Objective To analyse the health human resource allocation of all tertiary maternal and child healthcare(MCH)hospitals from 2015 to 2022 in China,and to propose basis for further strengthening the talent team construction and management of MCH hospitals.Methods Data were collected through the national MCH institution monitoring system to provide a descriptive analysis of the health human resources of all tertiary MCH hospitals in China.Results From 2015 to 2022,the number of health technicians in tertiary MCH hospitals increased with an average annual growth rate of 10.2%;The proportions of highly educated and professional health technicians increased year by year;The proportion of tertiary MCH hospitals with qualified health technicians has increased to 93.8%;The ratio of doctors to nurses has exceeded 1:1.4.Conclusion The allocation of health human resources in the tertiary MCH hospitals in China shows a good upward trend,which lays a foundation for improving the overall service level and service capacity of MHC hospitals.

A retrospective analysis was performed on one case of adult-onset type Ⅱcitrullinemia(CTLN2)caused by homozygous mutations of SLC25A13 genes.The patient,a 28-year-old male,had repeated limb convulsions for more than 4 years and worsened for 2 months.He usually liked to eat peanuts and meat.The brain MRI examination showed no abnormality,and anti-epileptic treatment was not effective.Further examination of blood aminotransferase,blood ammonia and citrulline were elevated,genetic testing showed that the SLC25A13 gene c.851_854del homozygous pathogenic mutation,the diagnosis was CTLN2,and the treatment was treated with a high-protein,high-fat,low-sugar diet and arginine,and there were no seizures followed up for half a year.Patients with recurrent seizures with special dietary preferences should be paid attention to the possibility of CTLN2,and genetic testing plays an important role in the diagnosis of CTLN2 and provides a basis for clinical diagnosis and treatment.

Objective:To acquire the impact of COVID-19 pandemic on the operation of tertiary maternal and child health(MCH) hospitals in China, for decision making support of health administrative departments and hospital managers.Methods:The National Maternal and Child Health Institutions Resources and Operations Survey Direct Reporting System was used to collect the resource allocation, workload, treatment quality, work efficiency and asset operation of the tertiary MCH hospitals in China in 2019(pre pandemic) and 2020(during pandemic). Statistical descriptions were made using median.Results:In 2019 and 2020, the number of tertiary MCH hospitals in China was 236 and 258, respectively, and their relevant data were analyzed. In terms of resource allocation, the number of health technicians in 2019 and 2020 was 560 and 548, respectively, and the actual number of available beds was 308 and 305 respectively. In terms of workload, the annual outpatient visits in 2020 were 337 990, a decrease of 23.6%from that in 2019; The total number of emergency visits was 28 997, a decrease of 32.5%; The total number of discharged patients was 13 673, a decrease by 20.5%; A total of 4 723 training sessions on MCH were held for primary institutions, an increase of 1.2 percent. A total of 1 953 724 primary-level health technicians were trained, an increase of 175.2 percent. In terms of work efficiency, the average length of hospital stay of discharged patients decreased from 5.56 days in 2019 to 5.00 days in 2020. Bed utilization rate decreased from 88.90% to 69.15%; Bed turnover decreased from 53.69 to 44.22. In terms of treatment quality, the critical illness mortality rate of inpatients was 0.37% in 2020, 0.11% lower than that in 2019. The in-hospital mortality rate for neonatal patients was 0.04%, a 0.03% drop. In terms of asset operation, the total revenue in 2020 was 248.355 million yuan, an increase of 4.46% compared with 2019, in which the proportion of financial subsidies increased from 11.26% to 15.72%.Conclusions:The in-hospital services and institutional health care services of tertiary MCH hospitals in China were downsized by the COVID-19 pandemic, while the work efficiency was relatively stable, along with acceptable resource allocation, good treatment quality and asset operation.

