Objective To investigate the value of differential diagnosis of the configuration of QRS complex in lead aVR in patients with inferior wall myocardial infarction. Methods The configuration of QRS in 52 patients with pathological Q-wave both in lead Ⅲ and aVF were analyzed and the result of selective coronary arteriography was compared. Results 13 patients with the configuration of QRS in lead aVR appeared rS ( s), while 10 patients appeared QS(qs) and 29 Q(q)r,correlated with 12,4 and 0 patients with coronary arteriography showed stenosis or occlusion lesion in fight coronary artery or left circumflex artery (χ2 = 35.56, P = 0.000). Conclusions The con-figuration of QRS in lead aVR is helpful to differential diagnosis of the patients with pathological Q-wave both in lead Ⅲ and aVF. Patients with the configuration of QRS in lead aVR appear rS(s) could be diagnosed as old myocardial infarction,but excluded from old myocardial infarction while appearing Q(q)r.

Benzene ; poisoning ; Chronic Disease ; Humans ; Occupational Diseases ; chemically induced ; Occupational Exposure ; adverse effects

The function of drugs is based on the interaction between drug molecules and their targets.Qualitative analysis and quantitative detection of drug-target interactions run through the whole process from drug discovery to clinical practice.After decades of development, the study methods on the interaction between drug molecules and target proteins have been transformed from traditional biochemical experiments to a diversity of efficient and accurate technology systems supported by advanced molecular biology and biophysics theory.In this review, representative methods and techniques were introduced from aspects of target discovery and validation, affinity determination, interaction sites and structural analysis, which might provide some references for drug discovery and mechanism exploration.

Objective:To explore the applicability of different exposure assessment methods in occupational health risk assessment of trichloroethylene (TCE) occupation posts in electroplating enterprise.Methods:In November 2018, the occupational health risk assessments are conducted in trichloroethylene (TCE) occupation posts of 6 metal plating enterprises in a street in Shenzhen by using the qualitative risk assessment, semi-quantitative risk assessment (including contact ratio method, contact index method and synthesis index method) and quantitative risk assessment method (including non-carcinogenic and carcinogenic risk assessment methods) , and the results of different methods are compared.Results:The results of qualitative assessment method are all level 4 (high risk) ; the results of contact ratio method show that the risk level is level 5 (very high risk) ; the results of contact index method and Synthesis index method show that the risk level is level 3 and level 4, 66.7% and 33.3% respectively; Non-carcinogenic risk assessment results show that TCE jobs are "unacceptable"; carcinogenic risk assessment results in carcinogenic inhalation excess risk of 50% each being "unacceptable" and "acceptable". The results of the six risk assessment methods showed that there were 3 "substantially consistent", 1 "partially consistent", and 2 "inconsistent" among the 6 companies.Conclusion:Synthesis index method and the carcinogenic risk assessment method are more suitable for occupational health risks of TCE occupation posts.

This article summarizes the understanding of Professor Zhu Ying,a guidance teacher for the inheritance of academic ex-perience of national senior traditional Chinese medicine experts,on the theoretical connotation of"earth being dredged by wood"in The Yellow Emperor's Inner Classic,and her experience in treating gastroesophageal reflux disease from the perspective of"earth being dredged by wood".It is believed that the pathogenesis of this disease is the imbalance of the spleen and stomach,failure of gallbladder qi to fall,rise of heart fire,and out-of-control kidney water;the treatment should be based on the principles and methods of soothing the liver and dispersing the gallbladder,coordinating the rise and fall of the spleen and stomach qi,stalling the heart fire and relieving depression,restraining and reducing the burning and dry stomach fire,supporting the spleen and aiding the kidney,and cultivating and nourishing the weak wood.The key is to restore the normal state of the growth and restraint of the wood and soil.

Objective:To explore the applicability of different exposure assessment methods in occupational health risk assessment of trichloroethylene (TCE) occupation posts in electroplating enterprise.Methods:In November 2018, the occupational health risk assessments are conducted in trichloroethylene (TCE) occupation posts of 6 metal plating enterprises in a street in Shenzhen by using the qualitative risk assessment, semi-quantitative risk assessment (including contact ratio method, contact index method and synthesis index method) and quantitative risk assessment method (including non-carcinogenic and carcinogenic risk assessment methods) , and the results of different methods are compared.Results:The results of qualitative assessment method are all level 4 (high risk) ; the results of contact ratio method show that the risk level is level 5 (very high risk) ; the results of contact index method and Synthesis index method show that the risk level is level 3 and level 4, 66.7% and 33.3% respectively; Non-carcinogenic risk assessment results show that TCE jobs are "unacceptable"; carcinogenic risk assessment results in carcinogenic inhalation excess risk of 50% each being "unacceptable" and "acceptable". The results of the six risk assessment methods showed that there were 3 "substantially consistent", 1 "partially consistent", and 2 "inconsistent" among the 6 companies.Conclusion:Synthesis index method and the carcinogenic risk assessment method are more suitable for occupational health risks of TCE occupation posts.

