post-partum hemorrhage and cesarean section of two groups were compared.Results The weight gain of pregnant women controlled in the standard range during pregnancy in observation group account-ed for 66.1%,which was significantly higher than that in the control group (P <0.01).The in-cidence of gestational diabetes,preeclampsia,overweight newborns and postpartum hemorrhage in observation group was significantly lower than that in the control group,the difference was signifi-cant (P <0.05).The cesarean rates because of overweight newborns,labor abnormalities,rela-tively cephalopelvic disproportion in observation group was significantly lower than that in the con-trol group,the difference was significant(P <0.01).Conclusion Individualized weight manage-ment for obese pregnant women may improve pregnancy outcomes.

Objective To investigate the effect of individualized weight management on pregnancy outcomes of obese pregnant women.Methods A total of 130 obese pregnant women with regular check-ups and hospital delivery of single fetus and without medical complications were randomly divided into observation group and control group with 65 cases in each group.Preg-nant women in control group were given antenatal examination and health education by convention-al methods,while those in observation group were given individualized weight management based on methods of control group.Weight gain,pregnancy complications,overweight newborns,post-partum hemorrhage and cesarean section of two groups were compared.Results The weight gain of pregnant women controlled in the standard range during pregnancy in observation group account-ed for 66.1%,which was significantly higher than that in the control group (P <0.01).The in-cidence of gestational diabetes,preeclampsia,overweight newborns and postpartum hemorrhage in observation group was significantly lower than that in the control group,the difference was signifi-cant (P <0.05).The cesarean rates because of overweight newborns,labor abnormalities,rela-tively cephalopelvic disproportion in observation group was significantly lower than that in the con-trol group,the difference was significant(P <0.01).Conclusion Individualized weight manage-ment for obese pregnant women may improve pregnancy outcomes.

The purpose of this study is to investigate the basic situation of self-regulated learning among clinical medical undergraduates in the stage of professional courses and construct a structural model suitable for them to carry out self-regulated learning . Zimmerman's self-regulated learning concept framework was determined as the theoretical basis of this study. A questionnaire survey was performed to identify five main dimensions affecting self-regulated learning including expression of learning intention, self-efficacy, adjustment of learning behavior, management of curriculum strategies, and adaption of learning environment, and then, Amos 24.0 software was used to construct the structural model and draw the conclusion that self-regulated learning in this group centers on the regulation of learning behavior, with learning intention and self-efficacy as sub-centers.

Nail diseases have similar clinical manifestations with a variety of causes. Dermoscopy, a non-invasive examination tool, can be used to rapidly and comprehensively evaluate changes of diseased nails at the early stage by observing nail cuticles, nail folds, nail plates, etc. It can be applied for diagnosis and treatment of nail diseases or evaluation of surgical performance. To improve clinicians′ understanding of nail diseases, the authors summarize dermoscopic manifestations of common nail diseases based on dermoscopic manifestations of definitely diagnosed nail diseases in Department of Dermatology, Xiangya Hospital, Central South University from June 2017 to February 2019.

Transforming growth factor-β (TGF-β) members are key cytokines that control embryogenesis and tissue homeostasis via transmembrane TGF-β type II (TβR II) and type I (TβRI) and serine/threonine kinases receptors. Aberrant activation of TGF-β signaling leads to diseases, including cancer. In advanced cancer, the TGF-β/SMAD pathway can act as an oncogenic factor driving tumor cell invasion and metastasis, and thus is considered to be a therapeutic target. The activity of TGF-β/SMAD pathway is known to be regulated by ubiquitination at multiple levels. As ubiquitination is reversible, emerging studies have uncovered key roles for ubiquitin-removals on TGF-β signaling components by deubiquitinating enzymes (DUBs). In this paper, we summarize the latest findings on the DUBs that control the activity of the TGF-β signaling pathway. The regulatory roles of these DUBs as a driving force for cancer progression as well as their underlying working mechanisms are also discussed.
Animals ; Humans ; Molecular Targeted Therapy ; Receptors, Transforming Growth Factor beta ; metabolism ; Signal Transduction ; Smad Proteins ; physiology ; Transforming Growth Factor beta ; physiology ; Ubiquitin Thiolesterase ; metabolism ; Ubiquitin-Specific Proteases ; Ubiquitination