The PBL teaching and the case teaching have begun to be applied to the course of health economics, which has strong adaptability to the two teaching methods. Two teaching methods not only have the same characteristics, such as diversified teaching, outstanding students as the main body, paying atten-tion to the theory and practice, emphasizing on the comprehensive use of knowledge, but also have different characteristics, such as teaching idea, applied range and points of focus. These similar characteristics and differences are reflected in the development of health economics course. Based on the differences and simi-larities of the two teaching methods and further integration of the characteristics of health economics, this paper puts forward the countermeasures to optimize the application of the two teaching methods in health economics course.

Objective:This paper aims to investigate the awareness and demand for medical liability insurance of doctors, and to provide policy recommendations for the further development of medical liability insurance in China. Method:A stratified random sampling survey is conducted on doctors from a Top3 general hospital in Guangzhou, and the relevant departments and individual doctors were interviewed. Results:The higher the risk in a department, the higher their awareness of medical liability insurance becomes;the longer the length of service for a doctor, the more understanding of medical liability insurance the doctor has. Medical liability insurance is generally supported by doc-tors with a strong willingness of demand, but they opinions on bearing and sharing the insurance premium are quite different. Discussion:Doctors still lack sufficient knowledge of medical liability insurance due to the lack of effective publicity. The structural mode of medical liability insurance is still relatively vague, and the government leadership and market operation ability have a serious shortage. Suggestion:This paper suggest to improve the relevant laws and regulations of medical liability insurance, to strengthen government supervision and publicity, to build a reasonable development model of medical liability insurance in line with the national circumstances, and to strengthen an effec-tive combination of government leadership and market operation.

AIM:To investigate isometric force displacement in isolated rat main pulmonary artery rings and right main branch pulmonary artery(second pulmonary artery)rings during hypoxia hypercapnia and the role of mitogen activated protein kinase(MAPK).METHODS:The main pulmonary artery rings were dissected from the male Sprague-Dawley rats and were randomly divided into control group and hypoxia hypercapnia group.The second pulmonary artery rings were also randomly divided into control group,hypoxia hypercapnia group,DMSO incubation group,U0126 incubation group and SB203580 incubation group.The tension changes of pulmonary artery rings were monitored in vitro.RESULTS:Under normoxia conditions,there was no statistically significant change between main pulmonary artery rings and second pulmonary artery rings.A biphasic pulmonary artery contractile response to hypoxia hypercapnia in the second pulmonary artery rings was observed instead of a sharp and transient increase in the main pulmonary artery tension.Both p38 MAPK inhibitor SB203580 and ERK1/2 inhibitor U0126 significantly attenuated the delayed,but not early,contractile phase of the biphasic pulmonary artery contraction.CONCLUSION:Acute hypoxia hypercapnia causes a biphasic pulmonary artery contractile response in the second pulmonary artery,and p38 MAPK and ERK1/2 may be two key mediators in the process.

Objective To evaluate the differentiation-inducing effect of phenylacetate on pancreatic carcinoma cells and underlying mechanism of RNA editing deaminase in cell proliferation and differentiation. Methods The effect of phenylacetate on cell proliferation and cell cycle were investigated in cultured pancreatic carcinoma BXPC-3 cell lines by methylthiazoletetrazolium( MTT) assay, and flow cytometry. The effect of phenylacetate on the expression of RNA editing deaminase (ADAR2 mRNA) in BXPC-3 cells and fresh pancreatic carcinoma specimen was evaluated by RT-PCR. Results ADAR1 mRNA expression was positive in human pancreatic carcinoma tissues and BXPC-3 cell lines. After application of 1.0 and 2.0 mmol/L phenylacetate for 24 h and 72 h, BXPC-3 cell growth inhibition rate increased, G0/G1 phase cells decreased, S phase cells increased, ADAR2 mRNA expression decreased ( P < 0.01 ). Conclusion ADAR2 mRNA played a vital role of regulation in the process of pancreatic carcinoma cells growth and differentiation. Phenylacetate could regulate the proliferation and differentiation of pancreatic carcinoma cells through the regulation of ADAR2 mRNA expression.

