Objective To evaluate application value of choledochoscope and nasal bile duct drainage in the treatment of complicated liver echinococcosis combined biliary fistula.Methods The anthors retrospectively summarized and analyzed the clinical data of 144 patients with complicated liver echinococcosis combined biliary fistula.Treatment group (n 68) underwent liver hydatid internal capsule remove + intraoperative choledochoscopy and nose biliary drainage,control group (n-76) underwent the traditional internal capsule remove.The average length of hospital stay,residual cavity drainage catheter time,residual cavity bile leakage and residual cavity infection index of two groups were measured.Results The rate of T tube utilization,residual cavity infection,the incidence of biliary fistula in treatment group were significantly lower than the control group (P＜0.05).The length of hospital stay,the rate of discharge with drainage tube and the average length with tube were significantly less than control group (P＜0.05).Conclusion Intraoperative choledochoscopy and nasal bile duct drainage treatment of complicated liver hydatid,can reduce liver hydatid content residual and biliary fistula,reliable to deal with biliary fistula,part of a primary suture common bile duct,biliary fistula and residual cavity infection rate is low,patients recover quickly,shorter time of hospital stays,is worth popularizing.

Objective To investigate the characteristics and risk factors of occupationai exposure to bloodborne pathogens among health care workers (HCWs),and evaluate prevention and treatment countermeasures.Methods Record Form for Occupational Exposure to Bloodborne Pathogens Among Health Care Workers was used for retrospective survey on the occurrence of occupational exposure to bloodborne pathogens in a hospital between January 1,2013 and December 31,2015.Results A total of 246 cases of blood/body fluid occupational exposure occurred.The main occupational exposure population were nurses (n =95,38.62％);occupational exposure mainly occurred in wards(n =148,60.16％);the main mode of occupational exposure was sharp injury(n =219,89.02 ％);the main opportunity of occupational exposure of HCWs was surgical accident(n =69,28.05 ％);the main exposure source was hepatitis B virus(n =123,50.00 ％);none of HCWs developed infection after local treatment and prophylactic medication.Conclusion Medical institutions should strengthen the training for HCWs about occupational exposure to bloodborne pathogens,enhance protection awareness,standardize operation procedures,and improve working environment,so as to minimize the occurrence of occupational exposure.

Objective: To explore the effects and mechanism of humble leadership on organizational trust and voice behavior of nursing staff. Methods: A total of 249 questionnaires were collected with a questionnaire survey, the effective response rate was 91.54%. The structural equation model was used to test the relationship between variables. Results: The humble leadership had a significantly positive influence on the organizational trust (β= 0.46, P<0.01) and voice behavior (β= 0.63, P<0.01) of nursing staffs, organizational trust played the partial mediating effect (β= 0.29, P<0.01). Conclusion A nursing manager who is good at humble behavior can promote organizational trust among the subordinate nursing team, which in turn, directly and indirectly enhances their positive voice behavior.

Objective To study the clinicalvalue of hyperbaric oxygen combined with cilostazol in treating diabetic foot .Methods 90 patients with diabetic foot in our hospital from June 2014 to July 2016 were selected and randomly divided into the observation group and control group according to the random number table method ,45 cases in each group .The control group was given the cilostazol treatment on the basis of basic treatment ,while on the basis of control group treatment ,the observation group was added with the hyperbaric oxygen therapy .The clinical efficacy and the changes of hemorheology ,blood parameters and plasma fibrinolytic indicators of the two groups were observed .Results The total effective rate in the observation group was 91 .11% ,which was sig-nificantly higher than 71 .11% in the control group ,the difference was statistically significant(P<0 .05);the whole blood viscosity (high shear and low shear ) ,hematocrit after treatment in the observation group were significantly lower than those in the control group(P<0 .05);the levels of HbA1c ,homocysteine(Hcy) and plasma high-sensitivity C reactive protein(hs-CRP) after treatment in the observation group were significantly lower than those in the control group (P<0 .05) ,the levels of plasma fibrinogen andtis-sue-type plasminogen activator(TPA) after treatment in the observation group were significantly superior to those in the control group(P<0 .05) .Conclusion Hyperbaric oxygen combined with cilostazol can effectively improve the levels of HbA 1c ,Hcy and hs-CRP in thee patients with diabetic foot ,promotesthe wound healing and improves the clinical treatment effect .

