围绕公立医院改革 推行“3456”管理

绍兴市人民医院结合医院实际,提出了医院＂3456＂管理原则,通过在院内采用无汞体温计和无汞血压计,打造＂无汞医院＂;严控抗生素使用,传播正确的用药观;推行全年无节假日医院;减少陪人,陪而不护;引导公众走出误区,规范输液行为;实施＂出院床边结账＂新举措等实现＂3无3低＂、即＂无汞、无抗、无假;低陪、低输、低结＂目标。通过＂4个不放过＂,关注患者安全,承载生命重托。实施＂5S＂管理,积极落实行动,营造有序医疗环境。引入＂6西格玛＂管理,改善服务流程,改进医疗质量,提升医疗服务品质。     

中风益气活络方中黄芪甲苷渗漉提取工艺实验研究

目的：考察复方对黄芪甲苷溶出率的影响。方法：通过正交试验确定复方中黄芪甲苷的最佳提取工艺。结果：乙醇浓度、颗粒大小、浸泡时间均对提取率有显著性的影响。结论：中风益气活络方中黄芪甲苷最佳提取工艺为50目,48h,60%乙醇浸泡渗漉。     

腰椎小关节退变的CT诊断

目的分析CT对腰椎小关节退变的诊断价值。方法对70例小关节退变的发病与CT表现进行回顾性分析。结果腰椎小关节退变的主要CT表现为：①小关节增生肥大及骨赘形成,关节间隙狭窄,小关节不对称,关节面硬化。②关节间隙内真空现象。③关节囊肥厚或钙化。④关节不稳。结论腰椎小关节退变是一种发病率很高的病例,CT为小关节退变诊断提供了可靠的影像学根据。     

应对重症手足口病的医院急救流程研究

目的制定救治重症手足口病的急救流程在预防、发现和救治重症手足口病的患儿。方法运用制定出的救治重症手足口病的急救流程,应用于1000张的综合性医院从2008年5、6、7、8月至2010年7月观察发现和排查重症手足口病病例、疑似病例的有效性。结果此套救治重症手足口病的急救流程,共筛查门急诊就诊患者数19856例、手足口部位皮疹明显伴发热6756例、并发脑炎23例、只有散在性皮疹症状不典型者1273例、医学观察328例、并发肺水肿1例、期间无院内感染病例,无医务人员感染、漏诊、漏登记和死亡病例。结论该套救治重症手足口病的急救流程在目前情况下是有效可行的,为未来在类似传染病的防治上积累资料。     

Novel and sensitive ELISA for the rapid quantification of recombinant p64K protein

The antigenic P64k protein from the pathogenic bacterium Neisseria meningitidis has been used as an immunological carrier in several conjugated vaccines. The aim of this report was to develop and validate a sensitive sandwich enzyme-linked immunosorbent assay (ELISA) for the quantification of recombinant p64k protein, to perform both manufacturing process and identification in different vaccine preparations. Validation studies were performed according to the guidelines of the International Conference of Harmonization (ICH). The reference curve showed to be precise and accurate over the entire linear range of 1.25 and 20ng/mL with a limit of quantification validated to 1.25ng/mL. The intra- and inter-assay coefficient of variation ranged from 0.35 to 6.65% and 4.70 to 10.63%, respectively. The ANOVA test used in the specificity/interference study revealed parallelism among curves (p>0.1), which indicates the lack of interference in the working range. Recovery obtained from the accuracy test, using three concentration levels, varied between 94 and 111%, confirming the assay's reliability. The short-term study shown the P64k is stable to -20°C up to 1-week. This ELISA was fully used to assess its manufacturing process and molecular interaction issues in several vaccine preparations. Thus, this immunoassay could be an excellent analytical choice to characterize the quality of that recombinant protein in several contexts as manufacturing process and molecular conjugates.     

Chiral HPLC studies on chemical behavior of 6-methoxydihydrosanguinarine in alcoholic solvent system

All the enantiomers of methoxydihydrosanguinarine (MS), ethoxydihydrosanguinarine (ES) and iso-propoxydihydrosanguinarine (PS) were separated by chiral HPLC. They were further identified by comparing the retention times of authentic standards as well as LC-MS. Interestingly, the approximately same conversion rates for the formation MS from ES or PS and the slower conversion of MS in isopropanol compared to ethanol demonstrated two step mechanism in the reaction of alkoxysanguinarine in alcohols, which is composed of the initial formation of sanguinarine as a planar intermediate and the addition of alcohol to intermediate as possible rate limiting step. Thus, sanguinarine has a pivotal role in the chemical behavior of alkoxysanguinarine in alcoholic solvents. Such possible variation of the structure of sanguinarine may be the source of its diverse biological activities.     

