探讨食品药品检验系统实验室质量监督措施的有效利用

目的：探讨食品药品检验系统实验室质量监督措施的有效性,建立质量监督互相渗透、互为利用的高效模式,促进实验室质量管理体系的有效运行。方法：采取对关键风险点控制、常规性定频次检查、检验原始记录及报告书、检验周期、各部门在线监督报告等模块定期监督的措施,在发现问题、解决问题和监督问题的过程中,不仅全面反映了实验室在体系运行方面遇到的具体问题,而且充分发挥了各级人员的主观能动性。结果与结论：通过对多措施质量监督的有效利用,在不断改进和完善中,使实验室的质量管理得到持续提高。     

月考评在护理组长管理中的应用

目的：探讨科室对护理组长管理的方式、方法问题。方法：护士长每个月组织对护理组长工作质量与岗位职责落实方面进行考评。结果：月考评可以促使护理组长完成护理二级查房、护理病例讨论、组织小讲课等工作及所分管患者的满意度提高。结论：月考评应用在对护理组长的管理可以督促护理组长主动、较好地落实岗位职责,从而提升了其护理小组所分管患者的护理质量。     

护士分层级管理模式对提高护理质量的作用

目的探讨护理分层级管理模式对提高护理质量的作用。方法实施分层级管理划分层级,确定各层级护士岗位职责,实施前后护理工作质量比较,实施前后护士专业知识考核成绩进行比较,比较分级实施前、后患者满意度。结果 14名护理名员经过分层级管理后护理知识较以前有所护高;科室各项护理质量考核指标明显提升,增强了护士的服务意识和责任意识,未发生任何护理投诉及护理差错事故。结论实施护士分层级管理模式可有效提高护理质量。     

血站检验科管理

国家对采供血机构加大了管理力度，血站应建立长效的规范化管理机制，提高工作质量，保证临床用血的供应及输血安全。这就对检验科提出了更高的要求，必须转变观念，建立科学的、有效的科室管理机制。因此，我们从以下几个方面论述检验科的管理：①质量是血站的生命，检验科应把质量作为科室管理的重点及核心；②制度化管理是科室的发展方向；③效益与质量都不容忽视，既要创新．开展新技术，又要注意节流，杜绝浪费；④以人为本是科室的发展理念；⑤加强职业道德规范培训．增加检验人员的责任感和爱心，保证血液检测结果和结论的真实性、可靠性、保密性；⑥人格魅力体现了科室管理的人性化。工作中有法可依，有章可循，及时、准确提供检测报告，配合相关科室完成好工作．为临床提供安全、可靠、充足的血液。     

国家药品抽检检验机构调研现状及对策

目的：通过梳理近年来国家药品抽检工作调研中发现的问题,聚焦质量管理体系运行情况,重点围绕抽检组织、样品管理、原始记录及报告书等问题进行分析,就如何在新的药品监管模式下做好抽检工作并提出建议,推动药品抽检管理模式的创新。方法：以数据完整性、真实性为重点,以检验报告为主线,通过审核程序文件、抽查检验报告、实地考察实验室并查看记录文件以及访谈工作人员等多种形式,调研2020年与2021年国家药品抽检完成情况,重点对抽检组织、样品管理、检验报告及记录、质量管理体系运行的有效性等进行全面核查。结果与结论：检验机构应确保各项数据与行为的合规性与可追溯性,促进药品抽样工作的科学性、合法性、代表性。     

医院供应室的管理体会

供应室是为全院临床科室、医技科室以及其他相关科室提供所需要的各种无菌医疗器械和无菌物品的科室,它是医院完成医疗、护理操作的重要保障．是医院不可缺少的重要组成部分。预防和控制院内感染已成为当前医院管理中的一项重要内容,是评价医疗管理水平的重要标志,供应室的质量管理．是预防、控制医院感染,提高医疗质量,保护人们健康的重要工作。因此注重细节。强化供应室质量管理、制定严格的工作制度及各级人员岗位职责至关重要,也是医院现代化管理的重要议题。     

