Assessment or evaluation of student performance in a problem-based learning (PBL) curriculum is difficult to plan or implement.Many medical schools which have switched to a PBL learning format usually use traditional evaluation methods based on factual recalls, which usually has a negative influence on the learning style of the students, thereby reducing the impact of PBL. The purpose of this review is to discuss the various evaluation methods with a particular focus on methods applicable to PBL, so that we can make intelligent use of these methods in our PBL curriculum. In combination with evaluation methods adopted at McMaster University, the article makes an elaboration about them.

As the capital WaS invested increasingly to key disciplines,the university regarded the performance.Strengthening the evaluation on performance will help to the development of the disciplines.The omni directional performance evaluation iS a mode of all orientation.which will help the performance evaluation of disciplines go on well.At the same time.it should be paid attention to the design of the evaluation index,and the selection of the persons ioining in the evaluation team and the time of the evaluation.

BACKGROUND: How to obtain human-derived hepatocyte of high quality is the key problem for both bioartificial liver and hepatocyte transplantation. Bone marrow stem cells (BMSCs) can differentiate hepatocyte under proper condition, which provides a new think for obtaining hepatocyte.OBJECTIVE: To investigate the methods of the trans-differentiation of human BMSCs into hepatocyte in rats so as to provide a new think for clinical transplantation of liver and source of bioartificial liver.DESIGN: Randomized controlled study.SETTING: General Surgery of Zhujiang Hospital of Southern Medical University.MATERIALS: The experiment was conducted at Central Laboratory of Zhujia ng Hospital of Southern Medical University from May 2004 to February 2005. Totally 40 male SD rats of clean grade were divided randomly into five groups: model group, modeling + 14-day transplantation group of human BMSCs, modeling + 28-day transplantation group of human BMSCs, modeling + 14-day transplantation group of CL-1 cell (human hepatocyte family), and modeling + 28-day transplantation group of CL-1 cell (human hepatocyte family) with 8 in each group.acetaminofIuorene + carbon tetrachloride + cyclophosphamide were esand differentiated into hepatocyte with remedial liver regeneration. Human BMSCs were observed for 14 days in modeling + 14-day transplantation group of human BMSCs, for 28 days in modeling + 28-day transplantation group of human BMSCs, for 14 days in modeling + 14-day transplantation group of CL-1 cell and for 28 days in modeling + 28-day transplantation group of CL-1 cell. However, cells in model group function of rats was measured at normal state, before and after transplantation. The expressions of human albumin mRNA in liver were detected by immunohistochemistry staining, polymerase chain reaction (PCR) and real time reverse transcription polymerase chain reaction (RT-PCR) respectively.of human albumin mRNA in liver.transplantation of human BMSCs on hepatic function and content of total bilirubin: Hepatic function and content of total bilirubin in each transplantation group were similar to those in model group at normal state and before transplantation (P ＞ 0.05); values in each group were obviously increased before transplantation as compared with those at normal state (P ＜ 0.01) and were obviously decreased after transplantation as compared with those before transplantation (P ＜ 0.01) but were higher ical section of hepatic cells: At normal state, pathological section of hepatic cells showed that hepatic cells lined in strip-chorda shape and radian shape around central vein; and inflammatory cells were not infiltrated in crossed-channel area. Necrosis was observed in model group. Proliferated changes were observed in transplantation groups of human BMSCs after a few of necrosis, and ovale-round cells and small bile duct proliferation main histocompatibility antigen-I in liver: Positive rate was 0 in model group; (13.03±0.18)% in modeling + 14-day transplantation group of human BMSCs; (9.47±0.46)% modeling + 28-day transplantation group of human BMSCs; (10.27±0.50)% in modeling + 14-day transplantation group of CL-1 cell; and (9.84±0.23)% in modeling + 28-day transplanwas detected in model group, but Sox11 and Alu-sx were detected in both transplantation groups of human BMSCs and CL-1 cells at various RT-PCR: Expression of human albumin mRNA was not observed in model group, but expression of that was observed in transplantation groups of human BMSCs and CL-1 cell as well as positive controls at various time points respectively.CONCLUSION: Human BMSCs can promote recovery of hepatic function.Replaceable rate of human-derived cells is 10% in liver of rats, which suggests that human BMSCs can converse into hepatocyte in xenoma and replace partly.

