Purpose To evaluate features of the left ventricular twist in patients with atrial septal defect (ASD) using speckle tracking imaging (STI) in order to guide clinical application.Materials and Methods Fifty-eight patients with ASD confirmed by ardiac ultrasound in Shanghai Children's Medical Center from October 2015 to January 2016 were enrolled in this study as case group,which were further divided into group ASD-A with 30 cases and group ASD-B with 28 cases according to the volume of right ventricular.The volume of right ventricular was significantly increased in the group ASD-A,but the volume of right ventricular was not significantly increased in the group ASD-B.At the same time,30 normal children with matched age and sex were chosen as control group.The parameters of left ventricular twist motion in each group were measured and compared by using STI.Results In group ASD-A,The basal and apical part of 6 children rotated counterclockwise.Compared with those in the control group,the basal rotation angle and apical rotation angle of left ventricular in group ASD-A were significantly higher (P＜0.01),and the peak twist and torison of left ventricular in group ASD-A were also higher (P＜0.05).Compared with those in the control group,only the apical rotation angle in group ASD-B was higher (P＜0.05),but the rest parameters of the left ventricular twist motion in group ASD-B were not statistically significantly higher (P＞0.05).Conclusion The significant increase in the volume of right heart load in ASD impacts on the basal and apical rotation of left ventricular.

Objective To analyze the skeletal characteristics of temporomandibular joint in patients with unilateral posterior scis-sors bite by using the cone-beam computed tomography(CBCT) .Methods Thirty-five patients of Angle class Ⅰ were scanned by CBCT (19 cases with unilateral scissors bite as the experimental group and 16 cases without scissors bite as the control group ) The CT images were reconstructed into 3D computer models by using the Dental Volume Reformat Function of the Ondemand 3D pack-age .9 anatomical landmarks were located and all data of 11 measured value were statistically analyzed .Results There were statisti-cal differences in the skeletal characteristics of temporomandibular joint in the scissors-bite side of the experimental group compared with those in the non-scissors-bite side (P<0 .01) .The side-to-side differences of the skeletal characteristics of temporomandibular in the controlled group were not statistically significant (P>0 .05) .There were statistical significances in the skeletal characteris-tics of temporomandibular joint of the controlled group compared with those in the scissors-bite side of the experimental group ,and the same with those in the non-scissors-bite side (P<0 .01) .Conclusion The CBCT is an effective tool to analyze the skeletal char-acteristics of temporomandibular joint characteristics .There were differences in the morphology of the condyle and the glenoid fossa of patients with unilateral posterior scissors bite .

Objective To analyze the main practices of capitation payment system reform in the case areas and put forward enlightenments and suggestions in this regard. Methods The implementation practices of the case areas were summarized, and descriptive statistical analysis was carried out on the implementation effects. Results By analyzing the effectiveness of the case areas′reform, it was found that the case areas are curbing the excessive growth of medical expenses (for example, outpatient fees per visit of Dingyuan county-level hospitals decreased from 245.11 yuan in 2015 to 218.40 yuan in 2017), increasing the actual compensation ratio of residents ( for example, the actual compensation ratio of Funan increased from 59.80% in 2015 to 63.28% in 2017), forming a medical treatment pattern within the county (for example, out-of-county compensation ratio in Dingyuan decreased from 37.38% in 2015 to 31.13% in 2017), achieving double-way referrals (for example, the number of referrals to superior hospitals of Jimo increased from 98 in 2015 to 328 in 2017), improving the subsidence of quality services, and controlling the risks of medical insurance funds. Conclusions At present, the reform of the case areas has been implemented steadily and achieved results. It is recommended to further improve such aspects as reform coordination, insurance standard setting, incentive mechanism establishment, and leadership to ensure the reform progress.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.