As China's medical and health reform continued to deepen,the medical service market increased competition,hospitals should be how to effectively grasp the clientele and further develop the medical services market.In order to compete in the rapid development of a brand through hospitals,and build credibility ethical system,updating operating concepts and adjust marketing strategies to expand service channels,expansion of service.

With the continually expanding enrollments in colleges and universities,the vulnerable groups among college students have also greatly increased,which must be addressed,stressed and focused by colleges and universities.This paper analyzes two major ethical social situations of this special group.Some countermeasures are also put forward in order to maintain stability in colleges and universities and strengthen the ethical and moral education for vulnerable groups among college students.

Health is an important component of human capital,and it is the premise and basis of other forms of human capital.This paper clarifies the impact of health on individual family income from several aspects.

The situation of investment in health is a measure of socio-economic and cultural development of a country or region.The health outcome from a certain amount of health costs is the economic benefits of investment in health.The World Health Organization has made "put investment in the field of health to promote economic development," a new development strategy for the purpose of investment in health,expanding domestic demand and the development of health which could be the cause of national macro-economic development.This paper briefly describes the impact of health investment on China's economic development from several aspects.

Objective To investigate the expression and clinical significance of Smac and HtrA2 in children with acute leukemia(AL).Methods Bone marrow samples were obtained from 77 children with AL (including 32 newly diagnosed children,33 complete remission children and 12 relapsed children)and the control group of 15 children without malignant blood disease.The expressions of Smac and HtrA2 protein were measured by streptavidin/peroxidase immunoperoxidase technique(SP) in all children.SPSS 13.0 software was applied to analyze the statistical data.Results Protein Smac was detected only in some samples,but HtrA2 was detected in all samples.The levels of Smac and HtrA2 protein in newly diagnosed AL children were both higher than those of the complete remission children (x2 =17.38,F =2.36,all P ＜ 0.05) and normal controls (x2 =12.89,F =5.26,all P ＜ 0.05),there was a statistical significance,but compared with those in the relapsed children,the difference had no statistical significance (x2 =1.18,F =1.57,all P ＞ 0.05).The levels of Smac and HtrA2 protein in complete remission children were both higher than those of the normal controls,and the difference had no statistical sigmficance(x2 =1.20,F =2.23,all P ＞ 0.05).In the newly diagnosed children,the levels of Smac and HtrA2 protein in children with acute lymphocytic leukemia(ALL) were higher than those of the acute myeloid leukemia(AML),but the differences had no statistical significance(x2 =0.113,t =1.024,all P ＞ 0.05).In newly diagnosed AL children,the complete remission(CR) rate of the negative expression of Smac(Smac-,90.9％) and the low expression of HtrA2(HtrA2low,84.6％) in the level of protein were higher than those of the positive expression of Smac(Smac +,47.6％) and the high expression of HtrA2 (HtrA2high,47.4％),and there was statistical significance respectively(x2 =5.772,4.596,all P ＜ 0.05).The CR rate of Smac-HtrA2low group (100％) was higher than that of Smac+ HtrA2high group(30.8％)in the children with AL,and the statistical data were of great significance(x =9.692,P ＜0.01).The protein level of Smac in newly diagnosed AL children was correlatedwith HtrA2 (r =0.979,P ＜ 0.001).Conclusions Pro-apoptotic protein Smac and HtrA2 may be involved in and af-fected each other in the pathogenesis and progression in AL,but levels of Smac and HtrA2 protein may be not correlatedwith the types of AL.In newly diagnosed AL children,the high expression of protein Smac and HtrA2 predicts poorprognosis.

Objective To detect the levels of insulin-like growth factors in children with acute leukemia (AL). Methods A total of 50 previously untreated AL patients were selected, meanwhile 30 healthy children were selected as normal controls. AL children were given regular chemotherapy. All cases were not given the brain radiotherapy. The levels of insulin-like growth factor-1 (IGF-1), free insulin-like growth factor-1 (fIGF-1), insulin-like growth factor binding protein 3 (IGFBP-3) in AL patients before treatment and 6 months after complete remission were measured by enzyme-linked immunosorbent assay (ELISA), and were compared with those in normal controls. Results Before treatment, compared with normal controls, the serum levels of IGF-1, IGFBP-3 in AL patients were lower while the level of fIGF-1 was higher, and the differences were signiifcant (P<0.01). At six months after complete remission, the levels of IGF-1 and fIGF-1 in AL patients were similar to those before treatment, but were signiifcantly different from those in control group (P<0.05);the level of IGFBP-3 was signiifcantly higher than that before treatment (P<0.01), but was similar to that in control group. Before treatment, the level of IGFBP-3 in AL patients was positively correlated with the level of IGF-1 (r=0.777, P<0.01), and negatively correlated with the level of fIGF-1 (r=-0.714, P<0.01). Conclusion Insuline-like growth factors were involved in the pathophysiological process in children with AL.

