Objective:To study the relationship between Fc? receptor ⅢB(Fc? RⅢB) genotype and severe chronic periodontitis or generalized aggressive periodontitis.Methods:DNA from 35 subjects with severe chronic periodontitis,25 with generalized aggressive periodontitis and 95 of periodontal healthy controls were sampled by buccal swab and extracted using Chlex-100 method.Polymerase chain reaction with sequence specific primers (PCR-SSP)was carried out to determine the Fc?RIIIB genotype.The data were analyzed with ? 2 test. Results: NA1/NA2 heterozygote was the predominant genotype in the 3 groups.No statistically differences of Fc?RIIIB genotype distribution were found between any two of the stuied groups.The gene frequencies of NA1 and NA2 were 0.6 and 0.4 respectively.Conclusion:No direct relationship exists between Fc?RⅢB genotype and the occurrence of severe chronic periodontitis and generalized aggressive periodontitis according to the present study.

A comparison of the number of clinicians per 1000 residents in the province,and analysis of their distribution and characteristics identified an imbalance of such resources between regionsand between urban and rural areas.A further analysis of the payment flow of medical insurance fund of the counties and districts probed into the deployment efficiency of clinical in the province,holding that the hck of a human resources deployment and guidance mechanism for clinical resources is key to toor healthcare equity and difficulties in accessibility of healthcare service.

Access of safe, effective, convenient and affordable medical and health care services to the people is set as the goal of public hospitals health services as stated in the "Guidelines for Public Hospitals Pilot Reform". Such a goal, however, can hardly be achieved by mechanism changes within the public hospitals. The input and output of public hospitals rely critically on such factors as the input mechanism, regional pattern of healthcare system, the economic and industrial conditions of the region,payment quota and payment approval procedures of medical insurance. This paper set off from the input compensation mechanism of public hospitals in China and analyzed the input and output characteristics of the hospitals. Furthermore, the paper proposed to establish an input compensation mechanism based on public welfare performance for such hospitals. This provided further reference for improving the management of public hospitals and building a public welfare-oriented operation mechanism of public hospitals.

Objective To explore the value of ultrasound in diagnosis and classification of pilomatricoma.Methods Ultrasonic features of 63 cases with pilomatricoma confirmed by operation and pathology were analyzed and summarized retrospectively.Results According to if there was calcification in the tumor,pilomatricoma cases were classified into two groups(calcific group and non-calcific group).In addition,there were three subgroups in the calcific group based on the size and disposition of calcification:subgroup Ⅰ,completely echogenic mass with strong posterior acoustic shadowing in the subcutaneous layer (n=17,26.98%);subgroupⅡ,hypoechoic nodules with tiny calcification diffused distributed(n=15,23.80%);subgroup Ⅲ,hypoechoic nodules with large calcification(n=8,12.70%).Twenty-three cases (36.51%)were distributed into non-calcific group.Conclusions Ultrasonography is valuable for diagnosis and differential diagnosis of pilomatricoma,and it is an essential examination method for the tumor before operation.

Objective To explore imaging features of the lateral atlanto-dental interval (LADI) of atlanto-axial joint and its value in the diagnosis of atlanto-axial joint dislocation/subluxation. Methods Two hurdred and forty healthy volunteers without atlanto-axial joint dysfunction and 32 patients with torticollis and/or functional impairment at atlanto-axial joint were enrolled into this study. All subjects were examined with multi-slice CT in both neutral and max rotation positions to the left/right. Clinical endpoints including VBLADI, variance range of the VBLADI and asymmetric conditions were evaluated. x2 test is used to evaluate the variance of incidence of bilateral LADI asymmetry in different age groups, Pearson-test(2-tailed) is used to evaluate the correlation between VBLADI and rotary function of atlanto-axial joint,precise test of fourfold table is used to compare normal group with patient groups. Results ( 1 ) In the normal control group: asymmetry of bilateral LADI were observed in 204 among 240 (85.00%) healthy volunteers including 60 youngsters( ＜ 15 years) and 180 adults( ≥ 15 years). The median and P95% of |VBLADI| were 0.850 mm,2.450 mm in the young ( ＜ 15 years) and 0.700 mm,2.051 mm in the adult(≥15 years),there were 2 and 10 volunteers whose |VBLADI| ≥P95% in the young and in the adult respectively. There was no correlation between VBLADI( -2.146 to 2.114 mm,Median 0.000 mm) and LA(22.949° to 44.649°, Median 34.500°), RA (25.284° to 45.334°, Median 35.300° ), VLRA ( - 11.643°to 8.623 °, median 0.000 ° ) respectively in normal people ( r = - 0.030, - 0.005,0.026, P ＞ 0.05 ). ( 2 ) In the study with 32 patients including 25 youngsters( ＜ 15 years) and 7 adults( ≥ 15 years). Seventeen of 32 had atlanto-axial lateral subdislocation (AALSD),in 16 youngsters( ＜ 15 years), the median of the |VBLADI| was 3.350 mm and 14 cases |VBLADI| ≥2.450 mm;1 adult patient(≥ 15 years) had |VBLADI| ≥ 2.051 mm; 7 of 32 patients had atlanto-axial rotatory dislocation (AARD) including 4 youngsters |VBLADI| ＜2.450 mm,median 1.200 mm,3 adults |VBLADI| ＜2.051 mm,all of the 7 patients with AARD had unilateral parasol LADI in neutral position;8 of 32 patients had atlanto-axial complicated dislocation(AACD) including 5 youngsters |VBLADI| ≥2.450 mm,3 adults |VBLADI| ≥2.051 mm. There are more cases whose |VBLADI| ≥P95% in group AALSD and group AACD than in abnormal group( P<0.01 ), but there is no difference between group AARD and normal group( P = 0.738 ).Conclusion The imaging finding of "asymmetry of bilateral LADI" may be either a physiological variation or a pathological condition, clinical manifestations and other imaging findings should be evaluated to make a diagnosis.

