本体构建工具设计与实现

从基于已有资源的本体重用与本体转化的本体构建需求出发,结合国内外技术进展和本体构建工具研究现状,以WebProtégé类库为基础进行本体构建工具代码开发与功能实现。在实现过程中注重工具自动处理与人工审核相结合的交互模式,收集具体的样例数据验证所开发的本体构建工具可行性和易用性。     

多语言领域术语系统构建工具TBench的设计与实现

目的：为满足领域术语系统的多样化构建需求,探讨一种灵活、快速的多语言领域术语系统构建方法。方法：提出了多语言领域术语系统构建工具（TBench）的整体架构与功能设计,建立了基于ISO 25964可自定义扩展的数据模型,实现了多语言环境下的术语、概念、关系的批量复用与灵活创建等内容建设,从访问冲突、工作流、用户、角色、权限等角度进行了协同控制与管理。结果：TBench基于Java语言开发完成,并用于开展中文临床医学术语系统（CSCT）大规模的概念及语义关系建设。结论：TBench适用于分类表、词表、本体等术语系统的协同构建与维护,也为领域术语系统构建的自定义扩展需求、灵活复用、跨语言对齐与重构等问题提供了一种新思路。     

糖尿病领域本体构建与语义推理实现

目的：构建糖尿病领域本体库与糖尿病诊疗规则库,在此基础上实现语义推理,糖尿病领域知识的重用、潜在知识的揭示及共享,为后续糖尿病管理系统研究奠定基础,进而为基层全科医生诊疗糖尿病提供决策支持。方法：以国内糖尿病领域相关临床指南和领域专家知识为依据,抽取其中的概念以及概念之间的关系,借鉴七步法和骨架法,在斯坦福大学Protégé平台构建糖尿病领域本体,编写SWRL诊疗规则库,继而使用JESS推理机实现语义推理。结果：构建了较为完整的糖尿病领域本体库与糖尿病诊疗规则库,包含概念233条、实例205条、实例间关系16条、数值属性18条、SWRL规则28条,并在此基础上实现了语义推理。结论：构建的糖尿病领域本体能够实现语义推理任务,是将本体技术应用于慢病诊疗领域的有益探索。     

卫生政策科研本体构建研究

在对现有科研本体和本体构建方法进行分析的基础上,利用Protege工具进行开发,选择0WL作为卫生政策科研本体描述语言,阐述了构建过程,初步设计了卫生政策科研本体模型,最后提出了问题和展望。     

生物医学领域本体网络整合工具研究进展

介绍3类国内外生物医学领域本体网络整合工具的研究成果,包括生物医学本体网络整合平台、疾病-药物本体知识发现工具、基因-蛋白质本体集成分析工具,分析其特点及不足,总结本体整合工具开发过程中应该注意的问题,希望能为相关研究者提供借鉴。     

经穴治疗领域本体构建实验性研究

本体构建是语义网背景下知识组织的新方法。介绍了经络、穴位治疗领域本体构建的基本方法、流程,借助本体构建软件的检索、推理及可视化展示,检测了本体在语义关系建立、知识组织增值方面的作用,发现本体构建方法在知识组织方面具有范围广、层次深、语义丰富、关联度强等特点,便于知识重组,为科学研究提供新的角度,创造新的价值。     

基于本体的医院医学术语管理系统设计研究

介绍基于本体的医学术语管理优势,阐述基于本体的医院医学术语管理系统设计及应用场景,分析不足之处并提出建议,为提高医院信息系统语义互操作性、医疗数据质量管理与应用水平提供参考。     

临床路径本体概念框架构建方法与实证研究

在总结国内外临床路径发展现状和纸质版临床路径管理弊端基础上,提出基于本体的电子化临床路径的概念框架构建方法,并以卫生部《乳腺癌临床路径(2009版)》表单为基础,参考医学专业叙词表、专业教科书及相关诊疗指南对乳腺癌临床路径本体概念框架构建进行实证研究。为临床路径电子管理系统建设提供理论参考,有助于医疗信息资源的开发和利用。     

面向医学科技评价的本体模型构建研究

目的：构建面向医学科技评价的本体模型,为完善医学科技评价本体奠定基础,为医学科技评价研究数据管理系统提供支持。方法：通过分析医学科技评价需求、调研医学科技评价维度及现有科研本体研究现状,以现有医学科技评价维度和科研本体为依据,构建本体模型,并抽取其中概念及属性。借鉴骨架法和七步法,利用Protégé构建本体并进行检索及可视化展示。结果：建立了包含8类顶层模块、303条概念及21种语义关系的医学科技评价工作的本体模型,并借助Protégé进行检索及可视化展示。结论：构建医学科技评价本体能够更好地管理和组织指标数据,揭示科研网络关系,为医学科技评价研究提供新的研究角度,便于科研数据或信息资源的共享。     

黑色素瘤单病种本体构建研究

利用百科知识、临床指南、科技文献、专家经验等多源异构资源进行本体顶层范畴界定,借助Onto-fox、Protégé等本体工具采集并组织黑色素瘤疾病、分子异常、症状、解剖结构、药物、干预与操作、并发症等顶层范畴的概念和术语,构建黑色素瘤单病种本体并对其评估,开发本体展示和检索工具,为相关领域研究提供参考.     