Objective To study the relationship between DNA methylation and pathogenesis of childhood immune thrombocytopenic purpura (ITP) by examining the expression of DNA methyltransferase 1(Dnmt1) and DNA methyltransferase 3a (Dnmt3a) mRNA in peripheral blood lymphocytes of the children with ITP. Methods Expression of Dnmt 1 and Dnmt3a mRNA in the peripheral blood lymphocytes in 36 children with newly diagnosed ITP and 26 healthy children were detected using RT-PCR. Results Dnmt1 mRNA expression in peripheral blood lymphocytes in children diagnosed with ITP was 3.02±0.49, significantly lower than 4.58±0.52 in the control group (t=11.95, P<0.001). Dnmt3a mRNA expression in peripheral blood lymphocytes in children diagnosed with ITP was 1.49±0.44, signiifcantly lower than 2.41±0.32 in the control group (t=9.12, P<0.001). Conclusions Children with newly diagnosed ITP have lower DNA methylation status in peripheral blood lymphocytes as compared to that in healthy children. The DNA methylation may play an important role in the etiology of acute ITP in children.

Objective To discuss DNA methylation's effect on pathogenesis of pediatric immune thrombocytopenia (ITP)through detecting the expression level of DNA methyltransferases (DNMTs)mRNA in peripheral blood lymphocytes of children with ITP.Methods Two mL peripheral blood was collected from each of 25 children with persistent and chronic ITP and 20 healthy children (the healthy control group)by using aseptic method in the pediatric ward of the First Affiliated Hospital of Xinxiang Medical University from January 2014 to January 2015.First ethylene diamine tetraacetic acid (EDTA) was used as the anticoagulant.Then separate the mononuclear cells,extract RNA and detect expression levels of DNMT1,DNMT3A and DNMT3B mRNA using reverse transcription-polymerase chain reaction (RT-PCR) method.Results (1) The blood platelet (PLT) of children with persistent and chronic ITP was (36.2 ± 19.6) × 109/L,which was obviously lower than the healthy control group(168.8 ±46.8) × 109/L(t =-11.85,P =0.000).(2)The DNMT1 mRNA expression level of children with persistent and chronic ITP was 0.17 ± 0.05,which was obviously lower than the healthy control group (0.27 ± 0.10) (t =-3.912,P =0.001).The DNMT3A mRNA expression level of children with persistent and chronic ITP was 0.20 ± 0.10,which was obviously lower than the healthy control group (0.32 ±0.11) (t =-3.779,P =0.000).The DNMT3B mRNA expression level of children with persistent and chronic ITP was 0.16 ± 0.1 1,which was obviously lower than the healthy control group (0.31 ±0.11) (t =-4.641,P =0.000).(3) There was positive correlation between the expression of DNMT1 and DNMT3B mRNA(r =0.433,P =0.031).There was positive correlation between the expression of DNMT3A and DNMT3B mRNA(r =0.721,P =0.000).Conclusions (1) Children with persistent and chronic ITP have lower expression levels of DNMT1,DNMT3A,DNMT3 B mRNA,which indicates that DNA methylation contributes to the pathogenesis of pediatric persistent and chronic ITP.(2) DNMTs have synergistic effect on DNA methylation of pediatric persistent and chronic ITP.

