门诊临时输液单生成算法的研究和应用

目的：研究门诊处方向输液医嘱序列转换的算法。方法：基于医院信息系统对电子处方的药品进行数据预处理,使用PB9实现门诊临时输液单生成算法。结果：完成了门诊临时输液单生成算法的设计,能够较好地解决门诊医生处方医嘱到输液单治疗医嘱的转换问题。结论：电子化门诊输液单的应用显著地减轻了医护人员的工作压力,提高了门诊临时输液的执行和管理水平。     

电子病历管理模式下病案科组织结构设计思考

电子病历管理给医院管理带来了新的变革。加强医院电子病历管理,促进医院有效管理电子病历,保证电子病历的原始性是医院信息化建设的一项重要内容。作者针对病案科的组织结构模式进行分析,提出病案科的发展趋势,在相应组织结构设计原则的基础之上提出了强矩阵式电子病历管理结构。     

电子垃圾污染区新生儿胎盘镉含量及金属硫蛋白表达水平

目的：检测贵屿电子垃圾污染区新生儿胎盘镉含量及胎盘金属硫蛋白（metallothionein,MT）表达量,评估贵屿地区新生儿镉暴露情况及对新生儿的可能影响。方法：选取贵屿当地医院妇产科2006年7~9月出生的足月健康新生儿胎盘100例为实验组,纳入研究的产妇为贵屿镇当地居民,妊娠期间在贵屿居住。取汕头市潮南民生医院妇产科2006年5~6月出生的足月健康新生儿胎盘52例为对照组,产妇来自贵屿周边乡镇。石墨炉原子吸收法检测胎盘镉含量。链霉菌素_生物素（S_P）免疫组化技术检测胎盘组织MT的表达水平。问卷调查收集可能影响镉负荷的产妇年龄、家庭、环境、健康、饮食等因素。结果：实验组新生儿胎盘镉水平的平均值为（0.17±0.48）μg/g,明显高于对照组（0.10±0.11）μg/g,差异具有统计学意义（P〈0.01）。相关分析表明产妇在贵屿居住时间、产妇妊娠期间在贵屿居住时间、产妇怀孕期间在公路附近活动时间是影响胎盘镉水平的主要因素。S_P免疫组织化学检测显示胎盘组织中蜕膜细胞、合体滋养层细胞、绒毛间质细胞均有MT的表达。实验组胎盘组织MT阳性表达率（67.00%）高于对照组（32.69%）（P〈0.01）。新生儿胎盘MT表达量与胎盘镉水平呈显著正相关（r=0.761,P〈0.05）。结论：贵屿部分新生儿处于高镉负荷状态,贵屿当地环境和从事电子垃圾作业是影响当地新生儿高镉负荷的危险因素。贵屿地区新生儿胎盘可能通过增加MT的表达拮抗镉的毒性。     

病历质量监控及管理实践

目的通过对病历质量监控及管理的实践,提高病历质量。方法分别对基础质量、环节质量、终末质量的监控和管理进行分析,阐述了在监控环节中对医疗保险及使用抗菌药物进行监控的内容。结论落实基础质量、环节质量、终末质量是提高病历质量的根本保证,强化对病历监控力度及制定完善的管理措施是提高病历质量的重要手段。     

基于卫生信息平台的电子病历信息共享研究和实现

研究信息共享的关键技术,通过电子病历的标准化和结构化处理、传输和交换,实现电子病历信息的共享。在卫生部电子病历数据标准的基础上,结合采用情景分析法和层次分析法,通过Delphi法专家咨询确定电子病历可以结构化的数据项,实现电子病历的标准化和结构化处理;然后运用SWOT分析法,结合应用可扩展标记语言（XML）和临床文档结构标准（CDA）两项技术,实现电子病历的标准化传输和交换,使得电子病历信息在传输和交换过程中能够被机器自动识别,实现数据的自动化传输和交换;最后,研发电子病历完整性测试系统,实现电子病历完整性的自动测试。完成电子病历信息标准化和结构化处理、传输和交换全流程的技术研究,形成技术规范。有123家医院实现电子病历标准化上传省级卫生信息平台,有16家电子病历提供商具备了电子病历标准化和结构化处理、传输和交换能力。初步实现了电子病历的信息共享,电子病历数据传输技术规范作为浙江省地方标准正式颁布实施。     

Quality Improvement Initiative to Improve Human Papillomavirus Vaccine Initiation at 9 Years of Age

Objective

Adolescent human papillomavirus (HPV) vaccine rates remain low. Early vaccination may improve the efficacy of the vaccine and immunization rates; however, clinicians have not routinely made a strong recommendation for younger adolescents. This study assessed the feasibility of routine vaccination at 9 years of age.

