红霉素乳酸盐转碱结晶工艺改进研究

针对目前红霉素乳酸盐转碱结晶得到的红霉素产品普遍存在的杂质含量高、效价较低、收率较低等问题，在对现行转碱结晶工艺研究的基础上，提出了在较高温度（５５℃左右）下起晶养晶的新工艺，该工艺可使产品的干效价提高至９６８ｕ／ｍｇ，一次效价收率达８４％。     

头孢他啶五水化合物结晶工艺的改进

本论文的实验目的是提高头孢他啶的含量，改善粉体的流动性，有利于工业生产。通过改变结晶浓度、pH值、加晶种，改进了反应结晶的方法。经过大批量实验得到满意的结果，含量达97％以上，收率提高1．6％，由此得出结论，此工艺可行。     

氨苄西林最佳结晶工艺的探索

通过实验的方法来研究结晶过程中各种参数对氨苄西林晶型的影响来考察混合时对氨苄西林溶液结晶过程的影响，选择最佳的结晶工艺条件，更好地指导生产实践过程。经过实验考察，获得最佳的结晶工艺，使产品的各项质量指标提高，认为是氨苄西林的最佳结晶工艺。     

我国医药原料和中间体研究开发新动向

头孢哌酮钠结晶工艺改进 头孢哌酮钠（cefoperazone sodium）是第三代头孢类抗生素，抗菌谱广，抗菌作用强，临床应用广泛。     

利福霉素SV发酵工艺优化的研究

本文通过对影响利福霉素SV发酵因素一温度、溶氧和补料方式的研究，得出结论：在控制培养温度28．5℃、溶氧25％以上的条件下，采用流加方式补料工艺，利福霉素SV的发酵效价较原工艺有明显提高，此工艺已在20T发酵罐上进行工业化生产，发酵效价比原生产工艺有较大提高。     

青霉素G钾盐结晶工艺改进

采用树脂法转钠盐工艺后,注射用青霉素G钠盐的成品质量与其钾盐的质量密切相关。为此,近年来我们对钾盐的结晶工艺作了多次改进。我们起先采用醋酸钾水溶液直接结晶工艺。由于可溶性杂质溶解于水,可随母液带走。产品色级好,但醋酸钾消耗大,转钠盐后280 nm的吸光度值常达不到优级品标准。后来改用醋     

20%甘露醇注射液配制工艺研究

配制20％甘露醇注射液常受许多情况困扰，如甘露醇易结晶，常粘附于滤纸和管道影响滤速，甚至堵塞；澄明度合格率低；热原阳性率高；甘露醇注射液结晶率高，临床使用不便等改进此工艺的主要做法为，过滤前先使滤纸吸附一层活性炭起助滤作用；分次吸附；加大活性炭量；不宜选用软包装输液袋；控制操作过程，减少不溶性微粒。     

克拉维酸钾反应结晶研究

克拉维酸钾是重要的β-内酰胺酶抑制剂。本文考察了溶剂种类、晶种、搅拌速率、流加速率、溶液pH值、结晶温度等工艺条件对克拉维酸钾反应结晶过程的影响。在优化工艺条件下，制得粒度较为粗大的棒状克拉维酸钾结晶，平均粒度48．86μm，分散性和流动性良好，产品质量符合中国药典2000年版和美国药典USP24要求。     

利福霉素B发酵工艺研究

研究温度、溶氧、巴比妥、磷酸盐及补料方式对利福霉素B发酵的影响。结果表明在控制培养温度27℃，溶氧25％以上的条件下，采用流加补料工艺，利福霉素B的发酵效价较原工艺有明显提高，此工艺已在60m^3发酵罐中进行工业化生产，发酵效价比朱生产工艺提高了一倍以上。     

金霉素发酵工艺研究

金霉素产生菌金色链霉菌（Streptomces aureofaciens）9647经紫外线（253.7nm,30W,距离20cm,照射60s）照射、金霉素耐受等处理,得到一株金霉素突变株1-1-14,其摇瓶效价较出发菌株提高18%。采用流加补料工艺,金霉素的发酵效价较原工艺有明显提高,此工艺在100m3发酵罐中进行工业化生产,发酵效价比原生产工艺提高15%。     

海淀区城乡结合部2016~2019年学生流感疫苗预防接种情况调查分析

目的对海淀区城乡结合部2016~2019年学生流行性感冒(流感)疫苗预防接种情况进行分析。方法统计分析2016~2019年于本中心接种的海淀区城乡结合部学校学生流感疫苗预防接种情况。结果2016年总接种率为46.77%,接种率最高的为101分校,接种率为60.85%;接种率最低的为翠微分校,接种率为31.08%。2017年总接种率为50.61%,接种率最高的为和平分校,接种率为57.59%;接种率最低的为中法实验学校,接种率为43.95%。2018年总接种率为45.18%,接种率最高的为中法实验学校,接种率为57.21%;接种率最低的为翠微分校,接种率为33.51%。2019年总接种率50.22%,接种率最高的为寄读学校,接种率为81.05%;接种率最低的为101分校,接种率为39.86%,其次为翠微分校,接种率为47.36%,由于2019年101分校在9月份新换了老师,对业务不熟悉,导致接种率<50%,而翠微分校4年中接种率低占了3年,均<50%。结论为了更好地做好预防保健工作,提高流感接种率,必须采取有效的干预措施,从而预防传染病的发生,提高广大人民群众的健康水平。     

