Effective budget management is crucial for the internal control of procurements in public hospitals.This paper investigates challenges such as unscientific budget preparation,insufficient market analysis,and inadequate procurement internal control in a tertiary hospital in Shenzhen.In addition,based on a budget inquiry mechanism,the study explores strategies to en-hance internal control management within procurements in public hospitals,focusing on the pilot implementation of budget price review mechanisms in the hospital.The paper proposes such rules as"whoever applies is responsible and conducts research,"departmental checks and balances,continuous feedback,and pre-budget inquiry.These measures are used to improve procure-ment cost control,enhance hospital operational efficiency,and increase economic benefits.

Objective:To investigate the effects of types of ulnar styloid process fracture on the treatment of distal radius fracture.Methods:The 80 patients were analyzed retrospectively who had been treated at The First Department of Hand Surgery, Honghui Hospital from January 2019 to January 2020 for fracture of distal radius complicated with fracture of ulnar styloid process. They were 25 males and 55 females, aged from 30 to 85 years (average, 58.6 years). According to the types of ulnar styloid process fracture, 40 patients were assigned into a Hauck type Ⅰ group and the other 40 into a Hauck type Ⅱ group. The 2 groups were compared in terms of operation, postoperative complications, hospital stay, bone union, visual analogue scale (VAS) on postoperative 1 to 3 days, and modified Mayo wrist function score, wrist range of motion and quality of life by WHOQOL-BREF at the last follow-up.Results:The 2 groups were comparable because there was no significant difference in age, gender, American Society of Anesthesiologists (ASA) rating, or time from injury to operation between them ( P>0.05). All the patients were followed up for 12 to 24 months (average, 17 months). There was no significant difference between Hauck type Ⅰ group and Hauck type Ⅱ group in operation time, intraoperative blood loss, hospital stay, rate of postoperative complications, fracture union, modified Mayo wrist function score or VAS on postoperative 1 to 3 days ( P>0.05). At the last follow-up, the palm tilt and ulnar inclination angles were 13.8°±1.9° and 21.6°±2.8° in Hauck type Ⅰ group, significantly larger than those in Hauck type Ⅱ group (11.9°±1.6° and 18.8°±2.3°) ( P<0.05). At the last follow-up, Hauck Ⅰ group scored 85.3±6.4,85.6±6.5, 84.7±6.3 and 85.0±6.7 respectively in the domains of physical health, psychology, environment and social relationships, significantly higher than those Hauck type Ⅱ group did (78.5±6.5, 78.9±6.5, 77.8±6.1 and 77.9±6.3) ( P<0.05). Conclusions:In open reduction and internal fixation for distal radius fracture, Hauck Type Ⅰ fracture of ulnar styloid process has no significant effect on the functional recovery of the wrist but Hauck Type Ⅱ fracture of ulnar styloid process may. Therefore, surgical fixation needs to be strengthened if Hauck Type Ⅱ fracture of ulnar styloid process is complicated.

