Design and implementation of surgical medical waste management system based on B/S structure / 中华医学科研管理杂志

Objective:To explore the application effect of medical waste management system based on B/S architecture in medical waste disposal.Methods:Select a third-class hospital in Yantai for continuous quality improvement of medical waste disposal, and verify the feasibility of the medical waste management system through key indicators such as medical waste related theoretical knowledge, medical waste disposal efficiency, and medical waste disposal management process standardization rate. Through monitoring indicators and result feedback evaluation, it is judged whether the medical waste management system has positive significance for the improvement of medical waste disposal.Results:Taking the adoption of medical waste management system as the node, a five-month comparison before and after was conducted to monitor key indicators such as medical waste disposal efficiency and standardized rate of medical waste disposal management processes. The daily error rate of medical waste classification was reduced from 6.00% to 1.33%, the daily confusion rate of working procedures was reduced from 6.67% to 0.67%, the time delay rate of medical waste disposal was reduced from 7.33% to 2.00%, and the standardized rate of medical waste disposal management processes was increased from 93.33% to 100%. All the data were statistically significant ( P<0.05). Conclusions:Since the operation of the medical waste management system, through the top-down management and control of the administrator and with its unique time retrieval function, the time delay problem of the previous manual management has been greatly improved. The classification management function of medical waste solves the criticism of unclear and chaotic classification of medical waste. The department retrospective function enables the division of responsibilities for medical waste work to be clear, and improves the work efficiency. The construction of medical waste management system based on B/S architecture provided a new information approach for the scientific management of medical waste and a reference for the scientific and effective management of clinical medical waste.

Assessment of Nervous System of High-risk Infants: 236 Cases Report / 中国康复理论与实践

Objective:To investigate evaluation methods to predict the outcome of nervous system development in high-risk infants. Methods:From March, 2015 to March, 2016, 336 high-risk infants were enrolled. They were assessed by General Movements (GMs) Quality Assessment, 0~1 Years Old 20 Items Neuromotor Assessment and Gesell Developmental Schedules. Results:A total of 236 infants finishied the study. GMs Quality Assessment showed that 203 cases were normal and 33 cases were abnormal in the writhing movements stage; 218 cases were normal and 18 cases were abnormal in the fidgety movemonts stage. 0~1 Years Old 20 Items Neuromotor Assessment showed that 202 cases were normal and 34 cases were abnormal. Gesell Developmental Schedules showed that 12 cases were abnormal. Conclusion:The combination of GMs Quality Assessment, 0~1 Years Old 20 Items Neuromotor Assessment and Gesell Developmental Schedules could better predict the nervous system development of high-risk infants.

Development and application of WEB-based information management sys-tem for chronic schistosomiasis patients / 中国血吸虫病防治杂志

To improve the management level of patients' information of schistosomiasis control stations in Nanchang City,the B/S three-layer architecture and ASP+SQL technology were applied to formulate the WEB-based management system of chronic schistosomiasis patients' information,so as to achieve the information sharing of chronic schistosomiasis among schistosomiasis control stations.

Development of whole process quality control and management system of traditional Chinese medicine decoction pieces based on traditional Chinese medicine quality tree / 中国中药杂志

The whole process quality control and management of traditional Chinese medicine (TCM) decoction pieces is a system engineering, involving the base environment, seeds and seedlings, harvesting, processing and other multiple steps, so the accurate identification of factors in TCM production process that may induce the quality risk, as well as reasonable quality control measures are very important. At present, the concept of quality risk is mainly concentrated in the aspects of management and regulations, etc. There is no comprehensive analysis on possible risks in the quality control process of TCM decoction pieces, or analysis summary of effective quality control schemes. A whole process quality control and management system for TCM decoction pieces based on TCM quality tree was proposed in this study. This system effectively combined the process analysis method of TCM quality tree with the quality risk management, and can help managers to make real-time decisions while realizing the whole process quality control of TCM. By providing personalized web interface, this system can realize user-oriented information feedback, and was convenient for users to predict, evaluate and control the quality of TCM. In the application process, the whole process quality control and management system of the TCM decoction pieces can identify the related quality factors such as base environment, cultivation and pieces processing, extend and modify the existing scientific workflow according to their own production conditions, and provide different enterprises with their own quality systems, to achieve the personalized service. As a new quality management model, this paper can provide reference for improving the quality of Chinese medicine production and quality standardization.

