新门诊大楼信息化建设核心系统研究

目的：探讨新门诊大楼中具备“亮点”的信息化系统及其对门诊信息化建设的意义。方法：从信息发布系统、自助服务系统以及智能化分诊排队系统3个方面分析了新门诊信息化系统对于改善就诊环境、优化门诊就医流程的重要性。结果：结合新门诊大楼建设的实际情况,给出了3个系统的设计方案及实际作用。结论：新门诊大楼的启用对于门诊信息化建设是一次极大的提升,必将对医院的管理模式、就医模式乃至全院的信息化建设产生积极影响。     

以电子病历为核心的门诊信息化系统的设计与实现

随着信息化技术的不断发展,中国医科大学附属盛京医院在信息化建设的过程中不断总结创新,率先以电子病历为核心,集成医院信息、医学影像归档和通信、检验信息等系统,建设数字化无纸化门诊信息系统,改善患者看病流程,提高医院服务质量与效率。笔者详细分析了门诊信息系统的看病流程,介绍了一种以C/S模式为主体结合B/S模式的框系统架构,描述了整体系统的功能结构,并利用.net技术实现了电子病历添加、检查在线申请、查看等功能,最后进行了系统的性能分析。结果表明:全面信息化门诊信息系统,优化了门诊患者的就诊流程,减少了就诊环节和非医疗等待时间,改善了患者就医感受,提升了医院服务能力。     

集平战、军地保障功能于一体的门诊大楼建设

为了更好地适应医疗市场的需求、提高军事斗争准备能力,本院新建了外观秀美、布局合理、功能齐全、高智能化、高节能性的战时急救中心暨门诊大楼。大楼顶层设有停机坪等配套空运与急救系统,可快速高效地进行战地伤病员的转进与后送。设立军人诊区,实行军地分诊切实落实为部队服务;再造就医流程,创新程序,简化环节,实行“一站式”就医新模式;引进配备国际先进的全实验室自动化系统(TLA)和全自动药品单剂量分包机;物业管理社会化专业化。管理规范、服务周到,体现了“以人为本”的服务理念。门急诊功能得到极大的加强与扩展,提高了门诊医疗质量、管理水平与效率;是集平战、军地保障功能于一体,科学合理设计的现代化智能化综合门诊医疗大楼。     

以电子病历系统为核心的门诊信息化建设实践

以患者为中心,开展以电子病历系统为核心的门诊信息化建设,是中国医科大学附属盛京医院投身医改的新规良策。随着门诊信息系统的广泛应用和不断完善,进一步促进医院数字化建设,优化服务流程,提高服务质量和服务效率,实现就医和服务理念的转变。医院率先推行电子病历,成功实现电子病历系统与医院信息系统(HIS)、医学图像档案管理和通信系统(PACS)、检验信息系统(LIS)等相关系统的集成,开启电子病历和电子处方新医疗模式的大胆尝试,必将有助于早日实现建立实用共享的医药卫生信息系统的总目标。     

门诊银医通系统的构建与应用

目的:为了规范门诊就医流程,提升医院的信息化应用水平,为患者提供快捷的医疗辅助服务,通过门诊银医通项目的建设,解决长期存在的门诊就医挂号、计价及缴费等非诊疗排队时间长的问题。方法:依托现有的医院信息系统(HIS)平台,与银行及手机平台实施联网,构建门诊银医通系统平台。结果:银医通系统实现了通过拓展挂号渠道,使用多种卡作为就诊卡,费用发生地计价,各楼层自助设备缴费,手机智能平台的引入,减少了患者在医院的就诊时间。结论:实施银医通系统项目,方便了患者就医,提高了医院门诊服务工作效率。     

便利患者就医的智慧服务平台建设与应用

目的 通过整合医院内部系统,实现患者一站式服务。方法 在微信小程序上开发了患者就医服务模块和在线客服系统,提供自助与人工服务相结合的智慧服务方案。结果 平台整合了多个平台的不同服务功能,技术架构包括医疗信息集成平台实现系统整合与数据交互,以及基于移动互联网技术的智慧服务平台。平台采用前后端服务分离模式,保障医疗数据安全,减少了患者使用不同平台的困扰,提高了患者就医满意度。结论 智慧服务平台的建立实现了患者就医无障碍,提升了患者就医体验,是医院信息化建设的必然趋势。     

医院智能化楼宇信息系统的设计与实施

目的为了营造幽雅的就医环境,提供优质的医疗服务,打造先进的智慧医院,建设医院智能化楼宇信息系统。方法结合智能化医院建筑的特点和使用需求,利用先进的通信、网络、信息、自动化控制等多项现代高新技术,完成医院整体的智能化楼宇信息系统的建设。结果完成了1个综合运维管理平台,5大分系统的楼宇智能化控制系统的集成,为广大患者和工作人员提供温馨、舒适的就医和工作环境,整体提升了医院的医疗服务水平。结论资源整合降低了能量消耗及运行成本,使医院的运营安全、高效、稳定。     

