Formative evaluation is a medical education evaluation form used to correct its own track in the course of activities so as to get better effect. In the medical education, it can significantly improve the medical students' ability such as active learning ability, relearning ability, ability to master and apply know l edge, ability of scientific thinking and debating, ability of innovation and analysis, ability of association and communication, and so on.

Objective:To evaluate the relationship between the mechanism of promoting wound healing by modified autologous blood transfusion and metastasis-associated lung adenocarcinoma transcript 1 ( MALAT1) in diabetic mice. Methods:Twenty SPF ICR mice, weighing 21-25 g, in which the diabetic model was successfully established, were divided into 2 groups ( n=10 each) using a random number table method: modified preservation group (group I) and ordinary preservation group (group O). Peripheral venous blood samples were collected and stored in the corresponding preservation solution for 7 days.The platelet aggregation rate, blood glucose, serum glycosylated hemoglobin (GHB) and phosphodiesterase (DPG) concentrations and WBC were measured.Autologous blood was transfused back immediately after the wound model was established.The percentage of wound healing area was calculated at 7, 10 and 14 days after autologous blood transfusion.The expression of hypoxia-inducible factor-1α, vascular endothelial growth factor, matrix metalloproteinase-9, β-actin, type Ⅰ collagen (Col Ⅰ), Col Ⅲ protein and mRNA and MALAT1 was determined by Western blot, immunohistochemistry and quantitative real-time polymerase chain reaction respectively, at 14 days after transfusion. Results:Compared with group O, the blood glucose, serum concentrations of GHB and DPG, and WBC were significantly decreased, platelet aggregation rate was increased, the percentage of wound healing area was increased, the positive staining rate of Col Ⅰ and Col Ⅲ was increased, and the expression of hypoxia-inducible factor-1α, vascular endothelial growth factor, matrix metalloproteinase-9, ColⅠ, Col Ⅲ and β-actin protein and mRNA and MALAT1 was up-regulated in group I ( P<0.05). Conclusion:The mechanism by which modified autologous blood transfusion promotes wound healing may be related to up-regulating MALAT1 expression in diabetic mice.

Objective: To investigate the efficacy and side effects of combination of methylprednisolone pulse (MDP) and mycophenolate mofetil (MMF) in the treatment of systemic lupus erythematosus (SLE) in the children. Methods: A total of 16 cases of children with SLE, lupus nephritis (LN) and type IV diffuse glomerular mesangial proliferative glomerulonephritis diagnosed by pathology were selected. Among them 7 cases were given MDP combined with MMF, and received intermittently oral small dose of corticosteroids (GC), and they were used as pulse therapy group; 9 cases were given oral GC and transitional reduction, and they were used as traditional therapy group. SLEDAI was used for the evaluation of the curative effect, and body mass index (BMI), blood pressure (BP), intraocular pressure (IOP), triglycerides (TG), fasting blood glucose (FBG) and serum calcium Ca) were analyzed during the treatment of 1 year and then the efficacies and side effects of the children in two groups were compared. Results: The SLEDAI scores, levels of complements C3 and C4, 24 h urinary protein outcome of the children in pulse therapy group were better than those in traditional therapy group; the differences in SLEDAI scores were statistically significant after treating for 3 and 6 months between two groups (P<0.05); ESR and 24 h urinary protein outcome had significant differences after 6 months of treatment between two groups (P< 0.05); the complement C3 difference was statistically significant between two groups (P<0.05) after 12 months of treatment. Compared with traditional therapy group, the BMI, IOP, TG, FBG of the children in pulse therapy group after treatment were decreased (P<0.05); the BMI, IOP and TG had significant differences after treating for 12 months between two groups (P<0.05); the differences in FBG were statistically significant after treating for 6 and 12 months between two groups (P<0.05). The Ca of the patients in pulse therapy group was higher than that in traditional therapy group, but there was no statistically significant difference (P>0.05). The SPB and DBP of the patients in pulse therapy group were higher than those in traditional therapy group, but the differences were not statistically significant (P>0.05). At the same time, gastrointestinal ulcers, bleeding, perforation, pancreatitis, cardiovascular events (such as cardiac arrhythmias) didn't occur in two groups. Conclusion: Compared with traditional therapy, the combined treatment of MDP and MMF can control the symptoms of SLE early and rapidly, and reduce the viscera damage. To choose 1 year after treatment as observation point, its disease activity is lower than the traditional therapy, and the curative effect is better than oral GC transitional reduction with immunosuppressant therapy. The GC-related side effects are lower than traditional therapy.

Juvenile idiopathic arthritis (JIA) is a genetically heterogeneous group of connective tissue diseases that are commonly characterized by chronic joint synovial inflammation with unknown etiology in childhood.It is cu-rrently incurable and the main therapeutic goal is to achieve clinical remission.The drugs currently used to treat JIA mainly include non-steroid anti-inflammatory drugs, glucocorticoid, disease modifying antirheumatic drugs, and biological agents.In this article, recent advances in the understanding of JIA treatment and related clinical research were reviewed, in an attempt to provide prospects for the future direction of drug development and treatment concepts.

