The application of the Six Sigma working methods is introduced in the use and maintenance of monitor.By using Six Sigma working methods,the needs of clients are researched,and improved method are put forward.A solution to lower the failure rate of monitor is suggested,and the various causes are analyzed.By the comparison between the fore-and-aft situations,desired effect is obtained with improved work efficiency and better economic and social benefits.

Objective To detect the infection rate of human papillomavirus (HPV) types in keratoacanthoma (KA) tissue, and to study the distribution of HPV DNA-positive cells. Methods In situ hybridization was performed to detect HPV subtypes 6/11, 16/18, and 31/33 in paraffin-embeded tissue samples from 46 patients with KA and 34 nomal human controls. Results Mucosal HPV DNA was positive in 31 (67.39%)of the 46 KA samples, and mixed infection rate of HPV amounted to 83.87% (26/31) in these positive samples.The DNA of tested mucosal HPV types existed mainly in episomal status. Positive reactions were observed within or at the edge of nuclei. HPV infected cells showed a stripe-, slice-like or focal distribution mainly in superficial middle lamina of spinous layer at the bottom or lateral margin of crater-shaped epidermal depression. No mucosal HPV DNA was noted in normal control samples. Conclusions Compared with normal controls, patients with KA are infected with mucosal HPV at a higher frequency, and mucosal HPV DNA mainly exists in episomal status in KA tissue, hinting that HPV infection play a certain role in the pathogenesis of KA.

Objective To investigate the regulatory effects of hedgehog pathway on intestinal epithelial barrier function under hypoxia.Methods The IEC-6 cells of rats were divided into 3 groups:the normoxia group (21％ oxygen concentration),the hypoxia group (2％ oxygen concentration) and the hypoxia + cyclopamine group (cells pretreated by 5 mmol/L of cyclopamine,and then exposed in an atmosphere with 2％ oxygen concentration).The mRNA expressions of IHH,PTCH and GLI-1 were detected,and the transepithelial electrical resistance (TER) was determined.The protein expressions of tight junction proteins (ZO-1,Occludin,Claudin-1) and IHH were assayed by using the Western blot.All data were analyzed using the one-way analysis of variance or LSD-t test.Results The relative mRNA expressions of IHH,PTCH and GLI-1 were 0.056 ± 0.009,0.459 ± 0.087,0.142 ± 0.023 in the normoxia group,and 0.303 ± 0.052,0.678 ± 0.073,0.483 ± 0.061 in the hypoxia group,with significant difference between the 2 groups (t =-14.05,-11.85,-6.52,P ＜ 0.05).The relative protein expressions of IHH in the normoxia group and the hypoxia group were 0.39 ±0.06 and 0.91 ±0.15,with a significant difference between the 2 groups (t =-8.08,P ＜ 0.05).The TERs of the normoxia group,the hypoxia group and the hypoxia + cyclopamine group were (134 ± 5) Ohm/cm3,(100 ± 6) Ohm/cm3 and (118 ± 5) Ohm/cm3,with significant difference between the 3 groups (F =1.04,P ＜ 0.05).Compared with the normoxia group,the TER of the hypoxia group was decreased by 27.7％ (t =7.84,P ＜ 0.05) ; compared with the hypoxia group,the TER of the hypoxia + cyclopamine group were increased by 16.4％,but it was still significantly lower than the normoxia group (t =4.23,P ＜ 0.05).The expressions of ZO-1,Occludin and Claudin-1 were 1.18 ± 0.24,0.80 ±0.13 and 0.90 ±0.09 in the normoxia group,and 0.58 ±0.08,0.32 ±0.05 and 0.50 ±0.09 in the hypoxia group,and 0.92 ± 0.21,0.43 ± 0.10 and 0.82 ± 0.11 in the hypoxia + cyclopamine group,with significant difference between the 3 groups (F =4.95,2.88,10.09,P ＜0.05).The expressions of ZO-1,Occludin and Claudin-1 in hypoxia group were decreased by 48.7％,40.0％ and 55.6％ when compared with the normoxia group (t =12.86,9.35,18.90,P ＜0.05).The expressions of ZO-1,Occludin and Claudin-1 in the hypoxia + cyclopamine group were increased by 59.9％,35.2％ and 65.1％ when compared with the hypoxia group (t =5.63,2.92,6.66,P ＜ 0.05).Conclusion Hedgehog signal pathway could be activated under hypoxia,and then the expressions of tight junction proteins are decreased,which finally induces the injury of intestinal epithelial barrier function.

