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.

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.

A case of mandible plasma cell myeloma is reported.Plasma cell myeloma is a monoclonal neoplastic proliferation of plasma cells of bone-marrow derivation,usually multi-centric but jaw bones are rarely involved.The treatment requires precise pathological diagno-sis.The prognosis of solitary jaw bone lesions can be good after treatment.

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.

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.

The mechanism of coronary artery thrombosis(CAT)caused by Kawasaki disease is not clear yet.Endothelial injury,hypercoagulability and hemodynamic change of coronary arteries are now considered as the main causes in recent studies.As The clinical symptom of acute thrombus caused by Kawasaki disease is un-conspicuous,cardiac ultrasound should be use actively and thrombolytic therapy should be performed within 12 hours after thrombus formation or the onset of acute myocardial infarction.Intervention or intravenous thrombol-ysis are both proved to be effective.Treatment with oral antitplatelet drugs,such as aspirin,combine with warfa-rin is suggested to relieve acute myocardial infarction in the chronic phase.The adverse reactions of antithrom-botic and anticoagulant drugs should be monitored though they are minor.

BACKGROUND:Human amniotic mesenchymal stem cel s have the potential to differentiate into insulin-secreting cel s and have immunomodulatory effects. Additional y, it has been clinical y proved that Gegen Qin Lian Tang can lower blood sugar. OBJECTIVE:To investigate the effects of Gegen Qin Lian Tang combined with human amniotic mesenchymal stem cel transplantation on rat early diabetic retinopathy, by detecting pathological changes, levels of blood indicators and expressions of vascular endothelial growth factor in retinal tissues. METHODS:By intraperitoneal injection of streptozotocin, 42 Wistar rat models with diabetes mel itus were prepared and then randomly divided into model group, human amniotic mesenchymal stem cel transplantation group (cel transplantation group) and combination of human amniotic mesenchymal stem cel s and Gegen Qin Lian Tang group (combination group). At 4 weeks after transplantation, levels of blood sugar and serum insulin in diabetic rats were detected;pathological changes of the retina in diabetic rats were observed by hematoxylin-eosin staining. Besides, expressions of CD45 and vascular endothelial growth factor mRNA were detected using immunohistochemistry staining and RT-PCR technology, respectively. RESULTS AND CONCLUSION:Compared with the model group, the levels of blood glucose and serum insulin in both cel transplantation and combination groups were significantly decreased and increased, respectively, and these changes were even more significant in the combination group (P<0.05). In the model group, the retinal edema could be found, accompanied by structural disorder and irregular cel arrangement, while these retinal lesions were relatively milder in the cel transplantation group and significantly improved in the combination group. In addition, the CD45 expression and in the retina was highest in the model group subsequently fol owed by the cel transplantation group (P<0.05) and lowest in the combination group (P<0.05). Furthermore, compared with the model group, the expression of vascular endothelial growth factor mRNA was also significantly lower in the other two groups, especial y in the combination group (P<0.05). These data show that Gegen Qin Lian Tang combined with human amniotic mesenchymal stem cel transplantation improves the severity of diabetic retinopathy by inhibiting expressions of CD45 and vascular endothelial growth factor in the retinal tissues.