This paper introduces the feasibility of the case teaching practice to health care management course.Based on teaching practice,the paper discusses design,application and evaluation of the case teaching practice in health care management teaching,and put forward some recommendations for putting into practice,such as selection of case,teaching methods and skills.Thus it supplies reference to cultivate students' abilities to analyze and solve problems,and improve the teaching effect of health care management course.

Objective To compare the effect of comparion of the effect of postoperative.Methods Forty patients with total gastrectomy for gastric cancer surgery were randomly divided into groups of early parenteral nutrition (EEN) and total parental nutrition (TPN) group,20 patients in each group.Nutritional index,immune status,complication rate and postoperative intestinal function recovery time and average hospital stay were observed.Results The first day of bowel movement and time to take a normal soft diet was significantly shorter in EEN group than that in TPN group(t =5.091,7.007,all P ＜ 0.05).and the hospital stays of EEN group all so significantly shorter than TPN group (t =5.802,P ＜ 0.05).Prealbumin and transferrin were significantly reduced on post-operative day (POD)7 and were slowly recovered until POD 90.but the increased rate in EEN group was significantly faster than that in TPN group [cprealbumin:t =9.501,7.913,7.182,6.154,all P ＜ 0.05] ; transferrin:t =5.501,5.712,5.733,5.801,all P ＜ 0.05).The TLC,CD4 and CD8 are lower than before total gastrectomy on POD 7,and have been recovered to the level before surgery.The TLC level on POD 7 and 14 were significantly higher in EEN group than that in TPN group (t =5.645,5.134,all P ＜ 0.05).The PG-SGA score was lower in EEN group than that in TPN group,particularly on POD 21 (t =5.211,P ＜ 0.05).Conclusion Total gastreetomy for gastric cancer after curative resection of early enteral nutrition support can improve the postoperative intestinal function recovery and shorten the time of hospital stay for patients.

BACKGROUND:The success of the preservation of vital pulp in carious deciduous teeth depends not only on determining the health status of the pulp,but also on selecting the most suitable pulp capping agent.At present,the commonly used pulp capping agent materials contain calcium hydroxide preparation and mineral trioxide aggregate (MTA).Recently,new biomaterials,such as Bioaggregate,Biodentine,and TheraCal,with good biocompatibility and good edge sealing,have been developed and extensively used.OBJECTIVE:To compare the efficacies of MTA,calcium hydroxide preparation,Biodentine and TheraCal LC that are commonly used in pediatric dentistry in the preservation of vital pulp in carious deciduous teeth.METHODS:This prospective,single-center,randomized controlled clinical trial will be conducted in Chengdu Maternal and Child Center,China.Children with deep caries of deciduous teeth,who will be scheduled to undergo indirect pulp capping,direct pulp capping,and vital pulpotomy,will be selected and randomized into four groups according to pulp capping agents:MTA group,calcium hydroxide group,Biodentine group and TheraCal group.Patients will receive return visit at postoperative 3,6 and 12 months during follow-up.By using X-ray,we will observe and compare the speed and quality of the formation of the dentin bridge with different biomaterials,and assess the reason for the failure of treatment.This trial was registered in ClinicalTrials.gov identifier:NCT03220360,on July 14,2017.The study protocol has been approved by the Ethics Committee of Chengdu Maternal and Child Center,China (approval number:20170506).All protocols will be performed in accordance with the Ethical Principles for Medical Research Involving Human Subjects in the Declaration of Helsinki.Written informed consent will be provided by each patient and their family members after they indicated that they fully understood the treatment plan.RESULTS AND CONCLUSION:This study will compare the efficacies of various biomaterials in the preservation of vital pulp in carious deciduous teeth.New materials Biodentine and TheraCal will be selected in classical technique to verify their efficacies and explore their superiorities.Classical materials calcium hydroxide and MTA will be selected as controls,which will be separately used in indirect pulp capping,direct pulp capping,and vital pulpotomy to provide reliable choices for clinicians.

With the establishment of the Republic Act No. 11036, more popularly known as the Mental Health Act, improvement in the mental, neurologic, and psychosocial health took a step forward in the Philippines. This law, which was signed on June 2018, gave specific provisions in different aspects of delivery of mental health services to Filipinos. This law proved very useful in the dilemma faced in the following case where a potential problem in confidentiality was encountered.
Mental Health Services ; Confidentiality ; Mental Health ; Philippines

