基于临床科研信息共享系统的糖尿病中医证治研究

临床科研信息一体化技术现已成为中医临床进行科学研究的基础支撑技术,是处理临床海量诊疗信息、挖掘科研数据的重要平台。安徽中医药大学第一附属医院作为国家中医临床研究基地,在其重点建设病种糖尿病中率先实施应用了此项前沿技术,纳入糖尿病病例1337例,利用结构化科研型电子病历进行录入,后期对患者临床信息数据进行提取、清洗,通过多维检索软件以及复杂网络软件对糖尿病患者临床药证信息进行统计分析。该文对基于临床科研信息共享系统的糖尿病中医证治研究的初步成果进行了阐述。     

中西医结合护理表格式电子病历的设计与应用

目的进一步规范中医护理病历的书写格式,提高书写的质量和效率,使中医护理病历规范化、科学化、简捷化。方法遵循国家卫生部《病历书写基本规范》要求,按照护理工作流程,开发研制了中西医结合护理表格式电子外科一般护理记录单。结果在全院手术科室范围内推广使用中西医结合护理表格式电子外科一般护理记录单,使用后护理病历质量较使用前明显改善(p<0.05)。结论中西医结合护理表格式电子外科一般护理记录单以书写快捷、格式规范、记录清晰等特点,在中医临床护理中充分体现了它的先进性,明显提高了护理病历书写的质量和效率,有效实现了护理文件书写信息化管理。     

电子病历系统在医院应用的优势及存在的问题

电子病历系统是信息技术和网络技术在医疗领域应用的必然产物,是医院病案现代化管理的必然趋势^[1]。电子病历具有提取及共享信息方便、容量大、信息完整、易保存、方便快捷等实用性,是临床、教学、科研的重要资料来源^[1]。我院于2008年开始使用电子病历,本文从书写修改病历、查询结果等在工作时间上对医护人员的影响方面进行调查,探讨电子病历在医院工作发展中的重要性;     

护理电子病历书写效率调查分析

目的 探讨使用护理电子病历系统书写护理病历的效率.方法 调查同一医院使用护理电子病历前后,以及未使用与已使用护理电子病历的两所医院书写护理病历所需时间,对结果进行统计分析,并对使用电子病历前后的护理病历质量进行分析.结果 使用护理电子病历后书写效率提高61.02%,存档护理病历质量在使用电子病历后也有所提高.结论 护理电子病历系统能有效提高病历书写效率.减少护士书写病历的工作量,对提高-临床护理质量有积极作用.     

护理电子病历缺陷及对策

临床护理电子病历是将计算机网络技术和信息技术应用于临床护理记录,并以此建立的一种以提高效率、改进质量为目的的信息系统。与手工书写护理病历相比,电子护理病历提高了书写质量及临床护士的工作效率,且电子护理病历可资源共享,有利于护理科研与教学,并能真正做到实时监控。2009年3月我院开始推行护理电子病历,我科作为试点科室,在充分享受其优越性的同时,也逐渐发现其存在的缺陷,现总结如下。     

中医护理结构化电子病历系统的应用与分析

目的:评价中医护理结构化电子病历系统的应用效果。方法:采集2018年10月至2019年6月我院风湿科病房第一诊断为"尪痹"的211例患者的数据,从辨证分型、临床常见症状、中医护理技术应用情况等角度进行分析。结果:结构化电子病历系统的应用利于数据的规范、完整及客观采集,为中医护理方案的优化提供数据支持。结论:结构化电子病历系统的应用促进了中医护理方案的有效落实,为方案的优化提供了依据,提升中医护理服务质量。     

临床电子护理病历的开发及使用

阐述了开发临床电子护理病历的意义,文章结合临床护理工作的实际。需要,提出了临床电子护理病历的实用书写方法。包括各护理模板的设计及其功能与使用方法,如：一般护理记录单,危重患者护理记录单,压疮预防监控传报单等的设计及使用方法。总结了临床电子护理病历使用效果和体会。     