Objective:To analyze the status of secondary maternal and child health hospital accreditation in China and the impact of such accreditation on their service improvement.Methods:The paper used the propensity score matching method to match the accreditation group and the non-accreditation group in 1∶1 ratio, and compared the related indicators of service capability of maternal and child health hospitals between the two groups by non-parametric test and Chi-square test.Results:A total of 842 maternal and child health care hospitals were matched. A comparison was made between the accreditation group and the non-accreditation group, and the differences of the following indicators of individual services within the hospital were statistically significant( P<0.01). These indicators were annual emergency attendance, the number of types of health services for women and children, the utilization rate of beds, the average daily hospital bed of each practicing physician; the following indicators of service management within their coverage were statistically significant: namely the proportion of institutions carrying out health education evaluation within their coverage, that of institutions producing uniform " Mother and Child Health Handbook", that of institutions carrying out information quality control, as well as analysis and utilization.These indicators of the accreditation group were higher than those in the non-accreditation group( P<0.01). Conclusions:Given the role played by maternal and child health institution accreditation in promoting secondary maternal and child health hospital regarding better service content, quantity, efficiency and the quality of business management within their coverage, there is still room for improvement.

Objective: To acquire the main result quality indicators status of tertiary maternal and child health(MCH) hospitals in China, supporting the decision making. Methods: The National Maternal and Child Health Institutions Resources and Operations Survey Direct Reporting System was used to collect the management operation, inpatient death, re-return, hospital-acquired infection, surgical complications and patient safety of these hospitals in China in 2017. Statistical descriptions were made using average, rate and composition comparison data. Results: The proportion of health technicians of tertiary MCH hospitals in China was 83.66%, the average hospitalization days were 5.96 days, with bed occupancy rate of 90.01%. The success rate of neonatal resuscitation was high. Meanwhile, the mortality rate of hospitalized maternal critical illness, the total hospitalization mortality rate of neonatal patients, the incidence of complications in surgical patients, the incidence of neonatal injury and the incidence of birth injury in vaginal delivery were higher in the institutions that had not participated in the MCH hospital accreditation. Conclusions The management of tertiary MCH hospitals in China was in good condition, and the relevant policies and projects have achieved remarkable results. Compared with general hospitals, hospital infection and re-return indicators were good. The quality and safety of tertiary MCH hospitals which have not participated in the MCH hospital assessment were poor. It is recommended to carry out MCH hospital accreditation to improve quality and safety.

Objective The failure mode and effect analysis (FMEA) were used to monitor the managerial process of high-value consumables in the implantation surgery, and establish the traceable management process for high-value consumables of the implantation surgery. Methods FMEA was used to carry out risk assessment process, formulate specific measures for improvement. The risk priority number(RPN),the qualified rate of the management index of implant surgical consumables,the patients satisfaction, and the number of adverse events reported were compared before and after the implementation of this process management. Results After FMEA was used to conduct management over implant surgery consumables,the RPN value decreased dramatically due to difficulty of traceability, information recording, and imperfect management system, thereby showing that the difference was statistically significant (t=16.655, 10.664, 9.321, P<0.01). Quality management measures: the access to consumables meets the requirements,complete information record,quality of stock consumables,paste bar code standard, charge accurate, return visits and records on time, consumables traceability, patient satisfaction rate were 99.2%(373/376),96.7%(363/376),99.5%(374/376),95.6%(361/376),98.6%(371/376), 95.7% (360/376), 100.0% (376/376), 97.1% (365/376), respectively after the implementation of this process management, which were higher than 90.9% (355/390), 81.8% (319/390), 94.2% (367/390), 91.3% (356/390),84.7%(330/390),87.3%(341/390),87.5%(342/390),91.8%(358/390)before the implementation of this process management, thereby showing that the difference was statistically significant (χ2=7.149-49.371, P<0.01).The number of adverse consumables event reports increased from 0 up to 5. Conclusions It was feasible and effective to improve the level of hospital management and ensure the safety of patients by using the FMEA model in the implantation surgical high-value consumables.