面向分类统计的传统医学疾病本体构建研究

目的：构建传统医学疾病本体,促进中医疾病分类统计的规范化与标准化,推动我国传统医学名词与国际医学术语标准的融合与创新发展。方法：通过借鉴国际疾病本体建设模式,提出复用已有资源构建传统医学疾病本体的新方法。利用精确、向上、向下和相关4种匹配方式,研究新建本体与ICD-11中文版的语义映射。结果：通过复用已有标准中的中医病名、定义、结构体系等资源,完成了传统医学疾病本体构建,并实现了新构建本体与ICD-11中文版的语义关联。结论：新构建的传统医学疾病本体为中医疾病分类统计的规范化和标准化奠定了基础。     

隆起器治疗先天性乳头凹陷畸形的临床研究

目的：总结隆起器治疗不同程度先天性乳头凹陷畸形的疗效确切性.方法：应用自行负压原理,设计带有自动阀门的大小不同隆起器,以治疗不同直径大小的凹陷畸形乳头.结果：1999至2004年应用有自行负压的乳头凹陷隆起器治疗2000例先天性乳头凹陷畸形患者,有效率100%,治愈率达99%.停止治疗后随访3个月至5年,无一复发.结论：运用乳头凹陷隆起器,无需手术即可矫正畸形,恢复正常形态,且无任何副作用.经过长达5年随访,疗效确切,无一复发.     

Epilepsy and seizure ontology: towards an epilepsy informatics infrastructure for clinical research and patient care

Objective

Epilepsy encompasses an extensive array of clinical and research subdomains, many of which emphasize multi-modal physiological measurements such as electroencephalography and neuroimaging. The integration of structured, unstructured, and signal data into a coherent structure for patient care as well as clinical research requires an effective informatics infrastructure that is underpinned by a formal domain ontology.

Methods

We have developed an epilepsy and seizure ontology (EpSO) using a four-dimensional epilepsy classification system that integrates the latest International League Against Epilepsy terminology recommendations and National Institute of Neurological Disorders and Stroke (NINDS) common data elements. It imports concepts from existing ontologies, including the Neural ElectroMagnetic Ontologies, and uses formal concept analysis to create a taxonomy of epilepsy syndromes based on their seizure semiology and anatomical location.

Results

EpSO is used in a suite of informatics tools for (a) patient data entry, (b) epilepsy focused clinical free text processing, and (c) patient cohort identification as part of the multi-center NINDS-funded study on sudden unexpected death in epilepsy. EpSO is available for download at http://prism.case.edu/prism/index.php/EpilepsyOntology.

Discussion

An epilepsy ontology consortium is being created for community-driven extension, review, and adoption of EpSO. We are in the process of submitting EpSO to the BioPortal repository.

Conclusions

EpSO plays a critical role in informatics tools for epilepsy patient care and multi-center clinical research.     

医护人员预立医疗照护计划培训需求评估工具的编制

目的 以培训需求分析(training needs analysis,TNA)理论中绩效分析模式为指导框架,编制医护人员预立医疗照护计划(advance care planning,ACP)培训需求评估工具条目池,为下一步培训需求调查工作提供研究基础。方法 先是以文献分析法及资料查阅初步构建ACP培训需求评估工具条目池,再依据Brislin翻译模型对初步构建的英文条目进行翻译及汉化调试,通过德尔菲专家咨询法及预调查对条目进行修订。结果 经文献分析及资料查阅,评估工具内容确定为23个条目,涉及三个主题,分别是基础知识、专科知识及沟通技能。翻译及回译后的量表整体语义评价较高,条目语义等价程度是78.6%~100.0%,量表语义等价程度是82.6%~100.0%。两轮咨询后专家积极性为100%,专家权威程度为0.87,专家咨询协调系数分别是0.271和0.353,各条目重要性均值4.29~5.00,变异系数0.05~0.11。40位进行量表表面效度评价的医护人员对量表各条目问法的认可度为87.5%~100.0%。结论 本研究培训需求评估工具编制过程科学严谨,编制结果良好,为进一步开展培训需求调查工作提供了参考。     

Establishment of a molecular tool for blood meal identification in Malaysia

Objective

To establish a polymerase chain reaction (PCR) technique based on cytochrome b (cytb) gene of mitochondria DNA (mtDNA) for blood meal identification.

Methods

The PCR technique was established based on published information and validated using blood sample of laboratory animals of which their whole gene sequences are available in GenBank. PCR was next performed to compile gene sequences of different species of wild rodents. The primers used were complementary to the conserved region of the cytb gene of vertebrate''s mtDNA. A total of 100 blood samples, both from laboratory animals and wild rodents were collected and analyzed. The obtained unknown sequences were compared with those in the GenBank database using BLAST program to identify the vertebrate animal species.

