After a description of the differences between formative evaluation and summative evaluation, the appli-cation of formative evaluation in literature retrieval course evaluation in medical colleges and universities was elabo-rated by analyzing the current situation of literature retrieval course and its evaluation in medical colleges and uni-versities with Xinjiang Medical University as an example, which showed that the principles should be followed when formative evaluation is applied in literature retrieval course evaluation.The problems related with the application of formative evaluation in literature retrieval course evaluation were pointed out.

Objective To explore the relationships between serum insulin-like growth factor 1 (IGF-1) level and children with tourette syndrome, and the significance of IGF-1 level for the diagnosis of tourette syndrome.Methods Enzyme-linked immunosorbent assay (ELISA) was adopted to detect the serum level of IGF-1 and S100B of 53 children patients with tourette syndrome and 53 children with physical examination.The receiver operating characteristic (ROC) curves were used to determine the cut-off value and assess the sensitivity,specificity and diagnostic efficiency.Results The concentration of IGF-1 was significantly lower in the children with tourette syndrome group than in normal group ((41.51±4.23) μg/L vs.(69.04±5.26) μg/ L,t=29.693,P＜0.01),and the concentration of S100B was significantly higher in the children with tourette syndrome group than in normal group((129.48±9.54) ng/L vs.(81.37±8.42) ng/L,t =27.526,P＜0.01) .When 59.28 and 93.35 ng/mL ware used as cut-off value, the sensitivity, specificity and area under curve for IGF-1 in diagnosis of children with tourette syndrome were 89.6％, 96.4％ and 0.931, respectively.The sensitivity,specificity and area under curve for S100B in diagnosis of children with tourette syndrome were 94.1％, 91.3％ and 0.969, respectively.And the diagnostic efficiency of IGF-1 was similar to that of S100B.Conclusion IGF-1 may play an important role in the development of tourette syndrome.Detection of IGF-1 in the serum is helpful in the diagnosis of children with tourette syndrome.

Objective To evaluate the effect of therapeutic communication on perioperative anxiety of cancer patients by using the Meta-analysis.Methods The randomized controlled studies of therapeutic communication for perioperative anxiety of cancer patients were gathered from Pubmed,Embase,Cochrane Library,China Biology Medicine Disc (CBM),China Scientific Journal Database by VIP (CSJD),China National Knowledge Infrastructure (CNKI) and Wangfang Data,while other relative researches were also searched by hand.According to inclusion and exclusion criteria articles were evaluated by two reviewers independently.The studies were assessed according to the Juni assessment.RevMan 5.2 was used for statistical analysis.Results Seven studies with 506 patients were included,of which therapeutic intervention group contained 256 patients,the control group included 250 patients.Meta-analysis showed that compared with the control group,therapeutic communication system could reduce perioperative anxiety of cancer patients [MD=-8.00,95％CI (-8.91--7.10),P ＜0.01],improve positive perioperative coping of patients [MD=5.50,95％CI(4.05-6.95),P ＜ 0.01],reduce negative perioperative coping of patients [MD=-7.62,95％CI (-9.13--6.11),P ＜ 0.01],increase the satisfaction degree of patients [MD=0.55,95％CI (0.33-0.77),P ＜0.01],the differenccs were statistically significant.Conclusions Therapeutic communication can contribute to relieve perioperative anxiety of cancer patients,optimize their coping styles and improve the satisfaction degree of patients with nursing work.

Recent evidence has shown that neurogenesis occurs throughout adulthood, and neural stem cells reside in the adult central nervous system (CNS) in mammals. Experimental stroke in adult mammals increases neurogenesis from neural stem cells or progenitor cells located in the dentate subgranular zone and the subventricular zone lining the lateral ventricle. New neurons can migrate to the areas of damage regions and express morphological markers characteristic of died neurons. These findings bring hope for self-repair after brain injury. The author of this paper reviewed the adult neurogenesis and its regulation in vivo, and described evidence for stroke-induced neurogenesis and neuronal replacement in the adult, and discussed the future research directions about neurogenesis after stroke and other brain injuries.

