PACS实践中的一些体会

简要介绍了构建PACS系统的几个关键技术,例如影像采集与接口、影像存储、管理和传输等.另外对PACS系统和HIS系统的整合也做了一些探讨.最后结合一个实例阐述了小型PACS系统的构建方案,并给出了系统的工作流程图和网络结构图.     

住院部基于电子病历系统的传染病报告效果评价

目的 评价住院部基于电子病历系统的传染病报告系统的效果,为进一步改善该系统提供依据.方法 比较传染病报告系统使用前后医院传染病报告率、及时率、完整率和准确率.结果 传染病报告系统的使用,传染病的报告率提高了3.2％,及时率提高了3.8％,完整率提高了12.8％,准确率提高了16.2％.结论 住院部基于电子病历系统的传染病报告系统的使用,实现了住院部传染病报告的信息化管理,极大提高了传染病报告的完整性和准确性,减轻了医务人员的工作量,一定程度上提高了传染病报告的质量.     

区域医学检验管理系统的设计与实践

目的:设计并应用区域医学检验管理系统.方法:从系统架构、系统运作流程、系统功能、系统接口4个方面对区域医学检验管理系统进行了全面设计.结果:该系统的应用,使医学检测机构内部实现了业务流程的电子化、自动化、集成化,同时也实现了医学检测机构与医疗机构间、医疗机构间、医疗机构内部之间的信息互动、诊断参考.结论:该系统的应用实现了医学检验结果的同城互认,充分发挥了区域设备、技术、人才优势,提高了检验效率,促进了区域化的新型医疗体制的建立.     

基于HIS的中成药不良反应监测系统设计与思考

目的:为中成药不良反应监测系统的建设提供科学有效的解决方案.方法:通过对中成药不良反应监测系统的特点和问题进行分析,从设计思路、体系架构、业务流程和功能等几个方面对基于HIS的中成药不良反应监测系统的建设进行了示范性的研究与设计.结果:建立了基于HIS的中成药不良反应监测系统的原型系统.结论:建立的原型系统具有自身的优点,可以作为国家监测平台的有益补充,并为进一步的研究指明了方向.     

磁共振系统的组成、常见故障和解决方法

论述了磁共振系统的主要组成部分磁体、梯度-射频系统、制冷系统、重建系统及操作系统组成.根据各组成部分的原理及功能,分析了磁共振系统在使用过程中容易产生故障的部位和原因,并阐述了各主要组成部分的故障解决方法.     

医院合理用药监测系统的建设

目的：为了进一步落实合理用药制度,以信息化手段实现对问题处方的统计分析而设计医院合理用药监测系统.方法：系统采用C＋＋语言开发,打包成一个DLL控件,嵌入到HIS中运行.结果：建立了基于HIS的合理用药监测系统,实现了对合理用药规则的实时监测.结论：该系统为临床医生和药师的工作带来很大的便利,有效控制了问题处方的产生.     

医学网络教学应用系统的建立

医学网络教学应用系统的建立为我院开展网络教学创造了有利的条件.论述了系统和资源库的建设、教学应用和面临的问题,并对完善系统建设和广泛应用进行了深入探讨.     

PACS系统的技术管理

本文阐述了PACS系统在医院数字化和信息化建设中的重要性.对PACS系统与传统人工操作方法进行了比较,得出结论：PACS系统的实施,降低了医疗成本,提高了医院医疗质量;提高了工作效益、社会效益和军事效益;提高了影像诊断的水平;实现了图像高保真实时传输;实现了远程会诊;实现了影像资料共享;极大方便了医疗、教学及科研.系统的管理和维护则是PACS得以实现的重要保证.本文介绍了我院影像科PACS系统,并对PACS系统的技术管理作一个比较全面的总结.     

议我院住院病案归档系统的革新

本文从实际工作出发,将顺序号归档系统与单一号归档系统的优劣性进行了详细对比分析.单一号归档系统的弊端表现在：重复工作多,易出错,不能保证信息的一致性,不便于合理规划病案库房空间等4个方面;顺序号归档系统的优势表现在：大大减少工作量,避免归档错误,充分利用病案库房空间,充分发挥病案管理信息系统的功能5个方面,彰显了由顺序号归档系统代替单一号归档系统的必要性.最后本文还强调了采用顺序号归档系统的几点注意事项.     