Results

Gene sequences of 11 species of wild animals caught in 9 localities of Peninsular Malaysia were compiled using the established PCR. The animals involved were Rattus (rattus) tanezumi, Rattus tiomanicus, Leopoldamys sabanus, Tupaia glis, Tupaia minor, Niviventor cremoriventor, Rhinosciurus laticaudatus, Callosciurus caniseps, Sundamys muelleri, Rattus rajah and Maxomys whiteheadi. The BLAST results confirmed the host with exact or nearly exact matches (>89% identity). Ten new gene sequences have been deposited in GenBank database since September 2010.

Conclusions

This study indicates that the PCR direct sequencing system using universal primer sets for vertebrate cytb gene is a promising technique for blood meal identification.     

Lasik手术中飞秒激光和机械刀制瓣的对比研究

目的分析Lasik手术中飞秒激光和机械刀制瓣的临床效果。方法选择内蒙古自治区人民医院于2011年3月-2012年9月收治的行Lasik手术治疗的近视患者200例作为研究对象。根据角膜瓣制作的方法不同随机分为使用飞秒激光的观察组及使用机械刀制瓣的对照组,各100例。观察两组患者的角膜瓣厚度及术后裸眼视力情况。结果观察组患者接受治疗后的角膜瓣厚度明显薄于对照组（P〈0.05）;观察组接受治疗后的各个阶段裸眼视力较术前最佳矫正视力进步一行以上的患者比例以及裸眼视力大于1.2的患者比例均明显高于对照组（P〈0.05）。结论 Lasik手术中运用飞秒激光技术可以更加有效地减少角膜瓣厚度,改善患者视力。     

Diabetes epidemic in the Asia Pacific region: has hemoglobin A1C finally earned its place as a diagnostic tool?

Two-third of the world''s population lives in the Asia Pacific region where prevalence of diabetes has reached epidemic proportion. With China and India being the most populous nations on the globe, it is believed that over 150 million diabetes reside in the region with more than 95% being of type 2 diabetes mellitus (T2DM). Furthermore, other Pacific islands in the region have high rates of T2DM including Tonga, Fiji, French Polynesia, and Nauru. The latter has the highest prevalence of T2DM per population in the world. Over the past two decades, in Australia and New Zealand, the prevalence of T2DM has more than doubled, mainly amongst the Aboriginal and Torres Strait Islander and Maori peoples respectively. With the increasing prevalence of diabetes in the Asia Pacific region coupled with the limited number of resources, use of a reliable and effective mode of diagnosis for T2DM is warranted. Yet to date, only New Zealand has adopted the American Diabetes Association recommendation of using hemoglobin A1C in the diagnosis of the disease. The aim of this review is to discuss the clinical usefulness of hemoglobin A1C and highlight its diagnostic role in the Asia Pacific region where T2DM is increasingly encountered.     

从工具论与人文素质论之争看八年制临床医学专业英语教学

外语界对于英语教学的指导思想究竟应该是“工具论”还是“人文论”一直争论不休.本文通过回顾英语教学的工具论和人文论的观点,分析八年制临床医学专业英语教学的现状,质疑了这两种观点独立存在的意义,对医学院校八年制临床医学专业英语教学的改革提出了建议.     

研究型医院建设——研究型医院发展战略的认识与思考

医院能否制定和实现正确的战略构想,关系到医院的生死存亡。惟有运筹帷幄,深谋远虑,在彻底了解和准确把握医院内部条件和外部环境变化的同时,制订出最佳的竞争战略,医院才能不断保持可持续、协调性发展,才能不断发展壮大,才能在激烈的市场竞争中求得生存。构建医院竞争战略,就是要将潜在的核心能力转化成现实的核心能力。基于对医学科学技术的发展预测,根据国际一流医院发展的特点,结合医院发展的实际,解放军总医院提出了创建研究型医院的战略决策。本文就研究型医院的发展战略进行初步探讨。     

Research and applications: Ontology-guided organ detection to retrieve web images of disease manifestation: towards the construction of a consumer-based health image library

Background

Visual information is a crucial aspect of medical knowledge. Building a comprehensive medical image base, in the spirit of the Unified Medical Language System (UMLS), would greatly benefit patient education and self-care. However, collection and annotation of such a large-scale image base is challenging.

Objective

To combine visual object detection techniques with medical ontology to automatically mine web photos and retrieve a large number of disease manifestation images with minimal manual labeling effort.

Methods

As a proof of concept, we first learnt five organ detectors on three detection scales for eyes, ears, lips, hands, and feet. Given a disease, we used information from the UMLS to select affected body parts, ran the pretrained organ detectors on web images, and combined the detection outputs to retrieve disease images.

Results

Compared with a supervised image retrieval approach that requires training images for every disease, our ontology-guided approach exploits shared visual information of body parts across diseases. In retrieving 2220 web images of 32 diseases, we reduced manual labeling effort to 15.6% while improving the average precision by 3.9% from 77.7% to 81.6%. For 40.6% of the diseases, we improved the precision by 10%.

Conclusions

The results confirm the concept that the web is a feasible source for automatic disease image retrieval for health image database construction. Our approach requires a small amount of manual effort to collect complex disease images, and to annotate them by standard medical ontology terms.