This paper introduces the feasibility of the case teaching practice to health care management course.Based on teaching practice,the paper discusses design,application and evaluation of the case teaching practice in health care management teaching,and put forward some recommendations for putting into practice,such as selection of case,teaching methods and skills.Thus it supplies reference to cultivate students' abilities to analyze and solve problems,and improve the teaching effect of health care management course.

Objective To analyze the impact of medical insurance reimbursement mechanism on the income of urban community health centers run by various entities. Methods The data of the baseline survey of community health centers in 28 cities made in 2007 were called into play. These data were used to compare the percentage of the annual medical insurance income from outpatient clinics of three types of community health centers in their gross annual income and their annual outpatient clinic income. Results For 929 community health centers with income from medical insurance reimbursement, the average percentage of their annual income from outpatient clinic accounts for 24% of their gross annual income and 26. 09% of their annual outpatient income;In respect of the reimbursement rates of medical insurance at outpatient clinics, the highest come from those run by enterprises, secondly those by the government,and the least those run by social organizations or individuals. Conclusion The mechanism of medical insurance reimbursement has already affected the income of the third type of community health centers. It is recommended to raise the coverage rate of medical insurance of such type of centers and their reimbursement rates of medical insurance. This may further consolidate the policies of medical insurance reimbursement.

To achieve the goal of universal healthcare coverage,and the objective of the ongoing healthcare reform to establish an essential healthcare system,the study proposed a financial framework for building the essential medical service package,covering medical services offered by primary medical institutions,treatment of major diseases,and essential medical services offered by secondary and tertiary hospitals.With data over the years of the total medical expense and medical service usage as the basis,and in the principles of affordability and cost-effectiveness,the total financing quota of essential medical services is expected to reach 1 940.846-2 1 62.41 7 billion,accounting for 30.66%-34.1 6% of the total healthcare expenditure.75% of the financing load should be carried by the government and society, focusing on financing medical services offered by primary institutions and lowering out-of-pocket burden of residents.

Objective To divide the medical services currently offered by various medical institutions into priority,extended and non-essential items.Methods The items were divided according to their actual usage at these hospitals,and such services were screened based on hospital positioning and clinical pathway of diseases.Results The selected priority services at the primary,secondary and tertiary hospitals were 255, 378 and 820 respectively.Their proportions in total medical services of these hospitals were 92.9%,95.9% and 97.4% respectively,and the proportion of their costs in total medical service costs were 57.9%,76.8% and 84.5% respectively.Conclusions The selected priority items had covered most of the services and costs,which deserve promotions at all the hospitals as it embodied the principle of benefiting the majority of the population.

Objective To determine the main contents and key points of the essential medical services by means of priority setting of diseases with high incidence and serious damage based on the demand of residential medical services.Methods The priority setting method is applied in this study,and the incidence,prevalence,hospitalization rates and the ratio of different types of inpatient are used as indicators to reflect medical demand and utilization.The integrated balance method is also used,and the priority diseases list is made based on the analysis from the view of disease onset,considering the service delivery,social equity and the health financing.Results Based on the data analysis made,this paper proposed that the priority diseases cover 29,66 and 103 types for primary hospitals,secondary hospitals and tertiary hospitals respectively.The main diseases so determined include hypertension,diabetes, maternal and child health,severe mental illness,infectious diseases,emergency treatment,etc.Conclusions The method and result of setting priority disease and main disease can be the basis of setting for main diseases in essential medical services.

Boundaries definition plays a key role in defining the scope of essential medical coverage of the country and the governmental role positioning in medical service offerings.It is also a precondition of furthering the ongoing healthcare reform.This paper analyzed the data of health service demand,supply and financing using the priority setting and the integrated balance methods.It suggested that the definition of the essential medical services should embody Chinese characteristics and be consistent with the Party′s governing philosophy and social core values.It also should be fully considered that the administration system,the governing philosophy,the medical insurance system and the government duty in the healthcare system of China.This paper proposed a multiple-criteria defining of the essential medical services,which should focus on main healthcare issues in China,and be adapted to the current healthcare reform process.Three dimensions need to be considered in the defining,which are the demand,supply and financing of the healthcare services,along with the impact of the housing,equipment,personnel, technology,supplies,drugs and other medical service elements.This paper presented the overall framework of essential medical services in four levels,which is composed of the basic package,the core package,the priority package and the expansion package.

