An analysis on the human resources, equipments and budgets of the township hospitals in Wenzhou City discovered the following setbacks: Changeable management system, poor positioning of their functionality, difficulty to play their roles, insufficient funding, inadequate infrastructure, slow development, lack of medical technicians, low level of medical services, and lack of development momentum. Based on these findings, the author proposed the following to upgrade their functionality and promote their development: Clearly positioning their functionality, improving the financial assurance mechanism, deepening system reforms in these hospitals, and further clarifying job divisions.

Purpose To investigate the value of dual-source CT with dual-energy virtual non-contrast imaging in the diagnosis of cervical lymph node disease. Materials and Methods The dual-energy scan data of 126 lymph nodes from 50 patients confirmed pathologically were reviewed. The difference of average CT value, signal to noise ratio, contrast to noise ratio, image subjective assessment and lesion detectability between virtual non-contrast imaging and conventional non-contrast scan were analyzed. The radiation dose of virtual non-contrast imaging and real non-contrast imaging of cervical lymph node were also compared. Results ①The consistency of virtual plain scan combined with dual-energy contrast imaging in the diagnosis of six typical pathological types were all satisfactory (Kappa>0.7, P<0.01), and the detection rate of non-specific lymphadenitis, lymphomas and lymph node metastasis of thyroid carcinoma was higher among the six types (93.1%, 86.7% and 100.0%, respectively, Kappa=0.983, 0.893; P<0.01), and had the highest detection rate of lymph node metastasis of thyroid carcinoma (100.0%, Kappa=1.000, P<0.01). ②There was no significant difference among the average CT, signal to noise ratio and contrast to noise ratio of conventional scan and virtual non-contrast imaging during arterial phase and venous phase (H=3.125, 4.374, 4.037;P>0.05).③ Compared with conventional enhanced scan, dual-energy phases reduced radiation dose by about 19%. Conclusion Dual-energy virtual non-contrast imaging combined with contrast imaging can provide clear images in the diagnosis of enlarged cervical lymph nodes and reduce radiation dose of subjects, thus can be expected to replace real scan.

Objective To investigate the diagnostic value of cervical metastatic lymph nodes by T1 perfusion-weighted imaging and analyse the effect of age on perfusion.Methods 18 cases of cervical lymph node metastasis (case group)and 30 healthy people (control group)were performed T1 perfusion-weighted imaging.The semi-quantitative parameters (including in maximum relative enhancement ratio,wash in rate,wash out rate and peak time)and time-intensity curve (TIC)were compared between case group and control group.Moreover,the effect of age on perfusion was investigated by the age of 40 years old.Results The inflow rate was statistically significant difference between the two groups (P<0.05)and that of 23 cases of metastatic lymph nodes was higher than 49 normal lymph nodes.However,the maximum relative enhancement ratio,outflow rate and peak time weren’t statistically signif-icant difference(P>0.05).The time-intensity curve in metastatic lymph nodes and normal lymph nodes were common in typeⅡ. The maximum relative enhancement ratio and wash in rate negatively correlated with the age and the maximum relative enhancement ratio and wash in rate below the age of 40 years old were higher than above the age 40.Conclusion The wash in rate is helpful to dif-ferentiate metastatic lymph nodes and normal lymph nodes.The effect of age on perfusion is considered.

China’s chronic disease management suffers from problems such as unclear institutional function， insufficient information technology application， and weak regulation support. On the basis of current chronic disease management condition in China， this paper proposes to apply the concept of “people-centered” integrated health management to community chronic disease management and discusses the content and procedure of establishing an integrated community-based chronic disease management model driven by massive databases. The model innovatively combines technology integration， data integration and service integration， and can accurately and efficiently realize the "people-centered" full-course health management of various chronic diseases. Shanghai has provided integrated community-based chronic disease management service for 1.98 million citizens through applying this model. The model warrants further effectiveness and economic evaluation. This study provides precious experience for the development of chronic disease prevention and treatment in China.