OBJECTIVE:To observe clinical efficacy of recurrent oral ulceration with combination of Zhibai dihuang pills and Compound danshen tablets. METHODS:110 patients with recurrent oral ulceration were selected and divided into control group and tri-al group with 55 cases in each group. Control group individually received vitamin C 0.2 g/time+vitamin B2 10 mg/time+levamisole 45 mg/time,three times a day,Cetylpyridinium chloride collutory,15 ml/time,for 1 min,3 times a day. Trial group received Zhibai di-huang pills orally,8 pills/time,Compound danshen tablets,3 tablets/time,3 times a day. A treatment course lasted for 10 days. Both groups received 2 courses of treatment. Therapeutic efficacy,VAS and relapse were observed and compared between 2 groups. RE-SULTS:The cure rate(80.00%)and total effective rate(94.55%)of trial group were higher than those of control group(47.27%, 74.55%),with statistical significance(P<0.05). The VAS score of trial group were significantly lower than that of control group after 3 and 7 days of treatment,with statistical significance(P<0.05). After 2,6,10 and 12 months of treatment,the recurrence rates of tri-al group were 0,7.27%,9.09% and 16.36%,which were all significantly lower than those of control group(18.18%,34.55%, 47.27%,56.36%),with statistical significance(P<0.05). CONCLUSIONS:Combination of Zhibai dihuang pills and Compound danshen tablets has definite effect on recurrent oral ulcer,showing high cure rate and not easily recur.

OBJECTIVE:To observe analgesic effect and safety of Shixin buccal tablets on pericoronitis of wisdom tooth. METHODS:120 patients with pericoronitis of wisdom tooth were randomly divided into control group and observation group with 60 cases in each group. Control group received periodontal pocket irrigation combined with metronidazole;observation group was additionally given Shixin buccal tablets on the basis of control group,1 tablet/time,4 times/d. Clinical efficacy,medication compli-ance,pain score and ADR were compared between 2 groups. RESULTS:The effective rate of observation group(95.00%)was sig-nificantly higher than that of control group(73.33%),with statistical significance(P<0.05);there was no statistical significance in medication compliance between 2 groups (P>0.05);the pain score of observation group was significantly lower than that of control group,with statistically significant difference(P<0.05). No serious ADR was found in 2 groups. CONCLUSIONS:Shixin buccal tablets significantly alleviate the pain caused by pericoronitis of wisdom tooth.

Objective To study the nursing of bedsore prevention in patients with unstable pelvic fracture. Methods Bedsore forewarning risk assessment went on in 39 patients with unstable pelvic fracture by Braden scoring method. Results No bedsore was observed in these 39 patients with unstable pelvic fracture.The nursing result turned out to be satisfactory. Conclusions The incidence rate of bed-sore can be degraded in patients with unstable pelvic fracture by forewarning risk assessment with Braden scoring method and early nursing intervention.

Objective To study influence of nursing intervention on pain and satisfaction degree of pa-tients after lower limb fracture. Methods 200 patients of lower limb fracture were divided into the experi-mental group and the control group randomly with IOO patients in each group. Routine nursing was given to the contrtol group and special nursing intervention besides routine nursing to the experimental group. Pain and sat-isfaction degree was compared between the two groups and the results underwent χ2 test. Results The pain degree in the experimental group was much less than that of the control group, the satisfaction degree of the ex-perimental group was much higher than that of the control group. Conclusions Nursing intervention can re-liege pain degree of patients with lower limb fracture,make them go through postoperation pain stage and in-crease satisfaction degree with nursing.

Objective To evaluate interventional therapy for acute massive and submassive pulmonary embolism.Methods From June 2011 to June 2014.53 patients were enrolled and divided into group massive pulmonary embolism (MPE,n =16) and group submassive pulmonary embolism (SPE,n =37),both receiving catheter thrombectomy + contact thrombolysis within 12 hours after diagnosis.Preand post-interventional measures were assessed,including mean pulmonary arterial pressure (MPAP),cardiac biomarkers,tricuspid regurgitation,right ventricular (RV) dilatation,and massive hemorrhage within 72 hours.Patients were followed up for 6 months for the occurrence of chronic thromboembolic pulmonary hypertension.Results In all 53 patients were successfully completed catheter thrombectomy +contact thrombolysis,the mean pulmonary artery pressure in group MPE decreased from (47 ± 6)mmHg to (34 ± 4) mmHg (P ＜ 0.05),and in group SPE decreased from (44.2 ± 1.5) mmHg to (31.4 ± 6.2) mmHg (P ＜ 0.05).The ventriculus dexter disfunction was alleviated in 78.4％ patient after therapy.Overall 1.9％ patients suffered from massive hemorrhage,(0) in group MPE,and (2.7％)in group SPE.The incidence of chronic thromboembolic pulmonary hypertension during 6 moths follow up was 0.Conclusion Early interventional therapy for massive and submassive pulmonary embolism decreased pulmonary artery pressure,relieved right ventricular dysfunction,reduced bleeding complications and the incidence of chronic thromboembolic pulmonary hypertension.