BACKGROUND: Neural axon regeneration is one of the difficulties that must be overcome in treatment of injury of central nerve system. Significant therapeutic effects have been obtained in transplantation of neural stem cells (NSCs), embryonic stem cells (ESCs) and Schwann cells. But the bottleneck situation of insufficiency of cell provider has limited the development on it.OBJECTIVE: To observe directional-differentiation of retinoic-acid induced ESCs so as to find optimal condition for neuronal differentiation.DESIGN: Non-randomized controlled experiment was designed.SETTING: Teaching-Research Room of Histology and Embryology, Department of Basic Medicines. Third Military Medical University of Chinese PLAMATERIALS: The experiment was performed in Staff Room of Histology and Embryology, Third Military Medical University of Chinese PLA from January to May 2000. Eighteen Kunming mice in disoestrus were employed, of which. 12 mice were female and 6 mice male. They were placed in same cage at ratio of 2:1 for mating. The date of pregnancy was recorded. MESPU35 ESC line was prepared.METHODS: Removed head. internal organs and four limbs, feeder-layer Feeder-layer adherent culture was used to proliferate MESPU35 ESCs.Classic 4-/4+ method [The embryoid body (EB) grew naturally for 4 days,without retinoic acid added. In the coming 4 days, retinoic acid was added to induce neural EB of high proportion] was applied to induce the directional differentiation of the nerve. EB was cultured with serum of different concentrations. Phase contrast microscope was used to observe nerve-like EB in serum of different concentrations and to count numbers. ②Immunocytochemical technique was used to observe cellular morphological charac ters at various differentiating phase spots (5th. 9th, 14th days) and with retinoic acid at various concentrations. Flow cytometer (FCM) was used to count the proportion of differentiated neurons.MAIN OUTCOME MEASURES: ①Estimated measurement of the length of process and cell body during formation of neural EB after retinoic-acid induced differentiation of MESPU35 ESCs. ② Observation of cell morphology with immunocytochemical staining and proportion of differentiated cells assayed with FCM.RESULTS: ①It was discovered with phase contrast microscope that serum of different concentrations affect neural directional differentiation after EB formation to certain extent. Excessively high and low concentrations of serum reduced the proportion of neural differentiation of EB. The differentiating proportion is high in serum with 5% concentration. ② It is observed with immunocytochemical technique that the proportions of NF200 positive cell and glial fibrillary acidicprotein (GFAP) positive cell in differentiation of MESPU35 ESCs induced by retinoic acid were increased with phase spots in differentiation and increased concentration of retinoic acid. NF200 positive cell is transformed as multipolar neurons from absence of process in morphology. The processes of GFAP positive cell became longer and linked among each other as reticular pattern finally. ③ It was assayed with FCM that the proportion changes of GFAP positive cell and NF200 positive cell manufactured in differentiation were similar to immunocytochemical one.CONCLUSION: Retinoic acid in combination with proper concentration of serum and differentiating phase spots can induce neural-differentiation of MESPU35 ESC at high proportion and its differentiating regulation is in the patterns of concentration dependence and time dependence.

Objective To investigate the influence of knocking down Ezrin expression in combination with HSP70-induced immune killing on the apoptosis and proliferation of mouse osteosarcoma cells.Methods Human osteosarcoma cell line MG63 was cultured,the HSP70 and Ezrin-shRNA DNA fragments were cloned into the expression vector pGFP-V-RS containing CMV and pU6 promoters,and constructed the expression vector pGFP-V-RS-shRNA and pGFP-V-RS-shRNA-HSP70.The vectors were transfected into MG63 cell line,respectively.The status of transfected MG63 cells was observed by fluorescent microscope.The expressions of Ezrin and HSP70 were examined by real time RT-PCR and Western blot.Flow cytometry 、MTS test was used to detect the changes of cell apoptosis and proliferation,and changes of the expression of apoptosis and cell cycle related proteins was detected by Western blot.The specific cytotoxic T lymphocytes (CTLs) were induced by HSP70,and its killing effect on target MG63 tumor cells was analyzed by MTT assay.Results The specific vector simultaneously knocking down Ezrin and overexpressing HSP70 was constructed for the first time in China and confirmed by fluorescence microscope and gene/protein expression analysis.Compared to Ezrin knock-down alone,simultaneous HSP70 overexpression partially recovered the promoted cellular apoptosis and proliferation suppression by Ezrin knock-down,however,when compared to the normal control,the apoptosis rate of LM 8 cells was still significantly increased from 11.01％±0.22％ to 24.28％±0.50％,while the proliferation rate decreased from 395.14％±2.24％ to 310％± 2.83％.In addition,Western detected that Ezrin-shRNA could promote the expression of Bax.However,the expression of Ezrin-shRNA could reduce the Bcl-2 and Cyclin D1.Ezrin-shRNA/HSP70 also has the same effect.MTT assays revealed that the CTL cytotoxic effect on target MG63 tumor cells at all concentrations were significantly higher in CT+IL-2+HSP70 group compared with that in CT+ IL-2 group,with a cytotoxicity as high as 56.33％± 1.95％.Conclusion Simultaneous knocking down Ezrin and overexpressing HSP70 promotes the apoptosis and inhibits the proliferation of osteosarcoma cell.And the HSP70 can induce CTL which enhances the killing effect on tumor cell.And the HSP70 can induce CTL which enhance the killing effect on tumor cell.