重症监护远程教学查房系统的构建

目的:创新重症患者管理、查房和教学的模式,构建重症监护远程教学查房系统.方法:针对重症监护病房的特殊性及其要求,通过信息化手段,借助现代音视频传输技术和数字处理技术来构建系统.结果:由重症监护病房(intensive care unit,ICU)重症示教系统、ICU视频示教移动手推车、数字化示教室、网络视频传输等组成的教学查房系统满足了ICU临床实践教学的要求.结论:该系统的使用,改善了教学效果,提高了教学效率,减少了ICU污染的机会,高水平发挥了重症医学临床实践教学的作用.     

口腔金属材料磁共振成像伪影的实验研究

研究3种口腔常用金属材料在l3种不同头颈部扫描序列中的伪影。测量伪影大小，并进行统计学分析。得出3种金属在相同序列成像中，纯钛伪影最小，硬质钴铬合金伪影最大；相同金属材料，6种自旋回波及快速自旋回波序列产生伪影最小，3种梯度回波序列产生伪影较大，4种平面回波序列伪影最大且使图像变形。口腔金属材料产生伪影与材料类型及成像技术密切相关，通过合理选择金属材料及成像技术得到最佳MR成像。     

漫漫长路 中文走近DICOM

医学数字影像设备CT、MR等已经在各级医院广泛应用。当初，各厂商生产的这些设备由于采用不同的协议，只能在系统内部传输图像，难以实现更大范围的信息共享。为了解决这一问题，制定了通用协议DICOM。近年来，越来越多的各种影像设备遵从这一协议，成为事实上的国际标准。中国的医疗机构总数和大型医疗设备总数均居世界前列。DICOM在定义了日文和韩文后即将完成对中文的定义。笔者希望通过披露鲜为人知的过程，介绍相关的背景知识，能让大家开阔视野并从中得到一些启迪。     

医学女生社会支持状况及其影响因素的调查研究

目的:了解医学院女生社会支持状况,为女大学生心理保健提供依据。方法:采用整群随机抽样的方法,对184名医学女生运用《社会支持评定量表》进行测试。结果:城市女生在邻居支持项目上得分均值低于农村女生,在参加活动项目上得分均值高于农村女生;独生女生在家人支持、主观支持因子及总分得分均值低于非独生女生;朋友支持以及同学支持项目得分均值大一高于大二,家人支持项目四年级高于其它年级,参加活动项目得分均值大二高于大四,主观支持因子得分均值大一高于大二,大二低于大四,差异均具有显著性意义。结论:医学女生社会支持呈现一定的特点,受其年级、生源地、是否为独生子女等因素的影响。对女大学生心理保健时,应鼓励其积极建立与主动获取社会支持。     

新疆阿拉山口口岸2012年入境集装箱空箱卫生状况调查

目的对阿拉山口口岸2012年入境1514个需进行卫生处理集装箱空箱卫生状况和携带微生物情况进行调查分析,为加强入境集装箱空箱卫生检疫及卫生处理工作提供依据。方法对箱内携带垃圾进行分类分析,随机抽取集装箱,对其箱内表面采样,参考国家有关标准,采用显色培养基和生化培养试剂盒做微生物培养、鉴定菌种。结果处理集装箱空箱中,检查结果如下：携带动物尸体集装箱3个;携带动植物残留物集装箱101个;携带生活垃圾集装箱1373个;携带人类或动物传染病病原体集装箱48个;携带病媒生物集装箱37个。微生物检测情况如下：随机抽取处理集装箱空箱采集412份样品,检出金黄色葡萄球菌225株;沙门氏茵20株;大肠埃希氏菌61株;蜡样芽孢杆菌199株;链球菌31株等病原微生物。结论入境集装箱空箱携带垃圾、病原微生物为国际间疫病的传播提供了便利通道,给各国的卫生安全及人体健康带来威胁。应加强阿拉山口口岸入境集装箱空箱的卫生检疫及卫生处理工作。     

Host range and emerging and reemerging pathogens

An updated literature survey identified 1,407 recognized species of human pathogen, 58% of which are zoonotic. Of the total, 177 are regarded as emerging or reemerging. Zoonotic pathogens are twice as likely to be in this category as are nonzoonotic pathogens. Emerging and reemerging pathogens are not strongly associated with particular types of nonhuman hosts, but they are most likely to have the broadest host ranges. Emerging and reemerging zoonoses are associated with a wide range of drivers, but changes in land use and agriculture and demographic and societal changes are most commonly cited. However, although zoonotic pathogens do represent the most likely source of emerging and reemerging infectious disease, only a small minority have proved capable of causing major epidemics in the human population.     

