In recent years , lean management has been applied to hospital management from industrial management .This arti-cle cultivatesthe idea of administratorfrom innovative awareness and quality view aspect .The daily medical management was improved by consummating the rules and regulations , the implementation of structured electronic medical record system management , and the estab-lishment of a feedback mechanism .In the aspect of advanced ideas , psychological intervention , and harmonious culture to create a people-oriented atmosphere , etc.lean management was implied to improve work efficiency and quality control .

Objective To learn the extent to which the inpatients perceive the surgical operations to take,for the purpose of safeguarding inpatients' legitimate rights.Methods 1753 inpatients were surveyed with cluster sampling and individual interview,and their medical records were studied to learn their perception of the surgery and the completion of their surgery consent.Results Problems found include poor perception of the operation and poor completion of the surgery consent; significant differences(P＜0.01)are found in their perception of the risk and the complications,as well as their perception of options,and supervision of pre-surgery talks.Conclusion It is imperative to improve the completion of the surgery consent and supervision of the pre-surgery talks,and to provide medical workers with better legal education,for better protection of inpatients' legitimate rights.

Objective To investigate the expression of P16 and CD44 in gastrointestinal stromal tumors (GIST) and their relationship with the prognosis of patients. Methods The GIST specimens of seventy patients who received surgical excision were collected. Tissue microarray of the seventy GIST samples was constructed. The expression of P16 and CD44 were detected by the immunohistochemical staining. The patients were followed up via out-patient examination and telephone. Results All the patients were followed up for 2-212 months, and the median time for follow-up was 68 months. The differences of the expression of P16 in GISTs among NIH risk ranks were insignificant (P > 0.05). The differences of the expression of CD44 in GISTs among NIH risk ranks were statistically significant (P < 0.05). Univariate analysis showed that tumor size, mitotic count, tumor location, NIH risk rank, the expression of P16 and CD44 were related to the prognosis of GIST patients. Multivariate showed that tumor size, mitotic count, tumor location, and the expression of CD44 was independent prognosis factors of GIST patients. Conclusion CD44 could be used as a biomarker in predicting the prognosis of GIST patients.

Objective To establish a cell model expressing the Langerhans cell-specific C type lectin receptor Langerin in vitro.Methods The cDNA of Langerin was obtained by PCR and cloned into a eukauotic green fluorescent protein (EGFP) expression vector pEGFP-C 1 with EGFP located in the N terminal region of the Langerin gene.Then,the recombinant plasmid was transfected into a human embryonic kidney carcinoma cell line HEK293T.Subsequently,laser confocal microscopy was performed to observe the expression of EGFP-Langerin fusion protein,and flow cytometry to measure the expression of Langerin.Laser confocal microscopy was also conducted to visualize the recognition and endocytosis of dust mite antigen (nDer p 2) by Langerin.Results PCR and Western blot confirmed the successful transfection of HEK293T cells with the recombinant plasmid as well as the expression of Langerin in the transfected cells.As flow cytometry revealed,the expression level of Langerin in transfected HEK293T cells was increased by 43％ compared with untransfected cells.Laser confocal microscopy showed that green fluorescein-labeled Langerin was successfully expressed,and could bind to and endocytose the red fluorescein-labeled antigen nDer p 2.Conclusions The fusion protein EGFP-Langerin expressed in HEK293T cells showed the distribution characteristic of cell surface receptors,and could bind to and endocytose allergens.

The nutrition and food hygienic character of the degreased castor protein in Neimeng autonomous region were studied by chemical analysis and rat experiment. Using casein as reference protein and soy flour as comparable substance, the contents of major nutrients and composition of essential amino acids in the degreased castor cake and its protein efficiency ratio (PER) and other indicators related to nitrogen metabolism in the animal experiment were studied by the recommended method of AOAC. Some harmful substances in the samples were examined quantitatively. The results showed that the protein content, the PER, the true digestibility, the biological value, and NPU of the degreased castor cake were 35.80%, 1.75-1.76, 62.51%, 91.16 and 57.04 respectively. The blood indicators and pathological observation of tested rats were normal. The content of several harmful substances in the product was allowable. The essential amino acid composition of the degreased castor protein was similar to soy protein. So the detoxified degreased castor cake protein could be used in food or feed industry.

