智慧医疗背景下心脑血管疾病医疗救治信息平台

阐述智慧医疗背景下基于互联网、大数据和人工智能技术的心脑血管疾病医疗救治信息平台的建设思路、平台架构、平台功能以及技术挑战等,提出构建远程急救和移动急救信息化平台、互联网心脑血管疾病联合救治医疗服务平台、人工智能和大数据分析的心电监测与高危人群预警平台以及心脑血管疾病的综合指导教育平台4个子平台,形成完整的心脑血管疾病医疗救治信息平台,实现现代智能网络和信息技术在医疗救治领域中的创新应用,达到医疗救治资源的互联互通,提高医疗救治服务质量与资源利用效率。     

5G智慧医疗院前急救模式探讨

院前急救是严重创伤救治体系的重要组成部分。指出了院前急救模式与标准多样、急救信息难以实现实时共享等问题,分析了将5G技术应用于智慧医疗院前急救的优势,包括实现区域急救资源调配合理化、生命体征信息传输实时化、患者个人基本信息同步化、远程急救远程会诊精细化和院前-院内急救衔接无缝化,并结合5G智慧急救系统的实践演练,认为该急救模式的创建可提高严重创伤抢救效率和抢救成功率。     

远程会诊系统在中毒事件中的应用研究

为了更好地完成中毒事件的应急处置,加强各级中毒救治基地之间的联系,提高专业人员应对各类中毒事件的快速处置能力,国家拨专款建立了化学中毒救治基地远程会诊系统。该系统基于Web技术,采用B/S和C/S混合模式,将视频、音频、录播等硬件、软件进行集成,实现视频会诊、现场指导、信息共享、远程教学等多功能的平台系统,丰富了国家化学中毒医疗救治基地之间的沟通方式,最大限度的满足了中毒事件处理的需求。     

重症救治方舱结构布局优化设计研究

目的:针对重症救治方舱对危重伤病员实施紧急救命处置的功能需求,研究一种优化的重症救治方舱结构布局方案,使其能够有效地实施快速、持续、综合的急救功能。方法:在总结分析二代方舱医院不足的基础上,系统梳理卫生装备构成体系和医疗设备配置方案,通过方案布局比较,实现重症救治方舱结构布局优化设计的目的。结果:重症救治方舱形成了一种以急救设备集成吊塔为核心功能区的优化方案,并进一步开展了方舱的试制。结论:优化后的重症救治方舱与前两代重症救治方舱相比,操作使用更加便捷,更加有利于开展急救处置等医疗作业,增强了重症救治方舱的救治能力。     

基于3G/4G无线网络的区域急救系统的设计

本文阐述了一套基于3G/4G无线网络的区域性急救系统的设计过程。该系统以医院急诊科为救治中心,依托专网专线和3G/4G通信网络建立,集成了数字化智能救护车系统、急救现场手提箱系统和区域性急救医疗信息系统。该系统的应用可以有效地提高院前医疗急救水平,提升应急突发事件的紧急救援处置能力,缩短院前急救时间,提高抢救成功率。     

基于无线3G网络的120院前急救系统研究

目的:针对国内院前急救的发展现状和不足,提出一种基于无线3G网络的120院前急救系统的解决方法.方法:利用无线3G网络通信技术,建立救护车、接诊医院与远端专家之间的信息通路,实现实时音视频和生命体征信息的传输.结果:该系统实现了远程救护指导、抢救方案的提前制订及接诊的准备,从而缩短了患者的救治时延,提高了患者的救治率,减少了医疗纠纷.结论:基于无线3G网络的120院前急救系统是可行的,并将在提高院前急救和转运水平、提高患者的救治率、节约急救资源、减少医疗纠纷等方面发挥更积极的作用.     

