Objective:To explore the trend of postpartum hemorrhage after two-child policy and to analyze the high-risk risks of postpartum hemorrhage so as to put forward intervention measures to reduce the postpartum hemorrhage.Methods:We retrospectively selected 8 784 delivery women with routine production inspection and hospitalized at a ClassⅢ Grade A hospital from 2014 to 2018. We collected the general information, record of production inspection, delivery record and analyzed the trend of postpartum hemorrhage rate, blood loss and related high-risk factors.Results:From 2014 to 2018, there were statistical differences in the postpartum hemorrhage rate, serious postpartum hemorrhage rate and blood loss ( P<0.05) . The trend showed an increasing trend. In 2017, the postpartum hemorrhage rate, serious postpartum hemorrhage rate and blood loss were 16.9%, 6.1% and (540.1±758.2) ml respectively highest in those years. From 2014 to 2018, the percentage of delivery women with advanced ages, multiple pregnancy, pregnancy times≥2, history of cesarean section≥2 were increasing; delivery women with the prenatal hemoglobin≤110 g/L and percentage of natural labor were decreasing with a statistical difference ( P<0.05) ; the percentage of emergency cesarean section was on the rise; the percentage of placental expulsion time from 15 to 30 minutes declined with statistical differences ( P<0.05) ; the percentage of placental expulsion time≥30 minutes and above was no significant trend. Conclusions:From 2014 to 2018, the postpartum hemorrhage rate, serious postpartum hemorrhage rate and blood loss did not show an increasing trend. However, the percentage of high-risk pregnant and delivery women increased gradually. Therefore, we should carry out the pregnancy risk assessment rating for pregnant and delivery women and formulate a suitable high-risk assessment tool for postpartum hemorrhage so as to reduce the incidence of postpartum hemorrhage.

Objective:To explore the influencing factors of the failure of labor induction by oxytocin and delivery outcome, and provide a basis for standardizing pregnancy management and process management of labor induction by oxytocin.Methods:Using a self-designed data collection form, the data of 1 705 pregnant women who underwent labor induction by oxytocin in the Department of Obstetrics of China-Japan Friendship Hospital from 2014 to 2018 were retrospectively collected, and the influencing factors of the failure of labor induction by oxytocin and the outcome of delivery were analyzed.Results:A total of 1 705 primary mothers were included in the study. Multiple factor analysis show that, amniotic fluid pollution, macrosomia, and the duration of labor induction by oxytocin were independent influencing factors for the failure of labor induction by oxytocin. The duration of labor induction by oxytocin was related to the method of delivery, weight of the newborn, and amount of postpartum hemorrhage, and the difference was statistically significant ( P<0.01) . The outcome of delivery labor induction by oxytocin was the cause of cesarean delivery, and "intrauterine fetal distress" and "cephalopelvic disproportion" accounted for the highest proportion. Conclusions:The main influencing factors for the failure of labor induction by oxytocin are amniotic fluid pollution, macrosomia, etc., and the influencing factors will gradually increase with the process of labor induction, thereby reducing the natural delivery rate. Therefore, it is necessary to strengthen pregnancy management, control pregnancy weight and fetal weight, and reduce pregnancy complications. It is also necessary to strengthen clinical management of labor induction by oxytocin, provide sound education and guidance for labor induction by oxytocin, and increase the vaginal delivery rate after labor induction by oxytocin.

To meet the emerging demands of clinical medicine development and transformation of doctor-patient relationship models,enhance medical students'theoretical knowledge and practical application level of medical humanities,as well as improve the educational experience,the medical humanities teaching team of Harbin Medical University introduced and innovated the workshop teaching model in teaching.By summarizing the basic connotation of workshop teaching mode and its innovation in medical humanities education,taking the"doctor-patient communication"course of Harbin Medical University as an example,this paper shared the specific practice and application of workshop teaching mode in course teaching from three aspects,including preparation,implementation,and evaluation and feedback of teaching,as well as explored its innovation and application prospects in medical humanities education,with a view to providing valuable references for the organic integration of medical humanities education and clinical professional education,professional theory and practice.

Objective:To investigate effect of Picroside Ⅱ(P-Ⅱ)on endothelial cell damage in rats with coronary heart disease(CHD)by regulating high mobility group box 1 protein(HMGB1)/receptor for advanced glycation end products(RAGE)signaling pathway.Methods:SPF grade SD rats were randomly separated into control group,CHD group,P-Ⅱ low,medium,high doses groups and P-Ⅱ high dose+DEX group(P-Ⅱ high dose+HMGB1/RAGE signaling pathway activator DEX).Except for control group,CHD rat model was established by high-fat diet combined with intraperitoneal injection of pituitrin,corresponding drugs were administered by gavage or intraperitoneal injection,once a day for 4 consecutive weeks.Biochemical analyzer was applied to measure blood lipid levels;ELISA was applied to detect levels of serum nitric oxide(NO),endothelin(ET)-1,angiotensin Ⅱ(AngⅡ),TNF-α,IL-1β and IL-6;kits were applied to detect levels of reactive oxygen species(ROS)and glutathione peroxidase(GSH-Px)in coronary artery tissue;HE staining was applied to observe pathological damage in coronary artery tissue;TUNEL staining was applied to observe apoptosis of vascular endothelial cells;Western blot was applied to detect expressions of vascular endothelial growth factor(VEGF),HMGB1 and RAGE proteins in coronary artery tissue.Results:Compared with control group,levels of TC,TG,LDL-C,ET-1,AngⅡ,TNF-α,IL-1β,IL-6,ROS,endothelial cell apoptosis rate,and expressions of HMGB1 and RAGE in rats in CHD group were signifi-cantly increased,levels of HDL-C,NO,GSH-Px,and expression of VEGF were significantly reduced(P<0.05);compared with CHD group,levels of TC,TG,LDL-C,ET-1,AngⅡ,TNF-α,IL-1β,IL-6,ROS,endothelial cell apoptosis rate,and expressions of HMGB1 and RAGE in P-Ⅱ low,medium and high doses groups were obviously reduced,levels of HDL-C,NO,GSH-Px,and expression of VEGF were obviously increased(P<0.05);HMGB1/RAGE signaling pathway activator DEX was able to attenuate protective effect of P-Ⅱ on endothelial cell damage in CHD rats.Conclusion:P-Ⅱ can effectively alleviate endothelial cell damage in CHD rats,whose mechanism may be related to inhibition of HMGB1/RAGE pathway activation.