Objective:To retrospective analyze the epidemiology, clinical characteristics, treatment and prognosis in patients with coronavirus disease 2019 (COVID-19).Methods:A total of 278 patients with COVID-19 admitted to Guangzhou Eighth People′s Hospital from January 20 to February 10, 2020 were selected. The general demographic data, epidemiological data, clinical symptoms, laboratory examinations, lung CT imaging, treatment and prognosis were analyzed.Results:There were 130 male patients (46.8%) and 148 females (53.2%) with age (48.1±17.0) years and 88.8% patients between 20-69 years. Two hundred and thirty-six (84.9%) patients had comorbidities. Two hundred and eleven cases (75.9%) were common type. The in-hospital mortality was 0.4% (1/278). The majority (201, 72.3%) were imported cases mainly from Wuhan (89, 44.3%). The most common clinical manifestations were fever (70.9%) and dry cough (61.5%). In some patients, hemoglobin (10.4%), platelets (12.6%) and albumin (55.4%) were lower than the normal range. Other biochemical tests according to liver and function were normal, while lactic dehydrogenase (LDH) was elevated in 61 patients (21.9%), creatine kinase increased in 26 patients (9.4%). Prolonged activated partial thromboplastin time (APTT) was seen in 52 patients (18.7%), D-dimer higher than normal in 140 patients (50.4%), while 117 patients (42.1%) had elevated high-sensitivity C-reactive protein. Typical CT manifestations included single or multiple ground glass shadows especially in lung periphery in early disease which infiltrated and enlarged during progressive stage. Diffuse consolidation with multiple patchy density in severe/critical cases and even "white lung" presented in a few patients. Two hundred and forty-two patients (87.1%) received one or more antiviral agents, 242 (87.1%) combined with antibacterials, 191 (68.7%) with oxygen therapy. There were 198 patients (71.2%) treated with traditional Chinese medicine.Conclusions:COVID-19 could attack patients in all ages with majority of common type and low mortality rate. Clinical manifestations involve multiple organs or systems. Progression of the disease results in critical status which should be paid much attention.

Objective:To assess the effectiveness of Vision Therapy System 4 (VTS4) combined with traditional comprehensive training for ametropic amblyopia.Methods:A non-randomized controlled clinical study was performed.A total of 168 children aged 4-10 years with ametropic amblyopia were enrolled in The First Affiliated Hospital of Zhengzhou University from January 2018 to March 2021.The children were assigned to conventional comprehensive training combined with Vision Therapy System 4 group (conventional+ VTS4 group) and conventional group according to the preference of their guardian.Patients in conventional+ VTS4 group (84 children) received conventional comprehensive training combined VTS4 and patients in conventional group (84 children) were treated with conventional comprehensive training only, and the intervention was continuously used for over a year.Best corrected visual acuity (BCVA) of the patients converted to the logarithm of the minimum angle of resolution (LogMAR) units was examined by international standard visual acuity chart before and after therapy.Spherical equivalent of the patients was detected by optometry under cycloplegic conditions and skiascopy.Binocular and fusion vision was examined with a synoptiscope.The stereopsis was evaluated using Titmus Stereogram.The ocular axial length (AL) and mean keratometry (Km) were measured with the IOLMaster 500.The basic cure rate, BCVA, reconstruction rate of stereopsis, △SE, △AL and △Km following training were compared to evaluate the effectiveness and myopic shift between two groups.The patients in conventional+ VTS4 group were divided into 4-5 years old group and 6-10 years old group, with 42 cases in each group, and the basic cure rate, BCVA, reconstruction rate of stereopsis were compared to evaluate the therapeutic effect between the two groups.The basic cure was defined as acuity improved to ≥0.9, with reduced myopic diopter and stable therapy outcome over 6 months.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2021-KY-0891-002). Written informed consent was obtained from guardians prior to any medical examination.Results:The basic cure rate of conventional+ VTS4 group was 58.33%(49/84), which was significantly higher than 40.48%(34/84) of conventional group ( χ2=5.358, P=0.021). The BCVA in the conventional+ VTS4 group was better than that in conventional group, showing a statistically significant difference ( Z=-2.537, P=0.011). The recovery rates of binocular vision, fusion vision and stereo vision were 87.93%(51/58), 78.33%(47/60) and 70.77%(46/65) in conventional+ VTS4 group, which were higher than 65.57%(40/61), 57.81%(37/64) and 52.86%(37/70) in conventional group, respectively, with significant differences between them ( χ2=8.259, 5.968, 4.566; all at P<0.05). No significant difference was found in △SE, △AL, and △Km between conventional group and conventional+ VTS4 group (all at P>0.05). The basic cure rate was 69.05%(29/42) in the children aged 4-5 years group, which was higher than 47.62%(20/42) in 6-10 years group, respectively, showing a significant difference ( χ2=3.967, P=0.046). Both BCVA and the stereo vision recovery rate in the 4-5 years old group were better than those in the 6-10 years old group ( Z=-2.046, P=0.041; χ2=4.624, P=0.032). Conclusions:A combination therapy of VTS4 and conventional comprehensive training can improve the visual acuity and reconstruct the fusion and stereopsis of children with ametropic amblyopia, without causing additional myopic drift.