Objective To explore the impulsivity and aggressivity,and its treatment outcomes of the inpatients with intemet addiction disorder (IAD) by intergration interview. Methods Barratt Impulsiveness Scale ( BIS), Buss Aggressive Scale (BAS) were used to assess the impulsiveness and aggressivity in 58 IAD patients, at the first week and after the point of intergration interview 3 months,54 normal subjects in the control group were conducted by BIS and BAS only when they were recruited. Results ①The intemet addiction group had significantly higher scores on the BIS and BAS total scores than the control group at the first week ( BIS score 99.3 ±15. 1vs 75.0 ± 15.4, t=8.47, P＜0. 01; BAS score 78.3 ±24.4 vs 54.8 ± 17.7, t=5.87 , P＜0. 01 ). IAD group had lower scores on the total scores of BIS-Ⅱ and BAS after intergration interview than before, but the subscales and total scores were higher than those in the control group ( BIS score 86.3 ± 16.6 vs 75.0 ± 15.4, t =4.98, P ＜ 0.01 ;BAS score 66.2 ± 22.6 vs 54.8 ± 17.7, t = 3.65, P ＜ 0. 01 ). ②Total score of SCL-90 in IAD group were significantly correlated with the BAS total score ( r=0. 376, P＜0. 01 ) ,and the decreased SCL-90 total score was also related with the decreased BAS score ( r= 0.508, P＜ 0. 01 ). Conclusion This study suggests that IAD group exhibit more impulsivity and aggressivity than those in the control group. After interview, their impulsivity and aggressivity are significantly decreased, but are still higher than those in the normal control group.

The objective of this study was to examine the inpatient bed (IB) allocation equity and utilization in Chinese city community health service centers (CHSCs). The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms of IB allocation quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.

Objective To investigate the expression of miR?126, miR?355 and exportin?5 in lung cancer. Methods The cancer tissue and the tissue adjacent to carcinoma of 47 cases of patients with lung cancer was used to detect the expression of miR?126, miR?355 and Exportin?5 by the real?time fluorescence quantitative PCR. Results Significant difference of the expression of miR?126 (t=2.02,P=0.03) and exportin?5 (t=4.62,P<0.01) was observed in lung cancer tissue and tissue adjacent to carcinoma. Mature miR?126 and pri?miR?126 (R=0.309 , P = 0.044) had a negative correlation in the tissue adjacent to carcinoma. In the cancer tissue,miR?126 and MRP (R=0.432, P=0.019), miR?335 and k167 (R=0.410, P=0.033) were positively correlated, however, exportin?5 and TOPO (R=0.357, P=0.045), the pri?miR?126 and drinking (R=0.340, P=0.024), the pri?miR?126 and MRP (R=0.427, P=0.027) had a negative correlation relationship. Conclusion Expression of miR?126 and exportin?5 was decreased in lung cancer tissue, which may contribute to the occurrence and development of lung cancer.

Objective To evaluate the curative efficacy and adverse events of in vitro hyperthermia in combination with chemotherapy for treating patients with advanced pancreatic carcinoma .Methods Seventy-five patients with advanced pancreatic carcinoma by pathologic diagnosis admitted in Beijing Friendship Hospital were enrolled and randomly divided into Group Combination ( hyperthermia and chemotherapy ) and Group Chemotherapy at the ratio of 1∶1.All the patients were treated for 4 cycles and the clinical efficacy were evaluated.Results After being treated for 4 cycles, the number of the patients in Group Chemotherapy who had complete response(CR), partial response(PR), stable disease(SD), progressive disease(PD) was 0, 10, 10 and 17, the objective response rate (ORR) was 27.0%, and the disease control rates (DCR) was 54.1%, which in Group Combination was 0, 18, 15 and 5, and 47.4% and 86.8%, respectively.DCR between the two groups was statistically significantly different ( P=0.002 ), but there was no statistical significance on DCR(P=0.069).In Group Combination, the pain relief rate and physical fitness improvement rate was 92.1% and 84.2%, which were significantly higher than 21.6% and 27.0% in Group Chemotherapy, which had statistical significance ( both P<0.05 ).The median survival time and 1-year survival rate in Group Combination was 8.8 months and 31.6%(12/38), which in Group Chemotherapy was 17.86 months and 27.0%(10/37), and there was no statistically significant difference between the two groups .The adverse events in two groups were mild , and no digestive tract reaction with III and IV degree and bone marrow suppression with IV degree were observed .Conclusions DCR and symptom improvement rate in Group Combination were higher than those in Group Chemotherapy , while the adverse events were mild , and patients could tolerate .This combination therapy was worthy of clinical application .