Objectives: To observe the clinical effects of nutritional support with protein diet in patients with moderate and severe burns. Methods: 50 cases were randomly divided into treatment group(25 cases) and control group(25 cases). The control group was treated with routine and nutritional support. The treatment group was given additionally with protein diet (80g/d,consisting of Gln 4g and protein 66g). Either oral admistration or tube feeling was chosen according to patient condition. The treatment lasted 21 days. Results: There was no significant difference between the two groups on the levels of Alb、PA、TF and TLC before the management. The level of Alb in the treatment group was obviously changed after the management. The levels of PA、 TF and TLC in the treatment group were increased significantly and had significant differences between the two groups(P

Objective: To observe the effect of peptisorb on the result of intestinal preparation,the change of correlated nutritional index,the fuction of intestine and the immune function after operation in perioperative colorectal cancer patients.Methods: Sixty patients were randomly allocated into two groups. The trial group (n=30) received peptisorb 3days before and 7days after operation. Control group (n=30) received coloclysis treatment.The the level of Alb, globulin,the number of IgG, IgA,IgM, CD3+,CD4+/ CD8+ ,the station of intestinal mucosa and intestine cleaning during operation, nutritional state after operation, immune function, infcetious complications, length of stay were detected.Results: There were no significant difference in the station of intestinal mucosa and intestine cleaning. The index of nutritional and immune in two groups were descend, but the trail group was better(P＜0.01). The number of IgG,IgA, IgM, CD3+ in the trail group were significantly higher than the control group(P＜0.01),the rate of postoperative infectious complications in the trail group was lower than the control group.The trail group aslo showed shorter average length of stay after surgery than the control(P＜0.01).Conclusion: The peptisorb can ameliorate the host immune function and improve clinical outcome,which is a good nutrition support pathway to perioperative colorectal cance patinets.

Objective To understand the drug resistance characteristics of pseudomonas aeruginosa and to guide the selection of clinical antibacterial drugs .Methods The clinically isolated 335 strains of pseudomonas aeruginosa from the Xuzhou Municipal First People′s Hospital in 2013 were collected and performed the drug susceptibility test .The test results and data were analyzed by using the WHONET5 .6 software .Results Clinically isolated 335 strains of pseudomonas aeruginosa had different degrees of re‐sistance to 15 kinds of antibacterial drugs ,in which the sensitivities to piperacillin/tazobactam ,amikacin ,tobramycin ,ciprofloxacin , levofloxacin ,ceftazidine ,cefepime and gentamicin were higher ;the resistance rate to ampicillin/sulbactam ,ceftriaxone ,ampicillin and cefotaxime was up to above 97% .In the same patients with several times of this bacterial detection ,larger volatility existed in the susceptibility results of piperacillin/tazobactam ,ceftazidine ,cefepime ,imipenem and gentamicin .Meanwhile the drug resitance spectrum of Pseudomonas aeruginosa had a certain tendency .Conclusion Strengthening continuous etiology and drug resistance moni‐toring is in response to the occurrence of acute drug resistance and nosocomial infection spread ,meanwhile guides clinical treatment .

Objective To explore the surgical skill, safety, and cosmetic outcomes of complete endoscopic subcutaneous mastectomy and immediate reconstruction with implants for breast cancer. Methods From August 2004 to September 2007, 31 women with breast cancer received complete endoscopic subcutaneous mastectomy and immediate reconstruction with implants in our hospital after neoadjuvant chemotherapy. The operation spaces were established by insufflating carbon dioxide after lipolysis and liposuction in the subcutaneous stratum and retromammary space. Subcutaneous mastectomy was carried out under a complete endoscope, sentinel lymph node biopsy or axillary lymph node dissection, and immediate reconstruction with implants were carried out via axillary small incision. Results The operations were completed in all of the 31 cases. Sentinel lymph node biopsy was performed on 15 cases (including supplemental axillary lymph node dissection in 8), and immediate axillary lymph node dissection was done in 16 cases. No cancer infiltration on tumor surface or into the nipple basement was observed in frozen sections during the operation. In one patient, the nipple was partly necrotic. No other complications were found in this series. Three months after the operation, cosmetic results were good in 22 cases (71.0%), average in 7 (22.6%), and poor in 2 (6.4%). The patients were followed for 3 months to 3 years (over 1 year in 15 patients), during which no one had metastasis or recurrence of the tumor. Conclusions Complete endoscopic subcutaneous mastectomy combined with immediate reconstruction with implants is less traumatic and safe with few complications and good cosmetic result. The method is a good choice for patients with early-stage breast cancer.

