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.

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.

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.

L-Carnitine plays an essential role in the transfer of long chain fatty acids from the cytoplasm of a cell into the mitochondrion,where they undergo ?-oxidation.Carnitine deficiency is characterized by plasma and tissue carnitine concentrations below those required for the normal functions of the organism,including cardiomyopathy,myopathy,hypoketonemia,hypoglycemia,hyperammonemia.Studies show that supplement of carnitine could improve the clinical symptoms of some diseases.

The paper analyzes problems existed in health certificate issuing management among employees in the service industries in Xi'an and points out the necessity of using informatization means to assist health certificate data management.It proposes the scheme of u-sing the management system based on two-dimensional code technology to manage health certificate information and makes detailed de-scription of design and realization of the system.

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.

Through focusing on widely concerned maternal death incident in Peking University Third Hospital,something can be discovered:for the upper hand in doctor-patient conflicts,they start to have a scramble for discourse power based on information dissemination of social media.On one hand,the evolution of social media builds a bridge for interactions and connections between doctors and patients.It contributes to rebuilding professional authority for doctors and increasing objectivity of information dissemination,On the other hand,information dissemination leads the new scramble for discourse power.It causes some problems:self-reflection decline of doctora,truth diiution about incident and even some moral and ethical risks both patients and doctors.Media tactics of doctors are Proposed to regulate and improve the scramble for discourse power in the social media context from two big aspects,namely establishing matrix platform and reducing propagation loss about social media.

This paper gave a dynamic analysis on the health resource allocation and utilization of Chongqing since it became a municipality,found out the extrusive problems existing in the health resource allocation and put forward some corresponding proposals,hoping to benefit the health administration on constituting regional health development planning.