Objective To apply six sigma management method to optimizing flow,enhancing treatment quality,prolonging service life and decreasing purchase cost of the non-coated surgical instrument.Methods The treatment flow of the noncoated surgical instrument was optimized through five steps of six sigma method including defining,measuring,analyzing,improving and controlling.The treatment results before and after flow optimization were compared,analyzed and evaluated.Results The rates for corrosion and rejection were both decreased significantly after flow optimization,while the quality was increased obviously (P＜0.05).Conclusion Six sigma management method involved in the treatment of the non-coated surgical instrument saves purchase cost,enhances the efficiency of disinfection supply room and facilitates effective supervision and monitoring.

Objective To test the reliability and validity of CRIES-13(Chinese edition). The Children Revised Impact of Event Scale (CRIES-13) was recommened for diagnosing PTSD of children. Methods In the last third of the September 2008,according to the suffering condition,600 students were choosed who were fit for the research standard as subjects in two middle schools randomly. The viability of CRIES-13 was weighted by testretest reliability,Cronbach' s alpha,Split half reliability. The validity of CRIES-13 was analysed by content validity ,criterion validity,construction validity. Results In the test-retest reliability of CRIES-13, the Spearman correlation coefficient of total,intrusion factor,avoid factor,high warkening factor were 0.79, 0.75, 0.71, 0.75. Significant correlation were found among these scores. The Cronbach' s alpha of population was 0. 81. The Cronbach' s alpha of three factors was 0. 79 ( intrusion factor) , 0. 71 ( avoid factor), 0. 65 ( high awarkening factor). CRIES-13's split-half reliability was 0. 85. In the content validity test,the Spearman rank correlation coefficient between total score and each item was 0. 83 (intrusion factor), 0. 75 (avoid factor), 0. 85 (high awarkening factor). The correlation between intrusion factor and avoid factor was 0.63. The correlation between avoid factor and high awarkening factor was 0.41. The correlation between intrusion factor and high awarkening factor was 0.41. In struction validity, variance orthogonal rotation factor analysis was adopted and got three general factors. Their cumulative contribution to total variance was 55.52%. In the criterion validity test,significant correlation was found between intrusion factor and SDQ emotional factor and depression scale total score. Significant correlation was found between high awakening factor and SDQ emotional factor and depression scale total score. Conclusion The reliability and validity of CRIES-13 was good. It could be used extensively.

Objective The Children's Revised Impact of Event Scale (CRIES-13) is used for Screening PTSD of children. The reliability and validity of CRIES-13 is good. To research the demarcation points of CRIES-13 (Chinese version) based on the reliability and validity analysis,and to improve the useful value of the scale.Methods In late September 2008, according affected condition, students were choosed who were fit for the research standard as subjects in two middle schools. First,general questionnaire (self-writing) and CRIES-13 were applied to the subjects. Second, according to K-SADS-PL, physician carried out diagnosis meeting and evaluation to 310 students who were classified by stratified rand sampling. Critical point of CRIES-13 was divided by K-SADSPL. The assessment value of it were sensitivity, specificity, veracity, PPV, NPV. The right choice of division was measured by ROC curve. Results When the critical score was higher than 30, the score of Se ( 0. 833 ), Sp(0. 836) and NPV (0.97) was in the high level. Conclusion When the critical score is higher than 30, the scale have a good discrimination for PTSD, non-PTSD and it can be used extensively.

