"军字一号”工程的维护

"军字一号”工程的维护工作是系统运行安全、准确的重要保障.通过一年多"军字一号”工程的维护,使"军字一号”工程的运行状态、应用水平和数据质量逐步达到完好、准确的目标.     

"军字一号”工程与PACS

在军队医院实施“军字一号”工程后,各个医院都有实施PACS系统的要求。本介绍PACS系统的主要功能并着重介绍如何实现PACS系统与“军字一号”工程的衔接。     

"军字一号”工程的建设与应用

目的：为探讨“军字一号”工程建设与应用中存在的问题和解决的办法。方法：调查部分正在运行和准备运行“军字一号”工程的医院。结果：在“军字一号”工程的建设与应用方面,虽然已取得了很大的成绩和许多成功的经验;但也存在一些共性问题。结论：提高主管领导的认识,建立平稳运行的系统,搞好建管用的衔接,达到管理模式的转变,对在全军医院用好“军字一号”工程,发挥现代医院管理效益,提高管理水平是必要的。     

应用SQL语言进行数据查询与统计

总后勤部卫生部从1995年开始启动“金卫工程‘军字一号’工程”，投入了上百人年，研制开发出医院信息系统的网络版软件，并于1997年开始在全军20多所医院开始试运行，到2001年底，全军几百所医院已经全部采用了军队医院信息系统。经过近10年的应用，业务部门已经熟练掌握了各功能模块的使用，完成了从手工操作向信息化的转变。     

"军字一号”工程的数据仓库技术的应用

为探讨“军字一号”工程中数据仓库技术的应用,根据如何将“军字一号”工程中现存的大量历史数据转变成有用的信息;并就今后“军字一号”工程应用的发展,提出了将数据仓库技术应用到“军字一号”工程中的设想。不但阐述了数据仓库技术应用的背景,以及“军字一号”工程应用数据仓库的意义,更多的是分析其可行性;并通过对实现目标的有利条件和可能遇到的问题及其解决办法进行了详细地分析和讨论。最后,提出了建立实验系统;并且列出要达到该目标所应该实施的工作内容。     

“军字一号”工程网络布线系统的设计

本介绍了南京总医院“军字一号”工程网络布线系统工程设计,阐述了综合布线设计要领、设计标准,以及“军字一号”工程网络布线系统的设计要求。从医院信息管理要求出发,网络布线系统的设计要充分满足“军字一号”工程应用及将来发展的要求。     

利用"军字一号"工程和PACS提高远程会诊水平

目的：为提高会诊信息的准确性和医学影像质量，减轻远程会诊工作量。方法：医院建立“军字一号”工程和PACS，并把远程会诊系统“军字一号”和PACS融合。结果与结论：会诊病人的临床信息直接人“军字一号”采集，医学影像从PACS采集，既减轻了工作量，又提高了远程会诊水平。     

“军字一号”工程与兰州市医疗保险接口方案

通过对医院HIS系统和地方医保系统优缺点对比分析,结合医院“军字一号”工程的应用实际提出了医院“军字一号”工程与驻地医疗保险接口方案。     

"军字一号”工程的风险因素和安全策略

为探讨“军字一号”工程的系统运行环境,利用一种风险因素的评估方法,重点阐述了“军字一号”工程系统存在的16种安全风险因素,得出“系统风险较高”的评估结果。最后,从网络安全性、系统安全性、用户安全性、数据安全性以及管理监督机制等方面讨论了“军字一号”工程系统应采取的安全策略。     

"军字一号”工程高质量运行的保证

为探讨“军字一号”工程高质量运行的条件,从宣传动员、组织协调、完善制度、建立字典和应用队伍建设等方面进行了阐述,为“军字一号”工程高质量地运行奠定了理论基础。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.