桂北地区远程医疗服务信息化平台建设研究

分析桂北地区远程医疗建设的现状和意义,提出建设远程医疗服务信息化平台的必要性,结合目前桂北地区应用需求,阐述该信息平台的系统构成、网络架构、总体解决方案及软硬件需求等。     

信息动态

《全国卫生信息化发展规划纲要》明确提出了区域医疗信息化的工作目标：“围绕国家卫生信息化建设目标选择信息化基础较好的地区．开展区域卫生信息化建设试点和研究工作．建立区域卫生信息化示范区”。毫无疑问,区域医疗协同网络的建设．将从根本上改变过去医院各自建立信息系统的模式．解决各大医院存在的”信息孤岛”问题,实现区域医疗整合优势的全面发挥。为了了解区域医疗协同网络建设的现状与发展方向,以及在区域医疗协同网络建设中存在的问题,香港艾力彼医院管理研究中心与《中国医院》杂志社决定联手开展“医疗网络与区域协同的现状及发展方向调研”。     

医改转型期医疗网络与区域协同的现状及发展方向调研信息发布

《全国卫生信息化发展规划纲要》明确提出了区域医疗信息化的工作目标：“围绕国家卫生信息化建设目标选择信息化基础较好的地区,开展区域卫生信息化建设试点和研究工作．建立区域卫生信息化示范区”。     

关于远程医疗如何促进区域医疗信息化建设的思考

目的探索远程医疗技术,使之更好地应用并促进区域医疗信息化建设。方法本文从区域医疗信息化建设跟远程医疗的关系、远程医疗建设在区域医疗信息化中的具体实施方案以及远程医疗在区域医疗信息化建设中的促进作用3个方面进行了讨论分析。结果远程医疗在区域医疗信息化中的应用有效克服了空间和时间上的限制,降低了医疗成本,有利于区域医疗信息化建设。结论卫生信息化已逐步迈向区域医疗信息化阶段,远程医疗的蓬勃发展有力促进了区域医疗信息化的建设与应用。     

民族地区基层医疗卫生机构信息化建设现状与效能研究

背景 "十三五"期间，民族地区基层卫生信息化发展迅速，为信息技术赋能基层医疗卫生机构能力提升奠定了基础，但卫生信息技术与基层医疗卫生机构效能的相关研究缺乏。 目的 了解民族地区基层医疗卫生机构信息化建设现状与效能，探索信息技术对于基层医疗卫生机构效能提升的影响。 方法 2020年7—10月，采用分层抽样的方法选取四川甘孜、凉山、阿坝3个自治州，共计23个民族县的84家基层医疗卫生机构进行问卷调查。问卷调查主要内容包括基层医疗卫生机构信息化建设现状、信息化效能。对23个民族县的卫生健康局负责人及基层医疗卫生机构院长进行座谈，主要围绕基层医疗卫生机构科室设置、服务开展现状、信息化建设现状、信息服务场景等内容开展座谈。 结果 软件建设方面，84家基层医疗卫生机构中，57家（67.9%）使用公共卫生系统，44家（52.4%）使用家庭医生管理系统，25家（29.8%）使用医院信息系统（HIS）。84家基层医疗卫生机构中，47家（56.0%）实现了纵向联通与区域信息化，联通机构多为区（县）级与医联体单位；69家（74.4%）横向联通单位是医保部门。仅18家（21.4%）基层医疗卫生机构设有独立的信息部门，34家（41.0%）机构没有从事信息化工作的人才。信息专业人才缺乏〔64家（76.2%）〕、资金不足〔52家（61.9%）〕及基础设施薄弱〔51家（60.7%）〕是目前民族地区基层医疗卫生机构信息化建设的主要问题。建设有区域信息化平台、纵向联通机制、以电子病历为核心的医院信息平台的基层医疗卫生机构在检验、检查科室设置及中医药服务提供情况方面优于未进行相应卫生信息化建设的机构，差异有统计学意义（P<0.05）。座谈信息显示，民族地区基层医疗卫生机构已基本完成信息化标准化建设，硬件设施配备到位，卫生信息化产生了效率提升、监管范围扩大、监管精细化、决策科学化、治理数字化等管理效能，以及服务效率提升、可及性增加、质量提升的服务效能。 结论 信息技术可突破民族地区基层医疗卫生机构服务开展"瓶颈"，促进民族地区基层医疗卫生机构科室设置、服务延伸，提高卫生服务可及性；信息技术可以创新民族地区基层医疗卫生机构服务模式；民族地区基层卫生信息化存在信息化运维投入持续性不足、应用不足、人才匮乏问题；应加强基层卫生信息化投入，建立规范、适用的卫生信息化培训机制，重视卫生信息人才队伍建设，深化信息技术在基层医疗卫生服务中的智能应用。     

区域医疗信息化建设规划思考

对区域内医疗信息化建设进程进行统一规划和建设。是经济、合理、高效地实现医疗现代化的有力途径。这已被国内外许多专家和各级医疗卫生机构所认识，越来越多的地区也正在或准备对本区域内的医疗信息化工作进行规划。这里对此类工程规划的结构做一探讨,并提出制定规划的一般模型。     

圆桌观察:区域医疗信息化是必经之途

作为现阶段我国医疗信息化的一个有益尝试,区域医疗信息化的建设自然受到各方关注.那么,作为医疗信息化专家、医疗IT厂商和政府信息主管部门等相关方,他们对区域医疗信息化有着怎样的认识?各方尤其是政府应该在区域医疗信息化过程中扮演一个什么样的角色?区域医疗信息化在现阶段存在哪些难点?我们就这些话题采访到了国内著名的信息化专家、医疗信息化企业以及政府相关官员,他们的看法或建议无疑能帮助我们更加全面地认识我国医疗信息化建设的现状,对区域医疗信息化建设的实现有一定的参考价值.     

圆桌观察:区域医疗信息化是必经之途

作为现阶段我国医疗信息化的一个有益尝试,区域医疗信息化的建设自然受到各方关注.那么,作为医疗信息化专家、医疗IT厂商和政府信息主管部门等相关方,他们对区域医疗信息化有着怎样的认识?各方尤其是政府应该在区域医疗信息化过程中扮演一个什么样的角色?区域医疗信息化在现阶段存在哪些难点?我们就这些话题采访到了国内著名的信息化专家、医疗信息化企业以及政府相关官员,他们的看法或建议无疑能帮助我们更加全面地认识我国医疗信息化建设的现状,对区域医疗信息化建设的实现有一定的参考价值.     

试论区域医疗信息化建设

随着我国社会信息化建设的不断发展,区域医疗的信息化建设也逐渐成为趋势.在不断推进区域医疗信息化建设的同时也暴露出了一些问题.因此,要结合现阶段出现的问题,对区域医疗信息化建设进行研究,以解决区域医疗信息化建设中存在的问题.     

云计算环境下的医疗信息化研究

信息技术的发展极大地促进了医疗信息化建设,从医疗信息化建设的障碍因素人手,简要介绍了云计算的概念和特点,提出了基于云计算技术的医疗信息化建设思路,设计了基于软件租用和存储服务医疗信息化应用模型,并分析了云计算在医疗信息化建设过程中面临的问题。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.