Objective To study teaching cases of health economics in the context of health reform and development in China.Method Preparing for lessons in groups,information collection,experiences summary,and field research.Result Three productions:a teaching plan,a case collection,and a guideline of case teaching.Discuss It is useful to improving students’ ability to contact theory with practices and enhance teacher’s teaching and researching ability,but it also needs further improvement.

Objective To investigate the correlation between the ratio change of circulating myeloid-derived suppressor cells (MDSCs) and cellular immune function in healthy volunteers,chronic gastritis patients,gastric intraepithelial neoplasia patients and gastric cancer patients.Methods From February 2011 to July 2011,129 peripheral blood samples were collected,including 32 healthy volunteers,48 chronic gastritis patients,27 gastric intraepithelial neoplasia patients and 22 gastric cancer patients.The percentages of peripheral blood MDSC,T lymphocyte subsets and regulatory T cells (Treg) were determined by flow cytometry.The data were analyzed by one way analysis of variance,pearson and spearman correlation.Results The percentages of circulating MDSC,CD8+ T lymphocyte and Treg were highest in gastric cancer patients (9.63％±3.24％,10.03％ ± 1.26％,69.45％±3.42％) and lowest in healthy volunteers (0.92％±0.33％,4.12％ ±0.99％,32.35％ ±4.83％).Those of gastric intraepithelial neoplasia patients (5.13％ ± 1.30％,7.54％ ± 0.79％,53.26％±4.30％) were lower than gastric cancer patients but higher than chronic gastritis patients (2.76％ ±0.64％,6.28％ ±0.61％,42.37％ ±4.02％).The differences among each groups were statistically significant (F=24.85,20.88,37.84,all P＜0.05).However,the percentage of circulating CD4+T lymphocyte was highest in healthy volunteers (65.10％±4.10％),55.15％ ± 4.00％ in chronic gastritis group,42.23％ ± 3.91％ in gastric intraepithelial neoplasia group,and lowest in gastric cancer group (26.84％ ± 3.69％).The differences among each groups were statistically significant (F=46.80,P＜0.05).A significant correlation between circulating MDSC and TNM stages of gastric cancer was also observed (r=0.856,P＜0.01).The percentage of circulating MDSC was positively correlated with Treg percentage (r =0.862,P ＜ 0.01),and negatively correlated with CD4+/CD8+ ratio (r=-0.768,P＜0.01).Conclusion The increase of MDSC percentage in peripheral blood is correlated with human cellular immune function,which might play an important role in the tumor immune evasion during the development of gastric cancer.

Objective To explore the levels of serum alkaline phosphatase ( ALP) as well as its impact on the cognitive impairment in patients with subcortical ischemic vascular disease ( SIVD).Methods One hundred and fifty-eight SIVD patients were divided into two subgroups which included 86 patients with mild cognitive impairment ( SVMCI ) and 72 patients with vascular dementia ( SVaD ) according to the severity of cognitive impairment.Sixty-seven old people with normal cognitive function were selected as control qruop.Multiple lacunar infarction ( LI) or leukoaraiosis ( LA) was detected according to their MRI scan appearances and graded LA according to the severity.Serum ALP was measured by an enzymatic method as well as the Mini-Mental State Examination ( MMSE) and the Cambridge Cognitive Examination-Chinese Version (CAMCOG-C) were used in assessments.Serum ALP was divided into 3 groups and the occurrence rate of LI , LA and cognitive impairment were compared with each other.The levels of ALP were compared in different cognitive impairment and Logistic regression was used to explore the relation between ALP and cognitive impairment.Results Both SVaD and SVMCI groups (17.00 (13.00, 20.00), 59.50 (49.00, 68.75);25.00 (25.00, 26.00), 82.50 (76.75, 89.00)) showed significantly lower scores in MMSE and CAMCOG-C than control group (28.00 (28.00, 29.00), 93.00 (89.00, 96.00); Z=187.337, P=0.000; Z=150.480, P=0.000).A positive relationship between the elevated ALP level and the severity of cognitive impairment was found after adjusting for sex , age and other confunding factors ((68.60 ±15.52), (78.76 ±13.39), (86.75 ±18.85) U/L, F=22.587, P=0.000).The occurrence rate of LI, LA and SVaD among the three groups were significantly different (χ2 =8.008, P=0.018;χ2 =17.998, P=0.000;χ2 =12.255, P=0.002).The ALP level was negatively correlated with MMSE and CAMCOG-C scores ( r=-0.350, P=0.000; r=-0.286, P=0.000 ).Logistic regression analysis revealed the relation between ALP and cognitive impairment was positive when we controlled all the vascular risk factors.However , the relation had gone when futher adjusting for the grade of LA.Conclusions The level of ALP is significantly higher in SIVD patients and positively relates with cognitive impairment especially in those whose grade of LA is severe.

