Objective To investigate the orientation relationship between the infarct related artery (IRA)and the change of the electrocardiogram (ECG)of the patients with anterior wall and extensive anterior wall acute myocardial infarction (AMI) .Methods ECG and coronary artery angiography (CAG)were compared and analyzed retrospectively through 171 patients(selected from January 1 ,2008 to March 31 ,2013)who were divided into anterior wall of LAD group and extensive anterior wall of LAD group .Re‐sults It was prompted that the IRA of the extensive anterior was the proximal occlusion of the left anterior descending (LAD) rather than distal occlusion (P<0 .05)if ST‐segment elevated in lead I ,aVL and aVR or ST‐segment depressed in lead Ⅱ ,Ⅲ and aVF in case of anterior wall and extensive anterior wall AMI .Conclusion Analyzing valuable ECG index could help us to prelimina‐rily infer IRA and the occlusion site in anterior wall and extensive anterior wall AMI .

OBJECTIVE:To provide reference for better improving the risk perception of Omeprazole sodium for injection in nurses in a third-grade class-A hospital,strengthening risk management of ward drugs and ensuring safety of patients. METHODS:Nurses in the clinical departments in a third-grade class-A hospital where usage frequency of Omeprazole sodium for injection was relatively more were adopted as study subjects and a self-designed questionnaire was used to investigate on related knowledge on medication risk in nurses in emergency department,gastroenterology department,ICU and CCU in 2012 and 2014. RESULTS:51 and 81 questionnaires were distributed in 2012 and 2014,and 51 and 81 were effectively received with effective recovery of 100%and 100%,respectively. In both surveys,100% surveyed nurses could correctly choose one solvent at least,1.96% and 3.70%nurses could correctly choose 2 solvents;correct answering rates of intravenous administration time were 94.12% and 96.30%,re-spectively;correct answering rates of stable duration after preparation were both lower than 9%;correct answering rates of adverse reaction of this drug were 3.92% and 1.23%,respectively;correct answering rates of interaction of this drug were 1.96% and 6.17%,respectively;correct answering rates of stable formulation of this drug were 17.65%and 22.22%,respectively;the propor-tion of nurses observing ADRs were 25.49% and 13.58%,respectively;the proportion of nurses finding inappropriate compatibility were 15.69% and 22.22%,respectively,Ornidazole and sodium chloride injection was the most used incompatible drug;45% or more nurses hoping to strengthen the continuing education of nursing personnel. CONCLUSIONS:Nurses in this third-grade class-A hospital lack certain knowledge on the medication risk of Omeprazole sodium for injection,the drug risk management is not sufficient,and awareness prevention of drug risk is relative weak. It is suggested that the hospital should strengthen drug risk management system,nurses should strengthen the learning about drug risk and play the role of clinical pharmacists in the drug risk management to reduce the related drug risk and incidence of adverse reactions.

Objective To observe the clinical efficacy of wrist-ankle acupuncture in treating pain due to laparoscopic cholecystectomy.Method Totally 150 patients who were going to receive laparoscopic cholecystectomy were randomized into group A, group B, and group C, 50 cases in each group. Group A was intervened by wrist-ankle acupuncture prior to anesthesia, with the needles retained for 12 h; group B was by subcutaneous needling at the area nearby the points prior to anesthesia, with the needles retained for 12 h; group C didn’t receive any intervention before anesthesia. For the three groups, general inhalational and intravenous anesthesia was adopted for surgery, and patient-controlled intravenous analgesia for post-operation analgesia. The incision pain and visceral pain in the three groups were recorded by using Visual Analogue Scale (VAS) respectively 1 h, 2 h, 4 h, 8 h, 12 h, 24 h, 36 h, and 48 h after the operation. The total effective rate, analgesics consumption after operation, and incidence rate of adverse reaction were compared.Result There were significant differences in comparing the VAS scores of incision pain and visceral pain between group A and group C 4 h, 8 h, 12 h, 24 h, and 36 h after the operation (P<0.01,P<0.05). Between group A and group B, there were significant differences in comparing the VAS score of incision pain 8 h, 12 h, 24 h, and 36 h after the operation and the VAS score of visceral pain 12 h, 24 h, and 36 h after the operation (P<0.05). The total effective rate was 96.0% in group A, which was significantly different from 84.0% in group B and 86.0% in group C (P<0.05). The consumption of Fentaneyl citrate injection was (52.4±10.8)μg in group A, which was significantly different from (92.2±11.0)μg in group B and (107.2±11.5)μg in group C (P<0.05,P<0.01). The incidence rate of adverse reactions was 12.0% in group A, which was significantly different from 58.0% in group B and 66.0% in group C (P<0.01).Conclusion Wrist-ankle acupuncture plus patient-controlled intravenous analgesia can mitigate pain after laparoscopic cholecystectomy, and thus it can be taken as one of the post-operational analgesic approaches.