Objective To investigate the efficacy of enteral nutrition containing glutamine on improving blood lipids and immune parameters in elderly patients with gastrointestinal cancer.Methods 98 cases of elderly patients with gastrointestinal cancer were randomly divided into observation group(n=5 1)and control group (n=47).The control group was additionally given conventional enteral nutrition,and the observation group was additionally given enteral nutrition containing glutamine.The levels of albumin (ALB),tumor necrosis factor (TNF),indicators of cellular immunity,indicators of humoral immune function and blood lipid,before and after operation,were observed in the two groups.Results 9 days after operation,the levels of ALB and total cholesterol,per-centage of CD8 + cells were lower than those in the control group,and levels of TFN,IgA,triacylglycerol,low density lipoprotein cholesterin,percentage of CD4 + cells and CD4/CD8 ratio were higher than those in the control group,and have significant differ-ences (P <0.05).While,there was no statistically significant difference of the percentage of CD3 cells between the groups(P >0.05).Conclusion Enteral nutrition containing glutamine can significantly improve blood lipids and immune function in elderly pa-tients with gastrointestinal cancer,which may have important clinical research value and be worthy of further application.

Objective To research the combined prognostic utility of NT-proBNP and hs-CTNI in NSTE-ACS risk stratification and early intervention therapy .Methods A total of 245 NSTE-ACS patients were divided to 4 groups(Aa ,Ab ,Ba ,Bb groups) ac-cording to immediate admission NT-proBNP and hs-CTNI .Patients were accepted percutaneous coronary intervention (PCI) ,coro-nary artery bypass grafting and conservative treatment were taken 6 months follow-up .Results The heart failure incidence of Aa group was significantly higher than Ba group(P<0 .05) .6 patients happened left main lesion or multivessel lesion in Aa group were obviously higher than other groups .The incidence of Bb group accepted PCI was obviously higher than Aa group (P<0 .05) .Bb group patients were accepted PCI earlier than other groups ,there was no significance(P>0 .05) .In 6 months follow-up ,5 patients died and 10 patients accepted revascularization again because of severe angina and AMI .Conclusion In NSTE-ACS patient ,NT-proBNP and hs-CTNI elevation was closely related with severe coronary lesions and worse prediction ,which could undergo early in-tervention therapy .

Nonalcoholic fatty liver disease (NAFLD) refers to a syndrome of a series of lesions such as simple fatty liver disease, nonalcoholic steatohepatitis, liver fibrosis, and even liver cirrhosis. With the improvement of living standards, there is an increasing number of children with obesity, and the detection rate of NAFLD also tends to increase. Major treatment methods for children with NAFLD include the changes in diet and lifestyle and medication. The article reviews the advances in the treatment of NAFLD in children in recent years.

