Health economics is an important part of general education for medical students,but the traditional,professional-education-oriented health economics courses do not adapt to the requirements of medical students' general education,which makes it necessary to reconstruct the course based on the concept of general education.Firstly,the course target should be reestablished with the full implementation of general education concept.Secondly,the teaching contents should be comprehensively optimized with a substantial streamlining of traditional content system.Thirdly,the teaching methods should be improved in order to meet the demands of the target.Finally,according to the teaching practice,it is suggested that more effort should be put on the teaching ability of teachers,the mining of new methods and cases,and the construction of high quality teaching materials.

Objective:To explore the effect of costunolide on sensitivity of chronic myeloid leukemia cell line K562/ADR to doxorubicin and its mechanism.Methods:K562/ADR cells in the logarithmic phase were used, and the cells were treated with different concentrations of costunolide, doxorubicin or costunolide combined with doxorubicin for 72 h. The cell proliferation was detected by CCK-8 method, the cell proliferation rate was calculated, and the half inhibitory concentration (IC 50) of the two drugs was obtained. The cells were treated with 10 μmol/L costunolide, 10 μmol/L doxorubicin or costunolide combined with doxorubicin for 48 h, the apoptotic rate was detected by flow cytometry, and the expression level of p38-MAPK pathway related proteins was detected by Western blot. Results:The cell proliferation rate in the costunolide combined with doxorubicin group was lower than that in the corresponding concentration of the two drugs alone groups, and the differences were statistically significant both ( P < 0.05). The IC 50 of doxorubicin for K562/ADR cells was (13.50±0.86) μmol/L, and costunolide was (7.30±0.55) μmol/L ( t = 7.044, P = 0.002). The results of flow cytometry showed that the apoptosis rate of K562/ADR cells in the 10 μmol/L costunolide combined with 10 μmol/L doxorubicin group was higher than that of the blank control group, costunolide alone group and doxorubicin alone group, and the differences were statistically significant [(19.68±3.21)% vs. (2.96±0.87)%, (9.34±2.89)%, (9.18±2.13)%, all P<0.01]. Compared with the 10 μmol/L costunolide alone group and the 10 μmol/L doxorubicin alone group, the expression of the apoptosis inhibitor protein bcl-2 in the two-drug combination group was down-regulated, and the expressions of bad, p-p38, cleaved-caspase-3 and cleaved-PARP proteins were up-regulated. Conclusion:Costunolide can enhance the inhibitory effect of doxorubicin on the proliferation of K562/ADR cells and promote doxorubicin-induced apoptosis, which may reverse the drug resistance of K562/ADR cells by regulating the p38-MAPK pathway.

From July 1997 to March 2000, internal fixation of posterior transpedicular screw system and posterolateral autograft bone graft fusion procedures were used in 25 patients suffering from Pott's paraplegia in our department. 17 of them were involved in a longitudinal study and followed up for a mean of 2(1 5～4)years postoperatively. The beginning of neurologic recovery was during the first 2 to 3 weeks postoperatively in 16 patients. 9 were completely recovered,7 were partly recovered 6 months postoperatively. At final follow up, 2 of the 7 patients were completely recovered, 5 had significant improvement of one grade(2 patients) or two (3 patients) according to ASIA Grades. It is concluded that internal fixation of posterior transpedicular screw system and posterolateral autograft bone graft fusion procedures were found to be helpful in strengthening the stability of the spine in spinal tuberculosis, providing successfu recovery of paraplegia and preventing the recurrence of paraplegia.

Objective To introduce the operative procedure of prosthetic disc nucleus(PDN)re-placement and investigate its clinical effectiveness in the treatment of lumbar disc herniation.Methods Nine cases of lumbar disc herniation were treated with PDN replacement from March2002to April2002.There were6males and3females,the average age of the patients was33.4years ranging from22to48years.The interval between the onset of the symptoms and the diagnosis was averagely18.4months,ranging from8months to3.6years.All of the patients were evaluated by anteroposterior and lateral radiography,computer-ized tomography and,if necessary,magnetic resonance imaging.The low back pain was predomi nant in two patients,the low back pain associated with radicular leg pain in6patients.The height of disc space became narrowed in varying grade.The operated level was at L 4-5 in6patients,L 5 S 1 in3patients.The standard pos-terior approach was used in8patients;the anterior lateral retroperitoneal approach was adopted in1patient.8cases were implanted with a single PDN,and1case with a couple of PDNs.Results All patients were followed up12to13months(average12.3months).The estimated intraoperative blood loss ranged from50to150ml (mean120ml ),and the total operation time ranged from45to120min(mean60min).The patients wore a brace for the first6weeks.Based on Oswestry low back pain and dis ability scores,the clinical successful rate was88.9%.The average percentage of the postoperative to preoperative disc height was128%.The slight displacement of PDN was observed in2patients,however there was no change of lumbar spinal mo bility.1patient had a bad recovery of back and leg pain.Conclusion PDN re placement can improve clinic symptoms,increase disc height and restore the normal lumbar motion as well.Its clinical effectiveness is excellent in short-term observation.