Batch statistical process control of a fluid bed granulation process using in-line spatial filter velocimetry and product temperature measurements

Fluid bed granulation is a batch process, which is characterized by the processing of raw materials for a predefined period of time, consisting of a fixed spraying phase and a subsequent drying period. The present study shows the multivariate statistical modeling and control of a fluid bed granulation process based on in-line particle size distribution (PSD) measurements (using spatial filter velocimetry) combined with continuous product temperature registration using a partial least squares (PLS) approach. Via the continuous in-line monitoring of the PSD and product temperature during granulation of various reference batches, a statistical batch model was developed allowing the real-time evaluation and acceptance or rejection of future batches.Continuously monitored PSD and product temperature process data of 10 reference batches (X-data) were used to develop a reference batch PLS model, regressing the X-data versus the batch process time (Y-data). Two PLS components captured 98.8% of the variation in the X-data block. Score control charts in which the average batch trajectory and upper and lower control limits are displayed were developed. Next, these control charts were used to monitor 4 new test batches in real-time and to immediately detect any deviations from the expected batch trajectory. By real-time evaluation of new batches using the developed control charts and by computation of contribution plots of deviating process behavior at a certain time point, batch losses or reprocessing can be prevented.Immediately after batch completion, all PSD and product temperature information (i.e., a batch progress fingerprint) was used to estimate some granule properties (density and flowability) at an early stage, which can improve batch release time. Individual PLS models relating the computed scores (X) of the reference PLS model (based on the 10 reference batches) and the density, respectively, flowabililty as Y-matrix, were developed. The scores of the 4 test batches were used to examine the predictive ability of the model.     

Peer and sexual relationships in the experience of drug-dependent adolescents in a therapeutic community

Introduction and Aims. Evidence for success of adolescent treatment programs, including therapeutic communities, has been found among those who complete treatment. However, there is a lack of research examining peer relationships as part of treatment experience. Given the central role of ‘community’, including peers, as agents of change in therapeutic communities, there is a need to better understand peer relationships in treatment. This ethnographic study provides a window into the dynamics of adolescent relationships in a residential treatment program. Design and Methods. Four months of participant observation, including 21 residents (15 male and 6 female) aged between 14 and 18 years—comprising all residents admitted during the study. All the data in this paper are from those who were 16 years or over. Results. The data reveal the complex peer relationships that form for some residents. Peer groups were found to provide a space for residents to feel included but more often were a mechanism to ostracise or bully others. In contrast to past studies, our study found sexual activity was widespread, in particular among girls. A lack of sex caused frustrations for some and sexual encounters were found to coincide with overt conflict between residents. Conclusions. Treatment programs for adolescents need to more explicitly grapple with the complexity of resident's peer relationships, which may impact on treatment experience. Our study suggests sexual relationships may be common in treatment programs for adolescents and a cause of conflict. Further research about the mediating impact of peer relationships, including sexual relationships, is needed.[Nathan S, Foster M, Ferry M. Peer and sexual relationships in the experience of drug‐dependent adolescents in a therapeutic community. Drug Alcohol Rev 2011;30:419–427]     

液体火箭发动机模块化通用仿真研究

以大型液体火箭发动机研制为背景,根据模块化建模思想和通用仿真要求,提出一种具有良好通用性和系统组织能力的仿真方法,数学模型在模块内的存储形式是代码文本,操作者只需从界面即可添加模型,扩展模块库。本文描述了实现这种方法的软件架构,在VC6.0平台上,采用C++语言开发出该仿真软件,并在MFC的文档视图结构的基础上实现了可视化建模,完成了对某液体火箭发动机瞬变过程仿真。通过计算结果与试车曲线的对比,初步验证了所采用仿真方法的可行性和正确性。研究工作可以很方便地实现对其它液体火箭发动机系统动态过程的仿真。     

海带中褐藻糖胶的超声提取工艺的优化

目的研究以水为溶剂超声波强化提取海带褐藻糖胶的工艺。方法采用正交设计,以超声提取时间、超声功率、固液比和提取温度为考察因素,优选了超声波提取海带中褐藻糖胶的最佳工艺。结果各因素对提取率的影响大小依次为：超声提取时间〉固液比〉提取温度〉超声功率,优选的最佳提取工艺为：超声作用时间30 min,固液比1∶30,提取温度40℃,超声功率320 W。按此条件重复实验3次,测得褐藻糖胶的提取量为19.89 mg.g-1。结论较之传统提取方法,超声法提取海带中褐藻糖胶具有省时、节能等优点。