One of the biggest differences between ordinary undergraduate education and higher vocational education is more emphasis on the cultivation of students' vocational skills so as to adapt to so-cial demand and employment. In order to overcome the deficiencies in current teaching outline of voca-tional education and to change from subject knowledge teaching to applied skill cultivating , medical and health curriculum standard including 'curriculum philosophy, curriculum goal, curriculum content, curriculum implementation' four elements was formulated based on concepts of 'education as base , practice orientation and lifelong learning' and cultivation mode combining industry standard with cur-riculum teaching goal and combing work with study. All measures taken above were aimed at promoting coordinated development of students' knowledge, ability and emotion and satisfying the social demand for talent.

Objective To prepare transferrin and Arg-Gly-Asp polypeptide co-modified nanoparticles(TF/RGD-NPs)and evaluate its targeting efficiency to melanoma.Methods The co-modified nanoparticles were prepared by emulsion method and its appearance,particle size and Zeta potential were evaluated.The cellular uptake experiment and melanoma tumor spheroids penetration test were used to evaluate the affinity and ability to penetrate tumor tissues of TF/RGD-NPs to melanoma B16 cells. Results The particle diameter of co-modified nanoparticles was(113.4 ±12.5)nm and the Zeta potential was(4.53 ±2.15)mV.In vitro uptake test demonstrated that the efficacy of cellular uptaken TF/RGD-NPs by B16 cells were 2.7 times and 2.9 times to TF-NPs and RGD-NPs,respectively,the differences were all significant(P<0.05 ).Tumor spheroid penetration test results showed that TF/RGD-NPs has good affinity to melanoma cells.Conclusion TF/RGD-NPs can target to melanoma B16 cell efficiency in vitro,it may be serve as a potential drug delivery system for targeting melanoma.

For stage Ⅱ colon cancer patients after surgery,the benefit of adjuvant chemotherapy remains controversial.Several studies indicate that the patients with high-risk stage Ⅱ colon cancer can benefit from adjuvant chemotherapy after surgery.According to the clinical and pathological features,the stage Ⅱcolon cancer patients including T4 lesion,perforation,peritumoral lymphovascular invasion can benefit from the adjuvant chemotherapy of oxaliplatin.In the horizontal of molecular and genetic levels,the stage Ⅱ colon cancer patients can express high microsatellite instability (MSI-H) and cannot benefit from the chemotherapy of Fluorouracil.The guiding functions of 18q loss of heterozygosity (18q LOH),Cx43 and gene expression profiling in adjuvant chemotherapy are still unclear,and need further study.

Transient receptor potential (TRP) is a kind of novel Ca2+ permeant channel.It is later found that TRP channels are expressed broadly in many organisms,tissues and cell types.It is involved in the regulation of sensory conduction and cell signal transduction.Further studies are required to assess which TRPC6(a member of TRPC subfamily) is associated with the cytosolic Ca2+ levels,development and progression of cancer and tumor cell cycle.TRPC6 may be regarded as new targets for the treatment of cancer.

