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Objective To explore the effect of Six-Sigma management on prevention and control of catheter-related bloodstream infection(CRBSI) in intensive care unit(ICU).Methods Patients with indwelling central venous catheter in the ICU of a hospital in March-December 2015 were selected,five phases of Six Sigma(define,measure,analyze,improve,and control) were used to find out the key factors that affected CRBSI,targeted improvement measures were taken,incidence of CRBSI before and after adopting Six-Sigma was compared.Results After SixSigma management was adopted,incidence of CRBSI declined from 15.95‰(13/815) to 6.19‰(4/646),difference was significant(P＜0.05).Conclusion Six-Sigma management can reveal the defect in workflow,guide researchers to propose corresponding measures,and effectively reduce the incidence of CRBSI in ICU.
ABSTRACT
<p><b>OBJECTIVE</b>To assess the association between matrix metalloproteinase-3 (MM-3) gene polymorphisms and subtypes of ischemic stroke (IS) in northern Han Chinese population.</p><p><b>METHODS</b>A total of 289 patients with acute IS (within 3 days after the onset, including 185 with large artery atherosclerosis (LAA) and 104 for small artery occlusion (SAO)) and 175 matched healthy controls were recruited for this case-control study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) or sequenc-based typing (SBT) was carried out to analyze 3 SNPs of the MMP-3 gene.</p><p><b>RESULTS</b>An incomplete linkage disequilibrium (LD) block was constructed with the 3 SNPs, and the distribution of genotypes of the 3 SNPs differed between the LAA group and controls in a dominant model: Carriers of 5A allele (5A5A+5A6A) of the rs3025058 locus were 1.72 times more susceptible to LAA stroke compared with carriers of 6A6A alleles (P=0.017, OR=1.72, 95% CI: 1.10-2.69), carriers of G alleles (GG+AG) of the rs522616 locus were 0.52 times more susceptible to LAA stroke compared with carriers of AA alleles (P=0.005, OR=0.52, 95% CI: 0.33-0.82), whilst carriers of A allele of the rs679620 locus were 1.55 times more susceptible to LAA stroke compared with carriers of GG alleles (P=0.042, OR=1.55, 95% CI: 1.01-2.37). However, no significant difference has been found between particular genotypes of such SNPs between SAO patients and controls (P> 0.05). Furthermore, 5A-A-A and 6A-A-A haplotypes were significantly more common in LAA group than the controls (P< 0.05), whilst 6A-G-G haplotype has been the opposite (P< 0.01).</p><p><b>CONCLUSION</b>Our study has demonstrated that serum MMP-3 level is significantly increased at acute stage of LAA as well as SAO type strokes. There may be an association of rs3025058, rs522616 and rs679620 of MMP-3 gene with susceptibility to LAA stoke in northern Han Chinese population.</p>