Objective: To estimate the prevalence of anxiety and depression symptoms during pregnancy among women from six districts of China and to explore the determinants of anxiety and depression during pregnancy. Methods: A cross-sectional study of maternal health status was conducted using the probability proportionate to size sampling method among pregnant women from six counties/districts in six provinces of China (Hebei, Liaoning, Fujian, Hunan, Sichuan and Yunnan). A questionnaire was completed by each of the women included in the study from August to December 2014. Women were recruited from three medical and health institutions with the most obstetrics patients in each district. A total of 4 210 pregnant women were included in the investigation. The hospital anxiety and depression (HAD) scale was applied to measure the symptoms of anxiety and depression in the pregnant women. Trend chi square test was used to assess the differences of anxiety and depression symptom among three trimesters. The multivariate logistic regression model was used to investigate potential contributory factors. Results: The detection rates for anxiety symptoms and depression symptoms during pregnancy were 8.5% (357/4 210) and 12.5% (525/4 210), respectively. The prevalence of anxiety symptoms during the first, second and third trimesters were 7.9% (110/1 392), 8.8% (124/1 413) and 8.8% (123/1 405), respectively (χ^2trend=0.89, P= 0.419). The prevalence of depression symptoms during the first, second and third trimesters were 14.0% (195/1 392), 12.6% (178/1 413) and 10.8% (152/1 405), respectively (χ² _trend=6.52, P=0.011). Multivariate logistic regression analysis showed an increased risk of anxiety and depression in women with an educational background of middle school rather than a college degree (OR=1.94, 95% CI: 1.44-2.63; OR=3.80, 95% CI: 2.45- 5.91). Furthermore, compared with planned pregnancies, women with unplanned pregnancies had a higher risk of anxiety and depression (OR=1.33, 95% CI: 1.06- 1.66; OR=1.35, 95% CI: 1.07- 1.71). Pregnant women who felt they lived in crowded residential conditions were at an increased risk of anxiety compared with those living in spacious residential environments (OR=1.82, 95% CI: 1.15- 2.87). Pregnant women with a household income of less than 10 000 yuan were at a higher risk of depression than living in a household with an income of ≥100 000 yuan (OR=1.91, 95% CI: 1.05-3.49). Similarly, multiparous women (≥2) were at higher risk of depression compared with nulliparous women (OR=1.88, 95% CI: 1.04- 3.41). Conclusion The prevalence of anxiety and depression symptoms during pregnancy appears to be associated with several demographic factors, along with a women's obstetrical history. Lower educational background, unplanned pregnancy, the feeling of living under crowded residential conditions were all found to be risk factors for anxiety during pregnancy. Similarly, lower educational background, unplanned pregnancy, a lower household income (<10 000) and a greater number of previous deliveries were all risk factors for depression during pregnancy.

[Absrtact] Objective To investigate the effect of anatomic quantitative target evaluation of class-room teaching on students' professional knowledge learning ability. Methods Twenty-five international students of 6-year program of grade 2013 were chosen as the experimental group, while twenty-seven Chinese students coming from the same class of grade 2013 and fifteen international students of 6-year program of grade 2012 were chosen as two control groups; quantitative and non-quantitative evaluation were imple-mented respectively by classroom questions and answers; teaching effects were evaluated by scales in the separation of teaching and examination, by records of answers for in-class questions and by questionnaire survey; SPSS 20.0 was used to make statistical analysis, one-way ANOVA and Kruskal Wallis test to com-pare the scores of three groups of students, P<0.05 indicates statistic significance. Results Compared with control groups, the accuracy of answers for class questions were improved greatly in the experimental group (2/3~3/4) vs. (1/2) and (2/3~3/4) vs. (1/2) and the average test scores (80.62±5.93) vs. (79.62±5.93) and (80.62 ±5.93) vs. (70.16 ±6.36) of the experimental group students were higher than control groups, the difference was statistically significant between the control group and the control group (P=0.045). Conclusions
Quantitative evaluation of teaching objectives in anatomy class can improve the learning attitude of foreign students and enhance their academic ability.

Objective To summarize the nursing effect of transcatheter ophthalmic artery chemotherapy ( TOAC) in treatment of children with retinoblastoma during perioperative period. Methods From March 2009 to December 2015, 421 children hospitalized in invasive technology department of our hospital with retinoblastoma were treated by TOAC with holistic nursing method. Results All 421 children were performed TOAC successfully and discharged within 1 week. After interventional treatment, no serious complications such as leukemia, liver and kidney function and hearing impairment, etc. chemotherapy toxicity reaction appeared, and no catheter-related complications were found. Postoperative follow-up of 4-36 months, the overall eye-keeping rate was: IIRC B stage 100%, IIRC C stage 100%, IIRC D stage 78. 6%, IIRC E stage 62%. Conclusions The optimization process of postoperative nursing with the service concept of holistic nursing method can reduce the incidence of complications, draw more attention to life care, strengthen diet guidance and pain nursing, which is conducive to the rehabilitation of patients and improvement of the quality of children′life.