基层医院实行分管院长查房的实践与体会

实行分管院长查房能将院长在医院质量控制中的主导作用与职能部门的检查监督作用有力结合起来,是全面了解各科室工作质量与管理情况,认真落实各项医院管理制度,全面控制医疗质量的有效方法。主要做法是由分管院长牵头,并与相关的职能部门负责人及部分科室主任组成查房小组,根据分管院长所分管的工作每周固定查房的重点内容,到科室现场查房。通过坚持分管院长查房促进了科室管理水平的提高,提高了医疗文书书写质量,强化了医疗核心制度的落实,协调了各科室之间的工作,加强了领导与科室之间的交流。     

浅议检验分析前的质量管理

质量是科室存在的的前题,效益是科室生存的保障,没有科学有效的管理,质量也就无从谈起。从医学检验到检验医学模式的转变使检验专业有了质的改变,怎样做好检验的质量管理工作成了检验工作者不断追求的目标。检验医学的质量控制过程分为三个阶段,即分析前质量控制、分析中质量控制和分析后质量控制。ISO15189定义分     

加强医院质量管理 促进医院达标上等

我院是一所医、教、研、防为一体的地市级综合性医院,在多次文明医院检查验收时,形成了医院质量管理的雏形。为加强医院质量管理,促进医院达标上等,针对质量管理的重点,对照标准作了以下工作。 1 建立健全医疗质量管理组织 成立院医疗质量管理委员会,科室质量管理小组,质量管理员三级质量管理网络。 1.1 院医疗质量管理委员会 院医疗质量管理委员会由院长、付院长任正、付主任委员、委员由医疗职能科室、临床、医技、护理、病案管理等部门负责     

ISO9001：2000质量管理标准在精神科护理管理的应用体会

目的实施ISO9001：2000质量标准,规范精神科护理管理。方法引入ISO9001：2000质量管理标准。制定精神科护理质量标准和评分细则,完善各项规章制度,细化各岗岗位职责,规范各项操作流程,建立健全精神科住院患者组织管理制度及落实健康教育责任制,对影响护理质量的关键环节进行控制。结果体系运行后,护理质量明显提高,护理管理达到了科学化、规范化、制度化、安全化。结论此项活动既规范了护理服务质量管理,又增加了患者的满意度,提高了科室的经济效益和社会效益,实现了精神科护理服务质量的自我完善和持续改进。     

Affective and Anxiety Disorders and Alcohol and Drug Dependence:

Depression and anxiety frequently coexist in patients with substance use disorders. This clinically-oriented article examiens the relationship between these conditions and emphasizes data showing that substances of abuse can cause signs and symptoms of both depression and anxiety. These substance-related syndromes appear to have a different course and prognosis than uncomplicated, independent anxiety and major depressive disorders, and clinicians should consider the role of alcohol and other drugs in all patients presenting with these complaints. The authors will also outline an approach for diagnosing and managing patients with the combination of a substance use and depressive or anxiety disorder.     

Modelling and simulation of variability and uncertainty in toxicokinetics and pharmacokinetics

Two important methodological issues within the framework of the variability and uncertainty analysis of toxicokinetic and pharmacokinetic systems are discussed: (i) modelling and simulation of the existing physiologic variability in a population; and (ii) modelling and simulation of variability and uncertainty when there is insufficient or not well defined (e.g. small sample, semiquantitative, qualitative and vague) information available. Physiologically based pharmacokinetic models are especially suited for separating and characterising the physiologic variability from the overall variability and uncertainty in the system. Monte Carlo sampling should draw from multivariate distributions, which reflect all levels of existing dependencies in the intact organism. The population characteristics should be taken into account. A fuzzy simulation approach is proposed to model variability and uncertainty when there is semiquantitative, qualitative and vague information about the model parameters and their statistical distributions cannot be defined reliably.     

