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 .

This paper analyzed the problems existing with the usage of assistive ambulatory devices (AADs) among older adults in America and proposed solutions to improve these problems. The effects of AADs － walker, rollator, and cane － on gait and posture of older adults were assessed. Also, the relationships between AAD usage, fall occurrence, and why older adults continue to fall despite use of AADs were analyzed. It was suggested that in order to prevent from falls among older adults in the community routine assessment and training in correct AAD use should be performed.

Objective To survey the distribution of TCM constitution of Guangxi adults.Methods Identification questionnaire of constitution in TCM was performed to identify the TCM constitution types of 3000 adults who were taken medical examination in the first affiliation hospital to GuangXi TCM university Health Administration Center or of permanent residence in Nanning,Wuming,Qinzhou,Hezhou.Results 612 cases (20.4％) had constitution of phlegm-dampness in 504 cases (16.8％) had constitution of phlegm-dampness,431 cases (14.3％) had constitution of yang asthenia,422 cases (14.1％) had constitution of qi asthenia,353 cases (11.8％) had constitution of damp-heat,348 cases (11.6％) had constitution of yin asthenia,159 cases (5.3％) had constitution of qi stagnation,100 cases (3.3％) had constitution of blood stasis,and 71 cases (2.4％) had allergic constitution.Conclusion There were 9 kinds constitutions in the adults of GuangXi province.The constitution of yin-yang harmony was the most among all.Most male had phlegm-dampness or damp-heat constitution.Most female had yang asthenia,qi asthenia,qi stagnation or yin asthenia constitution.

Objective To determine the relationship between the viral load of cerebrospinal fluid (CSF) and sensorineural hearing loss (SNHL) in newborns with symptomatic congenital cytomegalovirus (CMV) infection.Methods The study cohort comprised 36 newborns with symptomatic congenital CMV infection.CSF from all of the patients were analyzed for the presence of CMV DNA by PCR.Audiological function were performed on them by brain stem auditory evoked potential at birth,at 6 and 12 months of age.Results (1)Of the 36 newborns,15 cases (41.7％) had positive CSF PCR result,17 cases (47.2％) had SNHL.(2) The prevalence of SNHL in the group of newborns with positive CSF PCR result was 60.0％ (9/15),and it was 38.1％ (8/21) in the group of newborns with negative CSF PCR result,there was no significant difference of the prevalence of SNHL between the two groups (P =0.194).(3) In newborns with positive CSF PCR result,the amounts of CSF CMV DNA was not different between the newborns with SNHL and normal hearing (3.35 ± 0.68 vs.3.17 ± 0.56,P =0.36).Conclusion A positive CSF PCR result and the CMV viral load of CSF did not correlate with SNHL.

Objective To investigate the accumulation and maturation status of pulmonary conventional dendritic cells (cDCs) in the early phase of acute lung injury (ALI),and to explore the way of the inflammatory responses and lung injury modulated by cDCs in vivo.MethodsMale C57BL/6 mice were randomly ( random number) divided into the normal control group,6 h-ALI group and 24 h-ALI group.Murine model of ALI was made by intra-tracheal administration of lipopolysaccharide (LPS) and lung specimens were taken 6 h or 24 h later.The accumulation and maturation status of pulmonary cDCs were assessed by flow cytometry.IL-6 and TNF-α were quantified to evaluate the lung inflammation.Transcription factors T-bet/GATA-3 mRNA ratio was determined to estimate the balance between Th1/Th2 responses.IFN-γand IL-4 were quantified to evaluate Thl-specific and Th2-specific cytokine production respectively.Lung injury was estimated by lung wet weight/body weight ratio (LWW/BW) and histopathological assessment.Comparison between groups was performed using one -way ANOVA.ResultsCompared with normal control group,LPS challenge resulted in higher level of IL-6 and TNF-α,increased LWW/BW ratio and significant histopathological changes (P ＜0.01 ).The accumulation and maturation of pulmonary cDCs in 6 h-ALI group were significantly increased after LPS challenge (P ＜0.01 ),while the accumulation and maturation of pulmonary cDCs in 24 h-ALI group were significantly lower than that in 6 h-ALI group ( P ＜0.01 ).Compared with normal control group,the expression of T-bet mRNA in 24 h-ALI group was markedly enhanced ( P ＜ 0.01 ) and the production of IFN-γ was increased as well ( P ＜ 0.01 ).ConclusionsThe accumulation and maturation of pulmonary cDCs peaked within 24 h after LPS challenge,pulmonary cDCs may initiate and amplify acute lung inflammation of ALI by enhancing the Th1 immune response and ensuing cytokine production.

