Primary health care in China: is China's health reform reform for the whole nation?

BACKGROUND: Good primary health care can enhance national health status at relatively low cost. The barefoot doctor model in China was once considered to have been a successful health care policy. It was a model which was followed by other low-developed or developing countries. In recent decades, the Chinese government promulgated a number of new policies and health reforms to improve its health care system. AIM: This paper aimed to highlight the great significance of primary health care and appeal to the policymakers to change the priority to primary health care in order to be able to guarantee universal health care for the whole nation at least at primary care level. METHOD: This study discussed Chinese primary health care by reviewing its history and development. FINDING: Chinese government's efforts do not seem to be leading to a completely successful outcome for all the people of China as a result of the substantial imbalance of investments between tertiary level hospitals and grass-root level health care institutions. The government appears to have neglected the importance of primary health care in the implementation of health systems and resources.

Investigation and disposal of an outbreak of respiratory adenovirus type 7 in a university / 军事医学

Objective To analyze the epidemiological characteristics of an outbreak caused by respiratory adenovirus in a university,and study the factors of respiratory adenovirus outbreak and ways of prevention and control.Methods The pharyngeal swabs of each case were identified by real time-PCR and sequencing.All the epidemiological and clinical information of these cases was collected via field interviews and medical records.Epidemiological characteristics of the outbreak were analyzed descriptively.Results 193 cases,including 89 cases of pneumonia,from a total of 807 cases,were admitted to the hospital.The incidence was 32.79%(807/2461).798 adenovirus positive samples were detected from 2461 pharyngeal swab samples.The total positive detection rate was 32.42%(798/2461).The positive rate of adenovirus was 98.88%(798/807).Clinical symptoms included fever(95.7%), cough(76.9%)and sore throat(52.2%).The outbreak was brought under effective control after integrated intervention measures were taken.Conclusion Respiratory adenovirus often causes outbreaks in crowded populations.Early symptomatic surveillance and standardized laboratory detection methods are crucial for prevention and control of outbreaks.Integrated control measures should be taken according to the field conditions and characteristics of the outbreak.

Epidemiological characteristics of human adenovirus associated respiratory diseases in China / 军事医学

Objective To analyze the epidemiology of outbreaks and epidemic characteristics of respiratory diseases caused by human adenovirus in China so as to provide some data for its epidemic and outbreak control and clinical diagnosis .Methods Data on respiratory adenovirus outbreaks and surveillance from 1997 to 2015 was collected from PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Databases.All the data was analyzed according to the descriptive epidemiology , including the time , area and population distribution .Clinical data and the serotypes of adenovirus were also analyzed.Results From 1997 to 2015, the epidemical serotypes of adenovirus included 1 to 7, 11, 14 and 55 in China, and the dominating serotypes were 7 and 3, which accounted for 62.33％(599/961) and 24.97％(240/961)of the total cases of outbreaks, and for 36.79％(312/848) and 53.18％(451/848) of the total cases of surveillance.The peaks of annual outbreaks were in 2004 and 2013, which made up 41.12％(2212/5380) and 16.49％(887/5380)of the total outbreak cases in this study .Most of the surveillance cases years occurred in 2010 and 2011, which accounted for 17.59％(297/1688) and 17.77％(300/1688) of the total cases of surveillance .The seasonal distribution of the outbreaks was characterized by the highest possibility in spring and winter .Outbreaks of respiratory adenovirus were reported by 12 provinces or municipalities .The number of reported outbreaks related to serotype 3 was the largest in Jiangsu Province, which made up 58.33％(140/240) of the total.Most of the reported cases related to serotype 7 occurred in Hubei Province, which made up 67.41％ (333/494) of the total.Most of cases were found in Peking and Jiangsu , which accounted for 57.56％(971/1687)and 32.42％(547/1687)of the total positive cases respectively.The high-risk populations were children and new recruits , who accounted for 73.97％(2907/3930) of the total.The clinical features of adenovirus infection were fever (63％-100％),sore throat (31.9％-100％), pharyngeal hyperemia (60％-100％) and cough (5.88％ -100％).Conclusion Human respiratory adenovirus has become one of the main pathogenic microorganisms that induce acute respiratory diseases in schools and in the military in China , so human adenovirus and related respiratory disease should be monitored in such populations .The epidemiological characteristics of different types of respiratory adenovirus and the patterns of spread should be analyzed in order to reduce morbidity and mortality.