建立军队医院聘用人员管理信息系统的意义

根据军队医院聘用人员管理的特点和需求,建立相应的网络软件平台.将人力资源管理思想与信息技术完美融合,通过软件系统规范办事流程、改进统计手段,整合信息资源,从而提高效率、降低成本、辅助决策、提升管理水平.聘用人员管理系统的研发应用,是军队医院实现高效、科学、规范的人力资源管理,保证军队医院可持续发展,保持核心竞争力的必然要求.     

15956份病案首页网上质量监控体会

医院信息管理系统的建立和实施,实现了在信息发生地实时采集数据,对确保统计工作的时效性起到了积极的作用,但另一方面,由于基础数据录入源增多,使得信息质量源头的数据质量难以保证,一旦源头错误,再好的信息加工处理,也是垃圾信息,特别是病案首页,它是医院医疗统计信息的主要载体,25项院内重点监控的指标,有20项指标的计算依托于病案首页的内容;同时,它也是医院     

网络环境下卫生统计在现代医院管理中的职能

目的:阐明网络环境下要强化统计工作在医院管理中的监督职能,拓宽统计的预测、决策职能。方法:通过论述由于卫生统计工作在网络环境下工作流程的改变而引起统计职能的重心发生变化,统计人员针对统计的各个环节进行监督,对随时出现的问题及时发现并以较正,提出可行方案。结果:卫生统计人员通过网络系统操作平台共享门诊、住院和医技职能科室的各类数据信息,由此可以积极参与医院管理,拓宽统计预测、决策职能。结论:在新形势下医院要加强管理,促进自我生存和发展,必须充分发挥网络系统下的统计职能。只有依据科学的统计信息,才能提高医院的服务质量,从而促进医院的全面发展。     

医院统计与医疗数据质量管理信息系统开发

目的：探讨医院统计在医疗数据质量管理信息系统开发中的重要作用.方法：从数据特征描述、数据要素提取、信息质量内涵等方面叙述医院统计工作与医疗数据质量管理的密切关系.结果：随着医院信息化程度的不断深入,对于医疗数据质量问题,用信息科学视角可以更好地理解医院统计工作和医疗数据的质量要求.结论：要保证医疗数据质量管理信息系统的研发周期短、使用周期长,系统更稳定、更具有生命力,统计人员必须参与该系统的开发与研究.     

医学统计在医院网络化管理中的作用

随着医院改革的不断深入、医院信息网络化、一体化建设的全面展开，医院统计已由单纯的医疗业务统计向综合性统计拓展，其统计工作在医院网络化管理中依然有着不可忽视的作用。 1 实行规范管理，提高工作效率 首先，医院网络化工作的运行，必须以规范的基础工作为前提。基础工作的准确性直接影响着网络信息的可信度，比如，网络运行前期各项字典(包括科室字典、医院人员情况、床位情况、医师编码及诊断治疗项目情况等等)所要求的内容必须经过规范处理和准确的统计、审核后方可录入，从而为网络化的正常运行打下良好的基础；其次，以往的医院统计基础工作由各部门单机操作，独立运行数据不能共享，统计室要进行大量的数据重复录入，网络化管理后，病人的治疗信息和费用信息构成在网上，统计室只需运行统计系统，提取数据进行统计汇总和计算，减少了大量的重复填报工作，提高了统计工作效率。     

探讨统计报表的质量控制

医疗统计信息是医院各种信息的主要组成部分。统计信息质量影响和决定着医疗统计信息的可用性及医疗统计信息价值。文章通过对医院统计信息数据源的分析,指出影响统计数据准确性的主要原因有医师填写住院病案首页不准确,造成信息数据原始记录不完整、录入员输入错误及计算机程序查询缺失等问题,并提出建立统计审核制度,完善计算机程序的质量监控及终末出表前的核对等措施。只有提高基础数据质量质量,真正发挥医院统计信息监督的职能作用,才能有效提升医院管理质量。     

如何发挥统计在现代医院管理中的作用

目的:阐明统计工作在现代医院管理中具有重要的、不容忽视的作用。方法:通过论述加强医院统计人才队伍建设和发挥统计的信息、分析功能,来提高统计在现代医院管理中的水平。结果:在新形势下,医院要加强管理,促进自我生存和发展,必须充分发挥统计在现代医院管理中的作用。结论:只有在现代医院管理中充分发挥统计的作用,才能提高医院的服务质量水平,从而促进医院的全面发展。     

大数据背景下医院信息化建设

我国近几年来,互联网信息化发展十分迅速。医院由于每天接受很多病患,患者的信息数据也越来越多,越来越难以统计。所以这就需要医院借助互联网这个平台,建立与其实际情况相对应信息数据平台,用来统计医院的各项数据,从而确保可以顺利开展医院的各项工作。以此,在当前大数据的背景下,医院只有从建设信息化平台、进行数据的云计算等方面出发,才能从整体上建立一套完善的信息数据管理制度,从而进一步提高医院的管理水平,促进医院各方面工作的协调发展。     

"医院感染监控管理软件"在医院感染监测中的应用

目的应用“医院感染监控管理软件”,提高医院感染监测水平。方法“医院感染监控软件”的全部数据信息架构在“军卫1号医院管理信息系统(HIS)”上。该软件信息结构包括病人的基本信息、诊疗信息、用药信息、手术信息等。软件系统具有开放性的信息编辑功能、数据统计及数据组合查询等功能。结果通过HIS直接获取在院病人和出院病人的详细资料,实时掌握医院感染发生及相关危险因素的动态信息。结论应用“医院感染监控软件”,能及时、准确、客观的反应医院感染相关信息,提高了医院感染管理专职人员的工作效率和质量。     

医院信息统计工作方向探讨

目的提高信息统计质量,发挥信息统计工作在医院管理中的作用。方法根据医院管理需要,总结出统计工作中存在的不适应医院管理和发展的问题。结果对存在的问题进行思考,探索出信息统计工作以后的发展方向。结论只有不断提高统计人员专业素质,充分发挥信息统计工作的管理职能和作用,才能使医院信息统计工作更好地为医院管理服务。     

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.