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 investigate the contamination of Cd,Pb,Cu and Cr in the sediment of Guangzhou reach in Pearl River.Methods The sediments were collected in Yagang spot in April,2006.The content of heavy metals were determined,the heavy metals in the sediment were extracted with Tessier five stage sequential extraction procedure,and AAS was applied to determine the concentration of heavy metals in the sediment and extracts.Results The level of Cd,Pb,Cu,Cr were 2.29 mg/kg,217.97 mg/kg,320.60 mg/kg and 124.44 mg/kg respectively in the sediment in Yagang spot.They were higher than the background values of soil of Guangdong,and different heavy metals had different values of five forms.Cd existed as exchanged form mainly,and Cr,Pb existed as stable form mainly,so,Cd was easy to be resolved into water,Cr,Pb were relatively stable in the sediment.Conclusion The ecological risk of the four heavy metals is assessed with Hakanson potential ecological harmful index,the ecological risk of Cd is high,Cr,Pb is lower,Cu is moderate.

Objective To explain the material foundation of anti-inflammatory and analgesic effects of Jinxuan Zhike Xunxi San. Methods The foot swelling experiments in rat and xylene-induced ear edema experiments in mouse were adopted to observe the anti-inflammatory effects of the material extracted and purified from Jinxuan Zhike Xunxi San. The hot plate-induced pain experiment for studying the analgesic effect was established. Results The material of supercritical CO2 extract, saponins and flavonoids extract and minerals in Jinxuan Zhike Xunxi San had a inhibiting effect on egg-induced foot swelling in rat, saponins and flavonoids extract had a distinct inhibiting effect on xylene-induced ear edema in mouse. Every extract had obvious analgesic effects on hot plate-induced pain and significantly increased the threshold of pain. Conclusion The active ingredient groups of Jinxuan Zhike Xunxi San are the material of supercritical CO2 extract, saponins and flavonoids extract and minerals.

Bone mineral density (BMD) of lumbar spines, femoral neck, Ward′s triangle and greater trochanter was lowered, serum calcium, phosphate, alkaline phosphatase and bone Gla-protein levels were raised, and vitamin D receptor (VDR) contents in lymphocyte was lowered in hyperthyroid patients. Both FT 3 and FT 4 were negatively correlated with BMD, suggesting that hyperthyroidism results in high-turnover type of bone loss which causes the abnormalities of bone metabolic indices and VDR content.

Objective To summarize the experience of surgical techniques and prevention of postoperative complications of giant intracranial meningiomas.Methods The clinical data of 32 patients with giant intracranial meningiomas were analyzed retrospectively.The cause of operative complications was analyzed and the experience was summarized.Results The meningiomas Simpson grade Ⅰ resection was 16 is.cases,grade Ⅱ resection was 9 cases,grade Ⅲ resection was 5 cases,grade Ⅳ resection was 2 cases.The postoperative complications included anemia was 14 cases,intracranial hemorrhage was 2 cases,severe cerebral edema was 4 cases,epilepsy was 3 cases,cerebral infarction was 2 cases,and recovered well after treatment.Conclusion Good surgical technique,advanced prevention of surgical complications,early diagnosis and treatment can significantly improve the prognosis.

To optimize the formula of levodopa microcapsules floating tablets. Methods:The contents of levodopa and benserazide in the microcapsules floating tablets were determined by HPLC simultaneously. The release rate as the index, an orthogonal design was used to optimize the formula and preparation technology of levodopa microcapsules floating tablets. The release property of the microcapsules floating tablets was evaluated. Results:The HPLC method for the in vitro determination of levodopa and benserazide in the floating tablets met the methodological requirements. The selected formula was as following:the amount ratio of stearic acid, the drugs, acrylic resin and HPMC was 2∶5∶2∶1. The average weight of the tablets was 550 mg. The results of validated tests showed that the microcapsules floating tablets had floating and sustained release property, which could be used by divided dose. Conclusion: The optimized formula of the microcapsules floating tablets is reasonable, and the production process is stable and feasible.

Objective To study the clearance of high risk human papillomavirus(HPV)infection among the women with normal cervical pathologic diagnosis.Methods One hundred and seventy.two HPV-positive cases with normal cervical pathologic diagnosis were enrolled in the study.The infection status of HPV was monitored during follow-up from Aug 2006 to Aug 2008.The time of HPV infection spontaneous clearance,as well as effect factors,were analyzed.Results During follow-up,there were 62.2%(107 cases,107/172) of the HPV infection cleared.The medium clearance time was 11.3 months(95% CI:10.6-16.6 months).The medium clearance time of aged<30 years,30-39 years,40-49 years and>49 years were 11.3,12.0,10.9 and 8.5 months.respectively.There were not significant difference among aged intervals (P=0.384).The virus copies of HPV-clearance cases and persistent-infection were 22.6 and 95.0,respectively.There was not significant difference between groups(P=0.061).Conclusions Most of the high risk HPV infection with normal cervical pathologic diagnosis would spontaneously cleared.Age and HPV copies may play little role in the HPV clearance.