Interaction of estrone and estradiol with DNA and protein of liver and kidney in rat and hamster in vivo and in vitro

[6,7-³H] Estrone (E) and [6,7-³H]estradiol-17 (E₂) have been synthesized by reduction of 6-dehydroestrone and 6-dehydroestradiol with tritium gas. Tritiated E and E₂ were administered by oral gavage to female rats and to male and female hamsters on a dose level of about 300 g/kg (54 mCi/kg). After 8 h, the liver was excised from the rats; liver and kidneys were taken from the hamsters. DNA was purified either directly from an organ homogenate or via chromatin. The radioactivity in the DNA was expressed in the units of the Covalent Binding Index, CBI = (mol chemical bound per mol DNA-P)/(mmol chemical administered per kg b.w.). Rat liver DNA isolated via chromatin exhibited the very low values of 0.08 and 0.09 for E and E₂, respectively. The respective figures in hamster liver were 0.08 and 0.11 in females and 0.21 and 0.18 in the males. DNA isolated from the kidney revealed a detectable radioactivity only in the female, with values of 0.03 and 0.05 for E and E₂, respectively. The values for male hamster kidney were < 0.01 for both hormones. The minute radioactivity detectable in the DNA samples does not represent covalent binding to DNA, however, as indicated by two sets of control experiments. (A) Analysis by HPLC of the nucleosides prepared by enzyme digest of liver DNA isolated directly or via chromatin did not reveal any consistent peak which could have been attributed to a nucleoside-steroid adduct. (B) All DNA radioactivity could be due to protein contaminations, because the specific activity of chromatin protein was determined to be more than 3,000 times higher than of DNA. The high affinity of the hormone to protein was also demonstrated by in vitro incubations, where it could be shown that the specific activity of DNA and protein was essentially proportional to the concentration of radiolabelled hormone in the organ homogenate, regardless of whether the animal was treated or whether the hormone was added in vitro to the homogenate.Carcinogens acting by covalent DNA binding can be classified according to potency on the basis of the Covalent Binding Index. Values of 10³–10⁴ have been found for potent, 10² for moderate, and 1–10 for weak carcinogens. Since estrone is moderately carcinogenic for the kidney of the male hamster, a CBI of about 100 would be expected. The actually measured limit of detection of 0.01 places covalent DNA binding among the highly unlikely mechanisms of action. Similar considerations can be made for the liver where any true covalent DNA binding must be below a level of 0.01. It is concluded that an observable tumor induction by estrone or estradiol is unlikely to be due to DNA binding.Paper presented at the Satellite Symposium of the European Society of Toxicology, Rome, March 29, 1983     

Synthesis and anti-nociceptive and anti-inflammatory effects of gaultherin and its analogs

The synthesis of gaultherin (1) and its analogs was carried out to provide 11 glycosides under phase-transfer catalytic conditions. The activities of all synthesized compounds were evaluated by nitric oxide production inhibitory assay in vitro. Methyl 2-O-(4-O-β-d-galactopyranosyl)-β-d-glucopyranosylbenzoate (5f) showed significantly anti-nociceptive and anti-inflammatory effects by the evaluation in vivo. Structure–activity relationships within these compounds were discussed.     

Acamprosate and naltrexone treatment effects on ethanol and sucrose seeking and intake in ethanol-dependent and nondependent rats

