No abstract

These results suggest that SFA and CY provide an anti-inflammatory response through inhibiting the production of NO and PGE(2) by the downregulation of iNOS and COX-2 gene expression. Thus safflower petals have the potential to provide a therapeutic approach to inflammation-associated disorders.

BackgroundContinuous development and use of new technologies and methodologies are key features in improving the learning, performance, and skills of medical students and students of all health care professions. Although significant improvements in teaching methodologies have been made in all areas of medicine and health care, studies reveal that students in many areas of health care taking an objective structured clinical examination (OSCE) express difficulties. Thus, this study was planned as a feasibility study to assess the educational effectiveness of an integrated objective structured clinical examination (iOSCE) using both standardized patients and virtual patients.MethodsThirty (30) medical students in their first year of internship at Taipei Medical University volunteered to be part of a feasibility study for demonstrating the concept of iOSCE. They divided themselves into five groups of six students each and were requested to evaluate two cases: 1) a patient with abdominal pain and 2) a patient with headache using a combination of a standardized patient and a virtual patient. For each of the two cases, five stations were designed in which students were given ten minutes per station leading to a final diagnosis and concluded with a debriefing. The five stations were:• Station 1) Interacting with the standardized patient.• Station 2) Writing the patient note and developing a differential diagnosis.• Station 3) Selecting appropriate laboratory and imaging studies.• Station 4) Making a final diagnosis and stating the evidence for it.• Station 5) Having the debriefing.Each group of 6 students was assigned 2 hours per day for each case. All participants completed a survey regarding the usefulness and efficiency of the iOSCE.ResultsAll medical students (30/30; 100%) found the iOSCE program to be very satisfactory, and all expressed that they would like to have further iOSCE experiences if given the opportunity. In terms of ease and helpfulness, the students rated the program an average of 4.4 for the 1st case (abdominal pain) and 4.5 for the 2nd case (headache) on a scale of 1–5, with 5 being the highest and 1 being the lowest score.ConclusionsThe participants felt that the iOSCE program can offer certain advantages over the traditional OSCE with the SP alone. They cited that the iOSCE provided improved clarity of what was being assessed as well as providing an opportunity to improve their diagnostic reasoning.

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The incidence of noroviral gastroenteritis has increased dramatically in recent years, and norovirus (NoV) genogroup II.4 (GII.4) is associated with outbreaks worldwide. The NoV genotypes and their clinical relevance in children hospitalized with acute gastroenteritis between 2006 and 2011 in northern Taiwan were evaluated in this study. NoV sequences were amplified from 47 clinical specimens and phylogenetic analysis was performed. Based on noroviral capsid protein (VP1) and RNA dependent RNA polymerase (RdRp) phylogeny, circulating NoV could be divided into GII.2, GII.3, GII.12, and GII.4 and GII.16, GII.12, GII.g, and GII.4; respectively. The GII.4 subtype was predominant and could be divided further into the 2004 (Hunter), 2006b, and 2010 (New Orleans) subtypes. Regarding clinical manifestations, convulsive disorder occurred only in cases caused by NoV GII.4 2006b. Patients affected by NoV GII.4 2006b presented with a higher frequency of diarrhea (P = 0.0204), longer duration of diarrhea (P = 0.0215), more frequent hypoglycemia (P = 0.038), and electrolyte imbalance (P = 0.0487) than acute gastroenteritis caused by NoV GII.4 2010. Structural analysis showed that the amino acid changes in viral VP1 between GII.4 2006b and 2010 subtype were located mainly in the protruding domain 2 (P2 domain). In conclusion, the NoV GII.4 variants 2006b and 2010 were the main causes of acute gastroenteritis in hospitalized children in northern Taiwan during 2006-2011. The clinical presentations and structural changes in VP1 of the two NoV GII.4 variants should be evaluated in the future.