Flipping the classroom is a new teaching mode in which the students learn some-thing through the network autonomous learning before class, in classroom students interact with teach-ers, internalized and absorb what they have learned, and then consolidate it after class. So it can resultin real-timeevaluation of learning effect by different means, different objects and form and can ef-fectively give secondary feed back comments, which has important significance for the improvement of teaching and learning effects at all levels. Article discusses how to effectively use formative assess-ment method to conduct effective monit oringand feed back to improve the flipped classroom activi-ties. It also explore show to strengthen and exercise their student's ability in the application process.

ObjectiveTo explore the influence of cognitive behavioral intervention on hospitalized patients with schizophrenia.Methods100 hospitalized schizophrenia patients were randomly divided into experimental group and the control group.Routine treatment given to the patients in the control group and cognitive behavioral intervention was applied to the patients at the same time based on routine treatment in experimental group.The patients were assessed with the mini-mental state examination( MMSE),activities of daily living(ADL) and WHO battery of cognitive assessment instrument(WHO-BCAI) pre-and post-cognitive behavioral intervention.ResultsThe expenrentcl geoup and ntrol group before and after the intervention the average MMSE score was(21.8 ± 3.9),(24.4 ± 4.7 ),(21.5 ±3.4),(22.9 ±3.8) ;ADL score an average of(28.8 ±7.9),(25.1 ±4.5),(27.9 ±7.1),(25.2 ±4.8) (t =6.89,11.13,all P ＜ 0.05 ) ; cognitive function in the auditory vocabulary learning,language skills,visual identification,the connection test and cancellation tests were different ( P ＜ 0.05 or P ＜ 0.01 ).ConclusionCognitive behavioral intervention had positive influence on cognitive function in hospitalized patients with schizophrenia.

Osteochondral lesions of the talus are rare.The factors leading to them include trauma,chronic fatigue,family history,and idiopathic necrosis.The patients present with ankle pain,swelling,bruise,limited mobility and limp at an early stage while joint stiffness and walking and moving pain at a late stage.Normal check is likely to overlook them,resulting in delayed diagnosis and treatment.If an osteochondral lesion of the talus is suspected with negative X-ray manifestations,further radionuclide bone scan or MRI is indicated for definite diagnosis.As there is no blood supply to the talar cartilage which is relatively too small,it is difficult to treat osteochondral lesions of the talus.Early mild lesions can be treated by conservative therapy.If conservative treatment fails or the lesions deteriorate,surgery is required.This paper reviews the research progress in the treatment of osteochondral lesions of the talus.

Objective To investigate the clinical characteristics and prognosis of acute myocardial infarction (AMI) combined with ventrical septal perforation (VSP).Methods Fifty-seven AMI + VSP patients were retrospectively analyzed their clinical characteristics and outcomes who were treated in the Fourth People' s Hospital of Shenyang and the First Hospital Affiliated to China Medical University from June 2000 to May 2014.Results Of all patients,43 (75.4％) VSP occurred anterior wall AMI,and 14 (24.6％) were not.Echocardiogram show the end diastolic diameter of left ventricle was (53.7 ± 9.5) mm,left ventricle ejection fraction was (48.5 ± 11.8)％,VSP diameter was (9.8 ±7.9) mm,and 37(64.9％) were with near apex.The level of cardiactroponin I,C-reactive protein,and N terminal of B type natriuretic peptide of patients were (16.7 ± 12.9) μg/L,(99.7 ± 31.40 mg/L,(3 051.2 ± 879.7) μg/L.Total mortality was 71.9％ (41/57) in 30 days and 78.9％ (45/57) in 1 year.The mortality of operation group was 73.9％ (17/23) in 30 days and 91.3％ (21/23) in 1 year.The mortality of consecutive therapy was 64.7％ (22/34) in 30 days and 76.5％ (26/34) in 1 year.Conclusion The mortality of AMI + VSP is higher and operation is the most effective therapeutic method.

Objective To establish the disease-syndrome integrated animal models suitable for the studies of TCM through differen- tiating the property of TCM syndromes of spontaneous diseased animal models.Methods With the observation on general behaviors, irritable degree,turning endurance time,pain threshold,urine and stools,luster of hair,growing speed of hair,body weight,tongue condition,degree of eyeball protruding,conjunctiva chroma,blood pressure,heart rate,etc.of spontaneous hypertension rats(SHR) and the comparison with normal rats,the study was carried out on the macroscopic description of property of TCM syndrome of SHR (14～18 weeks of age)and their ethology.Results The blood pressure of SHR at the early stage tended to raise with age growing. Compared with the normal group,the heart rate of SHR rats was obviously quicker(P

