Objective: To investigate the perinatal mortality and its causes in Lishui City, Zhejiang Province, so as to provide insights into the reduction of perinatal mortality. Methods: The perinatal mortality data were collected from three designated monitoring counties (districts) in Lishui City from 2015 to 2020. The changing trend in perinatal mortality and causes of death were analyzed, and the differences of perinatal causes of death and maternal conditions in urban and rural areas were compared. Results: There were 406 perinatal deaths in three monitoring counties (districts) of Lishui City from 2015 to 2020. The perinatal mortality showed a downward trend (χ2trend=5.078, P=0.024), and the average perinatal mortality rate was 5.93‰. The top five causes of perinatal mortality were birth defects, unknown causes, umbilical cord factors, maternal factors and preterm delivery. There was significant difference in the causes of perinatal death between urban and rural areas (χ2=25.574, P<0.001); birth defects, umbilical cord factors and unknown causes were predominant in urban areas, accounting for 75.00% (138 deaths); while birth defects, unknown causes and maternal factors were predominant in rural areas, accounting for 67.57% (150 deaths). The proportion of junior high school education and below was significantly higher in rural women than in urban women with perinatal death (54.50% vs. 26.63%; χ2=32.117, P<0.001), and the proportion of more than 5 antenatal examinations was significantly lower in rural women than in urban women with perinatal death (46.85% vs. 59.24%; χ2=6.195, P=0.012). Conclusions The perinatal mortality appeared a tendency towards a decline in Lishui City from 2015 to 2020, and birth defect was the main cause. Prenatal and postnatal care and tertiary prevention should be strengthened.

Objective:To invetigate the use of targeted anticancer drugs in our hospital during 2011-2013 to provide reference for the clinical rational drug use. Methods:The utilization of anti-tumor molecular targeted drugs in our hospital during 2011-2013 was retrospectively analyzed in respect of consumption sum, DDDs and DDC. Results:The proportion of consmption sum of anti-tumor mo-lecular targeted drugs in the total consumption sum was increased year by year, and that in 2012 and 2013 was over 60%. Protease ki-nase inhibitors accounted for 41. 29%-73. 41% in the consumption sum of anti-tumor molecular targeted drugs; monoclonal antibody accounted for 19. 40%-30. 88%; the other drugs accounted for 7. 19%-27. 83%. The consumption sum and the number of receiving medication patients of rituxan and cetuximab were not synchronized well, and the patients were born the higher cost. Conclusion:The use of anti-tumor molecular targeted drugs in our hospital is increased year by year, and the oral administration of anti-tumor molecular targeted drugs is with especially wide application.

Doctor-patient communication could assist in medical diagnosing , strengthening the confidence of patients and relieving psychological pressure of the medical staff , so that it plays an indispensable role in the process of building a harmonious doctor -patient relationship .Improve the system of doctor -patient communica-tion, set up the third-party supervition of mediation system , convert the mode of thinking with a positive attitude , improve communication skills , correct use communication methods , strengthen the humanistic care and knowledge popularization .Therefore , under the medical model of people-oriented, it should shorten the distance between the doctors and the patients with heart and soul and gradually establish a new harmonious doctor -patient relation-ship with mutual respect , mutual trust , equal communication and cooperation .

OBJECTIVE:To evaluate the compatible stability of cefpiramide sodium for injection with metronidazole in-jection.METHODS:Content,color and pH value of the mixed solution at different time within6hours after mixing under room temperature were monitored.RESULTS:There were no significant changes in content,color and pH value for the mixed solu-tion determined at different time within6hours after mixing under room temperature.CONCLUSION:The mixture of cefpi-ramide sodium with metronidazole injection can be used within6h after mixing.

OBJECTIVE: To analyze the utilization and tendency of TCM injections in our hospital, and to provide reference for clinical use of drugs. METHODS: Based on hospital database, the category, consumption sum and DDDs of TCM injections in our hospital during the period of 2005～2008 were analyzed statistically. RESULTS: The proportion of consumption sum of TCM injections in the total consumption sum from 2006 to 2008 were 13.06%, 9.33%, 9.97%, 9.08% respectively. The consumption sum of TCM injections was increased year by year. Stasis-removing agent for cardio-cerebral-vascular system took up the first place in the list of category of drugs, comsunption sum and DDDs. CONCLUSION: TCM injections are widely applied in our hospital. The utilization structure of TCM injections is the reasonable basically. But great importance should be attached to the safety and effectiveness of TCM injections and reasonable choice.

