对精密医疗维修检测仪器管理的体会

随着科学技术的发展，医疗仪器也以飞快的速度向着电子化、自动化、计算机化发展，仪器越来越先进，结构越来越复杂、精密，这对医工科的维修工作提出了更高的要求。我院医工科作为全区的医疗设备三级维修站，负责胶东半岛驻军医院及团卫生队的医疗仪器维修安装任务。近几年来，由总部配发和自购了２０余万元的医疗仪器维修和检测设备，如何管好用好这些设备，更好地服务于临床和部队，使设备优势变为技术优势，是大家关心和亟待解决的问题。现将我们在维修检测仪器管理中的几点体会总结如下：①放置环境的要求：设备设置环境能否真正耐受震…     

粉末活性炭脱色液的微孔过滤

设计了以刚性高分子微孔煤结管（ＰＡ管）为过滤介质的精密微孔ＰＧＨ型过滤机，有效地解决了粉末活性炭过滤难题。并介绍了在葡萄糖、咖啡因、氨基酸活性炭脱色溶液过滤中的应用。     

大鼠肝纤维化精密切片技术的建立

目的：建立肝纤维化精密切片技术，摸索最佳体外培养条件，用于体外肝脏异物代谢和药物相互作用研究。方法：建立大鼠复合因素(高脂、酒精和CCl4)肝纤维化模型，制备肝纤维化状态下的肝切片，建立培养系统，以培养基中乳酸脱氢酶(LDH)漏出量、肝组织中谷胱甘肽S-转移酶(GST)活性、肝细胞噻唑蓝(MTT)还原能力为指标，观察切片厚度、培养液pH值和培养时间对肝切片活力的影响。结果：大鼠经复合因素处理后，3周即可造成肝纤维化早期病理改变。在切片厚度300μm、培养液pH7．0的条件下，肝切片在6h内能够维持最低的LDH漏出量和最高的GST活性、MTT还原量。结论：肝纤维化状态下的精密肝切片技术，其切片厚度300μm、培养液pH7．0、培养时间6h时为最佳培养条件。     

心灵跳远

他原来只是台湾一家航运公司的小业务员，因为不满足于夜夜饮酒笙歌的无聊应酬，决定借钱创业。     

EXADROP精密输液器在临床应用中的体会

随着医疗科学技术的发展，给护理工作者带来一个重要的问题，就是如何将药物准确、无误、及时地输入病人体内，维持有效的血药浓度，减少不良反应的发生。提高药物疗效，关键在于如何有效、精确地控制输液速度，匀速地将药物输入到人体内。德国贝朗公司生产的EXADROP精密输液器在我科应用以来，明显减轻了护士的工作负担，提高了护理质量。     

36种注射剂中不溶性微粒的研究

目的：研究36种注射剂中的不溶性微粒现状及解决方法。方法：将36种注射剂按治疗剂量(其中24种溶配于0．9％氯化钠注射液或5％葡萄糖注射液中，12种输液直接测试)，用HIAC Royco8000A仪计数该液中直径≥1，2，3，5，8，10，20，25μm的微粒数；对微粒进行理化性质和显微鉴别；考察精密药液过滤器流速、流量、吸附性和截留作用。结果：11种新药静脉注射剂超过《美国药典》(25版)标准，占实验总数30．56％。不溶性微粒有玻璃碴、活性炭、橡胶屑、毛屑索条和药物残渣；精密药液过滤器的流速、流量符合临床要求，截留率为91．01％～99．97％，未见其有吸附作用。结论：精密药液过滤器可截留注射剂中的有害微粒。     

28种静脉用中药注射剂不溶性微粒的研究

28种静脉用中药注射剂按治疗剂量加入各自溶媒后不溶性微粒的检测表明：每种药物均含有不同粒径及数量的微粒。其中多数符合《中国药典》标准，但有4种药物≥10μm的微粒数在20个以上或≥25μm的微粒多于2个，超过《中国药典》标准。值得注意的是，中药静脉注射剂中小于10μm的微粒个数明显多于西药静脉注射液。提示中药静脉注射剂质控的难度和改善工艺质量的迫切性。本实验对国产精密药液过滤器的滤过作用亦作了考察。     

利福霉素在临床使用上的新发现

目的观察利福霉素在使用过程中的配伍禁忌和护理注意事项。方法配制利福霉素液使用精密输液管静脉滴注，而后接上哌拉西林钠舒巴坦钠液。结果使用精密输液管滴注利福霉素液时不通畅，利福霉素液与哌拉西林钠舒巴坦钠液混合后，输液管里的药液变成绿色。结论临床上静脉滴注利福霉素时，不宜使用精密输液器，应采用普通输液器，以保证输液的畅通。需要同时使用利福霉素钠和哌拉西林钠舒巴坦钠这两种药物时，不宜续接，二者存在配伍禁忌。     

