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Aiming at the problems faced by the medical postgraduate students in the cooperative medical education and the classified training mode,combined with the characteristics of the cultivation of medical postgraduates,the article constructed the quality guarantee system of graduate education based on project management.From the three dimensions of time dimension,corpus dimension and objective dimension,the article established a model of training quality guarantee system and analyzed the four work modules:construction of project organization,standardization of whole life cycle process,control of project quality and integration of project information.In addition,the article introduced the practice of this quality guarantee system in Binzhou Medical University.
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Objective: To investigate the effect of serum growth differentiation factor-15 (GDF-15) in patients with acute ischemic stroke (AIS). Methods: Our research included 2 groups: AIS group,n=120 patients and Control group,n=60 normal subjects from regular physical examination. The serum levels of GDF-15 were examined within 24 hours of AIS attack by ELISA in both groups, the relationship between GDF-15 and the neurologic impairment was assessed. According to modiifed ranking scale score after 3 months follow-up study, the AIS patients were further divided into 2 sub-groups: Disabled group, the patients with MRS ≥ 2, n=65 and Non-disabled group, the patients with MRS < 2,n=55. The GDF-15 levels were compared between 2 sub-groups. Results: GDF-15 level in AIS group was 1594.00 (1128.00-2411.00) ng/L which was signiifcantly higher than that in Control group 656.00 (507.00-764.00) ng/L,P<0.05. GDF-15 level was positively related to neurologic impairment in AIS patients (r=0.390, P<0.001). Modiifed ranking scale score indicated that after 3 months of follow-up study, GDF-15 level in Disabled group was 2411 (2188-2569) ng/L which was much higher than that in Non-disabled group 1128 (980-1597) ng/L, (Z=-5.684,P<0.001). Conclusion: The serum level of GDF-15 was higher in AIS patients than normal subjects, it was positively related to neurologic impairment, AIS patients with higher GDF-15 would have poor prognosis.
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Objective To study the effects of Tongqiao-Huoxue decoction on neuron apoptosis in the CA1 region of the hippocampus and the serum nidogen expression of vascular dementia(VaD) rats and to investigate its mechanism. Methods 40 healthy male SD rats were randomly divided into a normal group, a sham operation group, a model group, a TCM group, and a placebo group. VaD rat models were established by Olsson method. After the models were successfully prepared, the rats in the TCM group were fed Tongqiao-Huoxue decoction, the rats in the placebo group were fed distilled water. Morris water maze test was adopted to investigate their learning and memory abilities, TUNEL was used to assay hippocampal CA1 neurons apoptosis, ELISA kits was used to detect Nestin serum levels . Results The neuron apoptosis index in the CA1 region of the hippocampus in the TCM group was(37.01±2.23)%,which was(55.15±1.54)%in the placebo group;the difference was statistically significant(P<0.05).The serum nidogen was(4.47±0.31)ng/L in the TCM group, which was(3.42±0.43)ng/L in the placebo group;the difference was statistically significant(P<0.05). Compared to the VaD group, escape latency in the TCM group in the third, forth, and fifth day was significantly shorter(P<0.05), the number of cross platforms were significantly increased(t=3.521, P=0.000). Conclusion Tong qiao-Huoxue decoction can improve learning and memory impairment in VaD rats, which may be associated with its increasing serum nidogen expression and decreasing the neuron apoptosis in hippocampal CA1.
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Objective To investigate the correlations between the hippocampal acetylcholine (ACh) content and neuronal apoptosis in the hippocampal CA1 region as well as the spatial memory impairment in a rat model of vascular dementia (VaD).Methods Forty male healthy Sprague-Dawley rats were randomly divided into either a VaD group or a sham operation group (n =20 in each group).A VaD model was induced by intermittently clipping common carotid artery.Microdialysis was used to collect dialysis solutions in rat hippocampus.High-performance liquid chromatographic analysis was used to detect the ACh content in the dialysis fluid.Morris water maze test was used to test their learning and memory abilities.TUNEL staining was used to detect neuronal apoptosis in the hippocampal CA1 region.Results Microdialysis analysis showed that the ACh content in the hippocampus in the VaD group was significantly lower than that in the sham operation group (0.442 ± 0.028 μmmol/L vs.1.560 ± 0.092 μ mmol/L; t =51.697,P =0.000).TUNEL staining showed that the apoptosis rate in the hippocampal CA1 region in the VaD group was significantly higher than that in the sham operation group (55.652％ ±2.051％ vs.6.530％ ± 1.872％ ; t =79.114,P=0.000).The escape latencies at different detection time points were prolonged significantly (At day 3:49.713 ± 18.161 s vs.13.322 ± 2.454 s; t =-8.881,P =0.000; at day 4:34.368 ± 7.424 s vs.10.503±1.415 s; t=-14.121,P=0.000; at day 5:30.676± 6.669s vs.7.311± 1.534 s; t=-15.270,P =0.000),and the numbers of cross platform were reduced significantly (3.768 ± 1.072 vs.10.218 ± 1.165; t =18.224,P=0.000).Pearson correlation analysis showed that the ACh contents in the VaD group were negatively correlated with the escape latencies (at day 3:r =-0.476,P =0.034; at day 4:r=-0.700,P=0.001; at day 5:r=-0.693,P=0.001).They were positively correlated with the numbers of cross platform (r =0.689,P =0.001),and negatively correlated with the neuronal apoptosis rates in the hippocampal CA1 region (r =-0.271,P =0.031).Conclusions The decreased ACh content,the increased neuronal apoptosis rate in the rat hippocampal CA1 region in the VaD model may be one of the mechanisms of cognitive impairment in VaD rats.
