移动医疗在慢性病防控中的应用

BACKGROUND: Nowadays, it has become the focus of people to seek effective and feasible prevention and control methods for chronic disease. With the vigorous development of electronic information, as a new thing in the development of science and technology, mobile health (mHealth) has a great potential in the prevention and management of chronic diseases. However, the current research on mHealth is less.     

石英光纤在医疗诊断和治疗中的应用

石英光纤在医疗应用中已成为远距离传导光能量的标准模式，石英光纤包括三种可相互对照的基本型号，石英包层材料和ＰＣＳ软硅酮包层光纤，ＴＥＣＳ包层光纤。本文对这些光纤在光导传播，数据孔径，弯曲性能，强度等方面作出了评估。     

生物反馈在糖尿病治疗中的应用

生物反馈在糖尿病治疗中的应用朱熊兆综述戴晓阳审校湖南医科大学医学心理研究中心生物反馈是指利用现代电子仪器将人体一些不被意识的生理活动如肌电、皮温等加以记录、放大，并转换为人们能理解的声、光等信号，训练病人认识和体验这些生理活动的变化，学会有意识地控制...     

皮温反馈疗法在糖尿病治疗中的应用

本文对３０例非胰岛素依赖型糖尿病患者进行了药物治疗加皮温反馈治疗并与３０例ＮＩＤＤＭ的同类患者单纯用药物治疗作对照组，结果表明：（１）研究组血糖明显下降，降糖药物用量减少，皮温的升温值增高，与对照组相比有显著性差异，血清胰岛素与Ｃ－肽水平未见明显升高。（２）研究组部分患者足背动脉搏动增加，麻木，疼痛症状缓解。试验过程中未发现该方法对血电解质，肝肾功能有明显影响，治疗过程中未观察到明显的副作用。     

基于“互联网+”的移动医疗技术在慢性阻塞性肺病稳定期管理的应用及问题研究

随着互联网的发展,移动医疗技术也越来越成熟,在慢性阻塞性肺病稳定期管理的应用方面取得较大进展。通过该技术对于稳定期慢阻肺患者线上复诊、调整治疗等提供了方便,从而使患者提高对于自身疾病认识,持续监测自身健康,提高治疗疾病的依从性。本文综述了移动医疗技术在稳定期慢阻肺的应用现状,并对互联网移动医疗技术应用的局限性及发展方向进行探讨。     

血糖检测仪在社区医疗中的应用分析

目的探讨社区医疗中血糖检测仪的应用。方法分析2010年1月～2010年10月在社区使用血糖仪的2型糖尿病患者30例,定期检测糖尿病患者的血糖控制情况,并进行健康教育。结果与同期未进行定期测量血糖的30例糖尿病患者比较,血糖控制情况差异有统计学意义。结论社区血糖检测仪应用方便,对实时检测糖尿病患者的血糖有较好的诊断价值,值得在社区广泛使用。     

灰色关联分析法在医疗质量管理中的应用

目的 探索灰色关联分析法在医疗质量管理中的应用.方法 应用灰色关联分析法对某院2002～2007年的入院人数及影响入院人数的院内因素进行分析.结果 所选的与该院入院人数相关的7个比较因素,其关联程度由强到弱依次为病床周转次数、平均住院日、病床使用率、入出院诊断符合率、治愈好转率、抢救成功率、病死率.结论 灰色关联分析在医疗质量管理中科学地分析与评价医疗质量对于提高医院整体医疗服务水平有重要的意义.     