Objective To investigate the effect of propofol on autophagy in SD rat heart during myocar-dial ischemia-reperfusion (I/R) injury. Methods Twenty-one male SD rats were randomly divided into three groups as follows (n = 7): the sham operation group, in which rats underwent sham operation without tightening of the coronary artery sutures; the myocardial ischemia-reperfusion group , in which rats were induced by occlud-ing the left anterior descending coronary artery for 30 min , followed by 120 min reperfusion and 0.9% NaCl in-fusion at 3 mL/(kg·h) at 10 min before occluding the left anterior descending coronary artery; the myocardial ischemia- reperfusion- propofol group, in which rats underwent I/R and propofol infusion at 6 mg/(kg·h) at 10 min before occluding the left anterior descending coronary artery. Before tightening of the coronary artery, at 30 min post-tightening of the coronary artery and at 120 min post-reperfusion, HR、 LVSP and ± dp/dtmax of rats were recordedin each group. Atter 120 min post-reperfusion, the serum concentrations of cTnT was measured. The in-jured cardiac tissue was collected to investigate the ultrastructure change under the TEM and to determine the levels of mTOR and p-mTOR. Results No signifcant differences in HR, LVSP and ± dp/dtmax before tighten-ing of the coronary artery. But, at 30 min post- tightening of the coronary artery, compared with groupⅠ, the HR, LVSP and ±dp/dtmax were significantly decresed in groupⅡ and Ⅲ(P < 0.05). Then, at 2 h post-reper-fusion, compared with groupⅠ, the HR, LVSP, ±dp/dtmax and the level of p-mTOR were significantly de-creased, but the serum concentration of cTnT was significantly increased in groupⅡ(P < 0.05); but, compared with groupⅡ, the HR, LVSP, ± dp/dtmax and the level of p-mTOR were significantly increased, the serum concentration of cTnT and the level of mTOR were significantly decreased in group Ⅲ(P < 0.05). Conclusions These data suggest that propofol could heighten the level of p-mTOR, and attenuate the expression of mTOR dur-ing the myocardial ischemia-reperfusion injury in SD rats.

OBJECTIVE To study the influence of focused ultrasound on the morphology of nasal mucosa in sheep. METHODS A model CZB ultrasound therapeutic system for rhinitis, developed and produced by Chongqing Haifu(HIFU)Technology Co.,Ltd.,Chongqing China,was used in this study. Linear scans were performed on bovine liver in vitro under different scan parameters, and the biologic focal field(BFF)was detected to evaluate if it met the requirements of designed. The nasal mucosa of inferior turbinate of sheep was exposed with the same scan parameters under the observation of nasal endoscope, and morphological changes of the nasal mucosa were observed by gross examination, light and electron microscopes. RESULTS This study revealed that the designed biological focal field in bovine liver in vitro could be obtained under the scan parameters mentioned above. Linear scan with the same condition,there was no obvious change in appearance and color of the treated nasal mucosa in the inferior turbinate of the sheep. However,3 days after treatment,there was an increased secretion in the nasal cavity,which recovered 7 days post-treatment. Light microscopic examination 3 days after exposure showed that the epithelia of the nasal mucosa was intact and there was diffused distribution of spot coagulated necroses in the subepithelia layer of treated nasal mucosa. Degeneration of vascular endothelial cells and thrombosis of blood vessels were found in the coagulated necrosis region. Besides,degeneration or necrosis of nerve cells was induced,and glandular cells werepartially or completely damaged. The structure of epithelial goblet cells and ciliated cells in the treated nasal mucosa appeared to be normal under the observation of electronic microscope. At the seventh day after treatment,signs of tissue regeneration such as hyperplasia of collagen fiber were found in the coagulated region,and the necrosis tissue began to dissolve and was absorbed at the 14th day post-treatment. CONCLUSION Under the above scan parameters,the energy of focused ultrasound could be deposited specifically at the subepithelia layer,and to ablate the targeted nasal mucous tissues which are rich in blood vessels,nerves and glands. There were no damage to the non-target area such as epithelial layer,which could maintain the normal structure and biological function of mucociliary of nasal mucosa.

