Comprehensive budget management has important significances in controlling public hospital operating costs, refining strategic objectives and optimizing work performance appraisals. In the process of comprehensive budget management, implementation effects of some public hospitals are not ideal. The major reasons are unsound corporate governance structure, inadequate implementation and imperfect evaluation index. Through the analyzing these important influencing factors and proposing the corresponding measures, the comprehensive budget management was smoothly carried out in public hospitals, which finally improved the management level of hospital.

Objective To analyze the concomitant malforrnations,chromosomal abnormalities and outcomes in prenatally diagnosed congenital diaphragmatic hernia (CDH) cases. Methods Cases of fetal CDH,prenatally identified in the First Affiliated Hospital of Sun Yat-sen University from January 2002 to November 2008,were recruited.The concomitant realformations,chromosomal abnormalities and outcomes of fetal CDlH were analyzed.Fisher's exact test was applied. Results During the study period,71 CDH cases were identified including 62(87.3%) left-sided CDH and 9 (12.7%) right-sided ones.Among the 71 CDH fetuses,38(53.5%)were isolated CDH.33 (46.5%)were complicated with other realformations(complex CDH),including 18(54.5 0A) cardiovascular defects,10 (30.3%)central nervous system abnormalities,9(27.2 0A)genitourinary abnormalities and others.Fetal karyotying was performed in 19 out of the 71 CDH fetuses.among which 12 were isolated CDH cases with normal karyotype,and 4 of the rest 7(4/7)complex CDH cases with chromosomal abnormalities showing a significant differenee compared to the isolated CDH (P.0.009).Sixty-five pregnancies were terminated including all complex CDH(n=33)and 32 isolated CDH.The rest 6 isolated CDH fetuses were term delivered and 5 of them survived after repair of diaphragmatic hernia and one died after birth. Conclusions Left-sided CDH are more common than right-sided ones. Approximately half of the CDH cases are complicated with other malformations,especially cardiovascular abnormalities.The risk of chromosomal abnormalities increases in complex CDH and is relatively low in isolated CDH.The influence of surgical procedure on the prognosis of CDH has not yet determined.

Objective To evaluate the association between fetal ventricular septal defects (VSD)and chromosomal abnormalities.Methods The 214 fetuses diagnosed VSD in the First Affiliated Hospital of Sun Yat-sen University from January 2008 to September 2011 were included.The VSD were categorized into 3 types:perimembranous,muscular and mixed (the defect could not be classified because the dimensions were larger than 5 mm) type.The perimembranous defect was subdivided into inlet and outlet subtypes.Complicated with other cardiac abnormalities/extracardiac abnornalities or not,the cases were divided into isolated VSD group,VSD complicating cardiac anomalies group (other cardiac and/or great vessels malformation),VSD complicating extracardiac anomalies group (include organ malformation and sonographic soft markers) and VSD with both cardiac and extracardiac anomalies group.G-banding chromosome analysis was advised for all cases.In cases that no karyotype was obtained,the phenotype of the newborns was examined by the pediatricians.And those appeared normal were defined as normal karyotype.Results (1) There were 134 (62.6％,134/214) perimembranous defects,including 91 (42.5％,91/214) inlet lesions and 43 (20.1％,43/214) outlet lesions.There were 35 (16.4％,35/214) muscular defects and 45 (21.0％,45/214) mixed type lesions.(2) Among the 214 VSD fetuses,46 (21.5％) were isolated VSD,34 (15.9％) were cases with other cardiac anomalies,87 (40.6％) were cases with extracardiac anomalies and 47 (22.0％) were cases with both cardiac and extracardiac anomalies.(3) The chromosomal karyotypes were obtained in 105 cases,and 21 cases were considered as normal according to the phenotype.Of all these 126 cases,46 (36.5％,46/126) had chromosomal abnormalities.(4) Inlet defects had the highest risk of chromosomal abnormalities (28/55,50.9％),while the muscular defects had the lowest risk (2/25,8.0％).The incidence of chromosomal abnormalities in outlet and mixed type was 33.3％ (9/27) and 7/19,respectively.The types of VSD were significantly correlated with chromosomal defects (P ＜ 0.01).(5) The incidence of chromosomal abnormalities in the 4 groups were 3.4％ (1/29),2/14,53.6％ (30/56) and 48.1％ (13/27),respectively.The risk of chromosomal abnormalities in the cases complicating extracardiac or both extracardiac and cardiac anomalies was significantly higher than the isolated VSD group (P ＜ 0.01).Conclusion Fetal VSD had a highest risk of chromosomal abnormalities,especially the inlet type and VSD with extracardiac abnormalities,and then the fetal karyotype should be recommended.

