Analysis of medical project is the first step in the work of medical institutions to carry out medical project cost accounting. It introduces a case of a general hospital by analyzing the structure, department distribution, contact ratio of medical project to design the practical steps of medical project cost accounting.

Objective: To evaluate the omrphological and histochemical properties of cartilage matrix of children with pectus excavatum(PE). Methods: The collagen of cartialge matrix of 19 PE and of 14 age-matched children was examined by transmission electron microscopy(TEM) and immunohistochemical staining examination. Meanwhile, the proteoglycan was studied by PAS and Safranin-O staining examination. All of the results of stanining were also analysed by the GT-2 model of image analysis software. Results: Compared with control group, although the intensity of type II collagen was intact, unequally distribution of collagen had been found by the TEM and immunohistochemical staining examination. The intensity and distribution of proteoglycan of PE group remained normal found by the PAS and Safranin-O staining examination. Conclusion: Although the intensity and distribution of proteoglycan was intact, as well as intensity of collagen, the distribution of collagen in PE was abnormal, and this change may possibly be related to the defectiveness of costal cartialge of PE.

Objective To explore the efficient, cheaper and practical water treatment process in removing algae toxins. Methods The different water treatment methods were used and the optimal combination was selected. The removing efficiency for different processes was compared and validated by beaker test. The enzyme-linked immunosorbent assay (ELISA) was conducted in microcystin testing. Results Coagulating sedimentation could remove a small part of microcystin (removing efficiency was from 4.3% to 29.7% ). When oxidants were applied in pretreatment processes, such as ozone combined with coagulant, 83.3% to 91.9% microcystin could be removed. The cost-benefit analysis showed these processes only increased 0.03 to 0.14 yuan RMB cost per cubic meter of water, for example, by using ozone pretreatment and oxidation plus adsorption processes. Conclusion On the basis of general water treatment, ozone(O3), potassium permanganate(KMnO4), chlorine, dioxide(ClO2)and powdered activated carbon(PAC) are effective for removing microcystin in pretreatment processes and the processes are cheaper and practical.

At present improper use of antimicrobial agents in China is rather prevalent. For this reason we started from January 2000 to take general management methods and corresponding intervention measures with regard to the use of antimicrobial agents. We then made a survey of the use of antimicrobial agents before and after the adoption of the above methods so as to evaluate the effect of the intervention measures.

Objective To make a clinical and mycological analysis of tinea capitis in Guangzhou region. Methods A retrospective analysis was performed on 241 cases of tinea capitis collected from Feb, 1997 to Aug, 2010 in the Department of Dermatology, Sun Yet-sen Memorial Hospital. Results Among the 241 cases, 179 (74.27%) were tinea alba, 34 (14.11%) tinea kerion, 28 (11.62%) black dot ringworm, and no favus was observed. The dominant pathogenic fungi in decreasing order were Microsporum canis (182,80.89%), Trichophyton violaceum (25, 11.11%), Trichophyton mentagrophytes (10, 4.44%), Trichophyton tonsurans (3, 1.33%), Trichophyton rubrum (2, 0.89%), Microsporum gypseum (2, 0.89%) and Trichophyton verrucosum (1, 0.44%). Children were the main population (39.00%) suffering from tinea capitis. Conclusions In Guangzhou region, tinea alba is the most common type of tinea capitis, Microsporum canis is the main causative pathogen, and children are the predominate population affected by tinea capitis.

Objective:To evaluate the value of ultrasound-guided transperineal systematic prostate biopsy(SPB)and cognitive fusion multi-parameter magnetic resonance imaging(mpMRI) suspicious transperineal targeted biopsy(CFTB) in the prostate cancer with different serum prostate specific antigen(PSA) levels.Methods:A retrospective analyses were performed in 527 patients with suspected prostate cancer who underwent ultrasound-guided SPB from January 2018 to December 2019 in Shanghai Jiaotong University Affiliated 6th People′s Hospital. According to the PSA levels, they were divided into group A(PSA 4-10 μg/L) and group B(PSA>10 μg/L). All the patients underwent ultrasound-guided SPB, 376 patients with suspicious mpMRI had two additional targeted biopsies. The detection rates of ultrasound-guided SPB and CFTB in prostate cancer were tested by χ 2 test. Compared with pathological results, the sensitivity, specificity, accuracy of two methods were calculated and tested by χ 2 test, and a P<0.05 was defined as statistically significant difference. Results:Prostate cancer was detected in 319 of 527 patients(60.5%). One hundred and three cases of 198 patients in group A were diagnosed as prostate cancer, with an overall detection rate was 52.0%. Among them, ultrasound-guided SPB detected 72 cases of prostate cancer, the detection rate was 36.4%, sensitivity was 67.9%, specificity was 17.7%, accuracy was 26.5%, the detection rate, sensitivity, specificity and accuracy of CFTB were 39.9%, 75.6%, 91.6% and 88.8%, respectively. In this group, there were no statistically significant differences in the detection rate and sensitivity of the two methods in the diagnosis of prostate cancer (χ 2=0.525, 0.005, both P>0.05), and the differences in specificity and accuracy were statistically significant (χ 2=108.340, 79.829, respectively, both P<0.05). Two hundred and sixteen cases of 329 patients in group B were diagnosed as prostate cancer, with an overall detection rate was 65.7%. Among them, 160 cases of perineal prostate cancer were detected by ultrasound-guided SPB, with the detection rate was 48.6%, sensitivity was 78.2%, specificity was 37.6% and accuracy was 49.5%. A total of 189 cases of prostate cancer detected by CFTB, the detection rate was 57.4%, the sensitivity was 89.3%, the specificity was 90.6%, and the accuracy was 90.2%. All the differences were statistically significant in group B(χ 2=5.131, 4.391, 61.339, 38.982, all P<0.05). Conclusions:When PSA is greater than 10 μg/L, CFTB has a higher diagnostic efficiency than SPB.When PSA is 4-10 μg/L, there are no significant differences between the two methods in the detection rate and sensitivity of prostate cancer.