Objective To study the compatibility of TCM prescriptions of TCM practitioners of all dynasties of Alzheimer disease (AD). Methods Amnesia, forgetting, dementia, and idiot were set as search words to retrieve relevant literature in Encyclopadia of Traditional Chinese Medicine. Prescription information was screened and standardized to build database. Frequency analysis and association rules were used to mine TCM prescriptions and compatibility rules. Results Totally 449 AD related prescriptions were selected, involving 682 Chinese medicinal herbs. The individual herb with the highest frequency was Ginseng Radix Rhizoma (192);the herbal pair with the highest frequency was Ginseng Radix Rhizoma-Polyhalae Radix (182);the herbal combination with 3 Chinese medicinal herbs with the highest frequency was Poria with Hostwood-Ginseng Radix Rhizoma-Polyhalae Radix (79);the herbal combination with 4 Chinese medicinal herbs with the highest frequency was Polyhalae Radix-Ginseng Radix Rhizoma-Poria with Hostwood-Glycyrrhizae Radix et Rhizoma (37). The results of association rules showed that Ginseng Radix Rhizoma-Polyhalae Radix, Ginseng Radix Rhizoma-Glycyrrhizae Radix et Rhizoma, and Ginseng Radix Rhizoma-Poria with Hostwood were commonly used compatibilities in AD related prescriptions. Conclusion Treatment of TCM practitioners in all dynasties for AD mainly chooses Chinese medicinal herbs with the efficacy of tonifying qi and soothing nerves. The compatibilities and combinations are reasonable and with certain representativeness.