BACKGROUND:Donor selection for high-risk acute leukemia is still controversial.OBJECTIVE:To compare the therapeutic efficacy of the unrelated donor peripheral blood and matched sibling allogeneic hematopoietic stem cell transplantation for high-risk acute leukemia.METHODS:Total 65 patients with high-risk acute leukemia treated during January 2008 to January 2016 were included,in which 30 patients chose the unrelated donor peripheral blood stem cell transplantation (UD), and other 35 chose the matched sibling allogeneic hematopoietic stem cell transplantation (MS) according to the wishes of patients and their own situation. After treatment, the chi-square test, Kaplan-Meier survival analysis method, and other methods were used to compare the implanted and hematopoietic reconstitution, the occurrence of graft-versus-host disease, relapse mortality and long-term survival between the two groups.RESULTS AND CONCLUSION:The implantation rate, platelet hematopoietic reconstitution time, the incidence of acute and chronic graft-versus-host disease, and its type exhibited no significant differences between the two groups (P > 0.05).The relapse rate, total death rate, and transplant-related mortality rates were 10.0%, 50.0%, and 40.0% in the UD group and 20.0%, 48.6%, and 25.7% in the MS groups, respectively, and the intergroup difference was insignificant (P > 0.05).The expected 2-year cumulative disease-free free survival and overall survival rates were (49.4±9.2)% and (52.6±9.2)% in the UD group and (53.9±8.5)% and (53.9±8.5)% in the MS group, respectively, and the intergroup difference was also insignificant (P > 0.05). Our experimental findings show that unrelated donor peripheral blood stem cell transplantation can be used as an effective alternative in the absence of sibling donors.

AIM: To test and verify the effect of Shexiang Baoxin Pills(SXBXW) on treating acute vertigo. METHODS: Sixty patients with acute vertigo were randomly assigned to the treatment group(40 cases) and the control group(20 cases).The treatment group was given four pills of SXBXW by sublingually. The control group was drip-fed Betahistine Hydrochloride and Sodium Injection 250 mL. Both groups were drip-fed normal saline injection 250 mL plus Vitamine B_6 0.2g at the same time. RESULTS: After three hours of observation, both the drugs could significantly reduce the sympton of acute vertigo, and its therapeutic efficacies were similar. CONCLUSION: SXBXW has obvious therapeutic efficacy and less side effect.

BACKGROUND: Hemorrhagic cystitis remains a common complication of hematopoietlc stem cell transplantation.Granulocyte-macrophage colony stimulating factor (GM-CSF) affects proliferation and differentiation of hematopoietic stem/progenitor cells, adjusts functions of monocytes, granulocytes, lymphocytes and endothelial cells.OBJECTIVE: To investigate the protective effects of GM-CSF bladder irrigation in hemorrhagic cystitis after allogeneic hematopoietic stem call transplantation.DESIGN: Case analysis.PARTICIPANTS: A total of 15 hematopathy patients undergoing allogenic hematopoietic stem cell transplantation at the Zhongshan Hospital of Sun Yat-sen University from January 2004 to August 2006 (routine treatment group). A total of 16 hematopathy patients undergoing allogenic hematopoietic stem cell transplantation from September 2006 to December 2008 (GM-CSF group).METHODS: In the routine treatment group, patients received mesna, hydration, alkalization and forced diuresis in the prevention of hemorrhagic cystitis. In the GM-CSF group, GM-CSF was infused into the bladder in addition to mesna,hydration, alkalization and forced diuresis in the prevention of hemorrhagic cystitis 24 hours before cyclophosphamide treatment. Catheter was extracted 3 days following cyclophosphamide withdraw. Following washing with saline, the bladder was emptied. 10 mL of saline and 5 mL of lidocaine were added into 300 μg of GM-CSF. The mixture was infused into the bladder for 60-120 minutes.MAIN OUTCOME MEASURES: The following parameters were measured: occurrence of hemorrhagic cystitis and its correlation to graft versus host disease, as well as the occurrence of cytomegalovirus infection and urinary system infection.RESULTS: Compared with routine treatment group, the occurrence rate of hemorrhagic cystitis was significantly decreased in the GM-CSF group (x2=4.39, P < 0.05), mean duration of hemorrhagic cystitis and duration of hospitalization were significantly shortened (t=3.97, P < 0.05; t=3.13, P < 0.05), and the occurrence rate of over grade HI hemorrhagic cystitis was significantly reduced (x2=5.04, P < 0.05). Cystitis degree was associated with degree and duration of graft-versus-host disease (r = 0.76).Compared with the routine treatment group, cytomegalovirus infection rate was slightly decreased in the GM-CSF group (x2=0.28, P> 0.05), and occurrence rate of over grade Ⅲ hemorrhagic cystitis was higher in patients with cytomegalovirus infection.Compared with the routine treatment group, the occurrence rate of urinary system infection was slightly reduced in the GM-CSF group (x2=0.28, P > 0.05).CONCLUSION: GM-CSF bladder irrigation is well tolerated and often effective, and should be considered as a preparative regimen of hemorrhagic cystitis after allogeneic hematopoietic stem call transplantation.

