成都市医疗保健机构产科工作评审结果分析

为贯彻执行《母婴保健法》,成都市对１６５家有产科的医疗保健机构从产房、设备、队伍建设、产科质量等方面进行了综合评审后的换证工作,其中１０９家合格,合格率６６．０６％。为提高产科质量,提出要增加产科投入,加强医疗保健基础设施的建设及产房改建工作;加强基层人员专业技术培训,提高业务素质;加强执法力度,对整改后仍不合格的单位和个人,取缔产科执业资格,确保母婴安全     

创等达标 促进妇幼保健机构全面发展

妇幼保健机构等级评审是保健院管理体制的一项重大改革,是落实《医疗机构管理条例》,加强行业管理,进行医院治理整顿的一个重要步骤,对加强保健院内涵建设起着重要的促进作用。广州市妇幼保健院通过创等达标建设,医院工作得到了全面发展,管理工作逐步走上规范化、科学化的轨道,达到了以评促建、以评促改、以评促管、以评促帮的目的。     

虚拟化——中国医药研究开发策略

的 :探讨现阶段我国医药行业的研究开发策略。方法 :分析目前医药行业药品研发的特点、我国医药产业研发的现状和虚拟化策略对药品研发与我国医药行业产生的积极作用。结果与结论 :现阶段在药品的研发领域采取虚拟化策略对我国医药行业将会产生积极的近期和远期效应     

“供给侧结构性改革”视角下我国中药制造业技术创新效率研究

研究江苏省中药制造业技术创新效率,提高该行业竞争力。运用数据包络分析法(DEA)和Malmquist指数方法,对江苏省2009—2014年中药制造业技术创新效率进行静态的面板数据分析和不同年份的动态分析。江苏省中药制造业技术创新效率整体较高,中成药制造业的技术创新效率高于中药饮片制造业,中成药制造业技术创新的投入和产出在整体运作上相对处于有效状态;6年间,江苏省中药制造业技术创新效率出现了一定幅度负增长(-3.1%),技术创新效率呈现曲折上升趋势;江苏省中药制造业技术创新效率也存在着城市之间的地区差异。通过加大创新资源投入并做到有效利用、优化产业结构及完善有关政策,有效提高江苏省中药制造业的技术创新效率。     

The role of technical assistance in expanding access to Xpert? MTB/RIF: experience in sub-Saharan Africa

To improve tuberculosis (TB) diagnosis, many national TB programmes have committed to deploying Xpert^® MTB/RIF. Implementation of this relatively new technology has suffered from a lack of comprehensive technical assistance, however, including the formulation of policies and plans to address operational issues. While providing technical assistance, we observed numerous operational challenges in the implementation and scale-up of Xpert in five sub-Saharan African countries: low coverage, poor laboratory infrastructure, limited access, poor linkages to treatment, inadequate data on outcomes, problems with specimen transport, diagnostic algorithms that are not aligned with updated World Health Organization recommendations on target patient groups and financing challenges. We recommend better country preparedness and training, laboratory information and quality systems, supply management and referral mechanisms.     

Sequentially updating the likelihood of success of a Phase 3 pivotal time-to-event trial based on interim analyses or external information

When performing a pivotal clinical trial, it may be of interest to assess the probability of success (PoS) of that trial. Initially evaluated when the trial is designed, PoS can be updated as the trial progresses and new information about the drug effect becomes available. Such information can be external to the trial, such as results from trials conducted in parallel, or internal, such as continuing after an interim analysis. We develop a framework to update PoS based on such internal and external information for a time-to-event endpoint and illustrate it using a realistic development program for a new molecule.     

玄参配方颗粒真空带式干燥工艺研究

目的:优化玄参配方颗粒的真空带式干燥工艺。方法:以哈巴苷与哈巴俄苷总和含量和含水量为考察指标,以进料量、加热板温度、履带速度为考察因素,采用L_9(3~4)正交试验确定玄参配方颗粒最佳真空带式干燥工艺参数。结果:确定进料量12 L/h,加热板温度95℃,履带速度20 Hz,为最佳干燥工艺条件。结论:该干燥工艺所得玄参配方颗粒含水量和含量稳定,适用于玄参配方颗粒产业化工艺。     

Zirconia-ceramic versus metal-ceramic posterior multiunit tooth-supported fixed dental prostheses: A systematic review and meta-analysis of randomized controlled trials

BackgroundThe authors aimed to compare the survival and complication rates of zirconia-ceramic (ZC) versus metal-ceramic (MC) restorative material in multiunit tooth-supported posterior fixed dental prostheses (FDP).Types of Studies ReviewedThe authors conducted a systematic search of randomized controlled trials (RCTs), with no time or language restrictions, up to May 2019 using the MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials databases, followed by a manual search.ResultsThe authors included 7 RCTs in the review and 5 RCTs in the meta-analysis. All studies had a low risk of bias. The authors included 330 participants (177 ZC and 173 MC tooth-supported FDP) in the meta-analysis, which revealed a medium-term survival rate of 95.4% (95% confidence interval [CI], 90.5% to 99.1%) for ZC FDP compared with 96.9% (95% CI, 94.3% to 99.4%) for MC FDP, with no significant differences (P = .364). The biological or technical complications did not show statistically significant differences, except in the global ceramic veneering chipping analysis (P = .023; risk difference [RD], 22.3%; 95% CI, 3.0% to 41.6%) and their subanalysis: minor chipping or chipping that can be solved with polishing (P = .044; RD, 19.5%; 95% CI, 0.5% to 38.4%), and major chipping or chipping that needs repair in the laboratory (P = .023; RD, 6.0%; 95% CI, 0.8% to 11.3%).Conclusions and Practical ImplicationsPosterior multiunit ZC restorations are considered a predictable treatment in the medium term, although they are slightly more susceptible to chipping of the veneering ceramic than MC restorations.     

Decision-making and technical factors account for the learning curve in complex surgery

INTRODUCTION: The general public, the legal profession, patients and relatives expect best practice and have difficulty with the concept of a learning curve in surgical interventions. However, it is improbable that technical and innovative skills can be developed, or optimized, without some aspects of learning by experience and indeed 'risk taking'. PATIENTS AND METHOD: A single surgeon experience with a novel, complex, surgical procedure for peritoneal malignancy is described and compared with recent literature reports on the surgical learning curve. In total, 100 of 242 (41%) patients referred underwent a laparotomy. The 100 were divided into three numerically equal groups of 33, 33 and 34 cases, and the proportions undergoing surgery, mortality and major morbidity rates for the three groups were analysed. RESULTS: The numbers undergoing surgery were 33/54 (61%), 33/96 (34%) and 34/92 (37%). The mortality was 6/33 (18%), 1/33 (3%) and 1/33 (3%), and the major morbidity rates were 9/33 (27%), 2/33 (6%) and 0/34 (0%) in the three groups. CONCLUSIONS: The main components of the learning curve were considered to be decision-making and technical factors. A mechanism to reduce the surgical learning curve is suggested involving teamwork, and at least two experienced surgeons involved in all major surgical interventions. Decision-making and technical factors account for the learning curve in complex surgery.