近年来,我国经济实力不断增强,医疗制度也得到逐渐完善.新医改政策的全面推进对公立医院财务管理工作实施也提出了更高的要求.随着信息技术的蓬勃发展,各行各业都迎来了全新的发展机遇,公立医院也不例外.为了更好地适应新医改政策要求,满足市场发展需要,公立医院亟需构建一套完善的会计信息化方案,实现内部管理效率与质量提升.公立医院在我国医疗体系中承担着十分重要的责任.推动会计信息化建设,对于公立医院的健康发展而言,不仅是顺应时代发展的必然要求,也是公立医院提高内部管理质量的不二之选.然而部分公立医院受传统管理思维制约

目的 比较中孕期非综合征唇和(或)腭裂(NSCL/P)胎儿脑各二维径线与对照组胎儿的差异.资料与方法 前瞻性纳入2018年1月—2019年12月在首都医科大学附属北京妇产医院接受产前MRI检查的60例中孕期胎儿,其中NSCL/P胎儿30例,对照组胎儿30例:采集入组胎儿全脑轴位T2加权像,比较两组胎儿脑骨双顶径(SBD)、骨枕额径(SOD)、小脑最大横径(TCD)、头围(HC)、外侧裂深度(SFD)、岛叶深度(ID)、SFD/SBD、ID/SBD的差异,并分析以上指标与孕周的相关性.结果 相关分析表明,两组胎儿SBD、SOD、TCD、HC、左右侧SFD、左右侧ID均与胎儿孕周呈正相关(NSCL/P组r=0.936、0.884、0.918、0.881、0.852、0.559、0.755、0.920,P均＜0.01;对照组r=0.878、0.937、0.888、0.512、0.513、0.847、0.817、0.931,P均＜0.01).两组 SBD、SOD、TCD、HC 差异均无统计学意义(P＞0.05).NSCL/P 胎儿左侧 SFD/SBD(0.162±0.018比 0.174±0.015)、右侧 ID/SBD(0.277±0.022 比 0.288±0.018)低于正常对照胎儿(t=-2.958、-2.246,P均＜0.05).结论 中孕期NSCL/P胎儿可能合并脑二维径线异常,产前量化评估NSCL/P胎儿脑发育,可为胎儿出生后尽早开始认知功能检测及干预提供参考.

例1 孕妇,36岁,孕1产0,因原发不孕行体外授精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)术,移植胚胎2枚,成活2枚,常规大剂量应用雌、孕激素,孕期定期产前检查.孕34周因胎儿生长受限入院治疗,37周入院剖宫产分娩一女一男双胎.早孕期超声检查提示双绒毛膜性双胎,两胎儿大小符合孕周;孕11～13+6周超声提示双胎颈项透明层(nuchal translucency,NT)测值均在正常范围内,两胎儿大小符合孕周.孕期行无创DNA检查提示低风险.孕22周超声检查提示胎儿外生殖器外观均呈现女性特征,两胎儿大小符合孕周.

Objective To investigate the diagnosis value of the three-dimensional transvaginal ultrasound volume technology in polycystic ovary syndrome (PCOS).Methods Totally 75 patients with PCOS and 50 normal subjects as controls from Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University were chosed. The volume of the endometrium and ovaries were measured with virtual organ computer-aided analysis techniques (VOCAL). While the follicular numbers and the volumes were measured by sono follicle technique. The ovarian volumes, the follicular volumes and the endometrial volumes were compared between the two groups. Independent samplest test was used to compare PCOS group patients and healthy subjects with endometrial volumes, ovarian volumes, follicle volumes and the average numbers of follicle. Pearson correlation analysis was used to analyze the correlation between the number of total follicles and the volume of ovary, follicle volume and serum sex hormone concentration in PCOS group.Results With the endometrial volume of PCOS patients about (1.6±0.9) cm3 was less than that of the control group [(3.1±1.7) cm3]. The ovarian volume, follicular volume and the average number of follicles were (13.6±4.6) cm3, (1.9±0.7) cm3 and (27.7±7.4). All of them were higher than those in healthy subjects [(7.4±2.9) cm3, (1.1±0.7) cm3, (8.4±3.4)], and the differences were statistically significant (t=6.013, P<0.001;t=8.087,P=0.015;t=7.222,P<0.001;t=15.637,P<0.001). The total number of follicles in PCOS patients were positively correlated with ovarian volume, follicle volume and serum testosterone concentrations (r=0.467,P=0.000;r=0.446,P=0.000;r=0.383,P=0.001). There was no correlation with luteinizing hormone (LH)/thyroid stimulating hormone (TSH) (r=0.048,P=0.702).Conclusion The sono follicle and VOCAL technology provide a new and objective measurement method for PCOS diagnosis.

Objective To investigate prenatal high-risk factors in developmental dysplasia of the hip (DDH) incidence using the Graf uhrasound method.Methods 2 124 infants,who were highly suspected as DDH based on clinical examination,were examined by Graf ultrasound method.All cases came from outpatients of Pediatrics and child care clinic,Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University,from January 2015 to December 2016.A total of 4 248 hip jonits were observed in morphology,α and 3 angle were measured,and maternal risk factors during pregnancy were explored.Results High-risk factors of mothers included age ＞ 35 years (720 cases,16.9％),gestation hypertension (792 cases,18.6％),gestational diabetes mellitus (1 836 cases,43.2％),hypothyroidism (1 188 cases,27.9％),embryo transplantation after operation (IVF-ET,900 cases,20.9％),multiple pregnancies (468 cases,ll.0％).4 187 of them (98.6％) were normal among 4 248 hips,abnormal hip accounts for 1.4％ (61 cases).The sub-types included hip joint type Ⅰ (4 187,98.6％);Ⅱ a (46 cases,0.69％),Ⅱ b (6 cases,0.21％),Ⅱc (3 cases,0.05％);Ⅲ (4 cases,0.03％);Ⅳ (2 cases,0.03％).Babies whose mother with hypothyroidism and gestation hypertension had lower α angle,there were no statistical difference of α angle between babies whose mother with other risk factors or not.Prevalence of DDH was higher in babies whose mother with gestation hypertension and hypothyroidism.Conclusion Graf hip ultrasound method can be used for classification the diagnosis of hip joint,and for screening high risk factors.Among all the prenatal high-risk factors,pregnancy hypertension and hypothyroidism may be the risk factors of DDH.

随着我国社会经济的快速发展,医疗行业也得到了快速的发展。但是,医疗市场的竞争程度也变得日益激烈。因此,医院为了实现持续稳定的发展,开始重视财务管理,不断的控制医院的成本,重视成本核算和会计核算,从而提高医院的财务管理水平。目前,医院在财务管理中朝着成本核算与会计核算一体化的趋势发展,加强财务管理。所以,本文就针对医院财务管理中成本核算与会计核算的一体化发展进行浅显的分析和研究。