Objective To compare the prenatal ultrasonic characteristics between left and right isomerism as referring to autopsy outcomes.Methods Between November 2007 and July 2010,fetuses with isomerism that were confirmed by autopsy,were identified from 1200 prenatal ultrasonic scans.Their abnormal spectrums and ultrasonic features were analyzed and comparied between left and right isomerism.Results A total of 18 fetuses with right isomerism and 4 fetuses with left isomerism were detected and confirmed.The major findings of the right isomerism were;viscerocardiac heterotaxy (17,94%),anomalous pulmonary venous connection (16,89%),complete atrioventricular septal defect (15,83%),juxtaposition of the descending aorta and inferior vena cava(12,67%),left persistent superior vena cava (11,61%),right aortic arch (10,56%) and univentricle (10,56%).As for the left isomerism,all had viscerocardiac heterotaxy and interruption of inferior vena cave,three of them had heart block,complete atrioventricular septal defect and hypoplasia of aorta,two of them had univentricle.Conclusions Viscerocardiac heterotaxy,complete atrioventricular septal defect,univentricle are the most common anomalies detected.Right isomerism cases usually exist with anomalous pulmonary venous connection,juxtaposition of the descending aorta and inferior vena cava as well as right aortic arch.The left isomerism cases usually have interruption of inferior vena cave,heart block and hypoplasia of aorta.

Objective To explore the value of sonogram index scoring system in the prenatal diagnosis of trisomy 18 syndrome.Methods Neonates who had prenatal sonographic screening in our tertiary center were followed up from January 2004 to December 2009.The fetuses who were suspected with abnormalities received karyotype analysis.All fetuses were divided into case group ( trisomy 18 group) and the control group (non-trisomy 18 group).The latter group was constituted of fetuses with trisomy 21,trisomy 13,other chromosomal abnormalitis and fetuses with normal karyotype.Logistic regression analysis was done to decide the individual sonographic features of trisomy 18.A score was assigned for ultrasound markers according to their likelihood ratios for trisomy 18 syndrome.A score of 3 was assigned for the sonographic features with likelihood ratio over 200,2 for those with likelihood ratio between 100 and 200,and 1 for those with likelihood ratio less than 100.The diagnostic efficacy of the ultrasound index scoring system was evaluated by diagnostic test.The optimal cutoff value was determined by receiver operating characteristic (ROC) curve.Results The study group included 59 fetuses with trisomy 18.And 26 486 fetuses did not have trisomy 18 syndrome,including 93 fetuses with trismoy 21,19 fetuses with trisomy 13,134 fetuses with other chromosomal abnormalities,3739 fetuses with normal karyotype and 22 501 fetuses with normal appearance after birth.Two or more structural defects were observed in each trisomy 18 fetus.The highest incidence of sonogram abnormalities was extremities abnormalities (85％,50/59 ),followed by cardiac defects (83％,49/59) and central nervous system (CNS) malformations (75％,44/59).Overlapping fingers,ventricular septal defect and strawberry-shaped skull were the most common abnormalities in extremities abnormalities,cardiac defects and CNS malformations,respectively.Logistic regression identified 16 markers,including choroid plexus cyst,strawberry-shaped skull,enlarged cisterua magna,holoprosencephaly,low-set ears,ventricular septal defect,hypoplastic left heart syndrome,etc.Different scores were assigned according to the likelihood ratios of these markers.In trisomy 18 group,fetuses with the sonographic score of 1,4,9,10 to 16 were 2％ ( 1/59),9％ (5/59),10％ (6/59) and 32％ (19/59) respectively,whereas in non-trisomy 18 group they were 2.549％ (675/26 486),0.215％ (57/26 486),0.004％ ( 1/26 486) and zero,respectively.When a score of 4 was used as the cutoff value for diagnosing fetal trisomy 18,the sensitivity and specificity were 0.966 and 0.997,respectively.The area under ROC curve was 0.999.Conclusions The ultrasound index scoring system may help to quantify the ultrasound features and has a good diagnostic value for fetal trisomy 18 syndrome.The cutoff value of 4 has the best diagnostic efficacy.