彩色多普勒超声诊断乳腺增生症的临床应用价值研究

目的研究彩色多普勒超声在诊断乳腺增生症中的应用效果。方法68例乳腺增生症患者为研究对象,均应用彩色多普勒超声进行检查。以病理诊断结果为金标准,观察彩色多普勒超声的诊断符合率。结果病理诊断:乳腺囊性增生16例,乳腺小叶增生13例,乳腺纤维腺瘤样增生12例,乳腺组织增生13例,乳腺混合性增生14例。彩色多普勒超声诊断:乳腺囊性增生15例,诊断符合率为93.8%;乳腺小叶增生13例,诊断符合率为100.0%;乳腺纤维腺瘤样增生11例,诊断符合率为91.7%;乳腺组织增生10例,诊断符合率为76.9%;乳腺混合性增生13例,诊断符合率为92.9%。结论彩色多普勒超声诊断乳腺增生症具有较高的诊断符合率,可作为临床诊断的根据,临床应用价值相对较高。     

Development of a membrane-controlled transdermal therapeutic system containing isosorbide dinitrate

The formulation of a transdermal delivery system for isosorbide dinitrate (ISDN) was examined. It was found that the target release rate should be 4.01 mg/h per 20 cm² for optimal dosing. In order to reach such this zero order release rate, a membrane permeation controlled transdermal therapeutic system (TTS) formulation was developed, with ethylene vinyl acetate copolymer (EVAC) and polyethylene (PE) membranes as rate controlling membranes; a carbomer gel was used as the drug reservoir. The release of ISDN from this drug delivery device was studied in vitro using FDA recommended method. PIB adhesive on the EVAC or PE membrane caused a decreased flux of ISDN; the release kinetics fitted Higuchi matrix kinetics. TTS with EVAC membrane release ISDN at a rate much lower than the calculated target release rate, but with PE membranes, the release rate was very close to the target. Release rate studies have revealed that, as the VA content in EVAC membrane increased, the flux of ISDN increased. All these results were compared with the commercial product Frandol^® Tape S from Japan. It was found that the release rate of Frandol was close to target release rate and fitted matrix kinetics. These results suggested that TTS that contain PE membrane as rate controlling membrane, polyisobutylene (PIB) adhesive and carbomer gel as a reservoir can be applicable as a TTS for ISDN.     

粒细胞-巨噬细胞刺激因子辅助治疗急性骨髓性白血病的系统评价

目的:评价粒细胞-巨噬细胞刺激因子(GM-CSF)辅助治疗急性骨髓性白血病(AML)的疗效。方法:计算机检索PubMed、EMBase、CBMdisc、CNKI数据库及Cochrane图书馆,手工检索其它白血病相关杂志,对纳入的GM-CSF治疗AML的随机对照试验(RCT)进行方法学质量评价,并用RevMan5.0软件进行Meta分析。结果:共纳入10个RCT,A、B、C级文章分别有3篇、5篇、2篇。分析结果显示,完全缓解率、复发率、感染率、住院时间等指标的组间差异均无统计学意义。结论:基于现有临床研究结果,GM-CSF不能提高患者完全缓解率,亦不能降低复发率、感染率和缩短住院时间。     

妊娠高危因素监测及管理模式转变探讨

目的 转变妊娠高危因素监测及管理模式,将高危妊娠监测网络延伸至社区医院、村（居）委会,将有生育意向的育龄妇女纳入监测对象,积极处理基础疾病及高危因素.对已筛查出的高危妊娠,主动上门督促定期产检.方法 2010年6月至2011年9月在我院高危妊娠管理辖区产检的孕妇设为对照组;将高危妊娠监测网络延伸至社区医院、村（居）委会后,2011年11月至2013年1月在我院辖区产检的孕妇设为观察组.对两组高危妊娠的管理情况进行回顾性分析.结果 观察组的高危妊娠发生率较对照组低（22.01％ vs.22.57％）,建册率、早期建册率、定期产检率、住院分娩率、产后随诊率较对照组高,剖宫产率、产后出血率、早产率、病残儿发生率、围产儿死亡率低于对照组（P＜0.05）.结论 对已筛查出的高危妊娠,主动上门督促定期产检,提高建册率、早期建册率、定期产检率、住院分娩率、产后随诊率,降低高危妊娠发生率、剖宫产率、产后出血率、早产率、病残儿发生率、围产儿死亡率,改善妊娠结局.     

