Dr. Rachel Yudkowsky et. al. have published the paper in Academic Medicine [2008,83 (10 Suppl):S13–S16] demonstrating a reformed Angoff method in which items were assigned to "Yes/No/Maybe" three-level categories for judges to estimate whether a borderline students would or would not accomplish each item,compared with "Yes/No" two-level categories. Five judges were provided three-level Angoff ratings for seven checklists used in a clini-cal skills exam for fourth-year students. 45% of 121 items had at least one "Maybe" rating. About 10% of all ratings were in the "Maybe" category. Case failure rates varied considerably depending on the simulated severity of ratings. Overall failure rates were not substantially impacted. The three-level Angoff retains the cognitive simplicity of the Yes/No Angoff while addressing the challenge of items midrange for the borderline candidate and avoids the potential bias.

In this paper we report the results of 1434 differert minority college students in Yunnan in response to SCL-90 test. Results showed that the mean of every factor was from 1.56 to 2.12. The factor mean was different between male and female except the hostility, psychotism, PSDI; and factor mean of female was higher than that of male. There was no difference be- tween minority students and Han students. The factor mean of the obsession, compulsion and interpersonal sensitivity was higher in different minority students.

Objective:To study the effect of dressing with insulin on the expression of HIF-1?and VEGF in deepⅡ degree burn wound healing of diabetic rats and explore the possible mechanisms. Methods:42 rats,either male or female,were established models of deepⅡ burn wounds with diabetes,which was induced by streptozotocin (STZ). They were completely randomly divided into two groups,that is the insulin group and the control group. Dressing changes with insulin and saline dressings twice daily,respectively. Full-thickness tissues of the wounds were collected respectively in the 1st,2nd and 3rd weeks after the treatment. The expression of hypoxia inducible factor-1?mRNA (HIF-1?mRNA)was detected with RT-PCR;and the positive staining of HIF-1?and VEGF and microvessel density in the wound healing were determined with IHC. Results:Compared with the control,the healing rate was obviously increased, the expression of HIF-1?mRNA and the positive expression of HIF-1?were significantly decreased (P

Since 1959,the Department of Medical Education at the University of Illinois at Chicago(UIC DME)has experienced five stages,i.e.,formation,going to the world,turmoil,consolidation and prosperous prospects.UIC DME has been contributing a lot to its home institute,medical schools in the United States and also the world's health professions education.There are many aspect,;worth learning from it:such as variOtis institution-based services;multi-discipline faculty for the department;innovative multi-field researches;efficient and effective communication and stimulation for faculty and staff;fruitful collaboration with other organizations and winning active leadership supports.

Objective To investigate the therapeutic effects of different surgical procedures for the treatment of gallbladder cancer. Methods The clinical data of 81 patients with gallbladder cancer who were admitted to the West China Hospital of Sichuan University from January 2000 to October 2009 were retrospectively analyzed.The efficacies of different surgical procedures for the treatment of gallbladder cancer, and the relationship between T stage and lymph node metastasis were investigated. The postoperative survival rates of patients in different TNM stages were analyzed and compared using the Kaplan-Meier method and Log-rank test, respectively. Results The median survival times of patients in stage Ⅰ , Ⅱ ,Ⅲ and Ⅳ were 68, 18, 7 and 5 months, respectively. The 1-,3-, 5-year survival rates were 100%, 80% and 60% for patients in stage Ⅰ, 57%, 29% and 14% for patients in stage Ⅱ, 27%, 7% and 0 for patients in stage Ⅲ and 11%, 4% and 0 for patients in stage Ⅳ. There were significant differences in the survivals of patients in different TNM stages ( P ＜ 0.05 ). Of the 81 patients, 67 received surgical treatment. The 5-year survival rate was 100% for patients in stage T1b who received standard radical resection and 0 for patients who received simple cholecystectomy. The median survival time was 45 months for patients in stage Ⅱ who received standard radical resection and 12 months for patients in stage Ⅱ who received simple cholecystectomy, and their 1-, 3-, 5-year survival rates were 67%, 33%, 33% and 50%, 0, 0, respectively, with significant differences ( P ＜ 0. 05 ). The 1-, 3-, 5-year survival rates of patients in stage Ⅲ who received standard radical resection were 33%, 17% and 6%, respectively. The survival time of patients who received extended radical resection was longer than 12 months, while the survival time of patients who received standard radical resection or other palliative therapy was shorter than 12 months. The 1-, 3-, 5-year survival rates of patients in stage Ⅳ who received extended radical resection and standard radical resection were 38%, 12%, 0and 14%, 0, 0, respectively. The survival time of patients in stage Ⅳ who received other treatments was shorter than 12 months. Lymph node metastasis were identified in 7 patients in stage T2(n = 15), 7 patients in stage T3(n = 14), and 12 patients in stage T4(n = 13), no patient in stage T1 (n =2) was found with lymph node metastasis. Conclusions Lymph node metastasis is significantly influenced by the depth of invasion of the gallbladder cancer. For patients in stage T1b, Ⅱ and Ⅲ, radical resection of gallbladder cancer is necessary; for patients in stage Ⅳ, although the incidence of complication is higher, the survival time is much longer when compared with other treatments.

Objective To explore the role of new emergency mode "Green track" in treatment on traffic injuries. Methods The data of 2 947 patients with traffic injuries rescued by prehospital emergency "green track" and inhospital emergency treatment from March 1998 to January 2009 were retrospectively studied in aspects of prehospital and inhospital treatment methods and their results. Results Of all patients, 2 089 patients were treated surgically and 858 patients treated conservatively, in which 2 736 patients (92.8%) were cured but 211 (7.2%) died, with mortality rate of 7.2%. Head, face and limbs were the main injury parts. Of all, 1 874 patients (63.6% ) were admitted into the hospital within one hour after injury. Conclusions The new emergency mode "Green track" , either prehospital or inhospital, can markedly improve success rate of treatment for traffic injuries, increase survival rate and is of importance to be clinically applied.