史大卓教授治疗介入后冠心病遣方用药规律的关联性分析

目的:基于数据挖掘技术分析史大卓教授辨治介入后冠心病的遣方用药特点和规律。方法:利用关联规则分析,采用WEKA实现的Apriori算法(即Agrawal研究提出的算法),进行中药组方配伍的关联规则知识发现。结果:史教授辨治介入后冠心病常用的中药配伍有:莪术配丹参、赤芍配丹参、黄连配丹参、莪术配赤芍、川芎配丹参、生黄芪配丹参、莪术配川芎;常用的多个药物配伍(药组)有:川芎、莪术、赤芍、丹参,莪术、赤芍、丹参,川芎、黄连、赤芍、丹参,莪术、川芎、丹参,莪术、川芎、赤芍,赤芍、生黄芪、川芎、丹参,黄连、丹参、赤芍,赤芍、川芎、丹参,黄连、川芎、丹参等。结论:史教授治疗介入后冠心病常用的重要组方配伍为丹参、赤芍、黄连、川芎、生黄芪,体现了他临床善用益气、活血、解毒的遣方用药特点。     

A systematic review of automatic text summarization for biomedical literature and EHRs

ObjectiveBiomedical text summarization helps biomedical information seekers avoid information overload by reducing the length of a document while preserving the contents’ essence. Our systematic review investigates the most recent biomedical text summarization researches on biomedical literature and electronic health records by analyzing their techniques, areas of application, and evaluation methods. We identify gaps and propose potential directions for future research.Materials and MethodsThis review followed the PRISMA methodology and replicated the approaches adopted by the previous systematic review published on the same topic. We searched 4 databases (PubMed, ACM Digital Library, Scopus, and Web of Science) from January 1, 2013 to April 8, 2021. Two reviewers independently screened title, abstract, and full-text for all retrieved articles. The conflicts were resolved by the third reviewer. The data extraction of the included articles was in 5 dimensions: input, purpose, output, method, and evaluation.ResultsFifty-eight out of 7235 retrieved articles met the inclusion criteria. Thirty-nine systems used single-document biomedical research literature as their input, 17 systems were explicitly designed for clinical support, 47 systems generated extractive summaries, and 53 systems adopted hybrid methods combining computational linguistics, machine learning, and statistical approaches. As for the assessment, 51 studies conducted an intrinsic evaluation using predefined metrics.Discussion and ConclusionThis study found that current biomedical text summarization systems have achieved good performance using hybrid methods. Studies on electronic health records summarization have been increasing compared to a previous survey. However, the majority of the works still focus on summarizing literature.     

The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population‐based to a more “personalized” approach to cancer staging

The American Joint Committee on Cancer (AJCC) staging manual has become the benchmark for classifying patients with cancer, defining prognosis, and determining the best treatment approaches. Many view the primary role of the tumor, lymph node, metastasis (TNM) system as that of a standardized classification system for evaluating cancer at a population level in terms of the extent of disease, both at initial presentation and after surgical treatment, and the overall impact of improvements in cancer treatment. The rapid evolution of knowledge in cancer biology and the discovery and validation of biologic factors that predict cancer outcome and response to treatment with better accuracy have led some cancer experts to question the utility of a TNM‐based approach in clinical care at an individualized patient level. In the Eighth Edition of the AJCC Cancer Staging Manual, the goal of including relevant, nonanatomic (including molecular) factors has been foremost, although changes are made only when there is strong evidence for inclusion. The editorial board viewed this iteration as a proactive effort to continue to build the important bridge from a “population‐based” to a more “personalized” approach to patient classification, one that forms the conceptual framework and foundation of cancer staging in the era of precision molecular oncology. The AJCC promulgates best staging practices through each new edition in an effort to provide cancer care providers with a powerful, knowledge‐based resource for the battle against cancer. In this commentary, the authors highlight the overall organizational and structural changes as well as “what's new” in the Eighth Edition. It is hoped that this information will provide the reader with a better understanding of the rationale behind the aggregate proposed changes and the exciting developments in the upcoming edition. CA Cancer J Clin 2017;67:93–99. © 2017 American Cancer Society.