Objective To assess the diagnostic significance of T cell receptor gamma gene rearrangemerits in mycosis fungoides (MF), so as to develop a sensitive diagnosis tool. Methods A total of 50 specimens were collected, including 33 skin lesion specimens and 2 lymph specimens from 30 patients with MF,15 skin lesion specimens from 15 patients with inflammatory dermatoses. PCR was performed with specific primers targeting TCR V gamma 8, 9, 10, 11 to detect T cell receptor gamma gene rearrangement. Results Monoclonai rearrangements of TCR gene was observed in 88% (29/33) of specimens from patients with MF and 33% (5/15) of samples from patients with inflammatory dermatoses. Conclusions The detection of TCR gene rearrangements, as an ancillary test, is useful in the diagnosis and differential diagnosis of MF.

Objective:To study the collapse of the contralateral femoral head after the total hip arthroplasty (THA) in patients with bilateral steroid-induced femoral head necrosis leg-length discrepancy (LLD) influences.Methods:A total of 108 patients with bilateral steroid-induced femoral head necrosis who were treated in Honghui Hospital Affiliated to Xi′an Jiaotong University from June 2014 to June 2016 underwent THA surgery on the hip joints that had symptoms and developed to Association Research Circulation Osseous (ARCO) Ⅲ. At the same time, the non-surgical hip-preserving treatment of the non-collapsed femoral head developed to the ARCO Ⅱ stage was performed. The follow-up period was 2 years, and 98 cases were finally included. According to the size of the leg-length discrepancy [LLD<3 mm group ( n=50), LLD≥3 mm group ( n=48)] and the type of leg-length discrepancy[non collapse side longer group ( n=58) and shorter group ( n=58)], the collapse of the femoral head and the THA were observed. Results:Finally, a total of 56 cases of femoral head collapse occurred in the non collapse side of the hip, of which 50 cases underwent THA within 24 months. There were significant statistical differences in THA and femoral head collapse between LLD<3 mm group and LLD≥3 mm group, non collapse side longer group and non collapse side shorter group ( P<0.05). The 2-year survival rate without collapse in the LLD<3 mm group and LLD≥3 mm group were 52.1% and 34.0%, respectively, and the 2-year survival rates in the longer and shorter non-collapsed limb groups were 56.9% and 22.5%, respectively. Compared with patients with moderate lesions, the survival rate of femoral heads in patients with larger lesions was lower ( OR: 4.25, 95% CI: 1.55-11.26; P=0.003). LLD<3 mm group ( OR: 0.24, 95% CI: 0.06-0.50; P<0.01) or non collapse side longer group ( OR: 0.13, 95% CI: 0.04-0.29; P<0.01) had lower risk of contralateral femoral head collapse after THA. Conclusions:For patients with bilateral steroid-induced femoral head necrosis who have collapsed lateral THA, postoperative leg-length discrepancy extremities is a potential risk factor for collapse of non-collapsed femoral head. LLD<3 mm and avoiding shortening of the uncollapsed limb may reduce the risk of collapse of the uncollapsed femoral head.

Objective To explore the therapeutic efficacy of nanometer high-frequency square pulse light technology targeting kidney cancer.Methods Fifty BALB/c nude mice were vaccinated with human ACHN cell line and randomly divided into 1 control group and 4 therapeutic groups.The 4 therapeutic groups were cured with high-frequency square pulse light and nanometer high-frequency square pulse light.The treatment cycle was 4 weeks.The tumor growth condition and tumor-repres-sion change were observed and compared.Results The tumor volumes of the control group in-creased obviously,whereas the tumor volumes of the therapeutic groups decreased obviously or in-creased gently.The mean tumor volume and the tumor growth curve of the therapeutic groups were significantly lower than those of the control group(P＜0.05),but there was no significant difference between the therapeutic efficacy of the kidney cancer using high-frequency square pulse light and nanometer high-frequency square pulse light(P＞0.05).Synteresis of kidney carcinogenesis experiments results indicated that using high-frequency square pulse light and nanometer high-frequency square Dulse light could prevent the production and development of the kidney cancer(P＜0.05),but the svnteresis efficacy of the 2 methods had no obvious difference(P＞0.05).Conclusion Using highfrequency square pulse light and nanometer high-frequency square pulse light can cure the kidney cancer and,to some extent,prevent the production and development of kidney cancer.

OBJECTIVETo study the value of clinical application and distribution character of regional pulmonary ventilation of patients with various type of pneumoconiosis.

METHODS132 patients with various type of pneumoconiosis were observed by electric impedance pneumograph(EIPV) and routine lung function test. The results were compared with the measured value of 100 healthy cases.

RESULTSThe regional pulmonary ventilation of the three kinds of pneumoconiosis(founder's pneumoconiosis, silicosis and asbestosis) was increased in both side of upper pulmonary region and decreased in both of lower pulmonary region. The ventilation distribution showed that the right pulmonary ventilation increased predominantly, accounted for 53.03% (70/132) of total lung ventilation. There was significant difference(P < 0.01) compared with the normal healthy men's EIPV, but no difference(P > 0.05) among various type of pneumoconiosis. There was also no difference(P > 0.05) between pneumoconiosis patients with normal ventilation function and various type of ventilation obstacle of pneumoconiosis. One silicosis patient complicated by atelectasis of the left upper lobe, another silicosis patient complicated by lung cancer and their EIPV accorded with their chest X-rays.

