Objective To discuss the effect of formative evaluation for flipped classroom of college English teaching. Method We chose 180 clinical medicine undergraduates from a college and divided them equally into experimental class and control class. In the experimental class, the formative evaluation was implemented for the flipped classroom of college English teaching from September 2014 to June 2015. At the same time, the teaching in the control class was carried out according to the basic process of flipped classroom, with no formative evaluation. At the end of the experiment, the students' satisfaction survey, autonomous learning ability and English proficiency test of the two classes were finished. SAS 9.1 software was used for statistical analysis, and t test was used to compare two class measurement information and count data with chi-square test. Result ①Experimental class' satisfaction of formative assessment teaching design for flipped classroom was 94.45%, which was obviously higher than that of the control class (66.66%). The difference was statistically significant (χ2=7.94, P=0.005). (χ2=7.94,P=0.005).②The score at first, fifth dimension and the overall score of independent learning in experimental classes were respectively (55.31± 4.99)、 (53.61±4.93)、 (247.16±22.10), and they were significantly higher than those in the control class (47.18±4.23)、(45.72±4.01)、(225.92±20.78) (t=8.889, P=0.001;t=7.299, P=0.001;t=6.642,P=0.001), and other dimensions' score was also significantly higher than that in comparative classes (P<0.05). ③The pass-ing rate of CET-4, and the number of students from 505 to 544 and more than 545 fraction in the experi-mental class were respectively 79 (87.78%)、19 (21.11%)、10 (11.11%), and they were significantly higher than those in the control class 61(67.78%)、10(11.11%)、0(0). Conclusion Formative assessment can obvi-ously improve the teaching effect of flipped classroom of college English.

Resident standard training for traditional Chinese medicine(TCM) is an important part of medical training, after-department examination plays the role of its quality control. Through the construction of question database for after-department examination, combining TCM residency standard training requirements and actual situation of the department, it contribute to the formation of standardized examination,improve the system of resident standardization training for TCM, help to training appropriate and qualified TCM residency.

To assess the impact of the operational simulation training system on the cultivation of ophthalmic students.
●METHODS: Four hundred and eighty ophthalmic students in China Medical University from 2009 to 2011 were chosen as objects and divided into two groups at random. The students in the experimental group used operation simulation training system combined with traditional teaching methods, while the students in the control group only used traditional teaching methods. We examined the operation skills and the confidence of all the students half a year later.
●RESULTS: The improvement of the operation skills during the suture technique examination, and the confidence for operation technology were significantly different in two groups. The basic skills of the students in the examination groups improved apparently during the operational simulation training and they were full of confidence to their operational technique.
●CONCLUSlON: The operational simulation training is useful for promoting the clinical ability for ophthalmic students and should be widely popularized.

Objective To discuss the surgical therapy of primary leiomyosarcoma of the inferior vena cava(PIVCLS).Methods Retrospective analysis of was made 5 patients of PIVCLS from Oct 2009 to May 2011 hospitalized in Department of Vascular Surgery,Provincial Hospital Affiliated to Shandong University.All patients underwent surgical resection,combined with reconstruction of bilateral renal vein and distal inferior vena cava using artificial vascular graft.Results Surgical resection was performed successfully in all patients.The mean operation time was 166.6 min,with mean blood loss 1 560 mL.Leiomyosarcoma intruding the inferior vena cava and right renal vein were observed in all patients during operation.The mean size was 12 cm × 10 cm× 8 cm.The diagnosis of PIVCLS in 5 patients was confirmed by postoperative pathologic examination.All patients did not present lower extremity swelling after surgery and discharged from hospital with normal blood (BUN) and (CREA).All patients were administrated with oral warfarin therapy after discharge.No clinical relapse and pulmonary embolism was observed during the follow-up (range 3 months to 12 months).The ultrasound revealed the patency of artificial vascular grafts in all patients.Conclusions Surgical resection combined with reconstruction of bilateral renal vein and distal inferior vena cava using artificial vascular graft is an effective and feasible treatment of PIVCLS.Leiomyosarcoma is completely eliminated and important abdominal viscera are protected well during the procedure because of minimal impact on hemodynamics.The incidence of postoperative pulmonary embolism also decreases obviously.