Objective:To evaluate the effect of stored autologous blood transfusion on the function of bone marrow hematopoietic stem cells and the recovery of reticulocytes in peripheral blood of rabbits.Methods:Thirty healthy male New Zealand rabbits, aged 3-6 months, weighing 2.5-3.0 kg, were divided into 5 groups ( n=6 each) using a random number table method: control group (C group), operation group (O group), blood collection group (O+ B group), stored autologous whole blood group (O+ WB group) and stored autologous component blood group (O+ CB group). In O+ B group, O+ WB group and O+ CB group, blood was collected via the right femoral artery at a rate of 3-5 ml/min at 7 days before surgery, the blood volume was 10% of the total blood volume, and blood was stored at 4-6 ℃.In O+ CB group, blood was centrifuged to remove plasma and white blood cells, and red blood cell suspension was prepared and placed in a blood storage bag.In O, O+ B, O+ WB and O+ CB groups, hepatectomy was performed, and bleeding was performed through the right femoral artery at a rate of 3-5 ml/min, and the blood volume was 10% of the total blood volume.Lactated Ringer′s solution 1 ml/min was intravenously infused during surgery in O and O+ B groups, stored autologous whole blood was intravenously infused during surgery in group O+ WB, and stored autologous red blood cell suspension 1 ml/min was intravenously infused during surgery in group O+ CB.Bone marrow blood samples were collected immediately before the start of surgery (T 2) and at 6 and 24 h after surgery (T 3, 4) to determine the percentage of CD34 + cells, cell cycle and relative expression of telomere DNA.Peripheral venous blood samples were collected before storage (T 1) and at T 4 for determination of the percentage of reticulocytes. Results:Compared with group C, the percentage of CD34 + cells was significantly increased at T 3 and T 4, the percentage of CD34 + cells in G1 phase was decreased, and the expression of telomere DNA in CD34 + cells was up-regulated in group O, and the percentage of reticulocyte in peripheral blood was increased at T 4 in the remaining 4 groups ( P<0.05). Compared with group O, the percentage of CD34 + cells was significantly increased at T 2-4, the percentage of CD34 + cells in G1 phase was decreased, and the expression of telomere DNA in CD34 + cells was up-regulated in O+ B, O+ WB and O+ CB groups, and the percentage of reticulocyte in peripheral blood was increased at T 4 in O+ WB and O+ CB groups ( P<0.05). Compared with group O+ B, the percentage of CD34 + cells was significantly increased at T 3 and T 4, the percentage of CD34 + cells in G1 phase was decreased, and the expression of telomere DNA in CD34 + cells was up-regulated in O+ WB and O+ CB groups, and the percentage of reticulocyte in peripheral blood was decreased at T 4 in O+ WB and O+ CB groups ( P<0.05). Compared with O+ WB group, the percentage of CD34 + cells was significantly decreased at T 3 and T 4, the percentage of CD34 + cells in G 1 phase was increased, the expression of telomere DNA in CD34 + cells was down-regulated, and the percentage of reticulocytes in peripheral blood was increased at T 4 in group O+ CB ( P<0.05). Conclusion:Stored autologous blood transfusion can inhibit the function of bone marrow hematopoietic stem cells and is not helpful for recovery of reticulocytes in peripheral blood of rabbits; stored autologous component blood transfusion has less effect on the hematopoietic function of bone marrow than stored autologous whole blood transfusion.

Objective:To explore the effect of sports training guidance based on Internet platform on the limb function and quality of life in home rehabilitation of stroke hemiplegic patients.Methods:Eighty patients with stroke and hemiplegia admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from June 2018 to December 2019 were selected and divided into observation group and control group with 40 cases in each group by random digits table method. The control group was given routine rehabilitation training. In addition to the regular rehabilitation training, the observation group was supplemented with home rehabilitation based on the WeChat platform for modified constraint-induced movement therapy. The limb motor function Fugl-Meyer Assessment (FMA) score, Upper Extremity Function Test (UEFT) score, Stroke-Specific Quality of Life scale (SS-QOL) score before and after intervention, and patients′ satisfaction and cares′ satisfaction score were compared between the two groups.Results:There was no significant difference in the score of FMA, UEFT, SS-QOL before intervention between the two groups( P>0.05). After discharge, the FMA score, UEFT score and physical function, physiological function, mental health, social function of SS-QOL score were (68.87±6.64),(72.38±7.33), (35.28±4.13), (36.55±4.23), (37.22±3.84), (38.23±3.44) points in the observation group and (55.25±6.20), (61.24±6.47), (28.72±4.56), (30.85±5.30), (31.28±4.63), (31.02±5.16) points in the control group, and the differences were statistically significant between the two groups( t values were 5.316-9.482, P<0.01). During the nursing period, the patients′ satisfaction and cares′ satisfaction score were 92.50%(37/40), 87.50%(35/40) in the observation group and 72.50%(29/40), 67.50%(27/40) in the control group, and the differences were statistically significant between the two groups( χ 2 values were 5.541, 4.588, P<0.05). Conclusions:The home rehabilitation based on the Internet platform for modified constraint-induced movement therapy helps to promote the recovery of limb motor function in stroke hemiplegic patients, improve the nursing satisfaction of patients and their families, and has a positive effect on improving the quality of life of patients.

AIM: To observe the effect of acute normovolemic hemodilution (ANH) autologous blood transfusion on the EEG bispectral index and muscle relaxation in elderly patients undergoing orthopedic surgery to explore the influence of autologous blood transfusion containing anesthetic components on the quality and safety of postoperative anesthesia recovery. METHODS: Forty patients, aged 65-75, weighing 55-80 kg, ASA grade I-II, with an estimated intraoperative blood loss of more than 600 mL, were selected for elective orthopedic surgery. The patients were randomly divided into two groups (n=20): group A was given acute normovolemic hemodilution (ANH), and the target value of Hct was 28%-30% after induction of anesthesia; group B was the control group which was given routine fluid infusion during operation without ANH. Bispectral index (BIS), TOF values and plasma concentrations of propofol and cisatracurium were measured at the beginning of autotransfusion (T