Objective To study the epidemic characteristics of hand foot mouth disease (HFMD) and the influence of meteorological factors on the incidence of HFMD in Beijing from 2010 to 2019, and to provide scientific evidence for the warning, prediction, prevention and control of HFMD. Methods Descriptive statistical analysis was conducted to analyze the epidemic characteristics of HFMD in Beijing from 2010 to 2019 using R4.0.2 software, and the relationship between meteorological factors such as daily average temperature, daily average relative humidity, daily average precipitation, daily average air pressure, and daily average wind speed and HFMD incidence from 2015 to 2019 was analyzed by using distribution lag nonlinear model. Results In 2010-2019, a total of 324 864 HFMD cases were reported in Beijing, with an average incidence rate of 155.10/100,000. May to July was the annual peak of HFMD. The average daily temperature, relative humidity and precipitation were positively correlated with the incidence of HFMD (Rs=0.66, 0.45 and 0.24, P=0.0000, 0.0000 and 0.0000, respectively). The average daily wind speed and pressure were negatively correlated with the incidence of HFMD (Rs=-0.14 and -0.3, P=2.22×10^-9 and 0.0000, respectively). The RR was the highest when the air temperature was 25℃ and at the lag of 10 day, which was 1.41 (95%CI:1.12-1.77). Humid weather conditions were the risk factors of HFMD, and the influence time was relatively long. The RR was the highest when the relative humidity was 84.5% and the lag was 15 days, which was 1.51 (95%CI:1.34-1.70). When daily average wind speed was 3m/s, and the lag was 14 days, the RR was the highest, which was 1.22 (95%CI:0.86-1.73). The RR was the highest when the daily average pressure was 842.5 hPa and the lag was 5 day, which was 1.20 (95%CI:0.66-2.07). When the daily average precipitation was 166.5 mm and the lag was 7 days, the RR was the highest, which was 4.37 (95%CI:1.61-11.84). When the above meteorological conditions were met, the risk of HFMD was the highest. Conclusion Meteorological factors such as daily average temperature, daily average relative humidity, daily average precipitation, daily average pressure and daily average wind speed are closely related to the incidence of HFMD, which is nonlinear and has certain lag. It can be used to predict the risk and epidemic intensity of HFMD, and to provide a scientific basis for the prevention and control, early warning, and prediction of infectious diseases.

Exponential growth of the mass spectrometry (MS) data is exhibited when the mass spectrometry-based proteomics has been developing rapidly. It is a great challenge to develop some quick, accurate and repeatable methods to identify peptides and proteins. Nowadays, the spectral library searching has become a mature strategy for tandem mass spectra based proteins identification in proteomics, which searches the experiment spectra against a collection of confidently identified MS/MS spectra that have been observed previously, and fully utilizes the abundance in the spectrum, peaks from non-canonical fragment ions, and other features. This review provides an overview of the implement of spectral library search strategy, and two key steps, spectral library construction and spectral library searching comprehensively, and discusses the progress and challenge of the library search strategy.

Objective To measure the concentration of serum transthyretin (TTR) of patients with different stages of diabetic retinopathy (DR).Methods A total of 176 patients with diabetes mellitus were included in this study.There were 104 males and 72 females.The patients aged from 21 to 74 years,with the mean age of(56± 11) years.The diabetes duration raged from 1 to 30 years,with the mean diabetes duration of (10 ± 7) years.The HbA 1C was 5.2％-14.1％,with the mean HbA 1C of (8.6 ± 2.0)％.According to the fundus examination,58 patients had DR (33.0％),but the other 118 patients not (67.0％).For these DR patients,10 patients were in stage Ⅰ (5.7％),26 patients in stage Ⅱ (14.8％),8 patients in stage Ⅲ (4.5％),and 14 patients in stage Ⅳ (8.0％).The concentration of serum TTR was measured by enzyme-linked immunosorbentassay kit.The differences in the concentration of serum TTR between different DR stages were compared.Bivariate analysis was used to analyze the influencing factors of TTR.Results The concentrations of serum TTR of the patients without DR or with DR of stage Ⅰ to Ⅳ were (224.96±65.47),(383.68± 102.99),(247.44±63.21),(228.2 ± 45.89),(189.34± 70.12) mg/L,respectively.The difference between different DR stages was statistically significant (F=14.690,P＜ 0.001).Bivariate analysis showed that the concentration of TTR was correlation to DR (r=0.179,P=0.017).There was no correlation between the concentration of TTR and diabetes duration (r=-0.027,P=0.727),hypertension (r=0.018,P=0.810),hyperlipoidemia (r=0.101,P=0.182),and the use of insulin (r=-0.032,P=0.675).Conclusion The concentration of serum TTR was increased in early DR patients,and gradually decreased with the progression of DR.The concentration of TTR is correlated to DR.