Development and optimization of self microemulsifying drug delivery of domperidone

The present investigation is aimed to develop self-microemulsifying drug delivery system (SMEDDS) to improve the in vitro dissolution of a BCS (Biopharmaceutical Classification System) class II anti emetic agent, domperidone. Solubility study was performed to identify the ingredients showing highest solubility of domperidone. The ternary phase diagrams were plotted for selected components to identify the area of microemulsion existence. D-optimal mixture experimental design was applied to optimize a liquid SMEDDS using formulation variables; the oil phase X1 (Oleic acid), the surfactant X2 (Labrasol) and the co-surfactant X3 (Transcutol HP). The liquid SMEDDS were evaluated for droplet size, emulsification time, % transmittance and drug release. Stability study was performed at 40 °C/75% RH. Liquid formulation was solidified by adsorption on carrier Aerosil 300. Solid SMEDDS was evaluated and compared with liquid SMEDDS and marketed formulation. Oleic acid was selected as oil, Labrasol as surfactant and Transcutol HP as co-surfactant for formulation of SMEDDS. The optimized batch showed best results in terms of smaller droplet size (<170 nm), emulsification time (<40 s) and drug release (>85% in 15 min) and was stable for 3 months. Solid SMEDDS containing Aerosil 300 showed good flow properties and uniform drug content. XRPD study revealed that the crystalline drug was converted to amorphous form in solid SMEDDS. The rate and extent of drug dissolution from solid SMEDDS was significantly higher than pure drug and commercial tablet formulation. The results demonstrate the potential of SMEDDS as a means of improving solubility, dissolution and hence the bioavailability.

O presente estudo teve como objetivo desenvolver sistemas de liberação auto-microemulsificantes (Self-Microemulsifying Drug Delivery System - SMEDDS) de domperidona, agente antiemético, classe II, segundo o sistema de classificação Biofarmacêutica, para melhorar sua dissolução in vitro. Estudo foi realizado para identificar os componentes que revelaram maior solubilidade da domperidona. Determinaram-se os diagramas de fase ternários para esses componentes selecionados tendo em vista a identificação da região de formação da microemulsão. O planejamento experimental foi empregado para otimizar os SMEDDS líquidos, utilizando as seguintes variáveis de formulação: a fase oleosa X1 (ácido oleico), o agente tensoativo X2 (Labrasol) e co-tensoativo X3 (Transcutol HP). Os SMEDDS líquidos foram avaliados quanto às seguintes características: tamanho da gota, tempo de emulsificação,% de transmitância e liberação do fármaco. O estudo de estabilidade foi realizado a 40 °C/75% de umidade relativa. A formulação foi convertida em forma sólida por sua adsorção em Aerosil 300. Os SMEDDS sólidos foram avaliados e comparados com SMEDDS líquidos e a formulação comercializada. O ácido oléico foi selecionado para a fase oleosa, Labrasol como agente tensoativo e Transcutol como co-tensoativo para a formulação de SMEDDS. O lote otimizado mostrou os melhores resultados: menor tamanho de gota (<170 nm), menor tempo de emulsificação (<40 segundos), e de liberação do fármaco (> 85% em 15 min). Além disso, a formulação otimizada manteve-se estável no período de 3 meses. Os SMEDDS sólidos contendo Aerosil 300 apresentaram boas propriedades de fluxo e uniformidade de conteúdo do fármaco. O estudo de difração de raios-X revelou que o fármaco cristalino foi convertido para a forma amorfa, nos SMEDDS sólidos. A velocidade de dissolução do fármaco a partir dos SMEDDS sólidos foi significativamente maior, quando comparado ao fármaco livre e à formulação de comprimidos comercial. Os resultados demonstram o potencial dos SMEDDS como meio para melhorar a solubilidade, a dissolução e, consequentemente, a biodisponibilidade da domperidona.