Objective To explore the constitution characteristics of patients with uterine fibroids.MethodsA total of 413 patients with uterine fibroids (patient group) and 413 healthy women (control group) were enrolled in this case-control study. All the participants were required to fill in a questionnaire on Chinese Medicine constitution.The frequency and percentage of indicators were calculated,and analysis of variance and Chi-square test were used to find difference between the two groups.Results The incidence of Qi-stagnation constitution in the patient group was higher than that in the control group (x2 =8.209,P ＜ 0.05 ). The incidence of menstrual abnormalities was increased in patients with constitution of Phlegm-dampness and Dampness-heat,Qi-stagnation and Blood-stasis.The detection rate of hypertension of the patient group was also significantly increased.ConclusionThe most common constitution of patients with uterine fibroid is Oi-stagnation.

OBJECTIVETo analyze clinical features, outcomes and correlative prognostic factors of the disease.

METHODTotally 14 newly diagnosed children with pancreatoblastoma at Shanghai Children's Medical Center, Children's Hospital of Chongqing Medical University, Sun Yat-sen University Cancer Center and Beijing Children's Hospital were enrolled into this study between April 2003 and July 2013. The clinical features, surgery, chemotherapy protocol and prognostic factors of patients were retrospectively analyzed.

RESULTThe median age at diagnosis was 6.5 years (0.6 to 11 years). Four cases had local tumor, 9 cases had local invasion, and in 1 case lung and liver metastasis was found at diagnosis. Increased serum α-fetoprotein were found in 8 cases (66-54,000 μg/L). In 8 patients the tumor was resected at first. The remaining 6 patients had biopsy and in four of them the tumor was completely resected after 4-6 cycles of chemotherapy. Except for 2 patients who gave up treatment, all the other patients fulfilled the comprehensive treatment including surgery and chemotherapy. One patient received radiofrequency ablation. The median follow-up period was 26 months(16-140 months). The estimated 2 year event free survival was (66.7 ± 13.6)%.On univariate analysis, non-resectable tumor(χ(2) = 6.663, P = 0.010), progression and metastases during treatment(χ(2) = 14.927, P = 0.000), poor response to treatment(χ(2) = 12.293, P = 0.000)were independent predictors for poor prognosis.

CONCLUSIONComplete resection and complete remission after treatment were excellent prognostic factors. Some initially unresectable disease seems to be resectable after adjuvant chemotherapy, which may be a key point of treatment strategy.

Antineoplastic Combined Chemotherapy Protocols ; Chemotherapy, Adjuvant ; Child ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Neoplasm Recurrence, Local ; Pancreatic Neoplasms ; diagnosis ; pathology ; therapy ; Retrospective Studies ; Survival Rate

Objectives To evaluate the clinical features, treatment scheme and long-term outcomes of stage 1、2 childhood neuroblastoma (NB). Methods The retrospective study included 49 newly diagnosed NB stage 1、2 patients from June 1998 to December 2010. Clinical data and long-term outcomes were analyzed. Results Twenty-four patients with stage 1 NB and twenty patients with stage 2 NB were found among all 237 patients with NB enrolled in this study. The median age at diagnosis was 25 months( 2 week to 9 year old),29 males and 20 females. Thirty-one patients (63.6%) without symptoms were discovered with tumor by physical or imaging examination. Thorax and abdomen were the most common sites of primary tumor (21 and 22 cases, accounting for 42.9% and 44.9% of all patients, respectively). Forty (81.6%) NB patients had favorable pathology classification. One patient was of MYCN amplification status. Urine vanilla mandelic acid was normal in 32 (91.4%) patients, and serum lactate dehydrogenase was less than five times of the normal value in all patients. Ten NB patients were treated ac-cording to the low-risk protocol who received surgery alone.Thirty-nine patients were treated according to intermediate-risk protocol who received both surgery and chemotherapy. All the patients achieved very good partial remission (100%).The medi-an follow-up period was 60 months(22 months to148months). Nine patients were lost after a follow up of 3 months in medi-an. The 2-、3-、5-year event free survival and overall survial of all 49 patients was 100%. Conclusions The prognosis for neu-roblastoma of stage 1、2 in this study was with 100%survival, which provides opportunity for further reduction of dosage and/or duration of episodes in chemotherapy.