ObjectiveTo investigate application value of parametric image processing in contrastenhanced ultrasound imaging in diagnosis of ovarian masses. MethodsFifty cases with ovarian masses underwent routine ultrasound and contrast-enhanced ultrasound imaging using a new dedicated parametric image processing software SonoLiver to analyze patterns of vascular formation and blood stream perfusion in the ovarian mass tissues on a digital video recorder in real time, compare their morphological characteristics of time-intensity curve (TIC) and dynamic vascular patterns (DVP) curve, and analyze quantitatively all indicators generated by SonoLiver.ResultsIn ultrasound imaging of the 50 cases, there were 24 cases (86％) displaying mainly blue lowly-enhanced imaging in those with benign masses and 15 cases (68％)displaying mainly red highly-enhanced imaging in those with malignant masses, with statistical significance (P ＜0. 01 ). There was significantly different characteristics of TIC and DVP between patients with benign and malignant masses. In 23 cases with benign masses, their DVP were significantly higher above the baseline than in those with malignant ones ( P = 0. 000), and in 15 cases with malignant lesions, their DVP were much shorter below the baseline than in those with benign ones, with statistical significance (P ＜0.05). The intensity of contrast medium, the time to reach its peak intensity and average transit time were all significantly higher in those with malignant masses than in those with benign ones (all P ＜ 0. 05 ). But, no statistical difference in the time of initial increasing between the two groups was found (P ＞ 0. 05). ConclusionsThere is significant difference in TIC and DVP of ultrasound imaging between benign and malignant masses, which if combined with contrast enhanced ultrasound parametric image processing can provide a more visualized quantitative information of benign and malignant ovarian masses with SonoLiver software.

To investigate the impact of maternal hepatitis B virus (HBV) carrier state on twin pregnancy outcomes. Methods From January 2004 to December 2012, 569 women with twin pregnancy were hospitalized in Nanjing Drum Tower Hospital. Thirty-two women positive for hepatitis B surface antigen (HBsAg)(negative for hepatitis B e antigen, with normal liver function before conception)were included in the HBsAg-positive group and the other 537 women were included in the HBsAg-negative group. The pregnancy outcomes of the two groups were compared by t test and Chi-square test. The risk factors for neonatal birth weight were analyzed by multivariate regression analysis. Results Compared with the HBsAg-negative group, the HBsAg-positive women had a higher incidence of abnormal liver function (alanine aminotransferase≥50 U/L) [18.8% (6/32) vs 5.8% (31/537), χ2=6.367, P=0.012]. The incidence of gestational diabetes mellitus was 21.9% (7/32) in the HBsAg-positive group, which was higher than in the HBsAg-negative group [11.6% (62/537)], although the difference was not significant (χ2=2.132, P=0.144). The incidences of intrahepatic cholestasis of pregnancy,hypertensive disorders complicating pregnancy, premature rupture of membranes, placenta previa, fetal distress, postpartum hemorrhage, preterm birth, caesarean section, umbilical cord around the neck, meconium-staining amniotic fluid and neonatal asphyxia were no statistical difference between two groups (all P<0.05, respectively). Multivariate regression analysis showed that gestational diabetes mellitus (β=67.869, 95%CI: 0.494-135.244, P=0.048), maternal age (β=6.592, 95%CI: 2.020-11.880, P=0.006) and gestational age (β=164.069, 95%CI:154.426-173.712, P<0.01) were risk factors for neonatal birth weight, but not the maternal HBsAg-positive status (β=78.864, 95%CI: -16.950-174.678, P=0.107). Conclusion Twin pregnancy and HBV carrier state increase the risk of abnormal liver function, but not other adverse pregnancy outcomes and newborn diseases.