Objective:To explore the effect of hydrogen sulfide (H 2S) on modulating the subunit Kir6.2 of adenosine triphosphate sensitive potassium channels via the cyclic guanosine monophosphate-dependent protein kinase (cGMP/PKG) signaling pathway in epileptic rat models. Methods:Sixty adult male SD rats were randomly divided into the following six groups (10 rats in each group) by random number table method: control, epileptic, H 2S donor, H 2S donor+epileptic, KT5823 (one inhibitor of the cyclic guanosine monophosphate-dependent protein kinase)+H 2S donor+epileptic, and glibenclamide (one inhibitor of the adenosine triphosphate sensitive potassium channels)+H 2S donor+epileptic groups. Except the control group, SD rats were intraperitoneally injected with plentylenetetrazole to make the kindling models and their behaviours were recorded including the latency period, the grade, and the duration of the first epileptic seizure according to the Racine′s standard. The waveforms of electroencephalogram (EEG) in hippocampus were also recorded during the seizure. The mRNA and protein levels of PKG and Kir6.2 in hippocampus were evaluated by Western blotting and quantitative real-time polymerase chain reaction, and the hippocampal concentrations of cGMP and phosphorylation of cyclic guanosine monophosphate-dependent protein kinase (p-PKG) were detected by enzyme linked immunosorbent assay. Results:Rats in the epileptic group showed Ⅳ-Ⅴ grade of epileptic seizure [4.500 (4.000, 4.875)], short latency period [(10.37±8.21) min] but long duration [(69.50±24.37) s] of seizure. Compared to the epileptic group, rats in the H 2S donor group showed Ⅱ-Ⅲ grade of epileptic seizure ( P=0.004), significantly longer latency period ( P<0.001), and shorter duration of seizure ( P<0.001). Compared to the H 2S donor+epileptic group, rats in the KT5823+H 2S donor+epileptic group showed Ⅲ-Ⅳ grade of epileptic seizures, significantly shorter latency period ( P<0.001), and longer duration of seizure ( P<0.001). The results of EEG showed that the wave patterns in the epileptic group were spike or sharp waves and the amplitudes were largest [(190.570±23.590) μV]. Compared with the epileptic group, amplitudes were reduced ( P<0.001) in the H 2S donor+epileptic group. PKG mRNA and PKG protein were expressed differently among all groups (PKG mRNA: n=5, H=26.714, P<0.001; PKG protein: n=5, F=30.597, P<0.001). Compared with the control group, the expression of both PKG mRNA and PKG protein was decreased (PKG mRNA: 1.000±0.001 vs 0.782±0.064, P=0.023; PKG protein: 0.550±0.037 vs 0.145±0.020, P=0.042) in the epileptic group. Besides, Kir6.2 mRNA and Kir6.2 protein were expressed differently among all groups (Kir6.2 mRNA: n=5, H=27.761, P<0.001; Kir6.2 protein: n=5, F=60.659, P<0.001). Compared with the control group, the expression of both Kir6.2 mRNA and Kir6.2 protein was decreased (Kir6.2 mRNA: 1.000±0.001 vs 0.897±0.033, P=0.004; Kir6.2 protein: 0.384±0.035 vs 0.215±0.016, P=0.024) in the epileptic group. And the concentrations of cGMP and p-PKG were decreased (cGMP: P<0.001; p-PKG: P<0.001) in the epileptic group. The results in the H 2S donor+epileptic group were up-regulated (PKG mRNA: P=0.047; PKG protein: P<0.001; Kir6.2 mRNA: P=0.011; Kir6.2 protein: P<0.001; cGMP: P<0.001; p-PKG: P<0.001) compared with the epileptic group. However, the results in the KT5823+H 2S donor+epileptic group were down-regulated (PKG mRNA: P=0.015; PKG protein: P=0.027; Kir6.2 mRNA: P=0.013; Kir6.2 protein: P=0.017; cGMP: P=0.005; p-PKG: P<0.001) compared with the H 2S donor+epileptic group. Conclusion:A possible mechanism is that H 2S prevents the epileptic seizure from modulating the subunit Kir6.2 of ATP sensitive potassium channels via the cGMP/PKG signaling pathway.

