浅谈医院管理信息系统的安全问题

我国的医院管理信息系统的发展，从20世纪80年代起步．大体上经历了以下发展阶段：一是单机单任务阶段，主要用于人事信菽管理、财务管理、仓库管理等单项管理；二是微机网络／文件服务器部门级信息系统阶段．主要是门诊、住院收费的HIS管理系统，检验管理(LIS)系统等部门及跨部门管理系统；三是客户机／服务器(Client／Server)二级结构完整的医院信息系统阶段，包括HIS系统、     

临床检验信息系统的网络实施与应用

随着医院信息系统(HIS)的不断发展及自动检验仪器设备的增多，组建临床检验信息管理系统(laboratory information system，LIS)，更好地存储共享检验数据显得尤为重要。我院在HIS系统局域网及省、市医疗保险局域网(连省、市医保中心城域网)的基础上，拓展了LIS，通过网络接口链接，将HIS系统、医疗保险系统及LIS连接在同一局域网内，使我院HIS功能扩大。     

PACS与HIS／RIS集成网关的研究与设计

本论文针对目前医院信息化建设中急需解决的PACS与HIS/RIS网关进行了研究，研究PACS如何同HIS/RIS系统进行信息交互方式，升给出了PACS与HIS／RIS网关的设计和实现方案。     

PACS与HIS/RIS集成网关的研究与设计

针对目前医院信息化建设中急需解决的PACS与HIS／RIS网关进行了研究,研究PACS如何同HIS／RIS系统进行信 息交互方式,并给出了PACS与HIS／RIS网关的设计和实现方案。     

医院管理信息系统运行维护质量因素分析

ISO9000标准ISO8402对质量的定义是：反映实体，明确和隐含需要能力的特性综合。而HIS(医院管理信息)系统运行质量是指HIS系统在经过维护后能满足用户需求能力的综合。它包括HIS系统输入信息，输出信息以及HIS系统提供的系统服务，它维护的目标，就是让其它依赖系统各项资源，最大限度，最理想的实现用户需求。     

探讨B／S结构的HIS在医院信息化中的应用

目的探讨B／S结构HIS的应用前景。方法结合我院的HIS开发项目，对B／S结构和传统的C／S结构的优缺点进行比较。结果B／S结构的HIS维护方便、性能良好，相比C／S结构具有明显的优势。结论HIS向B／S结构过渡是发展趋势     

浅谈医院信息管理系统的标准化

医院信息管理系统(HIS)的使用提高了医院的服务质量，但各医院使用的HIS系统的厂家不相同，多种系统和非标准格式阻碍了行业间的交流，就这一问题，本文简述了医院信息管理系统标准化的必要性。     

商业智能在医院信息系统数据深加工中的应用

从20世纪80年代至今，我国医院信息数字化已经走过20年的历程，从单纯的医院财务系统数字化、局部的药房药品、物资管理数字化到电子病历，再到集成医学影像存档和传输系统(PACS)、检验信息系统(LIS)等，医院信息系统(HIS)的解决方案及其功能得到了逐步的完善和提高。现在，HIS的数据规模越来越大，     

基于HL7标准与中间件技术集成方法的信息化平台

针对目前医院信息化建设中亟待解决的医疗信息共享的问题，本论文提出了一种以中间件为解决方案，以XML和HL7为具体手段，解决了医院内部子系统之间以及多家医院HIS与HIS的异构数据源环境下的数据集成与数据共享问题，成功地实现了医疗系统之间医疗信息的共享。     

医院HIS系统SQLServer数据库性能优化

医院HIS系统数据库性能的优化是通过调节规划将数据库服务器的网络流量、磁盘I／O和CPU时间减到最小。使每个查询的响应时间最短并最大限度地提高整个数据库服务器的吞吐量。性能问题的考虑应贯穿于HIS开发阶段的全过程。而不应只在最后实现系统时才考虑性能问题。许多使性能得到显著提高的事宜可通过开始时仔细设计得以实现。为达到此目的，需要了解HIS应用程序的需求和数据的逻辑和物理结构，并在相互冲突的数据库使用之间进行权衡，实现医院HIS系统数据库性能的最优化。     

长春新碱过量引起严重毒副反应1例的护理体会

报道1例霍奇金淋巴瘤患者因误用长春新碱（VCR）10mg一次性静脉推注后治疗护理情况。其出现间断性神志恍惚、眼睑闭合不全、言语不清、口腔黏膜糜烂、全身疼痛、麻痹性肠梗阻、尿潴留、手足麻木等症状,经积极解救,禁食,持续胃肠减压、胃管内注入麻油、开塞露、生理盐水灌肠,合理应用肠外营养,注重疼痛、心理护理,做好口腔、肛周护理,预防感染加重,患者病情得到控制好转出院。     

