统计软件平台结构研究

讨论了统计软件平台的概念,抽象描述了统计软件平台模型和统计软件平台体系结构,着重介绍了数据字典,统计分析和历史数据处理.采用层次支持的开放式软件结构,并综合统计事务中的各种统计需求设计统计软件平台,使实现的系统具有良好的动态可扩充性.中间件技术的应用使该平台能满足各种数据应用的特定需要.应用数据字典作为控制参数也使得该平台能够满足不同用户的统计要求.     

Diffusion of information about genetic risk within families

Recent developments in genetics are likely to exacerbate the ethical issues in clinical practice, especially with regard to privacy and disclosure of genetic information. To evaluate the behaviour of patients with respect to transmitting carrier information, we undertook a survey of 283 families with a balanced chromosomal rearrangement as a model. In these families, 1816 relatives were considered at risk and 806 of them were karyotyped (44.4%). The percentage of karyotypes performed is significantly related to the number of living children of the index couple, the reason for referral, the nature of the anomaly, the training of the counsellor and the age of the index case. This study shows the limits of the screening of at risk individuals within families, based on the willingness of the patients, and addresses practical and ethical issues around family disclosure in medical genetics.     

Application of Akaike's information criterion (AIC) in the evaluation of linear pharmacokinetic equations

According to linear pharmacokinetics, the time course of plasma concentration of a drug, C_p,is expressed by a sum of exponential functions, C_p= _i=1 ⁿ a_i .This article describes a statistical technique to estimate the number of exponential terms, n,for the time course of drug by the application of Akaike's information criterion (AIC). Plasma concentrations of ethoxybenzamide, sulfisoxazole, bishydroxycoumarin, and diazepam measured following bolus intravenous injection were used as clinical examples for this method. Selection of models is compared between the AIC method and an Ftest method at significance levels of 5% and 1%.     

Digital psychiatry

The American managed care movement has been viewed as a big experiment and is being watched closely by the rest of the world. In the meanwhile, computer-based information technology (IT) is changing the practice of medicine, much more rapidly than managed care. A New World of digitized knowledge and information has been created. Although literature on IT in psychiatry is largely absent in peer-reviewed psychiatric journals, IT is finding its way into all aspects of medicine, particularly psychiatry. Telepsychiatry programs are becoming very popular. At the same time, medical information sites are flourishing and evolving into a new health-care industry. Patient-physician information asymmetry is decreasing as patients are gaining easy access to medical information hitherto only available to professionals. Thus, psychiatry is facing another paradigm shift, at a time when most attention has been focused on managed care. In this new digital world, knowledge and information are no longer the sole property of professionals. Value will migrate from traditional in-person office-based therapy to digital clinical products, from in-person library search and classroom didactic instruction to interactive on-line searches and distance learning. In this time of value migration, psychiatrists have to determine what their 'distinctive competence' is and where best to add value in the health-care delivery value chain. The authors assess the impact of IT on clinical psychiatry and review how clinical practice, education and research in psychiatry are expected to change in this emerging digital world.     

Multiple representations of information in the primary auditory cortex of cats. II. Stability and change in early (<32 ms), rapid components of activity after conditioning with a click conditioned stimulus

Activity was recorded from single units of the A(I) cortex of awake animals to identify early (<32 ms) components of the population response to a 70 dB click and establish if they changed after using the click as a CS for conditioning. A 70 dB hiss was used as a discriminative stimulus. Responses to these stimuli were compared before and after a forward order of pairing that produced conditioning and a backward order of pairing that produced weak sensitization (backward conditioning). Averages of discharges in 2 and 4 ms bins distinguished primary (8-12 ms) from secondary (12-16 ms) temporal components of response to the click, and confirmed that the onset of the response was shorter in A(I) (8 ms, mean of 647 units) than in the adjacent, A(II) cortex (16 ms, mean of 95 units). (All times include a 1.6 ms transmission delay in sound arrival.) Primary and secondary components of A(I) responses to click did not change uniformly after changes in behavioral state, and were affected differently by both conditioning and backward conditioning. The percentage of cells with onsets of response to the click at secondary latencies (and to the hiss at tertiary latencies) increased after backward conditioning but not after conditioning, as did the magnitude of activity in response to the click. (The latter had a lesser degree of increase after conditioning.) The primary response to the click did not show these increases. The non-uniform changes suggested that temporal processing of the click was conducted differently in the 8-12 ms post stimulus period than in the 12-16 ms period. Within the total population of cells, it was possible to identify a small subgroup (13%) of highly auditory-responsive units that showed an increased primary response to the click as a CS selectively after conditioning and not after backward conditioning. The secondary component of response in these cells increased after both conditioning and backward conditioning. The percentages of cells responding to the click and hiss at primary latencies did not change significantly after conditioning, even in the subgroup of highly responsive cells. The results characterize differently timed components of rapid responses to acoustic stimuli in the A(I) cortex, disclose significant temporal differences in primary, secondary and tertiary information processing that affect the representations of the transmitted acoustic message across different behavioral states, and find one representation in a small subgroup of cells that supports the hypothesis that cells of the A(I) cortex have a selectively potentiated response to the CS after conditioning.     

数字化医院的信息共享与标准化

阐述了数字化医院的概念，详细介绍总结了数字化医院的业务及信息构成，分析了目前数字化医院所面临的问题和困难，针对这些信息共享中存在的问题，提出了在电子病历、医疗设备信息传输以及信息系统信息交换三个方面进行标准化建设的观点，最后展望了深入完善和发展数字化医院、远程医疗及社区医疗的前景。     

竞争情报与医院战略管理整合研究新视角:应用模式

在深化医院改革的过程中,当今医院处在体制转轨的特殊时期,医院为求生存走向市场,走向竞争也是必然,如何把医院办好、做强是摆在每个医院管理人员面前不容忽视的问题。怎样打破制约医院发展不科学的管理模式,打破瓶颈,走出新路。提出竞争情报与战略管理整合的新思路,即应用模式的研究,为推进医院现代化管理的理论研究提供参考。     

医疗设备管理信息系统的应用

医疗设备管理信息系统是现在医院管理不可缺少的部分,将其合理的开发和应用形成动态的全程的管理。     

医院网络与信息安全的问题和对策

随着医院信息化建设的发展，医院网络与信息安全得到了人们的重视。全文系统地阐述了医院网络与信息安全面临的各种问题，如网络设备可靠性、计算机病毒度非法入侵、内网安全、雷击和人为因素等，并提出了相应的对策。