Objective To evaluate the clinical features,diagnostic methods and treatment of venous thromboembolic disease (VTE) during pregnancy.Methods From June 2006 to June 2011,a total of 20 pregnant women were diagnosed VTE at the Department of Obsterics and Gynaecology,Qilu Hospital of Shandong University.Clinical data of these patients were analyzed retrospectively.Results (1) Characteristics of patients:the symptoms of all the 20 patients commenced in pregnancy.Of these,6 (30％) happened in the first trimester,7 (35％) in the second trimester,and 7 (35％) in the third trimester.Twelve (60％) patients went to hospital in one week after they had symptoms,while 8(40％ ) went to hospital after one week.(2)Clinical manifestation:18 patients were diagnosed deep venous thrombosis (DVT),one was diagnosed pulmonary embolism (PE).One patient was diagnosed DVT and PE simultaneously.Among the 19 DVT patients,16 (16/19)were on the left side,3 (3/19)were on the other.They all came with sudden swelling and pain of the affected lower extremity.In 17(17/19) patients,the circumference differences between two legs were beyond (4.0 ±0.5) cm.In all the 20 patients,12 (60％) had elevated plasma level of D-dimmer.The diagnosis of DVT was made mainly by a Doppler ultrasound.Among the 19 DVT events,7 (7/19) were proximal DVT,2 (2/19) were distal,and 10( 10/ 19) were mixed type.(3)Anticoagulant therapy:patients with VTE during pregnancy were treated with low molecular weight heparin (LMWH) (enoxaparin,once 1 mg/kg subcutaneous,twice a day).After delivery,patients were treated with subcutaneous LMWH and warfarin simultaneously for at least 5 days,until the prothrombin time-international normalized ratio ( PT-INR ) was ＞ 2.0 for 24 hours.( 4 ) Thrombolytic therapy:for most patients with VTE,we are against the routine use of thrombolytic therapy,especially before delivery.For patients with acute massive PE,urokinase of 600 000 units intravenously daily was recommended for 3 days.For those patients with DVT whose standard anticoagulation therapy was ＜ 30 days,an inferior vena cava filter(IVCF) placement was recommended before delivery or abortion.If it was ≥30 days,IVCF was not recommended as a routine,and anticoagulant therapy was used 24 hours after delivery.If there was no recurrent DVT or PE,IVCF was retrieved routinely in 12 days.(5)Outcome:among patients treated with LMWH (95％,19/20).Three received IVCF placement,which was retrieved successfully in 12 days,with no interventional complication.All patients recovered well after 2 weeks,and the circumference differences between two legs were within (2.0 ± 0.3 ) cm.Of the 18 patients maintained to the third trimester,17 received anticoagulant therapy,and no abnormal findings were found during antenatal examination.Ten patients received cesarean section (50％,10/20),while 8 had vaginal delivery (40％,8/ 20).Neither neonatal asphyxia nor malformation was observed.The patients were followed-up for 1 - 24 months,no venous thrombus extension was found in 17 cases by Doppler ultrasound,thrombus disappeared in 2 cases of distal DVT after 4 weeks and 8 weeks respectively.By echocardiography,the pulmonary arterial pressure of the 2 patients with PE was found normal 3 months after hospital discharge.There was no maternal death during the study,no recurrent PE or bleeding occured.Conclusions LMWH is safe and effective for VTE during pregnancy.Routine use of thrombolytic therapy is not recommended.VTE in pregnancy is not the absolute indication of termination of pregnancy.The indication of an IVCF placement should be stricter,and a retrievable suprarenal IVCF is recommended under certain circumstances.

Objective To evaluate the effect of embelin combined with paclitaxel on the inhibition of A 549 lung cancer cell proliferation and tumor growing in tumor bearing nude mice. Methods The anti-proliferation efficiency of embelin combined with paclitaxel were evaluated by MTT assay, and A 549 cell apoptosis were evaluated by lfow cytometry. A 549 cells were xenografted in mice to establish the animal model, which were used to evaluate the effect of anti-tumor. Results compared to saline group、embelin group and paclitaxel group, the (paclitaxel+embelin) group could inhibit the growth of A 549 cells effectively(P<0.05). The embelin combined with paclitaxel induced the apoptosis of A 549 cells more effective than paclitaxel alone. The (paclitaxel+embelin) group significantly inhibited the growth of tumor tissue. Conclusion the paclitaxel can inhibit the growth of A 549 cells, the embelin can induce the apoptosis of A 549 cells, and the combination of paclitaxel and embelin may be a potentially effective treatment for lung cancer.

Taking the modern occupation education concept as the guide,oriented by adapting to the demand of occupation post,we established a new open education mechanism of medical occupation education to promote the reform of personnel training mode,curriculum and teaching content to explore the effective way of the sustainable development of local medical occupation education.

Objective To evaluate t he efficacy of fluoxetine in treating tinnitus patients with depress. Methods A randomized,open-labeled,controlled clinical tri al was conducted.There were 31 patients in control group and 26 p a tents in fluoxetine group.The efficacy was assessed by tinnitus patients with Ra ting Scale and Hamilton Depression Rating Scale (HAMD). Results The total effective rate of fluoxetine group was 71.11%, and there was significant improvement rate in depression after 1 month f luoxetine treatm ent. Conclusion Fluoxetine is an effective drug for tinnitus p atients with depression.