OBJECTIVE To investigate the ESBLs-producing isolates and their resistance and genotypes in Escherichia coli and Klebsiella in three hospitals of Wannan area.METHODS The MIC of 13 antimicrobials against 79 strains of E.coli and Klebsiella were determined by 2-fold agar dilution method.The confirmation test was used to detect ESBLs-producing strains according to CLSI 2005.PCR method was used to amplify beta-lactamases of ESBLs-producing isolates by 8 premiers,PCR products were purified and then sequencing was performed.RESULTS The ESBLs-producing rates in E.coli and Klebsiella in three hospitals of Wannan area were 61.5% and 45.0%,respectively.The resistance rates to CRO,CTX,CAZ,CIP and LEV of ESBLs-producing strains were 81.0%,81.0%,47.6%,71.4% and 50.0%,respectively,all isolates were susceptible to meropenem and imipenem.PCR indicated that CTX-M1,CTX-M13,TEM and OXA1 types of beta-lactamases were the four major genotypes of the three hospitals in Wannan area.CONCLUSIONS The isolation rates of ESBLs-producing E.coli and Klebsiella as well as their resistance rates to cephalosporins and quinolones in the three hospitals in Wannan area are quite high.Monitoring ESBLs-producing isolates should be strengthened in clinic and laboratory.

Intestinal microecology is an important and complex biological system necessary for human health.Its disorder is involved in the development of various diseases of human body.The technology of intestinal microbiota transplantation can effectively regulate the intestinal flora,repair the imbalance of the intestinal microecology,and bring a new breakthrough for the treatment of many diseases of gastrointestinal tract and outside gastrointestinal tract.However,there is still no systematic and complete management standard for intestinal microbiota transplantation technology.This paper discussed related content involved in standardized management of intestinal microbiota transplantation technology and reflected the ethical problems involved in standardized management from the perspective of medical ethics,in order to promote the clinical application of intestinal microbiota transplantation technology.

Objective To investigate the effects of gabapentin(GBP) on plasma β-endorphin(β-EP) level in the patients with painful diabetic neuropathy(PDN). Methods We detected the plasma β-EP level in 24 PDN patients in the treatment with GBP, 18 PDN patients without GBP treatment, 20 diabetic mellitus patients without PDN and 24 healthy control subjects. Results (1)The level of β-EP in diabetic mellitus patients was lower than in the healthy control(P<0.01). (2)The patients who received GBP had a significant change of β-EP level after treatment(P<0. 01).. Conclusions Gabapentin is effective for the treatment of PDN and its adverse effects are mild. It can lower the plasma β-EP level in the patients with PDN.

[ABSTRACT]OBJECTIVEThis study aims to explore the molecular mechanism and expression of Wnt/β-catenin signaling pathway and tumor marker CD44 in nasopharyngeal carcinoma cells after transfection withβ-Catenin when the Wnt/β-catenin signaling pathway was blocked.METHODSSP cells and CD44+SP cells isolated from the nasopharyngeal carcinoma cell line CNE-2 by flow cytometry were identified. Changes in the number and biological characteristics of CNE-2 and CD44+SP cells in vitro were investigated after the Wnt/β-catenin signaling pathway was blocked through siRNA.RESULTSSP cells accounted for 2.3% of nasopharyngeal carcinoma CNE-2 cells, andCD44+SP cells accounted for 36.5% of the SP cells. CD44+SP cells showed significantly higher in vitro proliferation and resistance to chemotherapy (P<0.05). After transfection withβ-Catenin siRNA, the proliferation, cloning efficiency, and tolerance to chemotherapeutic drugs of the cells were found statistical differences compared with those before transfection ofβ-Catenin siRNA. CONCLUSIONWnt/β-catenin signaling pathway abnormalities are closely related to the biological behavior of nasopharyngeal carcinomaCD44+SP cells. Interference of this pathway can change the characteristics of nasopharyngeal carcinoma stem cells.

In present paper, research achievements of post-harvest handling concerning decorticating, boiling, sul-fur-fumigation, drying and sterilizing as well as quality control of Radix Paeoniae Alba were reviewed. Major prob-lems in the post-harvest handling and quality evaluation of Radix Paeoniae Alba were discussed. Strategies for im-provement in post-harvest handling and quality control were proposed, so that the safety and quality consistency can be assured in the medicinal application of Radix Paeoniae Alba.