草乌豆腐法炮制工艺研究

目的 探索最佳的豆腐法炮制草乌的工艺参数。方法 采用L₁₆(4₃)正交试验方法,以浸漂时间,水煮时间和豆腐用量三因素,各设置四水平进行16次试验,每次实验结果均以单酯型和双酯型生物碱总量测定数据为评判指标。结果 浸漂时间四水平四次试验结果的单酯型生物碱含量分别为0.11%、0.07%、0.062%和0.048%;水煮时间四次结果的含量分别为0.081%、0.066%、0.074%和0.067%;豆腐用量四次结果的含量分别为0.070%、0.072%、0.080%和0.073%;双酯型生物碱16次测定结果均小于0.034%。结论 三因素中对单酯型生物碱含量影响大小的次序为浸漂时间>水煮时间>豆腐用量。在上述任何条件下,毒性成分双酯型生物碱均小于中国药典的限度要求,均符合规定,而毒性成分双酯型生物碱总量随豆腐用量的增加而明显减少。豆腐法炮制草乌的最佳工艺条件为A3B3C2,即浸漂6天,水煮5小时,加豆腐25%。     

注射用米铂制剂配方与冻干工艺研究

目的 研究注射用米铂的配方及冻干生产工艺。方法 通过冻干溶剂的选择、原料溶解度试验、处方筛选、预冻工艺研究等确定注射用米铂配方和冻干工艺参数的控制范围。结果 确定冻干溶剂采用叔丁醇和环己烷的混合溶剂,环己烷最佳比例范围为10%~30%,药物浓度最佳范围为5~25 mg·mL^-1,确定冻干工艺采用阶段性预冻方式。结论 选定的配方和工艺可行,自研制剂与参比制剂质量等同,节约了工艺生产成本。     

多指标综合评分法优化痛风巴布剂的醇提工艺

目的 优选痛风巴布剂的最佳提取工艺。方法 以青藤碱、总生物碱的含量和干浸膏得率为评价指标,采用正交设计试验,考察乙醇浓度、乙醇用量、提取时间和提取次数对提取结果的影响,确定痛风巴布剂处方药材的最佳提取工艺。结果 痛风巴布剂的最佳提取工艺为65%乙醇,提取3次,每次6倍量溶剂,提取总时间为1.5 h,在该工艺条件下得到的青藤碱含量、总生物碱含量和干浸膏得率分别为2.79 mg·g^-1、1.22%和13.06%。结论 优选的醇提工艺稳定、可行。     

Study of the influence of coating methods on lipid spheres manufactured on rotor fluidized bed process

Abstract

Different previous works have shown that various kinds of spheres can be manufactured by rotor granulation in a ‘single-pot process’ using a lipid base: hydrogenated castor oil. This single-pot technology is based on wet granulation where all components are placed in the powder form in the rotor bowl; then, they are continuously suspended in a fluidized air, with a tangentially sprayed liquid solution. This process allows the granulation and manufacturing of sphere during the same time. Previous experiments have studied the influence of the formulation and the manufacturing process parameters on spheres in terms of feasibility and dissolution properties. Both the spraying time and the weight of liquid sprayed were found to be the most relevant parameters that govern the final quality of the sphere. Now, in a second part of the work, a first comparison is made with two different fluid bed methods: the tangential rotor spray and the Wurster bottom spray for coating the lipid spheres previously manufactured with the rotor tangential spray. The external aspect of the coated spheres manufactured has been evaluated with an electronic microscopy analysis and a study of dissolution properties of the active ingredient has been done by USP in vitro dissolution tests.     

