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 observe the relationship between impaired glucose regulation(IGR)and the degree of atherosclerosis(AS)on Lacunar Infact(LI)patients.Methods A total of 83 patients with LI confirmed by CT or MRI were collected and divided into 3 groups by their fasting blood glucose,and their medical history and physical examination,the fasting blood lipid,acidum uricum and INI profile were evaluated with an automatic biochemistry machine.By employing a high resolution B-mode ultrasonography the intimae smoothness,intimae-media thickness(IMT)and plaque(s)were observed in bilateral common carotid arteries.Results The hypertension history,smoke history,waistline body mass index(BMI)and the atherosclerosis were all more marked in subjects with IGR than those in NGT(all P

Objective To explore the effect of suction toothbrushing in oral care of patients with dysphagia.Methods sixty patients with dysphagia from the neurology department and rehabilitation department in our hospital were equally divided into the experiment group and the control group randomly: the former used suction toothbrushing for oral care and the latter physiological saline for oral care.The two groups were compared in respect of bad breath,oral cleanliness,time for conducting oral care,stomatitis, oral ulcer and pathogenic bacteria in oral cavity.Results The time for conducting oral care in the experiment group was significantly shorter than that in the control group(P<0.001).The score on oral cleanliness of the experiment group was significantly higher than that in control group(P<0.001).The bad breath,stomatitis or oral ulcer,and mucosa damage in the experiments group were all lower than those in the control group.The number of oral bacteria on the 5th day in the experiment group was smaller than that in the control group(P<0.005).Conclusion For the patients with dysphagia,the suction toothbrushing may be effective for cleaning the mouth,reducing oral complications and improving the satisfaction degree.

Systematic pharmacological evaluation of material basis for the efficacy of Chinese herbal formula is one of the key issues in Chinese materia medica(CMM),which is in urgent need of solution.However,its scientific connotation is still controversial in academic circles.The material basis for the efficacy of Chinese herbal formula is the total non-endogenous bioactive compound(derived either directly or indirectly from this formula) exerting the therapeutic effects,which is generated by the interaction of the formula with human body and reaches certain concentration in the target organs or tissues.Systematic evaluation of material basis for the efficacy of Chinese herbal formula is the cornerstone of modernization and internationalization of CMM,while the quality control of CMM is its prerequisite.

OBJECTIVE To investigate the clinical and etiologic characteristics and treatment of central venous catheter-related(sepsis).METHODS Forty cases of patients with central venous catheter-related sepsis and their clinical manifestation,etiologic profiles and outcome of treatment were retrospectively analyzed.RESULTS Forty six strains were isolated including 23 strains of Gram-positive cocci,19 of Gram-negative bacilli and 4 of fungi.The most frequent(isolates) were Staphylococcus epidermidis.CONCLUSIONS The most common organism causing CRS is S.epidermidis;the key preventive measure is to avoid inner and outer pollution of catheter;antibiotic lock-technique can be taken for the treatment of uncertain CRS.If it is no effect after 24-48 hours,it is necessary to remove venous catheter promptly.

Thirty assistant general practitioners (GPs) of Jiading District Shanghai were trained for clinical skills and communication skills by using standardized patients (SP) in outpatient department from January to April 2014.The scores of clinical skills and communication skills were evaluated and compared before and two months after training.The results showed that the score of clinical skills [(72 ± 5) vs (56 ± 7), t=7.871, P＜0.05] and communication skills [(71 ±4) vs (45 ±5), t =9.573, P＜0.05] were significantly improved after training.After training, the scores of medical history taking [(36 ±5) vs (28 ± 6), t =4.352], clinical thinking [(17 ± 2) vs (14 ± 3), t =3.974], health education [(3 ± 1) vs (2 ± 1), t =3.090] and medical record v,riting [(13 ± 1) vs (8 ±2), t =5.317] were significantly higher than those before training (all P ＜ 0.05).But there was no difference in reception time management [(4 ± 0) vs (4 ± 0), t =1.025] before and after training (P ＞ 0.05).After training, the scores and the proportions of the trainees qualified for building physician-patient relationship [(20 ± 3) vs (15 ± 4), t =4.056],collecting information and providing feedback [(22 ±4) vs (13 ±3), t =4.682], understanding complaints from patients' perspective [(5 ± 2) vs (3 ± 2), t =3.107], sharing information and obtaining informed consent [(19 ± 4) vs (11 ± 5), t =4.322] and closing consultation [(6 ± 2) vs (3 ± 1), t =2.987] were higher than before training (all P ＜ 0.05).The results indicate that training by using SP can effectively improve the clinical skills and communication skills of assistant GPs.

