With the rapid increase in health cost and transformation of modern medicine, how to allocate the health care resources rationally and increase the efficiency and equity has become the common issues in all coun-tries. Health Economics, a new discipline, has provided possible answers to the issues and attracted attention from both government and academics. This paper introduces the goals, methods, contents and textbooks in US. universities and puts forwards suggestions for health economics education in China.

Objective To determine the dynamic changes of ileum epidermal growth factor(EGF),transforming growth factor-α(TGF-α)and epithelial growth factor receptor(EGFR)in neonatal rats with intestinal injury and to investigate their role in the neonatal necrotizing enterocolitis(NEC). Methods One-day-old Wistar rat pups were divided into two groups.The rats in the lipopolysaccharide(LPS)-injected group(n=40)received an intraperitoneal injection with 5 mg/kg LPS and those in the control group(n=8)did not.Control group and LPS-injected group at 1,3,6,12 and 24 h following LPS challenge were sacrificed for histological evaluation of NEC and for measurernents of EGF,EGFR,EGFR mRNA and TGF-α mRNA. Results Compared with the control group(0.12 0.17).the LPS-iniected pups showed a significant increase in injury scores at 1,3,6,12 and 24 h(1.28±0.62,1.75±0.74,1.98±0.75,2.85±0.41 and 2.35士0.63,respectively)(P<0.01).EGF protein levels at 1,3,6,12,24 h[(235.9±44.3)pg/mg prot,(231.8±30.0)pg/mg prot,(223.3±48.1)pg/mg prot,(211.7±47.0)pg/mg prot and(221.4±39.0)pg/mgprot,respectively]were significantly lower than that of the control group[(287.7±42.6)pg/mg prot](P<0.05).There was a negative correlation between the EGF levels and the grade of intestinal injury within 24 h(r=1.000,P<0.01).The expression of EGFR protein and mRNA was increased after LPS administration.There was no correlation between the EGFR protein and the grade of intestinal injury(r=0.800,P>0.05).The expression of TGF-α mRNA was significantly up-regulated at 1 and 3 h following LPS injection. Conclusions Reduced levels of EGF may play a pivotal role in the pathogenesis of NEC.

This paper reviews studies on the relationship between health insurance and health status both at home and abroad. First, we put forward three viewpoints on their relationship;Second, based on different data, we review the studies from three different perspectives; Third, we review the recent studies at home. The paper draws the conclusion as following:(1) most studies on observational data prove that there is relationship between health in-surance and health status. To establish the causal relationship between them, we must overcome the endogeneity of health insurance. ( 2 ) Different studies have different conclusions, which are caused by different methodology and subjects. (3)The conclusions cannot be generalized to whole populations. Future studies should focus on the effect of different health insurance on different populations.

Objective The early stage of neonatal sepsis is short of specific clinical manifestations that easy to be misdiagnosed.This study aimed to demonstrate the clinical value of combined markers[proca-icltonin(PCT)and C-reactive protein(CRP)]in the early diagnosis of neonatal hospital-acquired infections by dynamic monitoring of PCT and CRP.Methods The study included 111neonates in the 1st Neonatal Ward of Shengjing Hospital from June 2013to August 2014which were divided into three groups and retro-spectively reviewed,including 37cases of diagnosed sepsis group,42cases of clinical sepsis group,and 32ca-ses of control group(non-sepsis neonates).We measured the serum levels of PCT and CRP in two sepsis group before antibiotic administration,12h and 24h after infection,3d and 7d after infection controlled,and in the control group before antibiotic administration.Results Before antibiotic administration,serum levels of PCT and CRP were significantly higher in two sepsis groups than in the control group(P﹤0.01).In two sepsis groups,PCT reached peak at 12h after infection[(15.00±15.51)ng/ml and(17.93±13.44)ng/ml] and decreased to normal at 3d after infection controlled[(0.49±0.47)ng/ml and(0.42±0.34)ng/ml];CRP reached peak at 24h after infection[(37.53±30.29)mg/L and(32.41±29.33)mg/L]and decreased to normal at 7d after infection controlled[(5.72±2.98)mg/L and(5.06±3.07)mg/L].The optimal cut-off values were PCT﹥2ng/ml and CRP﹥10mg/L(Youden index 76.11%,59.45%),the sensitivity were 88.61%and 75.70% ;specificity were 87.5% and 83.75% ;positive predictive value were 94.59% and 95.65% ;negative predictive value were 75.68%and 46.15%.Receiver operating characteristic area under the curve were 0.964,0.887.Conclusion In early stage of sepsis,both PCT and CRP increase.The optimal cut-off values are CRP﹥10mg/L and PCT﹥2ng/ml.CRP reaches peak at 24h after infection,decrease to normal at 7d after infection controlled,while PCT reaches peak at 12h after infection,decrease to normal at 3d after infection controlled.Combined detection of PCT and CRP can improve the sensitivity and specificity of the early diagnosis of neonatal hospital-acquired infections.

Epithelial-mesenchymal transition( EMT) refers to the transdifferentiation from epithelial cells to mesenchymal cells. The initial understanding of EMT is originated from the research on embryonic develop-ment,followed by the discovery of EMT phenomenon in physiological and pathological process in multicellular organism. In recent years,the occurrence and development of infiltration and metastasis of tumor cells along with fibrotic diseases that related to EMT are becoming the hot researches nowadays.

