单病种数据中心在临床科研中的应用

随着医院信息化建设的不断深入发展和建设,医院信息系统中积累了大量宝贵的临床数据。为了提高医院数据在临床科研中的应用,我们在智能数据平台的基础上建立了单病种科研数据中心。通过对临床科研需求的深入调研和数据的深度解析,我们在数据中心提取出临床科研所关心的患者诊疗数据。利用多维度筛选、队列研究、维恩图对比等工具临床科研人员可以方便获取科研样本集合。单病种数据中心的建立使得医院系统中临床数据资源价值得到了极大提升。     

心血管系统生物学研究进展

在后基因组时代中,系统生物学是最受关注的领域之一.系统医学生物学是系统生物学的一个重要的分支和组成部分,主要研究的对象是人体、疾病和防治措施.由于心血管疾病突出的重要性,研究人员正致力于心血管系统生物学的研究.本文综述了心血管系统生物学主要的研究课题,总结了用以整合数据的方法和策略,心血管系统模型的类型和应用,建模的工具和标准,未来的发展方向,以及心血管系统生物学可能将面临的一些挑战.     

大数据时代信息化管理平台在医院专科建设中的价值

大数据时代利用信息化管理平台可以优化并规范临床诊疗流程、提升诊疗服务质量与效率、提高科研质量与水平,符合医改对医院精细化管理和循证医学时代精准医疗的要求。此信息化管理平台可以自动获取临床诊疗全程结构化数据,通过顶层设计达到规范医疗文件内容,减轻临床文书工作的目的;通过一次记录同时满足临床科研、运营管理及常规临床文件的需求,对规范化诊疗、临床科研、科室运营管理意义重大,在医院专科建设中有较好的临床应用及推广价值。     

传染病临床研究信息系统的建立

目的:建立传染病临床研究信息系统,实现传染病临床研究的信息化管理.方法:按照FDA 21 CFR Part11规则,基于J2EE 技术、Struts三层体系架构以及Hibernate数据库技术,建立传染病临床研究信息系统.结果:开发了传染病临床研究信息系统,能够满足患者基本信息收集、病历管理、病情随访、目标数据挖掘及科研标本管理等多方面需求.结论:该信息系统满足传染病临床病例信息收集与科研的个性化需求,将显著增强传染病病例数据收集的效率和质量,为传染病临床与科研工作提供强有力的信息化保障.     

老年人中枢交感神经紧张性增加对心血管系统的影响

随着年龄的增加,中枢交感神经的紧张性增加,这会引起心血管系统的结构和功能有所改变,如四肢血流量减少、动脉血压调节发生改变、压力反射作用减弱、动脉管腔增厚以及心血管系统对肾上腺素受体的刺激反应性降低等。这些改变可能是在机体衰老过程中维持自身生理功能和机体稳态的重要代偿因素,同时也是促发老年人心血管疾病和代谢性疾病的危险因素。因此,研究老年人群交感神经的慢性紧张性增加对心血管系统的影响对进一步改善和提高老年人生活质量,治疗老年人疾病有着很大的意义。     

对心血管外科进修生的教学体会

为造福更多的心血管病患者,进一步提高治疗心血管疾病专业人才的质量,建立科学、健全的心血管外科进修生管理和培养模式很有必要。我科室通过总结多年的进修生教学经验,树立"双赢"理念,规范培训制度,实行导师负责制,实施PBL教学方式,进行多学科协作培训,定期对进修医生考核等方法措施,切实提高进修生的医疗水平,更好地为基层医院服务、为心血管病患者服务。     

美国《心血管技术质量评估指标的发展方法》解读

解读了美国心脏病学院基金会（ACCF）/美国心脏病协会（AHA）发布的《心血管技术质量评估指标的发展方法》的报告,重点概述了心血管技术质量指标的发展方法,以期借鉴国外先进医疗质量管理经验,在目前我国医疗质量指标体系尚不完善的情况下,创建并完善我国心血管技术的质量指标发展方法。     

转录中介体复合物在心血管发育和疾病中的转录调控作用

哺乳动物心血管系统发育过程中，各分子、细胞和组织器官形态发生过程的精细协调对于形成成熟且功能齐全的心血管系统是不可或缺的，这些过程出现异常通常会导致严重的先天性心血管发育缺陷。多细胞生物中细胞命运的决定和维持在很大程度上依赖于对RNA聚合酶Ⅱ (Pol Ⅱ)转录活性的时空精确调控，而转录中介体(Mediator)在Pol Ⅱ转录过程中起着重要的协同作用。Mediator是一种进化上保守的多亚基蛋白质复合体，包括头部、中部、尾部和激酶部四个部分，是转录因子和基础转录机器之间的功能联系的桥梁。近年来，鉴于Mediator在基因表达中的关键作用，越来越多的人类心血管疾病被证实与特定的Mediator基因突变相关，如心脏瓣膜缺陷、大动脉转位、DiGeorge综合征及一些与能量稳态失衡相关的心血管疾病。本文就Mediator在心血管系统发育和疾病中的作用进行综述，重点讨论Mediator对转录调控的影响在心血管疾病发生发展中的作用，旨在为与Mediator相关的心血管系统发育和疾病的研究提供广阔的研究思路。     

