The developed countries have increasingly used private sector involvement in the practices of developing, financing and providing public health infrastructure and services through public-private partnerships (PPPs) in recent years.The main reasons for this uptake in these countries are manifold ranging from the rising expenditures for refurbishing, maintaining and operating public assets, and the increasing constraints on the governmental budgets stifle because of the economic downturn.As a result, the government needs funds to cover inadequate inputs and seeks innovation through private sector experts and management expertise aiming for better operational risks mitigation.In this paper, 18 risk factors in health sector of China were tracked through the literature research, and the research aims to identify the risk allocation by issuing the questionnaires and conducting interviews with experts from the academia, and public and private sectors.This paper finally provides the scheme about the appropriate risk allocation to focus on improving the mitigation of the existing risks in order to achieve successful PPP projects.

Recently, Public-private Partnerships (PPPs) are being increasingly used in the public facilities and services provision in China.The procurement system ranges from simple contracting of services to the involvement of the private sector in the infrastructure financing, design, construction, operation and maintenance.However, organizing a PPP is not an easy task due to its complexity and long term contractual obligations and this some projects to fail to attract the private sector in the partnership and in the services provision.18 critical success factors of PPP project in the Chinese health sector were undermined by the investigation of this research.The mostly identified CSFs are thorough and realistic benefit assessment, sound policies, appropriate risk allocation and risk mitigation, and the public/private sector responsibilities.This paper finally puts forward the recommendations based on the statistics that are published from the Integrated Information Platform of CPPPC in order to focus on validating them for successful PPP projects achievement.

0.01), but the significant difference was found respectively between group C and B and between group C and A (P

Objective:To evaluate the characteristics of bonding interface and microstructure of different resin composite inlays. Methods:Different composite resins and adhesives were used for restoration of extracted molars, the results were evaluated under scanning electron microscope(SEM) and atomic force microscope(AFM).Results:The microstructure feature of Tescera was with higher density when compared with that of other conventional resins,and fewer small holes could be seen in Tescera. AFM pictures showed that Tescera was with a very smooth surface. Indirect composite resin could be combined with resin bonding agent tightly and infiltrated each other. The interface between direct resin inlay material and resin bonding agent was very clear,and no obvious interfiltration could be seen under SEM and AFM. Conclusion:After treatment with water, heat,light and pressure, the physical properties of indirect composite resin is improved effectively, and obvious infiltration can be found in the interface.

Objective To analyze the clinical treatment in patients with nevus of Ota with Q switched Nd∶YAG Laser. Methods Total 326 patients nevus of Ota were treated. According to the shade of pigment, age and gender of the patients, the different technical parameters were selected. Results After 2 4 times of treatment, excellent results were obtained in 221 patients, good in 74 patients, and improved in 31 patinets. The total effective rate was 90.5 %. After treatment, the skin exposured to the laser in the patients had reaction of continued pigmentation in different degree. Usually, the above reaction will gradually disappeared without any scar formation. Conclusion Satisfactory results are obtained in patients with nevus of Ota treated with Q switched Nd∶YAG laser. [

Objective To observe the clinical efficacy of acupuncture plus Chinese medicine iontophoresis in treating dry eye syndrome.Method Sixty-two patients with dry eye syndrome were randomized into a treatment group and a control group, 31 cases in each group. The treatment group was intervened by acupuncture plus Chinese medicine iontophoresis, while the control group was intervened by artificial tears. After 4-week treatment, the changes of tear secretion, tear film break-up time (BUT) and symptoms score were observed, and the clinical efficacies were compared.Result The total effective rate was 87.1% in the treatment group versus 61.3% in the control group, and the between-group difference was statistically significant (P<0.05). The total symptoms score, tear secretion and BUT were significantly changed after the treatment in both groups (P<0.05). After the treatment, the total symptoms score, tear secretion and BUT in the treatment group were significantly different from those in the control group (P<0.05).Conclusion Acupuncture plus Chinese medicine iontophoresis is an effective method in treating dry eye syndrome.

