Objective To investigate the critical thinking ability of medical students and its related factors in order to provide evidence for higher medical education reform. Methods A total of 325 medical students were selected by cluster sampling method, and Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) was adopted for survery. Results The average total score of critical thinking ability of medical students was above 280, and 51.08% of students showed positive critical thinking ability. Among all the seven critical thinking dispositions, average scores of each item were all positive (>40) except that the significance of truth seeking (37.23) and systematicity (39.05) were indefinite. There were significant differences in critical thinking ability between medical students with different gender and academic years (P<0.05). Conclusion The critical thinking ability of medical students is positive, however, there still exist some shortages. An equal relationship between teachers and students should be established, the traditional course system be continuously reformed, a good environment for clinical training be created, and a variety of teaching methods be implemented to further strengthen the critical thinking ability of medical students.

Background and purpose:Selenium is one of the essential trace elements for human activities, and plays an incomparable role in maintaining human health. It was reported that selenium compound 1,4-bis[2-(benzylse-lanyl)ethoxy] (BSEA) anthracene has antiseptic and antiphlogistic effects. However, the mechanisms underlying anti-cancer effects of BSEA are rarely reported. BSEA-induced apoptosis in human laryngeal carcinoma Hep-2 cells and its mechanisms were studied.Methods:Methyl thiazolyl tetrazolium (MTT) assay was used to determine inhibition ratio of Hep-2 cells 24 hours after Hep-2 cells were treated with different concentrations of BSEA. Fluorescence microscope was used to observe the morphology change of apoptosis in Hep-2 cells. The apoptosis was detected by Annexin Ⅴ-FITC. Mi-tochondrial membrane potential was assayed by JC-1. Microplate reader detected the activity of caspase-3 and caspase-8. The mRNA and protein levels of Bax and XIAP were measured by real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) and Western blot.Results:The results showed that BSEA caused a dose-dependent inhibition of the growth of human laryngeal carcinoma cell line Hep-2in vitro, andIC50 was 35.74μmol/L. The apoptotic bodies were distinctly observed at a concentration of 80μmol/L of BSEA by AO fluorescence staining. This study found that the eversion of phosphatidyl serine intensified, and mitochondrial membrane potential also began to decline. The activity of caspase-3 appeared the tendency of dependence on dosage, while the activity of caspase-8 did not change significantly. The mRNA and protein expression level of Bax increased, whereas the mRNA and protein expression level of XIAP de-creased.Conclusion:Therefore, BSEA could obviously inhibit human laryngeal carcinoma Hep-2 cells proliferation and induce apoptosis via the mitochondrial pathway.

Objective To study the expression of TrkB and c-fos in rat auditory cortex after long -term ad‐ministration of sodium salicylate and the mechanisms of salicylate ototoxiclty .Methods Normal adult rats were di‐vided into three groups :normal group without any treatment ,long -term treatment group given i .m .injections , 175 mg/kg ,twice daily at 9:00 am and 6 :00 pm for consecutive 14 days and the recovered group using the same method as the chronic group except that they were sacrificed 28 days after salicylate treatment ceased .After the de‐tection of ABR ,rats were sacrificed after deep anesthesia ,and the auditory cortexes were dissected rapidly .Real-time PCR and Western-blot were explored to detect the expression of TrkB and c-fos .Results The average ABR threshold of normal rats was 36 ± 2 .23 dB SPL .The average ABR threshold of long -term group was 41 .3 ± 3 .31 dB SPL ,which was significantly increased than normal group(P<0 .01) .The average ABR threshold of the recoveredgroup was 38 .6 ± 5 .51 dB SPL .There were no differences between the recovered group and normal group(P>0 . 05) .The expression of c-fos mRNA(1 .24 ± 0 .09)and protein(0 .70 ± 0 .12)in the long -term group were signifi‐cantly increased ,when compared with the normal group .The c-fos mRNA(1 .23 ± 0 .04)and protein(0 .68 ± 0 .08) expression in the recovered group were also significantly increased compared with the normal group .The expression of TrkB mRNA(1 .26 ± 0 .10)and protein(1 .85 ± 0 .17)in the long -term group were significantly increased ,when compared with the normal group .The TrkB mRNA(1 .23 ± 0 .07)and protein(1 .80 ± 0 .08)expression in the recov‐ered group were also significantly increased compared with the normal group .Conclusion The inereased expression of c-fos in the long -term group may be related to the enhancement of central auditory function .The inereased ex‐pression of Trk-B in the long -term group might be involved in instability of synaptic plasticity in tinnitus .