Objective: To study the feasibility, safety and aesthetics of laparoscopic cholecystectomy using a single-port through the umbilicus in patients with chronic cholecystitis with cholecystolithiasis. Methods: From Jan 2007 to Jun 2017, the clinical data of 4790 patients who underwent single-port, 4 426 patients conventional three-ports, and 3 304 patients two-ports laparoscopic cholecystectomy were retrospectively studied. Results: There were no death in all the three groups. There were no significant differences in the incidences of postoperative bleeding, bile leakage, biliary tract injury and other significant short-term complications (all P>0.05). The operation time of transumbilical single-port laparoscopic cholecystectomy was significantly longer than that of two-ports and three-ports laparoscopic cholecystectomy [(35.3±9.0)min vs. (28.4±7.2)min vs. (23.3±6.4)min, P<0.05]. Looking only in a single year, there was no significant difference in the operation time of the three groups in the year 2017 (P>0.05). There were no significant differences among the three groups in intraoperative blood loss, first postoperative passing of flatus, postoperative pain, and length of hospital stay (all P>0.05). The satisfaction score of surgical scar in the single-port group was higher than that in the two-ports and three-ports groups [(9.6±1.6) vs. (7.6±1.9) vs. (6.7±2.0), P<0.05]. Conclusions Transumbilical single-port laparoscopic cholecystectomy was safe and feasible, with good aesthetics and other advantages. It was more difficult than the traditional laparoscopic technique. After the learning curve, the operation time could be comparable to the three-ports technique.

The olfactory bulb (OB) is the first relay station in the olfactory system. In the OB, mitral/tufted cells (M/Ts), which are the main output neurons, play important roles in the processing and representation of odor information. Recent studies focusing on the function of M/Ts at the single-cell level in awake behaving mice have demonstrated that odor-evoked firing of single M/Ts displays transient/long-term plasticity during learning. Here, we tested whether the neural activity of M/Ts and sniffing patterns are dependent on anticipation and reward in awake behaving mice. We used an odor discrimination task combined with in vivo electrophysiological recordings in awake, head-fixed mice, and found that, while learning induced plasticity of spikes and beta oscillations during odor sampling, we also found plasticity of spikes, beta oscillation, sniffing pattern, and coherence between sniffing and theta oscillations during the periods of anticipation and/or reward. These results indicate that the activity of M/Ts plays important roles not only in odor representation but also in salience-related events such as anticipation and reward.

Neurons in the primary auditory area (AUDp) innervate multiple brain regions with long-range projections while receiving informative inputs for diverse functions. However, the brain-wide connections of these neurons have not been comprehensively investigated. Here, we simultaneously applied virus-based anterograde and retrograde tracing, labeled the connections of excitatory and inhibitory neurons in the mouse AUDp, and acquired whole-brain information using a dual-channel fluorescence micro-optical sectioning tomography system. Quantified results showed that the two types of neurons received inputs with similar patterns but sent heterogeneous projections to downstream regions. In the isocortex, functionally different areas consistently sent feedback-dominated projections to these neurons, with concomitant laterally-dominated projections from the sensory and limbic cortices to inhibitory neurons. In subcortical regions, the dorsal and medial parts of the non-lemniscal auditory thalamus (AT) were reciprocally connected to the AUDp, while the ventral part contained the most fibers of passage from the excitatory neurons and barely sent projections back, indicating the regional heterogeneity of the AUDp-AT circuit. Our results reveal details of the whole-brain network and provide new insights for further physiological and functional studies of the AUDp.