护理电子病历模板在临床带教护生中的使用效果

【目的】探讨护理电子病历模板在临床带教中的使用效果。【方法】将在本院乳腺外科60名实习护生分为两组（各30名）,一组为对照组,使用手工护理病历;一组为观察组,使用护理电子文档病历,设计并利用护理电子病历模板,指导护生进行护理记录书写和临床护理。比较两组护生的护理病历书写时间、合格率。【结果】观察组护生的护理病历书写时间显著短于对照组（ P ＜0．01）,护理病历合格率显著高于对照组（ P ＜0．05）。【结论】利用护理电子病历模板带教,能规范护生的护理记录书写,提高书写效率与质量。     

电子病历对护士工作影响的研究进展

护理工作是临床医疗工作的重要组成部分,电子病历在护理领域的应用范围及程度在很大程度上影响了整个医院电子病历的使用情况。文章从护理文书书写效率、医嘱执行率、护理质量3个方面介绍了电子病历对护士工作的影响,并对电子病历存在的不足进行了分析、探讨。     

结构化电子病历在护理文书管理中的应用效果

[目的]通过开发使用护理结构化电子病历,缩短护理文书书写时间,提高护理电子病历书写效率和质量。[方法]研发推广使用护理结构化电子病历,比较护士使用结构化电子病历和普通电子病历的书写文书时间和书写质量。[结果]应用护理结构化电子病历后,护理文书书写时间明显缩短、书写质量明显提高,与使用普通电子病历经比较,差异有统计学意义(P<0.01)。[结论]护理结构化电子病历较普通电子病历使用更为方便、快捷和规范,能够有效提高工作效率和质量。     

Hsp-based tumor vaccines: state-of-the-art and future directions

Hsp-based tumor vaccines, autologous tumor-derived Hsp-peptide complexes, have been applied to cancer immunotherapy for the treatment of cancer patients with a variety of advanced malignancies. Data from clinical trials, including those from phase III, have so far demonstrated that the immunization strategy can induce significant tumor-specific immune responses. Some improved clinical outcomes have also been observed but the clinical utility of this strategy awaits further investigations. In addition, preclinical studies have been conducted to design a variety of novel Hsp-based tumor vaccines with improved therapeutic potentials. These approaches include development of Hsp fusion proteins and genetic vaccines using plasmid DNA and adenoviruses. Successful cancer immunotherapy with Hsp-based tumor vaccines will depend on the results obtained from both clinical trials and preclinical studies.     

护士长在护理实习教学中的督导作用

为探索新形势下临床护理教学管理模式及护士长在护理实习教学中的督导作用,自2000年开始,科室建立并完善了临床教学管理组织,加强了带教组长和带教老师的选拔及培训,完善了临床教学质量评价体系,建立了竞争激励机制。带教老师素质提高,创造了良好的临床护理实习环境,护生综合能力明显提高,达到了教学相长。护士长的重视,科学的教学管理体系,多种形式的临床教学活动,严格的检查与监控是提高临床教学质量的关键。     

From delegation to specialization: nurses and clinical trial co-ordination

This paper considers an area of clinical research that has been delegated by physician-researchers to nurses and others in the United States, that of clinical trials co-ordination. It uses interviews with nurse trial co-ordinators to explore the occupational processes by which the boundaries of work enactment and the definition of work have been established by nurses and others. It then discusses the occupational processes that have been established to formalize a role for nurses in clinical research. It raises the question of (and offers speculation on) whether specialization alone will distinguish nursing from other occupational groups engaged in clinical research work.     

Current state and perspective of studies on hypertensive complications

Studies on cardiovascular complications in hypertensive patients have been extensively progressed in basic and clinical researches. The molecular mechanism of sensing system of mechanical stress have not been fully understood. Rho/Rho kinase and oxidative stress are molecules activated by stretch and are highly possible to contribute to cardiovascular complications. One of clinical progress in this area is the development and wide distribution of noninvasive diagnostic devices for atherosclerosis. Some of these devices are used as an surrogate markers in large scale randomized clinical trials. Currently, new therapeutic targets and strategies have been investigated and tailored medicine using pharmacogenetics is expected in the near future to manage hypertensive complications.     