Objective To study the effect of Src tyrosine kinase inhibition on subcutaneously transplanted tumor of human lung adenocarcinoma in mice and its mechanism. Methods For the subcutaneously transplanted tumor model, A549 cells or PC-9 cells were inoculated into SCID mice by subcutaneous injection. Immunohistochemistry was used to show the effect of Src tyrosine kinase inhibition on proliferation index (Ki-67 staining) and microvessel density (CD31 staining) of subcutaneously transplanted tumor of human lung adenocarcinoma in mice. Results Subcutaneously transplanted tumor of PC-9 cells was sensitive to src tyrosine kinase inhibitor. There was significant difference between treatment group and control group (P <0.01). There was significant difference between the two treatment group too (P <0.01). Stopping treatment for 1 week, the inhibition rate of tumor growth were 33.19 % and 84.79 % in 10 mg·kg-1·d-1 and 50 mg·kg-1·d-1 treatment group, respectively. The same treatment was less effective to subcutaneous tumors produced by A549 cells. Treatment with 50 mg·kg-1·d-1 Src tyrosine kinase inhibitor significantly reduced the proliferation index of subcutaneously transplanted tumor produced by PC-9 cells (P<0.01) and tended to reduce the proliferation index of subcutaneously transplanted tumor produced by A549 cells (P >0.05). Treatment with 50 mg·kg-1·d-1 Src tyrosine kinase inhibitor significantly reduced micro vascular density in both PC-9 and A549 induced subcutaneous tumors (P <0.05). Conclusion Inhibition of Src tyrosine kinase could suppress the progression of subcutaneously transplanted tumor, not only by the inhibition of cell proliferation of lung adenocarcinoma cells directly, but also by the inhibition of angiogenesis indirectly.

Objective To investigate the treatment method and prognostic factors of patients with non-Hodgkin lymphoma(NHL)of palatine tonsil.Methods 70 patients with NHL of palatine tonsil were re- viewed.According to Ann Arbor staging classification,12 patients had stageⅠ,39 stageⅡ,15 stageⅢand 4 stageⅣ.Working formulation was used in pathologic classification which was low grade 8 cases,intermedi- ate grade 28 cases and high grade 34 cases.30 cases were treated by chemotherapy alone,3 cases by radio- therapy alone,37 cases by chemotherapy and radiotherapy.Results The overall survival rate was 56.3%. They were 82.5% in 1 year,67.3% in 2 years and 58.5% in 5 years,respectively.The overall survival rates in high grade cases of pathologic classification were 20.0% in chemotherapy alone,0 in radiotherapy alone, 52.6% in chemotherapy and radiotherapy(P

AIM: To determine the optimized intranasal powders formulation of Panax Notoginseng Saponins(PNS). METHODS: According to the indexes of the in vitro release rate in 1h and 12h of Rb1 and Rg1, bioadhesive intensity and the ciliary toxicity in situtoad palatal mucosa of the preparations, the optimized formulation was determined by the central composite design-response surface methodology. RESULTS: When the correspondent percentage of PNS, microcrystalline cellulose (MCC) and moderate viscosity hydroxypropyl cellulose (H-HPC) was 31%, 60% and 9%, respectively, the release rate in 1h and 12h of Rb1 and Rg1 was 6.82%, 53.25% and 83.4%, 95.09%, respectively. The adhesive time was 78min, and the lasting time of ciliary movement after the rinsing of the PNS powders was 94.84% to the physiological saline group which suggested the powder was almost no toxicity. CONCLUSIONS: The optimized formulation of the PNS intranasal powder was obtained quickly and conveniently by the central composite design-response surface methodology.

Objective To study the effect of fusion protein FADDDEL-GFP in the treatment of type 1 diabetes by murine islet cell transplantion.Methods After transfecting the recombinate FADDDEL-GFP into mouse insulinoma cells NIT-1,insulin level secreted by the cells was examined.Type 1 diabetes was induced by STZ as animal model.NIT-fg cells,the NIT-1 cells modified by FADDDEL-GFP,were transplanted into the diabetic mice.Then the effects of islet cell transplantation on diabetic mice were checked.Results GFP was expressed in NIT-1 cells transfected with FADDDEL-GFP.Diabetic mice reached normoglycemia and prolonged the life span,which was obviously different from the control group.Conclusion FADDDEL-GFP may enhance the capability of resisting allogeneic transplantation rejection.

