Full thickness scalding of 37% TBSA was inflicted io rats. Three days later, the liver of the animals was isolated and the changes of the protein metabolism in the liver and the effects of insulin on the changes were evaluated.It was found that the protein and DMA levels of the liver showed no obvious changes after scalding, but the RNA content increased by 24% and the rate of leucine incorporation by 31%. After the addition of insulin, the leucine content increased by 23.% and 25.8% in the controls and the injured animals respectively. The results indicate that the rate of protein synthesis in the liver of the scalded animals increases, which is likely to be related to the increase of RNA content, and the liver protein synthesis remains to be sensitive to insulin.

This paper is to report the changes of the protein metabolism in the rat soleus muscle in vitro after 37% TBSA full-thickness burns covering one hindlimb and the effects of leucine and insulin on the burned muscle.It was found that there werea significant decreases of the protein content and marked exaggeration of the rates of tyrosine incorporation,tyrosine release and tyrosine net release in the burned muscle.No changes of the above-mentioned parameters could be revealed in the muscle of the unburned limb and the controls.Elevation of leucine concentration in the medium could not improve the protein metabolism of the burned muscle.0.1u/ml of insulin could significantly stimulate the tyrosine incorporation in the muscle of the unburned limb and the controls,but no similar effect was observed on the burned muscle.The results indicate that increased protein degradation of the local burned muscle is responsible for the postburn negative nitrogen balance;administration of leucine alone cannot improve the protein metabolism in the local burned muscle;and the sensivity of the burned muscle to insulin is suppressed.

Objective To evaluate gastric bypass on relieving type 2 diabetes mellitus. Methods From September 2009 to September 2010,Thirty two cases of type 2 diabetes mellitus patients underwent gastric bypass operation in Xijing Hospital.Preoperative FBG,2hPG,HbAlc,weight,blood pressure and fatty liver were compared with that on 1 month,6 months,12 months after operation. Result There was no significant postoperative complications.FBG on 1 month,6 months,12 months postop and preoperative level was respectively 7.8 ± 2.2,7.7 ± 2.2,7.2 ± 1.8 and 11.1 ± 2.7 ( mmol/L),P ＜ 0.05.2hPG was 10.2 ± 2.6,10.5±2.8,10.5 ±3.1 and 14.0 ±3.5 (mmoL/L),P＜0.05.HbAlc was 7.6％ ±1.4％,7.5％ ± 1.7％,7.1％ ±1.9％ and9.0％±2.3％,P＜0.05.FBG[(6.9±1.5) mmol/L],2hPG[(10.0±3.2) mmol/L] and HbAlc[ (6.9％ ± 1.9％ ) ] on 12 months after operation were lower than preoperative[ FBG ( 10.7 ± 2.9 ) mmol/L,2hPG ( 14.3 ± 4.1 ) mmol/L,HbAlc ( 8.8％ ± 2.0％ ) ] in patients with BMI ＜25 kg/m2 (P ＜ 0.05 ).In patients with preoperative BMI ≥ 25 kg/m2,FBG ( 7.5 ± 2.3 ) mmol/L,2hPG ( 11.3 ±2.9) mmol/L HbAlc (7.3％ ± 1.9％ ),12 mos pest were lower than that of preoperative levels of [FBG(11.7 ±2.3) mmol/L,2hPG(13.5 ±2.4) mmol/L,HbAlc(9.2％ ±2.7％)] (P ＜0.05).Postoperative blood pressure became normal in 5 out of 6 patients complicating preoperative high blood pressure as evaluated on 12 months after operation. Fatty liver ameliorated in 8 out of 17 patients.Conclusions Gastric bypass significantly improves glycometabolism and comorbidity in type 2 diabetes patients.

Objective To study the effectrve approach of the nutrition support in burn patients. Methods The means of immuno-precipitation-deduction,ELISA and fluore-photometion were used to test the change of activities,protein expression of the 19S regulator and the rate of protein degradation in skeletal muscle in scard rats with enteral feeding or parenteral nutrition. Results Compared with parenteral nutrition , enteral feeding could markedly reduce the activity and protein expression of the 19S regulator ,and the digeneration of skeletal muscle was also lower. Conclusions The early enteral feeding can distinctly inhibit the system of 26S proteasome , thereby reduce the protein degradation of skeletal muscle in scald rats,which may be benefical to the metabolic modulation of the burned patients.

Objective:To investigate the effect of methylphenidate on the ERP waveform of children with attention deficit hyperactivity disorder(ADHD) between responders and non-responders and it's psychological significance.Methods:ERP elicited by the continuous performance test were recorded before and under methylphenidate treatment in 28 ADHD children and their behavioral performance were collected simultaneously.Based on the behavioral results,the patients were divided into two groups:responders and non-responders.Results:After medcation,the responders' behavioral performance were significantly better,amplitude of NOGO-P3(30.24?10.78?v) were also larger than that of before treatment(20.34?11.42?v,P=0.04);No significant differences were found in the behavioral performance and NOGO-P3 amplitude before and after treatment(23.51?11.97?v/25.88?13.96?v,P=0.61) in the non-responders group.The amplitude of NOGO-N2 of the two groups did not have significant difference before and under methylphenidate treatment.Off medication,there were no differences between responders and non-responders.Conclusion:Methylphenidate can improve the ability of response inhibition in responders as well as increase the amplitude of NOGO-P3 of them.

