Membrane technology for optimizing process optimization of small bioactive compounds in Mailuoning Injection factory effluene北大核心CSCD

Objective: To enrich small bioactive compounds from Mailuoning Injection factory effluene by polyether sulfoxide hollow fiber membrane. Methods: The retention rate of the common polymer (protein, tannin, starch, and pectin) and the permeability of the small molecule pharmacodynamic substance chlorogenic acid were the indicators, and the stop time and membrane type in ultrafiltration process were optimized. The temperature, pressure, and feed rate were investigated to determine the influence degree of each factor on the permeability and retention rate, and then the optimum process parameters of the ultrafiltration membrane process were optimized by using Box-Behnken design-response surface method. Results: The sequence of common polymer retention rate from high to low is: the influencing factor A (temperature), B (pressure), C (feed rate), and there was a negative correlation with the temperature. For the chlorogenic acid transmission rate, the influencing factor A (temperature) was larger than B (pressure), and C (feed rate) was lowest. There was a “∩” relationship between chlorogenic acid permeability and pressure at a certain temperature and rate. The results of optimized process were as follows: liquid temperature was 35 ℃, feed rate was 262 mL/min, and membrane pressure was 15.0 psi (1 psi = 6.895 kPa). The chlorogenic acid transmission rate was (91.470 ± 0.988)%, and polymer retention rate was (80.080 ± 2.296)%. The comprehensive score was (85.780 ± 1.641)% and RSD was 0.46%. There was a small difference between the two processes. Conclusion: Hollow fiber membrane, which is a sustainable and green resource utilization, has a good permeability for small bioactive compounds in wastewater, and has excellent retaining effect on common macromolecules. © 2019, Editorial Office of Chinese Traditional and Herbal Drugs. All right reserved.     

基于信息技术的社区卫生服务绩效管理模式设计

本研究针对社区卫生服务绩效管理工作中的实际问题,探讨社区卫生服务与信息技术之间的结合点,设计社区卫生服务经费测算模型、评分基准、考核方案、异常绩效分析知识库等,以期通过信息化手段提升社区卫生服务绩效管理效率,构建基于信息技术的新型社区卫生服务绩效考核标准循证机制、信息流通机制和过程监督反馈机制。     

人类辅助生殖技术子代安全性问题

人类辅助生殖技术(ART)日渐成熟,已成为广大不孕不育患者克服疾病困扰获得后代的可靠助孕手段。围绕ART采用的相关医疗手段及对配子和早期胚胎采取的多种实验室干预措施如体外授精、卵胞浆内单精子注射、胚胎植入前遗传学诊断、胚胎冷冻保存及冻融胚胎复苏技术等对ART子代的安全性存在的影响,已成为生殖医学领域研究的重点。研究表明,ART子代和自然妊娠子代的健康状况相似,辅助生殖技术是相对安全的。然而,受ART子代年龄和群体样本量影响,研究只能阐述ART子代出生后早期的随访,尚无权威证据揭示其对子代成年后的远期影响,也无法证明这些研究结论是否与ART适应证、夫妻双方不孕原因、母体年龄、遗传因素、IVF技术本身、IVF相关的不良围产结局等是否存在相关性。对 ART 助孕的子代安全性问题进行综述,讨论ART常规技术与出生缺陷、ART与早产、ART与低体质量儿、ART子代生长发育评估、ART子代的精神健康等问题,为人类ART安全有效的应用提供依据。     

医院制剂补肺胶囊提取工艺研究

目的:优选补肺胶囊的提取工艺条件。方法:运用高效液相色谱法(HPLC)测定补骨脂素、异补骨脂素含量,流动相甲醇-水(55∶45),检测波长246 nm,流速1.0mL·min~(-1),柱温30℃。以补骨脂素、异补骨脂素含量总量为综合评分指标,采用L_9(3~4)正交试验设计考察加水量、提取时间、提取次数对补肺胶囊水提工艺的影响。结果:优选提取工艺条件为加8倍量水提取3次,每次1.5 h。结论:在优化条件下,工艺稳定可行,补骨脂素、异补骨脂素含量最高,可为补肺胶囊的质量控制及工业生产提供科学参考。     

影响体外鼠胚试验标准化的要素分析

不孕症已成为影响人类生殖健康的全球性问题,作为治疗不孕症的一种重要治疗手段,辅助生殖技术经过几十年的发展已经获得长足进步。辅助生殖技术用医疗器械产业快速发展,对此类产品进行风险管理,制定相应的安全性评价检测方法已势在必行。2016年行业标准YY/T 1434-2016《人类体外辅助生殖技术用医疗器械体外鼠胚试验》已经发布,本文就体外鼠胚试验中的关键节点和试验体系要素进行简要综述。     

