ObjectiveTo study the application of lean management in operation processing of central sterile supply department(CSSD)in order to promote its efficiency and quality improvement.MethodsFrom collecting international and domestic related literatures of lean thoughts, lean medical management, summarizing and introducing the application of lean management in medical domain, discussing the implementation of lean management in CSSD.ResultsThe implementation of lean management was ensured to be successful through establishing value stream mapping, mobile operation, waste elimination, obtaining support of top management, reforming of organization construction, placing personal and technological operation.ConclusionsThe flow of operation can be improved, the business model will be re-build and the efficiency and quality of CSSD can be improved by establishing the value stream mapping in CSSD and using the information technology.

Objective:To study the transdermal permeability of Psoralen (Pro) and Isopsoralen (Isopro). Methods:V C two compartment was adopted to research the permeability deferences between Pso and Isopso in nude mouse skin in vitro, and investigated the effect of penetration enhancers, such as EtOH, azone and glycerol on the permeability of them. Results: Pso and Isopso are suitable compounds for transdermal delivery system and the permeability coeffient of Isopso is larger than that of Pso. 10% EtOH-1% Azone greatly increased the permeability coefficient. Conclusion: The results can offer reference for Psoralea corylifolia TDS.

Objective: To study the effects of clarificant chitosan on contents of zinc,manganese,calcium and heavy metal lead in the water extraction liquid of chinese herbal medicines. Methods: The contents of these elements were determined by atomic absorption spectrophotometry.Results: The results indicated that the chitosan clarification could raise the transfer rate of some inorganic elements such as zinc,manganese and calcium as compared with water extraction and alcohol precipitation method,And it could also reduce the amount of heavy metal lead.Conclusion: chitosan as a clarificant is promising in the field of refining water extraction liquid of chinese herbal medicines.

Object To study the degree of deacetylation of chitosan and its residual amount left over in the clarified products when chitosan was used as a clarificant. Methods The free amino group in the deacetylated chitosan was determined by linear titration. Results The degree of deacetylation of chitosan was found to be about 80%. The residual amounts left over in the clarified products were lower than 10 -4 . Conclusion The results suggested that it is feasible to use chitosan as a clarificant for refining water extract of TCM.

Objective To investigate the effects of sodium aescinate(SA)on oxidative stress and pulmonary function during acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods One hundred and twenty patients with COPD were randomly divided into two groups:the control group(n =60) and the treatment group(n =60).All patients were treated with routine anti-infection,oxygen inhalation,relieving phlegm and anti-asthma The treatment group took SA in addition to the routine beteropathy.The changes of serum SOD,MDA,GSH-Px,T-AOC,pulmonary functions and 6 minute walk distance(6MWD) were detected before and after two-week treatment in patients of the two groups to compare with 60 healthy subjects.Results The total effective rate in the treatment group was 91.67％,while 76.67％ in the control group.The difference was statistically significant(x2 =5.065,P ＜0.05).Serum MDA level in both groups were comparatively higher than the healthy controls(9.25±1.55) μmol/L vs.(9.74±1.50) μmol/L vs.(2.06±0.29) μmol/L,P ＜0.001),while the levels of SOD,GSH-Px and T-AOC were lower than the healthy controls[SOD:(91.14±9.54) kU/L vs.(90.61±8.01) kU/L vs.(116.63±6.57) kU/L; GSH-Px:(139.38±36.56) U vs.(137.57±34.19) U/L vs.(189.34±35.54) U/L; T-AOC:(6.48±1.15) kU/L vs.(6.39±1.13) kU/L vs.(13.34±1.23)kU/L;P < 0.001].After treatment,all indexes of the two groups were obviously ameliorated in comparison with before treatment(P ＜ 0.001),but the level of MDA[(4.56±1.39) μmol/L]in the treatment group decreased more greatly than in the control groups(P ＜ 0.001).The levels of SOD[(103.85±7.07) kU/L],GSH-Px[(169.65±34.51) U/L],T-AOC[(10.52±1.09) KU/L],forced expiratory volume in 1 second/forced vital capacity(FEV1/FVC)[(60.49±6.11)％],FEVI％[(76.62±6.35)％]and 6MWD [(394.83±10.11)m]increased considerably more than those in the control group(P ＜ 0.001).Conclusion Oxidative stress might be involved in the course of acute exacerbation of COPD.Sodium aeseinate can improve the pulmonary functions by ameliorating the oxidative stress during acute exacerbation in patients with COPD.