Objective To evaluate the therapeutic effect of different types of biliary tract reconstruction on the post- resection of congenital choledochal cyst (CCC). Methods 106 cases of CCC undergoing resection of CCC with Roux-en-Y hepaticojejunostomy as biliary tract reconstruction were followed up and analysed. Results In this series, three kinds of biliary tract reconstruction were performed, including single Roux-en-Y hepaticojejunostomy in 48 cases, intussusceptive valve and rectangular valve lying on the jejunal segmental of Roux-en-Y hepaticojejunostomy in 37 and 21 cases, respectively. 61 cases were followed up for 4.82 years in average. None of them occurred anastomasis stricture. There were 4 cases with ascending cholangitis after primary operation: of them 3 after single Roux-en-Y hepaticojejunostomy; symptoms of 2 out of the 3 cases disappeared after reoperation to set up an intussusceptive valve plasty on the jejunal segmental of Roux-en-Y hepaticojejunostomy; another one was in rectangular valve group. Occasional abdominal pain tooke place in 8 patients, of them, 5 in single Roux-en-Y hepaticojejunostomy group, 2 and 1 in intussusceptive valve and rectangular valve groups, respectively. No patients suffered from ascending cholangitis in the intussusceptive valve plasty group. Conclusions The postoperative ascending cholangitis and anastomasis stricture can be prevented effectively, if a prophylactic intussusceptive valve on the jejunal segmental of Roux-en-Y hepaticojejunostomy is carried out after resection of CCC for biliary tract reconstruction. This procedure corresponds to the biliary tract physiology.

Objective To understand variation of weight for age Z scores in premature infants with extrauterine growth restriction(EUGR).Methods Retrospective analysis was adopted with the data of very -low -gestational age (VLGA)preterm infants who met with the following criteria:admitted to Neonatal Medical Center of Huai′an Maternity and Child Healthcare Hospital from January 201 1 to December 201 3,gestational age <32 weeks,more than 4 weeks of hospital stay and survived when discharged.All VLGA premature infants were divided into non -EUGR group and EUGR group according to whether the standard weight on hospital discharge was below the 1 0th percentile of body weight at corrected age.The weight for age Z scores of preterm infants were calculated at each time point.The differences and trends between 2 groups were compared.The receiver operating characteristic (ROC)curve in diagnosing EUGR by weight for age Z scores was drawn.Results A total of 1 77 VLGA premature infants were enrolled,and among them there were was 1 04 cases of EUGR and the incidence amounted to 58.8%.The weight for age Z scores curve of EUGR group was under that of all preterm infants,and the curve of non -EUGR group was above that of all preterm infants. The weight for age Z scores of all preterm infants and EUGR group showed overall downward trend along with prolonged hospitalization.However,the weight for age Z scores of non -EUGR group did not change significantly at each week point except for the first week.The weight for age Z scores of EUGR group was lower than that of non -EUGR group at birth (-0.84 ±0.39 vs -0.31 ±0.41 ),the first week after birth (-1 .1 9 ±0.36 vs -0.74 ±0.40),the second week after birth (-1 .1 7 ±0.36 vs -0.68 ±0.40),the third week after birth (-1 .23 ±0.34 vs -0.64 ±0.39),the fourth week after birth (-1 .35 ±0.41 vs -0.65 ±0.42),the fifth week after birth (-1 .45 ±0.41 vs -0.56 ± 0.38),the sixth week (-1 .54 ±0.49 vs -0.70 ±0.36)and on discharge time (-1 .72 ±0.38 vs -0.67 ±0.42). The difference at each week point was statistically significant (all P =0.000).The weight for age Z scores on discharge were negatively correlated with start time of enteral feeding in preterm infants (r =-0.271 ,P <0.05),time of paren-teral nutrition up to 41 8 kJ/(kg·d)(r =-0.388,P <0.05),time of full enteral feeding (r =-0.332,P <0.05),a-mino cumulative dose (r =-0.298,P <0.05)and fat milk cumulative dose (r =-2.221 ,P <0.05).Area under the curve at each week point of the weight for age Z scores predicting the EUGR gradually increased along with prolonged hospitalization.There was a statistical significance in the weight for age Z scores value at each week point on the diagno-sis of EUGR(P =0.000).There was a high sensitivity and specificity at each week point.Conclusions Dynamic mo-nitoring weight of age Z scores of the premature infants can show the nutrition and growth trend,and may be a risk warning of the preterm infants suffering from EUGR.