As the first country established universal health insurance in the world, UK has been devoted to construct the fairness and welfare of National Health Service(NHS) with constant development and improvement. It focuses on the reform process of NHS since the beginning of this century and studies the deep factors restricted the reform, compared with the current situation of health care system under China’s new medical reform since 2006, putting forward enlightenment to China’s reform.

Objective To evaluate the clinical effect of removable partial denture combined with composite resin veneer on occlusal reconstruction for aged patients with dentition defects,and discuss the critical steps of operation.Methods From Mar.2002 to May 2003,16 outpatients with Kennedy 1 type dentition defects with severe anterior attrition were selected.The distal extension removable partial denture(RPD) was used to reestablish the occlusal vertical dimension.The anterior teeth were bonded with the light-cured composite resin based on removable partial denture.The therapeutic effects for all the patients were assessed at 3-month,2-year and 4-year follow-up after treatment.Composite resin restorations were evaluated with modified USPHS criteria,and removable partial denture were assessed by routine examination and subjective questionnaire.Results After 4 years of observation,all prosthesis remained in good condition.The masticatory ability was increased than ever before and the patients were satisfactory with the esthetic appearance of dentures.The remaining rate of light-cured composite resin was 85.7% 4 years after reconstruction,fulfilling the requirements of esthetics and function.Meanwhile,the dental structure could be preserved and the unsatisfactory appearance of removable partial denture was improved by light-cured composite resin.Conclusions The dentition defects of aged people may be effectively restored by combined application of removable partial denture and composite resin veneer.This treatment has many advantagcs,including less trauma,economy and satisfactory in esthetics,and besides,it may better preserve the dental structure.This treatment is well accepted by aged patients,so it is worthy to do further clinical study.

BACKGROUND: Much attention has been focused on mandibular condyle fracture, which has long been considered as a severe injury to the temporomandibular joint(TMJ). Restricted by diagnostic methods, many studies have been conducted on transverse fracture whereas little attention has been paid to longitudinal fracture of the mandibular condyle. Even less is known about longitudinal fracture in young children.OBJECTIVE: To evaluate the effects of childhood longitudinal fracture of the mandibular condyle on secondary ankylosis of TMJ.DESIGN: A randomized controlled study.SETTING: Department of Stomatology, General Hospital of Chinese PLA.MATERIALS: The experiment was completed in the Center for Experimental Animals, General Hospital of Chinese PLA. Twelve young Chinese experimental miniature pigs bred by the Institute of Experimental Animals, Beijing Agriculture University, aged 2 -3 months and weighing(5 -5.5) kg, were used and raised with mixed feed, and then divided into 3 groups randomly.METHODS: Food and water was forbidden for the miniature pigs 12 hours before operation. Under anesthesia with(5.0 - 15.0) mg/kg ketamine/xylazine abdominally injected, conventional disinfection was performed in the right lateral decubitus position and layer-by-layer preauricular incisions were made on the left side of the miniature pigs. The joint cyst was incised transversely and the lower cavity of TMJ was exposed and dragged downwards. The mandibular condyle was cleaved into two vertically along the inner 1/3 part of it with a 5.0 mm-wide bone chisel to cause inferior and posterior sagittal fractures. The miniature pigs were executed 3 months and 6 months after operation, and their condyles were cut for observation.MAIN OUTCOME MEASURES:①The morphological changes of mandibular condyle specimens in the three groups observed with the naked eyes.②The pathological changes of mandibular condyle specimens under light microscope.RESULTS: The articular disc was adhered to the mandibular condyle after 3months. Temporal fossa adhered to the articular disc and mandibular condyle could still be observed in one specimen. Bifid condylar deformity was found in two specimens and no disc perforation was found. The adhesions became more severe after 6 months and bifid condylar deformity was formed in all the 3 specimens, with distinctly thickened discs. Light microscope observation:Three months after fracture, the adhesion between disc and condyle was obvious. There was no clear boundary between the surrounding tissues. The adhesion was composed of fibro-connective tissues, with a large number of chondrocytes in it. Fibro-connective tissues tightly adhered to the trabeculae were found in some adhesions. The fiber of disc became deranged and blood vessels and fatty cells were seen. Six months after fracture, blood vessels, a large number of fibroblasts and sparse chondrocytes were seen in the adhesions. The collagen fibers of the discs were arranged in whirlpool shape. There were a large number of fatty cells and blood vessels within it. The fiber-cartilage of the condylar surface was found thickened and the fiber deranged in the unadhered tissues. Proliferative changes were seen on disc surfaces.CONCLUSION: Childhood longitudinal fracture of the mandibular condyle causes severe secondary injury to TMJ, suggesting a close correlation between longitudinal fracture of the mandibular condyle and TMJ ankylosis.

