A Competent and Commercially Viable Process for the Synthesis of the Anti-Hypertensive Drug Olmesartan Medoxomil

Drug product purity and potency are of most significance in the regulatory market as we notice many recalled batches worldwide, particularly in the US and Japan. Olmesartan Medoxomil is an anti-hypertensive drug. The present invention relates to a process for the preparation of Olmesartan Medoxomil with 99.9% purity in an overall 62% yield. The synthesis includes three isolations and one purification with easy plant operations. This process describes the formation and control of each individual impurity in all stages. This process for Olmesartan Medoxomil and its intermediates is competent for industrial production in very short reaction time intervals with an appreciable yield and high purity.     

流程管理在肝癌患者行PD-1单抗治疗中的应用探讨朱燕1 俞静娴1 周海英1 王燕1 孙丽骏1

目的 探讨流程管理对优化肝癌患者PD-1治疗护理流程的效果。方法 成立流程管理小组,将2019年1-6月流程管理改善前收治的66例PD-1治疗患者与2019年7-12月改善后的62例PD-1治疗患者进行比较,比较流程管理改善前后患者的住院时间及患者的满意度情况。 结果 流程改善后,观察组住院时间显著优于对照组(P<0.001),患者的满意度大于95%。结论 运用流程管理,可有效减少患者住院时间,改善患者的就医感受,减轻医护人员的压力。     

A spiritually-based measure of holistic health for those with disabilities: Development,preliminary reliability and validity assessment

Purpose. To develop and test a spiritually-based measure of holistic health for those with chronic physical conditions.

Method. Two studies are reported. Study One used 69 ex-patients with chronic physical conditions to develop a spiritually-based holistic measure of health. An open-ended questionnaire, the Participant Health Questionnaire used the echo technique to obtain statements about the nature of health. These were assembled to form the Rating of Health Statements Questionnaire, which was completed by 59 participants. Reliability and validity analysis yielded a 38-item Health Attitude Scale, the HAS:1, to which the responses of 48 participants produced the 40-item HAS:2, which included an Intent subscale. Wording the HAS:2 in the past tense then created a behavioural measure, the QE Health Scale (QEHS). Study Two used 233 participants from the same population with chronic conditions to assess the reliability of the HAS:2 and QEHS, and their validity against the STAI and the SOC-13.

Results. The QEHS proved reliable (Cronbach's alpha = 0.92) and valid in that it correlated with the SOC-13 (r = 0.32, p < 0.01), the STAI (State) (r = 0. – 39, p < 0.01), the STAI (Trait) (r = 0.35, p < 0.01), the HAS:2 (Importance) (r = 0.61, p < 0.01) and the HAS:2 (Intent) (r = 0.61, p < 0.01).

Conclusion. The QEHS possessed sufficient reliability and validity as a spiritually-based holistic measure of health to warrant further investigation.     

Chondrocytes from Different Zones Exhibit Characteristic Differences in High Density Culture

Superficial and middle/deep zone chondrocytes were isolated from goat femoral cartilage by a zonal abrasion method. The cells were expanded 100-fold through two passages, then seeded into agarose wells to form high-density constructs through a self-assembling process. After 4 weeks in culture, the superficial zone constructs contracted into a dense cell mass, while middle/deep zone chondrocytes formed constructs with four distinct regions. Middle/deep zone chondrocytes produced 250% more glycosaminoglycans per dry weight and more collagen per dry weight than superficial zone chondrocytes. The superficial and middle/deep zone chondrocytes were found to retain characteristic differences even after 100-fold expansion, as evidenced by construct morphology and extracellular matrix content. This study uniquely demonstrated the ability of expanded superficial and middle/deep zone chondrocytes to form constructs of distinct characteristics without a scaffold. The goal of tissue engineering different zones of cartilage is to eventually replicate the specific function of each zone.     

Comparing Morbidities of Testing With a New Index: Screening Colonoscopy Versus Core-Needle Breast Biopsy

PurposeFocusing on outcomes of care alone may be too restrictive. Patients can experience morbidity that is important to them from health care processes themselves. However, many processes, such as testing and screening, have been little evaluated. This study’s purpose was to assess the construct validity of a new preference-based index, the Testing Morbidities Index (TMI), by comparing two common cancer-related procedures in prior publications: screening colonoscopy and core-needle breast biopsy.MethodsWomen evaluating their breast biopsies (n = 100) were compared with men and women who had undergone screening colonoscopy (n = 109) after both groups completed the TMI. The TMI addresses physical and mental or emotional quality of life affected by test-specific aspects occurring before, during, or after any test. It has 7 domains and survey items. TMI scores can be scaled in various ways, including multi-attribute value theory–based patient or societal preferences, where 0 = dead and 1.0 = full health, as used here.ResultsThere was significantly greater morbidity from breast biopsy (mean, 0.84) than from screening colonoscopy (mean, 0.88) comparing overall TMI preference scores (P < .0001). Breast biopsy showed significantly worse morbidity (P = .005 to P < .0001) in most domains. Pain or discomfort before testing was worse for colonoscopy because of bowel preparation. The TMI showed no floor effect and an acceptable ceiling effect.ConclusionsThe TMI provides the first objective evidence comparing the morbidity of one cancer-related testing procedure with another. The TMI may be useful in assessments of medical care processes informative to institutions and imaging departments, shared decision-making scenarios, and economic analyses.     

肿瘤专科医院日间手术管理流程构建

目的通过日间手术流程的构建旨在不断推进日间手术在肿瘤专科医院内的开展,提高运行效率,改善患者就医体验。方法本文通过对日间手术在国内外发展的理论研究现状以及对我国综合医院开展日间手术的实践调研,结合肿瘤专科医院在日间手术评价体系、日间手术病种选择和手术开展方面的工作实际,梳理并构建日间手术管理流程。结果构建了日间手术管理流程,流程包括术前、手术当日、术后三个部分,患者住院时间为24 h,最多不超过48 h,同时提出日间手术病历书写的管理规范。结论肿瘤专科医院开展日间手术需结合病种特点,在实施中需加强日间手术临床路径管理、信息系统建设等。同时提出如何结合肿瘤病种及技术特色,更好地开展日间手术工作是当前肿瘤专科医院推进日间病房的难点。