Objective To evaluate the effects of real-time continuous glucose monitoring (RT-CGM) system on oxidative stress and mortality in critically ill patients and to explore the correlation between glucose index,oxidative stress and mortality.Methods Selected 123 cases of critically ill patients were enrolled in this prospective randomized controlled study.They were randomly divided into the RT-CGM group(n =61) and blood glucose meter group (GM group,n =62).The following parameters were compared between the two groups:mean amplitude of glucose excursions (MAGE),hypoglycemia incidence,low blood glucose index (LBGI),high blood glucose index (HBGI),28-day mortality and plasma level of 8-iso-PGF2α (8-iso) at 48 hours (R2),72 hours (R3) and 96 hours(R4) after admission to ICU.The correlation between glucose index and plasma level of 8-iso-PGF2α were analyzed.The correlation between glucose index,plasma 8-iso level and 28-day death were analyzed.Results The parameters of MAGE,hypoglycemia incidence,LBGI and HBG1 in the RT-CGM group and the GM group were (3.73 ±1.09) mmol/Land (4.19±1.11)mmol/L(P=0.02),3.28％ and 14.52％(P=0.03),0.0011 and 0.0119 (P ＜ 0.01) and 0.2258 and 0.3697 (P ＜ 0.01),respectively.The plasma levels of 8-iso at R2,R3,R4 in the RT-CGM group and the GM group were (111.44 ± 16.99) ng/L and (114.03 ± 14.64) ng/L(P=0.37),(94.53 ±14.92)ng/L and (110.31 ±13.42) ng/L(P＜0.01) and (57.84±12.22) ng/L and (84.41 ± 14.16)ng/L(P ＜0.01),respectively.The r values between MAGE,LBGI,HBGI and the plasma level of 8-iso were 0.69,0.71 and 0.67,respectively (all P values ＜ 0.01).Multivariate stepwise regression analysis showed MAGE,LBGI,HBGI entered final models (corrected R2 =0.61,P ＜ 0.01) with β values of 0.64,0.65 and 0.6 respectively(all P values ＜0.01).The 28-day mortality in the RT-CGM group and the GM group was 9.84％ and 30.65％ (P ＜0.01).The OR values of MAGE,hypoglycemia incidence,LBGI,HBGI and the plasma level of 8-iso for 28-day death were 2.14 (0.98-4.35),3.43 (1.12-5.82),2.67 (1.01-5.14),1.32 (0.24-2.96) and 1.89 (0.67-3.44),respectively.Conclusion RT-CGM can optimize the care in critically ill patients by improving hypoglycemia,hyperglycemia,glucose variability and oxidative stress and bring more detailed concern in the process,and to reduce the mortality.

Objective To explore true thoughts and experience about student-based nursing teaching rounds among vocational college nursing students in Pediatric during the initial stage of clinical practice.Methods Interview was conducted on 27 nursing students of seven focus groups with semi-structured interview.The data was transcribed based on the tape and were analyzed by Giorgi analysis.Results Nursing students held positive attitude to this mode.Three themes were extracted:stimulating nursing students' learning potential,enhancing the comprehensive ability of nursing students; some students had difficulties in case selection,disease analysis and physical examination; suggesting that detailed rounds guideline should be issued to students first,and teaching rounds should be held every two weeks.Conclusions We should strengthen training of the ability of nursing assessment in pediatrics for nursing students,play the role of facilitator and advocate self-directed learning methods.

OBJECTIVETo compare the differences in the clinical efficacy on Alzheimer's disease between acupuncture and medicine.

METHODSOne hundred and forty-one patients were randomized into an acupuncture group (72 cases) and a medicine group (69 cases). In the acupuncture group, the needling technique for benefiting qi, promoting blood circulation, regulating mind and improving intelligence was used at Shenting (GV 24), Baihui (GV 20), Fengchi (GB 20), Wangu (GB 12), Danzhong (CV 17), Zhangwan (CV 12), Qihai (CV 6), Xuehai (SP 10) and Zusanli (ST 36). The supplementary acupoints were selected according to the symptoms and physical signs. Acupuncture was given once a day and 6 treatments were required for a week. In the medicine group, the choline sterase inhibitor, donepezil (aricept) was prescribed for oral administration, 1 tablet (5 mg) each time, once every night. Four weeks later, the dose was increased to 2 tablets (10 mg) each time. In the two groups, the treatment of 4 weeks made one session and 4 sessions were required. The changes of scores before and after treatment in the minimum mental state examination (MMSE), the activity of daily living scale (ADL), Alzheimer's disease assessment scale-cognition (ADAS-cog) and the digit span (DS) were observed.

RESULTSAfter treatment, scores of MMSE and DS were increased as compared with those before treatment (both P < 0.05) and scores of ADL and ADAS-cog were reduced as compared with those before treatment. The score differences in MMSE, ADL, ADAS-cog and DS before and after treatment were significant in the two groups (all P < 0.01).

CONCLUSIONThe needling technique for benefiting qi, promoting blood circulation, regulating mind and improving intelligence significantly improves the overall function, cognition and activity of daily life in the patients of Alzheimer's disease and the efficacy is better than donepezil.

