基于64位Windows 2003和Oracle 10g RAC的“军卫一号”数据库的升级

目的：完成＂军卫一号＂数据库平台升级,解决服务器负载过重及数据库并发连接数过多导致数据库无法连接的难题。方法：操作系统升级为Windows 2003（64位）,Oracle数据库从8.17升级为10g（64位）,并建立RAC,通过多进程、分用户的导出/导入模式完成数据迁移。结果：实现了＂军卫一号＂数据库的高性能和高可用性。结论：基于64位Windows平台、将数据库从Oracle 8.17升级为64位10g RAC是一个投入少、效益高的好办法。     

信息系统数据库升级方法研究及实现

目的:实现信息系统数据库的升级.方法:分析信息系统在升级中所面临的问题,提出了多种数据库升级方案,并在实施过程中采取对比的方式进行数据库的升级,同时对信息系统代码进行了升级.结果:业务系统的升级显著提升了系统的运行速度和效率.结论:在信息系统的升级过程中,数据库的升级占重要地位,需要重点处理,同时,必须采用模拟环境进行升级,最后才能正确实施到真实环境中.     

HIS服务器及数据库升级前后性能的对比研究

目的：测试数据库服务器软硬件升级前后数据库性能的具体变化。方法：从硬件的扩展性、硬件处理能力与系统稳定性以及数据库性能表现等几个方面，测试了数据库及数据库服务器升级前后的变化。结果：通过具体数据分析了引起性能改变的部分原因，总结了升级的变化规律。结论：系统升级后，系统性能得到了极大提升。     

大型公立医院国有资产管理系统设计、实现与应用

分析国有资产管理业务特点,设计相关角色及业务流程,从基础层、数据层、应用层、管理层及安全保护体系等角度设计国有资产管理系统整体架构。采用MVC架构开发,服务器采取虚拟化、集群化部署,数据库采用SQLServer,用户端采用B/S架构,与医院财务、办公、供应商管理等多个系统实现互联互通,形成数据集成平台,提高管理效率。该系统在医院实际应用中取得了较好效果。     

用传输表空间技术升级Oracle数据库

目的:实现Oracle数据库的快速升级。方法:使用Oracle自带的exp/imp工具,利用传输表空间技术实现数据迁移,可以实现数据库跨平台、跨版本升级。结果:成功实现了数据库从Oracle9i快速、平稳升级到Oracle11g。结论:采用传输表空间技术比其他升级技术停机时间更少,技术更简单、可靠。     

湖北省构建免疫规划信息管理系统大数据分布式云计算平台初探

目的构建湖北省免疫规划信息管理系统大数据分布式云计算平台。方法利用云计算平台基础架构及虚拟化应用技术,结合湖北省免疫规划信息管理系统既有的应用服务器部署特性,进行平台的应用分布式部署,评价应用效果。结果湖北省免疫规划信息管理系统在架构上实现了基于大数据与虚拟化的分布式云计算平台;预防接种客户端与市、省级应用服务器之间的数据交互通过专线的链路实现了网络资源共享;系统有能力对业务数据做进一步优化与利用。分布式云计算平台的应用部署显著提升了湖北省免疫规划信息管理系统的业务执行效率,实现了在系统运维级架构层面每个关键节点(服务器)都是冗余架构(≥1台服务器),单点瓶颈基本消除;用户故障反馈率同比下降约60%;业务系统可用率最高达99.5%。结论湖北省免疫规划信息管理系统基于大数据分布式云计算平台的应用实践行之有效,具有重大导向意义。     

运用存储区域网技术实现“军卫一号”数据库迁移与升级

运用存储区域网(SAN)技术实现"军卫一号"服务器硬件升级、操作系统从Windows server2008至Windows server 2012升级以及数据库版本从Oracle 10g至Oracle 11g的升级和备份,确保医院信息系统7×24 h不间断运行。该技术通过搭建SAN以及故障转移群集,完成Oracle版本升级以及数据库迁移,服务器性能得到明显提升。该方案对医院正常业务影响较小,安全可靠。     

容灾技术在医院信息化建设中的应用研究

目的:探索建立医院信息系统(HIS)核心业务系统应用级别的容灾架构与模式。方法:从容灾相关概念与技术指标、容灾的目标与分类、容灾规范、容灾技术与关键技术分析以及容灾系统建设方案与选择入手,通过容灾技术与容灾系统的深入研究,从低级到高级设计出多种医院信息系统容灾架构与模式。结果:选择适合的容灾模式,可以达到容灾应用要求,做到数据0丢失、服务0中断、业务0间断。结论:一地两中心的"2+2"模式在现实中具有实现成本低、容灾级别高、实用的优点,值得推广应用。     

基于Oracle数据库升级方法的研究

目的：论述升级Oracle数据库中的思路和具体实施步骤。方法：使用Oracle数据库自带的工具EXP、IMP实现数据库的全库导入导出,完成数据库的完整升级。结果：实现了我院数据库由Oracle8i升级到Oracle 10g。为我院后续PACS的实施和RAC技术的应用奠定基础。结论：由于每所医院实际应用环境的不同和复杂性．在升级Oracle数据库前一定要做好测试工作,针对不同的前端应用环境设置相应的参数,升级后服务器性能提升明显。     

双机镜像环境下Oracle数据库向Linux系统迁移

本文介绍我院中心机房搬迁的同时升级HIS服务器的实施过程。研究了双机镜像备份环境下Oracle数据库升级的方法和数据迁移时应注意的问题。将Oracle数据库顺利的升级到Linux系统，并充分发挥双机镜像的优势，缩短停机时间。     

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.     

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.     

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.     

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.     

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.     

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.