平战急救用多功能生命支持车的研制

目的研制一种多功能生命支持车,并能有效满足伤病员现场急救、基础治疗和转运的需要,从而提高伤病员救治能力、人装结合能力及环境适应能力。方法选用角钢、不锈钢制作车的骨架,骨架上铺设不锈钢板,轮子由万向轮及带自锁的轮子组成,多种急救仪器、药品、器械集成在生命支持车上。结果平战急救用多功能生命支持车,实现装备高度集成、减少人员跑动、高效完成救治任务。结论平战急救用多功能生命支持车高度集成,方便携带,机动性强,具有良好的推广应用前景。     

新型手持式创伤评分-急救系统的研制

详细介绍了一种基于掌上电脑研制开发的手持式创伤评分—急救系统。该系统体积小，操作简单，可同时提供各种伤情评定方案及小型专家系统指导，适用于大多数常见战、创伤现场急救，有助于提高急救成功率，对于远程医疗系统的建立也具有积极意义。     

基于云架构的区域智慧急救平台设计

构建基于云架构的区域智慧急救平台,为急救车提供车载智能终端和数字化医疗设备。利用4G物联网技术实现车载设备和患者生命体征信息的实时采集与远程传输,构建院前急救远程专家会诊网络。实现急救车和医院5大专科救治中心各救治环节信息的标准化和智能化,实现信息互联互通,提高院前急救的精准度和救治率,为救治急危重症患者提供技术支撑。     

车载式无线远程会诊系统的开发与应用

车载式无线远程会诊系统是全球卫星定位系统、车栽卫星通信系统、自动对星系统、计算机控制系统的集成，是计算机网络技术、卫星通讯技术和多媒体视频技术的综合运用，其目的是提高野外医务人员在执行特殊任务时的应急卫勤保障能力，利用该系统可进行卫勤指挥、远程手术指导、远程教学、远程会诊、上传卫勤数据、查阅检索电子医学信息等。解决了野外医务人员与后方医院或卫勤机构的信息共享问题，提高了野战医务人员的医疗救治水平和卫勤保障能力。为野外伤病员提供优质高效的医疗服务，解决了专家不能到达战场或救灾一线的问题。重点阐述了该系统的原理、组成、功能厦其在卫勘保障中的实际作用。     

A six country study of young children’s media exposure,logo recognition,and dietary preferences

Childhood obesity is a global public health concern. Previous research, mainly conducted in developed countries, suggests that marketing and media exposure is associated with unhealthy eating behaviors. This cross-sectional study was done with 2422 children, mean age 5.5 years, SD = .5, from six low- and middle-income counties (LMICs) (Brazil, China, India, Nigeria, Pakistan, and Russia). The analyses investigated media exposure, logo recognition, and preferences for international foods and beverages, such as globally distributed items like McDonald’s hamburgers and Coca-Cola soft drinks. Overall and in each country, path analysis models showed that media exposure and logo recognition directly and indirectly predicted the selection of international foods and beverages, controlling for child’s sex, age, home location, and parental education. Public health and communication experts must continue to investigate and understand these relationships, so as to inform regulations around food and beverage marketing.     

Workshop report: Nucleic acid delivery devices for HIV vaccines: Workshop proceedings,National Institute of Allergy and Infectious Diseases,Bethesda, Maryland,USA, May 21, 2015

On May 21st, 2015, the U.S. National Institute of Allergy and Infectious Diseases (NIAID) convened a workshop on delivery devices for nucleic acid (NA) as vaccines in order to review the landscape of past and future technologies for administering NA (e.g., DNA, RNA, etc.) as antigen into target tissues of animal models and humans. Its focus was on current and future applications for preventing and treating human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) disease, among other infectious-disease priorities. Meeting participants presented the results and experience of representative clinical trials of NA vaccines using a variety of alternative delivery devices, as well as a broader group of methods studied in animal models and at bench top, to improve upon the performance and/or avoid the drawbacks of conventional needle-syringe (N–S) delivery. The subjects described and discussed included (1) delivery targeted into oral, cutaneous/intradermal, nasal, upper and lower respiratory, and intramuscular tissues; (2) devices and techniques for jet injection, solid, hollow, and dissolving microneedles, patches for topical passive diffusion or iontophoresis, electroporation, thermal microporation, nasal sprayers, aerosol upper-respiratory and pulmonary inhalation, stratum-corneum ablation by ultrasound, chemicals, and mechanical abrasion, and kinetic/ballistic delivery; (3) antigens, adjuvants, and carriers such as DNA, messenger RNA, synthesized plasmids, chemokines, wet and dry aerosols, and pollen-grain and microparticle vectors; and (4) the clinical experience and humoral, cellular, and cytokine immune responses observed for many of these target tissues, technologies, constructs, and carriers. This report summarizes the presentations and discussions from the workshop (https://web.archive.org/web/20160228112310/https://www.blsmeetings.net/NucleicAcidDeliveryDevices/), which was webcast live in its entirety and archived online (http://videocast.nih.gov/summary.asp?live=16059).     

