卫生监督信息系统数据元标准化应用尝试

本文主要介绍中山市卫生监督信息系统在开发过程中使用"卫生监督基本数据集标准"效果.并根据现场实际情况对"基本数据集"进行扩充的情况,以及扩充设计与分类方案.     

DICOM-RT标准解决放射治疗信息系统标准化通讯模型的构建*

背景：放射治疗需要一个以患者为中心的信息系统来整合不同系统、设备间的有关患者的所有信息,实现放疗数据的无损传输。 目的：利用DICOM-RT标准解决放疗领域中数据非标准化存取的问题。 方法：设计了一种基于DICOM-RT标准的放疗信息系统的通讯模型。此模型分为客户端模块、TCP/IP接口模块、关联模块及服务类模块4个模块,实现了发送、接收功能及查询检索功能。此外,该模型还增加了对DICOM-RT对象的支持。 结果与结论：采用DICOMan软件和dcm4chePACS系统对此模型进行多次DICOM-RT数据传输测试,测试结果表明,该模型能实现放疗数据的无损传输,有效地完成放疗相关的信息交换和共享,达到了预定目标。      

基于DICOM标准的EECP血液动力学波形数据转换的研究

目的：将目前增强型体外反搏（EECP）设备采集到的二进制数据文件转换为DICOM血液动力学波形文件。方法：在深入研究DICOM信息模型、DICOM波形文件结构、数据元素结构、嵌套数据集结构、波形IOD模块结构等的基础上，利用Visual C＋＋．Net工具，运用C＋＋面向对象编程思想，把数据元素、嵌套数据集、波形IOD及其操作服务抽象成类，再分别读取二进制数据文件的相关信息赋给波形类对应的数据成员，最后调用有关成员函数将其存储为DICOM波形文件。结果：设计出了基于DICOM标准的EECP血液动力学波形数据转换的应用程序。结论：DICOM标准的不断应用将涵盖所有医学成像和信号类设备，EECP数据的DICOM标准化转换，为其共享和充分利用提供了重要前提。     

HIS中表间数据不一致性分析

本文针对医院信息系统数据库表间数据的不一致性，探讨了表间数据不一致的原因，以及信息标准化管理的作用与意义。     

国家食药监管总局发布10项食品药品监管信息化标准

为稳妥推进食品药品监管信息化建设,落实《国家食品药品监督管理局关于进一步加强食品药品监管信息化建设的指导意见》(国食药监办〔2013〕32号),促进食品药品监管信息系统互联互通、信息共享和业务协同,国家食品药品监管总局根据实际需要,按照急用先行的原则,先期组织编制了食品药品监管信息化标准体系等10项食品药品监管信息化标准。本次发布的10项标准,包括食品药品监管信息化标准体系、食品药品监管信息化基础术语(信息技术、药品、医疗器械部分)、食品药品监管信息分类与编码规范、食品药品监管信息基础数据元(总则、机构人员、药品、医疗器械部分)、食     

基于卫生信息平台的电子病历信息共享研究和实现

研究信息共享的关键技术,通过电子病历的标准化和结构化处理、传输和交换,实现电子病历信息的共享。在卫生部电子病历数据标准的基础上,结合采用情景分析法和层次分析法,通过Delphi法专家咨询确定电子病历可以结构化的数据项,实现电子病历的标准化和结构化处理;然后运用SWOT分析法,结合应用可扩展标记语言（XML）和临床文档结构标准（CDA）两项技术,实现电子病历的标准化传输和交换,使得电子病历信息在传输和交换过程中能够被机器自动识别,实现数据的自动化传输和交换;最后,研发电子病历完整性测试系统,实现电子病历完整性的自动测试。完成电子病历信息标准化和结构化处理、传输和交换全流程的技术研究,形成技术规范。有123家医院实现电子病历标准化上传省级卫生信息平台,有16家电子病历提供商具备了电子病历标准化和结构化处理、传输和交换能力。初步实现了电子病历的信息共享,电子病历数据传输技术规范作为浙江省地方标准正式颁布实施。     

结合多模态融合方式的脉搏波房颤识别

针对心房颤动疾病诊断检测复杂,病理检查有创等问题,构建基于脉搏波与深度学习的心房颤动分类预测模型,实现对心房颤动疾病的准确预测。首先,通过脉搏波设备采集数据,与MIMIC-Ⅲ数据库数据共同构建PPG-AF数据集;其次,基于Pytorch深度学习框架构建用于房颤分类的ResNet-CBAM-1DCNN双通道卷积神经网络;最后,将数据集按照8:1:1的比例划分为训练集,验证集和测试集,将脉搏波和其对应的格拉姆角场图作为输入,通过对网络结构和超参数的优化,在测试集中分类的F1分数达到了97.30%,准确度达到98.12%。本研究基于脉搏波信号与双通道卷积神经网络模型,能够实现对心房颤动疾病的准确诊断,有望为临床医师制定最佳治疗决策提供重要依据。     

"军字1号"工程建设中基础数据的准备方案

“军字1号”工程在解放军各医院已成熟运行多年。我院也计划年内启用“军字1号”工程,因此我们要做好大量的前期工作,其中包括基础数据的准备工作。 基础数据准备也称为数据字典初始化。就是把医院信息系统运行所必须的不同数据字典和业务数据标准化、规范化。其中包括物价、医疗、物资等不同数据字典。基础数据准备是系统正式运行前必须完成的重要准备工作,是系统运行前的核心工作,是系统能够平稳高效运行的基础。它的标准化、规范化是医院各业务系统之间进行信息交换和资源共享的基础和前提,而基础数据的准备工作其准备质量的好坏、快慢直接影响着系统数据标准化程度、医疗业务的规范性及系统的运行质量和进度。因此,我们吸取解放军医院的宝贵经验,并结合我院实际,制定了建立基础数据字典的方     

CORBA在医院信息系统中的应用

医疗信息的开放和共享是医院信息系统发展的必然趋势 ,但是由于以前的医院信息系统在设计时没有过多考虑标准化问题 ,造成大量异构医院信息系统的存在 ,给信息共享造成了困难。作为分布对象技术主流的 CORBA体系结构 ,是解决异构信息系统集成问题的有效方案 ;尤其是 CORBAMed的提出 ,为异构环境下医院信息系统的集成提供了统一的规范。本文通过介绍 CORBA体系结构以及 CORBA - Med的五个重要规范 ,分析了 CORBAMed的特点 ,提出了基于CORBA建设医院信息系统的新方向     

济南铁路医院网络信息安全的解决方案

本文围绕医院信息系统数据的安全性问题，从硬件设备、软件应用、人工培训等方面介绍了如何作好医院数据维护的几点做法。阐明了医院信息系统这样一个多元化、多系统庞大的信息数据集的良好运行，需要从各方面予以高度重视，忽略任何一个环节郝可能影响到医院信息系统的正常使用。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.