Design and optimization of self-microemulsifying drug delivery system (SMEDDS) of felodipine for chronotherapeutic application

The objective of this research work was to design, develop and optimize the self micro-emulsifying drug delivery system (SMEDDS) of Felodipine (FL) filled in hard gelatine capsule coated with polymer in order to achieve rapid drug release after a desired time lag in the management of hypertension. Microemulsion is composed of a FL, Lauroglycol FCC, Transcutol P and Cremophor EL. The optimum surfactant to co-surfactant ratio was found to be 2:1. The resultant microemulsions have a particle size in the range of 65-85 nm and zeta potential value of -13.71 mV. FL release was adequately adjusted by using pH independent polymer i.e. ethyl cellulose along with dibutyl phthalate as plasticizer. Influence of formulation variables like viscosity of polymer, type of plasticizer and percent coating weight gain was investigated to characterize the time lag. The developed formulation of FL SMEDDS capsules coated with ethyl cellulose showed time lag of 5-7 h which is desirable for chronotherapeutic application.

O objetivo desse trabalho de pesquisa foi planejar, desenvolver e otimizar sistema de liberação de fármaco auto-microemulsificante(SMEDDS) de felodipino (FL) em cápsulas de gelatina dura revestidas com polímero, a fim de obter liberação rápida após tempo desejado no manejo da hipertensão. A microemulsão é composta de FL, lauroglilcol FCC, Transcutol P e Cremophor EL. A proporção ótima de tensoativo e de co-tensoativo foi de 2:1. As microemulsões resultantes têm tamanho de partícula na faixa de 65-85 nm com potencial zeta de -13,71 mV. A liberação de FL foi ajustada adequadamente, utilizando-se polímero independente de pH, como etilcelulose com ftalato de dibutila como plastificante. A influência das variáveis da formulação, como viscosidade do polímero, tipo de plastificante e ganho percentual de peso do revestimento foi investigada para caracterizar o intervalo de tempo de liberação. A formulação de cápsulas de FL SMEDDS revestidas com etilcelulose mostrou intervalo de tempo de liberação de 5 a 7 horas, o que é desejável para uma aplicação cronoterapêutica.

Factors associated with unsafe sex behaviors for prevention of HIV/AIDS transmission among Myanmar migrant fishermen in Ranong, Thailand / ปัจจัยที่มีความสัมพันธ์กับพฤติกรรมทางเพศ ที่ไม่ปลอดภัยในการป้องกันการถ่ายทอดเชื้อเอช ไอ วี / เอดส์ ในชาวประมงแรงงานอพยพจากพม่า ในจังหวัดระนอง ประเทศไทย