Activities of Daily Living ; Acupuncture Points ; Acupuncture Therapy ; Aged ; Aged, 80 and over ; Alzheimer Disease ; psychology ; therapy ; Cognition ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

BACKGROUND: It has been recognized that the traditional herbal treatment and daoyin exercises(physical and breathing exercise) can relieve the symptoms such as tiredness of cancer patients and strengthen the tolerance to chemical drugs. But the criterion of quantitative evaluation for the effect should be scientific.OBJECTIVE: To evaluate the influence of Chinese herb for strengthening the body resistance and daoyin exercises on the survival state of lung cancer patients with the evaluation scale of life quality.DESIGN: Non-randomized and concurrent controlled trial.SETTING: Department of Integrated Traditional Chinese and Western Medicine, Clinical Cancer Research Center, Guangzhou Medical College;Zhaoqing First People's Hospital.PARTICIPANTS: Totally 60 inpatients of the Department of Integrated Traditional Chinese and Western Medicine of Clinical Cancer Research Center of Guangzhou Medical College were enrolled from October 1997 to March 2001 in the study. All of them were volunteers. There were 41 males and 19 females, 30 patients in the treatment group and 30 in the control group.METHODS: The treatment group was given chemical therapy, at the same time, the herbal treatment and daoyin exercises. The control group was given chemical therapy only. The same chemical therapy was applied to both groups. The appointed doctor familiar with the evaluation table of quality of life was responsible for evaluating the quality of life of the patients in the two groups before and after treatment and the observation of their accomplishment of chemical therapy. The evaluation table of quality of life of Chinese lung cancer patients was used in the evaluation. The table included 5 factors: the physiological state caused by lung cancer, social/family state, relation of altitude towards doctor and disease, emotional state, and functional state. The statistical analysis was done to see the accomplishment of chemical therapy of two groups.chemical therapy of the two groups.RESULTS: According to the intention-to-treat analysis, 60 patients all completed the whole process of study. The comparison of the score before physiological state after treatment was obviously lower than that before treatment[ (14. 1 ± 3.2), (31.7 ±2.9) scores, P ＜ 0.01] and of control state was obviously higher than that before treatment[(25.2±3.1),(12.2 ±2.3)scores, P ＜0.01] and of control group[(19.1 ±2.2) scores,after treatment was obviously higher than that before treatment[ (37.4 ± 5.2),(24.2 ±3.5) scores, P ＜0. 01 ]and of control group[ (29. 1 ±3.4)scores, P before treatment[ (43.8 ± 5.6), (28.5 ± 4. 7) scores, P ＜ 0. 01 ] and of tional state after treatment was obviously higher than that of before treatment [(26.3±2.3), (17.3±3.3) scores, P ＜ 0.01] and of control group [ (20. 3 ± 1.1) scores, P ＜ 0. 05] . The accomplishment rate of chemical control group, 26 patients accomplished 1 course(87%, 26/30) and 18rate of 2 courses of chemical therapy of treatment group was obviously higher than that of control group ( P ＜ 0.05 ).CONCLUSION: The herbal treatment combined with daoyin exercises can improve the tolerance of lung cancer patients for chemical therapy and relieve the symptoms, thus improving their quality of life.

AIM: To investigate the effect of fetal bovine serum (FBS) on the proliferation and differentiation of murine corneal epithelial cells in vitro.METHODS: Mouse corneal epithelial cells(MCEs) were cultured in serum-free low-Ca2+ medium(KSFM) and KSFM supplemented with 100mL/L FBS, respectively. Population doublings (PDs) were determined. The expressions of corneal epithelial cell markers p63, keratin 19 (K19) and involucrin were investigated by RT-PCR and Western blotting analyses. RESULTS: Cells in KSFM were stably subcultured over 25 passages; however, none of the cell lines could pass P3 in KSFM with FBS. In KSFM, the cells showed typical cobblestone appearance and expressed p63, K19 and involucrin. After medium was supplemented with FBS, cells became homogeneous, large and squamous. Furthermore, both RT-PCR and Western blotting analyses showed that the expression of involucrin was increased significantly.CONCLUSION: FBS has effects of inhibiting proliferation and triggering differentiation of MCEs.

Objective To study the expression of mdm2 genes in nephroblastoma in children and relationship between mdm2 gene and clinical pathological parameters.Methods The protein expressions of mdm2 in 24 cases of nephroblastoma were detected with S-P immunohistochemical method.The relationships between mdm2 expression and clinicopathological parameters were analyzed.Results The positive rates of mdm2 in 24 cases of nephroblastoma were correlated with lymph node metastasis,clinical stage and tumor differentiation.There was a positive relationship between mdm2 protein expression and clinicopathological parameters such as lymph node metastasis,clinical stage and degree of differentiation(P