Correlates of stages of change of smoking among inhabitants of deprived neighbourhoods

BACKGROUND: This study examines the prevalence and correlates of stages of change of smoking, in terms of psychosocial, structural and sociodemographic factors, among inhabitants of deprived neighbourhoods. METHODS: Cross-sectional data were obtained from a survey on health related behaviour. Subjects were 2009 current and former smokers, aged 20-46, living in deprived neighbourhoods in Rotterdam, the second largest city in the Netherlands. Three groups of smokers were formed according to the stages of change-definitions of the Transtheoretical Model: smokers not planning to quit (precontemplators), smokers planning to quit (contemplators/preparators) and former smokers (actors/maintainers). Smokers planning to quit and smokers not planning to quit were compared regarding psychosocial factors (attitude, social norm, self-efficacy), structural factors (neighbourhood problems, material deprivation, financial problems, employment status) and sociodemographic factors (age, gender, marital status, cultural background, educational level). Former smokers were compared with smokers planning to quit regarding structural and sociodemographic factors. Logistic regression was used to assess correlates of stages of change. RESULTS: Smokers planning to quit (prevalence = 19%) reported a more positive attitude, stronger social norms and higher self-efficacy expectations in quitting smoking than smokers not planning to quit (prevalence = 57%). Smokers planning to quit less often were Dutch-born, more often had attended higher vocational schooling or university and more often reported experiencing two or more neighbourhood problems compared to smokers not planning to quit. Former smokers (prevalence = 24%) were older, more often Dutch-born, married, employed and higher educated, compared to smokers planning to quit. Furthermore, former smokers less often reported material deprivation and financial problems than smokers planning to quit. CONCLUSION: Among people living in deprived neighbourhoods, different factors correlate with different stages of change of smoking. Implications for health promotion are discussed.     

Choice of measures of vaccination and estimates of risk of pediatric pertussis

BackgroundVaccination uptake at the individual level can be assessed in a variety of ways, including traditional measures of being up-to-date (UTD), measures of UTD that consider dose timing, like age-appropriate vaccination, and risk reduction from individual doses. This analysis compared methods of operationalizing vaccination uptake and corresponding risk of pertussis infection.MethodsCity-wide case-control study of children in Philadelphia aged 3 months through 6 years, between 2001 and 2013. Multiple logistic regression was used to isolate the independent effects of each measure of vaccination uptake and the corresponding relative odds of pertussis.ResultsBeing UTD on vaccinations was associated with a 52% reduction in risk of pertussis (OR 0.48, 95% CI: 0.34, 0.69). Evaluation of delayed receipt of vaccine versus on-time UTD yielded similar results. There was a decrease in risk of pertussis for each additional dose received with the greatest reduction in pertussis infection observed from the first (OR 0.48, 95% CI: 0.28, 0.83) and second dose (OR 0.17, 95% CI: 0.08, 0.34). Additional doses conferred minimal additional protection in this age group.ConclusionExamining vaccination status by individual doses may offer improved predictive capacity for identifying children at risk for pertussis infection compared to the traditional UTD measure.     

上海市某医院骨科平均住院日影响因素分析

对上海市某医院2003年-2007年骨科出院病人的住院日描述性分析．2003年-2007年骨科的床位利用指数与平均住院日相关性分析．2003年-2007年骨科床位与医护比例分析．2007年骨科前10大病种平均住院目影响因素分别进行单因素相关性分析和多因素逐步回归分析（STATA软件）。通过对骨科10大病种住院日影响因素分析,术前等待天数、手术类型、是否输血分别对10个、9个和8个病种的住院目有影响。输血因素和手术类型是医院不可控、由病人的病情决定的,术前等待天数是管理因素,是最值得医院重视的影响因素。     

两种不同肌瘤剔除术治疗子宫肌瘤的临床疗效比较

目的:比较腹腔镜子宫肌瘤剔除术与腹式子宫肌瘤剔除术的临床疗效。方法:回顾分析63例腹腔镜子宫肌瘤剔除术与61例腹式子宫肌瘤剔除术的临床资料,比较2种手术方式的手术时间、术中出血量、肛门排气时间、使用抗生素时间、术后感染率、体温恢复正常时间、住院时间等情况。结果:两组患者接受子宫肌瘤剔除术顺利完成,腹腔镜组手术时间长于开腹组(P0.05),腹腔镜组术中出血量及剔除肌瘤个数均少于开腹组(P0.05),术后腹腔镜组体温恢复正常时间、肛门排气时间、抗生素使用及住院时间均短于开腹组,两组患者最多随访6个月,腹腔镜组平均康复时间较开腹组短(P0.05),两组随访B超均未发现明显肌瘤结节。结论:腹腔镜子宫肌瘤剔除术损伤小,恢复快,住院时间短,是值得推广的微创手术。     

