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Objective: To evaluate the pilot technological process of Compound Banlangen Liyan Granules (CBLG). Methods: According to the indexes of six effective ingredients loss amount, accumulated loss rate, and HPLC characteristic spectrum similarity, the process quality of four key processes was evaluated and compared, such as microfiltration of ceramic membrane, vacuum concentration of extract, vacuum drying of concrete, and atmospheric drying of granules. Results: It was found that the total loss rates of glycyrrhizic acid, harpagoside, (R,S)-epigoitrin, liquiritin in two batches were 50.06%—66.99%, and angoroside C, adenosine were 35.49%—41.90%. The total content of the six effective ingredients of each material within the same batch of the two pilot batches from high to low were as follows: extract solution before membrane filtration > extract solution after membrane filtration > concentrate extract solution > dried concrete powder > granules of finished product. The comparison among four key processes loss rates was as follows: vacuum drying of concrete > ceramic membrane microfiltration > vacuum concentration of extract, atmospheric drying of granules. Loss amount of concrete vacuum drying process of the two pilot batches were 0.545 9 and 0.737 5 mg/g, and the process was the major loss process. The total loss rates of the two pilot batches were 48.15%, 50.85%, respectively. The HPLC characteristic spectrum similarity of each material within the same batch of the two pilot batches decreased from 0.998 to 0.818 with increasing process. The HPLC characteristic between the two batches of finished products was good (the similarity was 0.999). Conclusion: The consistency of the finished product quality between two batches was good. The study provided a basis for pilot production process control of CBLG. In the modernization and standardization study of traditional Chinese medicine preparation process, mild process of low temperature and short time heating should be applied as far as possible. It can reduce the effective components loss of original extract (decoction of herbal medicine) in the preparation process and maintain the quality and efficacy consistency of traditional Chinese medicine preparation and original extract (decoction of herbal medicine).
ABSTRACT
ANTECEDENTES Y OBJETIVO El Medical Loss Ratio (MLR) es la proporción de los ingresos que un asegurador de salud recibe por primas, que es gastado en servicios clínicos. Una de las intervenciones que se ha propuesto es establecer un porcentaje mínimo para este indicador, controlando las ganancias que las Isapres pudiesen percibir a costa de los usuarios. En este contexto el Departamento de Asesoría Ministerial solicita esta síntesis de evidencia con el objetivo de informar la toma de decisiones respecto del efecto de una política para controlar las ganancias del sistema ISAPRE, imponiendo un umbral al MLR. METODOLOGÍA Se formuló una estrategia de búsqueda para ser utilizada en 5 bases de datos con el objetivo de identificar revisiones sistemáticas del tema. Al no encontrarse, se seleccionaron todos los estudios primarios que abordaran el tema. Se incluyeron únicamente los casos de seguros individuales, excluyendo todo tipo de seguros colectivos o de vida. RESULTADOS El resumen NO utiliza revisiones sistemáticas -Los cambios ocasionados por el establecimiento de un MLR se centran más bien en el aumento de gastos en bonos más que en una reducción de las primas. -Los aseguradores con un MLR menor a 70% aumentan significativamente sus gastos en bonos al implementar un umbral de MLR obligatorio de 80%. -La definición de un umbral en el MLR generaría un aumento en los gastos para mejorar la calidad de la atención, no obstante, no se observó una mejora de calidad efectiva en salud mental. -Mercados monopólicos muestran menores MLR. Sin embargo, al aumentar la participación del asegurador en el mercado, aumentaría el MLR y número de bonos por persona. -Aseguradores con presencia en otros mercados tendrían menores MLR. -Para aseguradores con bajo MLR, la aplicación de un umbral para MLR generaría un aumento significativo de más de 10% en su MLR al año siguiente de aplicada la medida. -La experiencia de EE.UU. muestra que se redujeron los gastos administrativos, aumentaron las devoluciones de dinero a asegurados, mientras que el valor de las primas y la inversión en calidad se ha mantenido relativamente constante. Aseguradores con fines de lucro tendrían menores MLR.
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Income , ChileABSTRACT
PURPOSE: The purpose of this study was to compare the screw joint stability between the CADCAM custom-made implant abutment and the prefabricated implant abutment by measuring the reverse torque value after cyclic loading. MATERIALS AND METHODS: Twelve screw type implants (Implantium, Dentium Co., Seoul, Korea) were embedded in aluminum cylinder with acrylic resin. The implant specimens were equally divided into 3 groups, and connected to the prefabricated titanium abutments (Implantium, Dentium Co., Seoul, Korea), CADCAM custom-made titanium abutments (Myplant, Raphabio Co., Seoul, Korea) and CADCAM custom-made zirconia abutments (Zirconia Myplant, Raphabio Co., Seoul, Korea). The CAD-CAM milled titanium crown (Raphabio Co., Seoul, Korea) was cemented on each implant abutment by resin cement. Before cyclic loading, each abutment screw was tightened to 30 Ncm and the reverse torque value was measured about 30 minutes later. After the crown specimen was subjected to the sinusoidal cyclic loading (30 to 120 N, 500,000 cycles, 2 Hz), postloading reverse torque value was measured and the reverse torque loss ratio was calculated. Kruskal-Wallis test was used for statistical analysis of the reverse torque loss ratio. RESULTS: The CADCAM custom-made titanium abutments presented higher values in reverse torque loss ratio without statistically significant differences than the prefabricated titanium abutments (P>.05). Reverse torque loss ratio of the custom-made zirconia abutments was significantly higher compared to that of the prefabricated titanium abutments (P=.014). CONCLUSION: Within the limitation of the present in-vitro study, it was concluded that there was no significant difference in screw joint stability between the CADCAM custom-made titanium abutments and the prefabricated titanium abutments. On the other hand, the CADCAM custom-made zirconia abutments showed lower screw joint stability than prefabricated titanium abutments.