Objective: To investigate the therapeutic value of dual source CT coronary CTA (DSCTA) in coronary atherosclerosis. Methods: Ninety five cases with clinical highly suspected coronary artery disease in DSCTA were selected from January 2013 to December 2014, coronary angiography (CAG) as thegold standard, analysis of DSCTA assessment of coronary artery stenosis and coronary artery display accuracy and consistency of CAG findings. Results: ①CAG inspection coronary artery stenosis with mild, moderate stenosis, severe stenosis were 149, 81, 55, DSCTA accurate assessment of were respectively 140, 79, 54, accuracy rate of 95.79 %, consistency test was statistically significant (Kappa=0.679, P<0.05); ②CAG examination coronary artery branch show: <3, 3-5 branch,>5 were 8 cases, 68 cases, 19 cases, DSCTA were accurately detected in 8 cases, 65 cases, 15 cases, accuracy rate of 92.63%, consistency test was statistically significant(Kappa=0.608, P<0.05). Conclusion:DSCTA in assessing the degree of stenosis of coronary atherosclerosis and coronary branch vessels show areas with good results, worthy of recognition in clinical.

Humans ; Occupational Diseases ; diagnosis

Thymomas are most frequent primary tumors of anterior mediastinum.Surgery is the principal treatment method.Thymomas are sensitive to chemotherapy,and chemotherapy has showed a sig- nificant anti-tumor effect in locally advanced,recurrent or metastatic thymomas.Chemotherapy,radiother- apy or combined chemotherapy and radiotherapy before or after operation can offer patients excellent re- sponses,improve resectable rate.Some patients who are once inoperable obtain curative and palliative operation.Radiotherapy after operation can decrease residual tumor tissue,increase local control,de- crease recurrence,and prolong the survival.The multimodality therapy plays an important role in thy- moma treatment.

Objective To compare the clinical efficacy of different trough concentrations of vancomycin in patients.Methods A retrospective study in patients having at least one trough concentration of vancomycin for enrollment between January 2009 and December 2013 was carried out.The eligibility patients were divided into 3 groups according to the level of trough concentrations namely group A (＜ 10 mg/L),Group B (10 ～ 15 mg/L),and Group C (＞ 15 mg/L).The clinical efficacy,clearance of pathogens and in-hospital mortality were analyzed with the help of SPSS Statistics 17.0.The comparison of dosing days,length of hospital stay and time consumed from initial dosing to the appearance of recovery signs of survivors among the 3 groups.Results There were no significant difference among 3 groups in terms of clinical efficacy (55.6％ vs.33.3％ vs.51.7％),clearance of pathogens (38.9％ vs.25％ vs.24.1％) and in-hospital mortality (44.4％ vs.25％ vs.27.6％).After adjusting by age,the in-hospital mortality decreased along with the trough concentrations vancomycin.Along with increase in the trough concentrations vancomycin,the dosing day (14.90 ± 6.44 vs.18.75 ± 7.23 vs.17.93 ± 9.42) and length of hospitalization [(33.70 ± 18.17) vs.(79 ±45.53) vs.(66.20 ±52.48)] increased,and time required from dosageinitial dosing to the appearance of recovery signs of survivors among the 3 groups [(4.82 ± 2.62) vs.(3.75 ± 0.50) vs.(4.07 ± 3.20)] shortened.Conclusions Improving the trough concentrations of vancomycin could not increase clinical efficacy rate or bacterial clearance rate,but could lower in-hospital mortality.However,it might enhance the financial burden on patients as well.