Objective To investigate the source of CD147 expressing cells in joint and its corelation with rheumatoid arthritis (RA),and to study the expression of CD147 on different cells of peripheral blood and joint fluid of RA patients and normal health controls.Methods The expression rate and intensity of CD147 on lymphocyte (CD3 +T),monocyte (CD14 + Mo) and neutrophils (N) of 10 active RA patients before and after treatment and 10 normal health controls′ peripheral blood and synovial fluid were studied by bicolor immunofluorescence flow cytometry.Results ① Compared with normal control,the expression intensity of CD147 on CD3 + T and CD14 + Mo were higher (P

Objective To analyze the significance of the liquid-based thinprep cytologic test (TCT ) in early cervical cancer screening by comparing cervical atypical squamous cells (ASC) and the histologic diagnostic results in order to guide the clinician to correctly understand the meaning of ASC and further explore the effective method of early cervical cancer screening .Methods 163 cases of cervical ASC diagnosed by histology and TCT were retrospectively analyzed and the comparative analysis was performed . Results Among 163 cases of cervical biopsy ,50 cases were ASC of undetermined significance (ASC-US) diagnosed by TCT ,the positive cases verified by the histology accounted for 49 .3% ;13 cases were ASC of highly squamous intraepithelial lesions diag-nosed by TCT ,the positive cases verified by the histology accounted for 76 .9% .The cases of ASC-US diagnosed by cytology and cervical intraepithelial neoplasia grade Ⅱ(CIN Ⅱ) and above diagnosed by histology accounted for 12% .Conclusion ASC-H high-ly suggests the clinical possibility of high-grade intraepithelial neoplasia .ASC-US is a suggestive diagnosis rather than a clarity di-agnosis .Correctly understanding the clinical significance of ASC can discover early cervical lesions as early as possible .

Objectives To explore the optimal startup time of patient controlled intravenous analgesia (PCIA) in aged patients after thoracotomy for pulmonary lobectomy.Methods The 67 aged patients after thoracotomy for pulmonary lobectomy from January to December 2008 were randomized divided into two groups:PCIA was startup immediately after waking (instantly group) or after removal tracheal intubation (delayed group).The analgesia efficacy,cardiopulmonary function and side effect were evaluated at the awake time,12,24 and 48 hours after surgery respectively.Result Both of VAS scores at 12 hours after surgery and oxygenation index at 48 hours after surgery had significant difference (P<0.05) between the two groups.The analgesia efficacy was better in the instantly group.There was no significant difference on the duration of mechanical ventilation and side-effect rates between the two groups.No patient suffered from respiratory depression.Conclusion The early use of PCIA in aged patients after thoracotomy for pulmonary lobectomy can gain better pain control and oxygenation effect.

To solve the problems in the materials,spirit and abiligy of the students from the article poor family,claims to construct a fire-new university students subsidizing system from the trinity of ‘subsidize,encourage,quality development’ by the three sides:the multi-funding channels,multi-dimensional motivational strategies and diverse quality development training,aiming at enhancing the effect of the funded job in high school.

The application of continuous quality improvement program in standardized residency training examination in the central Hospital of Shanghai Jiading was introduced to inquire into the way to improve the quality of standardized training of resident doctors. Through the steps of FOCUS-PDCA, we continuously improved the examination content and quality compliance training personnel, and developed the examination process including test, training, supervision, learning and using. After the implementation of the project, the percentage of the departments that meet the residency training examination requirements has been increased from 33.3%to 100%in our hospital. The percentage of the students that passed the licensed medical skills examination was 96.6%in that year. 100%of the students passed the graduation comprehen-sive examination. Year-end evaluation showed that the students' satisfaction degree to the teachers increased from 94.5%to 98.2%. Thus, through the implementation of CQI project, we achieved the goal of promoting teaching and promoting learning.