The study was conducted on late February 2009, to describe independent variables (socio-demographic characteristics, condom availability, HIV/AIDS information, peer pressure, drug and alcohol use, HIV related knowledge, attitudes \& skills), and to assess any association of these independent variables with the dependent variable (unsafe sex with sex workers) among Myanmar migrant fishermen in Ranong, Thailand. The data was collected using interviewer administrated questionnaire and Focus Group Discussion. The majority of the respondents was in the 26-35 years age group, single, had attained middle school education, Barma, Buddhist, had an income of 4,000-5,000 Baht per month, stayed in Thailand for 1-4 years and never went back home. The mean knowledge score for total respondents was 0.6941. Most of the respondents received HIV/AIDS information and knew where they could get condoms. About 63% of the respondents have had sex with sex workers and 70.7% of them always used a condom when having sex with sex worker. 18.0% of the respondents had casual sexual partners. 40.1% of them always used condom when they had sex with casual partners in the six months previous to the study. In bivariate analysis, The results showed that longer duration of stay in Thailand and earning of more than 5,000 Thai baht, negative attitude towards HIV/AIDS and condom use, and injected narcotic drugs were statistically associated with practice of unsafe sex with sex workers (p-value \<0.005). Receiving HIV/AIDS information, known sources of condom, life skills such as refusing undesired sex, pressure to use drug, to have sex without condom and discussing to use a condom were statically associated with safe sex practice in sex workers (p-value \<0.005). In multivariate, the results suggest that Age, Duration of stay Thailand, Knew where to get condoms, Refusal to have sex without a condom, and Discussing condom use maintained significant association with unsafe sex while controlling for other independent variables. Given the high prevalence of risk behavior, providing health education together with condoms constantly to this group of Myanmar migrant fishermen in Ranong is crucial. Health education should include teaching life skills such as refusal to have sex without a condom, and discuss to use condoms. The 100% condom use program should be promoted among Myanmar migrant fishermen.

Development and physiology of central nervous system with fibroblast grow factors / 医学研究生学报

Fibroblast grow factors are important regulators of the embryonic and adult central nervous system during developmental processes and adult physiology.FGF control cell migration and establishment of the anterior-posterior body axis of the neural plate during gastrulation.At later shaping stage of the brain,FGF function in those organs and tissues control the morphogenesis and differentiation.During adult and injured in the adult brain,FGF contain the active hyperplasia of the adult stem cells and promote regeneration and repair in the central nervous system.This article mainly reviews the function of FGF family members in the central nervous system.

The Pattern of Cell Proliferation and Apoptosis in Human Embryonic and Fetal Brain

BACKGROUND: Cell proliferation and apoptosis account for the major morphogenetic mechanisms during development of the central nervous system. We investigated these processes in developing human brains. METHODS: We examined human embryonic and fetal brains. Cell proliferation was analysed by classical histology and MIB-1 immunohistochemistry; cell death was investigated by the TdT-mediated dUTP-biotin nick end labelling method. RESULTS: Most proliferating cells were observed in the ventricular zone (VZ) in the 3rd-10th week of gestational age (GA), and in both the VZ and the subventricular zone (SV) in the 19-24th week of GA. The proliferation index of the VZ was highest in the 8th week of GA and then decreased as the GA advanced. Apoptotic cells were observed in the VZ as early as the 5th week of GA. They were also observed in the intermediate zone in the 19-24th week of GA, although they were significantly lower in amount compared to that in the VZ and SV. CONCLUSIONS: These results suggest that apoptosis occurring early in the embryonic period is related to a cellular mechanism which selects and determines the cells that are committed to migration and differentiation during the development of the human brain.