Rationale  Two pharmacotherapies are approved for treating alcohol craving (acamprosate and naltrexone), but both have shown mixed findings in animals and humans. Objectives  The present experiments utilized a “reinforcer blocking” approach (i.e., rats were able to consume ethanol during treatment) to better understand the efficacy of these treatments for ethanol seeking and drinking using ethanol-dependent and nondependent rats. Materials and methods  In “nondependent” experiments, drugs (acamprosate 50, 100, and 200 mg/kg; naltrexone 0.1, 0.3, and 1.0 mg/kg) were administered over 3-week periods prior to operant sessions with a low response requirement to gain access to reinforcers for 20 min. For “dependent” experiments, rats were made dependent in vapor/inhalation chambers. Results  Acamprosate and naltrexone had similar effects on intake in nondependent and dependent rats; neither drug was selective for ethanol over sucrose drinking. In nondependent animals, naltrexone was more efficacious at more doses than acamprosate, and acamprosate’s effects were limited to a dose that also had adverse effects on body weight. Both pharmacotherapies showed more selectivity when examining reinforcer seeking. In nondependent rats, acamprosate and naltrexone had response-attenuating effects in ethanol, but not sucrose, groups. In dependent animals, acamprosate had selective effects limited to a decrease in sucrose seeking. Naltrexone, however, selectively decreased ethanol-seeking in nondependent rats. Conclusions  The naltrexone-induced decreases in seeking suggested a change in incentive motivation which was selective for ethanol in nondependent rats. The “nondependent” paradigm may model early stages of “problem drinking” in humans, and the findings suggest that naltrexone could be a good intervention for this level of alcohol abuse and relapse prevention.     

Antiinfective and encrustation-inhibiting materials--myth and facts

Catheters, urethral and ureteral stents and other urological implants are frequently affected by encrustration and infection due to their permanent contact with urine. Indwelling urinary catheters provide a haven for microorganisms and thus require extensive monitoring. Several surface modification techniques have been proposed to improve the performance of devices including the immobilization of biomolecules, the incorporation of hydrophilic grafts to reduce protein adsorption, the creation of hydrophobic surfaces, the creation of microdomains to regulate cellular and protein adhesion, new polymers and antimicrobial coatings. Physico-chemical explanation to elucidate the mechanism of such encrustation or infection inhibiting materials is still not available. Our series of experiments showed a marked decrease of silver-activity in biological fluids which corresponds with the controversial clinical results obtained with silver coated urinary catheters. Rifampicin/minocycline coated catheters had very low activity against Gram-negative rods, enterococci and Candida spp., the main causing organisms of urinary catheter infection. Surface engineered materials and antimicrobial drug delivery systems will be the next generation of sophisticated urinary catheters and stents, if both efficacy as well as efficiency has been proved clinically.     

成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

益生菌与肿瘤防治

益生菌广泛存在于自然界中,通过维持宿主体内菌群平衡、影响肠屏障功能和调节免疫应答等作用,提高宿主健康水平,被公认为"肠道健康卫士".一些益生菌可以增强机体的免疫功能,抑制致癌物质,影响肿瘤细胞的基因表达,对肿瘤具有拮抗作用.大量研究表明,益生菌在未来的肿瘤防治中有很好的应用和发展前景.     

Isolation and characterization of glycosylated and non-glycosylated prolactins from alligator and crocodile

Two molecular forms of prolactin (PRL). glycosylated and non-glycosylated, were isolated from pituitary glands of two reptiles, alligator and crocodile. The reptilian PRLs were extracted under alkaline conditions from the precipitate obtained after pituitaries were first extracted with 0.25 m sucrose, 1 mM NH₄HCO₃, pH 6.3. Purification was performed by ion exchange chromatography on DE-52, gel filtration on Sephadex G-75 superfine, and reversed phase high performance liquid chromatography. Two forms of both alligator and crocodile PRL, designated PRLI and PRLII, with molecular weights of 26000 and 24000 were isolated. Alligator and crocodile PRLI and PRLII were stained specifically in immunoblots with anti-sea turtle PRL and anti-ostrich PRL. Sequence analysis revealed that both forms of alligator and crocodile PRLs consisted of 199 amino acid residues with a glycosylation consensus sequence (Asn-Ala-Ser) at position 60 in alligator and crocodile PRLs with a molecular weight of 26000 (PRLI). In contrast, Thr was substituted for Asn at position 60 in the PRLs with a molecular weight of 24000 (PRLII). The sequences of alligator PRLs differed from crocodile PRLs only in position 134: Val for alligator PRLs and He for crocodile PRLs. There is a high degree of structural conservation between the reptilian PRLs isolated in this study and avian PRL; each showed 92% sequence identity with chicken PRL and 89% with turkey PRL.