Objective To analyze the functional changes and the clinical significance of B cell specific mono-clonal murine leukemia virus integration site -1 (Bmi -1 )and Th1 /Th2 cells in children with newly diagnosed im-mune thrombocytopenia(ITP)by testing the mRNA expressions of Bmi -1,helper T cell -related cytokine interferon (IFN)-γand interleukin(IL)-4 in children with newly diagnosed ITP.Methods Thirty -six cases of patients with newly diagnosed ITP in the experimental group came from the inpatient and outpatient children admitted to the Depart-ment of Pediatrics of the First Affiliated Hospital of Xinxiang Medical University from April to December 201 3.In the control group,26 cases of children requiring selective operation were admitted to the Department of Pediatric Surgery during the same period.The mRNA expressions of Bmi -1,IFN -γand IL -4 in the peripheral blood lymphocytes were detected by means of the reverse transcription -polymerase chain reaction(RT -PCR)method,and were analyzed and compared by t test and linear correlation analysis.Results (1 )The mRNA expressions of Bmi -1,IFN -γand IL -4 in peripheral blood lymphocytes in the experimental group were 2.63 ±0.54,3.84 ±0.43 and 1 .44 ±0.39,respec-tively;while the mRNA expressions of Bmi -1,IFN -γand IL -4 in the peripheral blood lymphocytes in the control group were 3.91 ±0.92,2.88 ±0.57 and 1 .87 ±0.34,respectively.The levels of IFN -γof the experimental group were significantly higher than those of the control group (P <0.001 )and the levels of Bmi -1 and IL -4 in the experi-mental group were significantly lower than those in the control group (all P <0.001 ).(2)The mRNA expressions be-tween IFN -γand IL -4 in the peripheral blood lymphocytes in the experimental group were in negative correlation (r =-0.667,P <0.001 ).The mRNA expressions between IL -4 and Bmi -1 in the same group were in a positive correlation (r =0.776,P <0.001 ).There were no correlation in the mRNA expressions between IFN -γand Bmi -1 (r =-0.206,P >0.05).Conclusions Bmi -1 may be involved in the pathogenesis of ITP by regulating Th cell, and Th cell dysfunction may occur in the children with ITP,and the disproportion between Th1 and Th2 may be due to the advantages of Th1 .

Objective:To detect the levels of cytokines in peripheral blood of patients with chronic immune thrombocytopenia (ITP) and analyze their significance in the clinical prognosis of children with chronic ITP.Methods:Thirty patients with chronic ITP who were treated in the Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical Univercity from October 2015 to October 2018 were followed and enrolled in the experimental group and 40 healthy children in the same hospital were enrolled in the healthy control group.The levels of interleukin-2(IL-2), interferon-γ(IFN-γ), tumor necrosis factor(TNF), interleukin-4(IL-4), interleukin-6(IL-6), interleukin-10(IL-10) and interleukin-17A(IL-17A) in the experimental group and the healthy control group were detected by flow cytometry (CBA). The relationship between cytokines and prognosis of children with chronic ITP were analyzed.Results:Thirty patients with ITP were enrolled. The expressions of IL-2 and IL-17A in the experimental group before treatment were (7.86±3.90) ng/L and (10.45±12.35) ng/L, while those of IL-2 and IL-17A in the healthy control group were (3.11±2.41) ng/L and (2.97±7.04) ng/L. The levels of IL-2 and IL-17A in the experimental group were significantly higher than those in the healthy control group, and the differences were statistically significant ( t=-7.123, -5.582, all P<0.01). The expressions of IL-4 and IL-10 in the experimental group before treatment were (0.38±0.25) ng/L and (1.80±1.25) ng/L, while those of IL-4 and IL-10 in the healthy control group were (3.08±0.26) ng/L and (4.55±3.44) ng/L. The levels of IL-4 and IL-10 in the experimental group were significantly lower than those in the healthy control group, and the differences were statistically significant ( t=8.400, 5.653, all P<0.01). The expressions of IL-6, TNF and IFN-γ in the experimental group before treatment were (7.30±9.16) ng/L, (4.85±7.60) ng/L and (7.68±20.41) ng/L, while those of IL-6, TNF and IFN-γ in the healthy control group were (5.44±4.18) ng/L, (1.97±0.37) ng/L, (4.81±17.71) ng/L. There was no significant difference between the two groups ( P>0.05), and no significant difference in the levels of cytokines between the patients with chronic ITP before and 12 months after treatment ( P>0.05). Conclusions:The changes of T lymphocyte related cytokines are closely related to the pathogenesis and development of chronic ITP in children. There may be persistent immune dysfunction in children with chronic ITP. Dynamic monitoring of cytokines IL-2, IL-4, IL-10, IL-17A, especially IL-17A, is helpful to judge the prognosis of ITP in children, and may be of guiding significance in evaluating clinical prognosis.