Objective To investigate the long-term oncological outcomes of laparoscopic radical hysterectomy (LRH) plus lymph node dissection (LND) and abdominal radical hysterectomy (ARH) plus LND for patients with stage Ⅰ a2-Ⅱ a2 cervical cancer.Methods A retrospective review of stage Ⅰ a2-Ⅱ a2 cervical cancer patients who underwent LRH + LND (n=372) and ARH + LND (n=434) at the First Affiliated Hospital of Sun Yat-sen University from Jan.2005 to Aug.2013 was performed.Individual patient matching was performed by the risk factors for recurrence [tumor size,lymph vascular space invasion (LVSI),depth of cervical stromal invasion,lymph node metastasis,parametrialinvolvement,and resection margin involvement] between two groups.After matched,a total of 203 patient pairs (LRH-ARH) were enrolled.The survival data,surgery data,intraoperative and postoperative complications were compared between the two groups.To assess the prognosis factors,the univariate and multivariate Cox's proportional hazards modelanalysis were conducted.Stratified analysis was performed based on the independent prognosis factors to investigate the survival data between the two surgery groups.Results (1) Surgery data:The operating time [(239±44) vs (270±42) minutes],estimated blood loss [(210± 129) vs (428±320) ml],the duration of bowel motility return [(2.0±0.8) vs (3.0± 1.6) days] and hospital stay [(11 ±6) vs (13±6) days] in the LRH group were significantly shorter than those in ARH group (all P＜0.01).(2) Intraoperative and postoperative complications:The intraoperative complications rate was similar betweentwo groups [6.4％(13/203) vs 6.9％(14/203),P=1.000].The rate of postoperative complications (excluded bladder dysfunction) in the LRH group were significantly lower than those in the ARH group [9.4％ (19/203) vs 20.2％ (41/203),P=0.002].While there was no significant difference in the rates of bladder dysfunction between two groups [36.5％ (74/203) vs 37.4％ (76/203),P=0.910].(3) Recurrence and survival data:There was no significant difference in the recurrence rates between the LRH group and ARH groups [7.9％ (16/203) vs 9.4％ (19/203),P=0.850].There were similar 5-year recurrence-free survival (RFS;92.1％ vs 91.1％,P=0.790) and 5-year overall survival (OS;93.7％ vs 96.1％,P=0.900).(4) Prognosis factor:In univariate analysis,the results showed that tumor size,International Federation of Gynecology and Obstetrics (FIGO) stage,adjuvant therapy,LVSI,stromal invasion,parametrium invasion,pelvic lymph node metastasis,and para-aortic lymph node metastasis were significantly associated with poor prognosis (all P＜0.01).However,age,body mass index (BMI),surgery type,histological type,grade were not significantly associated with poor prognosis (all P＞0.05).The multivariate analysis results,showed that tumor size,pelvic lymph node metastasis,and para-aortic lymph node metastasis were significantly associated with poor prognosis (all P＜0.01).Stratified analysis showed that,even in patients with tumor size ＞4 cm,pelvic lymph node metastasis positive,and para-aortic lymph node metastasis positive in all subgroups,there were not significant difference for the estimated 5-year RFS and 5-year OS between LRH and ARH group (all P＞0.05).Conclusion For patients with stage Ⅰ a2-Ⅱ a2 cervical cancer,LRH plus lymph node dissection is an oncologically safe and surgical feasible alternative to ARH.

Objective To analyze the characteristics of opportunistic infection (OI) in patients with HIV/AIDS in Guangdong and the relationship between OI and the change in blood CD4+ T lymphocyte count (CD4+ ).Methods Seven hundred and sixty two patients with HIV/AIDS admitted were analyzed. Results Among all the 762 patients, 704 (92.39% ) had more than one kind of OI, with 1428 episodes totally.Etiologically, fungus infection (38.38% ) was most common, followed by bacteria (36.20% ), and virus (7.77% ) infection. Most OI occurred in the lungs (33.05% ), mouth (26.89% ), skin (10.29% ) and gastro-intestine (8.96% ).Septicemia and other systemic disseminated diseases accounted for 6.58% and 9.94% respectively.The incidence of OI in patients with CD4+= 200/μ1 (103/136, 75.74%) was significantly lower than that in patients with CD4+ <200/μ1 (601/626, 96.01%), P<0.01.All the AIDS defining OI were found in patients with CD4+ <200/μ1 Among them, 81.97% of patients with pneumonia carinii pneumonia (PCP), 71.43% of patients with cytomegalovirus retinitis and all the patients with cryptococcal meningitis, disseminated cryptococosis, disseminated histoplasmosis, mycobacterium avium intracellular complex (MAC), disseminated penicilliosis mameffei and toxoplasma cerebritis had the CD4+ less than 50/ μ1.Conclusions The most common OI in patients with AIDS in Guangdong area are fungi, bacterial and viral infections.Lung, mouth, skin, gastro-intestine and systemic disseminated infections are the most prevalent infections.As the CD4+ decreased, the incidence of OI especially AIDS defining OI increased. Dynamic detection of CD4+ will be of great help for the prediction, prevention, early diagnosis and treatment of OI in patients with AIDS.

OBJECTIVE To explore the effect of the measures of protection and control of nosocomial infection in the period of H1N1 Influenza prevalence.METHODS Established emergency plan and concrete working procedure,enhanced training.Strictly disinfection and isolation and personal protection,supervising and checking were carried out.RESULTS No nosocomial infection happened in our hospital in the diagnosis and treatment of H1N1 Influenza.CONCLUSIONS Carried out general measures of protection and management are the key to provent nosocomial infection.