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.

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

This paper reviews outpatient security policy of typical developed countries .It provides reference for outpatient security system in China .Analysts believe that the experience for Chinese reference should be acquired in the following ways:The pooling of outpatient service is an inevitable trend in the development of health insurance , which is in principle an integral part of payment and financing system; the implementation of outpatient community first diagnosis system should be adapted to the local conditions; the community first diagnosis system is a necessary condition for capitation , so it is closely related to compensation methods and the elaborate degree of outpatient treat -ment catalog;Outpatient services should be supervised and payment policies should be developed respectively .There are two supervision models about outpatient service:external supervision and self supervision , but the key is to focus on the management of outpatient doctors .External regulation should be consistent with the current regulatory approach of the situation and patients have to bear some responsibilities for outpatient treatment expenses in some proportions , but the payment cap line should not to be low .The implementation of certain preferential policies for vulnerable groups can be considered under the harmonized system to partially reduce their medical expenses .

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:To provide reference for improving the data integrity management system of pharmaceutical produc-tion enterprises. METHODS:According to related reports in US Food and Drug Administration(FDA)and China Food and Drug Administration(CFDA),the source of data integrity problems was analyzed,its reasons were summarized and solutions were put forward. RESULTS&CONCLUSIONS:The reasons why there were data integrity problems in enterprises can be attributed to 3 as-pects(staff,hardware/software system and quality management),and the 3 aspects showed large gap with current standards. It is suggested that enterprises evaluate the existing system by adopting the gap analysis,establish a data integrity management project team,strengthen personnel training,upgrade hardware/software system to ensure its safety,stability and effectiveness;and opti-mize the quality management system by developing good ducument specification,special regulation system of data integrity. In addi-tion,the enterprise should establish quality culture,pay attention to industry and regulatory trends in real time to guarantee the data integrity effectively.

Recent studies about the GCT are focusing on searching for new standards and indexes to prognose the biological behavior of the GCT because of the traditional standards and indexes have been realized often not agree with to the clinic. we review the lately research about the biological behavior of the GCT, then analyse and sum up the correlative indexes that could be significant in studying the prognosis of the GCT.

Objective To establish the enzyme‐linked immuno sorbent assay(ELISA) method for a large‐scale screening of IgA deficiency in blood donors .Methods The indirect ELISA was adopted .The goat anti‐human IgA antibody was coated in microwell plates and labeled by horse radish peroxidase (HRP) as enzyme‐labelled secondary antibody .Results The sensitivity of established ELISA detection method was 0 .1 μg/mL .The intraassay coefficients of variation (CV) for IgA concentrations of 0 .1 ,100 μg/mL were 1 .74% to 3 .49% .The median interassay CV was 3 .48% (range:1 .83% -6 .96% ) .The assay process was 80 min . Conclusion TheELISA detection method is successfully established with high sensitivity ,strong specificity ,timesaving and easy operating and can be used for a large scale screening of Ig A deficiency and establishment of blood donors bank of Ig A deficiency .

Objective To investigate the distribution and duration of abnormal blood glucose level in SGA infants. Methods Blood glucose level was systemicly monitored in 37 SGA infants for (133?115) h(range 16～524 h, median 93 h), who were non NICU hospitalized and no feeding or IV infusion when admitted at (2 6?2 4) h (range 0.25~10.0 h, median 2.0 h) of age. Results During monitoring period, there was hypoglycemia in 19 cases (51%),hyperglycemia in 2 cases (5%), and both hypo and hyperglycemia in 3 cases (8%). The median of last time abnormal glucose level appeared was 10 hr after birth, its 95% confidence interval was 5~55hr after birth. Multiple regression analysis shown delivery models bad relationship with glucose level at admition (p= 0.013). The blood glucose level was higher in vaginal delivery babies. The lower the birth weight (BW)was, the longer the duration of abnormal glucose level lasted ( O