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 analyze the epidemiological characteristics of hospital admission cases with chemical poisoning in Guangdong Province from 2016 to 2020. Methods Data of hospital admissions for chemical poisoning in Guangdong Province from 2016 to 2020 were collected through Guangdong Province Health Statistics Network Reporting System，and descriptive analysis was conducted. The seasonal characteristics of the number of hospitalized poisoning cases were analyzed by the concentration method，the seasonal index（SI）was calculated by the weighted annual ratio averaging method，and the spatial auto-correlation of regional poisoning trend was analyzed by the global and local spatial autocorrelation. Results From 2016 to 2020，the number of hospital admissions for chemical poisoning in Guangdong Province was 54 656，showing a general decreasing trend. The sex ratio（male to female）was 0.90 ∶1.00. The top three types of hospitalization rates were carbon monoxide poisoning，alcohol poisoning and organic solvent poisoning. The main poisoning groups were students and children， farmers，workers and unemployed people，accounting for 31.74%，18.53%，13.91% and 10.39%，respectively. The 74.37% of poisoning cases were cured or improved and discharged，and the case fatality rate was 0.48%. The top three hospitalization rates in age group of 0-<5 years were organic solvent，metal and carbon monoxide poisoning. The hospitalization rate of carbon monoxide poisoning ranked the first among all age groups of ≥5 years. The top three regions with the highest average annual hospitalization rate were Shaoguan City （25.14/105 ），Qingyuan City （17.04/105 ） and Meizhou City （16.09/105 ）. Carbon monoxide poisoning had a strong seasonality（M=0.77），with high incidence months of January，February and December（SI were 3.60，3.08 and 2.48，respectively）. The inpatients with chemical poisoning showed non-random distribution and spatial correlation（all P<0.01），with a high-high clustering among 13 districts and counties in northern Guangdong（all P<0.05）. Conclusion The number of hospital admission cases of chemical poisoning showed an overall decreasing trend in Guangdong Province from 2016 to 2020. The main types of poisoning were carbon monoxide poisoning，alcohol poisoning and organic solvent poisoning. The spatial distribution of chemical poisoning types showed spatial correlation and there were high-high clustering areas.

ATP-Binding Cassette Transporters ; genetics ; metabolism ; Animals ; Biological Transport ; Child ; DNA Mutational Analysis ; Humans ; Hypertension, Pulmonary ; genetics ; metabolism ; Lung Diseases, Interstitial ; genetics ; metabolism ; Molecular Sequence Data ; Mutation ; Polymerase Chain Reaction ; Protein Conformation ; Pulmonary Surfactant-Associated Proteins ; genetics ; metabolism ; Respiratory Distress Syndrome, Newborn ; genetics ; metabolism

BACKGROUND:Preliminary studies of our research group have confirmed that the proliferation of preosteoclasts and the differentiation and function of osteoclasts could be inhibited when they were cultured in lower oxygen tension even hypoxia (2%O 2 ), but the gene expression of osteoclasts cultured in vitro have not been reported.
OBJECTIVE:To examine the effect of oxygen tension on specific gene expression of osteoclasts in vitro and explore the mechanism of osteoclast differentiation influenced by oxygen tension.
METHODS:The preosteoclasts were induced with 10μg/L macrophage colony stimulating facto and 10μg/L soluble receptor activator of nuclear factor-κB ligand into mature osteoclasts. Then the osteoclasts were cultured in normoxia, tissue oxygen and hypoxia (20%, 7%, 2%O 2 ) respectively. cells were then stained for tartarate-resistant acid phosphatase to assess osteoclastic formation. cells were col ected at 1, 2, 3, 4, 5, 6, 7 days after culture respectively. The soluble receptor activator of nuclear factor-κB ligand, tumor necrosis factor receptor-associated factor 6, tartarate-resistant acid phosphatase, and cathepsin K mRNA expression levels were determined using real-time quantitative PCR.
RESULTS AND CONCLUSION:The number of osteoclasts positive for tartarate-resistant acid phosphatase in the hypoxia was significantly lower than that in the tissue oxygen and normoxia (P<0.05). Under different oxygen tension, the mRNA expression levels of soluble receptor activator of nuclear factor-κB ligand in osteoclasts maintained unchanged. The mRNA expression levels of tumor necrosis factor receptor-associated factor 6 reached the peak at 5 days after culture in tissue oxygen and normoxia (P<0.05). The mRNA expression time of tartarate-resistant acid phosphatase and Cathepsin K were delayed accompanied by decreased oxygen tension, but the maximum were maintained in tissue oxygen. Compared with normoxia and hypoxia, osteoclasts cultured in tissue oxygen are more prone to differentiate and maintain the activity and functions.

Objective To analyze the demands and to evaluate training effect on the knowledge and technology of prevention and treatment about hypertension among doctors in county and countryside hospitals of Xinjiang.Methods 336 doctors were trained about knowledge of prevention and treatment of hypertension and technology of useful therapeutic regimen,and were investigated for demands of the knowledge and technology and self-evaluation of training effect by questionnaire.Results The knowledge of prevention and treatment about hypertension and the technology of useful therapeutic regimen were needed urgently by 94.8％ subjects.91.3％ trained doctors thought that the technology suited practically in county and countryside hospitals,and 96.7％ hospitals had condition of carrying out the technology.97.9％ trained doctors expected this kind of technology on hypertension prevention and treatment to be trained again.74.1％ trained doctors comprehended the technology,and the percent of doctor practically using the technology increased from pre-training 12.3％ to post training 62.1％.Conclusion The knowledge of prevention and treatment about hypertension and technology of useful therapeutic regimen were needed urgently and were comprehended with training for the most doctors in county and countryside hospitals of Xinjiang.

