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.

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.

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.

Blood Vessels ; physiopathology ; Humans ; Shock ; physiopathology

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.

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.

With the key words such as acupuncture and moxibustion, coronary heart disease, etc., CNKI, WANFANG and VIP databases were retrieved to get Chinese literature of coronary heart disease treated with acupuncture and moxibustion in recent 10 years. Related 76 articles were collected and 72 acupoints were applied. The potential relation among acupoints of the top 20 was analyzed by hierarchical cluster analysis. It was discovered that the main acupoints were Neiguan (PC 6), Xinshu (BL 15), Danzhong (CV 17), Geshu (BL 17) and Zusanli (ST 36), etc., especially the specific acupoints. The back-shu points and five-shu points were emphasized. Pericardium meridian of hand-jueyin was the high frequency meridian. The four extremities were the main position.
Acupuncture Points ; Acupuncture Therapy ; Coronary Artery Disease ; therapy ; Databases, Bibliographic ; Humans ; Meridians ; Moxibustion

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.

Holter monitoring remains an useful diagnostic tool in the evaluation of syncope in children if synco-pe remains unexplained after the initial examination.But it should not be used as a screening tool.Holter monitoring is recommended in children who were suspected as cardiac syncope or who had an abnormal electrocardiogram.For chil-dren with frequent syncope,Holter monitoring is highly recommended.More information can be provided with extended Holter monitoring to 48 hours if possible.Heart rate variability is probably useful in predicting head -up tilt test diagno-sis of neurally mediated syncope.

The essential factors of bone tissue engineering include seed cell,growth factor and scaffold material.The biological structure,biological function and preparation method of scaffold material,which is the key component in bone tissue engineering,have attracted our attention.An ideal scaffold material needs to have adequate mechanical strength,appropriate degradation speed,good biocompatibility,satisfactory availability,low price,et al.Common scaffold materials in bone tissue engineering mainly consist of inorganic matter,organic matter and natural derivatives.Silk fibroin which is extracted from silkworm protein fiber contains 18 kinds of amino acids.The glycine,alanine,serine are the main types in silk fibroin and its structure consisted of hydrogen bonding,hydrophobic bonding and crystalline region.Those special structures make it has good flexibility and tensile strength.Silk fibroin has other advantages incluing air permeability,moisture permeability and biodegradation.Besides silk fibroin with curing crystallization of diversification that easy to maintain biological affinity and form a special porous structure.Silk fibroin has good film and gel forming ability.Silk fibroin can bond with some other materials to further improve its physical and chemical properties.Silk fibroin can be formed into porous shape,membranous,gel and composite materials scaffold.The materials scaffold which based on silk fibroin has excellent mechanical performance,adjustable degradation speed,high biocompatibility and good osteogenesis performance,besides capability of loading cells,bioactive factors and drugs.In addition,silk fibroin which can be made into gel scaffold,porous scaffold,electrospinning fiber,and compound scaffold et al has three-dimensional porous and biological function for bone tissue engineering as a new choice and application prospect.