Objective To investigate the changes of the level of oxidative stress and cell apoptosis of secondary brain injury after traumatic brain injury,and the influence of brain-derived neutrophic factor on these parameters in rats,as well as its potential mechanisms.Methods A total 84 adult and healthy male rats was divided randomly into 2 groups:control (n =42) and traumatic brain injury (TBI) groups (n =42).The brain-derived neurotrophic factor (BDNF) group was induced using improved Feeney method and was received abdominal injections of BDNF (0.5 μg/μl) immediately after injury,the control group were received abdominal injections with the same dose sodium chloride injection immediately after injury and repeat one time everyday until the rats was killed.Each group was divided into seven subgroups by sacrificed time after injury,those are 1 h,3 h,6 h,12 h,24 h,3 d,and7 d,each subgroup got6 rats.Each subgroup was randomly selected three rats after being killed.The water content,superoxide dismutase (SOD),malonic aldehyde (MDA),and glutathione (GSH) of rats were measured contusion peri tissues brain tissue.Specimens were taken from left three rats of subgroup,which was part of the brain tissue.The expression of NF-κB p65,around the brain tissue with immunohistochemical methods were detected.TdT-mediated dUTP nick-end labeling (TUNEL) method was used to observe the peri cell apoptosis after brain contusion.Results NF-κB p65 was expressed obviously around the lesion in 1h group,and strongly expressed in TBI-3 h-12 h,and reached a peak in 24 h after the injury,while NF-κB p65 expression reduced in TBI-3 d-7 d,and still in high expression.NF-κB p65 expression strongly correlated with the degree of cerebral edema (r =0.651,P ＜0.05).For two groups,NF-κB p65 expression strongly correlated with the level of MDA (r1 =0.947,P ＜0.01;r2 =0.961,P ＜0.01).Conclusions Changes of NF-κB protein expression after brain injury were involved in a series of pathological processes of secondary brain injury,such as oxidative stress,and apoptosis,brain-derived neutrophic factor is probably through inhibit oxidative stress levels,control apoptosis,prevent the development of vasogenic cerebral edema,and reduce or mitigate secondary brain injury.

Objective To investigate the protective role of Xiongbitong capsule against liver injury in hyperlipemic rats.Methods Sixty Wistar male rats were randomly divided into 5 groups(12 rats in each group): a blank group, a model group, a simvastatin group(10 mg/kg, 2 ml intragastric administration daily), a Xiongbitong capsule high-dose group(25 mg/kg, 2 ml intragastric administration daily), and a Xiongbitong capsule low-dose group(12.5 mg/kg, 2 ml intragastric administration daily). Hyperlipidemia model in rats was indeuced by hyperlipidemic diet. The simvastatin group was intragastric administrated with simvastatin suspension 2 ml(10 mg/kg daily), and the rats in the control group and the model group were intragastric administrated with equal volume of saline. After 10 weeks, the serum leves of total cholesterol(TC), triacylglycerol(TG), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol (HDL-C), nitric oxide(NO), endothelin1(ET-1), and the whole blood viscosities(high-, medium-, low-shear)were measured. Liver injury were evaluated with histopathologic examination by H.E. staining. The expressions of intercellular adhesion molecule-1(ICAM-1), monocyte chemoattractant protein-1(MCP-1)in hepatic tissue were measured by immunohistochemical staining.Results The serum leves of TC(1.47± 0.10 mmol/Lvs. 3.48±0.19 mmol/L), TG(0.38±0.11 mmol/Lvs. 0.95±0.14 mmol/L), LDL-C(1.48± 0.18 mmol/Lvs. 2.39±0.22 mmol/L), ET-1(145.81±18.65 pg/mlvs. 177.70±17.70 pg/ml) in the Xiongbitong capsule high-dose group were significantly lower than those in the model group(allP<0.01), HDL-C(1.21±0.14 mmol/Lvs. 0.65±0.10 mmol/L)and NO(31.28±2.36μmol/Lvs. 19.61±1.28μmol/L) significantly lower than those in the model group(allP<0.01), the expressions of ICAM-1(0.133±0.019vs. 0.187±0.011)and MCP-1(0.153±0.014vs. 0.264±0.020)significantly lower than those in the model group(allP<0.01). The liver injury in the Xiongbitong capsule high-dose group decreased than that in the model group. Conclusions Xiongbitong capsule can protect against liver injury via regulating lipid metabolism, protecting endothelial function and down regulating expressions of MCP-1 and ICAM-1.