尘肺病患者145例死因调查

目的分析汉中市尘肺病的发生、发展和死亡原因，以提高尘肺病患者的生存质量。方法对145例尘肺病患者的死因进行回顾性分析，计算其平均发病年龄、死亡年龄及患尘肺病后的存活年限。结果矽肺的平均发病年龄和死亡年龄均早于煤工尘肺和石棉肺，尘肺病的主要死因为患肺部疾患，患尘肺病后的平均存活年限为12a。结论加强职业健康体检工作，对尘肺病人做到早发现早治疗和预防并发症的发生。     

性发育异常发病机制的研究进展

正常的性腺分化可分为3个过程：原始性腺形成、性别决定和卵巢/睾丸发育。在任一环节中,基因表达或调控发生异常均有可能导致性发育异常疾病的发生。性发育异常是指染色体、性腺和解剖性别不典型。随着分子生物学技术的发展,不断地发现新的基因或信号通路参与性腺分化和发育,如SRY、SF1、WT1、Sox9等基因与睾丸发育密切相关,Wnt/Rspo1/B连环蛋白通路、Dax1、Foxl2等基因在卵巢分化中发挥着重要作用,一些非编码RNA和转化生长因子也有重要的调节功能,且睾丸和卵巢发育均为主动过程,即使在出生后因某些基因的改变两者间也可出现横向分化。这些为揭示性分化异常的发病机制提供了可能。     

西林瓶装注射用水的装量检查分析

为了检查西林瓶装注射用水的实际分装量是否符合2005年版《药典》三部要求,按照2005年版《药典》三部中“生物制品分装和冻干规程”,分装规格为0．8ml的西林瓶装注射用水10000瓶,随机在分装过程的前、中、后阶段共抽取100瓶,轧盖、目检。分别用1ml标定注射器及1ml普通无菌注射器抽取每瓶注射用水的实际体积,以t检验法对实际抽取量与标示量的差值进行统计学分析,结果显示其与2005年版《药典》三部要求分装附加量为0．1ml相比有显著性差异（P〈0．001）。     

One-year stability of the Measure of Processes of Care

BACKGROUND: The Measure of Processes of Care (MPOC) is a 56-item self-administered measure designed to examine what parents of a child with a chronic health problem think of the services they and their child receive, and to measure the extent to which these services are family-centred. Reliability and validity of the MPOC were established in prior studies. The aim of the present study was to assess the 1-year stability of the MPOC to justify its use as an evaluative tool. METHODS: Nine paediatric rehabilitation centres in the Netherlands participated in this short longitudinal survey study. Subjects were 205 parents (response rate 74.8%) of children aged 1-18 years who received care in one of the participating paediatric rehabilitation centres. All subjects filled out two MPOCs with a 1-year interval. RESULTS: All correlations between the scale scores of the MPOC at the first and second administration were relatively high and significant (range: 0.443-0.609, all P < 0.001), demonstrating high inter-individual stability. However, all mean scale scores, except for Providing General Information, significantly reduced after 1 year. CONCLUSIONS: The MPOC has a moderate 1-year stability. However, because of its tendency to score lower when repeated after 1 year, its use as an evaluative follow-up instrument to assess the effectiveness of a programme intervention is restricted.     

儿童皮质发育畸形的MRI诊断

目的探讨儿童皮质发育畸形(MCD)的MRI表现特点,为MCD的早期诊断提供依据。 方法选择2010年1月至2012年12月在四川省医学科学院·四川省人民医院放射科经MRI检查确诊为MCD的44例患儿为研究对象。回顾性分析及总结其MRI影像学特征。本研究遵循的程序符合四川省医学科学院·四川省人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象及其监护人知情同意,并与监护人签署临床研究知情同意书。 结果本组44例经MRI确诊为MCD患儿中,巨脑回-无脑回为17例,多小脑回为14例,灰质异位为9例,脑裂畸形为4例。MCD的MRI特点中,巨脑回表现为脑回增宽、皮质增厚及白质变薄;无脑回表现为正常脑沟、脑回消失,皮质增厚及白质变薄;多小脑回表现为脑回增多、细小;灰质异位表现为皮质下及侧脑室周围深部白质区结节状、团块状或带状病灶,信号与灰质信号相同;脑裂畸形表现为从侧脑室到脑表面贯穿大脑半球的裂隙,表面覆盖灰质。 结论MRI是诊断儿童MCD的可靠影像学方法。