The interdisciplinary nature of health economics brings certain difficulty to the teaching of this course, so it is very important to rationally design and use case teaching. According to the characteristics of the course, this paper put forward design ideas from the guiding ideology, selec-tion, categories and forms. This paper argued that teacher should play a leading role and create a good learning environment and grasp four parts of the implementation.

Objective To investigate the effect and significance of minimally invasive removal of intracranial hematoma on the blood-brain barrier in patients with intracerebral hemorrhage (ICH).Methods Clinical data of 20 patients with ICH were randomly selected and received minimally invasive surgery (operative group) and 20 patients with ICH received expectant treatment therapy (expectant treatment group) were analyzed retrospectively,and 20 healthy people were randomly collected for control group.The blood-brain barrier (BBB) and serum myelin basic protein (MBP) concentration were analyzed.Results The BBB index of the iperative group was 0.0075 ± 0.0007,the expectant treatment group was 0.0083 ± 0.0006 and the control group was 0.0068 ± 0.0004.The BBB index in the operative group was significantly lower than that in the expectant treatment group (P ＜ 0.05),and the BBB index in these two groups was significantly higher than that in the control group (P＜ 0.01).The serum MBP concentration in the operative group was (3.29 ± 1.55) μg/L,the expectant treatment group was (6.55 ± 3.78) μg/L,and the control group was (1.12 ± 0.48) μ g/L.The serum MBP concentration in the operative group was significantly lower than that in the expectant treatment group (P ＜ 0.05),and these two groups were significantly higher than the control group (P ＜ 0.01).Conclusions The permeability of BBB in patients with ICH are increased,the BBB index and the serum MBP concentration in patients with ICH are increased,minimally invasive surgery can reduce the lesion of cytotoxicity to BBB and cerebral edema.

Chitin is one of the most important component in fungal cell wall.Biosynthesis of chitin is a complex processes and needs several chitin synthase isoenzymes.The knowledge of structure,function and regulation of chitin synthases is mainly derived from the study of Saccharomyces cerevisiae.In contrast with the 3 chitin synthases in S.cerevisiae,7 were found in most filamentous fungi.In this review the classification and function of chitin synthases are summerized,and progress in the studies on chitin synthases of filamentous fungi which are of theoretical or medical or agricultural importance,including Aspergillus nidulans,Aspergillus fumigatus and Ustilago maydis are emphasized.Recent ad-vance of research on chitin synthase as antifungal target is also discussed.

Department ofPediatrics,the Maternal and Child Health Hospital ofHuzhou,Huzhou,Zhejiang 313000,China(Shen ZZ)Objective To observe the effect of phentolamine in the treatment of severe hand foot and mouth disease with acute pulmonary edema.Methods 90 children with severe hand foot and mouth disease and acute pul-monary edema from January 2014 to December 2015 in our hospital were selected as the research subjects.All the children were randomly divided into 45 case of the observation group and 45 case of the control group.They were given conventional drug therapy and positive pressure ventilation,the control group was given milrinone,5μg/kg,the obser-vation group was given phentolamine,5μg/kg.The myocardial enzymes and cardiac troponin were detected before intervention and after 72h intervention,the blood gases index and ventilator parameter were analyzed,and the time of ventilator support and hospital stay were compared.Results (1)The CK -MB,CK,troponin of the observation group and the control group after treatment were (17.52 ±1.33)U /L and (28.23 ±3.89)U /L,(120.42 ±6.21)U /L and (150.86 ±8.67)U /L,(0.46 ±0.07)μg/L and (0.96 ±0.06)μg/L,which were significantly higher than before treatment (t =5.024 and 8.455,9.353 and 14.757,6.356 and 9.505,all P <0.01),but the CK -MB,CK,troponin of the observation group after treatment were significantly lower than the control group (t =5.601,7.426,5.829,all P <0.01 ).(2)The PaO2 and PaCO2 of the intervention group and the control group after 72h intervention were (80.24 ±14.35)mmHg and (62.30 ±5.68)mmHg,(39.38 ±6.08)mmHg and (46.10 ±3.42)mmHg respectively, which were significantly improved than before treatment,the differences were statistically significant (t =11.352 and 7.204,7.827 and 5.287,all P <0.01),there were statistically significant differences between the two groups after the intervention (t =7.426,5.829,all P <0.01).The FiO2 ,PIP,PEEP of the two groups after treatment were significantly lower than before treatment,the differences were statistically significant (t =8.446 and 6.905,9.705 and 7.832, 8.605 and 6.889,all P <0.01),there were statistically significant differences between the two groups after the inter-vention (t =3.461,5.165,4.532,P <0.05 or P <0.01).(3)The time of mechanical ventilation and hospitalization in the observation group and the control group were (3.42 ±1.61)d and (5.06 ±2.15)d,(15.40 ±3.62)d and (18.62 ±3.81)d,the differences were statistically significant(t =3.513,3.734,all P <0.05).Conclusion Phent-olamine has better effect than milrinone in the treatment of severe hand foot and mouth disease with acute pulmonary edema,it can control the disease progression and improve clinical outcomes and has better clinical value.

