Objective To assess the quality of examination paper,level of examination paper proposition,teachers' teaching quality and teaching effect by sampling inspection of examination paper.Methods Examination papers of 85 courses were quantitatively assessed by using evaluation form of Examination Paper Quality of Anhui Medical University.Results Propositions of papers were well or largely complied with the requirements of syllabus.2.4％ of examination papers had content errors.Students' scores of 91.6％ papers were in normal distribution.Quality of papers was improved year by year,but was significantly different among public basic courses,specialized basic courses and specialized courses(x2 =8.865,P =0.042).The qualitative analysis results showed that there were shortcomings in proposition,grading,paper analysis and archiving.Conclusions Management of examination paper is needed to improve the quality of teaching and studying and pave the way for the undergraduate teaching evaluation.

Objective To explore the expression and clinical significance of CD 8 +CD28 -T lymphocytes in the patients with endometriosis ( EMT) complicating with pelvic fluid .Methods Eighty patients with endometriosis complicating with pelvic fluid ( ca-ses of ⅠtoⅣwere 15, 12, 22, and 31, respectively) were enrolled.The peripheral blood as well as the pelvic fluid were collected and flow cytometry was applied to detect the frequencies of CD 8 +CD28 -T lymphocytes and their intracellular cytokines , including transforming growth factor β1 (TGF-β1) and interleukin 10 (IL-10).Twenty health women with the same range of age were enrolled as the control group .Results Compared with the control ones , the frequencies of peripheral blood CD 8 +CD28 -T lymphocytes , TGF-β1, and IL-10 of the EMT subjects were increased significantly (all P <0.05), which presented the order Ⅳ>Ⅲ>Ⅱ>Ⅰand the difference between every two of the Ⅰ~Ⅳgroups was significant (all P <0.05).Similarly, the data of CD8 +CD28 -T lymphocytes, TGF-β1, and IL-10 in pelvic fluid also presented as Ⅳ>Ⅲ>Ⅱ>Ⅰ.Moreover, the difference of pelvic fluid TGF-β1 between any two groups was more apparent compared with CD 8 +CD28 -T lymphocytes and IL-10 ( P <0.05 ) .Spearman correlation analysis showed that any one of CD8 +CD28 -T lymphocytes, TGF-β1, and IL-10 positively correlated with any stage of ⅠtoⅣ( rs =0.791, 0.753,0.726 and all P <0.05).Conclusions CD8 +CD28 -T lymphocytes, TGF-β1, and IL-10 were closely related to the stages and could be the negative roles in the pathogenesis of EMT .TGF-β1 played a vital role in the formation of pelvic fluid .

Objective To evaluate the Montreal cognitive assessment (MoCA) for detecting the mild cognitive impairment (MCI) in brain trauma patients with normal mini-mental state examination (MMSE) scores.Methods Fifty brain trauma patients with normal MMSE scores hospitalized from January 2013 to June 2014 were subjected to the MoCA test.The patients were classified as cognitive impairment group scored less than 26 on the MoCA and cognitive normal group scored 26 or above on the MoCA.Differences in MMSE and MoCA scores of the two groups were compared.Receiver operative characteristic (ROC) curve was used to determine the optimal cut-off scores in screening for MCI.Results Overall MMSE and MoCA scores were (27.84 ± 0.89) points and (23.24 ± 2.90) points.There was a positive correlation between MoCA and MMSE total scores (r =0.355 2,P ＜ 0.05).MCI was found in 79％ of the brain trauma patients using the MoCA.MMSE total score and subscores were all similar between the two groups.MoCA total score and subscores of attention,language,abstraction and delayed recall were much higher in cognitive normal group than in cognitive impairment group (P ＜0.05),but there were no significant differences in visuospatial,naming and oritention domains.Area under the ROC curve for MoCA(0.871 ± 0.038) was larger compared with MMSE (0.796 ± 0.054) (Z =3.592,P ＜ 0.05).The optimal cut-off scores of MoCA and MMSE for the identification of MCI were 25.5 and 28.5 respectively.Conclusions MoCA and MMSE total scores are positively correlated.MoCA is a better detector for the identification of MCI in brain trauma patients than the MMSE.

Delirium and cognitive impairment are common in the intensive care units (ICU). The Confusion Assessment Method Inten-sive Care Unit (CAM-ICU), Intensive Care Delirium Screening Checklist (ICDSC), Cognitive Test for Delirium (CTD), Nursing Delirium Scale (Nu-DESC) and Delirium Rating Scale (DRS) are recommended to assess delirium. CAM-ICU and ICDSC are the best in the reliabili-ty, validity, sensitivity and specification. Mini-Mental State Examination (MMSE), Abbreviated Mental Status Examination (AMSE), the Johns Hopkins Adapted Cognitive Exam are used commonly for cognitive impairment, and Johns Hopkins Adapted Cognitive Exam is one of the suitable scales for ICU as it is simple, comprehensive, and with higher reliability and validity.

