A program for teaching basic clinical skills to fifth-year medical students was started at Toyama Medical and Pharmaceutical University in 1999. The five units of basic clinical skills included: 1) medical interviewing, 2) general physical examination, 3) chest examination, 4) abdominal examination, and 5) neurologic examination. The educational strategies and evaluations in each unit consisted of: 1) lectures, 2) videotape demonstrations, 3) role-playing in small groups, 4) practice on patients in small groups, 5) written examinations, and 6) objective structured clinical examinations. The students evaluated each session of the program with a five-grade rating scale and comments. Small-group sessions (role play and practice on patients) and objective structured clinical examinations received the highest scores, followed by videotape demonstrations. Lectures received significantly lower scores than did other parts of the program. In addition, most students recommended standardization of educational content, increased practice time, and fewer lectures. We conclude that evaluation by students is essential for improving programs for teaching basic clinical skills.

The objective is to explore the effect and the mechanism of arsenic trioxide, As(2)O(3), on different cell lines of chronic myeloid leukemia (CML). Different concentrations of As(2)O(3) (0.2, 2 and 10 micro mol/L) were added to CML cell lines KU812 and MEG-01 and other leukemia cell lines U937 and PL21, the cell numbers were counted at different times, TUNEL and DNA ladder were assayed. Different antibodies, CD34, CD13, CD33, CD19, CD11b, CD14 and CD7, were added to detect the change of the molecules on cell surface, the change of bcr-abl by RT-PCR and the activity of caspase-3 were assayed. The results showed that different concentrations of As(2)O(3) had different effects on the survival of the 4 cell lines. After culture for 24 hours with As(2)O(3), there was no significant increase in CD11b in all the four cell lines. There were no changes of bcr-abl in the two CML cell lines treated and untreated with As(2)O(3) by RT-PCR. Activities of caspase-3 were all increased. It is concluded that As(2)O(3) can induce apoptosis in CML cell lines, the concentration to induce apoptosis is different, CML cell lines are more sensitive than the other 2 leukemia cell lines. As(2)O(3) induced apoptosis may have some relation with the activation of caspase-3.
Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Arsenicals ; pharmacology ; Caspase 3 ; Caspases ; metabolism ; Cell Division ; drug effects ; Dose-Response Relationship, Drug ; Fusion Proteins, bcr-abl ; genetics ; Humans ; In Situ Nick-End Labeling ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; genetics ; pathology ; Oxides ; pharmacology ; Tumor Cells, Cultured

The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach. Recommendations were graded as grade 1 (strong) or grade 2 (weak) according to the concepts of the grading of recommendations assessment, development, and evaluation system. The 31 CQs covered the six topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, and (6) radiation therapy. In the 31 CQs, 14 recommendations were rated strong and 14 recommendations weak. The remaining three CQs had no recommendation. Each CQ includes a statement of how the recommendations were graded. This latest guideline provides recommendations for important clinical aspects based on evidence. Future collaboration with the cancer registry will be key for assessing the guidelines and establishing new evidence.