Objective The aim of this study was to explore the serum 25-(OH) Vitamin D and its correlation with liver function in children who have suffered from non-alcoholic fatty liver disease (NAFLD),and to explore the necessity of vitamin D treatment of NAFLD in children.Methods Forty children with NAFLD diagnosed by imaging were selected from the outpatient of pediatric digestive department of Shengjing Hospital of China Medical University,selected as observation group from July 2017 to August 2019,and 37 healthy children were selected as control group.The clinical data were collected and serum 25-(OH) Vitamin D were detected at the same time.Results There was no significant difference in 25-(OH) Vitamin D among children with NAFLD at different ages and gender (P ＞ 0.05).The level of 25-(OH) Vitamin D in children with NAFLD [(21.30 ±8.77) μg/L]was significantly lower than that in the control group [(28.53 ± 10.18) μg/L] (t =3.343,P ＜ 0.01).The incidence of vitamin D deficiency (＜ 20 μg/L) and insufficiency (＜30 μg/L)in children with NAFLD (35/40 =87.50％) was significantly higher than that in the control group (22/37 =59.46％) (x2 =10.035,P ＜ 0.05).Serum 25-(OH) Vitamin D was negatively correlated with fasting insulin (r =-0.464,P ＜ 0.01) and homeostasis model assessment of insulin resistance (r =-0.444,P ＜0.01),but not correlated with BMI,transaminase level (ALT,AST),uric acid and blood lipid (TG,TC,HDL-C,LDL-C,sd-LDL,Apo-A1,Apo-B).Vitamin D deficiency was the risk factor of NAFLD (OR =1.088,P ＜ 0.01).Conclusion Vitamin D deficiency is common in pediatric NAFLD,which may be a risk factor of NAFLD.The mechanism may be that vitamin D deficiency aggravates insulin resistance and further aggravates liver damage in children with NAFLD.

Angioplasty, Balloon, Coronary ; Heart Injuries ; drug therapy ; etiology ; Humans ; Thrombin ; administration & dosage

Background: Feline calicivirus (FCV) is a common pathogen of felids, and FCV vaccination is regularly practiced. The genetic variability and antigenic diversity of FCV hinder the effective control and prevention of infection by vaccination. Improved knowledge of the epidemiological characteristics of FCV should assist in the development of more effective vaccines. Objectives: This study aims to determine the prevalence of FCV in a population of cats with FCV-suspected clinical signs in Hangzhou and to demonstrate the antigenic and genetic relationships between vaccine status and representative isolated FCV strains. Methods: Cats (n = 516) from Hangzhou were investigated between 2018 and 2020. The association between risk factors and FCV infection was assessed. Phylogenetic analyses based on a capsid coding sequence were performed to identify the genetic relationships between strains. In vitro virus neutralization tests were used to assess antibody levels against isolated FCV strains in client-owned cats. Results: The FCV-positive rate of the examined cats was 43.0%. Risk factors significantly associated with FCV infection were vaccination status and oral symptoms. Phylogenetic analysis revealed a radial phylogeny with no evidence of temporal or countrywide clusters. There was a significant difference in the distribution of serum antibody titers between vaccinated and unvaccinated cats. Conclusions This study revealed a high prevalence and genetic diversity of FCV in Hangzhou. The results indicate that the efficacy of FCV vaccination is unsatisfactory. More comprehensive and refined vaccination protocols are an urgent and unmet need.

Background: Feline calicivirus (FCV) is a common pathogen of felids, and FCV vaccination is regularly practiced. The genetic variability and antigenic diversity of FCV hinder the effective control and prevention of infection by vaccination. Improved knowledge of the epidemiological characteristics of FCV should assist in the development of more effective vaccines. Objectives: This study aims to determine the prevalence of FCV in a population of cats with FCV-suspected clinical signs in Hangzhou and to demonstrate the antigenic and genetic relationships between vaccine status and representative isolated FCV strains. Methods: Cats (n = 516) from Hangzhou were investigated between 2018 and 2020. The association between risk factors and FCV infection was assessed. Phylogenetic analyses based on a capsid coding sequence were performed to identify the genetic relationships between strains. In vitro virus neutralization tests were used to assess antibody levels against isolated FCV strains in client-owned cats. Results: The FCV-positive rate of the examined cats was 43.0%. Risk factors significantly associated with FCV infection were vaccination status and oral symptoms. Phylogenetic analysis revealed a radial phylogeny with no evidence of temporal or countrywide clusters. There was a significant difference in the distribution of serum antibody titers between vaccinated and unvaccinated cats. Conclusions This study revealed a high prevalence and genetic diversity of FCV in Hangzhou. The results indicate that the efficacy of FCV vaccination is unsatisfactory. More comprehensive and refined vaccination protocols are an urgent and unmet need.