慢性病管理信息系统使用意愿影响因素研究

以技术接受模型和任务技术匹配理论的整合模型为基础,引入任务技术匹配、感知有用性、感知易用性和使用意愿4个变量,构建研究模型,分析影响医务人员使用慢性病管理信息系统的因素。研究结果表明任务技术匹配、感知有用性、感知易用性均对使用意愿产生正向影响。     

基于信息系统成功模型的卫生信息系统建设效果评价模型

目的:构建卫生信息系统建设效果评价通用模型,为全面衡量卫生信息系统建设效果提供参考。方法:采用文献计量法、比较分析法和归纳演绎法,对国内外信息系统建设效果评价模型进行系统分析,以信息系统成功模型为基础,整合了不同视角下信息系统建设效果的经典模型。结果：从技术-组织管理-业务支撑综合视角出发建立卫生信息系统建设效果评价模型。结论：卫生信息系统建设效果应包括技术效果、组织管理效果以及业务支撑效果3个方面。根据我国当前卫生事业发展对信息化的要求,结合已有研究的经典指标,初步构建了适用于卫生信息系统建设效果评价的通用模型,包括7个一级指标和20 个二级指标。     

泛美国家卫生健康信息系统成熟度评估模型研究及启示

在数字健康策略大力发展的背景下,通过研究泛美国家卫生健康信息系统成熟度评估模型的内容与特点,提取总结其中可借鉴的内容,结合我国卫生健康领域信息化发展现状,提出我国卫生健康信息系统建设框架与建设原则,旨在一定程度上为卫生领域信息化发展提供参考.     

基于能力素质冰山模型的卫生信息化应用型人才培养模式研究

卫生信息化高级应用型人才培养模式改革,是在卫生信息产业深化与细分的背景下,对高校医学信息、信息管理与信息系统（医药卫生方向）等相关专业提出的一种新要求。根据卫生信息化高级应用型人才能力素质冰山模型,从培养目标、能力培养方案、师资队伍与培养体系几个维度对卫生信息化人才培养模式进行重构。并对重庆市某校信息管理与信息系统（医药卫生）专业基于能力素质冰山模型的人才培养模式改革进行实证研究。     

2011年《医学信息学杂志》编辑出版重点选题计划

2011年本刊将继续秉承传播党和国家有关医学信息方面的方针、政策和法规,报道医学信息领域的前沿理论、技术进展和应用成果,反映我国医学信息学科建设与事业发展的办刊宗旨,深入探究国内外医学信息学发展趋势、前沿热点、需求特点并分析应用实效,积极推进我国医学信息事业的发展。一、医疗卫生信息化1"十二五"期间卫生信息化建设"3521工程"的总体框架所涉及的各项研究内容与应用实践;2区域医疗卫生信息化体系架构与组织实施;3医院信息系统、医学影像系统、临床决策支持系统、中医药信息系统等的建设与发展;4医疗卫生信息化相关标准与规范建设;5远程医疗的组织方式与技术实现;6国外医疗卫生信息化建设与研究现状、进展动态、最新技术。     

卫生统计网络直报作用及应用中的问题

卫生统计网络直报系统促进了我国卫生信息化和统计信息化,提高卫生信息系统利用效率,充实公共卫生信息量,提高卫生信息及时性、准确性、灵敏度、共享性和数据分析能力,同时又充分利用现有的计算机网络和技术,发挥了各级医疗卫生单位计算机网络的作用。但在应用中也发现了一些不足。就此进行了探讨。     

电子认证服务在区域卫生信息化中的应用需求研究

在区域卫生信息化环境下,信息共享与互操作给信息安全带来了前所未有的挑战,电子认证服务通过数字证书验证用户的合法性,使系统操作具有可追溯性,有效保护信息安全。通过总结电子认证服务在不同卫生信息系统中的应用需求及特点,探讨区域卫生信息化环境中电子认证服务需求,并针对目前电子认证服务存在的问题提出建议,以对我国区域卫生信息化中推广电子认证服务提供理论参考。     

2003年医疗卫生领域信息化进展

介绍了国际国内医疗卫生领域信息化的进展情况:SARS刺激了医院信息系统的发展,医学信息标准化2003年开始有了实质性进展;卫生部制定了国家公共卫生信息系统建设现阶段的主要任务;美国国家疾病控制中心传染病监控系统的建设;我国区域卫生信息系统及其需进一步研究的难点是标准化问题、医院信息系统、门诊信息系统、医学图象处理系统以及医院信息系统中间件研究.     

WHO国家卫生信息系统框架和标准对加强我国疾病监测信息化工作的启示

随着国家深化医改和人口健康信息化的推进,研究卫生信息系统的评估办法,发现现行疾病监测信息化的不足及差距,进一步加强我国疾病监测信息系统建设质量将十分必要。重点介绍《国家卫生信息系统框架和标准》,结合我国疾病监测信息化工作,阐述对我国疾病监测信息系统规划和实施的思考,并提出一些工作建议。     

试论卫生执法监督信息系统建设

卫生执法监督信息系统是《全国卫生信息化2003—2010发展规划纲要》中明确提出的八大信息化建设任务和六大信息系统建设目标之一。作者从卫生执法监督信息系统建设的现状和问题着手，论述了卫生执法监督信息系统建设的目标、对策，以及建设方针和原则，期许为各级政府和卫生行政部门决策提供参考。     

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.