应用Access2000编制医学疾病登记系统

目的 开发自动化实用、可靠、功能完善的医学疾病登记管理系统。材料与方法 应用计算机WindowXP操作系统,以Microsoft Ac-cess2000(简体中文版)数据库软件作为编辑软件,包括创建数据表、输入数据窗体及功能按钮,建立查询及打印报表,建立WORD文档模版。结果 本系统可完成医学疾病登记的编辑及打印、文档模板的打印、自由词查询及收入统计等功能。结论 本系统是目前对医学疾病登记资料管理计算机化的有效方法之一。     

电子病历病案管理系统的功能需求

本文从电子病历的特点、电子病历病案管理系统存在的问题出发,对电子病历病案管理系统的功能需求进行了阐述。提出了电子病历病案管理系统应包括电子病历自动回收、按国际疾病分类标准及手术操作名称进行编码、实时监控病案质量、建立电子病案库、设立病案打印、病案查阅及全面的病案综合查询等功能,从而使电子病历能更好地服务于临床医疗和医院管理。     

高血压的社区筛查

我国慢性病死亡人数占总死亡人数的比例呈持续上升趋势，用于治疗慢性非传染性疾病的费用占疾病治疗总费用的比例高达60％，远远高于43．2％的世界平均水平。世界卫生组织指出，医疗卫生费用的恶性膨胀已经成为全球性医疗危机。美国健康管理20多年的实践表明，90％的个人和企业通过健康管理后，医疗费用将降到原来的10％；而没有进行健康管理的10％个人和企业，医疗费用会比原来上升90％。改变以治疗疾病为主的传统医院服务模式，开展对全人口的健康管理，     

使用VB开发医疗设备维修管理系统

使用VB语言和Access数据库对医疗设备维修管理系统进行设计,将系统结构划分为基本信息、维修管理、库存管理、报表打印、系统管理等5项功能模块,实现了设备信息登记、查询、维修情况、配件管理、报表打印、权限管理等功能.系统使用后运行稳定,大幅度提高了医学工程人员的工作效率,进一步加强了设备科的综合管理职能.     

肾移植患者健康管理系统在门诊随访中的应用

目的：设计和开发肾移植患者健康管理系统,应用于肾移植术后随访工作。方法：在微机安装 Windows XP 操作系统中使用Access 2010 数据库软件,创建肾移植患者健康管理系统,通过数据输入、数据查询、 数据打印、问卷调查、数据导出和随访管理6 大功能模块,对肾移植患者进行数据库管理和术后随访。结果： 系统运行稳定、可靠;输入数据简单、快捷;查询、统计、打印均比较方便。结论：肾移植患者健康管理系统 减轻了随访人员的工作压力,提高了门诊随访工作的效率。     

信息化管理在医疗设备档案管理中的运用

随着信息化技术的不断发展,信息化管理已逐步运用到医疗设备管理之中,信息化管理的运用,不仅适应了管理科学化、规范化的要求,而且大大地提高了医疗设备管理的效率。1建立医疗设备信息化管理库医疗设备的信息化管理,既可运用到医院的设备管理和材料管理中,还可运用到配件管理和维护管理中,其基本和重点是要建立各种管理类型的信息化管理库。根据各医院的具体情况,建立的信息库主要包括以下几个方面:1.1材料管理库。主要包括:①物品、采购、请购执行情况等;②入库(仓);③出库(仓);④溢损;⑤退库(仓);⑥退货;⑦盘点;⑧查询:查询主要包括:已记帐的入库单、出库单、退库单、退货单等;批次库存表;台帐等。⑨报表:报表主要包括:科室领用成本月报表;出入库(仓)凭证汇总表;科室领用按出库(仓)性质统计报表;某单位供应某种设备规格的某个价格范围内的入库统计明细表;科室领用设备明细表;科室领用某种设备规格的某个价格范围内的出库统计明细表等。1.2配件管理库。同材料管理库相同1.3设备管理库。在材料管理库的基础上增设报废和调拨二个内容,相应地在查询内容中增加:①已记帐的报废;②调拨单;③设备、小器械档案表。另外,相应地在报表内容中增加:①固定资...     

触摸屏查询系统在医疗服务中的应用

为了规范医疗服务价格行为，实行医疗服务价格公示制度。我院设立电子触摸屏查询系统，提高医疗服务价格透明度。接受患者和社会监督，完善病人费用查询和费用清单制度，让患者明明白白消费。我院在门诊部和住院部大厅都设置有触摸查询仪，免费向病人提供医疗费用服务查询。该系统是医院实现透明化服务，满足患者咨询需求而实施的一项多媒体信息系统工程，是医院信息管理系统的一个分支，病人的费用信息和物价信息都是通过提取医院信息管理系统相关库表而显示到触摸屏上的，它有别于医院信息管理系统，医院信息管理系统强调的是对信息的管理，而触摸屏查询系统注重的是利用信息为病人服务，正是这种联系和区别使它在设计和实施上有着自己特殊的解决方案和独特之处。     

心力衰竭病人健康教育策略

心力衰竭是各种心脏病的严重阶段,5年存活率与恶性肿瘤相仿。对心衰病人进行疾病管理干预能显著的降低住院次数、提高生存质量并降低医疗费用。健康教育是心衰疾病管理干预中的重要组成部分,文章主要介绍心力衰竭病人的健康教育的策略。     

健康保险公司与社区卫生服务机构共建的健康管理模式的建立与探讨

健康管理被认为是最有效的控制医疗费用过度增长的医疗投资方式,但在我国尚处于起步阶段。本研究通过对我国健康管理、健康保险公司和社区卫生服务机构的现状进行分析,建立起一种基于健康保险公司与社区卫生服务机构共建的健康管理的新模式,并对其实施的可行性进行了探讨。这一模式的讨论对促进健康管理的快速发展、提高全民健康水平具有重要意义。     

对67例知己健康管理对象的效果评价分析

通过知己健康管理对慢性病患者及高危群体存在的健康危险因素进行全面管理和量化饮食和运动等非药物干预手段,帮助慢性病患者建立新的健康的生活方式,从而达到降低血糖、血压、体重、血脂代谢紊乱指标,实现控制疾病及其并发症的发生和发展、改善健康效果,减少医疗费用,提高生活质量的目标.对2010年在我中心参加知己健康管理的67例人员进行调查和指标分析,评定自我管理的效果.     

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.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.