Objective To investigate whether human breast milk may bind to hepatitis B surface antigen (HBsAg) and its characteristics.Methods Breast milk samples from five women with negative HBsAg and hepatitis B surface antibody (anti-HBs) at one to two months post delivery were fractioned into cream and skimmed milk by centrifugation.The human breast milk and each fraction as well as cow and goat milk samples,served as controls,were separately incubated with highly purified yeast recombinant HBsAg,followed by determination of their binding capability to HBsAg by enzyme linked immunosorbent assay (ELISA) and the inhibition rate for binding of HBsAg to anti-HBs by quantitative chemiluminescence microparticle immunoassay.After boiled for 1 min or pasteurized in 65 ℃ for 30 min,the thermal stability of the active components of milk was detected.One-way ANOVA and SNK tests were performed for statistical analysis.Results The operative concentration of HBsAg was 0.1 μg/ml.Breast milk from all five women showed significantly better binding capability to HBsAg than cow or goat milk (1.306±0.300 vs 2.157±0.150 and 2.232±0.093,F=34.303,P＜0.01).The quantitative experiments showed that the inhibition rate of human breast milk was higher than that of the control group [(74.26± 17.26)％ vs (0.00±5.50)％,F=57.806,P＜0.01].The binding ability to HBsAg of skimmed milk was comparable with that of whole milk,indicating milk protein(s) played critical roles in binding to HBsAg (0.877 ± 0.486 vs 0.513 ± 0.069 and 0.376 ± 0.146,F=44.475,P＜0.01).After boiled for 1 min or Pasteurization,the binding ability to HBsAg of whole breast milk remained,but that of skimmed milk went down (F=16.598,P＜0.01).Both whole breast milk and skimmed milk could inhibit the binding of HBsAg to anti-HBs (F=278.341 and 269.408,both P＜0.01).Conclusions The inhibition of binding to HBsAg by human breast milk indicates that human milk may interact with HBsAg.The active components mainly exist in milk proteins and are thermal stable.

AIM: To evaluate the clinical efficacy of surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia.
●METHODS: A total of 22 eyes of 11 patients received surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia were included. Objective and subjective duration of the operation, degree of cooperation during surgery, postoperative recovery, recurrence and complications were observed.
●RESULTS: In the process of surgery, patients without pain and being-cooperated were recorded in 17 eyes. The patients who occasionally felt slight pain, but within endurance after adding topical anesthesia once and the operation was completed successfully were recorded in 5 eyes ( the second eye surgery ) . The operation was successfully completed in all the patients. Compared the coordination degree during surgery of Gradel with GradeⅡ, the difference was statistically significant ( t=-3. 123, P<0. 01). All eyes were healed well after operation.
● CONCLUSION: The surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia can ensure satisfactory anesthetic effect and get better quality of operation. It′s a simple, safe and effective anesthesia method for spontaneous subconjunctival orbital fat prolapse.

Objective To explore clinical features and antimicrobial resistance of lower respiratory tract infection (LRTI)with Streptococcus pneumoniae (S .pneumoniae)isolated from children in Nanjing.Methods Clinical data of children with confirmed S .pneumoniae LRTI through sputum culture at a children’s hospital in Nanjing between July 2013 and June 2014 were analyzed retrospectively,S .pneumoniae strains were performed antimicrobial susceptibility testing through K-B method and minimum inhibitory concentration (MIC)testing.Results Among 197 children with S .pneumoniae infection,72.59% were <3 years old,63.96% occurred in autumn and winter, 57.87% had elevated leukocyte count,cough and fever were the most common clinical symptoms,complications of digestive and circulatory system were also common.The resistance rates of S .pneumoniae to azithromycin, penicillin,and erythromycin were 94.92%, 92.98%, and 88.83% respectively; the sensitivity rates to vancomycin,chloramphenicol,meropenem,ceftriaxone,and ofloxacin were all > 90%,vancomycin was up to 98.98%.Conclusion The percentage of S .pneumoniae LRTI is high in children < 3 years old,most occur in autumn and winter,resistance rates to azithromycin,penicillin,and erythromycin are all high,antimicrobial agents should be selected for the treatment of infection according to antimicrobial susceptibility testing.

AIM:To explore whether A3 adenosine receptor plays a role in the modulation of vascular reactivity after hemorrhagic shock in rat,and to find out the prospective drug target to restore the decreased vascular reactivity following hemorrhagic shock. METHODS:The hemorrhagic shock (40 mmHg) model was established in rat,and the reactivity of superior mesenteric artery (SMA) to norepinephrine (NE) was observed. A3AR expression at protein level and mRNA level were measured by Western blotting and RT-PCR respectively. RESULTS:The vascular reactivity of SMA to NE after hemorrhagic shock (40 mmHg) was decreased significantly in a biphasic response manner. The expression of A3AR mRNA in SMA after hemorrhagic shock decreased without significant difference. The expression of A3AR protein has a slight increase without statistical difference after 30 min of hemorrhagic shock and then has a significant decrease (especially at 2 h and 4 h after hemorrhagic shock). The usage of IB-MECA,a selective A3AR agonist,significantly increased the responsiveness of SMA to NE in hemorrhagic shock in rat. MRS1523,the selective A3AR antagonist,significantly abolished the restoration of the vascular reactivity to NE by IB-MECA in hemorrhagic shock in rat. CONCLUSION:A3AR plays a role in the modulation of vascular responsiveness to NE in hemorrhagic shock in rat,and the selective agonist of A3AR could restore the reactivity of SMA to NE in hemorrhagic shock in rat.