复杂性肛瘘MRI扫描技术在临床中的应用价值

目的探讨复杂性肛瘘MRI扫描技术在临床中的应用价值。方法 50例疑为肛瘘患者采用横断面、斜冠状面、斜矢状面薄层及LAVA动态增强进行扫描,对MRI影像检查结果与手术病理进行综合分析。结果 50例肛瘘患者中30例为复杂性肛瘘、11例为原发性瘘管、9例为肛周脓肿。50例肛瘘患者的手术病理结果与MRI检查结果一致。结论采用横断面、斜冠状面、斜矢状面薄层及LAVA动态增强扫描技术对复杂性肛瘘诊断有重要意义,值得临床推广。     

Electronic Medical Records and Electronic Health Records: Overview for Nurse Practitioners

Electronic medical records (EMRs) and electronic health records (EHRs) have become essential systems by which nurse practitioners (NPs) communicate vital patient information to other members of the health care team as well as to patients. In this article we examine the important distinctions between EMRs and EHRs; review the genesis of these types of records; summarize applicable provisions of the Health Insurance Portability and Accountability Act from a recent legal case centered around NP utilization of EMRs and EHRs; address open patient access to medical information; and examine threats to security. Suggestions are offered on ways in which NPs can safeguard confidential patient information.     

Electronic Medical Records and Electronic Health Records: Overview for Nurse Practitioners

Electronic medical records (EMRs) and electronic health records (EHRs) have become essential systems by which nurse practitioners (NPs) communicate vital patient information to other members of the health care team as well as to patients. In this article we examine the important distinctions between EMRs and EHRs; review the genesis of these types of records; summarize applicable provisions of the Health Insurance Portability and Accountability Act from a recent legal case centered around NP utilization of EMRs and EHRs; address open patient access to medical information; and examine threats to security. Suggestions are offered on ways in which NPs can safeguard confidential patient information.     

光合细菌转化槲寄生制剂乙醇提取浓度的研究

目的确定光合细菌(PSB)转化槲寄生制剂中槲寄生乙醇提取的最佳浓度。方法以荷Lewis肺癌小鼠为模型,以抑瘤率、免疫指标、抗氧化指标为标准进行筛选。结果 PSB转化槲寄生制剂的各项指标均优于单纯的槲寄生制剂,其中以PSB转化槲寄生制剂Ⅱ的各项指标为最佳。结论槲寄生75%乙醇提取物所制光合细菌转化槲寄生制剂为最佳。     

智能药物管理系统在养老机构老年人中的应用

目的 探讨智能药物管理系统对养老机构老年人用药情况的干预效果。方法 2019年11月—2020年1月采用便利抽样法选取94例居住于重庆市2所养老机构的老年人作为研究对象,采用随机数字表法将其随机分为试验组及对照组,两组各47例,试验组应用由药物感应终端、web管理后台和微信小程序组成的智能药物管理系统进行干预,对照组采用常规用药管理模式,干预时间为3个月。于干预前及干预3个月时分别收集两组的用药依从性量表、用药知识问卷及合理用药自我效能量表得分,并在干预3个月时收集试验组的智能药物管理系统效果评价量表得分。结果 试验组用药依从性量表得分及合理用药自我效能量表得分干预前后差值显著高于对照组（P<0.05）;试验组中,使用微信小程序的老年人的用药知识得分干预前后差值显著高于未使用微信小程序的老年人（P<0.05）;95.7%的老年人对该系统整体感到满意。结论 智能药物管理系统能提高养老机构老年人用药依从性及合理用药自我效能,保障其用药安全。     

汇聚前沿热点,引领创新导向——以《科技导报》“年度科技热点回眸”专刊为例

【目的】 总结科技期刊通过专刊模式汇聚前沿热点的经验,旨在探索科技期刊引领创新导向、树立品牌形象的新路径。【方法】 以《科技导报》“年度科技热点回眸”专刊6年来的出版实践为例,分析专刊策划、组稿、出版以及宣传推广的策略,探析专刊的独特价值、出版成效和典型经验。【结果】 “年度科技热点回眸”专刊具有站位高、时效强、主题新颖、解读深入和传播形式多样等特点,学科覆盖面逐年扩大,影响力和传播力逐渐增强,在提升期刊品牌效应方面取得显著成效。【结论】 科技期刊将多学科多领域的年度前沿进展以专刊形式呈现,是有效汇聚科技热点和科研信息的办刊新实践,不仅能将国内外最新的科技成果加以总结,起到凝聚创新导向的重要作用,而且有助于提升期刊的学术引领力和传播力。     

Evaluation of user adoption during three module deployments of region-wide electronic patient record systems

BackgroundIn Sweden there are modular region-wide EPR systems that are implemented at various health organisations in the region. The market is dominated by four IT systems that have been procured and deployed in 18 out of 21 regions.MethodsIn a 2.5-year research study, deployments of three region-wide EPR modules: a patient administration system, eReferral module and eMedication module were followed and evaluated. Health professionals, EPR maintenance organisation, IT and health care managers were observed, interviewed and responded to questionnaires.ResultsAlthough the same deployment process was used during the three deployments, large variations in the units’ adoptions were observed. The variations were due to: (1) expectation and attitude, (2) management and steering, (3) end-user involvement, (4) EPR learning, and (5) usability and the possibility of changing and improving the EPR.ConclusionsIf changes in work processes are not considered in development and deployment, the potential benefits will not be achieved. It is therefore crucial that EPR deployment is conceived as organisational development. Users must be supported not just before and during the go-live phase, but also in the post-period. A problem often encountered is that it is difficult to make late changes in a region-wide EPR, and it is an open question whether it is possible to talk about a successful deployment if the usability of the introduced system is low.     

采用门控技术克服心脏搏动对肝脏DWI影响的相关研究

目的本文旨在探讨心电门控技术克服心脏搏动对肝脏DWI的影响效果。方法选择志愿者41例,均行无门控和心电门控肝脏DWI检查,心电门控组为实验组,无门控组为对照组,b值选取0和500s/mm2,分别采用不同的延迟触发时间触发扫描。第一次肝脏DWI扫描为10点和19点,采集2次的ADC值,由2名测量者分别测量,测完第一次数据后,间隔15天再进行第二次测量,总结分析ADC值,得出结论。结果对照组肝左叶ADC值明显高于肝右叶;实验组肝左叶ADC值明显低于肝右叶;Bland-Altman分析显示,该方法可重复率高;延迟触发时间为500ms时,可重复率高。结论心电门控技术能有效降低ADC值,提高肝脏DWI扫描图像质量,可重复性高,最佳触发时间为500ms。采用心电门控技术克服心脏搏动效果比较理想,适宜推广使用。     

European Experience and Perspectives on Transcatheter Aortic Valve Replacement

It could be argued that the European experience with transcatheter aortic valve replacement (TAVR) has been central to the success of this novel technology. After all, Europe provided the birthplace for the first clinical TAVR and allowed commercial approval of the early devices long before they were widely available elsewhere. Many of the largest registries are also European, helping to formulate contemporaneous guidelines with the backing of the influential cardiology and cardiothoracic societies. Despite the significant economic downturn that coincided with the availability of transcatheter technology, funding has been largely forthcoming and is increasing year on year. As we await the results of the randomised controlled trials examining TAVR in a lower risk cohort, the European adoption of the TAVR technology appears set to continue.