Adhering to the Chinese solution to solve the worldwide problem of medical and health system re-form is the highest summary of China's medical reform methodology.The Third Plenary Session of the 20th CPC Central Committee proposed to deepen reform of medicine and healthcare system,and the reform of the medicine and healthcare system has been promoted in depth.By systematically studying President Xi Jinping's series of im-portant speeches,and consulting the database of the ideological and theoretical resources of the Communist Party of China,combined with field research over the years,some basic issues of China's medical and health system re-form policies were theoretically discussed.The fundamental feature of the Chinese solution is to put the people first,its distinctive feature is pioneering,the basic method is to grasp the main contradictions and the main aspects of contradictions,the important principle is to build up a basic safety net,strengthen the community,and make due institutional arrangements,and the basic experience is to fan out from point to area,led by example and pro-mote by model.Exploring and studying this theoretical problem is helpful to further deepen the medical reform and build a sound foundation for the Chinese modernization.

Adhering to the Chinese solution to solve the worldwide problem of medical and health system re-form is the highest summary of China's medical reform methodology.The Third Plenary Session of the 20th CPC Central Committee proposed to deepen reform of medicine and healthcare system,and the reform of the medicine and healthcare system has been promoted in depth.By systematically studying President Xi Jinping's series of im-portant speeches,and consulting the database of the ideological and theoretical resources of the Communist Party of China,combined with field research over the years,some basic issues of China's medical and health system re-form policies were theoretically discussed.The fundamental feature of the Chinese solution is to put the people first,its distinctive feature is pioneering,the basic method is to grasp the main contradictions and the main aspects of contradictions,the important principle is to build up a basic safety net,strengthen the community,and make due institutional arrangements,and the basic experience is to fan out from point to area,led by example and pro-mote by model.Exploring and studying this theoretical problem is helpful to further deepen the medical reform and build a sound foundation for the Chinese modernization.

Objective:To evaluate the effectiveness and quality of ultrasound-based (BUS) process optimization in breast cancer screening.Methods:The program collected the first to fourth quarterly breast cancer screening statistic data and case report data from 30 provinces, autonomous regions and municipalities in 2015 by the online report system of national key service program of women and children′s public health. The call rate, mammography (MG) subsequent screen rate, biopsy rate, detection rate, early diagnosis rate, carcinoma in situ rate, missing detection rate, false positive rate and positive predictive value (PPV) of breast cancer were calculated.Results:A total of 1 501 753 rural women attended the BUS process optimization screening. The nationwide recall rate was 3.01%(45 156/1 501 753), and in the eastern and central area were 3.41%(17 173/503 130) and 3.56%(14 499/407 739), respectively, higher than 2.28% (13 484/590 884) of western area ( P<0.05). The nationwide MG subsequent screen rate was 2.78%(41 694/1 501 753), and in the eastern and central area were 3.19%(16 036/503 130) and 3.29% (13 421/407 739), respectively, higher than 2.07%(12 237/590 884) of western area ( P<0.05). The nationwide biopsy rate was 0.23%(3 462/1 501 753), and in the central area were 0.26%(1 078/407 739), respectively, higher than 0.21%(1 247/590 884) of western area and 0.23% (1 137/503 130) of eastern area ( P<0.05). The nationwide biopsy PPV was 37.00%(1 281/3 462). The biopsy PPV of eastern area was (34.30%, 390/1 137), lower than 39.33% (424/1 078) of central area ( P<0.05). A total of 1 281 cases of breast cancer were detected, the detection rate was 0.85‰(1 281/1 501 753), and the detection rates of central area was 1.04‰ (424/407 739), higher than 0.79‰(467/590 884) of western area and 0.78‰(390/503 130) of eastern area ( P<0.05). The BUS initiate screening positive rate from detected breast cancer cases was 96.96%(1 242/1 281), the MG subsequent screening positive rate was 2.42%(31/1 281). The nationwide early diagnosis rate was 85.25%(1 092/1 281), and in the eastern and central areas were 87.95%(343/390) and 88.21%(374/424), higher than 80.30%(375/467) of western area ( P<0.05). The screening rate of on or above stage Ⅱ breast cancer in eastern area was 55.64%(217/390), lower than 64.62%(374/424) of central area and 62.31%(291/467) of western area. The missing detection rate was 0.62%(8/1 281) and false positive rate was 1.20%(17 528/1 464 149). Conclusions:The BUS process optimization of breast cancer screening scheme is reasonable and applicable to China rural women. The effectiveness and quality of eastern area are superior to those of central and western area.

