Objective To evaluate the diagnostic value of 64-row VCT coronary angiography(CTA) in diagnosing coronary artery disease.Methods 64-row VCT coronary angiography(CTA) and cathter coronary angiography(CAG) were performed in 173 patients with suspected coronary artery disease.All images were analysed at GE AW4.3 workstation,the constructed images included maximum intensity projection(MIP),mlti-planar reconstruction(MPR) and volume rendering(VR).The results were compared with that of CAG.Results 746 segments of coronary artery with diameter ＞1.5 mm were showed by CTA in 173 patients.The sensitivity,specificity,positive predictive value and negative predictive value of the CTA in detecting coronary arterial stenosis were 94.15%(193/203),95.90% and 89.77% and 97.90% respectively.Statistical analysis using a 2-related χ~2 test showed that there were no obvious differences in diagnosing coronary arterial stenosis between CTA and CAG(χ~2=1.58,P＞0.05) and in evaluating the stenosis degree of coronary artery(Kappa=0.890,P＜0.001).Conclusion 64-row VCT has important clinical value in screening coronary arterial disease and in following-up post operational effectiveness of coronary stent implantation and vascular bypass.

Ojective To investigate the clinical application value of low dose contrast agent in computerized tomography pulmonary angiography (CTPA) with spectral CT imaging.Methods Totally 52 patients suspected with pulmonary embolism underwent multi-slice spiral CT pulmonary angiography,and were randomly divided into a control group (n =27) and a research group (n=25).The research group used spectral CT with 35 ml of contrast medium and the control group used 64-slice CT with conventional 80 to 90 ml of contrast medium.The CT values of the pulmonary trunk,left pulmonary artery (LPA),right pulmonary artery (RPA),pulmonary vein and ascending aorta were measured.The contrast to noise ratio (CNR) of the pulmonary artery was also calculated.In addition,the image quality of CTPA was evaluated independently by two experienced radiologists.Results The CT values (HU) of the pulmonary trunk,left pulmonary artery(LPA),right pulmonary artery (RPA) in the research group were (432.2±63.4),(373.5±48.8),(381.4±53.6) and (62.5-±6.4),respectively,and significantly higher than those in the control group,showing statistical differences (P＜0.05).The evaluation results of the CTPA images by two radiologists showed that the image quality in the research group was better than that in the control group (P＜0.05).Conclusion The image quality of pulmonary angiography with spectral CT using low contrast medium dose can be improved compared with the conventional spiral CT.

Objective To understand the current management situation of hand hygiene (HH)among health care workers(HCWs)in stomatology medical institutions in Zunyi,and provide basis for the scientific management of HH.Methods In October-December 2014,the on-site observation and questionnaire survey were adopted to investigate current management situation of HH in 127 stomatology medical institutions in Zunyi.Results The rates of qualified installation of sink,faucet,detergent,alcohol-based hand rub,and hand-drying facilities were 60.63%, 11 .02%,92.13%,22.05%,and 37.80% respectively.Except detergent and sink,the installation of other HH supplies in stomatology medical institutions in Zunyi were not ideal.The correct rate of HH among HCWs was 33.07%(42/127),qualified rates of HH methods among HCWs in departments of stomatology,comprehensive out-patient departments, stomatological clinics,and teeth-cleaning clinics were 50.00%,23.08%,23.53%,and 0 respectively.Conclusion HH facilities are not perfect in primary stomatology medical institutions in Zunyi,health ad-ministrative departments’supervision on HCWs’HH is inadequate,the awareness rate of HH knowledge and com-pliance to HH among HCWs are both low.

Objective:To evaluate the effectiveness and safety of intravitreal injection of different doses of aflibercept for polypoidal choroidal vasculopathy (PCV) with serous pigment epithelial detachment (PED) resistant to ranibizumab.Methods:A non-randomized controlled clinical study was conducted.Seventy-three eyes of 73 patients with PCV and serous PED resistant to ranibizumab were enrolled at the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2020.All patients were treated by intravitreal injection of 2 mg or 4 mg aflibercept according to patients' willingness.2 mg aflibercept or 4 mg aflibercept was intravitreally injected monthly for three consecutive months following pro re nata (PRN) regimen in 2 mg aflibercept group (38 eyes) and 4 mg aflibercept group (35 eyes), respectively.PED height and central macular thickness (CMT) were measured by optical coherence tomography, and the best corrected visual acuity (BCVA) was examined with a visual acuity chart and converted to logarithm of the minimum angle of resolution (LogMAR) unit before injection and 1 month, 2, 3, 6 months from the first injection.Intraocular pressure and treatment-related adverse events were recorded.This study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2021-KY-1252).Written informed consent was obtained from each patient prior to entering study cohort.Results:Thirty-three patients (86.84%) in 2 mg aflibercept group and 30 patients (85.71%) in 4 mg aflibercept group finished the treatment and follow-up, respectively. The PED, BCVA and CMT before treatment and at the end of follow-up were (379.24±95.50) and (280.09±120.50)μm, 0.68±0.27 and 0.51±0.19, (393.96±100.81) and (291.70±44.09)μm in 2 mg aflibercept group, respectively, showing statistically significant differences (all at P<0.05).The PED, BCVA and CMT before treatment and at the end of follow-up were (393.07±93.76) and (278.63±145.07)μm, 0.66±0.31 and 0.48±0.22, (377.43±79.61) and (284.67±84.88)μm in 4 mg aflibercept group, respectively, with statistically significant differences (all at P<0.05).The CMT value in 4 mg aflibercept group was significantly lower than that in the 2 mg aflibercept group in one month after injection ( P<0.05).No severe ocular and systemic adverse events were found during the follow-up, such as retinal detachment, endophthalmitis, cataract, and persistent high intraocular pressure. Conclusions:Both 2 mg and 4 mg aflibercept can effectively treat ranibizumab-resistant PCV with serous PED, and improve the anatomical structure of retina and BCVA.4 mg aflibercept can accelerate the recovery of PED and CMT.