This study aimed to explore Semaphrin4D (Sema4D) expression and clinical significance in non-small cell lung cancer (NSCLC), and to define the roles and mechanisms of Sema4D in regulating the malignant behaviors of A549 cells by small interfering RNA (siRNA). Firstly, immunohistochemistry revealed that Sema4D was more frequently expressed in NSCLC than in lung benign lesion (P<0.05) and its overexprssion was associated with low differentiation (P<0.05), poor pTNM staging (P<0.05) and occurrence of lymph node (LN) metastasis (P<0.05). Endogenous Sema4D expression was suppressed by Sema4D siRNA in A549 cells overexpressing Sema4D. Protein levels of Sema4D, total Akt and p-Akt were examined by Western blotting. Cell proliferation, migration and invasion abilities were measured by MTT assay and Transwell assay respectively. Results showed that Sema4D siRNA significantly suppressed phosphorylation of AKT in A549 cells, but it did not alter total AKT expression. In addition, efficient down-regulation of SemaD significantly inhibit cell proliferation (P<0.05), migration (P<0.05) and invasion (P<0.05) in A549 cells. These findings suggest that Sema4D might serve as a reliable tool for early prediction of NSCLC poor prognosis. Sema4D could play an important role in promoting tumor proliferation, migration and metastasis in the NSCLC, by influencing the Akt protein phosphorylation. Inhibition of Sema4D may be a useful approach for the treatment of NSCLC.

Objective: To preliminarily explore the clinical characteristics and gender difference of patients with variant angina (VA) in China. Methods: A total of 312 patients with spontaneous attack of VA admitted in our hospital from 2003-01 to 2009-12 without stimulation test were retrospectively studied. The clinical features were compared between male and female patients to reveal the similarities and differences of VA by genders. Results: The predilection of VA was in male gender (274/312, 87.8%), the common risk factors including smoking, hypertension and hyperlipidemia; 55/312 (17.6%) patients had allergy history. There were 59/312 (18.9%) patients combining arrhythmia while VA attack; coronary angiography (CAG) found that 155/283 (54.8%) patients were with ifxed coronary stenosis and 22/312 (7.1%) combining coronary myocardial bridge. Nitrates, calcium antagonist and stent implantation may effectively control VA attack. Compared with male, female patients had the lower ratio of smokers (10.5% vs 78.8%),P<0.01, higher ratios of family history of coronary artery disease (CAD) (31.6% vs 11.3%),P<0.01, ventricular tachycardia (13.2% vs 3.6%)P<0.05 and ventricular ifbrillation (7.9% vs 1.8%),P<0.05. Conclusion: VA is a cardiac ischemia caused by coronary artery spasm with high incidence for combining arrhythmia, without in time treatment it may incur myocardial infarction even sudden death. VA patients should receive routine CAG and stent implantation according to the severity of stenosis. Female patients were with less smokers while higher ratios in family history of CAD, ventricular tachycardia and ventricular ifbrillation.

ObjectiveTo evaluate setup errors of image guided radiation therapy (IGRT) for body tumors immbilized with vacuum cushions and localized with final isocenter marked method using kilovoltage cone beam CT (KVCBCT).MethodsA retrospective study has been carried out for 223 patients from March 2009 to April 2011.All patients were immobilized with vacuum cushions and localized with final isocenter marked method in Philips PQS CT or Philips Brilliance CT Big Bore scanner,which were equipped with LAP movable laser systems. The CT images were transferred to a Varian Eclipse workstation for contouring and treatment planning.Before irradiation,a KVCBCT scan was performed and image registration was done on a Varian iX linear accelerator via OBI system.Each set of setup errors in right-left ( RL),superior-inferior (SI),and anterior-posterior (AP) directions were gathered.An independent-samples t-test statistical analysis was conducted with the 758 sets of data using SPSS 16.0.Results The statistical analysis showed that setup errors from the 758 datasets were depicted a Gaussian distribution.The system errors ± random errors in RL,SI and AP were ( -0.5 ±2.8) mm,(0.0±3.0) mm and (0.4±3.4)mm,respectively.Referring to the formula for planning target volume margin calculation,M =2.5Σ + 0.7δ,the margins were calculated as 3.2,2.1 and 3.4 mm,respectively.ConclusionsThe margins derived from this retrospective study have confirmed the premise that the treatment plans were executed in patients with high reliability,thereby created a high sense of confidence for the clinicians.