Innovation in surgery: the rules of evidence

The intellectual infrastructures of evidence-based medicine (EBM) are the levels of evidence and the grades of recommendation for the following types of research articles: therapy/prevention, etiology/harm, prognosis, diagnosis, differential diagnosis/symptom prevalence study, economic analysis/decision analysis. The levels of evidence for therapy (1 to 5) progress from systematic reviews (with homogeneity) of randomized control trials (RCT) of high quality, level 1, to level 5-expert opinion without explicit critical appraisal, or based on physiology, bench research, or "first principles." The grades of recommendation (A, B, C, D) are founded on the quality of the evidence defined by its level. These grades are aimed at helping clinicians understand the source from whence came statements in, for example, guidelines. The development of surgical procedures and their introduction into practice has not depended upon the RCT but rather upon an enthusiast performing a case series, sometimes with clearly defined results. Should all operations and procedures be evaluated by an RCT? Clearly not, and the levels of evidence support this quite clearly with the "all or none" research category as level 1c. This relates to frequent clinical situations requiring a solution often immediate, eg, pus, a ruptured aneurysm, a sucking chest wound, that do not lend themselves to a trial, as the control regimen (doing nothing) would lead to death. Techniques evolve with experience usually based on an understanding of pathophysiology. At what point should an RCT enter into the resolution of surgical therapies? Can observational studies correctly designed and carried out do the job? Two new study classifications have been introduced: in level 1, category c "all or none" studies; and in level 2, category c "outcomes" research. In neither is there much definition. Are these the areas into which the evaluation of new surgical procedures and technology should be placed? The surgical community is faced with dramatic changes in technology and evolving techniques, and needs to define the rules of evidence applicable to their discipline with the same rigor that the EBM gurus have used, in order for surgeons to define evidence-based surgical practice.     

关节镜加微创锁定加压钢板治疗胫骨平台骨折

目的探讨子母钢板法治疗复杂胫骨平台骨折的临床疗效。方法 2004年3月至2007年12月我院采用手术复位、自体骨移植植骨和子母钢板固定治疗复杂胫骨平台骨折45例,其中男34例,女11例;年龄19～59岁,平均37.5岁。其中,交通事故伤37例,高处坠落伤5例,其他3例。胫骨平台骨折Schatzker型32例、型13例。结果随访14～26个月,1例骨折不愈合,1例感染,膝关节功能Rasmussen评分,优36例,良3例,中3例,差3例。44例患者骨折愈合完全负重行走后患膝与健膝的胫骨平台后倾角、关节面塌陷程度、胫骨平台最大横经的X线片测量值比较无差异。结论子母钢板法治疗复杂胫骨平台骨折对关节周围软组织损伤小,可最大程度解剖复位关节并坚强内固定,利于早期进行关节功能锻炼,降低并发症,是治疗复杂胫骨平台骨折安全有效的方法。     

Neurosurgical robotics: a review of brain and spine applications

Neurosurgery has traditionally been at the forefront of advancing technologies, adapting new techniques and devices successfully in an effort to increase the safety and efficacy of brain and spine surgery. Among these adaptations are surgical robotics. This paper reviews some of the more promising systems in neurosurgical robotics, including brain and spine applications in use and in development. The purpose of the discussion is twofold—to discuss the most promising models for neurosurgical applications, and to discuss some of the pitfalls of robotic neurosurgery given the unique anatomy of the brain and spine.     

重症监测治疗技术对重症手足口病患儿病情及预后的影响

目的：将重症监测治疗技术应用于重症手足口病患儿的救治,以探讨对病情及预后的影响。方法：选择自2009年1月1日-2009年9月6日24时入住我院手足口病重症病房的重症手足口病患儿492例．分析：①发病年龄．性别。（2）最高体温、皮疹、严重表现及并发症等。（3）机械通气患儿的带机时间。机械通气并发症。（4）WBC、血糖、血乳酸、心肌酶、肝功酶．胸片及病原学检查等辅助检查结果。应用重症监测治疗技术及脏器功能支持等。结果：83．7％患儿年龄在3岁以下：100％患儿发热;100％患儿口腔或手、足、臀部有皮疹。神经系统并发症表现为精神差．易惊、肢体抖动,嗜睡;呼吸系统表现为呼吸急促、浅慢,节律不规则;循环系统表现为心率增快、减慢．血压增高或降低、皮肤花斑、四肢皮温低;辅助检查：部分病例出现血WBC、AST．ALT、CK-MB和血糖、血乳酸升高,咽拭子EV71-PCR阳性率36．6％．肛拭EV71-PCR阳性率41．9％。胸片表现为肺纹理增粗。渗出或无明显异常。机械通气患儿147例。492例患儿治愈489例．死亡3例,死亡率0．61％。无1例患儿有机械通气并发症及神经系统后遗症。结论：在本次手足口病救治中。应用重症监测治疗技术对重症患儿各个脏器系统进行监测治疗,可降低死亡率．减少并发症,避免神经系统并发症。     

玻璃化冷冻不同来源卵母细胞的临床研究

目的 探讨玻璃化冷冻对卵巢刺激（ovarian stimulation,OS）和控制性超促排卵（controlled ovarian hyperstimulation,COH）来源的卵母细胞影响.方法 对OS和COH来源的卵母细胞进行玻璃化冷冻,解冻后观察存活率,继续发育潜能及移植后的妊娠率并与COH来源的新鲜卵母细胞进行比较.结果 OS和COH来源的卵母细胞玻璃化冻融后的存活率和继续发育潜能无统计学差异（P＞0.05）,与新鲜卵母细胞差异无统计学意义（P＞0.05）.COH冷冻组和OS冷冻组的妊娠率和种植率分别是25.0%（3/12）、20.8%（5/24）和33.3%（1/3）、12.5%（1/8）.结论 玻璃化冷冻技术可以应用于OS和COH来源的成熟卵母细胞的冷冻保存,对其继续发育潜能和妊娠结局无显著影响.