Objective To investigate the influence of the purging fire and removing toxin method on chemokines and adhesion factors related to vascular endothelialitis injury induced by toxin of trimeresurus stejnegeri bite.Methods ① Animal experiment:50 healthy New Zealand white rabbits were chosen.According to random numbers generated by statistical software,they were divided into normal control group,model group,low,middle and high dose Sheshang capsule groups,10 in each group.Trimeresurus stejnegeri bite model was replicated by injecting 0.75 mL/kg snake venom into subcutaneous tissues of rabbits' right hind legs.And the same volume of normal saline was injected into the rabbit in the normal control group.After the model was established for 6 hours,the rabbits in low,middle and high dose Sheshang capsule groups received 174,348 and 522 mg· kg-1 · d-1 of Sheshang capsule solution respectively (the content of capsules was dissolved in normal saline to make liquid with 17.4,34.8 and 52.2 g/L Sheshang solution respectively,so the volume of gavage of each group was 10 mL· kg-1 · d-1);in the model and normal control groups,the same amount of normal saline was given by gavage,once daily for consecutive one week.24 hours after the last gavage,the blood of the rabbits was collected through an auricular border vein and the serum was separated by centrifuge ready for use.Meanwhile,the whole abdominal aorta segment of the rabbit was harvested and kept them in liquid nitrogen ready for use.② Cell experiment:human umbilical vascular endothelial cell (HUVEC) was cultured with MEM for 24 hours.The solution was replaced and according to the random number generated by statistical software,the cells were divided into blank control group,model group and low,middle,high dose Sheshang capsule medicinal serum groups,10 wells in each group.Trimeresurus stejnegeri toxin cell model was reproduced by addition of 5 mg/L snake venom into the cell culture medium.After 6-hour culture,the cells of model group and blank control group received 10％ normal rabbit serum,and the cells of low,middle and high dose Sheshang medicinal serum capsule groups received serum containing 5％,10％ and 15％ drug,respectively.After culture for 72 hours,the cells were collected and the total RNA was extracted.The real-time fluorescent quantitative polymerase chain reaction (qPCR) was used to detect the levels of mRNA of interleukin-8 (IL-8),monocyte chemoattractant protein-1 (MCP-1),intercellular adhesion molecule-1 (ICAM-1) and vascular endothelial cell adhesion molecule-1 (VCAM-1) in the vascular endothelial cells of rabbit aorta abdominalis and human umbilical vein,and the content of serum E-select element (CD62E) was measured by enzyme linked immunosorbent assay (ELISA).Results In model group,the expression levels of mRNA in IL-8,MCP-1,ICAM-1,VCAM-1 and the content of CD62E were all increased significantly in the endothelial cells of rabbit aorta abdominalis and HUVEC compared with those in control group [when the mRNA expression levels of IL-8,MCP-1,ICAM-1 and VCAM-1 in normal and blank control group were all being 1,the mRNA expression levels (2-△ △Ct) of the above mentioned inflammatory factors and adhesion molecule in animal model group were 3.96 ± 0.39,3.07 ± 0.27,3.71 ± 0.26,3.94 ± 0.26,and the mRNA expression levels (2-△ △Ct) of the above mentioned inflammatory factors and adhesion molecule in HUVEC model group were 3.53±0.70,2.24±0.48,3.13±0.44,2.80±0.13,respectively,all P ＜ 0.01].The content of CD62E in serum was increased significantly in model group compared with that in normal control group (μg/L:1.31 ± 0.22 vs.0.82 ± 0.13,P ＜ 0.01),the mRNA expression levels of IL-8,MCP-1,ICAM-1 and VCAM-1 were decreased significantly in low,middle,high dose Sheshang capsule groups compared with those in model group in endothelial cells of aorta abdominalis of rabbits and HUVEC [abdominal aorta:IL-8 mRNA (2-△ △Ct) were 1.13 ± 0.19,1.26 ± 0.16,1.27 ± 0.17 vs.3.96 ± 0.39,MCP-1 mRNA (2-△ △ Ct) were 1.79 ± 0.24,2.22 ± 0.38,1.76±0.19 vs.3.07±0.27,ICAM-1 mRNA (2 △△Ct) were 2.05±0.11,1.68±0.09,2.37±0.48 vs.3.71±0.26,VCAM-1 mRNA (2-△△Ct) were 1.59±0.08,1.40±0.11,1.84±0.11 vs.3.94±0.26;HUVEC:IL-8 mRNA (2-△△Ct) were 2.33±0.59,2.82±0.82,2.51±0.77 vs.3.53±0.70,MCP-1 mRNA (2-△△Ct) were 1.59±0.35,1.48±0.36,1.54±0.29 vs.2.24±0.48,ICAM-1 mRNA (2-△△Ct) were 1.46±0.38,1.77±0.65,1.73±0.50 vs.3.13±0.44,VCAM-1 mRNA (2-△△Ct) were 2.49±0.24,2.18±0.19,2.45±0.24 vs.2.80±0.13,all P ＜ 0.05].The contents of CD62E were decreased significantly in middle,high dose Sheshang capsule groups compared with the content in model group (μg/L:1.01 ±0.14,1.04±0.13 vs.1.31 ±0.22,all P ＜ 0.01),but there were no statistical significant differences among the three drug group (all P ＞ 0.05).Conclusion The therapy of purging fire and removing toxin can treat vascular endothelial injury by inhibiting the inflammatory response induced by Trimeresurus stejnegeri bites.

OBJECTIVETo observe the effect of Bushen Huoxue Granule (BHG) on dopamine (DA) neurotransmitter and dopamine transporter (DAT) in the brain of patients with Parkinson's disease (PD) as an adjunctive therapy.

METHODSNinety-four PD patients were randomly assigned to two groups, 47 in each group. Madopar was given to all as the basic treatment group. The placebo was given to those in the control group while BHG was given to those in the treatment. The therapeutic course for all was three months. Before and after treatment DA levels in the brain of patients were detected by encephalofluctuograph (EFG) technique. Changes of DAT in the striatum of patients in the treatment group were detected by positron emission tomography (PET) and region of interest (ROI) analysis.