Heavy Metals in Aquatic Macrophytes from Two Small Rivers Polluted by Urban,Agricultural and Textile Industry Sewages SW Poland

This article presents the results from a study of the comparison of 2 lowland rivers: the Olobok and the Pilawa in southwest Poland polluted by urban, agricultural, and textile industry sewages. pH and concentrations of Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Ni, Pb, Zn, nitrate, nitrite, ammonia, phosphate, and sulfate were measured in water samples and concentrations of Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, N, Na, Ni, P, Pb, S, and Zn were measured in stream bottom sediments and in the aquatic macrophytes Elodea canadensis, Callitriche verna, Potamogeton crispus, Potamogeton natans, and Ceratophyllum demersum from the river Olobok and Elodea canadensis, Polygonum amphibium, Potamogeton crispus, and Veronica beccabunga from the river Pilawa. The matrix of concentrations of 16 elements in 27 plant samples of 7 species from 15 sampling sites of 2 rivers and concentrations of 15 elements and pH in water samples and 16 elements and pH in bottom sediment samples of these sites was submitted to numerical classification, which revealed that sampling sites from the rivers were differentiated by the value of factor 1 of principal component analysis (PCA), which was related to the pH of water, Ca, Cu, Mg, Mn, and Ni in water and Cd, Cr, Cu, Fe, K, Mg, Na, Ni, P, and S in bottom sediments. More polluted parts of both rivers were differentiated from less polluted parts by the value of factor 2 of PCA, which was related to Pb, Zn, and sulfates in water and Ca and Zn in bottom sediments. Macrophytes from the Olobok and Pilawa rivers were differentiated by the value of factor 1, which was related to Ca, Co, Cr, Cu, Fe, Mg, Ni, N, Na, Pb, and S. Groups of macrophytes of more and less polluted parts of both rivers differed by the value of factor 2, which was related to P, K, and Mn. Downstream of the sewage outputs in both rivers, a significantly increased level of pollution occurs with elements correlated with factor 1: Among others were Cu and Cr, typical for the textile industry along the river Pilawa, and among others were Mn and Ni, typical for the urban and agricultural activities in the river Olobok.     

Durational and generational differences in Mexican immigrant obesity: Is acculturation the explanation?

Using the Los Angeles Family and Neighborhood Survey (L.A.FANS-2; n = 1610), we explore the link between Mexican immigrant acculturation, diet, exercise and obesity. We distinguish Mexican immigrants and 2nd generation Mexicans from 3rd+ generation whites, blacks and Mexicans. First, we examine variation in social and linguistic measures by race/ethnicity, duration of residence and immigrant generation. Second, we consider the association between acculturation, diet and exercise. Third, we evaluate the degree to which acculturation, diet, exercise, and socioeconomic status explain the association between race/ethnicity, immigrant exposure to the US (duration since immigration/generation), and adult obesity. Among immigrants, we find a clear relationship between acculturation measures, exposure to the US, and obesity-related behaviors (diet and exercise). However, the acculturation measures do not clearly account for the link between adult obesity, immigrant duration and generation, and race/ethnicity.     

