Objective To know the status of Immunization program in Zhejiang Province.Methods The investigation on immunization program in zhejiang province was conducted,and the SWOT analysis was corducted to make a comprehensive evaluation.Results 11 citys,22 counties and 44 towns were investigated in this study,and the current immunization program in Zhejiang province were explored by SWOT analysis.Conclusion The SWOT Matrix,includes SO(strength-opportunity),ST(strength-threat),WO(weakness-opportunity)and WT(weakness-threat)can apply to make optimal strategy for the development of expanded program on immunization.

BACKGROUND: The repairing effect of distraction osteogenesis surgery in patients with craniofacial deformity secondary to cleft lip and palate remains unclear.OBJECTIVE: To evaluating the repairing effect of distraction osteogenesis surgery in patients with craniofacial deformity secondary to cleft lip and palate.METHODS: Databases of CNKI, Wanfang, VIP, CBM, Medline(ovid), science direct, ISI, as well as hand working were retrieved for the literatures about the curative effect of distraction osteogenesis on clef lip and palate patents with secondary craniofacial deformity which have been published. Clinical research about distraction osteogenesis used in clef lip and palate patents with secondary craniofacial deformity must have the same assignment style of investigation method and measurement indicators that include objective, design and detailed statistical method of the research. All of the findings can provide elementary data for weighted mean difference and 95% confidence interval (95%C/) or odd ratio and 95% C/. There are at least three patients included in the research and controlled by changes after operation. Meta-analysis was used to make a comprehensive quantitative analYSiS of ANB, the labial teeth overjet, SNA and nasolabial angle which are the soft or hard tissue measured by X-ray cephalometry for the forward-backward and perpendicular direction of the maxillafacial region. According to homogeneity tests, researches about ANB and overjet of the labial teeth adopted random effect model while SNA and nasolabial angle adopted fixed effect model. So total pooling weighted mean difference and its corresponding 95%CI for the models were calculated. RESULTS AND CONCLUSION: Totally 9 references and 123 patients were involved. Homogeneity test showed that, researches about ANB and overjet of the labial teeth are heterogeneous while SNA and nasolabial angle are homoeonomous. Conusarteriosus maps showed no publication bias was observed in all the literature that used in this article. Meta-analysis results showed that, the total pooled weighted mean difference of ANB, overjet of the labial teeth, SNA and nasolabial angle were below zero, all showed significant statistical difference. Meta-analysis can prove the .curative effect of extraoral support-type distraction on the craniofacial deformity secondary to cleft lip and palate. To some extent, this reseamh will provide guidance for choosing therapeutic regimen by the clinicians. After rigid external distraction by Le Fort Ⅰ ostetomy, most of the patients show great changes such as the increased SNA and ANB angle, the flatter of the upper lip curvature followed by the increased nosolabial angle, cured reverse overjet and returned normal occlusion relations.

OBJECTIVETo evaluate facial morphology characteristics of patients with unilateral complete cleft lip and palate (UCCLP) after cleft palate repair in different periods.

METHODS46 nonsyndromic UCCLP patients were chosen as test group and divided into three kinds (under 4-year-old, 4-7-year-old, over 7-year-old) according to periods of palate repair. 38 age and gender matched non-clefts children were involved as control group. 26 cephalometric measurements were measured to evaluate facial morphology of four groups.

RESULTSCompared with patients who received palate repair before 4-year-old, patients who received repair after 4-year-old had more protrusive ANS point (Ba-N-ANS, Ba-ANS) and less Y-axis angle. Patients who received palate repair after 7-yesr-old had greater A-PMP and ANS-PMP than patients who received palate repair before 4-year-old, patients who received palate repair before 7-year-old had smaller ANS-Me but after had no significant difference when compared with non-clefts.

CONCLUSIONWhenever palate repair is undertaken in the period of maxillary growth and development, patients' maxillary growth would be restrained, the delayed repair sample have better lower face height, maxillary protrusion, maxillary sagittal length and mandible growing direction when compared with the early repair sample, that is to say, the delayed repair sample have preferable head-face morphology.

Cephalometry ; Child ; Child, Preschool ; Cleft Lip ; Cleft Palate ; Face ; Humans ; Mandible ; Maxilla

Objective: To investigation the situation of cold chain on vaccine in parts of Zhejiang Province and to provide recommendations for the management. Methods: From October to December, 2016, we each selected an immunization clinic in Cangnan County of Wenzhou, Yongkang City of Jinhua, Jianggan District of Hangzhou. Temperature recorder and vaccine viral monitor (VVM) labels were used to monitor the cold chain during all the storage and transportation process. In Jianggan District, we use optical density sensor to detected 20 VVM labels every time when the vaccine was stock in and out. Results: In total, 54 958 records were collected by temperature recording devices in all the three immunization clinic. 275 records exceeded the temperature limit required for store and transportation, of which 270 (98.2%) were above 8 ℃ and 5 (1.9%) were under 2 ℃. Excessive temperature exposure mainly occurred during the transportation (38.2%, n=105), followed by storage process in CDCs at different levels (26.2%, n=72), stock in and out (20.7%, n=50) and storage in the refrigerators in immunization clinics (14.9%, n=41). The average optical density difference between VVM labels and the reference circular decreased from 0.404 to 0.344 when the vaccines were delivered from the Zhejiang provincial CDC to immunization clinics. The color of VVMs did not significantly changed before use. Conclusions The potential risk of vaccine cold chain in the monitoring sites is over-temperature. The weak links of cold chain management include the transportation, storage process, and stock in and out.

Objective To compare the efficacy of endoscopic sphincterotomy ( EST) combined with large-balloon dilation ( LBD) and that of LBD alone for large bile duct stones. Methods Data of 61 patients who received EST combined with LBD ( the combination group ) and 48 patients who received LBD alone ( the LBD group) from February 2008 to November 2014 were collected. The efficacy and adverse events of two groups were compared. Results The procedure time from successful cannulating to complete stone removal was shorter in the LBD group than that in the combination group [ 17. 3 min ( 8-35 min ) VS 21. 5 min ( 10-42 min) , P=0. 041] . There were no significant differences in overall complete stone removal rate[90. 2％ (55/61) VS 91. 7％ (44/48), P=1. 000] and complete stone removal rate without mechanical lithotripsy[78. 7％ (48/61) VS 83. 3％ (40/48), P=0. 542] in the combination group and the LBD group. Massive bleeding occurred in one patient of the combination group, but was successfully coagulated under endoscopy. There was no significant difference in the incidence of postoperative pancreatitis between the two groups[4. 9％ (3/61) VS 6. 3％ (3/48), P=1. 000]. Conclusion EST combined with LBD offers no significant advantage over LBD alone for the removal of large bile duct stones. LBD can simplify the procedure compared with EST combined with LBD in terms of shortening the procedure time.