Objective To explore the optimal time for clinical interventions on full-term or nearterm pregnant women with premature rupture of membranes(PROM). Methods A retrospective study was conducted on clinical data of 903 healthy, full-term or near-term (gestational age ≥ 35 weeks), singleton pregnant women with PROM, who admitted to our hospital from January 1, 2005 to December 31, 2009. All subjects were divided into 6 groups: women in group 1 were those fell into spontaneous labor within 6 h after PROM (n=269, 29.8%); women in group 2 were in spontaneous labor between 6 to 12 h after PROM (n= 161, 17.8%) ; women in group 3 were in spontaneous labor at 12 to 24 h after PROM (n = 75, 8. 3%); In group 4 oxytocin was administered for induction for women not in labor at 6 to 12 h after PROM (n= 124, 13.7%) ; Group 5 included those women who were not in labor at 12 to 24 h after PROM and oxytocin induction was offered (n=98, 10. 9%);Group 6 consisted of those women who were not in labor over 24 h after PROM and oxytocin induction was offered (n = 176, 19. 5%). The maternal and neonatal complications and outcomes of all pregnancies were reviewed and compared. Results Among the 903 cases, the total number of women without any medical interventions was 681, among which 505 (74.2%) fell into spontaneous labor, including 430 (63.2%) within 12 h with a cesarean section rate(CSR) of 20.7%(89/430), 75 (11.0%) at 12-24 h after PROM with the CSR of 50.7% (38/75), and 176 (25.8%) did not go into labor spontaneously (group 6) with a CSR of 70. 5% (124/176). (2) Among the 930 women, 398were induced at 6, 12 and 24 h after PROM. The CSR, incidence of intrauterine infection, puerperal morbidity and perinatal mortality rate in group 5 were significantly lower than those of group 6 [CSR:52.0%(51/98) vs 70. 5%(124/176); intrauterine infection: 6. 1%(6/98) vs 22. 7%(40/176);puerperal morbidity: 6. 1% (6/98) vs 19.9% (35/176); perinatal mortality: 7. 1% (7/98) vs 20.5%(36/176),all P＜0. 01], but no difference was found in the incidence of postpartum hemorrhage [1.0%(1/98) vs 4.0%(7/176), P＞0.05]. Conclusions Intervention is not recommended within 12 h after PROM in full term or near term gravidas. However, induction of labor should be offered thereafter. However, the CSR and incidence of maternal and neonatal complications rise up if induction of labor postponed to 24 h after PROM.

Objective To learn the economic operation and the existing problems of county TCM hospitals in Chongqing from 2012 to 2014.Methods 2012-2014 data of annual health financial report were used to conduct descriptive statistics and analysis of the current operation benefit, operating efficiency, debt paying ability, development ability, and cost management ability.Results From 2012 to 2014, the annual incomes of TCM county hospitals in Chongqing were 2.802, 3.412, and 4.385 billion RMB; the annual expenses were 2.813, 3.343, and 4.347 billion RMB; the ratios of income and expense about medical treatment were 0.86, 0.90, and 0.92; the ratios of income and expense of medicine were 1.16, 1.15, and 1.11; the outpatient amounts were 5.45, 5.87, and 6.99 million; the hospital discharge amounts were 330.4, 405.2, and 469.3 thousand; the charges per patient were 153.40, 177.12, and 188.71 RMB; the charges pre bed were 465.83, 533.14, and 571.02 RMB; medical expenses per patient were 4923.26, 5416.77, and 5576.01 RMB; the current ratios were 1.00, 1.06, and 1.09; the asset-liability ratios were 62.25%, 63.79%, and 61.37%; the annual growth rates of total assets were 14.06 % and 24.54%, and the annual growth rates of net assets were 19.44% and 21.70% during 2013 to 2014; 100-yuan hygienic materials and medicine consumption were 51.23, 51.10, and 50.07 RMB during 2012 to 2014; the management fee rates were 18.55%,15.44%, and 14.82%.Conclusion The general economic running of county TCM hospitals in Chongqing is stable and financial balance moves towards rationality; social benefit, expand capacity and cost management ability are enhanced gradually. However, the problems about insufficient government finance input, small medical income elasticity, poor debt paying ability, and diseconomies of scale still exist.

Deepening healthcare reform highlights the importance of medical services pricing adjustment, and the imperativeness to strengthen the informationized management of such pricing.With this concept in mind, the authors analyzed the problems and causes of the current management on medical service pricing informatization at public hospitals, and discussed the construction strategy of an intelligent error correction system in this regard. That is, to develop a technical process from the four aspects of software flow, interface flow, project rules, and reporting system. This system is designed with such functions as inpatient cost inquiry, inpatient information, price adjustment analysis, price feedback record statistics and inquiries over the hospitalization expense ceiling, as well as inpatient cost omission inquiry.This paper also discussed the construction of a platform to transform the knowledge of pricing policy into the knowledge base of medical service pricing, in order to improve the level of medical pricing management, promote the efficiency of hospital operation and management, and reduce the burden of patients.