Objective To provide reliable reference for improving teaching methods of case discus-sion, the teaching effectiveness evaluation on classroom-site segmented discussions of a patient case was completed in internal environment system. Methods The questionnaire survey was conducted among 250 clinic students of 8-year program and of 5-year program to investigate the teaching effectiveness following implementation of the teaching plan called"classroom-site segmented study of patient case debate competi-tion seminars". The contents of questionnaire survey included: the students' view on characteristics and advantages of this teaching plan and the reasons for favoring and supporting the plan. Investigation was conducted using an anonymous questionnaire. A total of 250 questionnaires were distributed and 247 valid questionnaires retrieved. Data collection and analysis were performed by using Excel and SPSS 17.0 statistical software, percentage of each observing parameter was calculated. Results ①The students' view on ad-vantages of the plan included following: reducing students' study burden by 78.5％ (194/247), increasing the students' engagement in class activities by 85.4％(211/247), improving teaching quality in class discus-sion by 80.5％ (198/246), enhancing team spirit among students by 78.5％ (194/246), expanding students' thinking and exploring space by 84.5％ (207/245), and similarity of this teaching plan to clinical diagnosis and treatment process reached to 84.0％(197/235). ②The students' reasons for favoring and supporting this plan included: reducing students' study burden by 83.4％ (206/247), improving teaching quality in class discussion by 72.4％(179/247), and training students' ability to search clinical information by 82.4％ (203/247). Conclusion Implementation of the teaching plan, "classroom-site segmented study of patient case debate competition seminars", in internal environment system has reduced students' study burden, improved teaching quality, and effectively trained students' clinic thinking, which is widely welcomed by students, therefore providing a positive valuable reference to other discussion class.

Objectives: To provide new ideas on how to shift students' learning attitude from passive learning to active learning, we explored and evaluated a case/problem-based and interactive teaching mode in pathophysiology curriculum. Methods: Case/problem-based and interactive teaching mode is an innovative teaching model adopted in pathophysiology curriculum for grade 2015 students of 5-year program in clinical medicine and other medical students of non-clinical majors in Xiangya Medical School, Central South University. The teaching effectiveness of the case/problem-based and interactive teaching mode was evaluated by questionnaire survey, with 460 medical students enrolled in the survey whose approval degree on current teaching mode was analyzed. Excel was used to collect and process data, complete descriptive analysis and calculation of the percentage of indicators. Results: A total of 460 anonymous questionnaires were distributed and 453 valid questionnaires were retrieved, from which the following information was obtained: ① Pre-class learners' guidance designed for current teaching mode: 88.7% of students (402/453) believed that "Pre-class Learners' Guidance" motivated them to preview relevant teaching contents before class. 82.8% of students (375/453) believed "Pre-class Learners' Guidance" improved discussion quality in class. 76.6% of students (347/453) believed "Pre-class Learners' Guidance" expanded thinking and exploring space, while it did not increase student study burden (306/453, 67.6%). ② Compared with traditional teaching mode, the case/problem-based and interactive teaching mode had following advantages: It's helpful to cultivate students' clinical thinking (414/453, 91.4%), strengthen students' memory and understanding during study (400/453, 88.3%), attract students' attention in class (380/453, 83.9%), and aroused student's interest in class discussion (327/453, 72.2%). ③ 83.4% of students (379/453) preferred current teaching mode: they believed this teaching mode could improve students' ability to analyze and solve problems (325/453,71.7%), train clinical thinking (321/453, 70.9%), improve students' self-study ability (247/453, 54.5%) and increase students' capabilities of making summary and conclusion (197/453, 43.5%). Conclusion Case/problem-based and interactive teaching mode in pathophysiology curriculum enhances students' ability of self-studying, activates classroom's atmosphere, improves teaching quality, and effectively fosters students' clinical thinking. Therefore, this teaching mode deserves to be spread and applied in classroom teaching of pathophysiology and other basic medicine disciplines as well.

Objective:To explore the effects of SOAP (subjective objective assessment plan) case recording method by reflective teaching combined with the framework of International Classification of Functioning-Children and Youth Version (ICF-CY) in rehabilitation therapy practice.Methods:Interns of rehabilitation therapywere randomly divided into ICF-CY record group taking the case recording method of reflective teaching combined with the framework of ICF-CY and traditional record group taking traditional SOAP case recording method for children with cerebral palsy. After the internship, examination based on the clinical analysis and assessment of cases records and questionnaire survey were conducted among the two groups of interns. SPSS 20.0 was used to conduct t test and chi-square test. Results:The scores based on the clinical analysis and assessment of the ICF-CY record group were higher than those of the traditional record group. The questionnaire showed that interns' satisfaction of the SOAP case recording method by reflective teaching combined with the framework of ICF-CY was superior to the traditional SOAP case recording method ( P<0.001). Conclusion:The SOAP case recording method by reflective teaching combined with the framework of ICF-CY can improve interns' abilities of clinical case analysis, stimulate their self-learning abilities, and help to cultivate their thinking of clinical diagnosis and treatment.

Background In recent years, the incidence of metabolic syndrome (MS) is increasing significantly in China. Some studies have found that temperature is related to single metabolic index, but there is a lack of research on associated mechanism and identifying path of the influence of temperature on MS. Objective Based on the data of Guangdong Province, to investigate the effect of temperature on MS and its pathway. Methods A total of 8524 residents were enrolled by multi-stage random sampling from October 2015 to January 2016 in Guangdong. Basic characteristics, behavioral characteristics, health status, and physical activity level were obtained through questionnaires and physical examinations, and meteorological data were obtained from meteorological monitoring sites. We matched individual data both with the temperature data of the physical examination day and of a lag of 14 d. A generalized additive model was used to explore the exposure-effect relationship between temperature and MS and its indexes, calculate effect values, and explore the effects of single-day lag temperature. Based on the literature and the results of generalized additive model analysis, a path analysis was conducted to explore the pathways of temperature influencing MS. Results The association between daily average temperature on the current day or lag 14 day and MS risk was not statistically significant. When daily average temperature increased by 1 ℃, the change values of fasting blood-glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and high density lipoprotein cholesterol (HDL-C) were −0.033 (95%CI: −0.040-−0.026) mmol·L⁻¹, −0.662 (95%CI: −0.741-−0.583) mmHg, −0.277 (95%CI: −0.323-−0.230) mmHg, and −0.005 (95%CI: −0.007-−0.004) mmol·L⁻¹ respectively. The effects of average daily temperature on FBG, blood pressure, HDL-C, and waist circumference lasted until lag 14 day. The effects of daily average temperature on SBP and DBP were the largest on the current day. Daily average temperature of current day had direct and indirect effects on FBG and SBP. Temperature had an indirect effect on TG, and the intermediate variables were waist circumference and FBG, with an indirect effect value of −0.011 (95%CI: −0.020-−0.002). The indirect effects of daily average temperature on SBP, FBG, and TG were weak. Conclusion There is no significant correlation between temperature and risk of MS, and daily average temperature of current day could significantly affected blood pressure and FBG with a lag effect. Daily average temperature of current day has indirect effects on FBG and TG.

Rab27a gene can participate in the secretion, transportation and exocytosis of T lymphocytes, mast cells, neutrophils, pancreatic β cells and hematopoietic cells through its encoded proteins, and participate in the development of diseases such as albinism, cancer, diabetes, inflammation and thrombosis. In addition, the secretion regulation of Rab27a to exosomes has also received much attention. The current research status of the secretion of exosome and the genetically modified exosomes of Rab27a gene in the treatment of diseases such as inflammatory injury, thrombosis and tumor were reviewed.