Objective: To research and analysis the effect of continued nursing support on speech intelligibility and the quality of life in postoperative patients with tongue cancer. Methods: A total of 80 patients treated in our hospital with tongue cancer from May 2014 to August 2016 were selected and randomly divided into the intervention group and the control group in accordance with the convenience sampling method, 40 cases in each group. All patients received the same health guidance education after discharge according to care routine.At the same time, the patients in the intervention group received the continued nursing support. Intervention effects were observed in two groups by using the Chinese speech intelligibility test table and the University of Washington Quality of Life Questionnaire (UW-QOLv4). Results: One day before the operation, the speech intelligibility (94.8±4.9) scores, the survival quality (1 076.3±51.9) scores in the intervention group compared to the scores (96.0±3.2, 1 084.7±46.5) in the control group,there were no statistical difference (t=-1.297,-0.762, both P>0.05). Two weeks after the operation, there were also no statistical difference (t=1.136,P>0.05) on the speech intelligibility scores between the intervention group (33.7±3.1) and the control group(32.9±3.2). One month,three months and six months after the operation, the scores in the intervention group(61.2±2.7,79.5±4.3,90.9±2.4 respectively) were much higher than that in the control group(49.6±2.4,63.6±3.8, 78.6±3.5) with significant difference (t=20.309,17.524,18.331, all P<0.05).Six months after the operation,the scores in the intervention group(786.4±67.1) were much higher than that in the control group (597.6±58.2) with significant difference(t=13.443,P<0.05). Conclusions The implementation of continued nursing support can effectively improve speech intelligibility and the quality of postoperative survival in patients with tongue cancer.

Objective To dynamically monitor the base excess(BE) in traumatic brain injury(TBI) patients within 3 d after admission,and to assess the impact of the early BE on prognosis.Methods Blood BE was monitored for 3 d in 56 TBI patients.Patients were classified into mild group(15 patients),moderate group (22 patients) and severe group (19 patients) according to the scores of Glasgow coma scale(GCS).Patients were classified into survival group(42 patients) and dead group(14 patients) according to prognosis.Patients were classified into high BE group (35 patients,BE≥-8 mmol/L) and low BE group (21 patients,BE ＜-8 mmol/L).The relations among BE,degree of injury and prognosis were analyzed.Results The level of BE in mild group,moderate group and severe group was increased after treatment for 1,2,3 d than that before treatment.The level of BE was consistent with the degree of injury [mild group:(-3.02 ± 0.21)mmol/L; moderate group:(-8.49 ± 1.44) mmol/L;severe group:(-9.64 ± 1.19) mmol/L].The level of BE in mild group and severe group had significant difference than that in moderate group (P＜ 0.01).The level of BE in dead group before treatment and after treatment for 1,2,3 d was significantly lower than that in survival group [(-11.97 ±2.13) mmol/L vs.(-6.29 ± 1.16) mmol/L,(-9.84 ± 1.33) mmol/L vs.(-4.89 ± 1.78)mmol/L,(-8.78 ± 2.01) mmol/L vs.(-3.61 ± 1.43) mmol/L,(-7.84 ± 1.42) mmol/L vs.(-3.10 ±0.98)mmol/L] (P ＜0.01).The scores of APACHE Ⅱ before treatment and fatality rate in low BE group were significantly higher than those in high BE group [(24.84 ± 3.68) scores vs.(16.27 ± 2.21) scores,52.4％ (11/21) vs.8.6％(3/35)] (P ＜ 0.01).The scores of GCS before treatment in low BE group was significantly higher than that in high BE group [(7.56 ± 3.09) scores vs.(10.51 ± 2.43) scores](P ＜ 0.01).Conclusion The level of early BE is a good factor on evaluating the condition and prognosis in TBI patients.

Objective To observe the relationship between early lactate clearance and APACHEⅡ in critically ill patients. Methods In 121 critically ill patients,APACHE Ⅱ and lactate clearance rate were recorded. According to APACHE Ⅱ score,all patients were divided into≤10 score group, (11 ～20) score group,(21 ～30) score group and ＞ 30 score group, then compared the level of the early lactate clearance rate. The early lactate clearance rate were also compared between survival group and death group. Then the relationship between early lactate clearance and APACHE Ⅱ were analyzed. Results In( 11 ～20) score group,the early lactate clearance rate was lower than those in ≤ 10 score group, but the difference was not significant ( P ＞ 0. 05 ). The early lactate clearance rate in (21 ～ 30) score group ( 18. 35 ± 10. 01 ) % was lower than those in ( 11 ～ 20) score group (27.35 ± 10. 22) % ( t = 3.481, P ＜ 0. 01 ),in ＞ 30 score group( 11.98 ± 9. 93 )% those was lower compared with (21 ～30) score group( t = 2. 968, P ＜ 0. 01 ). In death group, APACHE Ⅱ score(28. 1 ± 6. 7 ) was higher than that in survival group ( 18. 8 ± 8. 4) ( t = 3. 030, P ＜0. 01 ), the early lactate clearance rate was lower ( t = 3. 619, P ＜ 0. 01 ). APACHE Ⅱ score correlated well with the mean level of the early lactate clearance rate ( r = - 0. 641, P ＜ 0. 01 ). Conclusion The lactate clearance rate was the good fator on evaluation of condition and prognosis in the critically ill patients.