The article reviewed the current status, reform measures and progress of the tiered medical services in Zhejiang province, and analyzed main roadblocks in such a system.Proposals made in the paper include such reform measures as further expanding quality medical resources of better talents and equipments to enhance primary medical institutions;forming the gatekeeper practice featuring firstvisit at community health centers with enhanced primary capabilities;insisting on joint reform of medical treatment, medical insurance and drugs, promoting the development of tiered medical services and utilization efficiency of medical resources in the province.

Objective To estimate the burden of infectious diseases in Zhejiang Province by Sullivan methods.Methods According to data of morbidity surveillance and epidemiological investigation in Zhejiang Province in 2006,the disability-adjusted life expectancy(DALE)and disabled life expectancy(DLE)attributed to infectious diseases were calculated following the procedures developed by Sullivan to estimate the burden of diseases.Results A total of 27 391 respondents were valid,including 13 965 males and 13 426 females.Life expectancy of residents in Zhejiang was 75.2 years old.DLE attributed to infectious diseases in 0-year group was 0.163 3 years,and diarrhea,hepatitis,pulmonary tuberculosis,measles and dysentery accounted for 76.7% of DLE of 0-year group.DLE attributed to pulmonary tuberculosis was the first in all infectious diseases in persons aged over 10.The burden of infectious diseases in male residents was higher than that in female residents .Conclusion More attention to prevention and control of diarrhea,hepatitis,pulmonary tuberculosis,measles and dysentery should be paid,especially in males.On the prevention and control strategy,children are the high risk population of measles and diarrhea,and pulmonary tuberculosis has become the main threat to adults.

Objective To evaluate the disability weights of infectious diseases in Zhejiang.Methods Based on the criteria of a seven classes of disability and 22 indicator conditions in Global Burden of Disease(GBD),10 clinical experts and 18 public health experts were selected for evaluating the minimal and maximal disability weights of infectious diseases by using self-regulating experts consultation questionnaire.Results Response rate of questionnaires was 100%.The mean minimal and maximal disability weights of 6 kinds of infectious diseases were 0.048～0.295 and 0.300～0.950,respectively.Conclusion Differences were found between the results of this study and the results of Australia burden of disease study in the mean disability weights for those infectious diseases.

Objective To learn and analyse the epidemiologic and pathogentic characteristics of typhoid fever and paratyphoid fever,and explore counter measures for diseases prevention and control.Method A descriptive epidemiologieal and experimental analysis Was made on the data of epidemic situation monitoring for typhoid fever and paratyphoid fever in the whole distriets of Taizhou.Results The incidence of typhoid fever and paratyphoid fever increased from 22.83/100 000 in 2001 to 61.55/100 000 in 2004, but decreased to 9.02/100 000 from 2005 to 2007.Salmonella paratyphi A become dominant strains prevailed over Salmonella typhi from 2001,and dominated by X2 genotype in later years.The season of disease onset was in advance and its regional distribution of diseases was still shown to be wide, but relatively localized.The clinical features were not typical.The age distribution was also shown wide,however,90.34%pational distribution was mainly in the group of peasants,migrant workers and students.The main causation was the unsanitary drinking water and shellfish taking.Conclusions Comprehensive measures for the epidemic situation and etiology are urgently needed,such as improvement management and disinfections of drinking water,health education and promotion,and construction of domestic flushing toilet system.

Objective:To evaluate the disability weights of neuropathy and psychopathy in Zhejiang.Methods:In terms of Delphi method,based on the criteria of a seven classes of disability and 22 indicator conditions in Global Burden of Disease (GBD),10 clinical experts and 18 public health experts were selected to evaluate the minimal and maximal disability weights of neuropathy and psychopathy by using self-regulating experts consultation questionnaire.Results:Response rate of questionnaire was 100%.The mean minimal and maximal disability weights of 8 kinds of neuropathy and psychopathy was 0.102～0.618 and 0.311～0.932,respectively.Conclusion:Difference was found between the results of this study with the data of Dutch study in the mean disability weights for those neuropathy and psychopathy.