Objective To explore the image quality and diagnostic efficiency of coronary CTA (CCTA) in patients without heart rate (HR) control by optimizing acquisition phase with auto-ECG-gating technology using 256-row wide-volume detector.Methods Totally 200 patients with suspected coronary artery disease (CAD) were selected and underwent CCTA with auto-ECG-gating on a 256 row wide detector CT (Revolution CT).Patients were divided into 4 groups according to the real-time HR,group A (n=50):HR≤69 bpm;group B (n=50):HR 70-80 bpm;group C (n=50):HR 81-90 bpm;group D:HR≥91 bpm (n=50).CCTA images quality and diagnostic rate were assessed by two experienced radiologists blindly,and effective radiation dose were compared among 4 groups.Results There were no significant differences of age,sex,and body mass index among 4 groups (all P＞0.05),and there was significant difference of image quality score among 4 groups (P＜0.05).Totally,800 coronary arteries and 2 575 segments in 200 patients were assessed.There had no significant difference of diagnostic rate among four groups derived from the segment,coronary artery and patients (all P＞0.05).The effective radiation dose in A D groups were (1.05t0.48)mSv,(2.41± 1.20)mSv,(1.27±0.55) mSv,(2.66±1.12)mSv,and the difference was significant (F=29.22,P＜0.001).Conclusion It is feasible to perform CCTA in single cardiac cycle in patients with arbitrary heart rate by auto-ECG-gating using Revolution CT equipped widevolume detector.And it can improve image quality and success ratio in patients with moderate and high heart rate.

Objective:To explore the effect of health education model based on intelligent medical in patients who undergoing surgery with lumbar degenerative changes.Methods:A total of 80 patients with lumbar degenerative changes, who met the inclusion criteria, in the Orthopedics Department of Zhuhai People's Hospital from January 2019 to December 2020 were recruited as the research subjects by convenient sampling method. According to the order of admission, they were divided into control group and intervention group, with 40 cases in each group. The control group was given routine health education. A health education model relying on intelligence medical treatment was constructed and implemented in the intervention group, by making full use of their respective functional modules with the help of three intelligent medical tools: intelligent pad in the nurse station, electronic display screen and hand-held electronic devices. The pain, lumbar function, functional exercise compliance, satisfaction, anxiety and sleep quality and constipation of the two groups were compared by Visual Analog Score (VAS) , Japanese Orthopaedic Association (JOA) score, functional exercise compliance evaluation form for patients undergoing surgery for lumbar degenerative diseases, patient satisfaction questionnaire, Hamilton Anxiety Scale (HAMA) and Pittsburgh Sleep Quality Index (PSQI) .Results:The pain score and lumbar function score on the 7th day after surgery in the intervention group were (2.57±0.73) and (15.00±1.89) respectively, and those scores in the control group were (3.10±0.61) and (12.80±1.75) respectively. The differences were statistically significant ( P<0.05) . The compliance of functional exercise in the intervention group was better than that in the control group, and the satisfaction was higher than that in the control group, with statistical significance ( P<0.05) . The postoperative anxiety of patients in the intervention group was lighter than that in the control group, and the sleep quality and defecation were better than those in the control group, with statistical significance ( P<0.05) . Conclusions:Health education based on intelligent medical treatment can reduce the pain in patients who undergoing surgery with lumbar degenerative changes, at the same time improve the compliance of exercise and satisfaction, reduce anxiety, sleep disorder and constipation, which is worthy of clinical application.

Objectives:To explore the risk factors for recurrent in-stent restenosis(R-ISR)in patients with coronary heart disease after percutaneous coronary intervention(PCI)and to develop a risk prediction model for R-ISR using a nomogram. Methods:All patients treated for ISR at the Fuwai Hospital,Chinese Academy of Medical Sciences from January to December 2017 were eligible for this study.A total of 1 102 ISR patients were included for analysis.Based on the recurrence of ISR after PCI,patients were divided into R-ISR group and non-R-ISR group.Univariate Cox regression analyses,LASSO regression analyses,and the combination of clinical experience were used to select predictors of R-ISR.A multivariate Cox regression model was used to analyze the independent risk factors of R-ISR and to develop a risk prediction model. Results:The median follow-up duration for participants was 1 264(1 169,1 334)days,the incidence rate of R-ISR after PCI was 10.1%.Multivariate Cox regression analysis showed that age(HR=0.98,95%CI:0.96-0.99),total bilirubin(HR=0.95,95%CI:0.91-0.99),apolipoprotein A1(HR=0.08,95%CI:0.02-0.42),high-sensitivity C-reactive protein(HR=1.05,95%CI:1.01-1.10),and reference vessel diameter(HR=0.65,95%CI:0.44-0.98)were independent determinants of R-ISR.Accordingly,the R-ISR risk prediction model was developed with a nomogram,the AUC of this model to predicto R-ISR was 0.70(95%CI:0.64-0.77). Conclusions:Coronary heart disease patients with younger age,lower levels of total bilirubin and apolipoprotein A1,smaller vessel diameter,and higher levels of high-sensitivity C-reactive protein are at higher risk of R-ISR.The developed visual risk prediction model for R-ISR shows promising predictive performance but still requires further optimization and validation.