Objective To investigate the relation of Toll-like receptor 4 (TLR4)and monocyte chemoattractant protein-1 (MCP-1)with acute coronary syndrome.Methods 60 patients with coronary heart disease patients including 39 cases of a-cute coronary syndrome (ACS group),21 cases of stable angina (SA group)from January 2015-March 2016 in Xi’an First Hospital were in this observation.ACS group was divided into acute myocardial infarction (AMI,n=21)and unstable angina pectoris (UAP,n=18).Another 30 cases with angiographically normal was included in control group.Enzyme-linked immu-nosorbent assay (ELISA)detection was used to detect the serum content of MCP-1,TLR4 expression was tested by flow cy-tometry.Triglyceride (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C)and high-density lipopro-tein cholesterol (HDL-C)were detected.Results TLR4 levels of ACS group was significantly higher than SA group (t=4.455,P=0.021).Serum MCP-1 levels of ACS group were significantly higher than SA group (t=3.220,P=0.002)and control group (t=6.197,P=0.000).MCP-1 levels of ACS group were higher than control group (t=2.306,P=0.025). The Spearman correlation test TLR4 was positively with MCP-1 (r=2.389,P=0.025).Conclusion MCP-1 and TLR4 may determine the severity of coronary heart disease,combined detection of MCP-1 and TRL4 can provide the clinical value for early diagnosis and treatment of ACS.

OBJECTIVE:To strength pharmacy management,improve pharmacy stocktaking efficiency and lower the error rate of the stocktaking in outpatient pharmacy.METHODS:Based on "Army No.1" inventory management system,the data were retrieved and adjusted using Excel spreadsheet,and the inter-district small-scale inventory table of the outpatient pharmacy was designed in which certain individuals should be responsible for certain drugs and the order of drugs in the inventory table were in line with the arrangement order of drugs.RESULTS:The new drug stocktaking model reduced the error rate of traditional monthly drug stocktaking by 3%.CONCLUSION:The established drug stocktaking method reduces human and material resources,facilitates a more flexible,convenient and rapid stocktaking,and greatly enhances the conformity rate between drugs and accounts.

OBJECTIVE: To provide reference for the management of central pharmacy in our hospital. METHODS: In daily work, performance score of a job was related with quality evaluation using grouping work model and management method of allocating a specific responsibility to a specific person. RESULT & CONCLUSION: The work process of central pharmacy is clear and plays a great role in economizing on resources relatively.

Objective A retrospective study was conducted to evaluate the clinical significance of Video EEG monitoring in the diagnosis of epilepsy and other paroxysmal events Methods Video EEG monitoring under the state of awaking and sleeping and evoked tests were performed continuously in 216 patients with epilepsy and other paroxysmal events Results The characteristic events were captured in 130(60%) of the 216 patients And out of the 130 patients, 53 had clinical events accompanying epileptiform discharge 73 patients had no epileptiform discharge in both ictal and interictal period Seizure types were defined in 80%of 80 patients with epileptiform discharge, and classification was different from the original 42% of the 64 patients Conclusions Video EEG can record much more epileptiform discharge than routine EEG It should be an effective method in both diagnosis and classification of epilepsy

Objective To investigate transplantation of autologous peripheral blood stem cells(PBSC)for therapeutic treatment of ischemic arterial disease of the lower extremity.Methods Mobilized PBSC was directly injected into the ischemic hindlimb muscles in rabbit models.Two and four weeks after the transplantation of autologous PBSC selective angiography was carried out,and the capillary density was determined histochemically in the specimens using CD31 mAb.Results In angiography,collateral arteries were significantly increased in ischemic hindlimbs.The capillary density was significantly higher in treatment group.Conclusion Transplantation of autologous PBSC is a simple and effective therapy for the ischemia hindlimb.

Objective To study the complications of translaminar microendoscopic discectomy and their prevention and management. Methods The complications of translaminar microendoscopic discectomy performed on 487 cases of lumbar disc herniations were retrospectively analyzed. Results Most of the complications were seen in the first 50 cases, which included intraoperative CSF leak (8 cases, 1.64% ), cauda equina damage (1 case,0.21%) nerve root damage (1 case,0.21%) and inflammation of intervertebral disc (1 case,0.21%). Three patients (0.62%) converted into standard open lumbar disc surgery because epidural bleeding was difficult to control under endoscope. Conclusions There is a direct correlation between the compliations and the clinical experience in this technique. The complications of translaminar microendoscopic discectomy at the early stage are significantly higher than those of open techniques, but they are rarely seen at the later stage.