Special Considerations for Prophylaxis for and Treatment of Anthrax in Pregnant and Postpartum Women

In August 2012, the Centers for Disease Control and Prevention, in partnership with the Association of Maternal and Child Health Programs, convened a meeting of national subject matter experts to review key clinical elements of anthrax prevention and treatment for pregnant, postpartum, and lactating (P/PP/L) women. National experts in infectious disease, obstetrics, maternal fetal medicine, neonatology, pediatrics, and pharmacy attended the meeting, as did representatives from professional organizations and national, federal, state, and local agencies. The meeting addressed general principles of prevention and treatment for P/PP/L women, vaccines, antimicrobial prophylaxis and treatment, clinical considerations and critical care issues, antitoxin, delivery concerns, infection control measures, and communication. The purpose of this meeting summary is to provide updated clinical information to health care providers and public health professionals caring for P/PP/L women in the setting of a bioterrorist event involving anthrax.     

Neuropsychological sequelae of exposure to welding fumes in a group of occupationally exposed men

This study compares the neuropsychological function, emotional status, visual function, and illness prevalence of 76 former and current chemical industry welders primarily involved in steel welding, and exposed to welding fumes for an average of 24.9 years with that of 42 unexposed, non-welder controls. Health and occupational history questionnaires were administered, as were the neuropsychological tests included in the World Health Organization Neurobehavioral Core Test Battery, Luria Motor Test, and selected tests from the WAIS-III, and WMS-III. Emotional status tests included the BSI, POMS, BAI, and BDI, and vision tests included the Snellen near visual acuity, Lanthony d-15 color vision, Vistech Contrast Sensitivity, and Schirmer strips. While welders and controls performed similarly on tests of verbal skills, verbal retention, and auditory span, welders performed worse than controls on tests of verbal learning, working memory, cognitive flexibility, visuomotor processing speed, and motor efficiency. Welders had poorer color vision and emotional status, and increased prevalence of illnesses and psychiatric symptoms. The increased symptoms in welders were related to decreased scores on tasks measuring verbal learning, visuomotor abilities, visuospatial abilities, and information processing, and motor efficiency. Within the group of welders, the number of hours welding was negatively related to scores on verbal learning, auditory span, working memory, cognitive flexibility, and motor efficiency.     

肥胖对中小学生生理机能与常见疾病的影响

目的 使用2009年、2012年、2015年3个年份的样本量来分析重庆地区在2009—2015年间的肥胖检出情况、肥胖对学生的身体机能和常见疾病的影响情况,为改善学生生理机能、降低相关疾病寻找依据和方法。方法 通过分析2009年、2012年、2015年重庆市学生体质健康监测的累加数据,观察肥胖对学生血压、肺活量、肺活量指数、视力等身体机能的影响以及对近视、龋齿等常见疾病的影响。结果 2009年、2012年、2015年学生累计样本数为202 235人,体质量指数为肥胖的学生9 529人,肥胖率为4.71%,其中男生肥胖率为5.79%,女生肥胖率为3.73%,男生肥胖率高于女生,差异有统计学意义(χ2=473.66,P<0.01);城市学生肥胖率为5.88%,乡村学生肥胖率为3.66%,城市学生肥胖率高于乡村学生,差异有统计学意义(χ2=551.30,P<0.01)。在生理功能方面,非肥胖组学生右眼视力、左眼视力、收缩压、舒张压、肺活量、肺活量指数均优于肥胖组学生,差异有统计学意义(P<0.01)。肥胖组学生龋失补总牙数均值与非肥胖组学生比较,差值为-0.22颗/人,差异有统计学意义(t=-16.31,P<0.01);肥胖组与非肥胖组的龋齿检出率分别为13.43%和20.54%,差异有统计学意义(χ2=113.34,P<0.01);肥胖组近视检出率右眼左眼分别为57.45%、 57.00%,非肥胖组近视检出率右眼左眼分别为51.86%、51.47%,肥胖组近视检出率与非肥胖组近视检出率差异有统计学意义(χ2右眼=113.34,P<0.01;χ2左眼=109.11,P<0.01)。结论 2009年、2012年、2015年重庆市中小学生肥胖检出率均处于一个较低水平,肥胖表现出了显著的性别间、城乡间差异;肥胖易使学生视力降低、血压升高、肺功能储备降低。     