Objective To investigate the classiifcation, and reasonable choice and curative effect of the surgical procedures for pancreatic duct stone. Methods Clinical data of 18 patients with pancreatic duct stone undergoing surgery in Sun Yat-sen Memorial Hospital, Sun Yat-sen University from January 2010 to December 2012 were retrospectively analyzed. There were 13 males and 5 females with the average age of (53±12) years. Fourteen cases suffered from abdominal pain, 5 complicated with pancreatic cancer, 6 with bile duct stone and 8 with mellitus diabetes. The informed consents of all patients were obtained and the local ethical committee approval was received. Classiifcation, surgical procedures and postoperative complications of the pancreatic duct stone patients during perioperative period and the curative effect during follow-up were observed. Results All patients received surgical treatment. Two cases with typeⅠ pancreatic duct stone underwent pancreaticoduodenectomy (Whipple operation), 8 with type Ⅱand 1 with typeⅢunderwent pancreatolithotomy+pancreato-jejunal Roux-en-Y anastomosis (Partington operation). Two with typeⅢunderwent distal pancreatectomy+splenectomy. Among 5 cases with typeⅣ,2 underwent Whipple operation and 3 underwent Partington operation. No patients died during perioperative period. Postoperative complications were observed in 5 cases, including 3 with pancreatic ifstula and 2 with ascites, and the patients were cured after symptomatic treatments. Abdominal pain disappeared after surgery in 12 cases and was signiifcantly alleviated in 2 cases. One case complicated with pancreatic cancer died 1 year after surgery. No recurrence of stones was observed in the remaining cases. Conclusions Based on the priciple of individualized treatment, reasonable surgical procedure should be choosed according to the classiifcation of pancreatic duct stone. Pancreatolithotomy and pancreatojejunostomy are the main surgical procedures.

Objective To compare the effect of kidney-tonifying blood-activating recipe (KBR) and Aescuven Forte Tablets ( AFT) in improving the sperm quality of varicocele-induced male sterility, thus to optimize the therapeutic therapy for varicocele-induced male sterility. Methods A total of 102 varicocele-induced male sterility with abnormal sperm parameters after conservative treatment were randomized into KBR group (N=53) and AFT group ( N=49) . KBR group was given KBR plus natural vitamin E and AFT group was given AFT plus natural vitamin E, and the treatment lasted for 8 continuous weeks. Before and after treatment, the quality of seminal fluid was analyzed, sperm quantization parameters such as total number of sperm (TNS) , total number of progressive motility sperm ( TNPS) , total number of normal form sperm ( TNNS) and total number of nor mal form and progressive motility sperm ( TNNPS) were observed, and the improvement rate of sperm quantization parameter was compared. Results (1) Before treatment, the differences of TNS, TNPS, TNNS and TNNPS were insignificant between the two groups ( P>0.05) . After treatment, TNNS was not improved in AFT group ( P>0.05) , but TNS, TNPS, TNNPS were much improved in both groups ( P<0.01 compared with those before treatment) . The improvement of KBR group was superior to that of AFT group ( P<0.05) . ( 2) The improvement rate for TNS, TNPS, TNNS, TNNPS was 90.57%, 79.25%, 67.92%, 77.36%in KBR group, and was 75.51%, 73.47%, 28.57%, 61.22% in AFT group respectively. The improvement rate for TNS and TNNS in KBR group was superior to that in AFT group ( P<0.05 or P<0.01) . Conclusion Varicocele-induced male sterility patients usually have the syndrome of kidney deficiency and blood stasis, so KBR, which has the function of tonifying kidney and activating blood, has synergistic action on the effect of AFT in improving sperm quality of varicocele-induced male sterility patients.

