PACS的远程医学影像会诊系统的构建及应用

医学影像学已全面进入信息化时代。具有代表性的是常规放射中计算机X线摄影（CR）、直接X线摄影（DR）和医学图像归档通讯系统（PACs）。这些技术的普及及应用已经在悄悄地改变着影像学的工作方式和思维方式。远程放射学（Teleradiology）作为现代影像医学的一个重要分支，也将得益于计算机数字影像技术而进入一个新的应用阶段。     

远程会诊44例

为探讨远程医学的发展,本介绍了该院进行远程会诊的成功经验以及存在的不足,为我国的远程医学发展提供经验。     

远程医学影像会诊系统的发展状况与质量控制

随着计算机和通讯技术的发展,远程医学逐步发展起来,形成一种结合现代医学、计算机技术和通讯技术的新型医疗和医学教育工作模式。医学远程会诊系统基本包括三大系统:远程疑难病会诊系统,远程影像学会诊系统及远程病理学会诊系统。本文重点论述远程影像学会诊系统的发展状况及会诊质量控制。     

基于PACS的远程医学影像会诊系统的初步探索

本文旨在构建基于PACS的远程医学影像会诊系统,研究其在构架设计、数据传输、会诊流程及质量控制等方面所面临的问题及相应的解决措施,并通过首都医科大学宣武医院与顺义医院的应用实例对上述问题进行验证。     

图像存档与通信系统的应用进展及面临问题

随着上世纪70年代初CT的发明，医学图像开始了数字化的新纪元，其后，MR、DSA、CR、DR、PET等相继问世，产生了大量的数字化影像资料，而PACS(Picture archiving and communication system即图像存档与通信系统)即是为了管理和合理应用这些资料而诞生的。它是以数字成像技术、计算机技术和网络技术为基础，全面解决医学影像获取、显示、处理、储存、传输和管理的综合性系统，成为医院现代化建设中重要的基础设施，是医院信息化建设的关键工程，代     

无线远程会诊系统的研制

本文介绍了一种采用无线通讯技术实施的远程会诊系统。它彻底摆脱了电话线的制约，实现了随时、随地远程医疗支援，具有较强的环境适应性，非常适合突发事件及战争状态下的使用。     

远程会诊系统应用体会

随着计算机和通讯技术的飞速发展远程医疗这一高新技术产物也应运而生。为了医院信息化发展的需要,我院已开始运行远程医疗会诊系统,以下为安装及运行时的体会。1系统简介及主要功能目前我国的远程医疗会诊系统主要采用卫星通信、ISDN及电话通信等几种方式。鉴于我院的实际情况采用的是普通程控电话线及军线来进行远程会诊以后可根据实际情况逐步过渡到ISDN方式。远程会诊系统的基本配置为1台计算机、1台带透射扫描适配器的扫描仪、独立的程控电话线、通讯软件包为INTEL商用视频电话系统（内含AT3500DATA／FAX／VOICE33…     

远程医疗会诊集团化模式实施

远程医学(Telemedicine)从广义上讲是使用远程通信技术和计算机多媒体技术提供医学信息和服务。它包括远程诊断、远程会诊和护理等医疗活动、远程教育、远程医学信息服务等所有的医学活动。从狭义上讲是指远程医疗。它包括远程放射学(Teleradiology)、远程外科学(Tlesurgery)、远程护理(Telecare)、远程诊断(Telediagnosis)和远程会诊(Teleconsultation)等与医疗有关的活动。本文主要讨论远程医疗会诊集团化等问题。     

远程会诊系统

远程医疗系统将新兴的计算机和多媒体技术应用到传统医疗行业，近年来获得了快速的发展。本设计的远程会诊系统通过字、图象和语音的交互，实现了不同地域的医疗专家同时会诊。     

远程医疗会诊车应用及故障分析

1 引言高新技术在医学领域中的广泛应用,给军事医学发展提供了新机遇、新挑战,注入了新血液[1].近年来,部队相继推出了远程会诊车、单兵视频系统等高科技的用于医学领域的新设备.在野战条件下,这些设备充分应用网络技术、远程医学网和卫星通讯技术,通过与后方医院的连接,对音视频信号进行传输,解决了野战条件下医疗技术的匮乏问题,实现了医疗技术资源的共享,有效地提高了野战条件下的医疗救护能力和卫勤保障能力.2远程会诊车应用及工作原理2.1 远程会诊车应用作为目前信息化程度较高的野战卫生装备,远程医疗会诊车在突发事件应急保障中发挥了重要的作用,成功实现了矿井救援、抗震救灾、高原患者救治等野外救治[2].现列举如下:(1)远程会诊医疗车曾对被困井下196 h、严重颅脑外商的矿工实施突破,被301医院陈香梅院士誉为"生命史上的奇迹";(2)在"5.12"汶川大地震和玉树大地震中,我院医疗队应用远程医疗会诊车开展了多例远程会诊,使部分伤员得到及时救治,后期又针对官兵高原缺氧导致的疑虑、焦躁情绪,远程组织心理疏导和应急干预,取得了很好的效果;(3)灾后的通讯设施受到严重干扰,远程医疗会诊车通过远程医学信息网络,与后方指挥中心建立点对点连接,实现了后指任务的及时下达,解决了灾后通讯差的难题;(4)灾区条件艰苦、生活环境恶劣,一线官兵生活单调,远程医疗会诊车利用自身的优势缓解了官兵思乡之苦、生活之苦.通过网管中心的控制,将电视节目发到车内,并通过车外接口传到电视上,为战友们获取新闻、娱乐提供了平台.     