介入治疗患者的心理护理

介入治疗是指在医学影像技术（如X线透视、CT、超声波、磁共振）引导下，用穿刺针、导丝、导管等精密器械进行治疗和获取病理材料的过程，其核心是以微小的创伤获得与外科手术相似或更好的治疗效果。介入治疗应用数学技术，扩大了医生的视野，借助导管、导丝延长了医生的双手，     

精密输液器减少输液反应的疗效观察

目的探讨精密输液器减少输液反应的效果和使用安全性。方法实验组120例患儿使用精密滤过输液器,对照组120例患儿使用普通输液器。结果观察组发生不良反应4例,占3.1%,对照组发生不良反应23例,占21.7%,经x2检验,差异有统计学意义(P<0.05)。结论精密输液器能减少不良反应的发生,比普通输液器使用更加安全。     

青霉素钠结晶液过滤介质的筛选

通过使用国产、进口的两种过滤布进行丁醇．乙醅溶出物实验及结晶液的抽滤试验,经筛选比较,单层进口聚酯滤布、双层国产尼龙滤布对结晶液过滤效果较好。过滤速度快,滤液澄清,效价低。可以在生产中试用。     

滑石粉酸中可溶物过滤介质探讨

目的:研究不同过滤介质对滑石粉酸中可溶物测定结果的影响.方法:采用不同标准收载的过滤介质(中速滤纸和慢速滤纸),以及孔径为0.45μm的微孔滤膜对不同粒径与粒径分布的滑石粉酸中可溶物进行测定,并对测定结果进行分析比较.结果:采用不同孔径的过滤介质测定,酸中可溶物检测结果及结果的相对偏差随着过滤介质孔径减小而下降.结论:...     

Influence of cigarette filter ventilation on smokers’ mouth level exposure to tar and nicotine

Cigarette filter ventilation allows air to be drawn into the filter, diluting the cigarette smoke. Although machine smoking reveals that toxicant yields are reduced, it does not predict human yields. The objective of this study was to investigate the relationship between cigarette filter ventilation and mouth level exposure (MLE) to tar and nicotine in cigarette smokers. We collated and reviewed data from 11 studies across 9 countries, in studies performed between 2005 and 2013 which contained data on MLE from 156 products with filter ventilation between 0% and 87%. MLE among 7534 participants to tar and nicotine was estimated using the part-filter analysis method from spent filter tips. For each of the countries, MLE to tar and nicotine tended to decrease as filter ventilation increased. Across countries, per-cigarette MLE to tar and nicotine decreased as filter ventilation increased from 0% to 87%. Daily MLE to tar and nicotine also decreased across the range of increasing filter ventilation. These data suggest that on average smokers of highly ventilated cigarettes are exposed to lower amounts of nicotine and tar per cigarette and per day than smokers of cigarettes with lower levels of ventilation.     

肠炎宁糖浆过滤工艺的改进研究

目的：改进肠炎宁糖浆的过滤制备工艺。方法：以涤纶滤布替代原滤纸置于板框过滤机上,并添加滑石粉做助滤剂,用于过滤肠炎宁糖浆,即得澄清制剂,并与原滤纸进行对比。结果：改进工艺同样可获得澄清制剂,并符合质量要求。结论：改进过滤工艺良好,具有减轻劳动强度,且生产成本低的优势。     

Demonstration that methadone is being present in the exhaled breath aerosol fraction

Methadone has previously been found present in exhaled breath of methadone treated patients. This study aimed at studying if methadone is present in the aerosol fraction of exhaled breath and used different filter sampling techniques for that. Patients receiving methadone maintenance treatment were recruited for the study. Methadone was extracted from filters collecting methadone from exhaled breath using 2-propanol, methanol and ethyl acetate and measured using liquid-chromatography-tandem mass-spectrometry. The limit of quantification was 5 pg/sample and the intra-day imprecision and accuracy within 15%. The recovery of extracting methadone from filters was >90%. Two types of micro-particle filters were used in this study and were compared with the C18 silica filter (Empore) used before. The Glass fiber filter collected methadone from exhaled breath of methadone patients. The amount collected significantly exceeded the amount using the C18 Empore filter (3.6-14-fold), but the variability of amount trapped was large. The second filter type was a polymer filter. Also this filter was able to trap methadone from exhaled breath of methadone patients. The amount and variability was similar to the C18 Empore filter but smaller than the Glass fiber filter. The mean rate of methadone excretion measured with the best polymer filter was 92 pg/min with a range between 20 and 287 (n = 5). The polymer filter has the practical advantage of having a low flow resistance making it possible to sample without pumping assistance. The polymer filter was found to collect >90% of the exhaled methadone. The conclusion of this study was that methadone in exhaled breath is carried in the aerosol fraction known to be formed in the lung as a result of normal breathing.     