Objective To understand the status quo of self-concept clarity and professional life quality of male nurses, and to analyze the influence of self-concept clarity on professional life quality of male nurses. Methods In August 2017, a total of 251 male nurses from six Class Ⅲ hospitals in Zhejiang Province were selected by convenience sampling method. Self-Concept Clarity Scale and the Chinese version of Professional Quality of Life Scale Version 5 were applied in the investigation. A total of 251 questionnaires were distributed and 235 valid questionnaires were collected, with an effective recovery rate of 93.63％.Results The score of Self-Concept Clarity Scale and the Chinese version of Professional Quality of Life Scale Version 5 was (31.47±6.95) and (91.82±16.95) respectively in the 235 male nurses. There was a positive correlation between the two (r=0.324,P<0.05). Hierarchical regression analysis showed that working years, monthly income and self-concept clarity were the influencing factors of professional life quality of male nurses.Conclusions The level of self-concept clarity and professional quality of life among male nurses is at a moderate level. Self concept clarity is an important factor affecting the quality of professional life. It is necessary to strengthen the guidance of public opinion and increase the media publicity of male nurses so as to promote the acceptance and acceptance of male nurses and increase their job stability through social and family perspectives.

Objective To explore the effect of modified anal injection on preventing fecal incontinence caused by glycerol enema and reliving constipation in elderly orthopedic patients. Methods A total of 78 aged patients with constipation was selected and divided into experimental group (38 cases, modified anal injection enema method) and control group (40 cases, traditional enema anus method) according to the random numbertable method. And then, we compared the situation of fecal incontinence and relieving constipation. Results In the control group, there were 10 patients with fecal incontinence, while there was no case of fecal incontinence in the experimental group, it was statistically significant between them (P<0. 01). After using the enema, there were 14 ineffective cases in the control group and 5 ineffective cases in the experimental group, and the differences were statistically significant between the two groups (P <0. 05). The effect in the experimental group was better than that in the control group. Conclusions Modified anal injection enema can prevent fecal incontinence caused by enema and relieve constipation in elderly orthopedic patients.

Objective:To explore the prognostic value of survival after veno-arterial ECMO (SAVE) score combined with 24-h lactate on the machine in patients with extracorporeal cardiopulmonary resuscitation (ECPR).Methods:Totally 59 patients treated with ECPR in the Emergency Department of the First Affiliated Hospital of Nanjing Medical University from April 2017 to June 2021 were retrospectively analyzed. According to the 28-day prognosis, the patients were divided into the death group ( n=36) and the survival group ( n=23). The differences in baseline data were analyzed, and multivariate logistic regression was performed to identify the influencing factors of 28-day mortality in patients with ECPR. The receiver operating characteristic (ROC) curve was applied to evaluate the predictive value of SAVE score, 24-h lactate and their combined detection for predicting 28-day mortality risk in patients with ECPR. Results:The 28-day survival rate of patients with ECPR was 39% (23/59). SAVE score of the death group was significantly lower than that of the survival group (-11.67±4.60 vs. -2.43±4.77, P<0.001), and the 24-h lactate in the death group was significantly higher than that in the survival group [5.94 (3.37, 12.40) mmol/L vs. 1.65 (1.07, 3.15) mmol/L, P<0.001]. Multivariate logistic regression analysis showed that SAVE score ( OR=0.703, 95% CI: 0.566-0.873, P=0.001) and 24-h lactate ( OR=1.608, 95% CI: 1.025-2.523, P=0.039) were independent influencing factors of 28-day mortality in ECPR patients. ROC curve analysis showed that the best cut-off value of SAVE score was -6, the sensitivity was 78.30% and specificity was 91.70%. The best cutoff value of 24-h lactate was 4.7 mmol/L, the sensitivity was 63.90% and specificity was 100.00%. The sensitivity and specificity of the combined detection of SAVE score and 24-h lactate were 82.60% and 100.00%, respectively. The area under the curve (AUC) of SAVE score combined with 24-h lactate for predicting the 28-day mortality risk in patients with ECPR was larger than that of SAVE score and 24-h lactate alone (0.952 vs. 0.917; 0.952 vs. 0.847). Conclusions:Lower SAVE score and higher 24-h lactate are independently risk factors of 28-day mortality in patients with ECPR, and SAVE score combined with 24-h lactate on the machine has a good predictive value for the prognosis of patients with ECPR.

Objective:To study the application of blood products in patients with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and evaluate its effect on the prognosis.Methods:A total of 83 adult patients treated with VA-ECMO in the Emergency Department of the First Affiliated Hospital of Nanjing Medical University from January 2017 to January 2020 were grouped by survival to explore the risk factors of 28-day mortality using binary logistic regression, and the threshold was calculated by ROC curve.Results:Platelet transfusion ( OR=2.506, 95% CI: 1.142-5.499) and non-myocarditis disease ( OR=6.881, 95% CI: 1.615-29.316) were the risk factors of 28-day mortality in adult VA-ECMO patients. The threshold of platelet transfusion was 0.427 mL/(kg·d) (sensitivity 78.4%, specificity 69.6% , AUC 0.735). Conclusions:The increased platelet transfusion is related to the poor prognosis of adult patients with VA-ECMO. Refractory myocarditis patients are better treated with VA-ECMO.