Objective To test the reliability and validity of the Chinese version of the John Hopkins Adapted Cognitive Exam ( ACE) in NICU patients. Methods The English ACE was translated and adapted into the Chinese version . Cognitive functions of 40 critically ill patients in NICU were assessed with the Chi?nese version of ACE and MMSE battery.The scores of ACE and MMSE were analyzed to test the content va?lidity,construct validity,concurrent validity,internal consistency,inter?rater reliability and test?retest reliabil?ity.Result The correlation coefficient between each factor and the total score ranged from 0.617 to 0.938, and the content validity was good.The ACE was significantly correlated with MMSE( r=0.822, P<0.05). Five factors were extracted by main principle analysis, the cumulative contribution was 85. 90%, the factor loading of each item was all over 0.5,the scale had good construct validity.There existed a good internal con?sistency ( Cronbach’ α=0.756 ) as well as a good inter?rater reliability ( ICC>0.95) and test?retest reliabil?ity (ICC=0.652?0.979) of the Chinese version of ACE.Conclusions The Chinese version of ACE has been proved to be a reliable and valid screening tool for cognitive impairment in NICU patients.

Objective To compare the validity of Montreal cognitive assessment (MoCA) versus mini-mental state examination (MMSE) in screening cognition impairment in elderly patients with cranio-cerebral trauma.Methods Cognitive function in 40 elderly patients with cranio-cerebral trauma and 40 healthy elderly individuals were assessed by MoCA and MMSE.Receiver operating characteristic (ROC) curve analysis were performed to determine the optimal sensitivity and specificity of MoCA and MMSE.Results The total score and all the sub-test scores of MoCA were much lower in cranio-cerebral trauma patients than in the control group (all P＜0.05).The total score and orientation,calculation,recall,language sub scores of MMSE were significantly decreased in the elderly patients with cranio-cerebral trauma as compared with those in the controls (P＜0.05),while there were no significant differences in the immediate memory and language scores between the two groups (both P＞0.05).The area under the receiver operating characteristic curve showed that MoCA (0.92±0.03) ＞ MMSE (0.74±0.06) (Z=2.460,P＜0.01).When screening the cognition impairment in elderly patients with cranio cerebral trauma,the best cut-off scores of MoCA and MMSE were 24.5 and 27.5 respectively.Conclusions Cognition impairment is decreased in elderly patients with cranio cerebral trauma.The MoCA is superior to the MMSE as a screening instrument in detecting cognition impairment in elderly patients with cranio-cerebral trauma.

Objective To investigate the clinical efficacy of Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) battery for patients at the early stage of traumatic brain injury (TBI). Methods 72 patients with TBI hospitalized from January, 2013 to October, 2014 and 30 healthy controls matched gender, age and educational background were assessed with the Chinese version of LOTCA battery and Mini-Mental State Examination (MMSE) respectively. Results The score of MMSE and LOTCA were correlated (r=0.56, P<0.01). Compared with the controls, the scores of all the subtests of LOTCA decreased (P<0.01) in the patients, especially the orientation, visuomo-tor organization and thinking operation;with the more incidence of medium and serious dysfunction of all the subtests of LOTCA except perception (P<0.01), in which thinking operation was the most and attention was the least. The area under the receiver operating curve (ROC) was (0.84±0.04) in LOTCA, less than that of (0.91±0.03) in MMSE (P<0.05). Conclusion Cognition is widely impaired in patients after TBI, most involved thinking operation. LOTCA is less effective to identify cognitive dysfunction than MMSE, and can be used as an al-ternation or a supplement.

Objective To explore the risk factors of dysphagia in the patients with traumatic brain injuries (TBI). Methods 141 TBI patients were assessed with Gugging Swallowing Screen, and divided into the dysphagia (n=36) and normal (n=105) groups. The related factors were compared between 2 groups. Results The frequency increased in severe brain injury, brain stem injury, bilateral brain injury, tracheotomy, nasal-gastric tube insertion and cognitive defect in the dysphagia group compared with those in the normal group (P<0.05). Conclusion The severe brain injury, brain stem injury, bilateral brain injury, tracheotomy, nasal-gastric tube insertion and cognitive defect may be related with the dysphagia post TBI.

Objective To investigate the clinical validity of the Chinese version of John Hopkins Adapted Cognitive Exam (ACE) for in-patients in neurological intensive care unit (NICU). Methods From May, 2014 to June, 2015, 94 inpatients in NICU and 52 healthy persons were assessed with the Chinese version of ACE and Mini-Mental State Examination (MMSE). Results The total score of ACE correlated with the total score of MMSE (r=0.805, P<0.001). There was a significant difference in the total score and the scores of the subtests of both the ACE and MMSE between the patients and the controls (t>2.458, P<0.05). The area under the receiver operating curve was not different between ACE and MMSE (Z=0.707, P=0.480). Conclusion The Chinese version of ACE can be the tool for assessment of cognition for pa-tients in NICU.

Objective: To explore the mediating role of depression in the association between life events and Internet addiction, and to provide evidence for the intervention of Internet addiction. Methods: A total of 3 536 students randomly selected from 3 vocational colleges in Anhui Province completed the questionnaire survey, which included adolescents’ demographic characteristics, the Young Internet Addiction Inventory, the Adolescent Life Events Scale, and the Zung Self-Rating Depression Scale. Results: Of the 3 536 students surveyed, 427 were Internet addicts (12.08%), including 183 boys (14.89%) and 244 girls (10.58%). Negative life events were associated with depression and Internet addiction (r=-0.30，0.28, P<0.01); depression was mediated indirectly between negative life events and Internet addiction. There was statistical significance (a=0.30, b=0.13, P<0.01). Depression-mediated indirect effects accounted for 14.67% of the total effects. Conclusion Depression plays a mediating role in the relationship between negative life events and adolescents’ Internet addiction, suggesting that we can reduce the incidence of Internet addiction by reducing students’ depression through early psychological diagnosis and psychological quality training.