Objective　The conditional hierarchical clustering for 1-dimensional(1-d) ordinal data was discussed.Methods　Because the individuals are ordered in 1-d,the conditional matrix was constructed with all elements in the second-diagonal are 1 and the others are 0.Distance matrix of individuals defined by some particular definition.Then the conditional-distance matrix was made for the hierarchical clustering by connecting the conditional matrix and distance matrix.This method was called 1-dimentsional conditional hierarchical clustering.An example was illustrated by this method and a Monte Carol study showed that method was feasible and robust.Results　Compared with the least-squares partition,this method is easy to understand,easy to practice and easy to compute.It also can give us a stable result.Conclusion　Because of the austere theory,the simple thought and the convenient application,it's a good method for the 1-d ordinal data.

The study is to explore the effect of paeoniflorin on the level of glucocorticoid receptor, including glucocorticoid receptor-alpha (GCRalpha) and glucocorticoid receptor-beta (GCRbeta), of peripheral blood mononuclear cells (PBMCs) in rats of collagen-induced arthritis (CIA). CIA is induced in Wistar rats by an intradermal injection of bovine type II collagen emulsified with complete adjuvant. From the 14th day after primary immunization, the CIA rats were intragastrically administered paeoniflorin 25, 50 and 100 mg x kg(-1) or triptolde 20 microg x kg(-1) or paeoniflorin 50 mg x kg(-1) + RU486 15 mg x kg(-1), once a day, for 28 consecutive days. After administration, apart from PF + RU486 group all experimental rats were took blood by removalling eyeball, then separated PBMCs. The level of GCRalpha, GCRbeta in PBMCs were examined by ELISA, and the mRNA expression of GCRalpha, GCRbeta was detected by RT-PCR. All rats were sacrificed and took the joint with no immunization. The expression of IL-1beta, NF-kappaB p65, TNF-alpha, PGE2 of synovial tissue was detected by immunohistochemistry. Paeoniflorin was able to inhibit the expression of IL-1beta, NF-kappaB p65, TNF-alpha, PGE2 of synovial tissue in CIA rats. While RU486, glucocorticoid receptor's blocker, could weaken the fuction of paeoniflorin. Meanwhile, paeoniflorin obviously induced the expression of GCRalpha and GCRalpha mRNA, while obviously inhibited the expression of GCRbeta and GCRbeta mRNA. These results indicat paeoniflorine suppresses inflammatory mediator production may be relating with it regulating GCR in PBMCs of CIA rats.
Animals ; Arthritis ; chemically induced ; drug therapy ; genetics ; metabolism ; Cattle ; Collagen ; adverse effects ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Glucosides ; administration & dosage ; Humans ; Leukocytes, Mononuclear ; drug effects ; metabolism ; Male ; Monoterpenes ; administration & dosage ; Rats ; Rats, Wistar ; Receptors, Glucocorticoid ; genetics ; metabolism

