XDS-Ⅰ在区域医疗文书中的应用研究

目的：在区域医疗文书研究中引入XDS-Ⅰ的概念是为了解决医学影像规范化共享问题。方法：根据XDS-I模型,设计应用于多个医疗机构之间开展远程放射学业务的系统结构。结果：使用XDS-I实现了规范化医学影像的共享。结论：为区域医疗基于IHE技术框架的应用提供一种设计方案。     

基于云计算的区域医疗信息共享平台的设计与实现

目的 建立区域医疗信息数据共享平台,实现电子病历、医学影像等区域医疗数据共享,完善个人健康档案,提高医疗服务水平。方法 借鉴国内外相关研究成果和经验,对现有医疗信息化资源进行虚拟化改造,并利用SOA、Web服务等技术建立基于云计算的区域医疗信息数据共享平台,连接医疗机构之间异构的信息系统。结果提出一种基于Web服务的数据交换云平台设计方案,使用加密和压缩的XML技术来进行数据交换及保证数据的安全和私有性,研制的原型系统在多家军队医院部署运行,实现了临床信息的共享。结论 云计算平台具有便于动态扩展、分布式共享和泛在接入等特性,将其应用于区域医疗信息化有较高的可行性和实用性。     

载人航天试验任务中开展远程医疗保障探讨

远程医疗（telemedicine）是指医学专家利用通信、传感、多媒体、远程控制等技术实现异地疾病诊断、治疗、健康护理、远程教学与指导等多种医学活动的医疗模式.随着现代微电子学、通信技术、计算机与网络技术,以及医学数字影像设备如CT、MRI、CR、DR和DSA的迅速发展,远程医疗技术日趋完善.特别是,近年来医学影像存档与通信系统（Picture Archiving and Communication System,PACS）的逐步实施,实现了医学影像全数字化采集、存储、处理与传输,为今后普及远程医疗奠定了基础[1].     

烧伤湿性医疗技术规范化推广应用现状调查

目的:分析烧伤湿性医疗技术推广应用的现状,并在基层进行应用规范化、标准化研究及适宜技术推广.方法:调查培训前后烧伤湿性医疗技术的规范化推广应用情况,采用问卷调查的方式,由调查员统一发放.结果:接受培训后的医师对该技术的认知度明显高于培训前的认知度,P<0.01,两者差异有统计学意义,而在是否需要学习该技术或推广应用中,培训前后差异无统计学意义,P>0.05.培训后的医生都了解烧伤湿性医疗技术的真正含义,及时换药,并且为患者换药时都能始终遵守无损伤原则,对比培训前后的规范化操作,P<0.01,两者差异有统计学意义.结论:基层医院对中医药治疗技术的认知度不高,本课题以金秀县为推广应用示范基地,进行烧伤湿性医疗技术在基层的应用规范化、标准化培训及适宜技术推广,通过此次的培训及调查为以后相关适宜技术在基层进行推广提供了有益的借鉴经验.     

加强招飞体检医疗废物管理的探讨

目的加强招飞体检医疗废物管理,预防医源性感染。方法对招飞体检医疗废物管理的现状进行剖析,提出有效的对策措施。结果严格管理和规范处置体检中产生的医疗废物,保障参检人员身体健康,有效控制和预防招飞体检区域的医源性感染。结论医疗废物管理法制化、规范化、制度化是积极预防医源性感染的最有效措施。     

基于FHIR代理网关的移动终端医学影像传输方法

目的 提出一种基于快速医疗互操作性资源(FHIR)代理网关的医学影像传输方法,使医务人员可以随处使用移动终端通过互联网访问院内医学影像,提高工作效率.方法 利用RESTful WebService作为影像数据的互操作机制,结合FHIR影像资源模型构建3层网络架构的中间代理网关,解决了院内影像数据通过网关跨网传输给移动终端的问题.结果 使用本方法构建的基于互联网的移动终端阅片系统在医院实际环境试运行6个月,系统运行稳定,使用情况良好.结论 该网关访问方式简便、灵活,能够很好地支撑移动终端对后台影像数据中心的访问.     

企业级医疗影像信息集成平台研究

目的:探讨大型医院内部各影像系统信息共享和医疗资源整合方法.方法:采用IHE技术框架为理论指导,结合国内医院实际提出"企业级医疗影像信息集成平台"及其开放整合方案,通过各厂商的密切配合、实施,初步实现对全院DICOM影像的统一归档和统一发布.结果:经过实践验证,集成平台切实有效,既提高临床医生对医学影像信息的使用效率,提高诊疗质量,又便于医信技术人员对影像信息的集成管理.结论:基于IHE技术框架的企业级影像信息集成平台研究被证明是可行、可靠和有效的.     

简讯

大型门户网站“医学影像健康网(www.mih365.com或www.mih365.com.cn)”已开通。该网站集医学影像医疗、教学、科研、管理、科普宣传为一体,拥有“频道专栏”,涉及医学影像学的诸多内容,包括:专业信息、科研论文、继续教育,外语沙龙、医影科普、企业中心,休闲驿站等,此外,还涵盖妇幼科技及其保健的相关内容。网站设有“大型论坛”,其中“每周述评”由中华医学会影像技术分会中青年委员、南京军区南京总医院医学影像研究所王骏主持。该网站秉承“影像技师的摇篮、临床医师的助手、妇幼保健的家园、医患之间的桥梁、企业沟通的渠道、人才交流的…     

医学影像与人工智能

在医疗行业应用场景中,医学影像人工智能在产学研上均取得快速进展:医学影像人工智能研究初现了良好的研发态势及广阔的落地场景;人工智能在医学影像领域的进展表现在医疗影像设备、影像诊断及其智能服务等诸多方面;学术交流日益活跃,积极探讨人工智能的学术进展及未来发展;有关医疗人工智能发展的权威性报告亦相继发布。本期重点号刊登了几篇医学影像人工智能方面的文章,从不同角度展示人工智能在医学影像领域的最新研究成果和产品落地场景。     

美海军远程医疗特点对我海军远程医疗建设的启示

远程医疗能够最大限度地共享医疗卫生资源,对军队尤其是海军的卫勤建设具有重要的现实意义和广阔的发展前景.借鉴美国海军远程医疗的建设和发展的特点,提出我海军远程医疗的建设和发展中,应继续深化系统的规划、设计,完善组织指挥的体系、架构,加快先进技术装备的应用,重视远程医学的基础研究.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.