Fundus imaging and the telemedical management of diabetes

Diabetes is the major preventable form of blindness among people of working age in the Western world, despite the improvements in laser photocoagulation treatments. It is known that regular glycaemic control and annual retinal screening of people with diabetes can reduce its incidence. Effective treatment needs to be available but also screening methods which are simple to perform and cost-effective should be implemented. It will be important in future to integrate digital images of the fundus into the health records of diabetic patients. Screening programmes for the detection of diabetic retinopathy aided by image-processing software for processing fundus images will save manpower and increase quality. Before this can happen, we need more clinical studies of store-and-forward techniques, so that they can be standardized and their effectiveness established against that of traditional analogue screening.     

基于CDMA的移动医疗系统的研制

基于CDMA的移动医疗系统作为一种新的医疗手段正日渐受到重视。本文论述的移动医疗系统由两大部分组成。即移动单元与监护中心。移动单元实时监测用户的生理数据，当检测到异常时，自动拨通监控台，用户随身携带移动单元；监护中心由监控台和信息管理系统（电子地图、电子病历）组成、信息管理系统通过局域网与监控台连为一体，主要功能是管理电子地图信息以及用户的病历信息等。CDMA的移动医疗系统经验证是一套非常有效的医护保障系统，为紧急救护、远程会诊及实时监护提供了又一种可靠的手段。     

The Varna-Thessaloniki telemedical collaboration in setting up a regional transborder transplantation network

In most Balkan countries, with the exception of Greece, transplantation is very rare and equality of access does not exist. In 2003, a Balkan partnership was established called SETNET (South-Eastern European Transplantation Network) for the promotion of transplantation. The objectives are to bring about the diffusion of transplantation techniques and practices in the Balkans, to increase public support for and participation in transplantation, and to eliminate the disparities in access to good health-care. SETNET is already beginning to generate data for an analysis of transplantation-related needs in the Balkans and to accelerate cross-border data exchange in transplantation-related emergencies. In the next few years, a regional training programme will be introduced for all health-care staff involved in transplantation. A regional organ procurement and transplantation network will be set up to utilize the existing telemedicine infrastructure. If successful, it will also prove that telemedicine infrastructures, however modest, can be the backbone for other, far-reaching human networks.     

军队网络信息安全体系建设的对策

从组织建设、技术建设、人才队伍建设和管理建设四个方面论述了如何加强军队网络信息安全体系的对策。     

切实做好医院信息系统网络建设

医院信息系统网络改造主要包括几个方面：系统改造目标，系统改造原则，网络链路建设，核心网络优化，VLAN划分，网络管理，升级核心交换机。     

The role of the Picasso phone system in distance consultation for remote Pacific Islands

The U.S. affiliated Pacific Island nations spend an average of over 10% of total health budget on off-island referral care to tertiary centers. Tripler Army Regional Medical Center (TAMC) has been the major provider of this service for many years. Prior to 1995 communication to consultants at TAMC was by long distance telephone, fax and regular mail. Connecting to a specialist sometimes took hours and clearly a better communication link was needed. The AT&T Picasso phone, an instrument the size of a small briefcase was developed to reliably transmit still images over the regular phone. Freeze-frame images captured at the sending end by a cam recorder were transmitted to a remote receiver unit, where they were displayed and stored. A typical medical consultation involved about three images, with each transmission over the 28.8 Kbps modem taking about one minute. A separate consultation form submitted by fax to TAMC was attached to the transferred images. Four Picasso phones were used to test their usefulness in linking isolated Pacific islands to a metropolitan medical center. For the first time ever, coloured patient images, data, X-rays etc were transmitted with a faxed written medical report. The Picasso phone was the spark of the Telemedicine development in the US affiliated Pacific islands.     

Transfer of telemedical support to Cornwall from a national telemedicine network during a solar eclipse

During late 1998 and early 1999, planning officers in Cornwall predicted a huge increase in summer visitors to the county to observe the August solar eclipse. There was the possibility that a mass gathering in Cornwall could overload existing arrangements for handling accident and emergency patients. We therefore set up a telemedicine system to support the county's minor injury units (MIUs) from hospitals throughout the UK. Six main hospital accident and emergency departments outside Cornwall with existing links to their own MIUs were twinned with 10 of the 11 MIUs in Cornwall before the expected date of the gathering. The network was live for nine days, starting four days before the eclipse, and 2045 patients were seen in the 10 MIUs. There were 93 telemedicine calls from the 10 MIUs, involving 91 patients. Overall, 4.6% of the patients required a telemedicine consultation. Fifty-seven calls were made during working hours. Thirty-four patients were referred for further management, of whom 18 were referred on the same day. The transfer of telemedical support to a national network was successful.     

浅谈中小型医院信息系统网络机房的建设

本文针对郴州市第四人民医院网络机房的建设情况结合笔者在网络管理中的实际体会，重点讨论了中小型医院如何在有限的投资内建立一个安全稳定高效的网络机房，本文不求面面俱到，只求容易理解和参考性强。