Objectives: This study aims to determine the frequency of Post Traumatic Stress Disorder (PTSD) Anxiety and Depression among military personnel as well as describe their coping style. Methodology: This was a cross sectional descriptive study of military personnel. (Member of the Armed Forces of the Philippines), in active service i.e. must have been deployed to a combat zone at some point in time, drawn by convenience sampling. They were screened using the Filipino version of the Zung Depression Scale and the Hamilton Anxiety Scale after securing voluntary consent of the subjects. Results: There were 673 servicemen who participated in the study with many undergoing advancement schooling at the time of interview. Responses of only 598 subjects were included in the analysis since the others failed to complete the standardized demographic profile data sheet. Seven (1.1 %) were noted to be anxious; and 5 (0.8%) were depressed while no one were noted to have PTSD. The most common coping mechanisms in handling stress were smoking cigarettes, talking to a friend or drinking alcoholic beverages. Conclusion The prevalence of anxiety, depression and absence of PTSD were lower than expected but this may be due to the fact that at the time of interview the servicemen were not coming directly from a combat zone but had been taking up further studies over the past 1- 3 months in Metro Manila
Anxiety ; Depression ; Stress Disorders, Post-Traumatic ; Military Personnel

The management of the pregnant patient with a brain tumor must be individualized for each patient. It is a tailored and coordinated multi speciialty effort where well-defined seams are fitted for the individual and the outfit appropriate for the occasion. In the end, what matter most is the best appropriate management that is rational and safe is given for both individuals.
Human ; Adult ; PREGNANCY ; BRAIN NEOPLASMS ; MENINGIOMA ; PREGNANCY, HIGH- RISK

Disability is a major public health problem, particularly in developing countries, where there is a close link between poverty and disability. The complex nature of disability allows it to be addressed from a number of different perspectives. Community-based rehabilitation (CBR) is a holistic approach towards disability which is currently being supported in many parts of the world, including Papua New Guinea (PNG). Unfortunately CBR is frequently implemented in resource-poor contexts, which limits the scope for research. As a result little effort is put into determining a need before CBR programs are established, or into evaluating CBR programs following implementation. This research in the Middle Ramu, Madang Province, tested a method for acquiring information for the purposes of CBR planning in PNG. The method used an adapted form of the Ten Questions Screen for Childhood Disability. Quantitative and qualitative methods were further utilized to determine the types of disability presenting, the biomedical and perceived causes of the various disabilities, help-seeking behaviours, the disabled individual's participation in village activities, and the needs of both disabled individuals and their caregivers. A total of 158 disabled individuals were identified in a population of 4946 people and 20 in-depth interviews were conducted. The data obtained were analyzed to formulate an appropriate 'CBR package' that would cater for the specific needs of this population in the Middle Ramu. Evaluation of the basic survey method revealed that it was more sensitive than other methods previously tried in PNG, with an overall disability prevalence of 3.2% obtained. Qualitative methods allowed the fieldworkers to get a much deeper insight into the feelings and perceptions of disabled individuals. The methods tested for this research in the Middle Ramu could have application for CBR workers in other parts of PNG.
Disability, NOS ; Disabled Persons ; Median Site ; Research ; Rehabilitation aspects

Lots of evidence show a correlation between air pollution and chronic respiratory diseases, of which the effect of particulate matter is the most concerned.It is the current research hotspot that respiratory diseases in both children and adults are closely related with atmospheric pollution levels.The influence mechanisms of atmos-pheric pollution on respiratory diseases include oxidative stress, inflammation, genetic damage, etc.This paper made a review of the latest advances s on the pathogenesis of chronic respiratory diseases caused by atmospheric particulates PM2.5 .

Doctor-patient relationship has attracted increasing attention.In the light of modern model to study the related theory,a preliminary study of the ancient Chinese doctor-patient relationship model has been done.The doctor-patient relationship in ancient society is the same complex and multi-level.Therefore,doctor-patient model could not be lumped together.According to the social status of patients and the extent of their demand for medical services,and the social status of doctors and their medical technique,the doctor-patient relationship could be divided into three typies-equality type,authority type,and principal and subordinate type.With a view of doctor-patient relationship of traditional Chinese medicine,there draws an acquisition value of the current complex patient relationship.

Sixty five stroke patients undergoing rehabilitation training in our hospital from May 2010 to May 2013 were randomly divided into study group (n =32) and control group (n =33).Patients in study group received intramuscular injection of botulinum toxin A (BTX-A) in the affected limbs before rehabilitation training started.The F wave amplitude and F/M value,muscle tension and TUG test and 10 m free walking test results of patients in two groups were observed before and 4 weeks after treatment.Compared to the results before treatment,the amplitude of F wave and F/M value after 2 and 4 weeks of treatment in study group decreased significantly (P ＜ 0.05).Compared to control group,the indexes at each time point after treatment in study group were significantly different (P ＜ 0.05).The muscle tension score in study group after 4 weeks of treatment decreased significantly (P ＜ 0.05),and also lower than that in control group (P ＜ 0.05).Before treatment there were no significant differences in TUG test and 10 m free walk test between two groups (P ＞0.05) ; while TUG test and 10 m free walk test in study group were better than those in control group after 4 weeks of treatment (P ＜ 0.05).The TUG test and 10 m free walk test had little improvement in control group after treatment (P ＞ 0.05).The results indicate that botulinum toxin A injection can reduce amplitude of F wave in the corresponding segment of spinal cord motor neurons and improve the walking ability of stroke patients.