Objective To approach the significance of changes of percutaneous-arterial blood carbon dioxide partial pressure difference [P(tc-a)CO2] in liquid resuscitation of patients with septic shock. Methods One hundred and sixty-eight patients with septic shock admitted and treated in the Department of Intensive Care Unit (ICU) of Quzhou People's Hospital from January 2015 to January 2018 were enrolled, and after early goal-directed therapy (EGDT) for 6 hours, according to central venous oxygen saturation (ScvO2) and lactate clearance (LC), they were divided into ScvO2 and LC achievement group (ScvO2 ≥ 0.7 and LC≥10%), ScvO2 achievement group (ScvO2 ≥ 0.7 and LC < 10%), LC achievement group (ScvO2 < 0.7 and LC≥10%), and un-achievement group (ScvO2 < 0.7 and LC < 10%). The mechanical ventilation time, ICU hospitalization time, 28-day mortality, P(tc-a)CO2 etc. were compared among the four groups; the receiver operating characteristic curve (ROC) was used to evaluate the predictive value of P(tc-a)CO2 for 28-day prognosis in patients with septic shock. Results The trends of mechanical ventilation time, ICU hospitalization time, and 28-day mortality were all ScvO2 and LC achievement group < LC achievement group < ScvO2 achievement group < un-achievement group [the mechanical ventilation times (days) were respectively 6.12±2.59, 8.43±3.24, 11.78±4.12, 13.03±4.75, ICU hospitalization times (days) were 10.31±2.32, 13.85±3.56, 16.41±3.83, 18.52±4.05, and 28-day mortality rates were 28.85% (15/52), 40.91% (18/44), 51.28% (20/39), 69.70% (23/33)] and the differences among the four groups were statistically significant (all P < 0.05). After 6 hours of EGDT, the heart rate (HR), lactate (Lac), and P(tc-a)CO2 were lower than those before fluid resuscitation, but the mean arterial pressure (MAP), central venous pressure (CVP), and ScvO2 were higher than those before fluid resuscitation among four groups. Except CVP, the differences of other indicators compared among the ScvO2 and LC achievement group, ScvO2 achievement group, LC achievement group and un-achievement group were statistically significant (all P < 0.05). After 6 hours of EGDT, HR, Lac, P(tc-a)CO2 in ScvO2 and LC achievement group, ScvO2 achievement group and LC achievement group were significantly lower than those in the un-achievement group [HR (bpm): 89.05±29.43, 98.82±30.21, 94.33±28.64 vs. 112.85±32.74, Lac (mmol/L): 2.97±1.95, 3.87±2.32, 2.69±1.52 vs. 4.17±2.44, P(tc-a)CO2 (mmHg, 1 mmHg = 0133 kPa): 7.18±4.61, 12.61±5.34, 9.71±4.11 vs. 16.56±10.19], MAP and ScvO2 were significantly higher than those of the un-achievement group [MAP (mmHg): 88.05±21.67, 77.33±18.56, 83.11±19.71 vs. 70.32±18.79, ScvO2: 0.76±0.14, 0.75±0.16, 0.67±0.14 vs. 0.63±0.18, all P < 0.05]. The P(tc-a)CO2 of 28 days survivors were significantly lower than that of the deaths among four groups (mmHg: 5.78±2.27 vs. 14.14±3.65, 7.07±2.81 vs. 15.06±4.11, 6.35±2.09 vs. 14.94±4.06, 7.93±3.81 vs. 18.34±4.63, all P < 0.05). When P(tc-a)CO2 > 7.24 mmHg predicted 28-day mortality in ScvO2 and LC achievement group, the sensitivity was 89.29%, specificity was 91.45%, and the area under ROC curve (AUC) was 0.86; when P(tc-a)CO2 > 9.46 mmHg predicted 28-day mortality in LC achievement group, the sensitivity was 88.72%, specificity was 85.83% and AUC was 0.91; when P(tc-a)CO2 >12.05 mmHg predicted 28-day mortality in ScvO2 achievement group, the sensitivity was 82.79%, specificity was 86.90% and AUC was 0.79; when P(tc-a)CO2 > 16.22 mmHg predicted 28-day mortality in un-achievement group, the sensitivity was 73.35%, specificity was 80.68% and AUC was 0.68. Conclusion P(tc-a)CO2 can be used as an indicator to evaluate fluid resuscitation effect and prognosis in patients with septic shock.

