Objective To explore the application effect of action-oriented teaching method in senior midwifery practice teaching.Methods Selecting 30 students from class 1,grade 2011 of the midwifery professional for the experimental group,another 30 students from class 2 for the control group.We selected four core contents for the experimental teaching refbrm such as obstetric abdominal examination,external pelvimetry measurement,prenatal vulva washing disinfection and sterile towel covering before the delivery.The experimental group was taught by action-oriented teaching,in accordance with the procedures:putting forward the projects or work task,set goals and grouping,making work plans,implementing and evaluating.The control group was taught by traditional teaching.We used questionnaire smvey and skills examination to evaluate the teaching effects and conducted teaching satisfaction scores and scores for t test to two groups of students.Results (1)Questionnaires:The resuhs of the 18 issues on the teaching effect evaluation,professional technology level and nursing soft skills,etc.showed that the experimental group's evaluation of the action-oriented teaching is higher than the control group's evaluation of the traditional teaching(P＜0.05),action-oriented teaching is more helptul to improving the professional skill and nursing soft skills(P＜0.05).@The scores of skill examination:The skills scores of the experimental group(80.01 ± 9.36) were significantly higher than those of the control group(71.32 ± 8.85)(t=3.70,P=0.000).The difference was statistically significant (t=3.70,P=0.00).Conclusions Action-oriented teaching helps to raise practice teaching effecr,train students' clinical work ability and nursing soft skills.It is suitable for practice teaching of senior midwifery.

Objective To explore the clinical value of Doppler flow spectrums of umbilical artery and ductus venosus in fetus with arrhythmia by Doppler ultrasound in evaluating the fetal prognosis.Methods Umbilical artery and ductus venosus flow spectrums were obtained in a total of 796 pregnancies with gestation age between 16-41 weeks who were found abnormal heart rhythm by maternity auscultation,fetal electronic monitoring or ultrasound.All these fetuses were followed up by electrocardiography and echocardiography examination until the end of pregnancy and the pregnancy outcomes were recorded.Results Among 796 fetuses,136 cases of fetal arrhythmia were detected.There were 18 cases appeared with umbilical artery absent or reversed end-diastolic flow,and 9 cases with absent or reversed wave A.Among 18 fetuses with arrhythmia whose blood flow spectrums of umbilical artery were abnormal,twelve were compared with congenital heart disease.The proportion of fetal bradycardia associated with abnormal flow spectrums and congenital heart disease were higher than other types of arrhythmias.Conclusions Pregnancy outcome of the fetus with arrhythmias who appeared with normal umbilical artery and ductus venosus will be good,and conversely is poor.So Doppler flow spectrums of the fetal umbilical artery and ductus venosus is one of the important indicators in early intervention.

Objective To explore the clinical value of two dimensional and color Doppler echocardiography in diagnosis of infants with coarctation of the aorta(CoA),and to analyse the cause of missed diagnosis and misdiagnosis.Methods The echocardiographic characteristics of 87 infants with CoA were analyzed retrospectively,and the results were compared with surgical findings.Results Seventy-five patients were correctly diagnosed,while 9 patients were missed and 3 patients were misdiagnosed.Discrete coarctation was found in 67 cases,whereas tubular coarctation was detected in 8 cases of CoA.Conclusions Mastering the echocardiographic characteristics of infants with CoA and carefully scanning the sternum nest section,combined with two dimensional and color Doppler echocardiography,could avoid missed diagnosis and misdiagnosis.

Peking University Third Hospital is one of the first hospitals for experiments in clinical pathway selected by the Ministry of Health,which keeps optimizing the clinical pathway management mechanism and function of information system in its 4-year practice.This article described the combination strategy of clinical pathway management and information system applications,in terms of reasonable design of the management plan,standardized clinical pathway,strengthened execution control and improvement of the quality control.The purpose is to balance the relationship between clinical pathway management norms and user-friendliness of the system,enhance rationality and feasibility,improve efficiency and provide high-quality service to ensure medical safety.

Objective To explore the effect of health education combine with nursing intervention on improving the awareness of patients′ tuberculosis ( TB) knowledge effectiveness. Methods A total of 1 186 cases of TB from June 2012 to June 2014 in our hospital were selected. According to accepted care measures, patients were divided into two groups, 593 cases received health education combined with nursing intervention were as the observation group, while another 593 cases received conventional care were as the control group. The questionnaires about TB knowledge, vital signs and prognosis of patient satisfaction outcomes were analyzed. Results Before accepting health education, the difference of knowledge of TB between the two groups was not statistically significant (P>0. 05). After the health education combined with nursing intervention, 540 (91. 1%) patients in the observation group got a score of TB knowledge over 60, which was significantly higher than 402 patients (67. 8%) in the control group (P<0. 05). 402 (67. 8%) patients in the observation group got a score of TB knowledge over 80, which was significantly higher than 207 patients (34. 9%) in the control group (P<0. 05). The total score of quality of life in the observation group were (603. 6 ± 127. 4), which was significantly higher than (512. 9 ± 114. 9) in the control group (t =2. 59,P<0. 05). The rate of satisfaction in observation group was significantly higher than that in the control group (Z=91. 3,P<0. 05). Conclusions Health education combined with nursing intervention can effectively improve the knowledge and awareness of TB patients. The psychological status and quality of life had significantly enhanced, thus it is worthy of further promotion in clinical practice.

Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27％.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.

Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27％.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.

Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27％.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.

Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27％.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.

Objectives It was a preliminary exploration on rare disease management of comprehensive hospital based on the"Center-Multidisciplinary Team"structure.Methods By applying interrupted time series analysis,the characteristics and related medical service of rare disease patients discharged from sample hospitals from 2021 to 2023 were measured.Results The results showed that the hospital served 19 825 rare disease patients from 2021 to 2023.The proportion of patients whose main diagnosis were rare diseases was approximately 27％.The interrupted time series technique indicated that the expected proportion of rare disease patients increased instantly by 1.89 thousand points.The capability to diagnose has significantly improved,with a growing trend on volume of bioinformatics analysis services for rare diseases patients.Conclusion The rare disease management based on the"Center-Team"structure can increase the attention of medical staff to rare diseases,strengthen the diagnostic capacity of rare diseases,and make patient management more continuous and disciplinary co-operation more efficient without significantly increasing the input burden on hospitals.