Objective To explore the relationship between the expression of pS2 protein and the clinicopathological parameters in breast cancer and to evaluate the value of pS2 as a prognostic factor for breast carcinoma and a predictive factor for response to endocrine therapy. Methods Expression levels of pS2 protein, estrogen receptor (ER) and progestogen receptor (PR) in tissues from 75 cases of breast cancer were detected by immunohistochemical assay. The relationship of pS2 protein expression with patient age, menopausal status, tumor size, metastasis to the axillary lymph nodes, pathological types, ER and PR was analyzed. Results pS2 protein, expressed in 33.3% of breast carcinomas, was correlated with patient age and pathological types, but was not correlated with tumor size. The positive rate of pS2 protein before menopause was higher than that after menopause, but no significant difference was found. Similarly, higher positive rate of pS2 protein was found in patients with metastasis to axillary lymph nodes than those without, but no significant difference was found. pS2 expression was correlated with ER and PR, but they were not perfectly consistent. Conclusion In breast cancer, pS2 protein expression, associated with some clinical factors and pathological features, is a good prognostic factor. pS2 expression may be a reasonable index for endocrinotherapy of breast carcinoma, but the detection of pS2 protein can not be employed in place of the detection of ER and PR.

Objective To explore the application value of non‐concentrated urine protein electrophoresis in renal diseases in order to guide to adjust the treatment scheme and judge the prognosis .Methods The clinical data in 152 cases of renal biopsy in the Xuzhou Municipal First People′s Hospital from December 2010 to January 2016 were retrospectively collected ,mainly including the pathological report and the results of urine protein electrophoresis .The classification was performed according to the WHO renal pathology classification standard(Ⅰ ,Ⅱ ,Ⅲ ,Ⅳ) .The relationship between the renal pathological classification with the classification of urine protein electrophoresis and the proportions of various compositions in electrophoresis spectrum was comparatively ana‐lyzed .Results The glomerular lesion rate was higher than the renal tubules‐interstitial lesion rate ,the majority of renal tubules‐in‐terstitial lesion had combining glomerular lesions .The glomerular urine protein level reflected by the urine protein electrophoresis was associated with glomerular damage degree ,with WHO pathological grade (Ⅰ - Ⅳ ) increase ,the proportion of haptoglobin (HAP)and IgG/A in urine protein electrophoresis showed an increasing trend ,the differences were statistically significant (F=2 .237 ,P<0 .05 ;F=7 .269 ,P<0 .05) .Conclusion Detecting the proportion of HAP and IgG/A in urine protein electrophoresis has an important clinical value in reflecting the glomerular damage severity .

Objective To study the expressions of estrogen receptor(ER)and progesterone receptor(PR)in elderly patients with breast cancer,and the correlation between their expressions and clinicopathological characteristics.Methods The expressions of ER and PR in 110 elderly patients with breast cancer(over 60 years old)from 1995 to 2004 were detected,and their clinical and pathological features were analyzed retrospectively.Another 110 patients aging 30 to 59 years with breast cancer served as control.Results Breast cancer in aged and non-elderly group had similar pathohistological types,but the aged had more tumors with low-grade malignant types.ER and PR were found to be over-expressed in elderly patients but not in the control.No obvious correlation was seen with clinical pathological stages.The expression levels of ER and PR in 0-3 positive nodes group was higher than ≥4 positive nodes group.Conclusion Elderly patients and non-elderly patients have similar pathohistological types of breast cancer.The former have higher expressions of ER and PR,and their expressions are associated with axillary lymph node status.

ObjectiveTo evaluate the reliability and clinical value for detecting paraquat (PQ)concentration in serum by spectrometry. MethodsThe determinations of wave length for detecting serum PQ concentration by ordinary spectrometry and second-derivative spectrometry were carried out. When the second-derivative spectrometry was used for detecting PQ in serum, the linear range and precision for PQ concentration were well defined. The results of serum PQ concentration determined by second-derivative spectrometry and by HPLC (high performance liquid chromatography) were compared in 8 patient with PQ poisoning. A total of 21 patients with acute poisoning after PQ ingestion over 4 hours admitted from October 2008 through September 2010 were retrospectively studied. Patients were divided into two groups as per the serum concentrations more than 1.8 μg/mL or less than that by second-derivative spectrometry on the day of admission. The severity of clinical manifestations between two groups was analyzed with t-test or Fisher's exact probabilities analysis. Results ( 1 ) The absorption peak of 257 nm could not be found by using ordinary spectrometry to detect the PQ concentration in serum. (2) The calibration curve in the 0. 4 ～ 8.0μg/mL range for detecting PQ concentration by second-derivative spectrometry observed the Beer's law (r =0. 996) . The average retrieval rate of PQ was within the range of 95.0％～ 99. 5％ with relative standard deviation (RSD) within 1.35％～ 5.41％ ( n = 6), and the lowest detection limit was 0. 05μg/mL. (3) The results of PQ concentrations from 8 patients with PQ poisoning detected by second-derivative spectrometry were consistent with those of the quantitative determinations by HPLC ( r = 0. 995,P＜0. 01 ) . (4) The survival rate of patients with serum PQ concentration more than 1.8 μg/mL was 22. 2％ ,and the incidences of acidosis, oligouria and pneumomediastium in these patients were 55.6％,55. 6％ and 77.8％, respectively. These clinical manifestations were significantly different from those in patients with serum PQ concentration less than 1.8 μg/mL ( P ＜ 0. 05 ) . Conclusions ( 1 ) It was inappropriate to take 257 nm as the determination wave length for detecting serum PQ concentration by ordinary spectrometry. (2) The method of second-derivative spectrometry was reliable for detecting serum PQ concentration. (3) Serum PQ concentration detected by second derivative spectrometry could be used to predict the severity of clinical manifestations of patients with PQ poisoning and was an important predictive factor for poor prognosis if the serum PQ concentration more than 1.8 μg/mL after PQ ingestion over 4 hours.