Objective To explore the effect of inflammation and autoimmunity in peripartum cardiomyopathy(PPCM). MethodsA total of82 PPCM patients and 100 normal delivery patients were randomly selected and conducted epidemiological survey.High-sensitivity Creaction protein(hs-CRP),troponin I,human antimyocardial antibody IgG(AMA-IgG),Coxsackie B virus IgG(CBV-IgG)and adenovirus antibody IgG(ADV-IgG)were detected with ELISA. ResultsCompared with control group,PPCM patients had older age,higher pressure,higher proportion of cesarean section and infection.The levels of serum hs-CRP,cTNI,and leucocyte were markedly higher in PPCM patients compared with control.The positive proportion of AMA-IgG and CBV-IgG was significantly increased(P<0.01)in PPCM patients compared with the control.Logistic regression showed that infection(OR=2.87,95%CI 1.15-5.24),increased hs-CRP(OR=1.86,95%CI 1.08-4.02)and positive AMA-IgG(OR=2.68,95%CI 1.19-4.85)were independent risk factors for PPCM. ConclusionsInflammation and autoimmunity play an important role in peripartum cardiomyopathy.

In view of the new situation in rapid variation with food safety and nutrition, and an urgent need of the practical talents in China, this study proposes corresponding reforming measures in improving teaching principle, teaching content, teaching methods, teaching equipment, teaching evalu-ation and training teachers.

Objective To investigate colloidal gold immune chromatography (GICA ) and enzyme linked immunosorbent assay (ELISA) detection pepsinogen (PG) consistency of results ,so as to provide experimental evidence for the use of colloidal gold im‐munochromatography assay PG and briefly analysis of its clinical utility .Methods Totally 40 cases in our hospital digested samples and medical centers 60 healthy population sample in Endoscopy Center by endoscopy diagnosed with inflammation of the stomach disease ,respectively ,with colloidal gold immune chromatography and enzyme‐linked immunosorbent assay PG ,colloidal gold immu‐noassay chromatography method to be evaluated ,as the reference ELISA method .The results were compared to the method and bias analysis .Results GICA method with a correlation coefficient ELISA test results were greater than 0 .95 ,indicating a good correla‐tion between the two methods and there is no overall bias;sensitivity and specificity of the two methods were (0 .775 ,0 .85) and (0 .782 ,0 .823) .Conclusion Both GICA and ELISA can be used for screening or diagnosis of stomach illnesses .

Objective To explore the short to long term surgical outcomes and treatment experiences of esophageal atresia（EA）.Methods The clinical data of EA inpatients in our hospital from 2006 to 2009 were reviewed retrospectively.The birth weight,main associated anomalies,details of management,complications and outcomes were discussed.Main risk factors were evaluated with major prognostic classification systems.Results Totally 48 consecutive infants with EA were identified from 2006 to 2009,male 33（69%）,female 15（31%）.Mean birth weight was 2 668 g（range 1 700 g to 3 800 g）.All received primary operation.Complications included pneumonia,anastomotic leakage（16%）,tracheoesophageal fistula,incision sepsis（11%）,delayed tracheoesophageal fistula（7%）,stricture（10%）,and gastroesophageal reflux（GER）（67%）.Mortality was 12.5%,mainly due to severe pneumonia and complex cardiac anomalies.Conclusion Most patients with esophageal atresia could be cured after primary operation with excellent outcomes.The main factors for mortality were complex cardiac anomalies,aspiration and pneumonia.The main mid-term complications were GER and stricture.