Objective To examine the levels of serum adipaneetin in patients with incipient chronic kidney disease (CKD, GFR≥ 60ml/min, and identify the relationship between serum adiponectin and albumin (ALB), urinary protein excretion amount, blood lipid and renal function. Methods Forty-two CKD patients and twenty normal healthy persons were involved in this study. These patients were divid- ed into two groups: nephrotic syndrome and non-nephrotic syndrome. The level of serum adiponectin, serum ALB, urinary protein excretion amount, blood lipid, renal function were measured and compared. Results The level of serum adiponectin in nephritic syndrome patients [(21.9±11.3) mg/L] and non-nephrotic syndrome patients [ ( 11.0±7.0) mg/L] was significantly higher than that in normal healthy per- sons[ (5.6±3.3) mg/L] ( P<0.01 ), and the level of serum adiponectin in nephritic syndrome patients was higher than that in non-ne- phrotic syndrome patients( P <0.01 ). Correlative analyses revealed a negatively correlation between serum adiponectin and serum total pro- tein(TP, ALB, BMI( r=-0.5680, r = -0.6241, r = -0.4083,respectively), and a positive correlation between serum adiponectin and urinary protein excretion amount ( r =0.4083). Stepwise regression analyses showed that serum adiponoctin was highly influenced by BMI, ALB and urinary protein excretion amount. Conclusion Serum adipanectin was markedly increased in incipient CKD, especially in patients with macroalbuminura. The effect of high level adiponectin in CKD was still not clear.

Objective To evaluate the effect of single CVVH and HDF on endothelial system. Methods Group CVVH:20 patients with multiple organ dysfunction syndrome ( MODS) underwent CVVH for 12h.Vascular access was through two-lumen catheter in femoral vein;Group HDF:Twenty patients with end stage renal disease (ESRD) on maintenance hemodialysis underwent HDF for 4h.Vascular access was through internal arteriovenous fistula.Group control:Healthy people were examined at our hospital.The se-rum levels of sVCAM-1, sICAM-1, vWF and MMP-9 were measured by enzyme-linked immunosorbent assay ( ELISA) after centrifugation in treatment group before and after treatment.Four cytokines were also meas-ured in fasting healthy subjects in the morning.Results The levels of serum sVCAM-1, sICAM-1, vWF, MMP-9 were significantly higher in Group CVVH and HDF than control group before and after treatment( P<0.05).Group CVVH:The serum levels of sICAM-1 and sVCAM-1 were significantly lower in post-treat-ment than pre-treatment, But the serum levels of vWF and MMP-9 showed no obvious changes after CVVH;Group HDF:the levels of four cytokines showed no obvious changes after single HDF.Conclusions Endo-thelium becomes impaired in MODS and ESRD patients, Endothelium may be protected by CVVH through the partial removal of cytokines harmful to endothelium in MODS patients.Single HDF therapy does not pro-tect endothelial function obviously in MHD patients.

Objective To evaluate the effectiveness and safety on once-daily (OD) insulin detemir (IDet) in Chinese patients with type 2 diabetes mellitus (T2DM) who were treated with different types or combinations of oral anti-diabetic drugs (OADs).Methods The SOLVETM study was a 24-week observational study on the initiation of IDet OD in T2DM patients with uncontrolled hyperglycemia on diet,exercise,and one or more OADs.Subjects were grouped based on the numbers of OADs taken before (＞ 2-OAD,2-OAD,and 1-OAD groups).Efficacy and safety endpoints were evaluated and compared in different groups.Results This study includes 3 272 patients,among them 464 (14.2％) were treated with more than 2OADs,1511 (46.2％) with 2OADs,and 1 218 (37.2％) with 1OAD before the study.The mean glycosylated hemoglobin A1c (HbA1c) was 8.4％,8.3％,8.4％ at baseline,and 7.3％,7.2％,7.1％ at the end of 24-week in each 3 groups (all P ＜0.001 vs.baseline values).The HbA1c reductions were not statistically significant different among groups.Body weight tended to decrease in patients from all groups,however,only that in the 2-OAD group reached statistically significance.No major hypoglycaemia events were reported.However,the overall minor hypoglycaemia rate in the 2-OAD group was higher at the end of the study than that at baseline (P ＜ 0.05).No differences in the rate of nocturnal minor hypoglycaemia were observed in all groups after IDet treatment.Conclusion Initiation of IDet OD was effective and well-tolerated in Chinese patients with T2DM whose glycemia was poorly controlled on OADs irrespective of the number of OADs taken before.(registration number NCT00825643)