Objective To study the feasibility,efficacy,and safety of MRI-guided percutaneous cryoablation for the treatment of hepatic carcinoma. Methods From January to September 2008,27 cases of hepatic carcinoma were treated with MRI-guided percutaneous cryoablation with Cryo-Hit system via two cycles of freezing-thawing. During the procedure,MRI showed the expansion of ice globe wrapping the tumor. Ten days after the freezing treatment,TACE was carried out in 5 cases. Results MRI-guided percutaneous cryotherapy were completed successfully in all of the cases. In 26 patients (96.3%),expanded ice globe wrapping the tumor was detected by MRI,showing a dark zone with clear margin. Only in one patient,the tumor was wrapped. The patients were followed up for 1 to 12 months (mean,3.5 months),during which the level of AFP decreased to a normal value in 14 cases (51.9%),continued to increase in 1 cases,and increased after an reduction in 12 cases (44.4%). The patients received more than one times of re-examination by imaging,which showed completed necrotic tumor tissues or no confirmed living tumors in 14 cases (51.9%); and incomplete tumor necrosis or living tumor lesions in 13 (48.1%). No severe complications occurred in this series.Conclusions MRI-guided percutaneous cryoablation is feasible,effecitve and safety for hepatic carcinoma.

Background The visual evoked potential (VEP) is an important functional index to assess visual cortex plasticity.Monocular form deprivation(MD) of rat is a classic model to study visual cortex plasticity change.Utilizing VEP technique record the shift of ocular dominance in adult rats model is of an important significance for explore the treating opportunities of amblyopia.Objective The present study was to observe the pattern VEP changes in different ages of Long-Evens rats and the adult rats after binocular form deprivation.Methods Thirty-six healthy SPF Long-Evens rats were divided into PW3,PW4,PW5,PW6 groups according to the postnatal weeks,and PW7 rats included 36 SPF Long-Evens rats.The left eye lids of the rats were sutured in PW3,PW6 and PW7 rats for 3,5,7 days respectively,and PVEP in both left and right eye were recorded to assess the rat age that visual cortex plasticity ended.Bilateral PVEP were recorded in PW7 rats,and the bilateral eyelids were sutured to establish the bilateral form deprivation models.The right eyes were opened in 7,10,14 days,and the left eyes were opened in the next 3,5,7 days respectively and the PVEPs were recorded again to find the shift of ocular dominance and whether binocular form deprivation induce the visual cortex plasticity in adult rats.Results The P100amplitudes of the left eyes were gradually declined and those of the right eyes were raised from 3 to 7 days after MD of the left eyes in rats of PW3 group in comparison with before MD ( P＜0.01 ).In PW6 groups,no significant changes in P100amplitudes of both the right and left eyes were found in the third day after MD,but significant raise in the right eyes and lowing in the left eyes were seen in the 5 and 7 days after MD in comparison with before MD(P＜0.01 ).No any P100changes in both eyes were found in 3-7 days after MD compared with before MD in PW7 rats (P＞0.05).The C/I ratio (contralateral VEP amplitude to ipsilateral VEP amplitude in occluded eyes) in the rats of PW3,PW4 and PW5 groups were 1.07±0.15,1.16±0.16 and 1.14±0.15 respectively in 3 days after MD,showing the significant lowing in comparison with before MD (2.69±0.45,2.58±0.4,2.62±0.32) (P＜0.01),but those of PW6 and PW7 were unchanged (2.80±0.48 vs 2.90±0.46,2.59 ±0.36 vs 2.90±0.46,P＞0.05 ),indicating the absence of ocular dominance plasticity in the adult rats.In rats of PW7 with binocular form deprivation for 14 days,a significant decrease was observed in the C/I ratio in rats with next MD for 3 days,demonstrating that the visual cortex plasticity was reactivated after 14 days of binocular form deprivation in PW7 rats( 1.33±0.18 vs 2.70±0.45,P＜0.01 ).Conclusions PVEP can be recorded in Long-Evens rats.It is a major index for identifying the shift of ocular dominance in the Long-Evens rats.Binocular form deprivation can reflect the visual cortex plasticity in the adult rats.