Objective To analyze the related factors,and discuss the causes and prevention measures of pharyngocutaneous fistula caused by total laryngectomy.Methods The complete chnical data of 118 patients underwent laryngeal ancer surgery were analyzed retrospectively.Analyzed the relationship between pharyngocutaneous fistula and the factors of sex,age,pre-operative nutrition states,preoperative radiotherapy,prior tracheotomy,neck dissection,tumor position,clinical stage of tumor,patho-staging,post-operative infection comobidity with analysis of single factor.Results Among the 118 cases of laryngeal carcinoma,17 cases were pharyngocutaneous fistula after operation,the incidence was 14.4％ (17/118).According to the statistical analysis results,the predominant influencing factors in the causation of pharyngocutaneous fistula were:pre-operative nutrition states,pre-operative radiotherapy,clinical stage of tumor and post-operative infection.Concusion Pharyngocutaneous fistula after total laryngectomy is related to many factors,avoiding the above mentioned factors can reduce the rate of fistula and improve the life quality.

Objective To compare the efficacies between nasal packing and no nasal packing after endoscopic sinus surgery for chronic sinusitis,and explore the feasibility of no nasal packing after endoscopic sinus surgery.Methods Eighty-two type 1 or type 2 chronic sinusitis patients who received endoscopic sinus surgery under general anesthesia were divided into no nasal packing group (44 cases,75 sides) and nasal packing group (38 cases,65 sides) by random digits table method.The patients in 2 groups were taken preoperative anti-inflammatory and regulation blood pressure treatment.The volume of bleeding,postoperative pain (visual analogue score,VAS),degree of mucosal edema,efficacy and postoperative complications between 2 groups were compared.Results There were no statistical difference in volume of bleeding and efficacy between 2 groups (P ＞ 0.05).The postoperative VAS in no nasal packing group was significantly lower than that in nasal packing group [(2.46 ± 0.54) scores vs.(5.49 ± 1.26) scores],there was statistical difference (P＜ 0.01).There was no statistical difference in mucosal edema score postoperative 1 week and 6 months between 2 groups (P ＞ 0.05),but the mucosal edema score postoperative 1 month in no nasal packing group was significantly lower than that in nasal packing group [(1.32 ±0.63) scores vs.(3.52 ±0.72) scores],there was statistical difference (P ＜ 0.01).Postoperative comphcations in nasal packing group were significantly more than those in no packing group.Conclusion No nasal packing can be performed for type 1 or type 2 chronic sinusitis patients who has no significant bleeding after endoscopic sinus surgery under general anesthesia,it is actually beneficial of relieving distress of the patient and reducing postoperative complications.

Objective To investigate the changes of uvulopalatopharyngoplasty on the auditory function in adult patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS).The possible mechanism of hypoxemia was analyzed,and hypercapnia might affect auditory function and the effect of operation to hearing was improved.Methods A total of 82 adult patients who were made a diagnosis by polysomnography (PSG) with severe OSAHS had been diagnosed by pure tone audiometry,tympa-nometry,auditory brainstem responses (ABR),and otoacoustic emissions (OAE) before and 6 months after surgical treatments.The control group included 43 non-snoring healthy people through the same line of the above test.Results (1)Among 82 patients who underwent uvulopalatopharyngoplasty,symptoms were resolved in 51 patients,significantly improved in 24 patients,and somewhat improved in7 patients at 6 months followed-up,yielding a total effective rate of 100％.(2)There were no significant differences in hearing threshold across 250 to 4 000 Hz on pure tone audiometry between OSAHS and control groups (P ＞ 0.05),although hearing thresholds at high frequencies showed significant differences (P ＜ 0.05).(3)The latencies of ABR waves Ⅰ and Ⅴ in the OSAHS group were significantly longer than control group (P ＜ 0.05).The interpeak lantency intervals of wave Ⅲ ～ Ⅴ in patients with OSAHS were longer than that in the control group (P ＜ 0.05).No significant difference was showed before and after surgery (P ＞ 0.05).(4)Distortion product otoacoustic emission (DPOAE) detection rate and amplitudes at all frequencies were poorer in OSAHS group before surgery compared with the control group (P ＜ 0.05),and significant changes were found after surgical treatments (P ＜ 0.05).Conclusions OSAHS can impair auditory function,probably from chronic hypoxia,which can be improved by surgical treatment in adult patients with severe OSAHS.