Objective To evaluate the safety and effectiveness of Stoppa approach combined with iliac incision in periacetabular osteotomy for treatment of hip dysplasia.Methods From September 2011 to July 2012,18 patients (20 hips) with hip dysplasia were performed periacetabular osteotomy through Stoppa approach combined with iliac incision.There were 15 female patients with 17 hips and 3 male patients with 3 hips.The average age was 29 years old (range 19 to 35).The surgical incision included two parts with the abdominal transverse incision (Stoppa approach) and the iliac incision (the lateral window of ilioinguinal approach).The duration of surgery,length of incision,intraoperative blood loss,and amount of allogeneic blood transfusion were measured.The clinical function,radiographic parameters,and operative complications were analyzed at 12 months follow-up.Results The mean operation time was 145 min (range,125-180 min).The mean incision length of Stoppa approach was 7 cm (range,5-10 erm) for the abdominal part and 6 cm (range,4-8 cm) for the iliac part,and the average of total incision length was 13 cm (range,12-16 cm).The mean blood loss during operation was 800ml (range,500-1 600 ml).The mean amount of allogeneic blood transfusion was 1 161 ml (range,400-2 400 ml).The mean duration of follow-up was 19.6 months (range,14-22 months).Compared to the preoperative data,both postoperative Harris hip score and center-edge angle improved significantly,with a mean increase of 13.2±6.0 and 22.5°±4.5° respectively.The mean Harris hip score improved form 80.3±8.5 preoperatively to 93.5±5.2 postoperatively at the time of 12 months follow-up.The average center-edge angle improved from 7.5°±5.4° preoperatively to 30.0°±4.6° postoperatively.All of the osteotomies except two pubic osteotomies healed at the time of three months follow-up.The two pubic osteotomies were treated with protected weight bearing and had a delayed union until the six months follow-up.The mean time of osteotomies union was 3.3 months.Complications included three transient]ateral femoral cutaneous nerve palsies which completely resolved within three months after oral medicine therapy.There were no major neurovascular complications,no infection,no incision hernia or any other surgical complications.Conclusion Stoppa approach combined with iliac incision is a safe and effective approach for periacetabular osteotomy.It is an alternative to conventional ilioinguinal approach for treatment of mild hip dysplasia.

Objective To investigate the value of laboratory testing in kidney diseases and to assess whether these marks can predict the renal histological lesions for screening the best clinical test combination.Methods The main clinical data,pathological types and laboratory examination indexes in 117 patients with renal biopsy in our hospital from December 2010 to March 2014 were collected and graded according to the WHO renal pathological classification standard and the Katafuchi semi-quantitative score standard classification (Ⅰ,Ⅱ,Ⅲ,Ⅳ).The differences in serum CysC,urine NAG,urine alpha 1-MG,urine mAlb and 24 h urine total protein (24h-UTP)level were compared among the various groups and their relations with the glomerulus was analyzed;the correlation and the statistical significance of each index in different groups was analyzed.Results NAG,alpha 1-MG and CysC had statistical differences between in the grade Ⅳgroup and the gradeⅠ,Ⅱ,Ⅲ groups (P <0.05),24h-UTP and mAlb had significant correlation in reflecting the kidney diseases (r=0.565,P =0.000);NAG and alpha 1-MG also had significant correlation in reflec-ting renal tubular interstitial disease (r=0.509,P =0.000).Conclusion The detection results of various detection indicators when rising to a certain height can be used for judging the progression of the patients clinical and pathological condition,illustrating the serious condition of illness;at the same time according to the correlation among the indexes and the detection efficiency,three indi-cators of Cys C,mAlb,alpha 1 - MG are screened out for conducting the combination detection,the detection efficiency could be greatly improved.