ObjectiveTo understand the utilization of preconception healthcare services and the influencing factors among the women expecting additional childbirth in Jiading District， Shanghai， and to provide references for promoting the utilization of preconception healthcare services under the new population policy. MethodsA questionnaire survey on the utilization of preconception healthcare services and related influencing factors was carried out among 682 women expecting additional childbirth across six subdistricts in Jiading District， Shanghai. The results were statistically analyzed. ResultsThe average age of the women was （31.7±4.5） years， 30.2% of whom were ≥35 years old. The proportion of women having their third or subsequent children was low， at 16.4%. A significant majority， 92.4%， were found to have various risk factors during initial pregnancy screening. The utilization rate of preconception healthcare services among women seeking additional childbirth was relatively low at 26.7%. Awareness of the free preconception check-up program in Jiading District was also low at 28.6%， and the utilization rate for these services was even lower at 7.69%. Unplanned pregnancies were the primary reason for not utilizing preconception healthcare services， accounting for 63.6%. The results of multifactorial binary logistic regression analysis showed that the utilization rate of preconception healthcare services before the current pregnancy was higher for women aged between 35 and 39 compared to women aged ≤29 years old （OR=1.789， 95%CI： 1.033‒3.099）. Women with planned pregnancies had a higher utilization of preconception healthcare services prior to this pregnancy （OR=4.164， 95%CI： 2.627‒6.602）. Women who had received preconception care prior to their first birth had a higher utilization rate of preconception care prior to the current pregnancy （OR=7.534， 95%CI： 4.954‒11.456）. Women without a family history of chronic diseases had a higher utilization rate of preconception healthcare services （OR=1.903， 95%CI： 1.083‒3.345）. ConclusionUnder the context of three-child policy， the proportion of women seeking three or more children in Jiading District is low. Most of these women have risk factors identified during initial pregnancy screenings. The utilization rate of preconception healthcare services and the awareness of the free preconception screening program in Jiading District are both low. Unplanned pregnancies remain the primary reason for failing to receive timely preconception healthcare services. Age， whether the pregnancy was planned， whether the women had received preconception healthcare services before their first baby and family history of chronic diseases are the main factors affecting the utilization of preconception healthcare services. Relevant departments should enhance the promotion of preconception healthcare service programs， especially for women of childbearing age who have not yet given birth， so as to improve the utilization rate of preconception health care services.

ObjectiveTo understand the influencing factors of women’s intention to utilize preconception health care services， so as to promote the utilization of preconception care among women with future pregnancy plan. MethodsThe study was conducted at 8 outpatient health clinics of medical institutions providing perinatal health care in Jiading District of Shanghai. Women who had fertility intention for another child were invited to complete an electronic questionnaire from November 2020 to February 2021. ResultsWomen with better pregnancy and birth care behaviors during the last periconception were more likely to utilize preconception care service before the next conception than those with previous poorer behaviors （OR=1.980， 95%CI= 1.061‒3.694， P=0.032）. Women with higher preconception care knowledge scores had better pregnancy and birth care behaviors during the last periconception than those with lower knowledge scores （OR=1.362， 95%C1= 1.004‒1.846， P=0.047）. ConclusionsIn order to improve the utilization of preconception care among the population with future pregnancy plan， it is necessary to further strengthen health education and social mobilization to promote the preconception eugenic knowledge， planned pregnancy and pregnancy and birth care behaviors.

The application of big data and artificial intelligence technology in the medical field is key to hospital informatization. In October 2018, a tertiary hospital launched a clinical intelligent application platform. The platform took AI assistant as the carrier of intelligent application, supported the role expansion, function expansion and connotation expansion of intelligent application, and layed the foundation for the construction of clinical intelligence. As of July 2022, the platform had been embedded into the outpatient, emergency and inpatient business systems with the help of AI assistant, realizing such intelligent applications as auxiliary diagnosis, auxiliary treatment, risk warning, AI medical record quality control, research entry group and infectious disease management, as well as enriching the connotation of such specialty applications as orthopedics and ear, nose and throat. The platform satisfied the integration and integration of hospital information construction and provided convenient and effective intelligent auxiliary tools for clinical use.