Objective To evaluate the restorative effects of customarily designed resin bonded fixed partial denture(RBFPD) on single posterior tooth anodontia accompanied by tilted distal abutment,and summarize the indications and characteristics of RBFPD.Methods From 2002 to 2003,18 outpatients with single posterior tooth anodontia accompanied by tilted distal abutment were selected for the present study in the Department of Stomatology,General Hospital of People's Liberation Army.The gradient of tilted abutment was less than 50?.All the teeth with abutments were vital without obvious loosening or abnormal periodontal condition.The position and configuration of occlusion rest and retainer of denture were designed according to the inclination of abutment and cast survey.Titanium alloy or cobalt-chromium porcelain fused to metal RBFPD was prescribed,and all patients were followed up for 5 years.The clinical and X-ray examination were performed at each revisit and the subjective experience of patients was inquired.Results The average gradient of tilted distal abutment was 33?.During the period of 5-year follow-up,in all the 18 patients but 2,all the dentures were in function without detachment.The gum of abutment and the bottom of the pontic were in good condition,and no periodontitis in abutment was observed.There was no obvious change of abutment examined by X-ray during the period of follow-up.The patients were satisfactory with the prosthesis,and the success rate was 88.9% during the period of 5-year follow-up.Conclusion RBFDP used to restore the posterior single tooth anodontia with tilted abutment has the merit of less tooth reduction and reliable clinical effects,and root canal therapy is not necessary for tilted abutment.

Purpose:To study the expression of T lymphocyte activation associated membrane molecule in peripheral blood of patients with non small cell lung cancer and study the changes in its immunity function.Methods:The lymphocyte from the peripheral blood in patients with non small cell lung cancer were immunologically double fluorescent labeled by CD3 PE and CD25/ HLA DR/ CD69 FITC were determined by flow cytometry. 25 normal donors served as controls.Results:Peripheral blood CD3 + /CD25 + ,CD3 + /HLA DR + and CD3 + /CD69 + in T lymphocyte with lung cancer were significantly lower than those in normal controls ( P

Objective To investigate the clinical efficacy of Changqin No. 1 combined with Western therapy for severe traumatic brain injury and its effects on prognosis. Methods Totally 65 cases of severe traumatic brain injury were randomly divided into the treatment group (n=32) and the control group (n=33). The control group was treated with basic Western therapy (dehydration reduction of intracranial pressure, nutrition nerve, scavenging oxygen free radicals, improve cerebral circulation, nutritional support and maintain the internal environment stability, anti-infection, prevention and treatment of complications, hyperbaric oxygen). The treatment group was treated with Changqin No. 1 plus the basis of routine treatment, 1 dosage per day, 2 times stomach tube nasal feeding or blunt, for 14 d. One month after treatment, awake rate, awake time, the incidence of complications and MMSE in both groups were compared. Three months after treatment, the prognosis of two groups were compared by GOS. Results One month after treatment, the awake rate in treatment group was 77.4% (24/31) and 53.1% (17/32) in the control group, with statistical significance (χ2=4.089, P=0.043), and the death rate was 0. The awake time in the treatment group was significantly shorter than that of the control group (t=2.458, P=0.017). The incidence of pulmonary infection in the treatment group was lower than the control group (P=0.001). There was no statistical significance in urinary tract infection, epilepsy, liver and kidney dysfunction rate of the two groups (P>0.05). The number of awake case was 24 in the treatment group and 17 in the control group. The number of normal MMSE cognitive function was 3 in the treatment group and 2 in the control group, and the treatment group was better than the control group (Z=-2.205, P=0.027). Three months after treatment, the good prognosis was 58.08% (18/31) in the treatment group and 28.12%(9/32) in the control group, with statistical significance (χ2=5.763, P=0.016). Conclusion Changqin No. 1 combined with Western basic treatment can help patients with severe traumatic head injury awake early, reduce pulmonary infection complications, and improve the cognitive function of sober patients and improve the prognosis.