自制计算机软件在医疗收费,成本核算管理中的应用体会

医疗收费、成本核算是医院经济管理的核心它涉及面广,工作量大,成本项目繁多,实用性强,人工很难对伤病员在医疗过程中各种成本费用进行实际有效的计算和管理。因此,出现的漏洞大,浪费严重,成本高,效益低。要扭转这种状况,医疗收费、成本核算就必须采用计算机管理。我院自95年成立卫生经济信息管理科,根据部队医院医疗收费、成本核算管理试点医院的工作经验,结合本院实际情况,自行编制了全套实用型应用软件。通过计算机对军内外医疗服务成本的核算,准确计算军队和地方病员的医疗费用,有效地使用标准经费,合理分配对外医疗收益…     

人工智能在糖尿病研究和临床中的应用

人工智能是经济全球化应运而生的产物,随着数字化时代的到来,人工智能在各个领域扮演着越来越重要的角色,包括不断更新迭代的医疗领域。糖尿病是一种以高血糖为特征的慢性非传染性疾病,众多学者致力于从创新的角度研究糖尿病的预测、智能诊断、并发症早期筛查、健康管理等方面,以促进全人类的健康发展。本文主要总结近些年来人工智能在糖尿病研究和临床中的应用,并对糖尿病诊疗的智能化和自动化提出未来展望。     

骨髓间充质干细胞在1型糖尿病治疗中的应用

骨髓间充质干细胞是一种既具有自我更新能力又有多向分化潜能的细胞，研究显示骨髓间充质干细胞将可用于许多疾病的治疗，如心肌坏死、肝功能衰竭、1型糖尿病等。本文概述了骨髓间充质干细胞研究现状，结合现阶段糖尿病治疗进展并比较其它方法的治疗效果，阐述了骨髓间充质干细胞在治疗1型糖尿病中的运用前景。     

健康画像在慢阻肺个性化健康管理系统中的应用研究

目的:旨在探讨个性化健康画像在慢性病健康管理中的应用,以慢性阻塞性肺疾病（COPD）为例,为COPD患者构建健康画像模型,并基于模型开发设计个性化的健康管理系统。方法:以基于知识的标签提取技术结合电子病历数据挖掘构建患者健康画像模型,并在模型基础上,根据COPD全球倡议设计针对COPD的评估方法、药物推荐算法及个性化健康推荐方法,设计开发了基于.NET平台和SQL技术C/S架构的COPD个性化健康管理系统。结果:从患者及疾病两个维度,构建出包含患者个人信息、诊断信息、并发症、用药数据及住院情况的患者群体画像模型,包含患者基本信息、主要临床表现、检查检验结果、诊断记录、治疗记录、疾病相关因素的个性化健康画像模型,并设计开发由患者主导、医生参与、能够全面展示患者群体画像及个性化健康画像并能进行个性化健康评估及推荐的COPD管理系统。结论:患者健康画像模型能为COPD的诊断、评估、治疗、病情监测、疾病预后、管理提供数据支撑。本研究基于COPD患者健康画像开发的健康管理系统从患者个性化需求的角度出发,为COPD稳定期患者提供了一个契合自身特点的实用的健康管理平台。     

乐园化引导干预可提升儿童放疗摆位精度

目的:探讨乐园化引导干预对儿童放疗摆位精度的影响。方法:选取2020年3月～2022年5月在中山大学肿瘤防治中心放疗的儿童患者作为研究对象,按照是否参与乐园化引导干预分为试验组（24例）和对照组（21例）。试验组儿童患者在每次放疗前进行儿童乐园化诱导心理干预,待儿童患者完成心理适应后进行治疗;对照组实施常规放疗准备后治疗。比较两组儿童患者放疗实施的摆位精度。结果:试验组在左右（LR）、头脚（SI）、腹背（AP）方向的摆位误差分别为（-0.32±2.18）、（-0.12±2.24）、（-0.17±2.32） mm,对照组分别为（-0.93±1.91）、（0.79±1.75）、（-0.63±1.97） mm。两组摆位误差比较,在LR和SI方向的差异有统计学意义（LR:t=2.28, P=0.02;SI:t=-2.58, P=0.01）,而AP方向的差异无统计学意义（LR:t=1.63, P=0.11）。结论:乐园化引导干预可以提高儿童患者放疗的依从性,进而提高放疗的摆位精度,具有显著的临床应用意义和推广价值。     

