Objective To investigate the clinical efficacy and its mechanism of Yangyin Xiaoying decoction combined with western medicine in the treatment of Graves' Disease.Methods A total of 50 patients suffered from Graves' Disease in our hospital were selected from January 2012 to December 2014,and were randomly divided into observation group and control group using random number table method,25 cases in each group.Other 25 cases of healthy subjects were selected in the same period in our hospital as the healthy control group.The control group received the treatment of methimazole,propranolol and other western medicine.The observation group received Yangyin Xiaoying decoction combined with western medicine.After 2 months of treatment,the levels of free triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),thyroglobulin antibody (TGAb) and thyroid peroxidase (TPOAb),and the percentages of Th1,Th2,Th17 cells in CD4+ cells and their corresponding cytokine levels were detected.Results After treatment,the levels of FT3,FT4,TGAb and TPOAb in the observation group and control group were significantly decreased,and levels of TSH were significantly increased in the two groups (P＜0.05);percentages of Th1,Th2 and Th17 cells in the observation group and control group were significantly lower than those before treatment (P＜0.05).After treatment,the interferon-γ (IFN-γ),interleukin (IL)-4 levels and IFN-γ/IL-4 ratio,IL-12,IL-5 levels and IL-12/IL-5 ratio in the observation group and control group were significantly lower than those before treatment (P＜0.05).The IL-17A,IL-17F and IL-23 levels in the observation group and control group after treatment were significantly decreased,compared with those before treatment (P＜0.05).The degree of improvement of above indexes in the observation group were better than those in the control group (P＜0.05).Conclusion Yangyin Xiaoying decoction combined with western medicine can significantly improve patients' thyroid function,which suggests that it may have a role in the therapy in the treatment of Graves' disease.

Objective To observe the clinical efficacy and its mechanism of Tongluoyuzufang Ⅰ in patients with diabetic foot (DF).Methods A total of 60 cases with DF was randomly divided into experimental group and control group,30 cases in each group.All patients were given insulin and/or hypoglycemic drugs and other Western medicine comprehensive treatment to control blood sugar steadily.The control group received methylcobalamin treatment,and the experimental group received Tongluoyuzufang Ⅰ therapy treatment based on the methylcobalamin treatment.Both groups were treated for 4 weeks for a course of treatment.The clinical efficacy,ankle-brachial index,nerve conduction velocity,hemorheology,blood lipid,serum cytokines and adverse reactions before and after treatment were compared after 3 courses of treatment.Results After treatment,the total effective rate was 90.0 ％ in the observation group,higher than that in the control group(x2 =5.963,P＜0.05).After treatment,the ankle-brachial index,nerve conduction velocity,hemorheology and blood lipid level in both groups were significantly improved(P＜0.05).After treatment,serum levels of tumor necrosis factor-α(TNF-α) and vascular endothelial growth factor(VEGF) in both groups were significantly decreased,while the levels of anti-thrombin Ⅲ (AT-Ⅲ) has increased(P＜0.05).The improvement of the indexes in the observation group was better than that in the control group(P＜0.05).There were no serious adverse events during treatment.Conclusion Tongluoyuzufang Ⅰ can significantly improve limb ischemia and nerve conduction function in patient with DF.

Objective:To synthesize the influencing factors of oral nursing practice among ICU nurses, so as to provide reference for clinical nursing practice.Methods:The quantitative, qualitative, and mixed methods research on the influencing factors of ICU nurses' oral nursing practice was systematically retrieved in PubMed, Web of Science, Embase, CINAHL, Cochrane Library, China National Knowledge Infrastructure, WanFang Data, VIP, China Biomedical Database and so on. Data based convergent synthesis design was used for comprehensive analysis of included literature.Results:A total of 20 articles were included. A total of 34 influencing factors were extracted from the oral nursing practice of ICU nurses, including 16 promoting factors and 18 obstacle factors, which were summarized as knowledge, skills, beliefs about consequences, goals, environmental background and resources, and social influence areas.Conclusions:The influencing factors of ICU nurses' oral nursing practice are diverse and complex. Future research can develop specific intervention plans based on the promotion and obstacle factors of ICU nurses' oral nursing practices, so as to promote the development of ICU basic nursing practices.