Objective To study clinical application value of sacral and epidural block in treating lumbar intervertehral disc protrusion (LIDP), and explore technical operation methods, indications and con-traindications of sacral block. Methods Sacral block was adopted in 120 patients with LIDP(sacral group), they were injected triamcinolone acetonide 40 mg, vitamin B1 100 mg, vitamin B12 1 mg, 2% lidocaine 100 mg, added physiological saline 20-30 ml, twice a week, three times as a period. Compared therapy effect with epidural block (120 cases, epidural group). Results The achievement ratio of once puncture was 93.3% (112/120) in sacral group and 82.5% (99/120) in epidural group, P < 0.05. After treatment, the excellent and good rate of sacral group and epidural group were 85.0%(102/120) and 93.3%(112/120), there was not obvious difference, P>0.05, but the fair and bad rate were 15.0%(18/120) and 6.7%(8/120), there was ob-vious difference, P<0.05. Conclusions Sacral block and epidural block are effective methods to treat LIDP. They can relieve the stress at nerve root, especially sacral block, which has the advantages of easily operation, less pain, less side effect and safety.

Based on the ongoing health reform and Wenzhou's economic and social developments,this article made a complete analysis on the policy packages initiated by Wenzhou government in August 2012,in an effort to encourage and involve private capital to launch medical institutions.These policies and measures released take into account the policy and legal environment for private capital in medical sector in China,and target the demands of deepening health reform and shortage of health development funding.Such efforts of Wenzhou are designed as breakthroughs in terms of market access,doctors mobility,return on investment,health insurance and fiscal policy.

Objective To analyze and compare the capacity and efficiency of county-level hospitals′medical service by using the diagnosis related groups ( DRGs ) method. Methods The homepage data of discharged inpatients from seven county-level hospitals in Wenzhou region in 2013 - 2015 period were analyzed, for measurement of the medical service capacity changes of such hospitals using the number of DRGs, total multiplicity of weight, and CMI value, and that of their medical service efficiency changes using expense consumption index and time consumption index. Results The study found in the seven hospitals 8. 49% increase of the total number of DRGs, 17. 34% increase of total multiplicity of weight, and 5. 06%increase of CMI value, with unchanged expense consumption index and 9. 82% decrease of the time consumption index. These facts evidenced enhancements of these hospitals in both service capacity and service efficiency in general. Conclusions DRGs as tools prove useful objectively and scientifically. Policies of Two emphases at primary ends and two enhancements have been implemented desirably.

The paper reviewed the history of drug price addition system and its impact on hospital management. Based on such facts,authors stated that the significance of abolishing drug price addition helped hospital management not to run their hospitals as a business, helped medical practitioners to make their clinical decisions based on medical needs, and to make the health care service deserve the professionals′value and contributions. Following the abolishment, the hospitals need to reform their internal operating mechanisms before they can achieve better performance.

The authors reviewed the practice of integrated health care delivery system( IDS) at home and abroad, and based on experiences of collaborations between medical service institutions in Zhejiang province,proposed the strategic positioning,responsibilities and service innovation of urban public hospitals in a regional medical service system. It is held that the direction of China′s health care reform should move towards IDS in the future,and such hospitals should play an active role in the process via integration of its own resource and provide multi-level,diversified services for the regional health care system.