Percutaneous transluminal coronary angioplasty (PTCA) is a very effective approach to treat coronary artery disease.However,restenosis after PTCA affects 40% to 60% of patients in the months after an initially successful intervention.Although a number of new techniques and pharmacological approaches have been tried to reduce the rate of restenosis,only a few have shown even preliminary efficacy.Radiation therapy seems to provide an interesting,nonpharmacological approach to prevent the restenosis after PTCA during recent years.The experiments and clinical data of this new approach are reviewed in this paper.

Objective To explore the role of JNK signaling pathway in epithelial mesenchymal transition (EMT)process of human alveolar epithelial cells A549 induced by TGF‐β1 in vitro.Methods Human alveolar epithelial cells (A549)cultured in vitro were divided randomly into three groups :normal group ,TGF‐β1 group ( treated by TGF‐β1 with 10 ng/mL)and inhibitor group (treated by 10 ng/mL TGF‐β1 and 20 μmol/L Sp600125).Morphological observation on the cells was performed under light microscope after culturing in 3% serum medium for 72 h. The expression of E‐cadherin (E‐cad ,a epithelial cell marker) ,α‐smooth muscle actin (α‐SMA ,a mesenchymal cell marker)and Collagen fibers Ⅰ(ColⅠ ,a mesenchymal cell marker)were tested by RT‐PCR.The level of JNK phosphorylation (p‐JNK)was detected through Western blot.All experiments were repeated three times at least.Results The normal human alveolar epithelial cells (A549)cultured invitro were arranged closely like peb‐bles.E‐cad expressed at a certain level ,while the expression ofα‐SMA ,ColⅠand p‐JNK was weakly detected.In TGF‐β1 group , the cells were spindle‐shaped ,the expression of E‐cad was reduced ,while the expression ofα‐SMA ,ColⅠand p‐JNK was signifi‐cantly increased 72 h after treatment of TGF‐β1. However ,compared with TGF‐β1 group ,spindle‐shaped cells in the inhibitor group were recovered after 72 h being treated by TGF‐β1 and Sp600125 ,the expression of E‐cad was increased and the expres‐sion levels of α‐SMA ,ColⅠand p‐JNK were significantly decreased 72 h after treatment with TGF‐β1 and Sp600125 in inhibitor group. As compared with normal group ,the shape of the cells in inhibitor group was prolate ,and the expression of E‐cad ,α‐SMA ,ColⅠand p‐JNK was not significantly different.Conclusion JNK signaling pathway is related to the process of EMT of human alveolar epithelial cells induced by TGF‐β1. Sp600125 ,a special inhibitor of JNK ,could validly restrain the process.

Antiplatelet therapy and stent implantation have been the dominant treatment to reduce the mortality of patients with coronary artery disease.Recently,studies have showed that adverse cardiac events still occur in part of patients with coronary artery disease after the antiplatelet treatment with aspirin and/or clopidogrel.Thus,resistance to aspirin and clopidogrel has attracted increasing attention.It will be great benefit to these patients who were identified resistance and made tailoring antiplatelet therapy So far many platelet function tests has been used in clinical to monitor the reaction of the antiplatelet drugs for prevention and treatment of thrombosis in patients with coronary artery disease.These monitoring tests may be chosen based on different antiplatelet drugs including aspirin,clopidogrel and GP Ⅱ b/Ⅲ a antagonist.The results of antiplatelet drug resistance may be different due to different platelet function methods,thus the related clinical adverse events needs further verification.

Hepatic cancer is currently the fifth most common malignant neoplasm in the world.Surgical resection is considered as radical treatment.Patients with hepatic cancer in middle or advanced stage according to the Barcelona clinic liver cancer staging system (BCLC) are usually with huge and (or) multinodular lesions and vascular invasion,which are not generally recommended for surgical resection because of high operative mortality,recurrence rate and dismal survival benefit.However,many centers have proved an opposite and encouraging result against the opinions above.With the development of surgical techniques and intensive medical care,the concern of high postoperative mortality for middle or advanced stage hepatic cancer patients is no longer unsolvable.Precise preoperative assessment is essential.The estimation of the liver functional reserve has developed from simple Child-Pugh score to an integrated system including computed tomography evaluation,indocyanine green clearance test,hepatic venous pressure gradient,etc.The estimation of the remnant liver volume after hepatectomy is especially important for surgical treatment for the middle or advanced stage hepatic cancer.Insufficient liver remnant was absolute contraindication for major hepatectomy because of high incidence of postoperative liver failure.In-situ liver transection with one branch of the portal vein ligation has been invented as a novel method to stimulate fast liver regeneration; by this way,a second-stepped radical resection can be performed with a plenty of liver remnant one week later.However,the reliability for hepatic cancer patients with liver cirrhosis is still unknown.Meticulous surgical procedure is another key factor for a safe major hepatectomy.Radical resection is most expected to provide better survival.The development of the technique of liver blood flow occlusion has a markedly influence on partial hepatectomy.Highly selective occlusion and even occlusion-free hepatectomy can reduce warm ischemia injury and improve postoperative survival.Anterior approach is a reasonable maneuver for huge hepatic cancer resection.Cancer thrombosis usually indicates poor prognosis,however,if en-bloc resection or separate thrombectomy can be achieved,surgical resection for the middle and advanced stage hepatic cancer still can provide a better survival benefit to this category of patient than palliative treatment as TACE.