Objective To explore the effect of comfort care on sleep quality of patients after thoracic surgery.Methods A total of 148 patients after thoracic surgery were randomly divided into the observation group (73 cases) and the control group ( 75 cases ) .The observation group received comfort care while the control group was given traditional methods .Sleep quality was compared between two groups before and after the surgery.Results PSQI score after a week was (6.26 ±2.35 ) in the observation group and (10.29 ±3.28 ) in the control group, with statistically significant difference (t=8.572 6,P<0.05).Conclusions Comfort care can improve sleep quality of patients after thoracic surgery , promote their recovery and nursing quality .

Objective To investigate the effect of comfort care on patients ’ anxiety after video-assisted thoracoscope surgery ( VATS) .Methods 148 patients were randomly divided into the control group ( n=75 ) and the observation group ( n=73 ) .The control group performed routine nursing care , while the observation group performed special comfort care .Patients ’ anxiety on 1 day before operation and 7 days after operation were compared between groups .Results Patients’ mean score of anxiety on 1 day before operation was (55.58 ± 12.33).There was no significant difference between groups (χ2 =0.7, P>0.05).For the patients in the observation group, 16.44%had no anxiety, 61.64%had a mild anxiety, 17.81%had a moderate anxiety, and 4.11%had a severe anxiety 7 days after operation.For the patients in the control group , 13.33% had no anxiety, 13.33%had a mild anxiety, 70.67%had a moderate anxiety, and 2.67%had a severe anxiety 7 days after operation.The difference was significant (χ2 =46.88, P <0.05).Conclusions The comfort care intervention can improve the nurse-patient communication and can reduce the degree of anxiety . It also contributes to promoting the postoperative rehabilitation of patients and improving the quality of nursing care .

Objective To investigate the effect and synaptic plasticity mechanism of dexmedetomi-dine(Dex)on alleviating cognitive impairment induced by myocardial ischemia/reperfusion(I/R)in aged mice.Methods Forty elderly male C57BL/6 mice were randomly divided into sham group,Sham+Dex group,I/R group,and I/R+Dex group,with 10 mice in each group.On the 7th day of reperfusion,cognitive function was evaluated using an eight arm water maze and novel ob-ject recognition.Electrophysiological recordings of hippocampal CA1 area was performed to meas-ure field excitatory postsynaptic potential(fEPSP)in in vivo long-term potentiation(LTP).The serum levels of cardiac troponin T(cTnT),lactate dehydrogenase(LDH),and N-terminal pro-B-type natriuretic peptide(NT-proBNP)were detected by ELISA.Western blotting was used to determine the expression of brain-derived neurotrophic factor(BDNF),tyrosine kinase receptor B(TrkB)-FL,and TrkB-T1 in hippocampal tissues.Golgi-Cox staining was utilized to observe the density of dendritic spines in hippocampal CA1 area.Immunofluorescence staining was performed to detect the expression of synaptic growth factor(SYN)and postsynaptic dense protein 95(PSD95).Results On the 7th day of reperfusion,the working memory error(WME),reference memory errors(RME)and total errors(TE)of the eight arm water maze and the expression lev-els of cTnT,LDH,NT-proBNP and TrkB-T1 were significantly higher,and the recognition index,fEPSP and expression levels of BDNF,TrkB-FL,SYN and PSD95 and density of dendritic spines were remarkably decreased in the I/R group and I/R+Dex group than the Sham group and Sham+Dex group(P＜0.05).The I/R+Dex group had obviously reduced TrkB-T1 expression(0.86±0.07 vs 1.51±0.18),and increased expression levels of BDNF(0.70±0.07 vs 0.39±0.06),TrkB-FL(0.67±0.10 vs 0.45±0.08),SYN(20.53±0.59 vs 16.50±1.05)and PSD95(17.73±0.52 vs 14.71±0.91)when compared with the I/R group(P＜0.05).Conclusion Dex exerts protective effect on cognitive impairment induced by myocardial I/R in elderly mice,and the specific mecha-nism may be related to alleviating cardiac injury,increasing the expression of BDNF,SYN and PSD95,improving the imbalance of TrkB-FL and TrkB-T1 ratio in hippocampal tissue,and enhan-cing synaptic plasticity.