新医改下公立医院医用耗材成本控制体系的建立

结合某大型综合性医院医用耗材管理工作实践,通过医用耗材成本全过程控制体系的建立,界定医用耗材成本上游、中游、下游的控制边界,促进医用耗材精细化管理,总结并提出医用耗材成本全过程控制的思路。为继续完善医用耗材成本控制体系,探索科学合理的临床耗材使用途径提供参考。     

西北五省基本公共卫生服务均等化水平测量研究*

基本公共卫生服务均等化,作为当前深化医药卫生体制改革的一项重要制度和工作重点之一,是保证公共卫生资源优化配置和实现2020年达到"人人享有基本医疗卫生服务"目标的前提条件。本文首先通过以往研究,结合专家咨询法与层次分析法构建基本公共卫生服务均等化指标体系,并计算指标权重,运用西北五省的相关数据,在对原始数据进行标化的基础上,计算各省份的最终结果并进行排名,对进一步优化基本公共卫生均等化提出合理化建议。     

应用Delphi法和AHP法构建中小学校公共卫生应急能力评估指标体系研究

目的 构建中小学校公共卫生应急能力指标体系,为加强中小学公共卫生应急处置能力建设提供科学依据。方法 在专家咨询和文献回顾的基础上,选取疾控专家、学校领导和校医共40人为调查对象,使用德尔菲法(Delphi)初步确定各级指标,使用层次分析法(analytic hierarchy process,AHP)确定各级指标的权重,建立中小学公共卫生应急能力指标体系。结果 指标体系由4个一级指标、12个二级指标、51个三级指标组成。4个一级指标分别为基础保障能力、应急队伍建设、应急体系建设、事件应对能力,权重系数分别为0.496 8、0.286 0、0.119 0和0.098 3。模型具有较好的一致性,一级指标CR=0.095 8,各项二级指标CR值均小于0.1。结论 本研究通过定量方法建立的指标体系具有较高可信度和实用性,可为中小学公共卫生能力建设提供科学依据。     

Twelve months of implementation of health care performance‐based financing in Burkina Faso: A qualitative multiple case study

To improve health services' quantity and quality, African countries are increasingly engaging in performance‐based financing (PBF) interventions. Studies to understand their implementation in francophone West Africa are rare. This study analysed PBF implementation in Burkina Faso 12 months post‐launch in late 2014. The design was a multiple and contrasted case study involving 18 cases (health centres). Empirical data were collected from observations, informal (n = 224) and formal (n = 459) interviews, and documents. Outside the circle of persons trained in PBF, few in the community had knowledge of it. In some health centres, the fact that staff were receiving bonuses was intentionally not announced to populations and community leaders. Most local actors thought PBF was just another project, but the majority appreciated it. There were significant delays in setting up agencies for performance monitoring, auditing, and contracting, as well as in the payment. The first audits led rapidly to coping strategies among health workers and occasionally to some staging beforehand. No community‐based audits had yet been done. Distribution of bonuses varied from one centre to another. This study shows the importance of understanding the implementation of public health interventions in Africa and of uncovering coping strategies.     

A retrospective public health analysis of the Republic of Ireland's Food Harvest 2020 strategy: absence,avoidance and business as usual

The concept of an Ecological Approach to health and including Health in All Policies warrants inter-sectoral and transdisciplinary collaboration to improve health determinants and reduce health inequities. Agriculture policies, which greatly influence food production and its environmental impacts as well as food availability and dietary consumption, are therefore of interest to public health. Increasing rates of non-communicable diseases linked to diets containing high levels of processed foods, increasing numbers of households unable to access nutritious food and the environmental consequences of the food system are amongst the major health challenges of today, both globally and in Ireland. In 2010, Ireland’s Department of Agriculture, Food and Fisheries published Food Harvest 2020 a roadmap for Irish agriculture for the subsequent decade prepared against a backdrop of rising diet-related ill-health and increasing environmental concerns. This article critically analyses the process of consultation and stakeholder involvement in the development of Food Harvest 2020 from a public health perspective. Publically available documents including submissions to the Food Harvest 2020 consultation process were the primary source of data. This study highlights a distinct absence of public health representation in the process, an avoidance of some key public health challenges and the dominance of a ‘business as usual’ approach.     

QbD理念在新型抗菌药磷酸特地唑胺工艺研究中的应用

目的 抗菌药磷酸特地唑胺的工艺研究。方法 QbD理念指导工艺研究,以中间体A和焦磷酸四苄酯为原料合成磷酸特地唑胺。结果 以58%的总收率实现了磷酸特地唑胺的制备,HPLC纯度为99.2%。 结论 新开发的工艺反应条件温和,有效地避免了水解杂质、二聚体杂质的产生,保证了磷酸特地唑胺的产品质量。