Objective To explore the mechanism of negative nitrogen balance in the treatment after burns. Methods The means of immuno precipitation deduction and ELISA were used to test the activities and contents of 26S proteasome and 19S regulator in skeletal muscle of rats inflicted with 30%TBSAⅢ burns. Results TNF? markedly raised the activities and contents of 26S proteasome and 19S regulator in skeletal muscle after scalding. Conclusion TNF? activates the 26S proteasome system in skeletal muscle, thus it enhances the degradation of protein, which is associated with the development of negative nitrogen balance following scalding.

Objective To explore the effect of straddling chair on paraplegic patients complicated with pressure sore. Methods Nineteen paraplegic patients complicated with pressure sore were set as the control group where they were managed with routine rehabilitation training and adapted negative pressure drainage at the sore.Another twenty-three paraplegic patients complicated with pressure sore were set as the experiment group where conventional rehabilitation trainings was taken and besides the patients were managed with rehabilitation training by riding on the straddling chairs.The curative effect of pressure sore and the activities of daily living(ADL)at discharge were compared between the two groups.Result The experiment group was significantly better than the control group in terms the curative effect,time for discharge and ADL(all P<0.05).Conclusion Rehabilitation training of paraplegic patients’riding on the straddling chair may be helpful for the improvement of the activities of ADL and effective prevention and curative treatment of the pressure sore.

Objective To probe into the clinical effect of the sickbed management system for student nurses.Methods The student nurses at the first department of gynecology from June 2010 to April 2012 were set as the experiment group,in which the sickbed management system was used so that they completed their nursing work at fixed shifts and sickbeds under the nursing teacher’s instructions.The student nurses at the second department of gynecology during the same period were set as the control group,in which the student nurses took different tasks for unfixed sickbeds at different shifts every day.The two groups were compared in terms of the student nurses’knowledge about the patients’diseases and the degree of patients’satisfaction with their nursing work.Result The experiment group was significantly better than the control one in terms of student nurses’knowledge about the patients’diseases and the degree of patients’satisfaction with their nursing work(both P<0.05).Conclusion The sickbed management system for the student nurses may not only enhance nurses’sense of responsibility for their work,but also improve the quality of nursing teaching and patients’ satisfaction with the nursing service.

Objective To explore the clinical efficacy of modified corneal ulcer debridement combining with anti-fungal agents in the treatment of keratomycosis(fungal corneal ulcer).Design Prospective case series.Participants Criteria for inclusion:1)fungal corneal ulcer was diagnosed under direct 10% KOH wet film microscopic examination;2)corneal ulcer located away from the center with superficial infiltration,or located in the center but in small size;3)depth of corneal infiltration was uncertain.From January,2007 to December,2009,141 cases of fungal corneal ulcer patients in Shandong Eye Institute affiliated to Qingdao Eye Hospital were recruited into this study.Methods All patients received modified corneal ulcer debridement including stripping off ulcer lesion as well as infiltrated tissue,and repairing ulcer fringe.For postoperative treatment,0.25% amphotercin B or 5% natamycin and 0.5% fluconazol eye drops were topically administrated with high frequency to the diseased eye.In the meantime,itraconalzole was orally taken as systematic treatment.Clinical efficacy of the above therapy was evaluated at last.Main Outcome Measurs Corneal ulcer infiltration,corneal epithelium reparation and recovery of vision acuity were closely observed following surgery.Results 10% KOH wet film examination showed that hypha was found in all of the 141 cases.The average time for postoperative follow-up was 29 days(from 14 to 60 days).All 141 cases of fungal corneal ulcer were completely healed,of which 127 cases were healed by taking corneal ulcer debridement surgery and anti-fungal medication,and the other 14 cases had to take penetrating keratoplasty(10 cases) or lameller keratoplasty(4 cases) due to uncontrolled infection.No recurrence was found during follow-up.The average time for healing in the 127 cases was 8.5 days,and among these cases,29 cases had a preoperative visual acuity below 0.05,80 cases between 0.05 and 0.3,and 32 cases between 0.3 and 1.0.Postoperative evaluation showed that 6 cases had a visual acuity below 0.05,42 cases between 0.05 and 0.3,93 cases(65.96%) between 0.3 and 1.0,and among 93 cases,81 cases(57.45%) had a visual acuity between 0.5 and 1.0.Conclusions The modified corneal ulcer debridement combining with anti-fungal agents has proved to be an effective treatment for fungal corneal ulcer.It greatly improves patient's visual acuity and shortens the disease duration.For cases of superficial or uncertain infiltration,corneal ulcer debridement enables better ulcer observation and provides guidance for further treatment.

Objective To explore the occurrence of surgical site infection(SSI)in patients in different levels of hospitals.Methods SSI among patients in 47 hospitals at 0:00-24:00 of May 16,2012 were investigated by medi-cal record reviewing,doctor inquiry,and bed-side visiting.Results A total of 5 977 surgical patients were investiga-ted,SSI prevalence rate was 1 .76%.SSI prevalence rate in secondary hospitals was higher than tertiary hospitals (χ2 =9.337,P =0.002);SSI prevalence rates in clean-contaminated and contaminated incision in secondary hospi-tals were both higher than tertiary hospitals (χ2 =4.315,8.129,both P <0.05);departments with high SSI preva-lence rates were general surgery,orthopedic,and neurosurgery;the major isolated pathogens were Escherichia coli , Staphylococcus aureus ,and coagulase negative Staphylococcus .Conclusion SSI rates of different types of incision and different departments are varied,corresponding prevention and control measures should be taken.