Objective: This research is conducted to analyze the background, the main practices and the results of the synergistic service of health institutions in Changzhou city, as well as to provide references for promoting the construction of integrated medical and health service system.Methods: This paper uses qualitative interviews and questionnaires to collect information and analyzes the data based on synergetic management theory.Results:Changzhou city has tentatively achieved the synergy of its health institutions by introducing relevant policies, setting up healthcare unions at the municipal level, integrating internal resources among healthcare unions, establishing health information platform and feedback mechanism, etc.Conclusion: The regional synergistic service of health institutions can be effectively promoted by introducing policies at the municipal level, promoting the mutual sharing and communication on information, and integrating internal resources among healthcare unions.But, as there still exist problems such as the distribution of benefits is not perfect, the degree of synergy is not close, etc., thus, the government is suggested to expand the implementation scope of the close-type medical service synergy and further improve the distribution policy of benefits.

Objective: To summarize the different cardiac shunt presentation in right heart contrast echocardiography and to clarify its clinical value for diagnosing the patients with congenital heart disease (CHD).
Methods: We retrospectively analyzed 102 patients who received right heart contrast echocardiography in our hospital from 2006 to 2014. The contrast media was the hand-vibrated mixture of 9 ml 50% glucose solution with 1 ml air.
Results: There were 49/102 patients with abnormal blood shunt detected including 8 patients of atrial septal defect (ASD) with right to left or dual shunt, 7 of ASD with left to right shunt, 9 of patent foramen ovale (PFO) with functional right to left shunt, 13 of patent ductus arteriosus (PDA) combining pulmonary arterial hypertension, 3 of pulmonary arteriovenous ifstula (PAVF), 9 patients with persistent left superior vena cava (PLSVC) and 8 of them drain to coronary vein sinus, 1 drain to left atrium.
Conclusion: Right heart contrast echocardiography may simply and effectively detect abnormal blood shunt in patients combining pulmonary arterial hypertension and improve the diagnostic accuracy of CHD.

Based on SWOT analysis and relevant information about the premarital healthcare services through on-site survey and literature research , this paper systematically analyzed the Strengths , Weaknesses , Opportunities and Threats of “one-stop” premarital healthcare services .It also puts forward some strategic suggestions on premarital healthcare services in China including enhancing communication and cooperation between the related national minis -tries and commissions , building a government-led multi-sectoral coordination mechanism , increasing the resource in-vestment , promoting the premarital health care service and pre-pregnancy physical examination integration , and strengthening publicity and mobilization of “one stop” service for premarital healthcare service policy recommenda-tions to provide a basis for decision-making in the promotion of the policy-related works .

With the universal two-child policy implementation, the birth rate increased, posing challenges to pediatrician allocation. Based on the birth rate, we calculated pediatrician demands and gaps during the period from 2016 to 2020 by the method of health service demand. The results showed that except Beijing and Shanghai, the ped-iatrician supply and demand ratios are less than 0 . 80 and additional numbers of pediatricians ranging from 191 981 to 198 287 are needed to meet the service demands. We recommend increasing the number of pediatricians taking both national supply-demand ratios and gaps by rationally using reasonable enrolment quota and improving the treatment and other reasonable ways to increase pediatricians. In addition, we should enhance information disclosure and guid-ance, and improve the hierarchical hospital visit system to alleviate the pressure of big cities.

With the universal two-child policy implementation, the birth rate increased, posing challenges to the maternity beds resource allocation. Based on the birth rate and the method of health service demand, we calculat-ed the maternity beds demands and gaps during the period from 2016 to 2020 . Results showed that numbers between 73 478 and 99 004 of maternity beds are needed annually and mainly allocated to eastern and central areas as well. In addition, the maternity beds of different delivery institutions should be adjusted and the hierarchical diagnosis system should be improved in order to alleviate the pressure of the obstestric acceepts in big cities like Beijing and Shanghai.

Objective:To discuss the effects of premarital health care services on birth defects in order to pro-vide some references for promoting the premarital policy .Methods: The rate of premarital healthcare and the inci-dence of birth defects and other relevant data during the period from 2000 to 2014 were collected in Guangxi province using SPSS18 .0 statistical software to carry out descriptive analysis , rank correlation analysis and time series analysis of the relevant collected data .Results: With the increase in premarital healthcare rate , the incidence of birth de-fects, neural tube defects , cleft lip and fetal edema syndrome decreased .Having a premarital subsequent effect , the higher the premarital healthcare rate , the lower of the incidence of the congenital heart disease and neural tube de-fects in the next year .Conclusion:The premarital healthcare services play an important role in reduction of birth de-fects and people's health quality improvement .As a suggestion , more attention should be paid to premarital health-care services and strengthen them , intended to improve people's health and reduce birth defects incidence .