Objective To investigate clinical characteristics and risk factors in elderly patients with type 2 diabetes mellitus (T2DM) complicated with chronic kidney disease (CKD).Methods Two hundred and two T2DM patients aged ≥60 y admitted in Tongren Hospital from August 2009 to February 2012 were enrolled in the study,including 64 cases complicated with CKD (CKD group)and 138 cases without CKD (non-CKD group).Hemoglobin (Hgb),albumin (ALB),glycated hemoglobin A1C (HbA1 c),fasting plasma glucose(FBG),postprandial glucose (PBG),serum creatinine (Scr),blood urea nitrogen (BUN),uric acid (UA),total cholesterol (TC),triglyceride (TG),high densitylipoprotein (HDL-C),low density lipoprotein (LDL-C) were measured and ratio of urinary albumin to creatinine (UAER/CR) were calculated,ankle brachial index (ABI) and ambulatory blood pressure was examined.Results The duration of diabetes in CKD group was longer than that in non-CKD group [(13 ± 11) vs.(10 ± 7) y,t =2.35,P ＜ 0.05].Hgb and ALB in CKD group were lower than those in non-CKD group [(12.1 ± 1.7) vs.(13.3 ±1.3) g/L,(34.4±2.6) vs.(36.8 ±3.4) g/L,t=-5.73,-4.75,allP＜0.01]; UA,TG,24 h systolic blood pressure (SBP),24 h pulse pressure (PP)in CKD group were higher than those in non-CKD group [(367 ± 81) vs.(323 ± 74) μmol/L,(1.6 ± 0.9) vs.(1.3 ± 0.7) mmol/L,(133 ± 14) vs.(127±16)mmHg,(65 ±12) vs.(58 ±12)mmHg,t =3.82,2.50,2.47,3.68,all P＜0.1].The UAER/CR in CKD group and non-CKD group was 86.2 mg/g (24.6-374.8 mg/g) and 6.0 mg/g (3.6-17.8 mg/g),respectively (P ＜ 0.01) and ABI in CKD group and non-CKD group was 0.94 ± 0.18 and 1.03 ±0.18 (-2.78,P ＜0.05).There were no significant differences in FBG,PBG,HbA1c,TC,HDL-C andLDL-C between two groups(t =-2.02,1.47,1.48,-0.53,-1.20,-0.76,all P＞0.05).Logistic regression analysis showed that ALB,TG and UAER/CR were the independent risk factors of CKD in T2DM patients(OR:0.79,3.63 and 1.04,95％ CI:0.62-1.01,1.45-9.01 and 1.00-1.08).Spearman correlation analysis demonstrated that eGFR was positively associated with Hgb,ALB,ABI (r =0.38,0.33 and 0.28,all P ＜ 0.01),negatively associated with age,BUN,Cr,UA,TG,UAER/CR,24 hSBP and PP in all diabetes patients(r =-0.32,-0.63,-0.89,-0.34,-0.18,-0.65,-0.16 and -0.248,all P ＜0.01).Conclusions ALB,TG,UAER/CR are the independent risk factors of chronic kidney disease in elderly patients with type 2 diabetes mellitus.

After the significance to asses the value of information resources in hospital library was elaborated, the methods to assess the value of information resources in hospital library were constructed by contingent valuation and investment return analysis in combination with the practical service in hospital library according to the analysis of the economic value assessment in domestic and foreign public libraries and academic libraries.