双体位CT仿真结肠镜的临床应用

目的探讨体位对结肠隆起性病变CT仿真结肠镜(CTvirtualcolonoscopy,CTVC)成像的影响。方法56例患者行结肠直肠螺旋CT检查,并进行工作站后处理,分别获得结肠、直肠的CTVE、表面遮盖显示(SSD)、容积再现(VR)及多平面成像等二维、三维图像,并于临床病理对照。将病灶按直径≤5mm、5mm~10mm、≥10mm分为3组,分析双体位下CTVC对病灶的检出率。结果增生性息肉4例,腺瘤8例,多发性息肉3例,结肠、直肠癌31例。双体位下病灶检出率较仰卧位提高,双体位下大肠扩张满意度高。结论采用双体位能有效提高结肠隆起性病变的CTVC成像效果。结合其他后处理方法,能明显提高CTVC病灶的检出率。     

实验诊断学CAI课件的制作及应用

CAI课件的制作需要多方面的支持和帮助,需要全体教学人员的参与,针对性要明确,风格要统一、脚本要详细,素材要广泛,应该注意到教师主导作用与学生能动性之间的关系,制作中“量”和“质”的关系、内容和技术的关系等,更好地发挥多媒体教学的优势.     

出入境人员健康检查证书及档案管理系统的应用

[目的]提高国际旅行卫生保健中心制作出入境人员健康检查证书的速度、核销证书的准确率；提高档案管理水平。[方法]通过对出入境人员健康体检工作流程的分析,对体检后证书制作、证书核销和档案管理等费时费力环节的研究,采用计算机技术研究开发出《出人境人员健康检查证书及档案管理系统》。[结果]运用该系统(1)能够收到“1次录入,3次受益”的效果；(2)能够建立1套完整的电子档案,达到节约人力物力,提高工作效率的目的。[结论]《出入境人员健康检查证书及档案管理系统》具有快速高效、准确无误、简单方便、严密细致的特点,能够提高工作效率和质量并建立电子档案。     

卫生检验网络信息管理系统的开发与应用

目的遵循ISO/IEC17025质量体系要求,针对市级疾病预防控制中心建立新型的卫生检验网络化管理系统。方法使用SQL Server 2000和Power Builder 9.0软件,设计和开发网络化的管理系统。结果系统实现了检验科与疾病预防控制中心相关业务科室的联网,主要用于检测信息、防病信息、管理信息的网络化管理。结论系统流程标准,管理规范,操作简单,应用广泛。     

Are multiple objective measures of student performance necessary?

BACKGROUND: This study examines the effect of using multiple modalities to evaluate medical students. METHODS: Thirty-four students were evaluated by a complex model utilizing National Board of Medical Examiners (NBME) shelf examination, Objective Structured Clinical Examination (OSCE), Computer Patient Simulation (CPS), faculty and peer evaluation. Results were compared with a traditional model based on NBME and faculty evaluation alone. RESULTS: Reliability (coefficient alpha) of the complex and traditional models were 0.72 and 0.47, respectively. Item correlations suggested that NBME was most discriminating (r = 0.75), followed by OSCE (r = 0.52), peer evaluation (r = 0.43), CPS (r = 0.39), and faculty evaluation (r = 0.32). Rank order correlation (Spearman's rho) between scores calculated using each model was 0.87. CONCLUSIONS: Although the complex model has improved reliability, both models rank students similarly. However, neither model fully captures and reflects the information provided by each of the specific evaluation methods.     

Interaction of the cardiovascular system with an implanted rotary assist device: simulation study with a refined computer model

In recent years, implanted rotary pumps have achieved the level of extended clinical application including complete mobilization and physical exercise of the recipients. A computer model was developed to study the interaction between a continuous-flow pump and the recovering cardiovascular system, the effects of changing pre- and afterloads, and the possibilities for indirect estimation of hemodynamic parameters and pump control. A numerical model of the cardiovascular system using Matlab Simulink simulation software was established. Data of circulatory system modules were derived from patients, our own in vitro and in vivo experiments, and the literature. Special care was taken to simulate properly the dynamic pressure-volume characteristics of both left and right ventricle, the Frank-Starling behavior, and the impedance of the proximal vessels. Excellent correlation with measured data was achieved including pressure and flow patterns within the time domain, response to varying loads, and effects of previously observed pressure-flow hysteresis in rotary pumps. Potential energy, external work, pressure-volume area, and other derived heart work parameters could be calculated. The model offers the possibility to perform parameter variations to study the effects of changing patient condition and therapy and to display them with three-dimensional graphics (demonstrated with the effects on right ventricular work and efficiency). The presented model gives an improved understanding of the interaction between the pump and both ventricles. It can be used for the investigation of various clinical and control questions in normal and pathological conditions of the left ventricular assist device recipient.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rapid assessment of psychosocial well-being: Are computers the way forward in a clinical setting?

