Medical Education in the United States and Canada released by the Carnegie Foundation in 1910,known as The Flexner Report,laid scientific foundations and set excellent standards for American medical education.However,the 20th century reality fell behind the professional ideals advanced in the report.In 2010,the Carnegie Foundation released Educating Physician:A Call for Reform of Medical School and Residency,called The Flexner Report 2,which recommends four goals for medical education in the 21st century:standardization of learning outcomes and individualization of the learning process;integration of formal knowledge and clinical experience;development of habits of inquiry and innovation;and focus on professional identity fornation.

Centering on medical human spirit that holds life in awe and esteem, the paper formulates a framework for medical humanities in terms of categories, scopes, problematics and skills, and designs a setup regarding the goals, curricula, and pedagogies for teaching practice.It is intended to inspire education reform for mnedical humanities in China by providing such a problem-based and competence-oriented education guide.

Objective To investigate the correlation between bronchial provocation tests and the onset of the disease.Methods One hundred and seven patients who hospitalized in General Hospital of China Aviation from 2013-2014 were selected as our subjects.They all were with unexplained symptoms such as cough and asthma suppress.All the patients were performed bronchial provocation tests.In accordance with the onset time,patients were divided into acute (＜ 3 weeks),subacute (3-8 weeks) and chronic (＞ 8 weeks) groups.The positive rates of bronchial provocation test of three groups were compared.Results Of all 107 patients,36 patients were positive and 71 were negative in terms of bronchial provocation test.The cases with acute,subacute and chronic disease history were 16,36 and 55 respectively.The positive rate of bronchial provocation tests in different onset were 56.3％ (9/16),36.1％ (13/36),23.6％ (13/55) respectively,and there was statistics significant difference(x2 =6.275,P ＜ 0.05).The positive rate of bronchial provocation tests in acute group was higher than that in chronic group (x2 =6.165,P ＜ 0.05).There was positive correlation between the positive rate of bronchial provocation tests and the onset,and the correlation coefficient Pearson was 0.239 (P ＜0.05).Conclusion There is a correlation between the positive rate of bronchial provocation tests and the onset.We should strengthen the monitoring in patients with acute onset and follow-up.

Objective To elucidate the clinical characteristics and the outcome of acute renal failure (ARF) in the elderly. Methods Clinical data of 109 elderly patients(≥60 years) with ARF were analysed and compared with that of 175 younger adult ARF patients(18 40 years) in the same period. Results 109 out of 422 patients(25 8%) with ARF were more than 60 years. The mortality rate of ARF in these patients was 58 7%. ARF was induced mainly by prerenal factors (20 2%) and sepsis (15 6%). Complications such as infections (52 3% vs 29 7%), cardiovascular events (64 2% vs 38 3%), respiratory failure (43 1% vs 20 0%) and hyperkalemia (29 4% vs 15 4%) were more prevalent in elderly patient than that in the younger adult ARF patients ( P

Objective To obtain the most effective preventive management for corticosteroid-induced osteoporosis by the evidence-based medicine approach.Methods We attempted to find the current best evidence for the prevention of corticosteroid-induced osteoporosis by searching ACP Journal Club(1991-Sep.2005),USA Agency for Healthcare and Research evidence report,Cochrane Library(Issue3,2005)and MEDLINE(1990-Sep.2005),and further critically appraised the available evidence.Results We found that VitD or its analogues with calcium and bisphosphonates could improve bone mineral density significantly.But the effects on reducing the development of fracture were not concluded.Conclusion VitD or its analogues with calcium can be the preferential method as prevention for corticosteroid-induced osteoporosis,while bisphosphonates may be an alternative way.

Several cytokines which play key role in asthma patients with chronic inflammation and reconstruction of air duct,are important targets for anti-asthma agents.In this review,we summarize the latest advancement of anti-asthma agents which targeted for cytokines(interleukins,TNF,eotaxin)and investigation development of new anti-asthma agents emerged in recent years.

Objective:To study the identification method and extract of Nodus Nelumbinis Rhizomatis.Methods:The identification of Nodus Nelumbinis Rhizomatis was carried out by TLC and the extract was determined by 65% alcohol.Results:The relevant spots on TLC plates were clear,and it was feasible to determine the extract of Nodus Nelumbinis Rhizomatis with 65% alcohol.Conclusion:Nodus Nelumbinis Rhizomatis can be identificated by 3-epibetulinic acid and ?-sitosterol as reference substance,there were differents on quantity of the extract of Nodus Nelumbinis Rhizomatis,which bought from different districts.

Objective To set up the reference standard of cyclovirobuxine D.Methods Thermal analysis,HPLC/MS,HPLC with terminal wavelength,HPLC with fluorescence derivation and with ultraviolet derivation,TLC and nonaqueous titration methods were applied to determine the content of cyclovirobuxine D control.Results Thermal analysis can not be used to analyse the purity of cyclovirobuxine D ,and HPLC/MS,HPLC with terminal wavelength,HPLC with fluorescence derivation and HPLC with ultraviolet derivation can obtain the same purity.Conclusion The methods used for the assay of cyclovirobuxine D control were practical.

The present paper is a study on the use of English movies in the teaching of college English,focusing on the design and interactive teaching process of the course "The Appreciation of English Movies".The paper argues that English movies play a positive role in creating an authentic communicative situation and acquainting students with western culture.

The present paper analyzes common mistakes in exemplification in the writing part of Band 4 College English Test.It discusses pertinence,appropriateness,typicality,logic and novelty of exemplification instead of dwelling on mistakes in spelling,wording and grammar,and offers some practical strategies of exemplification.