我院信息化建设的发展思考

本文简要介绍了我院近年来信息化建设的成效,通过对医院信息化建设现状分析,就医院信息化发展提出思考与建议。在现有系统完善功能、优化流程、扩展应用的基础上,抓好系统全面建设,围绕电子病历、就医流程、绩效管理、网络安全等多条主线作全面考虑,要注重系统间的有效集成和数据的高度融合,以及数据利用,充分发挥信息化的作用;同时要形成有效管理机制,提高应急保障能力,增强科技创新能力,信息部门要成为医院信息化的有力支柱。     

门诊楼智能化建设研究与实践

分析了医院门诊楼智能化建设的现状．指出了门诊楼智能化建设的特性和配置要求．提出了智能化门诊的服务设计理念。重新整合了门诊就医流程，设计并实践了全新的HIS门诊就医业务流程，为门诊“人文服务”提供了一个理想的提升平台。     

基于自助的妇幼门诊“一站式”服务流程优化及效果分析

目的探讨基于自助的门诊“一站式”服务流程优化效果,通过门诊信息化建设,提高门诊医生工作效率,缓解门诊病人“看病难”的压力。方法进行门诊流程优化和资源整合,构建门诊“一卡通”系统（自助办卡、充值、缴费、打印等）,推行“一站式”服务;比较信息化前后的就医流程、工作效率、就诊耗时、医疗投诉、患者满意度等指标。结果门诊信息化后与信息化前相比,就医流程得到明显的优化,医生工作效率明显提升,门诊病人就诊时间显著缩短,医疗投诉下降,满意度明显改善（P〈0．01）;信息化后门诊和住院业务指标增长明显;通过优化流程、环境美化、服务人性化,缓解了医患压力,增加了社会和谐度。结论推行基于自助的“一站式”服务,促使医患双方受益,得到了政府及主管部门的重视,值得在妇幼保健院门诊及综合性医院门诊推广使用。     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

骨钙素与儿童生长发育

骨钙素是成骨细胞分泌的骨蛋白 ,骨钙素水平与成骨细胞活性成正相关 ,是一项很好的反映骨形成与骨转化的生化指标。小儿骨生长发育有自身特点 ,骨钙素水平的改变类似儿童身高生长曲线 ,可以很好地应用于评价儿童生长发育及监测生长障碍患儿对治疗的反应     

Cholesterol and Egg Intakes with Cardiometabolic and All-Cause Mortality among Chinese and Low-Income Black and White Americans

We examined the associations of dietary cholesterol and egg intakes with cardiometabolic and all-cause mortality among Chinese and low-income Black and White Americans. Included were 47,789 Blacks, 20,360 Whites, and 134,280 Chinese aged 40–79 years at enrollment. Multivariable Cox models with restricted cubic splines were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes using intakes of 150 mg cholesterol/day and 1 egg/week as the references. Cholesterol intake showed a nonlinear association with increased all-cause mortality and a linear association with increased cardiometabolic mortality among Black Americans: HRs (95% CIs) associated with 300 and 600 mg/day vs. 150 mg/day were 1.07 (1.03–1.11) and 1.13 (1.05–1.21) for all-cause mortality (P-linearity = 0.04, P-nonlinearity = 0.002, and P-overall < 0.001) and 1.10 (1.03–1.16) and 1.21 (1.08–1.36) for cardiometabolic mortality (P-linearity = 0.007, P-nonlinearity = 0.07, and P-overall = 0.005). Null associations with all-cause or cardiometabolic mortality were noted for White Americans (P-linearity ≥ 0.13, P-nonlinearity ≥ 0.06, and P-overall ≥ 0.05 for both). Nonlinear inverse associations were observed among Chinese: HR (95% CI) for 300 vs. 150 mg/day was 0.94 (0.92–0.97) for all-cause mortality and 0.91 (0.87–0.95) for cardiometabolic mortality, but the inverse associations disappeared with cholesterol intake > 500 mg/day (P-linearity ≥ 0.12; P-nonlinearity ≤ 0.001; P-overall < 0.001 for both). Similarly, we observed a positive association of egg intake with all-cause mortality in Black Americans, but a null association in White Americans and a nonlinear inverse association in Chinese. In conclusion, the associations of cholesterol and egg intakes with cardiometabolic and all-cause mortality may differ across ethnicities who have different dietary patterns and cardiometabolic risk profiles. However, residual confounding remains possible.