浅谈档案管理信息化时代医院档案工作者的角色转变

在市场经济和信息社会影响下,医院档案工作者囿于传统的思维方式,使医院档案利用工作无法面向民众开展,档案信息生产、流通和利用被阻碍.转变档案工作者的传统角色,提高医院档案的利用率,适应社会档案管理信息化需要,是我们医1党档案工作者的迫切任务.     

医院信息管理部门的职责探讨

医院信息管理部门做为医院信息化的主要力量，承担着医院信息化的重要任务，医院信息化对于提升医院管理、提升工作效率、提高医疗服务水平、降低医疗成本、降低医疗事故，从而提高医院核心竞争力等各方面起着越来越重要的作用，因此建立一个功能齐全、技术能力强、工作效率高的医院信息管理部门也就越来越重要。明确信息化管理部门的职责及其建设方向，对于建设一个好的信息管理部门、做好医院的信息化工作至关重要。结合我们医院的信息主管部门——计算机中心的的发展情况，我们认为信息主管部门主要包括以下职责：     

无线医护工作站的建设

在医院信息化建设逐步走向以病人为中心的临床信息系统建设的同时,我院建设了无线医护工作站,利用无线网络技术来提高医院网络系统的快速响应能力,临床医护人员通过无线医护工作站能及时获取患者在医院的诊疗信息,并可通过区域医疗服务平台获取市民完整的健康档案信息。     

医院信息化在医院经营管理中的作用

在信息高速发展的时代，医院要不断提高经营管理水平，就要实现信息化管理。医院信息化在医院经营管理中尤其在提高医疗质量、加强病种管理、提高科研教学能力、及人财物管理、为领导决策服务方面起着越来越重要的作用。以信息化管理为主体的新型医院管理模式，已成为新时期医院发展的必然方向。     

基于区域医疗的医院服务平台设计

本文通过分析区域医疗信息化建设的背景，提出了建立基于区域医疗的医院服务平台的总体目标。重点阐述了系统设计方案和功能，论述了系统的价值意义，探讨了医院服务平台更加充分地发挥基于健康档案的区域卫生信息平台的作用及意义。     

基于HL7标准的居民健康档案研究

目的随着医疗信息化的不断深入,医院内以及区域医疗信息共享已成为全球医疗卫生信息化的发展趋势。为临床医学科研提供更为准确和高效的信息检索与分析功能,是居民健康档案未来的发展方向。方法本文基于HL7（Health Level7）标准及可扩展标记语言（extensible markup language,XML）技术,在介绍居民健康档案功能和特点基础上,分析了健康档案的数据模型设计和实现方案,包括数据存储模式、XML存储方式选型、数据库选型等。结果通过运用XML技术和HL7标准的数据转换,可实现医院内部多个系统的无缝集成。结论在实际应用中,基于HL7标准的居民健康档案可以较好地保证数字化医疗信息的完整性、一致性,实现医疗信息共享。     

谈医院档案的编研工作

医院档案编研工作，是开发医院档案信息资源，力求反映医院创建、发展、变化过程的本采面目，为医院改革开放和各项工作提供优质服务的有效方式。     

浅谈医务人员的信息素养的培养

本文从信息素养的内涵出发,提出了加强医务人员信息素养的紧迫性,分析了我院医务人员信息素养的现状及提高信息素养的必要性,从加强医院信息化建设,增强医务人员的信息意识及提高医院科研管理人员的信息素养等方面探索了提高医务人员信息素养的方法.从而推动了医院的信息化建设与可持续发展.     

加强医院电子信息服务的思考

作为驻地偏远的驻军医院，由于编制床位较少、驻地经济落后等客观原因，致使信息更新缓慢，医疗服务水平得不到及时提高。因而如何在信息时代的今天，充分发挥网络和多媒体优势，使医院工作人员能够在最快的时间里了解最新的专业发展动态，是医院在信息化建设中所面临的新问题。作为祖国最北边的驻军医院，近年来。我院积极更新观念，在信息化投入上走在了同类医院的前列，在建立了HIS、远程会诊系统的基础上，先后购进了光盘文献检索系统和医学期刊全文检索系统，这些系统的实现为临床医疗、科研、教学等提供了方便快捷的资料查询方式，大大的提高了医院信息理念，有力地促进了医院整体医疗水平的提高，现就搞好电子信息服务丁作提出几点思考：     

浅谈病案管理者的信息素养

病案事业的信息化建设是医院发展的必然趋势，病案管理者的信息素养直接影响病案工作的新发展。本文围绕这一发展要求，从信息知识素养，信息意识素养，信息技能素养三方面来提高、完善病案管理者的信息素养，促进病案管理工作的发展。使病案信息在医院发展中体现其应有的价值。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.