0.05). However, the MDA level in the experimental group was higher than that of the control on day 3 [(55.92?5.53)nmol/mg prot vs (22.52?4.36)nmol/mg prot, P

miRNAs are a group of 22 ~25 nucleotides endogenous non-coding RNAs,which regulate gene expression at the post-transcription level by cause the degradation or translational suppression of target mR-NAs.In recent years,studies have demonstrated that miRNAs widely participate in cell differentiation,prolifera-tion,organ development and lipid metabolism,and are closely related to the formation of many kinds of diseases. The biological function of miRNAs and their effects on regulating prenatal and postnatal lung development are reviewed in this paper.

Objective To investigate the correlation between brain injury and premature infants with bronchopulmonary dysplasia (BPD)and to analyze the risk factors of brain injury in premature infants with BPD based on MRI changes.Methods A total of 1 13 premature infants diagnosed with BPD were studied as case group from January 2010 to December 2014 at the neonatal ward of Shengjing Hospital of China Medical University.One hundred and sixty-two premature infants without BPD were selected as control group.There were no significant differences in gestational age and birth weight between the two groups.All cases were per-formed MRI examination in hospital.The occurrence of brain injuries(white matter injury and intracranial hemorrhage)were compared based on MRI changes between the two groups,and the risk factors of brain in-jury in case group were analyzed.Results The case group and control group were performed MRI on (33.73 ±16.00)d,(24.40 ±12.29)d after birth respectively.The ratio of brain injury,intracranial hemor-rhage,cerebral white matter damage and severe brain injury of case group was higher than those of the control group(48.7% vs.32.7%,3 1.9% vs.21.6%,31.9% vs.21.6%,16.8% vs.8.6%,respectively).The differences were significant in the ratio of brain injury and severe brain injury (P =0.008,P =0.040,respec-tively).Logistic regression analysis showed that postnatal infection was a risk factor for brain injury of the case group(OR =2.21 ,95%CI 1.04 ~4.72,P ﹤0.05).Conclusion More brain injury(including the white matter injury and intracranial hemorrhage)and severe brain injury(including grade III ~IV intraventricular hemorrhage and periventricular leukomalacia)are detected in premature infants with BPD.Postnatal infection is a risk factor of brain injury for premature infants with BPD.

Objective To investigate the changes of epithelial sodium channel(ENaC) expression and sodium and water transport function in the neonatal rat pulmonary edema induced by hyperoxia.Methods The neonatal rats were randomly divided into the hyperoxia group and the control group.After 1,3,5 and 7 d hyperoxia exposure,the lung tissues were collected to measure the wet-to-dry weight ratio and the expression of α-,β-and γ-ENaC subunits were detected by western blot analysis.Alveolar fluid clearance (AFC) and amiloride-sensitive AFC were measured after 5 d to reveal the effect of hyperoxia on the activity of ENaC.Results The lung water contents significantly increased in the hyperoxia group indicating that pulmonary edemahappened(3 d:(6.37 ±0.64) vs (5.56±0.15),t=3.46,P＜0.01;5 d:(5.86 +0.52) vs (5.11±0.21),t=-3.82,P ＜0.01;7 d:(5.56±0.45) vs (4.80±0.09),t =-4.72,P ＜0.01).AFC increased significantly,but no significant difference was found in amiloride-insensitive AFC between the two groups which indicate that amiloride-sensitive AFC increased significantly (AFC:(20.32 ± 3.33) ％ vs (12.97 ± 2.46) ％,t =-6.16,P ＜ 0.01 ; amiloride-insensitive AFC:(10.42 ± 3.44) ％ vs (8.67 ± 3.13) ％,t =-1.30 P =0.21).The expression of α-,β-and γ-ENaC did not reduced after hyperoxia exposure compared with the control group.Conclusion Although bronchopulmonary dysplasia of early pulmonary edema induced by hyperoxia,dysfunctional transport of Na + may not be a key factor involved in pulmonary edema at the early stage of bronchopulmonary dysplasia.

Objective To investigate the early MRI performance and the evolution of premature infants who developed into periventficular leucomalacia (PVL) eventually.Methods Twelve premature infants diagnosed as PVL by MRI in the department of neonatology in Shengjing Hospital of China Medical University from Jan 2010 to Dec 2013 were selected,all of the cases underwent conventional MRI and diffusion-weighted imaging (DWI) examination twice,the first examinations were finished in 2 to 7 days (mean 5.5 d) after birth and the second examinations were taken in 17 to 23 days(mean 20.3 d).Results The first examination showed:all cases performed high signal intensity of periventricular matter,including 6 diffuse and symmetrical,3 linear and 3 clustered high signal.However,only 5 of the 12 cases showed slightly high signal on T1 weighted image with low signal on T2 weighted image on conventional MRI,the other 7 cases showed no change;for the reexamination:foci of different numbers and sizes showed up in all cases,with the performance of low signal on T1 weighted image,high signal on T2 weighted image and low signal on DWI correspondingly.Conclusion DWI is superior to conventional MRI in finding and forecasting PVL;diffuse white matter damage have more probability to develop into PVL,severe local white matter damage such as multi-clustered and linear damage also can develop into PVL.