Objective:To evaluate the effectiveness and quality of ultrasound-based (BUS) process optimization in breast cancer screening.Methods:The program collected the first to fourth quarterly breast cancer screening statistic data and case report data from 30 provinces, autonomous regions and municipalities in 2015 by the online report system of national key service program of women and children′s public health. The call rate, mammography (MG) subsequent screen rate, biopsy rate, detection rate, early diagnosis rate, carcinoma in situ rate, missing detection rate, false positive rate and positive predictive value (PPV) of breast cancer were calculated.Results:A total of 1 501 753 rural women attended the BUS process optimization screening. The nationwide recall rate was 3.01%(45 156/1 501 753), and in the eastern and central area were 3.41%(17 173/503 130) and 3.56%(14 499/407 739), respectively, higher than 2.28% (13 484/590 884) of western area ( P<0.05). The nationwide MG subsequent screen rate was 2.78%(41 694/1 501 753), and in the eastern and central area were 3.19%(16 036/503 130) and 3.29% (13 421/407 739), respectively, higher than 2.07%(12 237/590 884) of western area ( P<0.05). The nationwide biopsy rate was 0.23%(3 462/1 501 753), and in the central area were 0.26%(1 078/407 739), respectively, higher than 0.21%(1 247/590 884) of western area and 0.23% (1 137/503 130) of eastern area ( P<0.05). The nationwide biopsy PPV was 37.00%(1 281/3 462). The biopsy PPV of eastern area was (34.30%, 390/1 137), lower than 39.33% (424/1 078) of central area ( P<0.05). A total of 1 281 cases of breast cancer were detected, the detection rate was 0.85‰(1 281/1 501 753), and the detection rates of central area was 1.04‰ (424/407 739), higher than 0.79‰(467/590 884) of western area and 0.78‰(390/503 130) of eastern area ( P<0.05). The BUS initiate screening positive rate from detected breast cancer cases was 96.96%(1 242/1 281), the MG subsequent screening positive rate was 2.42%(31/1 281). The nationwide early diagnosis rate was 85.25%(1 092/1 281), and in the eastern and central areas were 87.95%(343/390) and 88.21%(374/424), higher than 80.30%(375/467) of western area ( P<0.05). The screening rate of on or above stage Ⅱ breast cancer in eastern area was 55.64%(217/390), lower than 64.62%(374/424) of central area and 62.31%(291/467) of western area. The missing detection rate was 0.62%(8/1 281) and false positive rate was 1.20%(17 528/1 464 149). Conclusions:The BUS process optimization of breast cancer screening scheme is reasonable and applicable to China rural women. The effectiveness and quality of eastern area are superior to those of central and western area.

The comprehensive establishment of the basic medical and health system with Chinese characteristics is key to the healthcare reform. Taking the basic medical and health system as the specific research object, this paper elaborated the system examples of various countries' health systems. It also, using the classic system theory as the theoretical research basis, defined the connotation of the basic medical and health system with Chinese characteristics and described such characteristics. The purpose is to lay a theoretical foundation for the development of such a system, and provide references for the healthcare reform and Healthy China initiative.

From the perspective of the government′s positioning of public hospitals, the basic problems of functional positioning of public hospitals are clarified. According to different positioning subjects, the positioning of public hospitals is divided into three categories: government positioning, social positioning and self-positioning. By analyzing the connotation of the positioning mechanism of public hospitals, the outstanding performance of the insufficient realization of the government′s positioning of public hospitals, and the influencing factors of the government′s positioning of public hospitals, this paper tries to provide a theoretical basis for formulating a scientific and comprehensive reform plan of public hospitals.

Objective To explore the status of intracranial aneurysms screened by CTA among the population with family history of stroke.Methods 200 patients including 108 men and 92 women in our hospital were involved,who had a family history of stroke.Head CTA examination,physical examination and laboratory tests were performed.Results 200 male and female had no statistical significance in demographic characteristics,past medical history and physical testing (P＞0.05);in lifestyle,smoking and drinking prevalence among male were higher than female (P＜0.05),and drug-usage rate of female were higher than male (P＜0.05).27 cases (13.5 ￥)had intracranial aneurysms,including 13 male cases (12.03 ％) and 14 females cases(15.22 ％),and there was one occurred aneurysm rupture and subarachnoid hemorrhage,the prevalence rate of aneurysm rupture was 87％.The 27 intracranial aneurysms cases had 29 CPC aneurysms,with 2 cases had two aneurysms.The number of aneurysm diameter ＜3 mm were 7 (24.14％),3 7 mm diameter were 12 (41.38％),and ＞7 mm were 10 (34.48％).Classified by the morphology,there were 7 (24.14％) fusiform aneurysm,22 (75.86％) cystic,3 (10.34％) small drops of blood sample.Conclusion CTA is a noninvasive and effective method for intracranial aneurysm,can provide additional valuable diagnostic information particularly for emergency of aneurysm screening.

Through analyzing documents of healthcare departments, this paper explored the public benefit nature of the medical and health sector from such aspects as culture, philosophy, management, ethics,economy, politics and society. Furthermore, it analyzed the commonweal in the healthcare reform documents,including the commonweal in public health and medical services,basic medical care and health services,public hospitals and medical and health services. Public hospitals were cited as examples for an in-depth review of the profound connotation of commonweal in the medical and healthcare sector.

The financial compensation mechanism for public county hospitals are discussed and analyzed in the paper.Such a mechanism is analyzed by means of media coverage and literature consulting,along with field survey.Roadblocks have been found in implementation of the mechanism, namely delayed payment of capital expenditure compensation,poor support for medical equipment purchase,gaps in development key disciplines development,insufficient compensation for retirees expenses,poor definition of policy-incurred losses,and unclear compensation of public health services.in a word,it is imperative to change the unreasonable financial compensation mechanism,before the six financial compensation subsidies can be fully put in place and financial compensation made efficiently.

Given the significant improvement in terms of its coverage and compensation depth,China's basic medical insurance system has inherent setbacks in its structure as held by the authors.They hold that the medical insurance as the most important source of compensation for medical institutions,should further reform its structure of financing and reasonably raise the percentage of compensation; adjust the time reference and space reference for prepayment estimation such as the total prepaid amount; deepen supportive reforms for the payment manner.All these measures aim at minimizing impact of the payment control mechanism on routine medical activities and exploring diversified payment manners that are feasible.