Objective: To compare the agreement between anxiety, depression and supportive care needs data obtained using a touchscreen computer survey with traditional pen-and-paper surveys. Methods: The sample consisted of 1304 consecutive patients attending the medical or radiation oncology outpatient department in two public cancer treatment centres. Of the 357 eligible patients, 355 (99%) consented to participate and 350 (98%) completed both touchscreen computer and pen-and-paper versions of the Hospital Anxiety and Depression Scale (HADS) and short-form Supportive Care Needs Survey (SCNS-short). Results: Simple values indicated moderate agreement ( = 0.57) between the two modes of survey administration for most HADS items. Simple coefficients indicated only fair agreement ( = 0.28) when a simplified response option format was used in the computerised SCNS-short. When the paper and computerised survey used the same response format, simple kgr; coefficients increased and indicated moderate agreement ( = 0.44) for most SCNS-short items. Coefficients indicated at least moderate agreement ( > 0.41) in identifying patients with elevated levels of anxiety and depression; there were no significant differences in the proportion of patients identified with elevated levels of anxiety and depression according to computer survey compared to paper survey. Prevalence-adjusted bias-adjusted (PABAK) coefficients indicated at least moderate agreement ( = 0.79) in identifying participants with moderate/high levels of unmet needs. However, participants tended to report lower levels of unmet needs with a simplified response format in the computerised SCNS-short compared to the paper survey. This was not observed when the response format of the computerised SCNS-short replicated the paper survey. Conclusions: Despite the advantages that computerised surveys offer for simplifying survey presentation, current results suggest the need to exactly replicate the question and response option format of the original paper survey to ensure the data collected are equivalent. This finding is particularly important given the potential application of computerised surveys in the clinical setting to quickly assess and identify patients' concerns requiring intervention by health care providers.     

Computer-vision-enabled augmented reality fundus biomicroscopy.

PURPOSE: To guide treatment for macular diseases and to facilitate real-time image measurement and comparison, investigations were initiated to permit overlay of previously stored photographic and angiographic images directly onto the real-time slit-lamp biomicroscopic fundus image. DESIGN: Experimental study in model eyes, and preliminary observations in human subjects. METHODS: A modified, binocular video slit lamp interfaced to a personal computer and framegrabber allows for image acquisition and rendering of stored images overlaid onto the real-time slit-lamp biomicroscopic fundus image. Development proceeds with rendering on a computer monitor, while construction is completed on a miniature display interfaced directly with one of the slit-lamp oculars. Registration and tracking are performed with in-house-developed software. MAIN OUTCOME MEASURES: Tracking speed and accuracy, ergonomic acceptability. RESULTS: Computer-vision algorithms permit robust montaging, tracking, registration, and rendering of previously stored photographic and angiographic images onto the real-time slit-lamp fundus biomicroscopic image. In model eyes and in preliminary studies in a human eye, optimized registration permits near-video-rate image overlay with updates at 3 to 10 Hz and misregistration errors on the order of 1 to 5 pixels. CONCLUSIONS: A prototype for ophthalmic augmented reality (image overlay) is presented. The current hardware/software implementation allows for robust performance.     

应用计算机技术合理调配护理人力资源的研究

文章阐述了进行“科学合理地利用与分配护理人力资源”研究的科研设计思路与研究方法,并且对研究成果实施于临床护理人员调配的管理进行了可行性评估,认为该项管理方法应用于我国大城市的大医院是可行的。目前这种管理方法是我们让有限的劳动力资源发挥出最大效益的一种行之有效的调配方法,能真正做到根据病人需求的护理工作量来合理调配护士资源,从根本上解决传统的经验管理劳动力调配所带来的“人浮于事”或“超负荷运转”两个