Clinical data of 151 patients with acute occlusion of right coronary artery were retrospectively analyzed.Coronary angiography and electrocardiography (EEG) were performed in all 151 patients,angiography showed proximal-middle segment occlusion in 114 cases and distant segment occlusion in 37 cases.The correlation of ECG findings with coronary artery occlusion sites was analyzed.Results showed that EEG findings related to proximal-middle segment occlusion were:ST segment elevation in lead V4R ≥0.05 mV,Ⅲ degree atrioventricular block,ST segment depression in lead Ⅰ ＞0.1 mV,ST segment depression in lead AVL≥0.2 mV,ST segment elevation in lead l ≥0.25 mV,the total ST depression in lead V2,V3 and V4 ≥0.4 mV,the total ST depression in lead Ⅰ and aVL ≥0.25 mV;among which ST depression of Lead Ⅰ ＞0.1 mV,ST elevation of Lead V4R ≥0.05 mV and Ⅲ degree atrioventricular block were used to predict occlusion of proximal-middle segment of right coronary artery with 100％ specificity.ECG findings related to distal segment occlusion were:ST depression in lead Ⅰ ≤ 0.1 mV,ST segment depression in lead AVL ＜0.2 mV,ST elevation in lead Ⅲ ≤0.25 mV,the total ST depression in lead V2,V3 and V4 ＜ 0.4 mV,ST segment were not depression in lead V1-V5,the total ST depression in lead Ⅰ and aVL ＜ 0.25 mV.Based on a 4-step flow method,ECG might be adopted to identify the acute occlusion sites in proximal-middle segment and distal segment of right coronary.

Objective To Study the method for determination of aluminium in water by spectrophotometry of Be ryllon Ⅲ. Methods Be ryllon Ⅲ reacts on aluminium in oppropriate temperature and acidity in water and produces a red complex compound?The red complex compound can be determined by spectrophotometry. Results The optimum reaction temperature was 85 ℃, the optimum reaction time was 5 min, pH of buffer was 6.1, Beer's law was obeyed in the concentration range of 0-0.02 mg/L for aluminium, rates of recovery were 80.0%-96.0% and RSD was 0.70%. Conclusion This method is accurate, simple, sensitive and repeatable.

Objective To introduce three-dimensional management mode to manage the devices in the operating room so as to reduce the risks.Methods A three-dimensional quality control group was established to strengthen the devices management.From three dimensions of thinking,communication and action some measures were proposed including training for standardized operation and incident treatment,improving guidance,sticking warning signs,advocating active report of adverse events,preventive maintenance and etc.Efficacy inspection and continuous improvement were carried out.Results The examination scores,inspection results and active reports of adverse events were significantly different before and after the introduction of three-dimensional management mode.Conclusion Three-dimensional management mode,in which the three dimensions connect to and cycle through each other,makes nursing staffs progressively develop the habit of safe operation in an environment of safety culture.Three-dimensional management mode is a scientific and applicable management method to reduce risks in using the devices in the operating room.

Objective:To investivate the relationship of serum estradiol and oxidative stress with microcirculation resistance in women with syndrome X.Methods:A total of 120 patients with syndrome X who were hospitalized in the Department of Cardiology in Guangzhou First People's Hospital from January 2015 to January 2019 were enrolled. All patients underwent coronary angiography and pressure wire examination and were divided into two groups according to the index of microcirculation resistance (IMR). Forty healthy people in the medical examination center were used as controls in the same period. The level of serum estradiol, interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α), superoxide dismutase (SOD) were measured among three groups.Results:The rate of diabetes mellitus in high IMR group was higher than that in control group and low IMR group ( P<0.05). There was no significant difference between low IMR group and control group ( P>0.05). The levels of serum estradiol and SOD were significantly lower in high IMR group than those in low IMR group and control group. The levels of IL-1 and TNF-α were significantly higher in high IMR group than those in low IMR group and control group ( P<0.05). These indexes have the same relationship between low-IMR group and control group ( P<0.05). The level of serum estradiol was negatively correlated with the levels of IL-1 and TNF-α in high and low IMR groups and positively correlated with the level of SOD in these groups. Multivariate logistic regression analysis showed that diabetes, low serum estradiol level, low SOD level, high IL-1 level, high TNF-α level were the independent risk factors for microcirculation resistance in women with syndrome X ( P<0.05). Conclusions:The decreased serum estradiol is an important factor for coronary microcirculation disorders in women with syndrome X. The decrease of serum estradiol level leads to the loss of the corresponding antagonistic effect in oxidative stress state, which may be one of the important mechanisms of the formation and progress of coronary microcirculation disorder.

