Evidence-based medicine(EBM) is a new medical model,which is an inevitable tendency of modern clinical education.This article analyses the advantages and disadvantages of the evidence-based medical education(EBME) and emphasizes the great significance of EBM in paediatrics teaching.

The second class is not only a useful supplement to the first class but also an effective way to improve the comprehensive quality and ability of students.Through the deliberate research training and laboratory work,the second class of scientific research facilitates the medical students' developing scientific thinking,expanding professional knowledge,enhancing the ability to do scientific research and cultivating the spirit of teamwork.

Objective The purpose of the study was to explore influence of family factors on dietary behavior of primary and secondary studen t s in Guangzhou city, in order to provide suggestions for intervention of dietary behavi or. Methods The study population included 1 539 student-parent s pairs selected from Guangzhou city by using the method of stratified multistage cluster random sampling, and data were collected through questionnaires. Results The ratio of parents who often reminded and forced the ir children to eat some fo od they thought of as nutrition were 56.0% and 7.7%, and 39.7%, 29.2% of ch ildren complied with their parents, respectively. At dinner, 14.8% and 27.5% of parents often and sometimes criticized their children, and the ratio of childre n couldn't eat anything and only eat a little food were 5.9%,19.3%, respectively . Forty-two point three of primary and secondary school students watched televi sion wh en they had a dinner, which made 39.4% of students not eat seriously. C onclusions Dietary behavior of primary and secondary school students is influenced strongly by their parents and family environment, it is necessary for parents and themselves to grasp enough nutritional knowledge.

Objective To investigate the effects of miR-135a on HOXA10 expression,proliferation and apoptosis of SKOV3 cells.Methods (1) Through computer-aided algorithms,the predicted target gene of miR-135a (HOXA10)were determined.(2) miR-135a mimics,miR-135a inhibitor and negative control were transfected into SKOV3 cells,respectively.Reverse transcription (RT)-PCR,western blot analysis were used to examine the expression levels of HOXA10 at different times (24,48 and 72 hours).(3) A luciferase reporter assay was used to confirm the direct regulation between miR-135a and HOXA10.(4) SKOV3 cells proliferation at different times (24,48 and 72 hours) was detected by methyl thiazolyl tetrazolium(MTT) assay [quantified by absorbance(A)].Western blot was used to examine the expression of apoptosis-associated protein bcl-2,bax and caspase-3 in SKOV3 cells after 48 hours transfection.Results (1) HOXA10 was predicted to be the target gene of miR-135a by computer-aided algorithms.(2) RT-PCR shown that HOXA10 mRNA levels were decreased over time (24,48 and 72 hours) after miR-135a mimics transfectionin SKOV3 cells (0.94 ±0.04 vs 0.78 ±0.03 vs 0.70 ±0.03,P ＜0.05).While,the expression of HOXA10 mRNA was increased over time after miR-135a inhibitor transfection (1.14 ± 0.05 vs 1.16 ±0.03 vs 2.60 ±0.08,P ＜0.05).After transfected with miR-135a mimics or miR-135a inhibitor over 48 and 72 hours,the HOXA10 expression levels in SKOV3 cells were significantly lower or higher than each control group,respectively (all P ＜ 0.01).Western blot analysis of HOXA10 expression in SKOV3 cells confirmed the results of RT-PCR detected.(3) After cotransfection of miR-135a plasmid and pMIR-REPORT luciferase plasmid containing HOXA10,luciferase reporter assays showed that the luciferase activity reduced by 67.8％ (P ＜0.01).(4) MTT showed that SKOV3 cells growth after miR-135a mimics transfection for 48 and 72 hours were significantly lower than those in control group (0.38 ± 0.03 vs 0.52 ± 0.05,0.67 ±0.05 vs 0.75 ± 0.06 ; respectively,all P ＜ 0.05).While,SKOV3 cells transfected with miR-135a inhibitor for 72 hours grew significantly faster than that in control group (0.95 ± 0.05 vs 0.75 ± 0.06,P ＜ 0.01).After miR-135a mimics transfection,the level of bcl-2 protein was significantly lower than that in control group (0.28 ±0.06 vs 0.76 ±0.09,P ＜0.01).The activity of caspase-3 was significantly higher than that in control group (115.0 ± 2.4 vs 95.4 ± 2.1,P ＜ 0.01).While,there was no statistical difference of bax expression (P =0.142).However,after miR-135a inhibitor transfection,the expression level of bcl-2 protein was significantly higher than that in control group (0.92 ± 0.03 vs 0.76 ± 0.09,P =0.037) and the activity of caspase-3 was significantly lower than that in control group (59.5 ± 4.1 vs 95.4 ± 2.1,P ＜ 0.01).There was also no statistical difference of bax expression (P =0.066).Conclusion miR-135a may play an important role in cell proliferation and apoptosis of ovarian cancer cells by regulating HOXA10 and its downstream pathways.