CONCLUSIONEIPV could not be measured by routine lung function test. It may be the supplement to latter parameter and as a substitute for radio imaging of pulmonary ventilation in pneumoconiosis complicated by other regional pulmonary disorder.

Objective To evaluate the effect of small-dose ketamine on the onset time and course of modified electroconvulsive therapy (MECT) in mentally depressed rats.Methods Sixty SPF adult male SpragueDawley rats,aged 2-3 months,weighing 220-250 g,were randomly divided into 6 groups (n =10 each) using a random number table:normal control group (group C),depression group (group D),ECT group,propofol + ECT group (group PE),ketamine + ECT group (group KE) and ketamine + propofol + ECT group (group KPE).The depression model was established by chronic unpredictable mild stress (CUMS).Mter CUMS,C,D and ECT groups received intraperitoneal normal saline 8 ml/kg,group PE received intraperitoneal propofol 100 ml/kg,group KE received intraperitoneal ketamine 10 ml/kg,and group KPE received intraperitoneal ketamine 10 ml/kg + propofol 80 ml/kg.All the groups received ECT once a day for 7 consecutive days starting from the time point when righting reflex was lost except C and D groups.Open-field test was performed before CUMS,at 1 day after CUMS and at the end of each ECT (T0 8).The total distance and the number of standing on the back legs were recorded.Morris water maze test was performed at 2 days after CUMS and 1 day after the end of therapy,and the escape latency and time of staying at the original platform quadrant were recorded.Results Compared with group C,the total distance was shortened and the number of standing on the back legs was reduced,the escape latency was prolonged,and the time of staying at the original platform quadrant was shortened at T1-8 in D,ECT,PE and KE groups and at T1 5 in KPE group,and no significant was found in KPE group in the total distance,number of standing on the back legs,escape latency,and time of staying at the original platform quadrant at T6-8.Compared with group D,the total distance was prolonged and the number of standing on the back legs was increased at T6-8 in ECT and PE groups and at T4-8 in KE and KPE groups,the escape latency was prolonged,and the time of staying at the original platform quadrant was shortened in ECT group,and the escape latency was shortened,and the time of staying at the original platform quadrant was prolonged in KPE group.Compared with ECT and PE groups,the total distance was prolonged and the number of standing on the back legs was increased at T4-7 in group KE and at T4-8 in group KPE,and the escape latency was shortened,and the time of staying at the original platform quadrant was prolonged in KPE group.Compared with group KE,the total distance was prolonged and the number of standing on the back legs was increased at T6.7,the escape latency was shortened,and the time of staying at the original platform quadrant was prolonged in KPE group.Conclusion Small-dose ketamine can shorten the onset time and course of MECT in mentally depressed rats.

10.3969/j.issn.1007-3969.2013.05.006

Objective:To explore the effect of applying standardized patient teaching based on Calgary-Cambridge communication model in nurse patient communication training for junior college interns, and to enrich the teaching methods of nurse patient communication training in domestic medical institutions.Methods:This study was a quasi-experimental study. In July 2022, 78 students were selected from 335 junior college interns in the First Affiliated Hospital of Shandong First Medical University by random coding method, and were randomly divided into the experimental group (39 students) and the control group (39 students) by lot. The control group received routine training. The experimental group received standardized patient teaching based on Calgary Cambridge communication model: teaching the key points of communication, guiding demonstration based on Calgary Cambridge communication model, and guiding reflection and exploration. The nurse patient communication ability, nurse patient communication practice skills, communication self-efficacy, and teaching satisfaction of the two groups of interns were compared between the two groups after 8 weeks of training.Results:After training, the total score of nurse patient communication ability evaluation in the experimental group was (91.41 ± 5.35) points, higher than that in the control group (88.08 ± 7.40) points, there was significant difference ( t=2.24, P<0.05); after training, the communication self-efficacy score of the experimental group was (30.21 ± 4.28) points, higher than that of the control group (27.94 ± 5.09) points, there was significant difference ( t=2.09, P<0.05); the total score of communication practice skills in the experimental group was (173.59 ± 18.48) points, higher than that in the control group (158.44 ± 15.57) points, there was significant difference ( t=3.82, P<0.05); the total score of communication teaching and training satisfaction in the experimental group was (16.77 ± 2.94) points, higher than that in the control group (15.22 ± 1.90) points, and there was significant difference ( t=2.68, P<0.05). Conclusions:The standardized patient teaching based on Calgary Cambridge communication model can effectively improve the practical skills of nurse patient communication of junior college interns, and promote the improvement of their nurse patient communication self-efficacy, which is conducive to the improvement of nurse patient communication ability junior college intern.