Objective To investigate the effects and the mechanism of tirofiban administration in myocardial ischemical reperfusion injury(MIRI) in patients with acute myocardial infarction(AMI) undergoing primary percutaneous coronary intervention(PCI). Method The study included 158 STEMI Patients who accepted primary PCI therapy and were randomly (random number) divided into two groups: tirofiban administration group and control group. Incidence of MIRI during PCI, Correct TIMI frame count(CTFC), ST segment resolution(STR), peak value and peak time of MB isoenzyme of creatine kinase( CK-MB), and incidence of major adverse cardiac events (MACE) during 30 days postoperation in both groups were measured. Results Tirofiban administration group was superior to control group in terms of incidence of MIRI, CTFC, STR, peak value and peak time of CK-MB, and incidence of MACE during 30 days postoperation (P < 0.05). Multiple factor logistic regression analysis indicated that intravenous tirofiban administration before primary PCI was the independently protective factor for MIRI. Conclusions Intravenous tirofiban administration in patients with STEMI before primary PCI can significantly decrease the incidence of MIRI,reduce myocardial damage and improve the prognosis.

Objective To investigate the effect of stress-induced hyperglycemia (SHG) on myocardial perfusion and clinical prognosis in elderly patients with acute myocardial infarction (AMI) who underwent primary percutaneous coronary intervention (PCI).Methods 348 elderly patients with first-time occurrence of acute ST-elevation myocardial infarction (STEMI) who underwent primary PCI within 12 hours from June 2008 to June 2010 were enrolled and followed up.All patients were divided into three groups according to serum glucose (SG) on admission:normal group (SG＜ 7.0 mmol/L,n=112);SG elevation group (7.0 mmol/L≤SG≤11.1 mmol/L,n=128) and (steady high blood glucose) SHG group (SG＞11.1 mmol/L,n=108).Myocardial perfusion indexes,including ST segment resolution (STR),TIMI myocardial perfusion grade (TMPG),peak value of creatine kinase CK-MB,left ventricular ejection (LVEF),and major adverse cardiac events (MACE) of patients in three groups,were measured and compared after emergency PCI.Results The blood glucose levels were increased,ST-elevation 2 h after PCI were well declined,the percentages of patients with TMPG 2-3 were decreased and peak values of CK-MB were increased in the three groups (all P＜0.01).After 12 months of follow-up,Kaplan-Meier survival analysis showed that patients of three groups had significantly different cumulative non-events survival rates [89.3％ (100/112) vs.85.9％ (110/128),76.3％ (83/108),P＜0.05].Multivariate Cox regression analysis showed that steady high blood glucose were the independent predictor for the occurrence of MACE in patients undergoing PCI after adjusting for age and gender,and the risk of MACE was increased by 5.811 folds in SHG group as compared with normal group (P＜0.01).Conclusions Stress induced hyperglycemia in elderly patients with STEMI can decrease myocardial perfusion level after primary PCI,which will lead to high incidence of MACE.

Objective To explore the clinical effect of the radial artery perforator flap on repairing soft tissue defect after palm postoperative scar contracture. Methods Eighteen patients with palm scar contracture were selected. The palm soft tissue defect was repaired by radial artery perforator flap after the operation of scar removal and soft tissue release. The areas of soft tissue ranged from 5 cm × 3 cm to 8 cm × 5 cm. The area of donor flap exceeds 20%of the wounds area, and wounds were repaired by free skin grafting. Six months after operation, the hand function was compared with that before operation. Results All the patients were followed up for 6-15 months (mean 10.8 months), all flaps survived with good shape, and flap donor site wounds were healed by skin grafting. The patients were evaluated 6 months after operation according to the Chinese Medical Hand Surgery Society of upper part of functional assessment criteria: excellent in 11 cases, good in 5 cases and general in 2 cases, but preoperative functional evaluation was excellent 0 case, good in 3 cases, general in 7 cases and poor in 8 cases. Compared with that before operation, the postoperative function was significantly improved. Conclusions It is a commendable approach of repairing soft tissue defect after postoperative palm scar contracture by radial artery perforator flap, because it can provide reliable blood supply, and significantly improve hand function with exactly clinical effect.