Objective? To establish a digital protection system for incontinence-associated dermatitis based on earlier prevention to reduce the incidence of incontinence-associated dermatitis. Methods? Based on the informationization of nursing platform, we run the digital protection system module of incontinence-related dermatitis based on the forward moving of the prevention gateway in Zhejiang Provincial People＇s Hospital. Through comparative study, 108 patients with incontinence and incontinence-related dermatitis from January to March 2018 were randomly selected as the pre-operation data, and 108 patients with incontinence and incontinence-related dermatitis from January to March 2019 as the post-operation data. The nurses of the two groups were observed and compared in terms of their assessment accuracy in patients＇ incontinence risk, position and Incontinence Associated Dermatitis Severity(IADS), clinical staging, and implementation of prevention strategies. Meanwhile, the incidence of incontinence-related dermatitis among all inpatients in the hospital from January to March in 2018 was compared with the same period of 2019. Results? After the operation of the digital protection system for incontinence-related dermatitis based on earlier prevention, the nursing staff's accuracy rate in the risk assessment of incontinence (χ2=38.095,P＜0.01), IADS (χ2=64.901,P＜0.01), clinical staging accuracy (χ2=42.424,P＜0.01) and the implementation of protective measures (χ2=50.000, P＜0.01) had significant statistical differences. The incidence of incontinence-related dermatitis in hospitalized patients decreased from 0.35% before operation to 0.06% after operation with statistical significance(χ2=41.031, P＜0.01). Conclusions? The operation of the digital protection system for incontinence-associated dermatitis based on earlier prevention can reduce the incidence of incontinence-associated dermatitis and improve the prevention and management competence of nursing staff.

Objective:To build a medical service experience system based on role play of hospital staff, and explore its contribution to upgrading medical service, elevating medical service quality, and improving patients′ satisfaction.Methods:An indicator system for medical service experience was developed via literature review. 20 newly recruited hospital employees in 2019 were sampled randomly to form a service experience team, who were arranged to experience the full medical service process of outpatients and inpatients based on role play. The questionnaire for service quality based on patient perception and expectation was used to survey the expectation and perception values of those role players on their medical service experiences, and summarize the defects found on such six dimensions as hospital reliability, responsiveness, tangibility, assurance, empathy and cost-effectiveness. After due corrections of these defects, further experiences and patient satisfaction survey were made to assess the effects of such actions taken. Paired t test was used respectively in statistical analysis of service experience value and actual perception value, as well as the perception values before and after the actions taken, and χ2 test was used for a statistical analysis of patient satisfaction. Results:Role players experienced respectively at the emergency, outpatient and inpatient departments of the hospital for a week in August 2019. Statistics of their experiences indicated≥0.50 points difference between the mean expectation and perception values on doctor-patient communication, patient help responsiveness, outpatient process, examination report delivery duration, service attitude, patient trust on medical workers, medical environment and patient privacy protection.Following a 3-month reform, role players found improvements in such aspects as hospital reliability, responsiveness, tangibility, assurance, empathy and cost-effectiveness; patient satisfaction improved sizably in December 2019 over January of the same year( P<0.05). Conclusions:The construction and application of the medical service experience system based on role play of hospital staff prove highly useful in upgrading medical service actions, improving medical service quality, and improving patient satisfaction.