The proliferation of vascular smooth muscle cells is closely related to the pathogenesis of a variety of diseases, such as atherosclerosis, hypertension, diabetes, vascular restenosis, and etc. A proper model for smooth muscle cell proliferation can be served as an important tool for exploring the molecular mechanisms of smooth muscle cell proliferation and the screening of potential inhibitory agents. Various factors can induce the proliferation of smooth muscle cells with different mechanisms and pathological significance. The ox-LDL, AGEs, angiotensin II (AngⅡ), high glucose, tumor necrosis factor (TNF) and etc. have been successfully applied in the establishment of smooth muscle cell proliferation model. This article summarized the most commonly used models for smooth muscle cell proliferation. The inhibitory effects of Chinese herbal medicine, especially the isolated pure compounds were discussed. It was aimed to provide references for the screening of smooth muscle cells based medications as well as studies on related research and development of Chinese herbal medicine.

Tanshinones are a large class of hydrophobic natural products isolated from traditional Chinese herb Salvia miltiorrhiza Bunge and related plants. Tanshinones include tanshinone ⅡA, cryptotanshinone, tanshinone I, dihydrotanshinone, and so on. Both the tanshinones and the salvianolic acids have been identi-fied as the characteristic and main active ingredients of Salvia miltiorrhiza Bunge with cardiovascular protective activities. Ac-cumulated data in recent years have revealed that tanshinones possess remarkable anti-cancer activities both in vivo and in vitro. In this review, we summarize the latest progress of the an-ti-cancer effect and the underlying mechanisms of tanshinones, particularly with emphasis on tanshinone ⅡA, which might pro-vide reference for the further research and development of these compounds.

Objective To investigate the clinical application of statins for secondary prevention and its efficacy in patients with ischemic stroke.Methods A total of 300 patients with ischemic stroke were divided into statins group (n=91) and control group (n=209) according to whether statins was received or not.Serum lipid parameters,liver and kidney function,carotid artery intimamedia thickness (IMT) and plaque area were compared between the two groups.Results In 209 patients not taking statins,68 cases (32.5％) were not advised by clinic doctor; 55 cases (27.8％)were reluctant to take statins in fear of adverse reactions; 77 cases (36.8％) discontinued stains when serum lipids were normal; 3 cases (1.4％) developed skin allergic reaction and the skin rash that disappeared after stains discontinuance; 3 cases (1.4％) had elevated liver enzyme levels and the enzyme levels were declined to normal after stains discontinuance.The levels of total cholesterol (TC),triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) were significantly lower in statin group than in control group [(4.93±0.45) mmol/L vs.(5.87±0.38) mmol/L,(1.68±0.61)mmol/L vs.(2.01±0.58) mmol/L,(2.49±0.57) mmol/L vs.(3.76±0.44) mmol/L,t=18.60,4.46,20.94,P=0.000,0.007,0.000,respectively].High density lipoprotein (HDL-C) level was significantly higher in stain group than in control group [(1.36±0.31) mmol/L vs.(1.03±0.25)mmol/L,t=9.75,P=0.001].There were no significant differences in liver and kidney function parameters such as alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,serum total bilirubin,direct bilirubin,indirect bilirubin,glutamyl transferase,blood urea nitrogen and serum creatinine between the two groups (all P＞0.05).The carotid IMT and carotid atherosclerotic plaque area were significantly lower in stain group than in control group [(1.62 ± 0.23) mm vs.(1.74±0.31) mm,(0.57±0.12) cm2 vs.(0.65±0.18) cm2,t=3.32,3.88,P=0.008,0.002,respectively].Conclusions Most patients with ischemic stroke are still not taking statin for secondary prevention.Statins can improve the blood lipid levels and carotid arteriosclerosis status,and no obvious adverse reactions are observed.

This study is to investigate the effect of artesunate on transforming growth factor-beta1 (TGF-beta1) induced epithelial-mesenchymal transition (EMT) and its possible mechanism. After the in vitro cultured RLE-6TN cells were treated with TGF-beta1 then artesunate intervened on it, after 24 h, expression of the markers of mesenchymal cell was assayed using Western blotting and real-time PCR analysis. Western blotting was also used to detect the effect of TGF-beta1 on the Smad3 and Smad7 expressions of RLE-6TN cells. Morphological alterations were examined by phase-contrast microscope, and ultrastructure changes by electron microscope. Incubation of RLE-6TN cells with TGF-beta1 resulted in the up-regulation of the expression of the mesenchymal cell markers, after artesunate intervened on it, resulted in the down-regulation of the expression. Meanwhile, incubation with artesunate intervened on RLE-6TN cells could lead to the apparent down-regulation of the expression of Smad3 and up-regulation of Samd7 and the transition of RLE-6TN cells to mesenchymal-like by TGF-beta1 induction, after artesunate intervened on it, RLE-6TN cells to epithelial-like. TGF-beta1 induced epithelial-mesenchymal transition process; artesunate can inhibit TGF-beta1-induced epithelial-mesenchymal transition process, the possible mechanism is up-regulation of the expression of Smad7 and down-regulation of the expression of Smad3, meanwhile inhibits phosphorylation of Smad3.