Heat shock proteins and their role in early mammalian development

Elevated body temperature can result from many agents in the natural environment, such as fever, hot weather and heavy exercise. In our modern living conditions additional sources of induced hyperthermia including hot baths, saunas, drugs, electromagnetic radiation and ultrasound have been introduced. Hyperthermia during pregnancy has been shown to cause a wide spectrun of effects in art species studied, including humans, the outcome depending on the dose of heat absorbed by the mother and embryo and the stage of enbryonic or fetal development when exposed. The dose of heat is the product of the elevation of temperature above normal and the duration of the elevation. In relatively uncontrolled natural environmental exposures, embryonic death and resorption or abortion are probably the most common outcome. In less severe exposures (smaller doses) major or minor developmental defects can result and the central nervous system appears to be a major target for its effects. Heat damage to embryos appears to be by apoptotic and other forms of cell death in organs at critical stages of development. Over many millennia all living orgaisms appear to have developed protective mechanisms against excess heat, known collectively as the heat shock response. This response has been studied intensively over the last 20 years and its mechanisms of protection are now becoming more clearly defined. Exposures to heat (and a number of other toxic agents) trigger the heat shock response which is characterized by abrupt suspension in the normal protein synthesis and the concurrent induction of heat shock genes (hsp) and the synthesis of a set of protein families known collectively as the heat shock proteins (HSP). The hsp ape known to be involved in the response in embryos, each has at least two copies, one which appears to have functions in the normal embryonic development (cognate) and another which is induced at a certain dose of heat (induced) and which can offer some protection against damage for some time after the initiating dose. Most cognate HSP can normally be found in embryos at all stages of development. At certain critical, early stages of organ formation increased activity of one or more of the hsp families can be identified at the site of the organ analogue. The inducible HSP are usually undetectable during normal development and generally become inducible at these critical inductive stages of organ development, implying a protective function for that process. Excess heat is known to cause denaturation of proteins. Each of the known HSP families appears to protect cells through their chaperone functions in which they bind to adhesive sites on newly synthesized or heat damaged and partially unfolded structural and functional proteins. This prevents the formation of function-less aggregates. The damaged proteins are then either presented for degradation or are reconstituted by orderly disengagement from the chaperone protein. The molecular mechanisms of initiating and regulating the response are now becoming more clearly defined. Trigger mechanisms include release of prostaglandin Al which can be modulated by glucocorticoids and nonsteroidal anti-inflammatory agents. A heat shock factor (HSF) binds to the heat shock element (hse) on the gene sequence and initiates the hsp response. The signal induction pathway involves mitogen activated proteins (MAP) and stress activated proteins (SAP) which are regulated by phosphorylation. Signals are amplified by kinase cascades while they are being transmitted to the nucleus. Activated MAP and SAP kinases regulate the process by phosphorylation of proteins including transcription factors, HSP, other protein kinases and phosphorylases, growth factor receptors and cytoskeletal proteins. Although this research has defined some pathways indicating how and why heat can cause some defects, a means of preventing them has not yet emerged.

Strategic Planning and Development Plan Model for a Hospital Information System / 대한의료정보학회지

The IS(Information System) strategic planning must be based on objectives and strategic planning of the organization. The IS strategic planning for a hospital is not different from other organizations. Perhaps it can be more important than other types of organizations. Hospitals possess unique characteristics which hinder implementation of the IS. Therefore when the objectives and the focus of IS are clear, the resources can be allocated effectively and integrated IS can be applied. This study will suggest general objectives and strategic planning of the hospital. Thereby we will propose the strategic planning and development planning model of IS for hospitals. Suppose that the objectives of a hospital are the quality service and effective costs reduction. To achieve these objectives we will propose the strategies such as procurement of qualified physician and personnel, maximization of productivity, maintenance of good services and comfortable environments, and redesign of business process. Thus strategic planning of IS for hospital organizations is established as the follows: 1. The objectives of the IS for a hospital are to monitor the outcome of medical services and hospital performance, and to deliver the doctor's order in order to provide the quality services to patients. Therefore the IS design strategy for the hospital should be planned to achieve these objectives. To establish these goals all hospital data should be computerized and the IS should be able to monitor the performance of the hospital. Direct dat input environment is essential for the system. 2. The direction of master plan of the IS for a hospital is the integrated system. The methods of approach for the integrated system is selected to cover the all primary data from medical services rather than functional units. 3. The objectives of development of medical service information system, first phase of master plan, include : on-line input and delivery system of all doctor's orders, inquiry about all test in any time at any places in the hospital, automated scheduling of nursing work at nurse station, hospital billing, and ancillary services. 4. In order to achieve the goal, CSFs(critical success factors) to be resolved are : doctors must enter their own orders, the employee consents to replace the manual paper work with IS, the system is maintained with rapid response even though peak time, many functions must be constructed in the short period. 5. Therefore development strategic planning of IS is suggested to maximize user's convenience, specially, for doctors, to apply several data servers with independent functions, and to introduce client-server system, and to use the commercial DBMS.