OBJECTIVE To analyze the current status and associated factors of human rabies immunoglobulin （HRIG） use in children with rabies-exposure， so as to provide a reference for the rational use of HRIG.METHODS Clinical data of children with rabies-exposure who were admitted to the outpatient and emergency departments of Xiamen Children’s Hospital from January to December 2024 were retrospectively collected. HRIG use in these children was analyzed， and univariate and multivariate Logistic regression analyses was used to identify independent risk factors for non-use of HRIG among children indicated for it.A questionnaire survey was conducted to assess 42 surgeons’ knowledge of rabies-post-exposure prophylaxis，self-rated factors influencing HRIG use，and reasons for non-use in high-risk exposure scenarios.RESULTS A total of 564 pediatric patients were enrolled， of whom 122 met the indications for HRIG use； however， only 24 received HRIG， yielding an actual utilization rate of 19.67%. Multivariate Logistic regression analysis showed that head and facial exposure was an independent risk factor for non-use of HRIG [OR＝7.77， 95%CI （1.11， 54.27）， P ＝0.039]. The questionnaire survey revealed that surgeons had the lowest awareness rate regarding the time to antibody production after rabies vaccination （35.71%）， followed by the appropriate timing of HRIG administration （50.00%）. Among the self-rated factors influencing HRIG use by surgeons， wound depth and bleeding status had the highest mean scores （2.95 points）. The primary reasons for non-use HRIG in special cases and grade Ⅲ exposure pediatric patients were the judgment that the offending animal was healthy or posed low risk，accounting for 45.24% and 38.10%， respectively； followed by parental refusal due to cost， pain， or other concerns，accounting for 26.19% and 33.33%， respectively.CONCLUSIONS The actual utilization rate of HRIG among children meeting the indications for HRIG use in our hospital was relatively low. Head and facial exposure was an independent risk factor for non-use of HRIG. Some surgeons had insufficient understanding of the time to antibody production after rabies vaccination and the appropriate timing of HRIG administration. Animal-related risk assessment and parental preferences may influence the use of HRIG.

ObjectiveTo valuate the three-dimensional CT angiography(3DCTA) in diagnosing blood vessel diseases.MethodsCTA findings of 284 patients confirmed with blood vessel diseases were retrospectively analyzed.They were divided into two groups:141 cases of head and neck and 143 cases of trunk and extremities.Scan was performed with the beam collimation of 0.625 ～ 3.0mm,increment of 0.3 ～ 1.4mm,pitch of 1.0 ～ 1.5,with the gross contrast medium of 1.5 ～ 2.0ml/kg.3D imaging methods included volume rendering(VR),multi-planar reformatting (MPR),curved planar reformatting(CPR),surface shade display(SSD),maximum intensity project(MIP) and virtual endoscopy(VE).The diagnostic results of CTA were compared with those of DSA and/or surgery.ResultsIn this study,3D images of vasculature met the diagnostic criterion.The diagnostic sensitivity,specificity and accuracy of CTA was 97.28％,82.35％ and 96.48％,respectively.The size of artery aneurysm shown with CTA and DSA had no significant difference( P ＞0.05 ),both smaller than that in surgery( P ＜ 0.05 ).Conclusion3DCTA could be used in diagnosing the cardiovascular diseases and compensate the limitation of conventional CT.It had the characteristics of non-invasion,high accuracy and could partly substitute DSA.

Objective To evaluate the techniques of separating, fusing, opacifying and falsecoloring- volume rendering( SFOF-VR)3D imaging on the bone and blood vessels in the region of atlantoaxial joint(AAJ). Methods SFOF-VR 3D imaging was performed on 35 cases, including normal (n = 6),variations and lesions( n =29), which were selected from cases with the head-neck CTA examination. With the original scanning data, the VR imaging was performed, then SFOF-VR imaging. Comparisons were made between the features of 3D images of SFOF-VR and VR in showing the anatomy, diagnosing the variation and lesion of AAJ and VA, and the results were analyzed by using the Fisher exact test. Results The results of 35 cases included 6 normal cases in the region of atlantoaxial joint and VA, 16 variations in atlantoaxial joint or VA, 6 cases with arteriosclerosis in VA and 7 cases with fracture or dislocation of atlantoaxial joint. All SFOF-VR imaging are satisfactory. SFOF-VR imaging can show the atlas, epistropheus and VA independently or jointly, cut or color the structures freely and get 3D measurements in any direction.Comparisons showed that SFOF-VR images were much clearer and more comprehensive than VR in displaying the anatomy, variation and lesions of AAJ and VA. Statistical differences were found in showing the spatial structure, blocking structure, space measurement, variation and disease and image edge ( there are25,7,3,0, 31,3,1,0, 26,3,6,0, 23,7,5,0, 0,10,20,5 cases for SFOF-VR image with excellent,good, ordinary and poor quality, and 2,5,24,4, 0,2,8,25, 0,7,25,3, 5,6,23,1, 29,4,2,0 cases for VR;χ2 values 40. 259, 61.444, 42.245, 24.220, 51.299, P<0. 01 ). Conclusions SFOF-VR is a new 3D imaging technique which can clearly and directly show the bones and blood vessels in the region of AAJ.It can provide anatomical information for imaging diagnosis and surgical operation.

Objective To evaluate the clinical value of CT three-dimensional(3-D) imaging on diagnosing of bone and joint diseases.Methods The imaging findings of 357 cases proved by operation or clinic were analyzed retrospectively by the 3-D imaging.The diagnosis accuracy of 3-D imaging was compared with that of routine CT.3-D images were obtained by surface shade display(SSD),multi-planar reconstruction(MPR),maximum intensity project(MIP) and volume rendering(VR).Results In 357 patients,257 cases were traumatic disease,100 cases were non-traumatic disease.The diagnosis accuracy of 3-D imaging was 98.3%,which was higher than that of routine CT(P