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??OBJECTIVE To investigate the influencing mechanism of the particle size of hydroxypropyl methylcellulose (HPMC) on the release behavior of nifedipine from a sustained-release tablet system based on the compaction properties of HPMC. METHODS The compaction properties of HPMC K4M of different particle sizes were determined. Hydrophilic matrix sustained-release tablets were prepared using nifedipine as the active ingredient and HPMC K4M as a hydrophilic matrix former. The effect of compaction properties of HPMC K4M on the porosity, release, and other properties of nifedipine hydrophilic matrix sustained-release tablets were also studied. RESULTS The decrease of the particle size of HPMC K4M resulted in higher bulk density, tap density, compressibility index, and tensile strength and smaller elastic recovery of HPMC K4M, which all led to the decrease of thickness and porosity and the increase of HPMC concentration per unit volume of nifedipine hydrophilic matrix sustained-release tablets. These factors resulted in faster gelation rate of nifedipine sustained-release tablets and decreased water ingress and polymer swelling, so the release of nifedipine from the delivery system was prolonged. CONCLUSION The obviously different compaction properties of HPMC of different particle sizes influence the porosity and gelation rate and then the release of hydrophilic matrix nifedipine sustained-release tablets.     

桂枝饮片标准汤剂质量标准研究

目的制备桂枝饮片标准汤剂,并进行质量标准研究。方法依照标准汤剂的制备要求,制备15批桂枝饮片标准汤剂,以肉桂酸作为定量检测指标,计算转移率与出膏率,并建立其HPLC指纹图谱分析方法。结果通过对15批桂枝标准汤剂进行测定,肉桂酸转移率为56.93%~94.06%,出膏率为3.30%~9.40%;并用中药色谱指纹图谱相似度评价系统(2012A)软件进行指纹图谱分析,标定了9个共有峰,确认4个,分别为原茶儿酸(1号峰)、香豆素(4号峰)、肉桂酸(6号峰)、桂皮醛(7号峰)。对15批桂枝饮片标准汤剂分别进行了相似度评价,其相似度均高于0.95。结论建立了桂枝饮片标准汤剂指纹图谱,该方法精密度、稳定性和重复性良好,具有一定的鉴别意义,可为桂枝配方颗粒的质量控制提供参考。     

PDCA循环理论对医疗服务质量管理的效果观察

目的分析医疗服务质量管理中运用计划、执行、检查以及调整(PDCA)循环理论的实际效果。方法2017年1月—2017年12月期间在医院未实施PDCA循环理论从中选取200例住院患者作为对照组,2018年1月—2019年6月期间在医院实施PDCA循环理论从中选取200例住院患者作为观察组,对比两组患者相关指标。结果相较于对照组,医疗费用、就医环境、诊治过程、医疗技术、护士服务态度、医生服务态度和满意度观察组评分均显著较高(P<0.05);病历书写合格率和处方书写合格率观察组显著高于对照组(P<0.05)。结论PDCA循环理论应用于医疗服务质量管理中的效果显著,各维度得分均较高,提升了满意度,且加强了病历书写合格率和处方书写合格率。     

经尿道前列腺电气化术结合电切术治疗前列腺增生83例分析

目的：探讨经尿道前列腺电气化术结合电切术治疗前列腺增生（BPH）并提高其安全性及有效性。方法：使用德国WOLF F24连续冲洗气化电切镜对83例BPH患者进行了经尿道前列腺电气化术加电切术治疗。结果：平均手术时间69min,无尿失禁和死亡病例,术后随访3～36个月,国际前列腺症状评分平均9.4分,残余尿量平均为21.7ml。结论：先用铲状气化切割圈切除增生的大部分前列腺组织,并进行快速、有效的止血,再用电切环修切,可快速切除增生的前列腺组织,安全有效,并发症少,值得广泛推广。