Airway mucus hypersecretion exhibits distinct circadian rhythmic characteristics， and its occurrence and progression are temporally associated with the accumulation of phlegm-rheum during the night and the tendency for symptoms to emerge or worsen in the early morning. These characteristics are consistent with the decline of neuroendocrine activity and abnormalities in core circadian clock rhythms described in modern chronobiology. Based on this understanding， time-based intervention is applied in addition to conventional syndrome differentiation. During the period from shen （申） hour to hai （亥） hour （approximately 15：00-23：00）， phlegm-resolving and panting-relieving Chinese herbal medicinals can be administered in advance to reduce excessive phlegm accumulation during the night.Furthermore， a combined "time-pattern-medicine" therapeutic strategy is proposed. For attacks occurring mainly in the morning， treatment focuses on diffusing lung and resolving phlegm. For symptoms aggravated at night， emphasis is placed on clearing heat and resolving phlegm， and for episodes occurring after midnight， treatment should additionally consider both tonifying the kidney and promoting qi reception. In addition to pharmacological intervention， therapies that follow annual and daily rhythms， including winter disease treated in summer， and midnight-midday acupuncture， may also be incorporated to promote circadian rhythm coordination and maintain homeostasis of the body's biological clock.

Objective:To explore the effects of two dimensional gray-scale blood flow imaging (hereinafter referred to as " B-flow" ) combined with color Doppler flow imaging (CDFI) in guiding arterial puncture and catheterization through wounds in patients with large burns.Methods:Sixty-seven patients with large burns who met the inclusion criteria and hospitalized in the First Hospital of Jilin University from January 2017 to January 2019 were enrolled in the prospectively randomized control study. According to the random number table, CDFI alone group was allocated with 35 patients (23 males and 12 females) and B-flow+ CDFI group with 32 patients (22 males and 10 females), aged 19-60 and 18-58 years, respectively. According to the progress of the disease, arterial puncture and catheterization were performed in the right time. During the operation, CDFI was used alone for guidance in patients of CDFI alone group, while B-flow and CDFI were used together for guidance in patients of B-flow+ CDIF group. Based on the first time of catheterization, the catheterization location, one-time catheterization success rate, post-back stitching re-catheterization success rate, catheterization failure rate, catheterization duration, and incidences of wound sepsis, catheter-related bloodstream infection, and arterial thrombosis within post catheterization day (PCD) 3 of patients in the two groups were recorded. Data were statistically analyzed with the independent-sample t test, chi-square test or Fisher′s exact probability test. Results:(1) All the patients underwent catheterization through wounds, and there was no statistically significant difference in catheterization location of patients between the two groups ( χ2=0.574, P>0.05). The one-time catheterization success rate of patients in B-flow+ CDFI group was 81.25% (26/32), which was obviously higher than 51.43% (18/35) in CDFI alone group ( χ2=6.594, P<0.05). The catheterization failure rate of patients in B-flow+ CDFI group was 3.12% (1/32), which was obviously lower than 20.00% (7/35) in CDFI alone group ( P<0.05). The post-back stitching re-catheterization success rate of patients was similar between the two groups ( χ2=1.029, P>0.05). (3) The catheterization duration of patients was (15.7±1.1) min in B-flow+ CDFI group, which was obviously shorter than (17.1±2.2) min in CDFI alone group ( t=11.316, P<0.01). (4) Within PCD 3, the incidences of wound sepsis and catheter-related bloodstream infection of patients in CDFI alone group were 2.86% (1/35) and 0, close to 0 and 3.12% (1/32) in B-flow+ CDFI group ( P>0.05); the incidence of arterial thrombosis of patients in B-flow+ CDFI group was 0, which was obviously lower than 20.00% (7/35) in CDFI alone group ( P<0.05). Conclusions:Compared with CDFI alone, B-flow combined with CDFI can improve the success rate of arterial puncture and catheterization through wounds in large area burn patients, shorten the catheterization duration, and effectively reduce the incidence of arterial thrombosis after catheterization, with a good clinical application value.

OBJECTIVETo establish a systematic method for isolation and identification of aerobic and facultative anaerobic bacteria in the oral cavity.

METHODSSamples of the saliva, dental plaque and periapical granulation tissue were collected from 20 subjects with healthy oral condition and from 8 patients with different oral diseases. The bacteria in the samples were identified by morphological identification, VITEK automatic microorganism identification and 16s rRNA gene sequencing.