松弛素在心血管疾病中的研究进展

松弛素是一类新近发现可作用于心血管的肽类激素,参与心血管系统的生理和病理过程。大量实验研究显示松弛素有扩血管、改善心血管重塑及调节炎症反应的心血管保护作用,也有利于改善高凝状态和胰岛素抵抗。松弛素作用广泛,可与松弛素受体或糖皮质激素受体结合,但其受体后的确切机制以及不同生理和病理状态对松弛素的调控还需进一步基础研究阐明。在从实验室到临床应用转化的初期临床试验中可观察到,人重组松弛素治疗急慢性心力衰竭安全性好,可改善症状、血流动力学指标及近期预后,为Ⅲ期临床试验奠定了基础,其临床应用前景令人期待。     

国家级生物大数据中心展望

大数据时代下,科学大数据已经成为科技创新和社会经济发展的新动力。我国是生物数据生产大国,生命大数据是人口健康和国家安全的重要战略资源。面对我国生物数据因存储零散、缺乏系统监管而大量丢失和流失,以及严重依赖国际生物组学大数据中心的局面,亟需从国家层面建设我国自己的生命大数据保存和管理体系。本文以美国NCBI为例介绍了国际生物大数据中心的发展历程及现状,阐明我国建立国家级生物大数据中心的重要性、迫切性、当前历史机遇和发展前景。中国科学院北京基因组研究所生命与健康大数据中心为此做了大量努力,并在数据存储、汇交和转化应用上取得了阶段性成果,以期推进我国生物大数据中心的建设,提高生命科学研究的国际竞争力和影响力。     

Advances in growth hormone therapy: a new registry tool

Growth hormone (GH) deficiency is a rare condition, and physicians may lack clinical experience of its treatment. Despite evidence for the efficacy and tolerability of GH therapy, a substantial proportion of patients remain untreated. Registries and other large-scale databases are an important tool for expanding the evidence base for GH treatment. Since the mid-1980s, registries have provided data on important aspects of the safety and efficacy of GH treatment. Registries have also allowed pooling of data from patients with rare conditions that could otherwise not be recruited in sufficient numbers for clinical trials. Importantly for patients and their relatives, use of registry data has allowed the development of prediction models that indicate the likely outcomes of treatment. MEGHA (Metabolic Endocrinology and Growth Hormone Assessment) is a recently developed, observational database with a number of features not found in existing registries, including its use as a day-to-day clinical management tool, the ability to create individual sub-studies, direct comparison of personal data against the full database, and a particular focus on the transition from childhood to adulthood. This creative registry is a promising instrument for further research into GH-related disorders that will improve GH therapy and thus provide benefits for patients.     

Analyzing, Mapping, and Managing Environmental Impacts along Supply Chains

This article reports on research toward a pragmatic and credible means for analyzing, mapping, and managing environmental impacts along supply chains. The results of this research include a management tool called "ecological supply chain analysis" (EcoSCAn) that is presented here for the first time. Its structure bears a passing resemblance to that used in some streamlined life-cycle assessments, but its operation and purpose are quite different. The EcoSCAn tool frames a comparative environmental analysis of products capable of performing broadly equivalent functions. The analysis occurs over complete extended supply chains and within defined supply chain stages at a product level and, to some extent, at a site level. The results are mapped with data confidence indicators. A range of tactical and, where data quality is sufficient, strategic supply chain actions are prompted. Actions to mitigate environmental stress are possible in the absence of good quality data across entire product life cycles, although the extent to which management actions are limited is made plain.     

Measuring riparian condition: A comparison of assessments by landholders and scientists

Summary   To a large extent, the condition of riparian areas in Australia is determined by the management actions of private landholders. In this study, we discuss findings from our research in the Goulburn Broken Catchment comparing landholder and scientist assessments of the condition of riparian areas. We interviewed 33 landholders and undertook ecological condition assessments at 38 sites on privately managed river frontages. Using mail survey data that included landholder assessments of riparian condition, we were then able to compare landholder and scientist assessments. Despite substantial effort in this catchment to improve riparian condition, the riparian zones sampled were generally in poor condition. Landholder and scientist assessments of ecological condition showed a significant positive correlation. This indicated broad agreement, despite some substantial differences in assessment of some components of the condition score. Disparities between scientist and landholder assessments were related to the estimation of native ground cover, leaf litter cover and tree canopy continuity within riparian zones. The capacity of this simple assessment tool to differentiate varying levels of riparian zone degradation demonstrates the potential utility of mailed, self-assessment surveys to inform management programs and decisions about the allocation of resources for restoration efforts.     