Objective:To observe and analyze the macular choroidal thickness and choroidal blood perfusion (CBP) in eyes with idiopathic macular hole (IMH) and their correlation.Methods:A cross-sectional observational clinical study. From March 2019 to October 2021, 60 IMH patients with 60 eyes (IMH group) and 60 healthy volunteers with 60 eyes (control group) who consecutively visited Department of Ophthalmology of The First Affiliated Hospital of Zhengzhou University were included in the study. Among the 60 eyes in the IMH group, 8, 8, 15, and 29 eyes were at stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. There was no significant difference in age, spherical equivalent power and axial length between the two groups ( t=1.327, 0.157, 0.542; P>0.05). The average macular choriodal thickness (AMCT) and CBP in different regions of the macular region of the examined eye were measured using a swept-frequency light source optical coherence tomography scanner. According to the zoning method for the treatment of diabetic retinopathy, the choroid within 6 mm of the fovea was divided into 3 concentric circles with the fovea as the center. They are the central area with a diameter of 1 mm, the inner ring area of 1-3 mm, and the outer ring area of 3-6 mm; the inner ring area and the outer ring area were divided into 4 areas by 2 radiations respectively, including the upper part of the inner superior (IS), the lower part of the inner inferior (Ⅱ ), and the nasal side of the inner nasal (IN), inner temporal (IT), outer superior (OS), outer inferior (OI), outer nasal (ON), outer temporal (OT), a total of 9 regions. The distribution characteristics of AMCT and CBP in different regions were observed. The correlation between AMCT and CBP was analyzed by Pearson correlation; the correlation between AMCT, CBP and IMH stage was analyzed by Spearman correlation. Results:Compared with the eyes of the control group, the AMCT of the affected eyes in the IMH group was significantly thinner in all areas of the macula, and the difference was statistically significant ( t=2.378, 4.641, 2.888, 3.390, 3.575, 4.870, 4.077, 4.946, 4.578; P<0.05). Compared with the control group, the CBP in the OS and OT regions of the affected eyes in the IMH group was significantly lower, the difference was statistically significant ( t=3.424, 4.516; P<0.05). The results of Pearson correlation analysis showed that there was a significant positive correlation between AMCT and CBP in the OT region ( r=0.314, P<0.001). Spearman correlation analysis showed that there was a significant positive correlation between AMCT and IMH staging in each region ( r=0.375, 0.374, 0.289, 0.379, 0.441, 0.392, 0.303, 0.341, 0.292; P<0.05). There was no significant correlation between CBP and IMH staging in IN, OI and OT regions ( r=-0.138, -0.016, -0.221; P>0.05); CBP and IMH staging in other regions were significantly negatively correlated ( r=-0.560, -0.390,-0.819, -0.692, -0.329, -0.587; P<0.05). Conclusions:The choroidal thickness in the macular region of the eyes with IMH is significantly thinner than that of the normal subjects; there is choroidal hypoperfusion in local areas. There is a significant positive correlation between local regional AMCT and CBP; IMH stage is higher, the trend of AMCT in each region is thickening, and the CBP in most regions decrease.

【Objective】 To investigate the feasibility and safety of semiconductor blue laser in the treatment of non-muscle invasive bladder cancer (NMIBC) in the day surgery model. 【Methods】 The clinical data of 22 NMIBC patients (average age 55.8 years and tumor size 1.4 cm) who underwent outpatient screening and accepted blue laser ambulatory surgery in our hospital during Jun.2022 and Sep.2022 were retrospectively analyzed. On the day of admission, transurethral resection of cancer was performed using blue laser en bloc enucleation. On the day of surgery or in the morning of next day, bladder irrigation was stopped, the catheter was removed, and patients were discharged. The baseline data, pre-hospital waiting time, operation time, length of hospital stay, hemoglobin decrease, complications and management, follow-up, medical costs, and patients’ satisfaction rate were recorded. 【Results】 The pre-hospital waiting time was 2 to 7 days, average (4.1±1.3)days. The operation time was 29 to 50 minutes, average (40.8±5.5)minutes. The length of hospital stay was 0.6 to 1.2 days, average (0.9±0.2)days. Hemoglobin decrease was 1 g/L to 8 g/L, average (3.8±1.8)g/L. The catheter was indwelt for 0.5 to 1 day, average (0.7±0.1)day. The medical costs were 13 790 to 16 811 Yuan, average (14 941.5±690.2) Yuan. Patients’ satisfaction rate was 100.0%. Mild intraoperative and postoperative complications occurred in 2 cases. One patient developed symptoms of cystitis which disappeared after 2 days of oral antibiotic cefixime, and another patient developed bladder spasm which was relieved after oral solifenacin succinate tablets. No adverse events such as obturator nerve reflex or bladder perforation occurred. After removal of the catheter, no urinary retention was observed. 【Conclusion】 This study was the first to apply blue laser ambulatory surgery in the treatment of bladder cancer, confirming that it is a safe, feasible, economical and efficient model for selected patients, which can be promoted in suitable hospitals.