RESULTSVITEK automatic microorganism identification and 16s rRNA gene sequencing showed an agreement rate of 22.39% in identifying the bacteria in the samples. We identified altogether 63 bacterial genus (175 species), among which Streptococcus, Actinomyces and Staphylococcus were the most common bacterial genus, and Streptococcus anginosus, Actinomyces oris, Streptococcus mutans and Streptococcus mitis were the most common species. Streptococcus anginosus was commonly found in patients with chronic periapical periodontitis. Streptococcus intermedius and Staphylococcus aureus were common in patients with radiation caries, and in patients with rampant caries, Streptococcus mutans was found at considerably higher rate than other species.

CONCLUSIONAerobic and facultative anaerobic bacteria are commonly found in the oral cavity, and most of them are gram-positive. 16s rRNA gene sequencing is more accurate than VITEK automatic microorganism identification in identifying the bacteria.

Actinomyces ; isolation & purification ; Dental Caries ; Dental Plaque ; microbiology ; Humans ; Mouth ; microbiology ; RNA, Ribosomal, 16S ; genetics ; Saliva ; microbiology ; Staphylococcus aureus ; isolation & purification ; Streptococcus ; isolation & purification

Objective To establish a systematic method for isolation and identification of aerobic and facultative anaerobic bacteria in the oral cavity. Methods Samples of the saliva, dental plaque and periapical granulation tissue were collected from 20 subjects with healthy oral condition and from 8 patients with different oral diseases. The bacteria in the samples were identified by morphological identification, VITEK automatic microorganism identification and 16s rRNA gene sequencing. Results VITEK automatic microorganism identification and 16s rRNA gene sequencing showed an agreement rate of 22.39%in identifying the bacteria in the samples. We identified altogether 63 bacterial genus (175 species), among which Streptococcus, Actinomyces and Staphylococcus were the most common bacterial genus, and Streptococcus anginosus, Actinomyces oris, Streptococcus mutans and Streptococcus mitis were the most common species. Streptococcus anginosus was commonly found in patients with chronic periapical periodontitis. Streptococcus intermedius and Staphylococcus aureus were common in patients with radiation caries, and in patients with rampant caries, Streptococcus mutans was found at considerably higher rate than other species. Conclusion Aerobic and facultative anaerobic bacteria are commonly found in the oral cavity, and most of them are gram-positive. 16s rRNA gene sequencing is more accurate than VITEK automatic microorganism identification in identifying the bacteria.

Objective To establish a systematic method for isolation and identification of aerobic and facultative anaerobic bacteria in the oral cavity. Methods Samples of the saliva, dental plaque and periapical granulation tissue were collected from 20 subjects with healthy oral condition and from 8 patients with different oral diseases. The bacteria in the samples were identified by morphological identification, VITEK automatic microorganism identification and 16s rRNA gene sequencing. Results VITEK automatic microorganism identification and 16s rRNA gene sequencing showed an agreement rate of 22.39%in identifying the bacteria in the samples. We identified altogether 63 bacterial genus (175 species), among which Streptococcus, Actinomyces and Staphylococcus were the most common bacterial genus, and Streptococcus anginosus, Actinomyces oris, Streptococcus mutans and Streptococcus mitis were the most common species. Streptococcus anginosus was commonly found in patients with chronic periapical periodontitis. Streptococcus intermedius and Staphylococcus aureus were common in patients with radiation caries, and in patients with rampant caries, Streptococcus mutans was found at considerably higher rate than other species. Conclusion Aerobic and facultative anaerobic bacteria are commonly found in the oral cavity, and most of them are gram-positive. 16s rRNA gene sequencing is more accurate than VITEK automatic microorganism identification in identifying the bacteria.

Objective To evaluate the influence of handshake and consolation combined with breathing direction on the pain during dressing changes for the burn patients.Methods 64 patients were randomly divided into the experimental groups and the control groups according to their time of hospitalization,with 32 cases in each group.Patients in the experimental group were given the handshake and consolation combined with breathing direction during the dressing changes,while the control group was given routine care.Two groups used the same dressing method by the same physician,and cared by the same nurse before and after dressing.Pain scores (visual analogue scale VAS) were compared between the two groups before and after dressing changes.Results Before dressing,the pain scores of patients in the two groups were respectively (3.79 ± 2.27) and (3.85 ± 2.46),and there was no significant difference (t =0.147,P ＞ 0.05).After dressing,the pain scores of the experimental and the control groups were respectively (2.17 ± 1.53)and(4.30 ± 2.98),and the difference was statistically significant (t =6.796,P ＜ 0.01).Conclusions The handshake and consolation combined with breathing direction can effectively ease pain in the burns patients during dressing changes.