Objective To explore the application of students' evaluations of educational quality questionnaire (SEEQ) and related influencing factors in the teaching effectiveness evaluation of medical faculty.Methods 477 Grade 1-4 five-years medical students in China medical university were investi-gated to evaluate the teaching effectiveness.We used the internal consistency and principal component method to test the reliabihty and validity of the scales.We analyzed different influencing factors of educational quality including different gender,grade,student academic achievement and curriculum type with the t-test and AVONA in the SPSS 19.0 software,P＜0.05 was considered statistically.Results The Cronbach's α coefficient of SEEQ was 0.89,the cumulative variance contribution rate was 86.43％,the reliability and validity of the questionnaire were good.Girls scored higher in the teacher-student relationships domain than boys(P=0.022).Students in the lower grade had lower scores in the dimen-sions of the scales (P＜0.05).Clinical courses scored higher in all dimensions of the scales(P＜0.05) than basic medical courses.Outstanding students had higher scores in the sense of the learning value,teacher-student relationships,the scope of teacher's knowledge and curriculum management than nor-ma] students(P＜0.05).Conclusions It is feasible that SEEQ questionnaire is applied in the teaching evaluation of medical facuhy.Medical faculties should carry out teaching innovation according to the characteristics of different students and course type with the targeted method.

Objective To investigate possible reasons of different incidence of femoral head necrosis between two populations exposed to corticosteroid: severe acute respiratory syndrome (SARS) and renal allograft transplantation. Methods 67 cases of SARS and 59 cases of renal allograft transplantation were enrolled in the study. The following relevant data were reviewed: cumulative dosage (intravenous methylprednisolone and oral prednisone respectively), maximum single dosage, corticosteroids-exposing days, body weight, weight-load index, and minimum arterial oxygen pressure. MRI of bilateral hips was taken in all the patients. Results The incidence of femoral head necrosis of SARS (23.9%) was significantly higher than the renal allograft transplantation patients (6.8%) (P0.05). There was a very significant difference in minimum arterial oxygen pressure between two groups (P

The importance of cultivating evidence-based consciousness of thinking and implementation capability of specialization postgraduates was analyzed,and experiences and suggestions acquired from the practice of teaching of specialization postgraduates were shared by demonstrating the enlightening of evidence-based consciousness of thinking,the cultivation of evidence-based implementation capability and the establishment of evaluation system,with PBL integrated.

Background:The efficacy of traditional medicine on ulcerative colitis (UC) is often unsatisfactory, hence development of drug based on the pathogenic mechanism of UC becomes a hot topic in the research of UC.It has been revealed in recent studies that activation of nuclear factor-κB (NF-κB) is implicated as a key regulator in the immune and inflammatory responses in UC.Aims:To explore whether bortezomib, a potent proteasome inhibitor that inhibits NF-κB activation can be used for treatment of UC.Methods:Thirty-two BALB/c mice were used to induce acute experimental colitis by drinking 3%dextran sulfate sodium (DSS) freely for 7 days, and then randomly allocated into four groups injected intraperitoneally with 0.2 (low-dose group), 0.6 (medium-dose group), 1.0 mg/kg (high-dose group) bortezomib and normal saline (model control group), respectively.On the 7th day after treatment, the disease activity index (DAI) and histopathological change of colonic tissue were observed;the colitis-related parameters including peripheral blood hemoglobin (Hb), C-reactive protein (CRP) and colonic myeloperoxidase (MPO) activity were measured, and the nuclear translocation of NF-κB was assessed by electrophoretic mobility shift assay.Results:Compared with the model control group, the DAI, CRP, MPO activity, and injury score of colonic tissue were decreased gradually, and the Hb was increased gradually in mice treated with low-, medium-and high-dose bortezomib (P all <0.05).The efficacy of medium-and high-dose bortezomib was notable.In mice treated with medium-and high-dose bortezomib, nuclear translocation of NF-κB was inhibited obviously.Conclusions:Bortezomib can modulate the colonic inflammation in mice with experimental colitis by inhibiting NF-κB activation and subsequently improving the clinical manifestations, colitis-related parameters and tissue damage.Increasing the dosage of bortezomib in a safety range may enhance the treatment response.

[Objective]To evaluate the feasibility of early off-bed exercises after arthroscopically assisted radiofrequency release of gluteal muscle contracture.[Method]Patients of gluteal muscle contracture underwent arthroscopically assisted radiofrequency release of gluteal muscle contracture.Post-operative off-bed time,side effects,duration of urinary catheter drainage,wound healing,early recovery of function,and in-hospital time were studied.[Result]Off-bed time averaged 7 hours(6~8 hours).Two cases complained of being faint and nausea.After allopathic treatment,no serious complications appeared.Averaged duration of urinary catheter drainage was 7.5 hours.Primary healing of wounds were found in 67 patients,while 1 case got delayed wound healing.None of them had any infections.Functional scores averaged 9 at the time of discharging and 10 after 1 month.Post-operative in-hospital time averaged 2.58 days(2~6 days).[Conclusion]Arthroscopically assisted radiofrequency release of gluteal muscle contracture results in early post-operative off-bed time and reduction of suffering,which is propitious to functional recovery,rate of healing,and shorter in-hospital time.