临床运行中电子直线加速器的故障原因及干预对策

目的：探讨临床运行中电子直线加速器的故障原因及干预对策。方法：对1台于2020年9月至2021年12月临床运行1年3个月的医用电子直线加速器的故障发生原因与频率调查结果进行回顾性分析,并制定出有效的干预对策。结果：医用电子直线加速器的常见故障原因主要为X射线容积成像影像系统故障,占比为21.82%(12/55),其次为机械运动故障,占比为18.18%(10/55);电路故障的发生频率虽然不高,但因此故障所导致的功能停用与停机时间却相对较长。结论：在医用电子直线加速器临床运行过程中,要减少X射线容积成像影像系统与机械运动故障,降低故障发生频率,应该结合医用电子直线加速器临床运行故障发生原因与频率,制定出定期维护保养等有效的干预对策。     

Feasibility of a mobile phone-based data service for functional insulin treatment of type 1 diabetes mellitus patients

Background

Patients with type 1 diabetes mellitus (DM1) have to be active participants in their treatment because they are inevitably responsible for their own day-to-day-care. Availability of mobile Internet access is advancing rapidly and mobile phones are now widely available at low cost. Thus, mobile phones have the potential to assist in daily diabetes management and to enable a telemedical interaction between patients and health care professionals.

Objective

The aim of the study was to evaluate the feasibility and user acceptance of a mobile phone–based data service to assist DM1 patients on intensive insulin treatment.

Methods

A software application called Diab-Memory (based on Java 2 Mobile Edition) has been developed to support patients when entering diabetes-related data with synchronization to the remote database at the monitoring center. The data were then processed to generate statistics and trends, which were provided for the patient and his/her health care professional via a Web portal. The system has been evaluated in the course of a clinical before-after pilot trial. Outcome measures focused on patients’ adherence to the therapy, availability of the monitoring system, and the effects on metabolic status. General user acceptance of the system was evaluated using a questionnaire.

Results

Ten patients (four female) with DM1 participated in the trial. Mean age was 36.6 years (± 11.0 years) and prestudy glycated hemoglobin (HbA_1c) was 7.9% (± 1.1%). A total of 3850 log-ins were registered during the 3 months of the study. The total number of received datasets was 13003, which equates to an average of 14 transmitted parameters per patient per day. The service was well accepted by the patients (no dropouts), and data transmission via mobile phone was successful on the first attempt in 96.5% of cases. Upon completion of the study, a statistically significant improvement in metabolic control was observed (HbA_1c: prestudy 7.9% ± 1.1% versus poststudy 7.5% ± 0.9%;P= .02). While there was a slight decrease in average blood glucose level (prestudy 141.8 mg/dL ± 22.5 mg/dL vs poststudy 141.2 mg/dL ± 23.1 mg/dL;P= .69), the difference was not statistically significant.

Conclusion

The results of the clinical pilot trial indicate that this proposed diabetes management system was well accepted by the patients and practical for daily usage. Thus, using the mobile phone as patient terminal seems to provide a ubiquitous, easy-to-use, and cost efficient solution for patient-centered data acquisition in the management of DM1. To confirm the promising results of the pilot trial further research has to be done to study long-term effects on glycemic control and cost-effectiveness.     

Family-based intervention by pharmacists for type 2 diabetes: A randomised controlled trial

Objectives

To investigate the effectiveness of family intervention for type 2 diabetes and to examine predictors of glycaemic control.

Harnessing context sensing to develop a mobile intervention for depression

Background

Mobile phone sensors can be used to develop context-aware systems that automatically detect when patients require assistance. Mobile phones can also provide ecological momentary interventions that deliver tailored assistance during problematic situations. However, such approaches have not yet been used to treat major depressive disorder.

Objective

The purpose of this study was to investigate the technical feasibility, functional reliability, and patient satisfaction with Mobilyze!, a mobile phone- and Internet-based intervention including ecological momentary intervention and context sensing.