RESULTS(1) Before treatment the DA level was lower in the two groups than the normal value, showing significant difference (P < 0.01), but with no significant difference between the two groups (P > 0.05). After treatment the DA level obviously increased in the two groups, showing significant difference from that before treatment (P < 0.01). No significant difference existed in the DA level in the two groups when compared with the normal value (P > 0.05), but with significant difference between the two groups (P < 0.05). Better results were obtained in the treatment group than in the control group. (2) The DAT radioactive accumulation inside the striatum increased obviously in the treatment group after treatment. ROI analysis showed the total ratio of striatum/cerebellum before and after treatment was 1.86 +/- 0.32 and 2.61 +/- 0.53 respectively, showing statistical difference (P < 0.05).

CONCLUSIONBHG could improve the DA level of PD patients, and increasing DAT contents in the striatum, thus playing a role in effectively treating PD.

Aged ; Brain ; metabolism ; Dopamine ; metabolism ; Dopamine Plasma Membrane Transport Proteins ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease ; drug therapy ; metabolism ; Phytotherapy

OBJECTIVETo study whether acupressure could relieve urinary retention after radical hysterectomy in cervical cancer patients.

METHODSA randomized controlled prospective double-blinded trial was carried out in 107 urinary retention patients undergoing grade III radical hysterectomy. They were assigned to Group A (positive acupoints, 40 cases), Group B (negative acupoints, 32 cases) , and Group C (with no acupoints, 35 cases). All patients received protective 115 000 potassium permanganate sitz bath, 15 - 20 min each time, 3 times per day. Patients in Group A received acupressure at positive points [liniao point and Qihai (RN6)] combined points by syndrome typing [Guanyuan (RN4) , Zhongji (RN3) , Shenshu (BL23) , Zusanli (ST36), Sanyinjiao (SP6), and Taixi (K13)]. Patients in Group B received negative acupressure at sham-acupoints (for adjusting gastrointestinal functions). Patients in Group C only received conventional sitz bath. All medication was performed 3 times per day, 7 days as one therapeutic course, 21 days in total. The residual urine volume was detected. The recovery time for bladder function was recorded. The average residual urine volume was also recorded at day 7, 14, and 21.

RESULTSCompared with Group B and C, the time for ureter retention was shortened for mild and severe CKD patients in Group A (P <0. 01). The residual urine volume was also lessened for mild and severe CKD patients in Group A at day 7, 14, and 21 (P <0.01).

CONCLUSIONCervical cancer patients could relieve urinary retention by self-acupressure after radical hysterectomy.

Acupressure ; Acupuncture Points ; Female ; Humans ; Hysterectomy ; Prospective Studies ; Urinary Bladder ; Urinary Retention ; therapy ; Uterine Cervical Neoplasms ; therapy

The growth and development of plant is affected by environmental factors that include light,temperature and water. Many cis-elements that are response to these elicitors interact with transcription factors, and regulate the expression of target genes. It concludes by pointing out recent studies of cis-elements and transcription factors in the plant environmental response promoters, such as light, temperature and water inducible promoter. The molecular mechanisms of gene expression regulated by environmental factors was discussed. This is important to study the mechanisms that plant adapt the environment.

Objective To investigate the rule of the cerebral tissues aquaporin-4(AQP-4) expression in acute and chronic hepatic failure mice.To study the molecular biologic mechanism of the diffusion weighted imaging(DWI).Methods Sixty five male Sprague-Dawley rats were divided into 3 groups randomly,including acute(n=25),chronic hepatic failure(n=25)and control group(n=15). Thioacetamide(TAA)intraperitoneal injection produces the acute and chronic hepatic failure models.All rats in groups were examined with MR DWI.We Observed the distribution of abnormal signal on DWI.The DWI single values of top and lateral cortex of parietal lobe,peripheral region of lateral ventricle in the highest hyperintensity section of brain were measured.Blood ammonia values were examined.The pathologic and immuno-histochemistry and RT-PCR examination for brain specimen were performed.All date were analyzed with statistical methods.Results The mean values of blood ammonia were significantly different (P0.05).Conclusions Increase of the blood ammonia was the main cause for the brain energy metabolic abnormality and AQP-4 mRNA and protein expression.The hyperammonemia was the key factor in the occurrence and development of the hepatic brain edema.The abnormal findings in DWI signal could reflect the range and degree of the brain edema and AQP-4 protein expression.

