40% TBSA) were observed for 10 days after burn. The results showed that CRP, REE, UUN and UcA increased significantly postburn, CRP and REE had identical dynamic curves, and CRP had a direct bearing on REE, IL—1 might be an important medium of both. It is advisable to use CRP as a parameter to monitor burn hypermetabolism.

Objective:To study the changes of energy expenditure regularities in Chinese burn adults.Methods:The resting energy expenditure(REE) was observed in 75 burn adults. Results: Burn metabolism can be divided into a slow-rise stage and a sharp-rise stage.The extent of respose and lasting time in hypermetabolism were proportional to the magnitude of total body surface area(TBSA).The peak level of REE may be 1.5-2.0 times as high as control.Even after the wound healing higher level of REE may lasts for a longer period,especially in severe burns.In case of sustaining lower REE and/or shart drop of REE are observed,the outcome is usually poor.After burning,the catabolism of protein is obviously increased,the utilization of glucose is decreasd,and the mobilization and utilization of lipid are markedly increased.Conclusion:The changes of energy expenditure regularities in Chinese burn adults are showed,the nutrition treatment should be actively given in severe burn patients.

0.05),but positively on PBD 7(r= 0.890,P

Objective: To study the relationship of resting energy expenditure(REE) with wound depth in burn patients and offer some guidance for the nutrition treatment of burn.Methods: Twenty-three burn patients with a similar total burn surface were randomly divided in accordance with the Ⅲ? wound area into Goups A,B,C and D,their total burn surface and Ⅲ?wound area were(66?18)% and(12?9)%,(59?18)% and(20?5)%,(62?6)% and(39?5)%,and(65?16)% and(54?4)%,respectively.Their REE was determined on PBD(postburn day) 1,2,3,7,14,21 and 28 with the indirect measuring method.The measured values of 13 normal adults were used for comparison.Results: The mean value of REE of each burn group was higher than the normal control.REE enhanced significantly with the increase of the Ⅲ? wound area.Conclusion: REE obviously increases in burn patients,and,with a similar total burn surface,the larger the Ⅲ? wound area,the higher REE.Therefore,increased calories should be furnished in the nutrition treatment of burn patients with a larger Ⅲ? wound area.

Relative deficiency of serum insulin and insulin resistance of tissues are the main causes of postburn hypercatabolism.In order to evaluate the clinical effects of tolbutamide to improve postburn hypermetabolism,9 burn patients were given tolbutamide and observed for 10 days after the drug had gone through animal experiments.It was found that tolbutamide could improve postburn hyper-metabolism through following ways:1.To stimulate the secretion of insulin and enhance the effect of insulin.2.To reduce the insulin resistance of tissues and promote glucose utilization of skeletal muscles.3.To inhibit the secretion of glucagon.

The rate of resting energy expenditure (REE) was determined in 75 cases of burn patients with different total areas of burned wounds.Itwas found that.1.The rate of REE increased with the increase of the total area of burned wounds.2.When the total burned body surface area was equal,the rate of ERE increased more signficantly in the case with more extensive third degree burns.3.In the period immediately after the healing of the burned wounds,the rate of REE remained significantly higher than in the normal subjects.

Thirty-two adult patients with burn wounds over 50% TBSA were randomized into the nutritioal and the control group.Energy supplement Ifor the patients of the nutritional group was given according to the burn nutrition formula of the Third Military Medical College as follows,Energy (kJ) /day=4184 (1000 cal)?body surface area (m2) +105 (25 cal)?burn surface area (%)glucose,fat:protein=55~60:20~30:15~20calorie (cal):nitrogen (g)=150~170:1The patients of the control were prescribed to eat the hospital diet freely.All the patients of the 2 groups were observed for 28 days postburn with their burn wounds similarly and properly treated.It was found that most of the nutritional indices observed were better in the nutritional group than in the control.

The resting energy expenditure (REE) and the relative ratio of carbohydrate,fat and protein were investigated on the 1st to the 28th dqy postburn in 75 adult burn victims with burn area ranged between 5~98% TBSA.It was found that there was high catabolism of fat and protein but relatively low consumption of carbohydrate after burns.The more severe the burn injury,the more marked the above changes.On the basis of the metabolic characteristics of burn patients and on the traditional dietary habits of Chinese,a reasonable relative ratio among carbohydrate,fat and protein,the 3 main nutritional elements,in the diet of burn patients was suggested,viz,carbohydrate:fat:protein=55~60:20~30:15~20.

Objective To discuss the value and effect of monitoring BNP(Brain Natriuetic Peptide)used in the CHF (Chronic Heart Failure)community management.Methods 126 Patients with CHF in our community were randomly classifed to the BNP monitoring group the comparing group.We regularly monitored the dynamic BNP density in the BNP monitoring group According to the BNP level,we adjusted the rensonable treatment mersures and enhanced community management,and made a follow-up visit for one year.Results The severe degree of CHF was correlated to the BNP density,the repeated hospitalization rate,cardiovascular accident rate and fatality rate were significantly higher in BNP monitoring group than in the comparing group.They 19.3%,16.3%,4.76% respetively in the BNP monitoring group, and 39.6%4 0%,16.66% respectively in the comparing group,which is average P

OBJECTIVE To improve the compliance of medical institutions in the prevention and treatment of influenza A(H1N1) by introduction of game theory.METHODS Solving the mixed strategy Nash equilibrium with the application of game theory model.RESULTS There was inevitable relationship between the proportion of inspections,amercement amount and compliance of prevention and treatment.CONCLUSIONS If the health administration departments decrease the proportion of inspection,the probability will be reduced on the attitude of the medical staff;If the health administration departments increase the proportion of inspection,the probability will also be increased.