Methods

We developed a mobile phone application and supporting architecture, in which machine learning models (ie, learners) predicted patients’ mood, emotions, cognitive/motivational states, activities, environmental context, and social context based on at least 38 concurrent phone sensor values (eg, global positioning system, ambient light, recent calls). The website included feedback graphs illustrating correlations between patients’ self-reported states, as well as didactics and tools teaching patients behavioral activation concepts. Brief telephone calls and emails with a clinician were used to promote adherence. We enrolled 8 adults with major depressive disorder in a single-arm pilot study to receive Mobilyze! and complete clinical assessments for 8 weeks.

Results

Promising accuracy rates (60% to 91%) were achieved by learners predicting categorical contextual states (eg, location). For states rated on scales (eg, mood), predictive capability was poor. Participants were satisfied with the phone application and improved significantly on self-reported depressive symptoms (beta_week = –.82, P < .001, per-protocol Cohen d = 3.43) and interview measures of depressive symptoms (beta_week = –.81, P < .001, per-protocol Cohen d = 3.55). Participants also became less likely to meet criteria for major depressive disorder diagnosis (b_week = –.65, P = .03, per-protocol remission rate = 85.71%). Comorbid anxiety symptoms also decreased (beta_week = –.71, P < .001, per-protocol Cohen d = 2.58).

Conclusions

Mobilyze! is a scalable, feasible intervention with preliminary evidence of efficacy. To our knowledge, it is the first ecological momentary intervention for unipolar depression, as well as one of the first attempts to use context sensing to identify mental health-related states. Several lessons learned regarding technical functionality, data mining, and software development process are discussed.

Trial Registration

Clinicaltrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01107041","term_id":"NCT01107041"}}NCT01107041; http://clinicaltrials.gov/ct2/show/{"type":"clinical-trial","attrs":{"text":"NCT01107041","term_id":"NCT01107041"}}NCT01107041 (Archived by WebCite at http://www.webcitation.org/60CVjPH0n)     

The intersection of adolescent development and intensive intervention: age-related psychosocial correlates of treatment regimens in the diabetes control and complication trial

OBJECTIVE: To provide evidence relevant to developmentally sensitive intervention and prevention of adolescents' psychosocial distress associated with treatment of type 1 diabetes. METHODS: We used self-reports on the Diabetes Quality of Life and SCL-90-R inventories administered at baseline, 1, and 3 years following adolescents' (n = 224) entry into the Diabetes Control and Complications Trial. RESULTS: Initiation of intensive treatment in early adolescence was associated with increasing school dissatisfaction; initiation in later adolescence resulted in marginal elevations in psychological distress. CONCLUSIONS: Age at entry moderates impact of intensive treatment on reported psychosocial distress. Intervention and prevention efforts sensitive to the interaction of developmental tasks with health treatment goals may optimize the well-being of adolescents with type 1 diabetes.     

糖尿病患者管理与教育软件系统的开发研究

目的编制能够满足糖尿病患者进行标准化管理、自我管理以及健康教育需求的软件系统。方法在临床对糖尿病患者进行和糖尿病俱乐部对患者开展自我管理的基础上,运用VisualFoxpro6.0编制一套包括糖尿病患者标准化管理、自我管理及其有关知识、技能练习的软件。结果软件包括八项模块:项目管理、病情记录、自我管理活动、糠尿病知识库、工具、财务报告、管理网络、综合分析。系统实现了图形界面人机交互、数据资料管理、自动分析并反馈结果、健康教育、网络连接等功能。结论本系统功能较为完善并且操作简易,可以提高糖尿病患者的标准化管理和自我管理的效率。     

妊娠糖尿病的治疗进展

妊娠糖尿病的治疗涉及到改善本次妊娠结局和预防将来成人胎源性疾病发生两个方面,要求为母亲和胎儿提供一个适合的孕期体内代谢环境。与普通糖尿病相比,妊娠糖尿病的治疗有着许多自身不同的特点。本综述从妊娠糖尿病治疗的获益、营养治疗、血糖及尿酮体的监测、运动治疗、药物治疗等几方面论述近年来在妊娠糖尿病治疗方面所取得的进展。