AIM:Neural stem cells(NSCs)and their supporting factors are related to nerve regeneration after central nerve injury, but there are few evidences for the changes of NSCs and their derived supporting factors.This study explores the change of NSCs and gene expression of stem cell-derived neural stem/progenitor cell supporting factor(SDNSF)in the injured spinal cord tissues of rats,and investigates the relation between the NSCs and expressions of SDNSF. METHODS:The experiment was carried out in the laboratory of Nantong University Neuroscience Institute between September 2005 and March 2006.①A total of 27 SD rats,cleaning grade,were offered by the Animal Experimental Center of Nantong University.Twelve rats used for immunohistochemistry assay were divided into sham operation group and spinal cord injury group,while other 15 rats used for RT-PCR detection were assigned into sham operation group and spinal cord injury group.All the disposals were in agreement with the ethical standard for animals.②The spinal cord contusion model of rats was established according to Allen's falling strike method.Laminectomy was conducted without strike in the sham operation group.The quantity and morphology of NSCs,gila cells and SDNSF-positive cells were observed by immunochemistry to detect expressions of nestin,glial fibrillary acidic protein(GFAP)and SDNSF in the injured spinal cord on days 8 and 16 after injury.The expression of SDNSF mRNA in the injured spinal cord was studied by semi-quantitative RT-PCR on days 4,8,12,16 after injury. RESULTS:①There were nestin-positive cells about central canal of spinal cord in the sham operation group.The nestin-positive cells showed erupted roots,migrated peripherally and proliferation,some GFAP-positive cells emerged and the SDNSF-positive cells were observed,which were similar to neuron on morphology on day 8 after injury.The quantity of nestin-positive cells decreased obviously,there were a number of GFAP-pesitive cells and few SDNSF-positive cells were showed on day 16 after injury.②RT-PCR revealed that SDNSF mRNA expressed in normal rate,and the expression was up-regulated on day 4 after injury,peaked on day 8,and decreased to the normal level on day 16. CONCLUSION:①There are some NSCs about the central canal of spinal cord,which proliferate and soon may differentiate to gila cell after injury in normal rats.②SDNSF is expressed in the normal spinal cord.The expression of SDNSF mRNA in the spinal cord varies with injured time,accompanying the proliferation and differentiation of NSCs. There are intimate relations between NSCs and expression of SDNSF in the repair of spinal cord injury.

Objective To examine the differences in the level of sedation and adverse effects produced by equivalent analgesic doses of remifentanil,sufentanil and fentanyl.Methods Eighty ASA Ⅰ female patients aged 18-39 yr with BMI of 18-25 kg/m2 scheduled for laparoscopic surgery under general anesthesia were randomly divided into 4 groups ( n =20 each):group control (group C) ; group remifentanil ( group R) ; group sufentanil (group S) and group fentanyl (group F).Remifentanil 2 μg/kg,sufentanil 0.2 μg/kg and fentanyl 2 μg/kg in normal saline 10 ml were infused iv over 2 min in groups R,S and F respectively.Depth of sedation was assessed and scored using OAA/S scale (5 =alert,1 =no response to prodding) and wavele index (WLI),before (baseline) and at 2,4,6,8 and 10 min after drug administration.Besides RR,pulse oxygen saturation,BP,HR were also monitored.The incidences of apnea,muscle rigidity,nausea and vomiting,pruritus,vertigo,bradycardia,profuse sweating and skin rash were measured and calculated.Results The 4 groups were comparable with respect to age,BMI and height.The lowest values of OAA/S scores,WLI and RR were significantly lower in groups R,S and F than in group C.Sufentanil produced the deepest sedation among the 3 opioids.Remifentanil produced strongest respiratory depression and nausea and vomiting.Conclusion The equivalent analgesic dose of sufentanil produces deeper sedation than that of remifentanil and fentanyl while remifentanil has the greatest impact on RR.

Objective To test the diathesis-stress component in the hopelessness theory and demonstrate the mediator effect of hopelessness in depression-generating process. Methods In the 6-month longitudinal study,latent growth curve model(LGM) was used in a sample of 269 Chinese undergraduates on the base of questionnaire investigation. Results The intercept for hopelessness depression had a significant association with the intercept for negative life events (path coefficient =0.48) and depressogenic attributional style (path coefficient=0.26).The slope for hopelessness depression had a significant association with the slope for negative life events (path coefficient=0.73). The complete mediator effect of hopelessness between depressogenic attributional style and the intercept for hopelessness depression was 0.143. The complete mediator effect of hopelessness between the slope for negative life events and the intercept for hopelessness depression was 0.131. The partial mediator effect of hopelessness between the intercept for negative life events and the intercept for hopelessness depression was 0.151.Conclusion Depressogenic attributional style interacted with the occurrence of negative events to predict the occurrence of hopelessness depression. Hopelessness made partial mediator effect on the hopelessness depression-generating process.

AIM:To evaluate the efficacy of Wuling Capsule(xylaria) in treating senile systolic hypertension. METHODS: Sixty-four patients with senile systolic hypertension were randomly divided into two groups.Both the treated group and the control group were treated with anti-hypertensive for 4 weeks,but the treated group received Wuling Capsule.Therapentic effects were evaluated with HAMA.Noninvasive resting blood pressure was taken every day after treatment,and dynamic blood pressure before and after treatment. RESULTS: HAMA in both groups decreased somewhat but blood pressure in the treated group was lower than that in the control group,remission rate of the treated group was greater than that in the control group.Treatment period of the treated group was shorter than that of the control group. CONCLUSION: Wuling Capsule can relief anxiety in senile hypertension patients,and it can rise the control rate of blood pressure,and also shorten the treatment period.