Diagnosis before procreation is an important examination in pregnancy.It could find out abnormity during the period of fetation,so we could use techniques like terminating pregnancy treatment in the uterus to improve the quality of babies.However,with the development of obsteric techniques,people can choose their baby's gender,as a result,it will certainly break the balance between male and female.It can impair the development of human being,so we have to deal with more ethical problems.

Biogenic molluscicides refer to the use of plants,animals and micro?organisms or their metabolites,and synthesis biomimetic molluscicides to kill Oncomelania hupensis snails. With the rapid development of science and technology,new bio?genic molluscicides are continuously emerging and the category also continues to expand. According to the molluscicidal active ingredient and sources,at present,the biogenic molluscicides with in?depth studies include plant?derived molluscicides,micro?organism molluscicides,microbial metabolite molluscicides and animal molluscicides. This paper reviews the advances in the re?searches of biogenic molluscicides in recent years.

Objective To discuss two simulation studies on the closed and open peritoneum in abdomenal operations. Meth-ods We selected 120 domestic female rabbits from animal laboratory of Qi Qi Ha’er Medical College at random and divided them into four groups(according to whether the peritoneum was open or not,the degree of peritoneum defect at the right side of incision and the existence of peritoneum hemorrhagic focus ),with 30 cases in each group. Group Ⅰ: no peritoneum suture and making a defect of 4cm?3cm at the right side of the incision; Group Ⅱ: no peritoneum suture and making a defect of 4cm?3cm at the right side of the incision,with a hemorrhagic focus at peritoneum defect;Group Ⅲ: with peritoneum suture; Group Ⅳ:with dense and compact peritoneum suture.And then we analyzed postoperative peritoneum healing progress. Results Observeations of the incision infection by the naked eye were that one case was identified in group Ⅰ,Ⅲ and Ⅳ;and a significant difference of occurrence rate was identified between the fallowing groups: groupⅠandⅡ(P

Cutaneous dyschromia is a common problem of plastic and cosmetic surgery. There are not good methods to resolve this problem in present. The mechanisms of skin pigmentation process are not well understood. It is now recognized the correlation between melanogenesis and alpha-melanocyte-stimulating hormone. Alpha-msh enhances activity and quantity of tyrosinase as well as stimulates melanogenesis, specifically to stimulate eumelanin synthesis by activating the melanocortin-1 receptor (MC-1R) on melanocytes. Alpha-msh stimulates melanocyte prolixferation, formation of dendricity, and transfer of melanosomes to keratinocytes, It also protects melanocytes from the damaging effects by immunomodulation. Also, alpha-msh interact with other factors to affect pigmentation indirectly. Agouti signaling protein(ASIP) is a endogeneous antagonist of alpha-msh can induces pheomelanin synthesis by competing with alpha-msh for binding to the MC-1R.Follwing better understood the mechanisms of skin pigmented process, it will provide effective methods to resolve acquired human cutaneous hyperpigmentation and hypopigmentation.

Impaired ability to undergo apoptosis in response to a wide range of external stimuli acquires melanomas a selective advantage for progression and metastasis as well as their notorious resistance to therapy. Changes at genomic, transcriptional and post-translational levels of G-proteins and protein kinases (Ras) , their transcription factor effectors (c-jun,ATF2, stat3 and NF-?B) and upregulator of antiapoptosis gene (Bcl-2、Bcl-X_L、survivin、ML-IAP)affects apoptosis-induced of TNF, Fas and TRAIL receptors, which play important roles in acquiring melanoma's resistance to apoptosis. The complexity of the molecular variants involved in signal transduction along apoptotic pathways suggests that the cell may have a variety of possibilities for regulating apoptosis and generating apoptosis deficiency.

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.