浅析医院信息系统中医保接口的实现方案

本文介绍了医院信息系统与医保系统接口的实现方案,重点研究了文件导出导入、嵌入式DLL和WEB服务接口三种接入模式,详细描述了我院门诊和住院的医保业务流程。     

Stability of a chronic implanted brain-computer interface in late-stage amyotrophic lateral sclerosis

ObjectiveWe investigated the long-term functional stability and home use of a fully implanted electrocorticography (ECoG)-based brain-computer interface (BCI) for communication by an individual with late-stage Amyotrophic Lateral Sclerosis (ALS).MethodsData recorded from the cortical surface of the motor and prefrontal cortex with an implanted brain-computer interface device was evaluated for 36 months after implantation of the system in an individual with late-stage ALS. In addition, electrode impedance and BCI control accuracy were assessed. Key measures included frequency of use of the system for communication, user and system performance, and electrical signal characteristics.ResultsUser performance was high consistently over the three years. Power in the high frequency band, used for the control signal, declined slowly in the motor cortex, but control over the signal remained unaffected by time. Impedance increased until month 5, and then remained constant. Frequency of home use increased steadily, indicating adoption of the system by the user.ConclusionsThe implanted brain-computer interface proves to be robust in an individual with late-stage ALS, given stable performance and control signal for over 36 months.SignificanceThese findings are relevant for the future of implantable brain-computer interfaces along with other brain-sensing technologies, such as responsive neurostimulation.     

Using conceptual work products of health care to design health IT

This paper introduces a new, model-based design method for interactive health information technology (IT) systems. This method extends workflow models with models of conceptual work products. When the health care work being modeled is substantially cognitive, tacit, and complex in nature, graphical workflow models can become too complex to be useful to designers. Conceptual models complement and simplify workflows by providing an explicit specification for the information product they must produce. We illustrate how conceptual work products can be modeled using standard software modeling language, which allows them to provide fundamental requirements for what the workflow must accomplish and the information that a new system should provide. Developers can use these specifications to envision how health IT could enable an effective cognitive strategy as a workflow with precise information requirements. We illustrate the new method with a study conducted in an outpatient multiple sclerosis (MS) clinic. This study shows specifically how the different phases of the method can be carried out, how the method allows for iteration across phases, and how the method generated a health IT design for case management of MS that is efficient and easy to use.     

Skin permeation and metabolism of di(2-ethylhexyl) phthalate (DEHP)

Phthalates are suspected to be endocrine disruptors. Di(2-ethylhexyl) phthalate (DEHP) is assumed to have low dermal absorption; however, previous in vitro skin permeation studies have shown large permeation differences. Our aims were to determine DEHP permeation parameters and assess extent of skin DEHP metabolism among workers highly exposed to these lipophilic, low volatile substances.     

Virtual planning in orthognathic surgery

Numerous publications regarding virtual surgical planning protocols have been published, most reporting only one or two case reports to emphasize the hands-on planning. None have systematically reviewed the data published from clinical trials. This systematic review analyzes the precision and accuracy of three-dimensional (3D) virtual surgical planning of orthognathic procedures compared with the actual surgical outcome following orthognathic surgery reported in clinical trials. A systematic search of the current literature was conducted to identify clinical trials with a sample size of more than five patients, comparing the virtual surgical plan with the actual surgical outcome. Search terms revealed a total of 428 titles, out of which only seven articles were included, with a combined sample size of 149 patients. Data were presented in three different ways: intra-class correlation coefficient, 3D surface area with a difference <2 mm, and linear and angular differences in three dimensions. Success criteria were set at 2 mm mean difference in six articles; 125 of the 133 patients included in these articles were regarded as having had a successful outcome. Due to differences in the presentation of data, meta-analysis was not possible. Virtual planning appears to be an accurate and reproducible method for orthognathic treatment planning. A more uniform presentation of the data is necessary to allow the performance of a meta-analysis. Currently, the software system most often used for 3D virtual planning in clinical trials is SimPlant (Materialise). More independent clinical trials are needed to further validate the precision of virtual planning.     

稳态视觉诱发脑机接口特征提取方法的研究

目的为有效提取稳态视觉诱发脑机接口(SSVEP-based brain-computer interface)中的脑电特征,提出一种基于独立成分分析(independent component analysis,ICA)与希尔伯特黄变换(HilbertHuang transform,HHT)的特征提取方法。方法对采集得到的脑电信号进行带通滤波,得到预处理的脑电信号,将滤波后的脑电信号作为ICA的输入,经过ICA实现独立成分的快速获取。引入HHT对独立成分进行经验模态分解(EMD),分解获取固有模态函数(intrinsic mode function,IMF),通过对IMF的频域分析,即可提取出特征。将ICA和HHT法同WT法、ICA法以及HHT法等常用的特征提取方法在频域、功率谱估计、在时间消耗等多方面进行比对分析。结果频域分析和功率谱估计中,本文提出的方法明显优于WT法和ICA法,略优于HHT法。时间消耗方面,本文提出的方法略优于HHT法。结论基于ICA和HHT的特征提取方法在稳态视觉诱发脑机接口的特征提取中是可行的,并有效去除了脑电信号中的噪声。