Under the new situation of rapidly expanded medical education scale and its great development,combined with the characteristics and position of higher medical education, and keeping the quality of teaching in this school lifeline,we explore the specific measures and methods to improve the quality of medical education, from the quality monitoring system of classroom teaching,clinical teaching and teaching management.

OBJECTIVE:To establish a method for the content determination of paeoniflorin in Bazhen pill(concentrated pill). METHODS:HPLC was performed on the column of wondasil C18 with mobile phase of acetonitrile-1% phosphoric acid(15∶85, V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 230 nm,and column temperature was 30 ℃. RESULTS:The lin-ear range of paeoniflorin was 0219-1.32 μg(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 1%;recovery was 95.82%-101.82%(RSD=2.13%,n=6). CONCLUSIONS:The method is simple,stable and reproducible, and can be used for the content determination of Bazhen pill(concentrated pill).

Objective To summarize the effect of predictive nursing combined with high-quality nursing in patients with pulmonary embolism or having risk factors of pulmonary embolism (PE).Methods A retrospective analysis of nursing in 57 PE patients was camied out,Nursing flow chart was established.For patients with high risk factors of PE,predictive nursingwas administered,including analysis of risk factors,health education,general nursing and pertinent nursing.For PE patients,holistic nursing was administered,including emergeney nursing,basic nursing,observation of illness,nursing of thrombolytic therapy,psychological nursing and rehabilitation nursing, Results All patients accorded with thrombolysis indication and received thrombolysis treatment. Conclusions Predictive and high-quality nursing should be used in PE patients in order to improve treatment effect.

Objective To investigate the cause and related factors of hospitalization in patients with diabetic nephropathy with maintenance hemodialysis.Methods Fifty-six patients of diabetic nephropathy were enrolled in current study who hospitalized in Beijing Tongren Hospital affiliated to Capital Medical University from March 2009 to February 2012.All subjects were divided into hospitalized group (n =29) and non hospitalized group (n =27).The information including age,dialysis age,blood pressure,hemoglobin,blood glucose,serum creatinine,serum potassium,plasma albumin,serum calcium,serum phosphorus,albumin,intact parathyroid hormone (iPTH) and hemodialysis sufficienc (KT/V) were collected.Stepwise multiple regression analysis was applied to explore the main causes and related risk factor.Results Twenty-nine out of 56 patients were hospitalized and they had 56 hospitalization records during 24 months of observed period.Average hospitalization was 1.0 times per patient and hospitalized days were (29.62 ± 14.30) days per hospitalized patients.The main causes of hospitalization were cardiac vascular diseases (35.7％),vascular access stenosis (30.4％),and pulmonary infection (17.8％).Compare with non-hospitalization group,age of patient hospitalization group was older((66.97 ± 9.94) vs.(57.42 ± 11.77),t =2.917,P =0.02) and the level of albumin and Kt/V were lower(albumin:(34.02 ± 4.76) vs.(38.93 ± 3.82),t =-4.573,P =0.000 ; Kt/V:(1.16 ± 0.09) vs.(1.39 ± 0.18),t =6.503,P =0.000).Stepwise multivariate regression analysis showed plasma albumin and KT/V were risk factors to influence the hospitalization in diabetic patients undergoing maintenance hemodialysis (β =-1.724,-0.040 respectively,P =0.00,0.02 respectively) Conclusion Cardiovascular disease,vascular access stenosis and pulmonary infection were the important factors for hospitalization in hemodialysis patients with diabetic mellitus.Cardiovascular disease was the top reason of hospitalization in diabetic patients with maintenance hemodialysis.Hypoalbuminia and inadequacy dialysis were risk factors to influence the hospitalization in diabetic patients undergoing maintenance hemodialysis.

Objective To compare the diagnostic values of 3D CT and 2D CT imaging for tibial plateau fractures. Methods A retrospective study was performed to evaluate 21 tibial plateau fractures. Four experienced orthopaedists were asked To make assessmem of fracture classifications and characteristics using 3D CT and 2D CT images.Agreement test Was performed to evaluate interobserver and intraobserver reliability for fracture classification and criteria validity for fracture characteristics(intraoperative findings were taken as the golden standard).Furthermore,MeNemar test was used to compare the agreement of 3D CT results and 2D CT results respectively with the golden standard for fracture characteristics.Results When 3D CT images were used.interobserver reliability and intraobserver reliability for fracture elassiftcation increased to"almost perfect agreement".The agreement of golden standard with 3D CT results for fracture characteristics Was significantly higher than that with 2D CT results. Condmiou Since 3D CT imaging can improve the reliability and accuracy of preoperative assessment oftibial plateau fractures,it is helpful and valuable for tibial plateau fractures.

Purpose To quantitatively evaluate longitudinal strain and strain rate (SR) of left ventricular (LV) in normal infants and young children using velocity vector imaging (VVI). Materials and Methods A total of 50 normal infants and young children were enrolled in the study. The longitudinal strain peaks and SR peaks in three sections of LV walls during systole period and relaxation period were measured by VVI from apical four-chamber view, apical two-chamber view and long axis view, respectively. Results Forty-one cases (82%) presented a smooth strain curve without incisures and a double peak in SR curve (systolic peak and single diastole peak). The strain in anterior septum and posterior septum, the systolic SRs and diastolic SRs decreased from basal to apical segments. However, only the strain in basal segment and that in apical segment in anterior septum showed statistic difference (t=1.79, P<0.05);the systolic SRs of the same level in different walls and those in the same wall at different levels had no statistic difference (P>0.05). Conclusion Most normal infants and young children present a smooth diastolic strain curve and a double peak SR curve of LV, which can provide clinical guidance in the early diagnosis of myocardial abnormality for infants and young children.