Binding of selected drugs to a "treated" inline filter

The binding of several drugs to an inline i.v. filter that had been treated to inhibit drug-binding was studied. Solutions of mithramycin, vincristine sulfate, digitoxin, insulin, dactinomycin, and nitroglycerin in both 5% dextrose injection and 0.9% sodium chloride injection were allowed to flow through an i.v. administration set containing a 0.22-micron cellulose ester filter that had been treated with a proprietary agent. Actual administration conditions were simulated by using drug concentrations and flow rates commonly employed in clinical practice. The amount of each drug retained by the filter was determined by assaying aliquots of the solutions sampled before and after the solution passed through the filter membrane. In a second experiment, drug binding to the filter membrane was measured by incubating small pieces of the treated membrane in drug solutions and determining concentrations periodically until equilibrium was reached. Untreated filter membrane pieces were used as a control. In the experiment simulating actual i.v. administration, cumulative binding of mithramycin, vincristine sulfate, dactinomycin, and nitroglycerin to the treated filter was less than 6% of the initial dose infused; approximately 8-12% of the initial amounts of digitoxin and insulin were bound to the filter. In the equilibrium binding studies, the untreated filters bound twice as much digitoxin, 5-7 times as much mithramycin, vincristine sulfate, and dactinomycin, and 20 times as much insulin as the treated filters. The amount of nitroglycerin bound to the treated and untreated filters was not substantially different. Insulin had a greater binding tendency in 5% dextrose injection than in 0.9% sodium chloride injection in both experiments regardless of the filter treatment. Treatment of a cellulose ester i.v. filter with the proprietary agent used in this study facilitates drug delivery through this filter.     

Aerosol filters.

This review discusses filter materials, filter mechanisms, filter testing and applications of filters in medicine. While many applications are satisfactorily solved, there seems to be a research need for generating particle free air to relieve pains from people suffering from allergens and standardization of filter testing procedures for filters used in exhalation lines with humid air.     

Evaluation of a 5-mum stainless steel filter as an intravenous inline filter or prefilter.

The suitability of a 5-mum stainless steel filter as an inline filter or a protective prefilter during simulated i.v. therapy was evaluated using flow rate measurements of two routinely used i.v. fluids and parenteral nutrition fluid. As an inline i.v. filter, the 5-mum stainless steel filter was capable of maintaining suitable flow rates. The addition of antibiotic additives decreased the flow rates slightly but not below the range required for i.v. therapy. Flow rate profiles, however, when compared to a 0.45-mum membrane filter suggest that antibiotic additives contain high numbers of particles in the less than 5-mum range. Consequently many of the particles, especially those in the less than 3-mum range will pass the 5-mum filter. As a protective prefilter, the 5-mum filter device in combination with a 0.45-mum membrane filter provided more uniform flow rates over longer periods of time when additives were employed. Using the aspiration device as a prefilter for adding antibiotics to the infusion fluid resulted in improved flow rates through a 0.45-mum membrane filter for lactated Ringer's containing cephalothin sodium, while for solutions containing ampicillin or oxytetracycline, prefilteration did not change the flow rate profiles.     

洁净区高效过滤器检漏测试

目的:准确检测高效过滤器的质量,以避免高效过滤器泄漏,影响生产。方法:用尘埃粒子计数器检测高效过滤器是否有泄漏现象。结果:检测各点的悬浮粒子若超出洁净区要求的范围则有泄漏现象,需堵漏或更换。结论:本法操作简便、准确。     

Simple selection criteria for drug-like chemical matter

A simple pharmacophore point filter has been developed that discriminates between drug-like and nondrug-like chemical matter. It is based on the observation that nondrugs are often underfunctionalized. Therefore, a minimum count of well-defined pharmacophore points is required to pass the filter. The application of the filter results in 66-69% of subsets of the MDDR database to be classified as drug-like. Furthermore, 61-68% of subsets of the CMC database are classified as drug-like. In contrast, only 36% of the ACD are found to be drug-like. While these results are not quite as good as those obtained with recently described neural net approaches, the method used here has clear advantages. In contrast to a neural net approach and also in contrast to decision tree methods described recently, the pharmacophore filter has been developed by using "chemical wisdom" that is unbiased from fitting the structural content of specific drug databases to prediction models. Similar to decision tree methods, the pharmacophore point filter provides a detailed structural reason for the classification of each molecule as drug or nondrug. The pharmacophore point filter results are compared to neural net filter results. A statistically significant overlap between compounds recognized as drug-like validates both approaches. The pharmacophore point filter complements neural net approaches as well as property profiling approaches used as drug-likeness filters in compound library analysis and design.