Objective To investigate the expression of DNMT3b and its correlation with clinicopathological parameters of pancreatic cancer.Methods The expressions of DNMT3b protein in 12 pancreatic cancer tissues and para-cancerous tissues were detected by Western blot.The expressions of DNMT3b protein in 59 pancreatic cancer tissues were detected by immunohistochemistry.The association of DNMT3b expression and clinicopathological parameters of pancreatic carcinoma were analyzed.Results Western blot results showed the expressions of DNMT3b protein in pancreatic cancer tissues and para-cancerous tissues were 0.69 ±0.13and 0.14 ±0.03,and the protein level of DNMT3b in pancreatic cancer tissues were significantly higher than that in para-cancerous tissues (t =4.464,P ＜0.05 ).Immunohistochemistry examination showed that the positive rates of DNMT3b protein were 59％ in pancreatic cancer tissues and negative in para-cancerous tissues.DNMT3b expression was positively correlated with the TNM stage and lymph node metastasis.Conclusions DNMT3b is highly expressed in pancreatic cancer tissues,and it is related with malignant biological behaviors of pancreatic cancer cells.

OBJECTIVE: To improve effectiveness of diagnosis and therapy in patients with tracheobronchial specific foreign body. METHOD: Fourty-six cases with specific foreign bodies in the trachea and bronchi, admitted from March 1998 to June 2006, were analyzed retrospectively. RESULT: Forty-one of 46 the specific foreign bodies were successfully removed through bronchoscopy. Three cases were removed by chest surgery. Two cases were died. CONCLUSION Suitable surgical instrument should be well selected and the best operation should be applied according to different conditions of the foreign bodies. Rigid bronchoscopy for removal of specific foreign bodies under general anesthesia is a main measure presently.
Adolescent ; Adult ; Aged ; Bronchi ; Bronchoscopy ; Child ; Child, Preschool ; Female ; Foreign Bodies ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Trachea ; Treatment Outcome ; Young Adult

OBJECTIVE: To investigate the diagnosis and treatment of neurinoma of the head and neck. METHOD: The clinical data of 33 patients with neurinoma of the head and neck, from 1980 to 2004, were retrospectively reviewed and analysed. RESULT: The tumors of all the cases were totally resected. Thirty of thirty-three cases have been followed up. Twenty-seven cases were fully recovered without any serious complication. One case with malignant tumor were died. The other 2 cases were died of other diseases. CONCLUSION Tumor resection is still the most effective treatment available for patients with neurilemmomas of the head and neck. Resection of tumor should be performed as soon as possible with careful protection of the function of the nerve. Extensive resection should be performed to treat malignant tumors.
Adolescent ; Adult ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Middle Aged ; Neurilemmoma ; surgery ; Retrospective Studies ; Young Adult

【Objective】 To explore the predictive value of preoperative liver function for massive blood transfusion (MBT) in patients undergoing ascending aorta surgery. 【Methods】 Data from 238 patients undergoing ascending aorta surgery in the Department of Cardiovascular Surgery at The Affiliated Lihuili Hospital of Ningbo University were collected. Preoperative liver function tests were performed for all patients. Based on the perioperative transfusion volumes of red blood cell suspension, patients were divided into the MBT group, non-MBT group, and no blood transfusion (NBT) group. Clinical data during the perioperative period were compared among different groups. Receiver operating characteristic curve (ROC curve) analysis was used to assess the predictive value of liver function indicators for MBT and determine cut-off values. 【Results】 Compared with the non-MBT group and NBT group, the MBT group showed statistically significant differences in preoperative levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), direct bilirubin (DBIL), and serum albumin (SA) (P<0.05). ROC curve analysis revealed that AST had the largest area under the curve (AUC) for predicting MBT, with a value of 0.723. ALT had the highest specificity for predicting MBT at 86.7%, and SA had the highest sensitivity at 89.7%. When AST >28.50 U/L, ALT >40.00 U/L, SA ≤34.55 g/L, and DBIL >4.25 μmol/L, there was a significant increase in the transfusion volume of various blood components and the incidence of MBT. 【Conclusion】 Preoperative liver function indicators (AST, ALT, SA, DBIL) have a moderate predictive value for MBT in patients undergoing ascending aorta surgery.