Cholera in Haiti and other Caribbean regions, 19th century

Medical journals and other sources do not show evidence that cholera occurred in Haiti before 2010, despite the devastating effect of this disease in the Caribbean region in the 19th century. Cholera occurred in Cuba in 1833-1834; in Jamaica, Cuba, Puerto Rico, St. Thomas, St. Lucia, St. Kitts, Nevis, Trinidad, the Bahamas, St. Vincent, Granada, Anguilla, St. John, Tortola, the Turks and Caicos, the Grenadines (Carriacou and Petite Martinique), and possibly Antigua in 1850-1856; and in Guadeloupe, Cuba, St. Thomas, the Dominican Republic, Dominica, Martinique, and Marie Galante in 1865-1872. Conditions associated with slavery and colonial military control were absent in independent Haiti. Clustered populations, regular influx of new persons, and close quarters of barracks living contributed to spread of cholera in other Caribbean locations. We provide historical accounts of the presence and spread of cholera epidemics in Caribbean islands.     

How Healthy Are Health-Related Behaviors in University Students: The HOLISTic Study

The aim of this cross-sectional study was to assess the health-related behaviors among university students, with emphasis on health sciences students from Croatia, Italy, Lebanon, Poland, Romania, Spain and Turkey. We included 6222 students in Medicine, Dentistry, Nursing, Pharmacy, Nutrition and Dietetics, Sports Sciences, Veterinary, and Economics enrolled between April 2018 and March 2020. We assessed dietary patterns, sleeping habits, physical activity and perceived stress among students by means of validated questionnaires. The median age ranged between 19 and 24 years, smoking prevalence between 12.0% and 35.4%, and body mass index (BMI) ranged between 21.1 and 23.2 kg/m². Breakfast was less often and more often consumed daily in Turkey (36.7%), and Italy (75.7%), respectively. The highest Mediterranean diet score was recorded in Spain and Italy, and the lowest in Turkey, followed by students from Croatia, Lebanon, Poland and Romania. Sleep duration, physical activity and stress perception also differed between countries. Multivariable regression analysis revealed a small, but positive association between BMI and several characteristics, including age, female gender, smoking, physical activity, mobile phone use, and perceived stress. A negative association was found between BMI and sleep duration on non-working days. Self-rated health perception was positively associated with female gender, breakfast, physical activity, and time spent studying, and negatively with BMI, smoking and stress. Our results demonstrated diverse habits in students from different countries, some of which were less healthy than anticipated, given their educational background. Greater emphasis needs to be placed on improving the lifestyle of these adolescents and young adults, who will be tomorrow’s healthcare workers.     

Age-Associated Glia Remodeling and Mitochondrial Dysfunction in Neurodegeneration: Antioxidant Supplementation as a Possible Intervention

Aging induces substantial remodeling of glia, including density, morphology, cytokine expression, and phagocytic capacity. Alterations of glial cells, such as hypertrophy of lysosomes, endosomes and peroxisomes, and the progressive accumulation of lipofuscin, lipid droplets, and other debris have also been reported. These abnormalities have been associated with significant declines of microglial processes and reduced ability to survey the surrounding tissue, maintain synapses, and recover from injury. Similarly, aged astrocytes show reduced capacity to support metabolite transportation to neurons. In the setting of reduced glial activity, stressors and/or injury signals can trigger a coordinated action of microglia and astrocytes that may amplify neuroinflammation and contribute to the release of neurotoxic factors. Oxidative stress and proteotoxic aggregates may burst astrocyte-mediated secretion of pro-inflammatory cytokines, thus activating microglia, favoring microgliosis, and ultimately making the brain more susceptible to injury and/or neurodegeneration. Here, we discuss the contribution of microglia and astrocyte oxidative stress to neuroinflammation and neurodegeneration, highlight the pathways that may help gain insights into their molecular mechanisms, and describe the benefits of antioxidant supplementation-based strategies.