心肺复苏成功相关因素的分析

目的探讨心肺复苏成功相关的影响因素,为提高复苏成功率提供相应的建议。方法对本院急诊2011年1月～2012年5月108例心跳骤停患者的临床资料进行回顾性分析。结果患者的年龄越大,心肺复苏成功率就越低（P〈0.05）;在5min内实施心肺复苏的患者成功率明显高于〉5min的患者（P〈0.05）;电除颤患者复苏成功率高于未除颤者（P〈0.05）;建立人工气道实施插管的患者复苏成功率高于未插管者（P〈0.05）。结论早期实施心肺复苏、早期电除颤、建立有效的人工气道有助于提高复苏成功率。     

医院感染现患率调查与分析

目的了解齐鲁石化医院集团中心医院医院感染现患率和横断面抗菌药物使用情况。方法采用横断面调查方法,床旁调查和病历调查相结合,对2009年8月10日的住院患者进行医院感染现患率调查。结果调查住院患者394例,发生医院感染17例、18例次,医院感染现患率4.31%,例次现患率4.57%;神经外科现患率最高为17.65%,下呼吸道感染占首位为38.89%,其次是泌尿道感染为22.22%;抗菌药物横断面使用率为42.89%,治疗性用药占53.25%,预防性用药占35.50%,治疗兼预防用药占11.24%,一联用药占60.36%,二联用药占36.69,三联用药占2.95%。结论加强临床科室的目标性监测,提高病原体送检率和分离率,合理使用抗菌药物,减少耐药菌株的产生,控制医院感染发生。     

Influence of the centrifugal granulating process on the properties of layered pellets.

Drug-layered pellets based on microcrystalline cellulose (MCC) beads as substrates were prepared using a laboratory-scale centrifugal granulator. The effect of three independent process parameters (rotor rotation speed, slit air flow rate, and spray air rate) on responses describing the amount of drug loss during the process, amount of agglomerates, bulk density, flowability, friability, shape, and surface roughness were studied using a 3(3) full factorial experimental design. The variables studied were found to have a significant influence on the responses evaluated. Rotor rotation speed and slit air flow rate had a significant positive influence on the amount of drug loss during the process and the amount of agglomerates, whereas rotor rotation speed and spray air rate had the same effect on the bulk density, flowability, and the roundness of the pellets. The amount of agglomerates and the roundness value of the pellets were negatively affected by the spray air rate while the slit air flow rate showed the same effect on the bulk density and flow rate of the pellets. In addition to the main effects, there were some significant paired interactions between slit air flow rate and spray air rate as well as rotor rotation speed and slit air flow rate. Based on the results, the significance of these three parameters should be considered carefully for quality pellet preparation by the centrifugal granulating technique using MCC beads as substrates.     

The effect of various surfactants on the release rate of propranolol hydrochloride from hydroxypropylmethylcellulose (HPMC)-Eudragit matrices.

Hydrophilic and lipophilic polymers are widely used excipients to control the release rate of drugs from matrices. Researchers found that surfactants are able to control the release rate of drugs. The aim of the present investigation is to determine the effects of surfactant type, its concentration and the different ratios of surfactants on the release rate of highly soluble drug (propranolol HCl). In this study, sodium lauryl sulphate (SLS) as an anionic surfactant, cetyl trimethyl ammonium bromide (CTAB) as a cationic surfactant, Tween 65 and Arlacel 60 as non-ionic surfactants were selected. The different concentrations of surfactants were incorporated into hydroxypropylmethylcellulose-Eudragit matrices and then dissolution rate of the drug from the matrices were evaluated at pH 1.2 or 6.8. The results showed that the release rate of propranolol decreased as the concentration of SLS increased. This is due to that SLS is able to form complex with propranolol. In contrast Tween 65 caused an increase in the release rate of the drug. Cationic surfactant (CTAB) had little effect on the release rate of the drug. It was shown that as the ratio of CTAB:SLS increased the release rate of propranolol increased from matrices. This indicated that as CTAB is able to interact with SLS molecules, therefore number of the interacting anionic molecules with the cationic drug was decreased. It can be concluded that, the type and ionization of surfactant, hydrophilicity and lipophilicity of surface active agent and various ratios of surfactants are important factors in controlling the release rate of propranolol.     

12导动态心电图在病窦综合征诊断中的应用价值

目的 探讨12导动态心电图在病窦综合征诊断中的临床意义。方法 选取经临床确诊的40例病窦综合征患者作为观察组,另选取同期40例健康者作为对照组,比较两组人群的动态心电图结果。结果 观察组最快心率,最慢心率、24 h平均心率和24 h总心率均低于对照组,差异有统计学意义(P<0.05);观察组窦性心动过缓、窦性停搏、窦房阻滞、交界性逸搏心律及慢快综合征等心律失常检出率均高于对照组,差异有统计学意义(P<0.05)。结论 12导动态心电图可全面观察患者心律和心率变化,显著提高心律失常检出率,是早期诊断病窦综合征一项必不可少的检测方法。