Antibiotic-associated diarrhea(AAD) is a frequent adverse effect of antibiotic in children.AAD is associated with longer hospitalization, higher healthcare cost and even lead to death.Pediatricians usually do not pay enough attention to AAD.Domestic experts from pulmonary medicine, infection and gastroenterology are organized to develop the consensus, to improve the diagnosis, treatment and prevention of AAD, and contribute the children health in future.

Objective:To explore the effects of mindfulness-based decompression therapy on fear of disease progression, quality of life and sleep quality in patients with acute ischemic stroke, in order to provide intervention measures to alleviate fear of the disease progression degree and improve sleep and quality of life in patients with acute ischemic stroke.Methods:This study was a randomized controlled study. Using the convenience sampling method, 98 patients with acute ischemic stroke who attended the Department of Neurology at the Third Hospital of Hebei Medical University from November 2021 to September 2022 were selected for the study, and the study population was divided into experimental group ( n=49) and control group ( n=49) using the random number table method. The control group received conventional care, and the experimental group received mindfulness-based stress reduction therapy for 8 weeks in addition to conventional care. Compared the scores of the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Stroke-Specific Quality of Life Scale (SS-QOL), and Pittsburgh Sleep Quality Index (PSQI) between the two groups of patients before and after intervention using two independent sample t-tests, and further compared the score spread of each scale before and after intervention between the two groups of patients using Mann-Whitney U test. Results:In the experimental group, 4 cases fell off and 3 cases had imperfect questionnaire information, while in the control group, 2 cases fell off and 5 cases had imperfect questionnaire information. Finally, 42 cases were included in each group. The 23 males and 19 females in the control group aged (48.31 ± 7.61) years old, while 25 males and 17 females in the experimental group aged (50.19 ± 8.64) years old. There was no significant difference in FoP-Q-SF, SS-QOL and PSQI scores between the two groups before intervention (all P>0.05). After intervention, the scores of FoP-Q-SF and PSQI in the experimental group (35.79 ± 7.04, 7.19 ± 2.58) were lower than those in the control group (38.52 ± 4.02, 9.45 ± 2.28), while the SS-QOL score (200.36 ± 21.75) was higher than that in the control group (185.41 ± 15.90), the differences were statistically significant ( t=2.19, -4.26, 3.60, all P<0.05). After intervention, the scores of FoP-Q-SF and PSQI in the experimental group were lower than those before intervention (39.69 ± 4.15, 10.00 ± 2.85), while the SS-QOL score was higher than that before intervention (176.93 ± 23.54), the differences were statistically significant ( t=4.80, 10.45, -11.43, all P<0.05). The score spreads of FoP-Q-SF, SS-QOL, and PSQI in the experimental group before and after intervention were 1.00 (0.00, 9.25), 20.00 (12.75, 32.75), 3 (1, 4), which were higher than 1.00 (-1.25, 2.00), 5.50 (1.00, 10.25), 0 (-1, 2) in the control group, the differences were statistically significant ( Z=-2.30, -5.74, -5.53, all P<0.05). Conclusions:Mindfulness-based decompression therapy can effectively relieve the fear of disease progression and improve the quality of sleep and life in patients with acute ischemic stroke.