Objective:To determine initial concentrations of ozonated water under different temperatures,attenuation rules ofozonated water under the room temperature (25 ℃),and to inspect the effects ofozonated water under different concentrations on common microorganisms.Methods:The online test method and the plate cultivation method were employed to check the concentrations and killing rates on common microorganisms of ozonated water produced by HZ-2601 B Ozone Water Generating Instrument.Results:The initial concentrations of ozonated water at 20,25,30,35,and 40 ℃ were 4.38,4.26,3.12,2.76,and 1.31 mg/L,respectively.The ozonated water was rapidly attenuated at first 10 min.The concentration ofozonated water still remained at 1.06 mg/L and 0.37 mg/L at 25 and 30 ℃ after 30 min.The average killing rates for Pseudornonas aeruginosa,Escherichia coli,Staphylococcus aureus,methicillin-resistant Staphylococcus aureus,and Candida albicans in 1.0 mg/L ozonated water for 1 min were 99％,100％,100％,100％,and 100％,respectively.The average killing rates of Escherichia coli,Staphylococcus aureus,methicillin-resistant Staphylococcus aureus,Pseudomonas aeruginosa,and Candida albicans in 0.3 mg/L ozonated water for 1 min were 100％,100％,100％,95％,and 92％,respectively.Conclusion:The initial concentrations of ozonated water produced by HZ-2601 B Ozone Water Generating Instrument decrease with the increase of temperature.Ozonated water under 20-30 ℃ has good sterilization effect on common microorganisms.

Objective:To observe the clinical efficacy and safety of topical ozone therapy for patients with herpes zoster by reflectance confocal microscopy (RCM).Methods:A total of 60 patients with herpes zoster were divided into a control group and an ozone treatment group (n=30).In the control group,patients took oral valacyclovir tablets or granules (0.3 g per day,three times a day) and they were subjected to local weak laser irradiation treatment plustopical 2％ mupirocin ointment twice a day.In the ozone group,the treatment is same as the control group except mupirocin ointment was replaced with topical ozone treatment (hydrotherapy every day plus ozonated oil twice a day).The clinical symptoms,discoid cell and adverse reactions were observed and taken records at day 0,3,7 and 14.Statistical analysis was performed to compare the clinical efficacy between the 2 groups.Results:On the seventh day of treatment,the discoid cells of the ozone group disappeared,and the difference between the control group and the ozone group was statistically significant (P＜0.05).The difference of decreased percentage of pain scores at each time point between the 2 groups was statistically significant (P＜0.05).The clinical efficacy was 100％ in the ozone group and 86.7％ in the control group,with significant difference between the 2 groups (P＜0.05).Conclusion:Topical ozone therapy in patients with herpes zoster is helpful in relieving pain,shortening the course as well as improving the clinical efficacy without obvious adverse reactions.It is worth to be popularized.

Objective:To verify the effect of ozone on Staphylococcus aureus (S.aureus) colonization in patients with atopic dermatitis (AD) and its correlation with the patient's status.Methods:A total of 12 patients with moderate or severe AD,aged from 6 to 65 years,were recruited from outpatient of the Third Xiangya Hospital.The treatment sides were showered with ozonated water and smeared with ozonated oil for 7 days (twice a day),while the control sides were washed with warm running water and smeared with base oil.At different time points,the severity scoring ofatopic dermatitis (SCORAD) scores,sleep and pruritus scores were assessed and compared between the two sides.Meanwhile,plate cultivation was used to quantitatively detect the changes ofS.aureus colonization in skin lesions.Results:After 7 days treatment,erythema and pimples were decreased in the treatment sides.The clear skin texture,smooth skin,improved skin lesions were also observed by dermoscopic examination.The results of reflectance confocal microscopy (RCM) demonstrated that the parakeratosis was improved,the structures were clearer,and the inflammatory cells infiltration was reduced after ozone treatment for 7 days.After ozone treatment for 3 and 7 days,the S.aureus colonization in the treatment sides decreased by (75.55±21.81)％ and (97.24±2.64)％ respectively.Compared to that of control sides,the percentage of S.aureus colony after ozone treatment for 7 days decreased significantly (P＜0.01).After ozone treatment for 7 days,the SCORAD scores,sleep and pruritus scores were significantly decreased (all P＜0.01).There was a linear correlation between the decreasing percentage of S.aureus colony and the declining percentage of SCORAD scores in AD patients.Conclusion:Topical ozone therapy can effectively reduce S.aureus colony in skin lesions and alleviate the severity of AD patients with moderate to severe degree.