This paper analyzes by many kinds of methods,such as collecting literature,case analysis,positive analysis to discuss the necessity and feasibility of utilizing ISO9000 management idea in the higher vocational medical education field.Then analyzes the utilizing case of Tianjin Medical College.At last,this paper gives some solutions about how to improve it in future.

There are many existing problems which are to be solved in Chinese medical undergraduate education evaluation.It can be improved by founding the scientific scheme for medical undergraduate education evaluation through carrying out the diversification of evaluation subject,formulating a reasonable evaluation system,optimizing the evaluation process,establishing the rule of law and access system and playing the leading role of evaluation.

With the aging of the population,management of cancer in the elderly aged people represents a priority for health care.However,fewer evidence-based data are available to promote the treatment of these patients.Comprehensive geriatric assessment (CGA) is developed recently as a multi-disciplinary in-depth evaluation to assess life expectancy and risk of morbidity from cancer in elderly patients,which is helpful for physicians to develop a coordinated plan for cancer treatment and to provide appropriate interventions to decrease the risk of morbidity and mortality.

Objective To observe the effects of Yishen-Pinggan dcoction on the urine microalbumin and the expression of ACE2, AngⅡin the spontaneously hypertensive rat kidney(SHR);to observe the kidney level hepatic side of the protective effect of early renal in SHR hypertension. Methods The same old male SHR and normal rats(Wistar-Kyoto rats, WKY) for the study, at 10 weeks of age, SHR rats were randomly divided into a model group, a Chinese medicine group, and a lotensin group;while WKY rats were served as a normal control group(n=8). They were continuously treated for 12 weeks. Urine mAlb and β2-MG of rats were quantified at pre-experiment and after experiment, immuno-histochemical detection of renal ACE2 and AngⅡwere performed, the obtained results were statistically analyzed by computer image analysis. Result At the 12th week, compared with urinary mAlb(509.3±160.3)ng/ml,β2-MG(0.150±0.037)μg/ml, Ang kidneyⅡ(7 174.24±1 068.99)μm2,kidney ACE2(2 158.90±376.60)μm2 in the WKY group, the urinary mAlb(908.3 ±13.2)ng/ml, β2-MG(0.378±0.099)μg/ml, kidney AngⅡ(11 085.37±1 398.03)μm2 in the hypertension model group were significantly higher(P<0.01), and kidney ACE2(1 375.77±466.21)μm2 was decreased significantly(P<0.01); compared with hypertensive model group, rat urinary mAlb(574.9±197.8)ng/ml,β2-MG(0.198±0.040)μg/ml, kidney AngⅡ(8 462.91±781.23)μm2 in Chinese medicine group, rat urinary mAlb(644.4±147.5)ng/ml, β2-MG(0.206±0.044)μg/ml, kidney AngⅡ(8 696.88±679.70)μm2 in lotensin group were significantly decreased(P<0.01); while kidney ACE2(1 904.02 ± 454.08)μm2 in Chinese medicine group, kidney ACE2(1896.11±445.43)μm2 in lotensin group was significantly increased(P<0.01). Conclusion Yishen-Pinggan decoction can reduce the SHR urinary microalbumin excretion so as to reduce high blood pressure early kidney damage; its role may be associated with its increasing local renal ACE2 expression and reducing the kidney Ang Ⅱ expression.

Blood Vessels ; physiopathology ; Humans ; Shock ; physiopathology

Objective:In order to study the antitumor effect of AD injection and its immunological mechanisms.Methods:Liver cancer H22-bearing mice were treated with AD injection and 7 days later to observe the effect of AD injection on the inhibitory rate of tumor,indexes of thymus and spleen,lymphocytes transformation function,phagocytosis of the peritoneal macrophage,activity of TNF,the level of IL-2 and IFN-α in serum.Results:AD injection could inhibit the growth of tumor in bearing mice significantly and promote the transformation function of lymphocytes and enhance the peritoneal macrophage phagocytosis and the activities of TNF.AD injection could improve the level of IL-2 of spleen cells and IFN-α in serum.Conclusion:These results suggested that AD injection could obviously inhibit the growth of tumor and enhance the immune functions in bearing mice.

Objective To study the reliability and validity of the Chinese version of AKT(the Apnea Knowledge Test).Methods The AKT was tested in a sample of 91 middle aged and elderly patients with obstructive sleep apnea and hypopnea syndrome and the AKT was retested in 30 of them after 1 month.Results Cronbach's alpha reliability coefficient was 0.76.Retest correlation coefficient was 0.96.There was significant difference between test and retest.Item analysis indicated that there was significant difference in most items between higher scores group and lower one except the fourth item.Conclusions AKT has satisfying reliability and validity which is suitable for evaluation of sleep apnea knowledge.

AIM　To study the direct effect of tyrphostin AG114 on recombinant human protein kinase CK2 holoenzyme and its kinetics. METHODS　Recombinant human protein kinase CK2 α and β subunits were cloned and expressed by genetic engineering, and purified to homogeneity. The two subunits were mixed at equal molar ratio and reconstituted CK2 holoenzyme, which exerted the maximum biological activity. The CK2 activity was assayed by detecting incorporation of 32P of ［γ-32P］ATP or ［γ-32P］GTP into the substrate in various conditions. RESULTS　The recombinant human CK2 was a second messenger (Ca2+, cAMP and cGMP) independent protein kinase, the characterization and function of the reconstituted holoenzyme were consistent with those of native CK2. AG114 strongly inhibited the holoenzyme activity of recombinant human protein kinase CK2 with an IC50 of 20.8 μmol·L-1, which lay between IC50 of 5,6-dichloro-1-β-D-ribofuranosyl-benzimidazole(DRB) and N-(2-aminoethyl)-5-chloronaphthalene-1-sulfonamide(A3), known as CK2 special inhibitors. Kinetic studies of AG114 inhibition on recombinant human CK2 showed that the inhibition was mixed competitive with GTP and noncompetitive with casein. CONCLUSION　AG114 not only is an effective inhibitor of protein tyrosine kinases, but also is a novel potent inhibitor of protein kinase CK2. The recombinant human protein kinase CK2 might be used as a molecular target for simpler screening method and development of more effective inhibitors of CK2.

Objective To learn the awareness rate of patients for dual referral and analyze factors affecting their intent, in order to provide references for healthcare decision making. Method Data were collected with questionnaires, and analyzed with logistic regress model. Results (1) Factors for patients' awareness rate: Patients' attitude toward first treatment in community) accessibility to community healthcare centers in their vicinity. (2) Factors affecting patients' intention for dual referral: Patients' attitude toward dual referral feasibility; patients' attitude toward rehabilitation back to community if the community joins hands with a hospital; whether patients would choose the community for treatment if the community offers benefits. Conclusion Greater efforts are expected to encourage the people to embrace the practices of dual referral and first treatment in community, and to support community healthcare centers, in addition to expanding the cooperation between such centers and hospitals.

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.