Single-disease management is an important means of medical quality management, and data is the basis of single-disease management. Aiming at the problem of difficult data collection of single disease in hospital, the authors designed a solution to realize the fine management of single-disease data based on data center. The hospital optimized the data quality through overall management, unified the data collection source based on the data center, built a single-disease intelligent collection platform to complete the data collection, and calibrated the data to ensure its accuracy, so as to form a single-disease index management process and realize high-quality data collection. The average actual backfill rate was as high as 95.7%. On this basis, the hospital optimized the single-disease reporting and quality control management mode to further promote the fine management of medical quality.

As medical record management is key to hospital management, a hospital introduced paperless practice of automatic archiving in the following practices. Clarification and identification of the scope of business system transformation, establishment of an architecture integrating various business systems, integration platform, hospital data center, archiving system and certification authority, creation of three automatic archiving processes: initial archiving, late return archiving and modification archiving, for refined management of the review and tracking of archived medical records. Thanks to this paperless management, the automatic archiving rate was as high as 95.95%for medical records, 96.47%for laboratory reports and 99.58%for medical orders respectively. A full-process and whole-cycle informationized closed loop management was achieved for the collection, archiving, review and utilization of medical records, substantially upgrading hospital informationization and medical record management.

Objective To study the preventive effect of epigallocatechin gallate(EGCG)on hyperoxiainduced bronchopulmonary dysplasia in mice.Methods Eighty-eight Kunming mice born 36-40 hours were randomly divided into four groups:air + saline group (n =22),air + EGCG group (n =22),hyperoxia + saline group(n =22) and hyperoxia + EGCG group(n =22).Drug was administrated once a day by air-driven atomization,till 28 days.Furthermore,the hyperoxia groups were transferred into the room air for recovery after raised in (70 ± 3) ％ oxygen for 28 days.Lung pathological morphology and homogenization ELISA were performed on the 21th,28th and 49th day.The pathological changes of lung tissue radical alveolar counts(RAC) were observed and the levels of interleukin-2 (IL-2),tumor necrosis factor(TNF-α) and myeloperoxidase(MPO) were measured.Results The levels of IL-2 and TNF-α in the air groups were significantly lower than those in hyperoxia group(IL-2:air(1 760.83 ±303.38)pg/g vs hyperoxia(4 251.00 ±644.07) pg/g;TNF-a:air(4 308.83 ±1 114.91) pg/g vs hyperoxia(8301.83 ± 802.26) pg/g) (P ＜ 0.01),and MPO level decreased in hyperoxia +EG-CG group(7 472.83 ± 1 922)U/g,hyperoxia +NS group(4 767.68 ± 1 110.72)U/g,air + EGCG group(3712.68 ± 734.40)U/g,air + NS group(2 711.68 ± 763.39)U/g(P ＜0.05).In the hyperoxia groups,though IL-2 on 21th day and TNF-αt on 49th day were no statistic difference in hyperoxia group and air group,the inflammatory factors in EGCG group were lower than in hyperoxia + NS group.Pathology showed that the RAC count of the air groups increased gradually,while the hyperoxic groups were gradually decreased,however,the EGCG group tend to recover after 21 days recovery in room air.Conclusion Inhalation of EGCG can reduce the level of inflammatory response in lung tissue of hyperoxia exposed mice.EGCG attenuated lung injury in hyperoxia-exposed mice,and accelerated lung recovery after hyperoxia exposure in experimental animals.EGCG has potential effect to prevent hyperoxia induced bronchopulmonary dysplasia.

Objective To compare the clinical evaluation in diagnosis of thyroid nodules between fine needle aspiration(FNA) and core needle biopsy(CNB).Methods 82 cases with thyroid nodules undergoing FNA and 33 cases with thyroid nodules undergoing CNB were selected.Cytology,histopathology,and postoperative results were compared with postoperative pathology as the gold standard.Results The accuracy,sensitivity,specificity,positive predictive value,negative predictive value,false positive rate,false negative rate of FNA and CNB were 91.5％ vs 87.9％,93.2％ vs 87.5％,87.0％ vs 88.9％,94.8％ vs 95.5％,83.3％ vs 72.7％,13.0％ vs 11.1％,6.8％ vs 12.5％,respectively.There was no significant difference between FNA and CNB (P＞0.05).Conclusion Both of FNA and CNB examination show high accuracy,sensitivity and specificity in diagnosis of benign and malignant thyroid nodules,but FNA is more economical,safe,convenient and thus has more extensive clinical application.For lymphoma or borderline tumor,CNB examination combined with immunohistochemistry is of more advantages.