Objective To study the clinicopathologieal features and expression of cyclin D1 and p53 in epithelial ovarian tumors,and to investigate the correlation between pathogenesis of ovarian cancer and epithelial borderline tumors.Methods Fifty four cases of ovarian borderline tumors and 45 cases of ovarian carcinomas from the People's Hospital,Peking University were reviewed retrospectively.The clinical data and pathological findings were analyzed.Immunohistochemical study of cyclin D1 and p53 was performed in all 99 cases.Results(1)In borderline tumors,the age of patients ranged from 14-82 (mean age=42.5)years.International Federation of Gynecology and Obstetrics(FIGO)stage of borderline tumors was stage Ⅰ in 48 cases,stage Ⅱ in 3 cases,and stage Ⅲ in 3 cases.In ovarian carcinomas,the age of patients ranged from 26-80(mean age=53.5)years.FIGO stage of carcinoma was stage Ⅰ in 6 cases, stage Ⅱ in 8 cases,stage Ⅲ in 26 cases,and stage Ⅳ in 5 cases.In follow-up of 54 cases with borderline tumors the 5-year survival rate was 98% and of 45 cases with carcinomas a 5-year survival rate of 51% was noted.(2)In 54 cases of borderline tumors,mucinous types accounted for 56%(30/54)and serous types accounted for 30%(16/54).There were 5 cases with micropapillary pattern,3 cases with peritoneal implants,3 cases with lymph node involvement,6 cases with microinvasion,one case with intraepithelial carcinoma,and one case with mural nodules.In 45 cases of carcinomas,serous carcinoma was the most (49%,22/45).The remainder included 3 cases of mucinous types,8 cases of endometrioid types,6 cases of transitional cell types,3 cases of mixed phenotype and 3 cases of undifferentiated types.(3) Overexpression of cyclin D1 and p53 was observed in 31%(14/45)and 56%(25/45)of ovarian carcinomas, respectively.There was a significant association between p53 overexpression and tumor grade.In the borderline tumor group,69%(37/54)had overexpression of cyelin D1 and 6%(3/54)had overexpression of p53.There were significant differences in expression of cyclin D1 and p53 between conventional serous borderline tumors and high-grade serous carcinomas(cyclin D1:91% vs 26%;p53:0 vs 58%).However, micropapillary serous borderline tumors and low-grade serous carcinomas showed remarkably similar expression of cyelin D1 and p53.Conclusions Epithelial ovarian borderline tumors are distinct from ovarian cancer in clinical progress and prognosis,and histological types.Overexpression of cyclin D1 is common in ovarian borderline tumors and low grade carcinomas.And overexpression of p53 is more common in high grade ovarian carcinomas.Conventional serous borderline tumors are distinct from high-grade serous carcinomas in pathogenesis.Micropapillary serous borderline ovarian tumors may be closely related to low grade serous carcinomas.

Objective To retrospectively analyse pathogenic bacteria isolated from inpatients with lupus erythematosus (SLE) and lupus nephritis (SLE‐LN ) ,and provide references for diagnosis and treatment for these patients with infection . Methods A total of 380 inpatients diagnosed with SLE/SLE‐LN in our hospital from 2010 to 2014 were enrolled in this study ,in‐cluding 96 cases of patients with SLE‐LN .Bacterial inoculation ,culture ,isolation ,identification and drug sensitivity test were carried out .Statistical analysis and susceptibility analysis was performed by using the SPSS 19 .0 and WHONET5 .6 software .Results For patients with SLE and SLE‐LN ,urinary tract infection accounted for 25 .0% and 27 .1% ,hematogenous infection accounted for 8 .1% and 10 .4% ,skin tissue infection accounted for 12 .0% and 8 .3% ,respectively .The most common gram negative bacteria was Escherichia coli ,which accounted for 25 .53% and 30 .21% in patients with SLE and patients with SLE‐LN ,respectively .Followed by Bauman Acinetobacter ,which accounted for 13 .42% and 14 .54% in patients with SLE and patients with SLE‐LN ,respectively . The most common gram positive bacteria was Staphylococcus aureus ,which accounted for 11 .58% and 11 .46% in patients with SLE and patients with SLE‐LN ,respectively .Strains of Escherichia coli were isolated from urine specimens of 69 .79% of patients with SLE and 66 .67% patients with SLE‐LN ,the percentages were significantly higher than that of the conventional urine culture (45% ,P< 0 .01) .The resistance rate of Escherichia coli strains isolated from patients with SLE to quinolones was higher than 66 .00% ,the resistance rate to ampicillin was 89 .69% ,and the resistance rate to piperacillin/tazobactam was low (3 .09% ) .The iso‐lation rates of ESBLs‐producing Escherichia coli strains and ESBLs‐producing Klebsiella pneumoniae strains in patients with SLE‐LN were higher than those in patients with SLE .Conclusion The patients with SLE have a higher risk for infection .The beta‐lac‐tams could be used for the treatment of Escherichia coli urinary tract infection in patients with SLE .