ObjectiveTo explore the application of clinical pathway in patients undergoing orthopedic day surgery.MethodsPatients who were scheduled for orthopedic treatment at Day Surgery Department of the Second Hospital of Shanxi Medical University from May to October 2020 were selected as the clinical pathway group, and all of them were managed by clinical pathway. Patients who were scheduled for orthopedic treatment at Day Surgery Department of the Second Hospital of Shanxi Medical University from May to October 2019 were selected as the routine group, and all of them were managed by conventional clinical methods. The general conditions of patients, physicians’ work efficiency, medical costs and medical quality were compared between the two groups.ResultsThe clinical pathway group included 246 patients, and the routine group included 391 patients. There was no significant difference in gender, age or disease distribution between the two groups (P>0.05). Compared with the routine group, the clinical pathway group had obvious advantages in terms of average time spent by a physician in issuing a medical order each time [(5.64±3.29) vs. (2.12±1.05) min], average number of revisions per physician’s order (1.40±0.24 vs. 0.38±0.19), rate of filing medical records within 3 days (90.28% vs. 97.97%), hospital costs [(7462.10±1035.01) vs. (6252.52±1189.05) yuan], drug costs [(652.21±88.53) vs. (437.17±108.20) yuan], length of stay [(1.23±1.04) vs. (1.02±0.18) d] and delayed discharge rate (7.93% vs. 2.03%), with statistically significant differences (P<0.05). There was no significant difference between the two groups in terms of unplanned reoperation rate, unplanned rehospitalization rate, or patient satisfaction (P>0.05).ConclusionCompared with routine clinical management, clinical pathway management can improve work efficiency, reduce medical cost and improve medical quality more effectively in the implementation of orthopedic day surgery, which has very positive effects and is worthy of promotion and application.
ObjectiveTo analyze standards of alginate-based medical devices at home and abroad, and to emphasize key issues of quality control that should be concerned about.MethodsBased on investigation of alginate application in medical devices and alginate-related medical standards, alginate-related technical indicators and quality control points were comprehensively analyzed.ResultsWith the rapid development of alginate-based medical materials and medical devices, the relevant standards at home and abroad have been elaborated on the basic technical indicators and detection methods. In addition to Chinese Pharmacopoeia, China has issued one alginate standard for tissue engineering and three alginate related product standards.ConclusionConsidering the special physical and chemical properties of alginate, researchers also need to focus on the sterilization method, expiry date, molecular weight, and ratio of α-L-guluronic acid to β-D-mannuronic acid of alginate, and impurity content.
目的 依托四川大学华西医院的临床资源，建立了一个规范化、标准化的肿瘤组织标本库，对临床医学研究提供了珍贵的资源。 方法 于2009年6月创建四川大学华西医院肿瘤组织标本库、进行质量控制、规范化管理及总结实践经验。 结果 从创建肿瘤组织标本库至2012年2月，共收集各类肿瘤（胃、食管、肝、肺、肠、乳腺、胰腺、甲状腺、纵隔、肾脏、喉、脑）组织标本44 609例，包括肿瘤组织、肿瘤旁组织（距离肿瘤组织2 cm的组织）和切缘远端非肿瘤组织（距离肿瘤组织＞5 cm的组织）。对肿瘤组织标本进行有效和科学的管理，为科研提供了便利和高质量的资源。 结论 建立了一个国际标准化、规范化、信息完善的肿瘤组织标本库，可为肿瘤的发生、发展、转移及生物标志物的研究提供高质量的标本。
【摘要】 目的 考察用乌头碱水解物、新乌头碱水解物、次乌头碱水解物的含量作为附片水煎剂及附片质量控制指标的可行性。 方法 采用高效液相色谱分析法，色谱柱为Shimpack CLC-ODS，以甲醇-乙酸铵溶液（0.2 mol/L）（200︰210）为流动相，流速1.0 mL/min，检测波长为241 nm，对乌头碱新，乌头碱、次乌头碱水解物的含量测定进行研究。 结果 3种水解物检测方法测得水解物在进样范围有良好线性关系，重现性好，稳定性好，生药提取时间宜选定为40 min，不同批号的附片中3种水解物含量差别较大。 结论 此方法简便，使用新乌头碱、乌头碱、次乌头碱的水解物作为含附片制剂的质量控制指标是可行的。【Abstract】 Objective To examine the feasibility of regarding the hydrolyzate from aconitine, new aconitine, and hypaconitine to be the decoction of radix aconite and the quality control index. Methods High performance liquid chromatographic method (HPLC) method was adopted. Shimpack CLC-ODS column with UV detection at 241 nm was used. The mobile phase consisted of (200∶210), and the flow rate was 1.0 mL/min. Results The content of the hydrolysis objects in the water decoction and toxicity were correlated with each other, and the contents of hydrolysis were significantly different among different groups of radix aconiti. Conclusion This method is simple, accurate and effective for content research of hydrolyzate from aconitine-type alkaloids in Monkshoo decoction of Radix Aconiti, and it is feasible to take it as the quality control index.
Mitochondrial quality control includes mechanisms such as mitochondria-derived vesicles, fusion / fission and autophagy. These processes rely on the collaboration of a variety of key proteins in the inner and outer membranes of mitochondria to jointly regulate the morphological structure and functional integrity of mitochondria, repair mitochondrial damage, and maintain the homeostasis of their internal environment. The imbalance of mitochondrial quality control is associated with leukemia. Therefore, by exploring the mechanisms related to mitochondrial quality control of various leukemia cells and their interactions with immune cells and immune microenvironment, this article sought possible targets in the treatment of leukemia, providing new ideas for the immunotherapy of leukemia.
Objective To analyze and compare the domestic quality standard and foreign quality standard of sodium hyaluronate (HA), and to expatiate on the critical process monitoring parameters. Methods Different quality standards of HA were compared by translating and sorting, and some experimental data were analyzed as well as the manufacturing practice was elaborated. Results Differences exist in raw materials standard or specifications of products between domestic and foreign, but the basic control points are concordant. Conclusion The company should set up reasonable and controllable quality standard based on quality requirements and related process characteristics so as to assure the safety and effectiveness of the clinical application.