Organ transplantation and the immune response gene. Clinical correlations and donor requirements

Major gains have been made in the area of clinical organ transplantations due to recent studies concerning the human histocompatibility locus (HLA). These basic science findings, along with developments in clinical pharmacology have allowed for a much broader use of donor sources, and a significant prolongation in clinical life span for these transplantation recipients.     

Biological Aspects and Clinical Importance of Ultrasound Therapy in Bone Healing

Objectives. The purpose of this study was to review past and recent literature findings regarding the effects of ultrasound therapy on bone healing and its clinical efficacy in medical and dental interventions. Methods. A literature review was conducted on the effects of ultrasound therapy on bone healing. The studies regarding clinical applications in long bones and maxillofacial bones were evaluated separately from each other. Results. The effects of therapeutic ultrasound on bone healing have been studied for half a century. Numerous clinical and experimental studies have addressed this relationship, and many of them have shown positive correlations. Although several theories have been proposed to explain the mechanism of action, the exact mechanism has not been fully understood. Conclusions. Therapeutic ultrasound therapy in clinical settings is a noninvasive application and has no serious complications or side effects. It may be an acceptable treatment of choice in many types of clinical procedures involving maxillofacial bones.     

Three-year update of sildenafil citrate (Viagra) efficacy and safety

In the three years since its launch, sildenafil citrate (Viagra), an oral agent for the treatment of erectile dysfunction (ED), has been prescribed to more than 10 million patients worldwide and has been further evaluated in clinical studies in diverse patient populations. Significant improvements in erectile function have been demonstrated in double-blind, placebo-controlled trials in patients with ED and underlying diabetes, cardiovascular disease, minor depression, spinal cord injury and multiple sclerosis. Promising results have also been reported for patients with treated prostate cancer, end-stage renal failure, Parkinson's disease, and spina bifida and in multiple organ transplant recipients. Accounts of sildenafil use in clinical practice and postmarketing data reflect clinical trial findings of effectiveness in a broad spectrum of ED aetiologies and overall good tolerability. As in the clinical trials, most adverse events associated with sildenafil use have been transient, mild or moderate effects that rarely lead to treatment discontinuation.     

The role of neurotrophic factors in disorders of peripheral nerves and motor neurons

Recent, exciting research in neurotrophic factors has significantly enhanced our understanding of their actions. Neurotrophic factors have been shown to have robust effects on neuronal survival and differentiation in vitro and in vivo and have been tested in animal models of human neurologic disorders. These studies have encouraged initiation of clinical trials of several neurotrophic factors for diseases of peripheral nerves and motor neurons. In this article, the author reviews the data for the actions of neurotrophic factors on peripheral nerves and motor neurons, the rationale for their use in clinical trails. The results of clinical trials of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and insulin-like growth factor type 1 (IGF-1), three neurotrophic factors that have been tested in phase III studies, are also reviewed.     

Myths and truths of growth hormone and testosterone therapy in heart failure

Heart failure is a chronic clinical syndrome with very poor prognosis. Despite being on optimal medical therapy, many patients still experience debilitating symptoms and poor quality of life. In recent years, there has been a great interest in anabolic hormone replacement therapy – namely, growth hormone and testosterone – as an adjunctive therapy in patients with advanced heart failure. It has been observed that low levels of growth hormone and testosterone have been associated with increased mortality and morbidity in patients with heart failure. Animal studies and clinical trials have shown promising clinical improvement with hormonal supplementation. Growth hormone has been shown to increase ventricular wall mass, decrease wall stress, increase cardiac contractility, and reduce peripheral vascular resistance, all of which might help to enhance cardiac function, resulting in improvement in clinical symptoms. Likewise, testosterone has been shown to improve hemodynamic parameters via reduction in peripheral vascular resistance and increased coronary blood flow through vasodilation, thereby improving functional and symptomatic status. To date, growth hormone and testosterone therapy have shown some positive benefits, albeit with some concerns over adverse effects. However, large randomized controlled trials are still needed to assess the long-term safety and efficacy.