Targeted quantitation of CVD-linked plasma proteins for biomarker verification and validation

Despite significant advances in treatment, cardiovascular disease (CVD) remains one of the leading causes of morbidity and mortality in developed and developing countries. Judicious monitoring of common risk factors has been unable to control this global epidemic, necessitating novel biomarkers for improved screening and earlier disease detection and management. Although numerous plasma proteins have been associated with CVD, only a few of these potential biomarkers have been validated for clinical use. Here we review the quantitative proteomic methods used to verify and validate new biomarker candidates in human plasma. These methods center on a bottom-up approach involving multiple or selected reaction monitoring, for targeted detection, with stable isotope-labeled standards, for peptide normalization. Also included are a discussion of future strategies for improved CVD protein biomarker verification and validation, recommendations for method translation to the clinic, and future projections for protein biomarker research.     

Evaluation of cardiovascular parameters in cynomolgus monkeys following IV administration of LBR-101, a monoclonal antibody against calcitonin gene-related peptide

Calcitonin gene-related peptide (CGRP) is a well-validated target for migraine therapy and a known potent systemic vasodilator. LBR-101 is a monoclonal antibody against CGRP in clinical development for the preventive treatment of episodic and chronic migraine. Understanding the hemodynamic and cardiovascular consequences of chronic CGRP inhibition is therefore warranted. Given the conservation in CGRP sequence between monkeys and humans, addressing this question in monkeys is ideal as it allows dosing at super-therapeutic levels. To this end, two independent studies were conducted in monkeys: a single dedicated cardiovascular safety study and a repeat-dose, chronic study, both with electrocardiogram and hemodynamic assessments. LBR-101 was very well tolerated in both studies, with no clinically significant changes noted in any hemodynamic parameter, nor any relevant changes noted in any ECG parameter. In cynomolgus monkeys, cardiovascular and hemodynamic parameters do not appear to be affected by long-term inhibition of CGRP with LBR-101.     

Evaluation of cardiovascular parameters in cynomolgus monkeys following IV administration of LBR-101, a monoclonal antibody against calcitonin gene-related peptide

Calcitonin gene-related peptide (CGRP) is a well-validated target for migraine therapy and a known potent systemic vasodilator. LBR-101 is a monoclonal antibody against CGRP in clinical development for the preventive treatment of episodic and chronic migraine. Understanding the hemodynamic and cardiovascular consequences of chronic CGRP inhibition is therefore warranted. Given the conservation in CGRP sequence between monkeys and humans, addressing this question in monkeys is ideal as it allows dosing at super-therapeutic levels. To this end, two independent studies were conducted in monkeys: a single dedicated cardiovascular safety study and a repeat-dose, chronic study, both with electrocardiogram and hemodynamic assessments. LBR-101 was very well tolerated in both studies, with no clinically significant changes noted in any hemodynamic parameter, nor any relevant changes noted in any ECG parameter. In cynomolgus monkeys, cardiovascular and hemodynamic parameters do not appear to be affected by long-term inhibition of CGRP with LBR-101.     

北京市心血管介入质量控制和改进中心管理模式探讨

通过对北京市心血管介入质量控制和改进中心成立1年来的运行状况进行分析,总结了质控中心在管理方面取得的经验和存在的问题,认为医疗专业质控中心应该着眼于本专业特点,制定有效、合理的质控管理模式,以质控管理促进专业的长期发展和技术进步。     

Animal- and human-based evidence for the protective effects of stem cell therapy against cardiovascular disorders

The increasing rate of mortality and morbidity because of cardiac diseases has called for efficient therapeutic needs. With the advancement in cell-based therapies, stem cells are abundantly studied in this area. Nearly, all sources of stem cells are experimented to treat cardiac injuries. Tissue engineering has also backed this technique by providing an advantageous platform to improve stem cell therapy. After in vitro studies, primary treatment-based research studies comprise small and large animal studies. Furthermore, these studies are implemented in human models in the form of clinical trials. Purpose of this review is to highlight the animal- and human-based studies, exploiting various stem cell sources, to treat cardiovascular disorders.     

构建医疗质量决策平台 促进精细化管理

信息技术为医院全面质量管理提供了巨大支持。本文通过建立医疗质量决策平台对医院终末质量管理进行提升。利用来自各环节医疗活动的数据,通过融合、加工、分析,获得医疗质量相关指标,并通过图形化报表工具进行展现,为医疗质量控制和精细化管理提供了决策依据。