Objective To study the clinical characteristics of primary Sj(o)gren's syndrome (pSS) patients with dry eyes.Methods Ninety-six pSS patients with dry eyes admitted to the Department of Rheumatology and Immunology,the Affiliated Hospital of Guilin Medical College from August 2009 to August 2011 were retrospectively analyzed.Results In all 96 patients,89 patients had symptoms,23 of whom had two or more symptoms.The tear-film break-up time (BUT) of 154 eyes were Less than 5 seconds,18 were between 5-10 second,and twenty were more than 10 seconds,with the average of 3.7±1.9 seconds.The length of tear flow of 154 eyes'width of tear mocus was less than 3 millimetres (mm),with the average of (0.21±0.10) mm.The average score of corneal fluorescein staining score was 5.2±2.4.The wet lengths of filter paper of 192 eyes were all less than 10 mm/5 min,with the average of (4.6±1.8) mm.The average score of meibomian gland function was 1.5±0.9.Conclusion In patients with pSS,the width of tear meniscus and the wet lengths of filter paper are reduced,which implies less tear secretion.At the same time,BUTs are short,and the Meibomian gland dysfunction are observed.Dry eyes of pSS are mixed in type,not only aqueous tear deficiency.

A method was evaluated for determination of twenty-one doping (including nandrolone, boldenone and methandienone) in human urine by gas chromatography-high resolution mass spectrometry. Samples were prepared by liquid-liquid extraction, concentrated, TMS derivatization and limit of detection at ng x mL(-1) by MID/GC/HRMS. According to the code of the World Anti-Doping Agency (WADA), precision and recoveries of the procedure were evaluated by replicate analysis (n = 6), the recoveries in the range of 66%-103%, with the RSD below 10.0%. The precision within the day of the method with three different concentrations was also determined RSD were less than 9.5%, 10.0% and 9.7%.

Objective To discuss the method of stomach tube instead of normal nasointestinal tube for severe craniocerebral injury patients.Methods Placing the stomach tube into the jejunum blindly according to the patient's gastrointestinal peristalsis for 99 severe craniocerebral injury patients and observing the success rate and plugging rate.Results Ninety-two tubes were successfully placed,the success rate was 92.9％(92/99).The placement time was (45.9±26.7) min.The time of successful insertion tube enteral nutrition was (46.0±34.2) d.No clogging occurred during this period.Conclusions The method of stomach tube instead of normal nasointestinal tube is safe and effective.

Objective To investigate the association between elevated levels of hsCRP and prognosis after stroke in Chinese patients.Methods Two hundred and ninety consecutive patients with firstonset stroke(197 ischemic and 93 hemorrhagic)and 290 age-and sex-matched control subjects without any cerebrovascular disease were studied.Plasma hsCRP level was measured and subsequent vascular events and death were determined in both groups over a 5-year period.Results Compared to control group,patients with stroke had higher plasma hsCRP level((3.3 ±3.8)vs(1.3±2.2)mg/L,t=8.048,P<0.01).Furthermore.within the group of patients with stroke,the mean plasma hsCRP level was higher in patients who experienced subsequent vascular events or death compared to patients without further complications ((4.4±4.3)vs(2.7±3.3)mg/L,t=3.496,P=0.001).Compared to the patients with lower hsCRP level(<1 mg/L),the relative risk for vascular events and death in stroke patients was 2.807(95%CI 1.544-5.495,P=0.001)in the hish hsCRP(>3 mg/L)patients.This increase of relative risk for vascular events and death in stroke patients persisted after the adjustment for age,sex and other cardiovascular risk factors such as hypertension and diabetes(OR 2.661,95%CI 1.323-5.352.P=0.006).Conclusions Patients presenting with stroke have higher levels of hsCRP compared to agematched controls.The degree of hsCRP elevation is correlated with the likelihood of subsequent VasCular events and death.These findings indicate that inerease of hsCRP level is associated with worsening prognosis after stroke in Chinese patients.