XML技术及其应用概述

1 XML的简要介绍 XML（Extensible Markup Language）是由一系列规则所组成的描述语言，其本质为一种定义语言，主要用来在网站上储存与传输信息。任何行业均可遵循这些规则来定义各种标识，对信息中的元素进行描述，然后通过分析程序进行处理，使信息实现“自我描述”。对于大型的复杂文档，XML更是一种理想语言，它不仅允许指定文档中的词汇，而且允许指定元素之间的关系。随着网络的发展，XML在网络开发中的地位已逐渐赶超HTML，     

全面数据在医院系统的应用

数据的概念可以分为结构化数据和非结构化数据。结构化数据——即行数据，存储在数据库里，可以用二维表结构来逻辑表达实现的数据；非结构化数据——包括所有格式的办公文档、文本、图片、XML、HTML、各类报表、图像和音频，视频信息等等。简单理解结构化数据为数据库数据，非结构化数据为其他离散的数据。     

MEDLARS系统联机多文档检索结果的合并和排序功能

美国国立医学图书馆今年又推出了ELHILL3.3a新版本联机检索软件,该软件是在去年ELHILL3.3的保留性文档转换(TFILE)、多文档检索(MFSEARCH)和多文档检索结果输出(SUPERPRINT)等功能的基础上,又增加了联机多文档检索结果合并和联机多文档检索结果排序等功能,从而使多文档检索和多文档打印变得更为简便、省时和经济。     

利用医院网络平台建立行风建设工作信息系统

目的建立科学、实用、适应医院行风建设工作的信息管理系统，有利于医院管理部门有效评价、监控医院行风建设工作，提高病人满意度。方法以超文本（HTML）为基础，利用动态网站的核心技术，以数据库为信息储存方式．以ASP为技术框架，以HTML为表现形式，以Web服务器为运行环境，设计开放式的Web服务器应用程序，把脚本HTML组件和强大的Web数据库访问功能结合在一起，形成一个能在服务器上运行的应用程序。结果为行政职能科室和临床科室提供了一个互动的平台，为医院决策者提供了科学、准确、快速的行风信息，为医院确立自身发展目标提供了保证。     

GreenCDA方法学研究

CDA标准是我国基于文档共享的医院信息化和区域卫生信息化的重要基础性标准，GreenCDA创造了一种更易于让用户使用并产生标准CDA的方法。在CDA标准基础上，GreenCDA减少CDA标准应用的复杂性，促进CDA标准应用。重点介绍了GreenCDA的发展历史，方法学原理，并详细描述了制定流程中需求确定、制定GreenCDAschema文件、制定GreenCDA与CDA文件问的转换文件、转换测试与验证等。最后分析了我国采用这一标准的可行性，并探讨了基于GreenCDA建立中文医疗文梢共享标准的可行性。     

基于数据库技术的电子病案医疗文档的建立和管理

目的:通过对比两种建立医疗文档的方法:模板文档和专用程序,阐明利用数据库技术建立医疗文档在电子病案系统中的重要性;方法:利用数据库技术,采用格式定义语言,编写专用程序来建立医疗文档;结果:建立的250张电子病案文档,近2年实践中,满足系统全数据库保存的要求,并能从格式,专业需要,使用方便,选择自由度,发展需要,安全等方面满足病案的要求,同时使这些文档的管理更具合理性和科学性;结论:数据库技术是建立电子病案医疗文档最佳方法,为病人信息在医院信息系统(HIS)的信息共享提供技术基础,满足远程医疗的技术需要.同时,其管理方法立足院情,并满足了医院发展的需要.     

GE医疗CCA助文档管理逐步深入

2013年，GE医疗推出了“影像及临床文档管理中心Centricity? Clinical Archive?”解决方案（CCA），仅仅看到这个名称也许不为人注意，但其实，CCA运用行业Vendor Neutral Archive（VNA）理念，通过将多个部门或系统的数据和影像文档合并成统一、规范、可靠的系统，提高工作效率，降低医疗成本，促进管理决策。最重要的是此方案将解决文档的集成与管理问题。目前，这在国内是比较少见的一款针对文档管理的解决方案。     

基于HL7和IHE的中国卫生信息文档共享规范深入研究

中国区域卫生信息共享依赖的标准体系中，语义层次必须的《卫生信息文档共享规范》具有关键作用。它在HL7CDAR2的基础上，利用IHEPCC、HL7CCD模板库作为基础参考库制定中国本地化文档模板。目前处于征求意见稿阶段，通过对其深入研究，发现关于一致性、完整性等几方面存在的问题，并进行相关阐述和建议。     

对文档一体化管理的几点思考

文件生命周期理论的产生，信息时代对各个行业高速度、高效益的要求，办公自动化的日益推进，使文档一体化管理成为档案事业发展的必然趋势，成为全体档案工作者努力的方向。如何稳步、有序地推进高校文档一体化管理进程是一个值得关注、亟待探讨的问题。该文从提高认识、建立文档一体化业务体系、计算机管理系统等方面提出了对文档一体化管理的几点建议。     

患者转诊信息及其结构化与标准化

根据我国医疗文书管理相关规定，遵循有关国际组织的健康文档标准化技术和方法，探讨了患者转诊时需要携带的个人健康信息的内容、文档结构以及数据标准化问题。转诊信息包括基本信息、转诊事件信息和临床信息三个方面，按照文档段／子文档段、数据组／子数据组、数据元等三个层次划分，形成包括10个文档段（子文档段）、18个数据组（子数据组）、123个数据元的转诊文档基本框架结构。文档段限定了所包含数据产生的背景和语境，数据组由一系列数据元组成。通过数据元属性描述进行标准化。研究表明，结构化和标准化的转诊文档可促进医疗信息传递中数据的准确、一致性理解。但有赖于共享范围内标准制定和应用的协调一致，目前我国还有大量的临床概念、术语和数据元有待标准化。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.