Patterns of sexual abuse and assault

Patterns of sexual abuse and sexual assault are analyzed from 162 reports involving victims with disabilities. Results suggest that abuse and assault are frequently repeated and chronic, often result in significant harm to the victim, and are rarely reported to child welfare or law enforcement authorities. Many offenses are committed by paid service providers and occur in disability service settings, but other offenses occur in the same situations as sexual abuse and assault of victims without disabilities. Victims are predominantly female and offenders are predominantly male. Charges and convictions are rare. Victims with disabilities often experience difficulty obtaining treatment services that are accessible and appropriate to their needs. Discussion considers a multifactorial, ecological model of abuse and recommends some possible prevention strategies.     

Globalisation and transboundary risk regulation: Pesticides and genetically modified crops

Globalisation of food production systems and accompanying pressures for trade liberalisation are raising new issues for risk regulation and also placing greater demands on risk regulatory systems. Transboundary food-related risks are categorised here as 'traded' risks, subdivided into those which are product-based and those which are production system based. The international systems for regulating the risks of pesticide residues in food and of GM crops are summarised and examples are given of how the risks are monitored and evaluated. For GM crops and pesticides, although in different proportions, concerns focus on risks inherent in food products themselves and in the food production systems of which they form components. Different public motivations (self-interest versus fundamental values) underlie the expressions of concern and different approaches are needed for resolution and public reassurance in each case. We propose an approach which assigns legitimate and clearly specified roles to the two approaches, product based and production system based, which would elevate the debate about GM crops to a higher systemic level where it may have a greater chance of being resolved.     

Who provides GP after-hours care?

Understanding the demographic and financial factors likely to influence the supply side of after-hours GP care is crucial in meeting the increasing demand for these services. This study answers two questions: which GPs are more likely to provide after-hours GP care, and of those who do, which are more likely to take a heavier load. Data from the first wave of the Medicine in Australia: Balancing Employment and Life (MABEL) survey is used, with logistic regression applied to address the decision to undertake after-hours work and linear regression to address the question of the quantum of work. The results show that female, older, and urban GPs are less likely to work outside of normal hours. GPs who are employees are less likely to participate in after-hours work than GPs who are principals or partners of a practice. On the other hand, principals and partners, are likely work more hours in the after-hours period than employee GPs if they do participate in this work. Similarly, those GPs in solo practice who work after-hours also tend to take a heavier after-hours workload than the GPs who are not in solo practice. The role of GP wages and family income does not seem to be compelling. These conclusions are likely to relate to the ways doctors behave independent of the health system.     

Maltreatment and Behavioral Characteristics of Youth Who Are Deaf and Hard-of-Hearing

This paper summarizes the available literature on child abuse and neglect among children with disabilities in general and considers children who are deaf and hard-of-hearing within this larger rubric given the low prevalence rates of children who are deaf and hard-of-hearing among the disabled population. This procedure allows for comparisons between disabilities as well as abused and non-abused children who are deaf and hard-of-hearing. Maltreatment data on children who are deaf and hard-of-hearing in a large epidemiological study of the prevalence of child maltreatment among children with disabilities are summarized. Children who are deaf and hard-of-hearing comprised 6.1% of the disabled population who were identified as victims of maltreatment. Their most prevalent form of maltreatment was neglect, followed by physical abuse and sexual abuse. Although children who are deaf and hard-of-hearing are significantly more likely to be maltreated by immediate family members, placement in a residential school is a risk factor for sexual and physical abuse. Maltreated children who are deaf and hard-of-hearing exhibit significantly more behavior problems including Post Traumatic Stress Disorder related behaviors than nonmaltreated peers.