Objective To explore the effects of Chinese herbal compound Tangbikang on the expressions of p38 MAPK of sciatic nerve and plasma TNF-α in diabetic rats. Methods Ten of the sixty male SD rats were selected randomly as normal group, and the rest were fed with high-fat diet and low-dosage STZ was used to induce type Ⅱdiabetic rat models. Model rats were randomly divided into model group, mecobalamine group and Tangbikang low-, medium-, and high-dosage groups, 10 rats in each group. Each medication group was intervened with relevant medicine. Rat unilaterals sciatic nerves were taken after 16 weeks. The content of TNF-α in plasma was determined by radioimmunoassay. Western blot method was used to detect the expressions of p38 and p-p38 MAPK protein of sciatic nerve. Results Compared with normal group, the expressions of p38 and p-p38 protein and content of TNF-αin model group significantly increase (P<0.05, P<0.01). Compared with the model group, the expressions of p-p38 protein and the content of TNF-α significantly decreased after medicine intervention in different doses Tangbikang groups and mecobalamin group (P<0.05, P<0.01). The expression of p38 protein in Tangbikang high-dose group significantly decreased (P<0.05), with statistical significance (P<0.05). Conclusion Tangbikang can reduce the expression of p38 and p-p38 MAPK protein of the rat sciatic nerve, and reduce the content of TNF-α protein in rat plasma, which may be one of the effective targets of neuroprotection and abirritation of diabetic peripheral neuropathy.

A cross-sectional study of 92 women with polycystic ovary syndrome(PCOS) was performed.The patients were composed of 4 groups according to the Rotterdam criteria and were also divided into 2 groups according to body mass index and divided into 2 groups according to insulin-releasing test.Anthropometric measurements were recorded,and hormonal profile was assessed by measuring FSH,LH,prolactin,and testosterone.The metabolic profile was investigated by measuring glucose and insulin level during oral glucose tolerance test (OGTT),then calculating the homeostasis model assessment (HOMA).Serum lipid levels,including total cholesterol,triglycerides,high-density lipoprotein-cholesterol,and low-density lipoprotein-cholesterol were determirned.The result suggests that the classification according to the revised 2003 Rotterdam consensus on diagnosis does not reflect dyslipidemia in PCOS.Dyslipidemia in hyperinsulinemic group and obesity group were more severe than that in non-hyperinsulinemic group and non-obese group ; this finding needs our attention in early treatment and prevention of late complications of PCOS.

Objective To study the clinical curative effect of syndrome differentiation-based treatment with traditional Chinese medicine on patient with Chronic Kidney Disease (CKD3-4). Method According to prospective multicenter randomized controlled study which was applied to the patients with CKD3-4 , the total of 339 patients were divided into two groups. To one group as standard including 167 patients ,the other including 172 patients. Chinese Traditional Patent Medicine single or combined-prescription oral treatment according to syndrome differentiation-based treatment was employed. To the other group as reference , Chinese Traditional Patent Medicine oral treatment according to experienced rule was applied. The clinical curative effect results were obtained after a 24 weeks-treatment. Result The Scr ,eGFR and UTP with CKD3 in standard group illustrate statistics significance (P<0.05). On the opposite, those of the reference group remain insignificance (P > 0.05). The clinical curative effect result of patient in standard group was better than that of reference group. About the clinical curative effect of CKD4, no statistics significance difference (P > 0.05) could be found between groups or between patients in one group. The TCM score of patient with CKD3-4 in standard group have improved (P < 0.05) according to baseline. However, that of reference group did not show any statistics significance (P > 0.05). Conclusion Syndrome differentiation-based treatment with traditional Chinese medicine illustrated a better result in protection of renal function, reduction in urinary protein and decline in TCM score than the treatment according to experienced rule.