Objective To explore the significance of using cytologic and RT-PCR methods to examine(peritoneal) washings and peritoneal tissues of gastric cancer patients in prediction of peritoneal micrometastasis.Methods The peritoneal washings of 38 patients with gastric cancer and 5 patients with benign gastric(lesions) were collected and,at the same time,a small amount of omentum and peritoneum were removed for control.CEAmRNA expression of free cells in peritoneal washings were detected by RT-PCR method and(also) cytology of the washings were performed.Results The CEAmRNA expression rate of peritoneal washings and peritoneal tissues were 36.8%(14/38) and 39.5%(15/38)respectively.Both were more(sensitive) than that of cytologic examination 26.3%(10/38).TNM staging,depth of invasion,lymph node metastasis,and serosal involvement were related to the expression rate of CEAmRNA.Conclusions mRNA of CEA is more sensitive and specific than cytologic examination for detecting free cancer cells in peritoneal cavity.It is an effective method for detecting peritoneal micrometastases in gastric cancer patient.

Objective To evaluate effect of intensive insulin treatment(IIT)on healthcare-associated infection (HAI)rate in patients with acute stroke and stress hyperglycemia.Methods Databases,including PubMed,Em-base,Cochrane Library,WanFang,and China National Knowledge Infrastructure(CNKI)Data,were electronically searched,relevant journals and references of the included literatures were also searched manually,literatures were selected according to the uniform inclusion and exclusion criteria,incidence of HAI and mean blood glucose in patients who received IIT for acute stroke were assessed systematically.Results A total of 13 randomized controlled trials (RCT)involving 1 032 patients were included in this systematic review.Meta-analysis results showed that 10 studies involving 832 patients were finally enrolled for comparing HAI rate, HAI rates in IIT group and conventional insulin treatment group were 28.3% and 56.1 %,respectively(Z =4.50 ),difference between two groups was statistically significant (RR=0.53 [95 %CI :0.40 to 0.70],P <0.001 );A total of 328 patients in 5 studies were finally included in the comparison of blood glucose,difference in mean blood glucose between two groups was statistically significant(MD =-2.52 [95% CI :-4.30 to -0.74],P =0.006).Funnel plot of HAI rate revealed that there was publication bias.Conclusion IIT is used for the regulation of stress hyperglycemia in acute stroke,it can reduce the incidence of HAI and blood glucose in patients.

Objective To study the effects of MF59 in combination with heat-killed BCG ( hBCG) as adjuvant on the immunogenicity of Mycobacterium tuberculosis fusion protein PstS1-LEP.Methods BALB/c mice were divided into six groups from group 1 through group 6.They were immunized with PstS1-LEP+MF59 ( group 1 ) , PstS1-LEP+MF59/hBCG ( group 2 ) , PstS1-LEP+hBCG ( group 3 ) , MF59 ( group 4 ) , PstS1-LEP (group 5) and hBCG (group 6) for three times at intervals of two weeks , respectively.The mice were sac-rificed two weeks after the last immunization .The serum samples were collected for antibodies detection .The splenic lymphocytes and peritoneal macrophages were isolated and cultured with PstS 1-LEP.Indirect ELISA and sandwich ELISA were used to detect PstS 1-LEP-specific antibodies and cytokines in the supernatants of culture , respectively.Results The level of IFN-γ, IL-1β, IgG, IgG1 and IgG2a in group 1 were higher than those in groups 4, 5 and 6 (P<0.05).The level of IL-2 and IL-4 in group 1 were higher than those in groups 4 and 6 (P<0.05).The level of IFN-γ, IL-1β, IL-12, IgG, IgG1 and IgG2a in group 2 were higher than those in groups 4, 5 and 6 (P<0.05).The level of IL-2 was higher in group 2 than that in groups 4 and 6 (P<0.05). The level of IL-4 in group 3 was higher than that in group 4 ( P=0.05 ) .The level of IL-1βin group 3 were higher than that in groups 4 and 5 ( P<0.05 ) .The level of IgG was higher in group 3 than that in groups 4 and 6 (P<0.05).IgG1 level in group C was up-regulated in comparison with that in groups 4, 5 and 6 (P<0.05 ) .Conclusion hBCG as PstS1-LEP adjuvant induces a shift towards Th 2-type immune response , while MF59 induces Th1/Th2-type immune response.The combination of MF59 and hBCG inhibits the secretion of IL-4 by spleen lymphocytes , but enhances the secretion of IL-12 by macrophage .

Objective To sum up the specificity in clinical care of repetitive transcranial magnetic stimulation (rTMS),and provide reference for putting forward scientific and effective clinical care project.Methods 200 male schizophrenia patients with rTMS treatment were divided into the research group and the control group with 100 cases in each group randomly.Then,the research group adopted the specific nursing which was obtained from the pre-experiment while the control group adopted the routine care.Moreover,NORS scale was used to evaluate the treatment effect.Changhai Pain Measuring Scale was employed to assess headaches in pre-treatment and post-treatment.Results The data of the research group in NORS scale was obviously lower than the control group,and the difference between two groups had statistical significance.No case occurred adverse reaction in the research group,in contract with many cases with adverse reaction in the control group.Conclusions Specific nursing can reduce complications effectively for schizophrenia patients receiving rTMS treatment,and it is a scientific,effective and mature clinical care method.