Objective:To study the epidemiology of attention-deficit hyperactivity disorder(ADHD) in pupils of Zhenjiang urban districts. Methods: Questionnaire was designed and employed for parents of 3 698 pupils at schools in Zhenjiang urban districts. ADHD was diagnosed according to the international DSM-Ⅳ scale. Differences were determined by Qi-square test and multiple regression analysis. Results: Prevalence of ADHD was 6.54% in pupils of Zhenjiang urban districts, and was 9.14% in male pupils and 4.01% in female. There was significant difference between 2 gender groups (? 2=34.933,P

Objective To explore the methods and the nursing points during the course of using methotrexate to cure moderate and severe psoriasis.Methods 41 moderate and severe patients with psoriasis have been adopted in this study.The procedure of nursing care included medical education,clinical care and psychological nursing in order to increase the compliance of patients.Results All the patients have accepted the therapy of using methotrexate to cure psoriasis,the effective rate was 80.5%,only one case have withdrawed from the study because of leucopenia.The compliance of patients have increased significantly.Conclusion Using methotrexate to cure psoriasis is effective and safe,which can increase the compliance and the confidence of patients.

This paper explored and analyzed difficulties in English teaching and put forward some ways to deal with this situation.The suggestions included changing the curriculum from general English to medical English,establishing the multiple assessment system and developing multilingual teaching modes.

Objective To investigate the correlation between red cell distribution width RDW) and prognosis in patients with severe traumatic brain injury.Methods A total of 264 consecutive patients with severe traumatic brain injury admitted from May 2012 to November 2014 were enrolled.The patients were divided into low-RDW group (RDW ＜ 15％,n =198) and high-RDW group (RDW ≥ 15％,n =66) based on their RDW levels.Between-group differences were evaluated on general conditions,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ),inflammatory markers [high sensitivity C-reactive proteins(hs-CRP) and arterial lactate],liver/renal dysfunction,and 28-day mortality.Spearman correlation analysis of RDW with mortality was conducted.Independent factors of 28-day mortality were identified using multivariate Logistic regression.Kaplan-Meier 28-day survival curve was analyzed and survival probability of the two groups was compared using Log-Rank test.Results The 28-day mortality was significantly enhanced in high-RDW group compared to that in lowRDW group (43.9％ vs 26.8％,P ＜ 0.01).RDW ≥ 15％ related positively to APACHE Ⅱ and mortality(r =0.172 and 0.253 respectively,P ＜ 0.01),but negatively to Glagow coma score (GCS) (r =-0.169,P ＜0.01).RDW≥ 15％ was the independent risk factor for predicting the 28-day mortality (OR =2.144,95％ CI 1.202-3.826,P ＜0.01).After adjusted gender,age,and other relative factors,RDW≥15％ was still strongly correlated with the 28-day mortality(OR =2.244,95％ CI 1.076-4.678,P ＜ 0.05).Significantly lower 28-day survival rate was found in high-RDW group than in low-RDW group (P ＜ 0.01).Conclusions RDW level rises beyond the normal range on admission in patients with severe traumatic brain injury,which is closely correlated with the 28-day poor outcome.RDW≥ 15％ has significant predictive value in the prognosis.

Humans ; Integrative Medicine ; Medicine, Chinese Traditional ; Occupational Diseases ; therapy ; Osteoarthritis, Knee ; therapy

Objective To assess the application of Xpert MTB/RIF assay in rapid diagnosis of tuberculous lymphadenitis.Methods Lymph node samples were collected from 1 02 clinically diagnosed patients with lymph node tuberculosis and 65 patients with other lymph node diseases from Zhejiang Provincial Hospital of Traditional Chinese and Western Medicine during January 201 4 and February 201 5. Xpert MTB/RIF,pathological examination and mycobacterium tuberculosis culture were conducted in all specimens of two groups.Taking clinical comprehensive diagnosis as the gold standard,the diagnostic sensitivity,specificity,positive predictive value,negative predictive value and diagnosis efficacy of three detection methods were assessed.The sensitivity of Xpert MTB/RIF in determining rifampicin resistance was analyzed using drug susceptibility testing as gold standard.Results The mean detection time of Xpert MTB/RIF was (2.2 ±0.2)h.Among 1 02 patients,Xpert MTB/RIF achieved higher sensitivity (96.1 %, 98 /1 02 ) than pathological examination (76.5%,78 /1 02 ) and mycobacterium tuberculosis culture (33.3%,34 /1 02)(χ2 =1 6.558 and 87.91 9,both P <0.01 ).Among 65 patients with other lymph node diseases,the specificity of all three detection methods was 1 00%.The receiver-operating-characteristic curve analysis demonstrated that diagnostic performance of Xpert MTB/RIF was better than that of other two methods.In 8 patients resistant to rifampicin confirmed by drug susceptibility testing,Xpert MTB/RIF detected 6 resistant-resistant patients.Conclusion Xpert MTB/RIF shows higher sensitivity and specificity in diagnosis of lymph node tuberculosis with the advantages of easy and rapid performance.