Background and purpose:Colorectal cancer(CRC)is globally recognized as one of the most prevalent malignant tumors.Advanced CRC is marked by a relatively poor prognosis for patients,signifying an urgent need to identify novel potential biomarkers for CRC.A particular focus has been given to circulating tumor cells(CTC),which are cells that have detached from the primary tumor mass and subsequently entered the circulatory system.These cells can be detected within the blood and are currently considered significant potential biomarkers for CRC.This study aimed to investigate if FCGBP and BIGH3 in CRC could be potential markers for colorectal cancer.Methods:This study obtained 3 CRC datasets(GSE74369,GSE117606,and GSE164191)with CTC from the GEO database.Bioinformatics analysis was conducted to screen differentially expressed genes between CTC and normal samples.One dataset that includes clinical information was used for WGCNA analysis,and two key gene modules were identified,containing 1 148 genes in total.Then,functional enrichment analysis was carried out for these genes in the modules.Venn diagrams,PPI network construction analysis,and candidate gene screening were employed.Finally,survival analysis was performed using TCGA and GTEx data in the GEPIAS database,and key genes associated with CRC were identified.The expression of BIGH3 gene was validated in colorectal cancer tissues by real-time fluorescence quantitative polymerase chain reaction(RTFQ-PCR),and its association with colorectal cancer was verified through clonogenic,scratch,and transwell assays in HCT116 and SW620 cell lines.Results:Through the analysis of CRC datasets from GEO,we screened a total of 2 214 differential genes.With the help of WGCNA analysis and PPI network construction,4 CTC-related genes associated with CRC were identified.Survival analysis from the GEPIA database revealed that FCGBP and BIGH3 are associated with overall survival and disease-free survival.Further experiments indicated that BIGH3 gene is overexpressed in 30 matched colorectal cancer samples.The downregulation of BIGH3 expression could slow down cell proliferation and migration rates,as well as decrease invasiveness in HCT116 and SW620 cell lines.In contrast,upregulation of BIGH3 expression could increase its invasiveness or accelerate migration rate.Conclusion:FCGBP and BIGH3 are positively correlated with TNM staging,indicating their pivotal roles in CRC progression.They bear good prognostic value and may serve as potential biological markers for CRC clinically,and could provide potential therapeutic targets.Moreover,our experimental data revealed the crucial role of BIGH3 in colorectal cancer,suggesting it may influence the biological behavior of this disease.

Objective:To explore the influencing factors of clinical pregnancy outcomes in patients with hydrosalpinx undergoing in vitro fertilization-embryo transfer(IVF-ET) after interventional embolization and whether residual hydrops has an adverse impact on pregnancy outcomes.Methods:Clinical data from 65 patients who underwent interventional embolization and IVF-ET for hydrosalpinx at the Third Affiliated Hospital of Zhengzhou University from March 2021 to October 2022 were collected retrospectively. The hydrops index was quantified by the ratio of the widest diameter to the pelvic transverse diameter of the intraoperative hydrops, and the patient′s age, body mass index(BMI), follicle-stimulating hormone(FSH), lutenizing hormine(LH), estradiol(E2), automated matetials hangling(AMH), endometrial thickness at the time of transplantation, the number of transplanted embryos, embryo type, and location of the hydrosalpinx were recorded. In addition, the clinical pregnancy outcomes of the first transplantation after embolization were followed. Two independent samples t-test, rank sum test and chi-square test were used to analyze the difference of the above indexes among different clinical pregnancy outcomes by SPSS 25.0. The receiver operating characteristic (ROC) curves and Youden index were used to calculate the cut-off value of the water accumulation index. Results:Among 65 patients, the clinical pregnancy rate was 63.1%(41/65), among the 45 patients who underwent embryo transfer before embolization without success, the clinical pregnancy rate after embolization was 62.2%(28/45). Based on data analysis, it showed that IVF-ET clinical pregnancy outcomes were not associated with age, BMI, FSH, LH, E2, AMH, endometrial thickness at the time of transplantation, the number of transplanted embryos, embryo type, as well as location of hydrosalpinx( P>0.05), but associated with hydrosalpinx index( P<0.001). ROC curve analysis showed that the hydrops index could be used as a predictor of pregnancy outcome, and the area under the curve was 0.825, and the optimal cut-off value of the hydrops index was 12.925% based on the Youden index analysis result. Conclusions:Interventional embolization of hydrosalpinx may improve clinical pregnancy rates. When the hydrosalpinx is large enough, it could adversely affected IVF-ET clinical pregnancy, and further aspiration of hydrosalpinx should be performed prior to transplantation.

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.