Objective To investigate the incidence of the newborn's clavicle fracture,the high risk factors related to the fracture,and the possible methods to prevent and treat the fracture. Methods Forty-four newborns with fractured clavicles in our department from Sept.1994 to Dec. 1997 were analysed retrospectively.Results There were 44 newborns suffered from clavicle frac- ture in 3 135 vaginal deliveries with an incidence of 1.4%.Thirty-four cases(77.26%,34/44)were diagnosed immediately after delivery or before discharge from the hospital.The risk factors for clav- icular fracture include:high birth weight,forceps delivery,shoulder dystocia,and prolonged second stage of labor and persistent occipital transverse or posterior.However,41%(18/44)of cases had no high risk factors.The right clavicle is more likely to be affected,which may be due to the fact that the anterior shoulder was over-pressed as the infant descended through the pelvic outlet under the symphysis pubis.Conclusions Newborn's clavicle fracture is one of the common injuries in vagi- nal delivery.Close attention should be paid during delivery when any of the above mentioned high risk factor is presented,and careful examination of the newborn can not be neglected.

Objective To discuss the influence of bath frequency on neonatal skin condition and body temperature. Methods 108 newborns from obstetrics of People′s Hospital of Peking University during November 2015 to December 2015 were selected, and were randomly distributed t into two groups by lottery. The control group took bath every day, whereas the experimental group did every three days. The newborns were followed up for 4 weeks on their skin condition and body temperature. Then the data were systemized and performed statistical analysis. Results During the first 4 weeks after babies were born, the control group and experimental group showed no significant difference on their skin condition (P>0.05). When compared at the time of first 3 days, 1 week and 2 weeks after the babies were born, body temperature of the experimental group were (36.693±0.182), (36.738±0.174), (36.772±0.185)℃, while the control group were (36.591 ± 0.160), (36.671 ± 0.158), (36.684 ± 0.155)℃,which tended to be significantly lower than the experimental group (t values were -2.697,-2.087,-2.669, P <0.01 or 0.05), but still within the normal range. However, this difference of body temperature disappeared after the first 2 weeks (P>0.05). Conclusions Reducing the bath frequency form once a day to every third day showed no influence on neonatal skin condition. Meanwhile, it did avoid significant reduce of body temperature after bath. This may help improve healthy skin care of newborns, promote their growth, and at the same time, redistribute the clinical nursing work efficiently.

With the rapid development of social economy and the improvement of multi-level medical insurance system, the health demand of people continually grow and the content and quality of health demand are more and more diversified. By contrast, the growth of health resources was very slow. The contradiction between supply and demand of health services becomes increasingly sharp and health expenditure growth rapidly. So by systemizing the related concepts and main international practices and enlightenment of managing health demand in developed countries, this article aimed to provide references and suggestions for reasonably managing health demand, standardizing the order of medical treatment and improving the phenomenon ofdifficulty in treatment.