Overall enhancement of the public health system ranks a key task and goal for the ongoing health reform.This paper described the public health development in Shenzhen amid the ongoing health reform.Shenzhen has achieved the following objectives as required in the reform:better public service by public health institutions,availability of major and primary public health services as required by the state and city,overall elevation of public health service capabilities,and significant drop of disease morbidity and mortality.Challenges ahead include room of improvement in public health service network,incentive mechanism of public health service providers,and that of public health service delivery capability.

Objective:To compare the effects ofpropofol and sevoflurane on the plasma thromboxane B2 (TXB2),endothelin-1 (ET-1) and D-dimer (D-D) levels of patients underwent posterior retroperitoneal laparoscopic surgery.Methods:84 cases of patients underwent post retroperitoneal laparoscopic surgery in our hospital from May 2015 to December 2016 were selected as research objectives and randomly divided into two groups with 42 cases in each group.The same anesthesia induction were provided for two groups,the observation group was given 2％～3％ sevoflurane for continuous inhalation,while the control group was given 4～12 mg/(kg·h) of propofol for continuous injection by pump.Both groups received remifentanil 10 μg/ (kg ·h) target-controlled infusion simultaneously.The levels of plasma TXB2,ET-1 and D-D in the two groups were measured after anesthesia induction (T0),at 0.5 h (T1),1 h (T2),1.5 h (T3) after pneumoperitoneum.Meanwhile,the anesthetic effects and adverse reactions were compared between two groups.Results:The time of consciousness disappearence,time of tracheal intubation,spontaneous breathing recovery time,eye opening time,verbal response time,orientation recovery time and extubation time of observation group were significantly shorter than those of the control group (P＜0.01).No significant difference was found in the occurrence of adverse reactions between two groups (P＞0.05).The plasma TXB2,ET-1 and D-D levels of both groups were gradually increased at T1,T2 and T3,and all were significantly higher than that at T0 (P＜0.01).The plsma TXB2,ET-1 and D-D levels at T1,T2 and T3 of observation group were significantly lower than those of the control group at same time (P＜0.01).Conclusion:Posterior laparoscopic surgery could cause different degrees of hypercoagulability of blood.Compared with propofol,sevoflurane could effectively inhibit the release of TXB2,ET-1 and D-D in anesthesia after retroperitoneal laparoscopic anesthesia,and play a better role of anticoagulation.

Objective:To compare the effect of modified postauricular transverse incision and traditional vertical incision for microvascular decompression in the treatment of hemifacial spasm.Methods:Prospective study method was used. A total of 116 patients with hemifacial spasm in Handan Central Hospital from January 1, 2019 to January 1, 2020 were selected, and divided into two groups according to the admission order. Both groups underwent microvascular decompression; control group (57 cases) received traditional vertical incision, while treatment group (59 cases) received modified postauricular transverse incision. The brainstem auditory evoked potential (BAEP), pain degree, surgical indicators, facial aesthetic satisfaction and complications were compared between two groups.Results:After treatment, the BAEP of latency, wave interval and wave amplitude in the two groups increased compared with that before treatment, and the BAEP of latency, wave interval and wave amplitude in the treatment group were higher than those in the control group: (1.89 ± 0.15) ms vs. (1.62 ± 0.21) ms, (7.89 ± 0.15) ms vs. (6.25 ± 0.41) ms, (1.79 ± 0.19) ms vs. (1.54 ± 0.11) ms ( P<0.05). After treatment, the visual analogue score (VAS) of patients in the two groups decreased compared with that before treatment, and the VAS of patients in the treatment group was lower than that in the control group: (1.15 ± 0.27) points vs. (2.18 ± 0.24) points ( P<0.05). The operation time, intraoperative bleeding volume and postoperative scar length of patients in the treatment group were less than those in the control group: (60.41 ± 3.81) h vs. (76.87 ± 3.87) h, (30.18 ± 4.19) ml vs. (56.87 ± 4.15) ml and (4.18 ± 1.07) cm vs. (6.87 ± 1.05) cm ( P<0.05). The satisfaction rate of patients in the treatment group was higher than that in the control group: 91.53% (54/59) vs. 71.93% (41/57) ( P<0.05). The complication rate of patients in the treatment group was lower than that in the control group: 5.08% (3/59) vs. 21.05% (12/57) ( P<0.05). Conclusions:Compared with traditional vertical incision, the modified transverse incision for microvascular decompression in the treatment of hemifacial spasm can reduce intraoperative blood loss and postoperative scar area, enhance brainstem auditory evoked potential, and improve facial aesthetics, which is worthy of recommendation.