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ObjectiveTo explore the expression of hemopoietin(EPO) mRNA on cerebral ischemia-reperfusion injury in rats brain tissue and the effect of Tongxinluo on it.Methods The model of rat (MCAO) were perfused with Tongxinluo,the changes of neural stem cell proliferation and differentiation related cell factors of EPO mRNA were detected after ischemia-reperfusion injury 3、5、7、14 d by means of reverse transcriptase polymerase chain reaction(RT-PCR).ResultsEPO mRNA of ischemia-reperfusion models showed expression in different period,the expression enhanced in the third day,reached the highest in the fifth day; the ischemia side EPO mRNA expression enhanced in the third day after give Tongxinluo,in the 5,7 and 14 day,PCR expression gray values were higher than the model group.ConclusionEPO mRNA expression enhanced after cerebral ischemia,this expression can be strengthened by Tongxinluo,and may further induce neural stem cell proliferation and differentiation.
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Objective Idiopathic pulmonary fibrosis (IPF) and nonspecific interstitial pneumonia (NSIP) are the two largest subsets of idiopathic interstitial pneumonia (IIP). They have a sharply differences in therapy and survival, however, the identification of them is difficult In general, NSIP has a much better responsiveness to therapy and good survival On the other hand, in IPF, was demonstrated to be associated with poorer survival and responsiveness to therapy. To diagnosis of IPF and NSIP need histopathologic classification which however, requires surgical lung biopsy. Therefore, we try to set up an equation using those data from non-invasive methods to identify IPF and NSIP. Methods A retrospective review of 32 patients with IPF (n = 14) and NSIP (n = 18) was carried out. General clinical data, pulmonary function, chest radiographic, and bronchoalveolar lavage fluid were recorded. The statistical methods of logistic regression and multiple linear regression are used to establish the equation. The method of curve fitting is used to find the critical value of the equation to the differential diagnosis between the IPF and NSIE Results (1) Compare to NSIP, patients of IPF are older, more males than females, having a bigger proportion of smokers. (2) Compared with NSIP patients, IPF patients have higher CT score of "grid shadow", "cellular shadow" and lower CT score of "ground-glass shadow". (3) Bronchoalveolar lavage (BAL) lymphocytosis was more frequently observed in NSIP than IPF. (4) We get an equation: y = 0. 9 + 0. 123x1 -0. 045x2 +0. 009x3 +0. 033x4 and it can improve the differential diagnosis between the IPF and NSIP in this group of patients. Conclusion Clinical,high resolution computerized tomography and BAL are useful non-invasive tools in diagnosis IPF and NSIP. The equation: y = 0.9 + 0. 123x1 - 0.045x2 + 0. 009x3 +0. 033x4 can help us to distinguish the IPF and NSIP.
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Objective: To study the therapeutic method of treating hypertensive cerebral hemo rrhage and to evaluate the curative effects.Methods: Thirtynine cases (A group) with hypertensive cerebral hemorrhage wer e treated wit h therapeutic method of internal medicine and other 40 cases (B group) treated with internal medicine combined with traditional Chinese herbs fed via gastric tube plus drawing hematoma through skull pun cture.Results:The cured rate (32.5%) and effective rate (90.0%) in B group were signific antly higher than those in A group (10.3％ and 46.2％ respectively) meanwhil e the complete obsorbsion and clearan ce time of hematoma were significantly shorter,and the complications were lesse r.Conclusions:The therapeutic method of traditional Chinese herb fed via gastro tube combined with drawing through skull puncture for treating hypertensive cere bral bleeding is easy to manipulate and worth spreading.