Objective To explore the efficiency and safety of sodium valproate intravenous therapy on refractory status epilepsy(RSE)by diazepam in Chinese adult.Methods Twenty-five patients of RSE,consecutively admitted to West China Hospital of Sichuan University from September 1999 to May 2007,received intravenous administration of sodium valproate after being refractory to intravenous diazepam and intramuscular phenobarbitone.The efficiency and side effect of sodium valproate were then evaluated.There were ten males and fifteen females with mean age of fifty-five years.The symptoms of status epilepticus(SE)included generalized tonic-clonic status epilepticus(GTCS)(14 cases),complex partial status epilepticus(CPS)(7 cases),simple partial status epilepticus(SPS)(2 cases)and myoclonic status epielepticus(MS)(2 cases).The primary diseases prior to SE were viral encephalitis(13 cases),withdrawal of antiepilepsy drug(AEDs)(5 cases),cerebral trauma and brain surgery(3 cases),cerebral infarction(2 cases),intoxication(1 case)and cerebral palsy(1 case).Among them nine patients had a history of epilepsy.Results Of all the 25 cases of RSE,twenty-two were controlled with sodium valproate within one hour,and consciousness recovered within next one hour.No significant changes were found in blood pressure,heart rate,respiratory rate and cardiac rhythm,and no encephalopathy occurred.On the other hand,the other three cases who failed to be controlled,frequency and duration of seizure were redured.Conclusions Although intravenous sodium valproate has not been approved to be the drug of first choice for SE therapy,but it is non-sedative anti-convulsion drug that can be safely used to stop different kinds of diazepam resistant SE efficiently without obvious side effect.In addition,a quick recovery of patients' consciousness may be expected within an hour afte RSE being controlled.

Object:To create a practicable and valid scale used to evaluate postgraduate tutors in medical universities.The scale will be applied to tutor evaluation in order to activate the tutors in their responsibility for postgraduate education.Method:Some mature scales and questionnaires offered by some oversea'universities such as University of Michigan were offered for reference.The scale designed for tutor evaluation in medical universities was applied to evaluate most of the master tutors in Capital Medical University.All of the data was analyzed by SPSS 11.5,and the scale was modified according to the results of statistic analysis.Conclusion:The modified scale showed satisfactory reliability and validity.

Objective To understand the status of comprehensive health function impairment in elderly patients with rheumatoid arthritis, and to explore its influencing factors. Methods A total of 80 elderly patients with rheumatoid arthritis were enrolled in the first Affiliated Hospital of Kunming Medical University from December 2014 to October 2016. The quality of life SF-36 score was used to measure the physical health, mental health, daily activities and social health to assess the overall health status of patients. The factors influencing the comprehensive health function of the patients were analyzed by univariate analysis and multivariate linear regression analysis. Results The univariate and multivariate analysis showed that the low level of education, general occupation, marital misfortune, poor economic condition and self-treatment expense were the risk factors affecting the comprehensive health function in elderly patients with rheumatoid arthritis ( P<0.05). Conclusion Elderly patients with rheumatoid arthritis have problems of the functions of daily life, physical health, mental health and social health. To alleviate the high medical costs, improve the level of medical treatment, improve the people 's health and education level and maintain a good mood are the key to improve the overall health in patients with rheumatoid arthritis.

OBJECTIVETo discuss the clinical effect on swelling and pain after total knee arthroplasty treated with acupoint massage, mild moxibustion and routine detumescence.

METHODSOne hundred and twenty patients of knee osteoarthritis (KOA) after total knee arthroplasty (TKA), were randomized into an observation group and a control group, 60 cases in each one. In the control group, after TKA, the routine detumescence was applied, including elastic bandage compression, the operated limb raising exercise, knee joint braking, local ice compress, intermittent pneumatic compression, active ankle pumping and quadriceps contraction exercise, continuous passive mechanical exercise, using stretch socks, oral administration of rivaroxaban tablets, 10 mg, once a day, continuously for 21 to 24 days. In the observation group, on the basis of the routine detumescence as the control group, 1 h after operation, acupoint massage was done at Zusanli (ST 36) and Sanyinjiao (SP 6) till soreness and distension presented, twice a day; 48 h after operation, mild moxibustion was intervened at Zusanli (ST 36) and Sanyinjiao (SP 6), avoiding burning pain, once a day, continuously till the 7th day after operation. Before and after operation, the limb swelling condition and the scores of visual analogue scale (VAS) and HSS (hospital for special surgery) knee joint function were observed in the patients of the two groups.

RESULTSOn the 1st, 3rd, 5th, 7th and 14th days after operation, the swelling incidence in the observation group was apparently lower than that in the control group (P < 0.05, P < 0.01). On the 1st, 3rd, 5th and 7th days after operation, the scores of VAS in the observation group were lower than those in the control group (all P < 0.05). On the 7th and 14th days after operation, the scores of HSS in the observation group were better than those in the control group (all P < 0.05).

CONCLUSIONThe combined intervention of acupoint massage and mild moxibustion reduces the incidence of lower limb swelling, alleviates pain and promotes knee joint function recovery of TKA and the effects are better than those achieved by the simple routine detumescence therapy.

Acupuncture Points ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; Combined Modality Therapy ; Female ; Humans ; Knee Joint ; surgery ; Male ; Massage ; Middle Aged ; Moxibustion ; Osteoarthritis, Knee ; surgery ; therapy ; Treatment Outcome