基于视联网的远程门诊系统应用探讨

远程门诊可拓展远程医疗服务范围和服务内容,将成为未来远程医疗发展的一种新型服务模式。文章介绍了远程门诊的概念和发展现状,分析了基于视联网技术的远程门诊系统框架和业务流程,探讨了基于视联网的远程门诊系统在远程门诊诊疗、门诊检查和门诊咨询等方面的应用及未来发展前景。     

国内临床医师绩效分配模式的现状、不足与对策

科学构建和优化医师绩效分配模式,着力体现医务人员技术劳务价值,关注医疗服务内涵,对有效调动医务人员工作积极性、提高公立医院运营效率和精细化管理水平有着重要意义。通过广泛文献研究,系统分析了我国目前公立医院绩效分配模式现状及存在的不足,同时针对存在的主要问题提出了相应的对策建议。     

试析围手术期安全管理的切入点

通过建立信息技术控制体系和JCI标准下管理制度保障体系,不断优化工作流程,强化质量监控部门管理职能,定期开展临床技能培训,能够实现围手术期患者安全目标。     

上海市临床医师对基因技术与生命伦理的认知

上海市公立医院临床医师对基因技术与生命伦理的认知调查显示,临床医师对基因技术的优势与风险有一定的认知,但认知差异较大,需要对临床医师加强生命伦理的培训,加强基因相关法规的建设。     

影响上海市临床医师对基因技术与生命伦理认知的因素

通过上海市临床医师问卷调查,应用Logistic模型分析临床医师对基因技术与生命伦理认知的影响因素。结果显示,临床医师的性别、年龄、学历和职称等人口学因素主要影响对基因技术优势的认知,基因工作经历、伦理委员会任职经历、对伦理与相关法规的知晓度主要影响对基因技术风险的认知。建议加强基因伦理与相关法规教育,重视部属或市属综合性医院基因技术研究与应用的管理。     

质量控制在病案管理工作中的应用效果分析

目的 通过建立病案质控部门,提高病案管理工作的质量和效率。通过对医院17个科室的病历质控前与质控后的工作效果分析,强调质控工作在病案管理中的重要性。方法 医院对17个科室病历的终末质量进行控制,主要采用对比法与描述统计学方法对质控前与指控后的病案质量进行质控工作的效果分析。结果 通过在病案管理中加入质量控制,病案质量得到显著提高,甲级病案率显著上升,乙级病案率下降,无丙级病案,病案书写中的具体问题也得到改善。结论 病案质控对病案质量提升有显著成效。     

军队传染病医院援外防控埃博拉疫情的工作与启示

2014年9—11月,解放军第302医院派遣一支由30人组成的医疗队赴西非塞拉利昂执行抗击埃博拉疫情的任务,在2个月的时间里,依托当地医院改建成了留观中心,收治埃博拉疑似患者274例,对塞拉利昂疫情防控起到了重要作用,实现了中塞双方工作人员“零感染”,圆满完成了国家和军队赋予的任务。通过归纳总结在人员抽组、培训,医疗后勤物资准备,医疗队选址及改造,规章制度建设,工作人员管理等方面的经验,为今后疫情防控工作提供指导。     

Concepts of taxonomy and concepts of biodiversity: the problem of interaction

There is, or there should be, an interaction between concepts of taxonomy and biodiversity. On the one hand, taxonomy develops some general and particular classificatory paradigms, which own diversity is to be taken into account to understand the nature of variety of natural kinds. On the other hand, analysis of the properties of biodiversity may put forward nontrivial problems for taxonomy that cannot be deduced directly from its own statements. From the point view of taxonomy, it is argued that the current concept of biodiversity based entirely on the species concept is deeply rooted in reductionistic view of nature. It is outdated epistemologically and should be replaced by the modern taxonomic concept of the hierarchical phylogenetic pattern. Operationally, the latter presumes a possibility for each species to be assigned a certain "phylogenetic weight", according to its phylogenetic uniqueness. From the point view of biodiversity, it is argued that the global biodiversity is a three component entity, as it includes, in addition to phylogenetic and ecological hierarchies, a biomorphic hierarchy, as well. This calls for taxonomy to elaborate the general principles of classification of biomorphs.     

Kullback-Leibler Markov chain Monte Carlo--a new algorithm for finite mixture analysis and its application to gene expression data

In this paper, we study Bayesian analysis of nonlinear hierarchical mixture models with a finite but unknown number of components. Our approach is based on Markov chain Monte Carlo (MCMC) methods. One of the applications of our method is directed to the clustering problem in gene expression analysis. From a mathematical and statistical point of view, we discuss the following topics: theoretical and practical convergence problems of the MCMC method; determination of the number of components in the mixture; and computational problems associated with likelihood calculations. In the existing literature, these problems have mainly been addressed in the linear case. One of the main contributions of this paper is developing a method for the nonlinear case. Our approach is based on a combination of methods including Gibbs sampling, random permutation sampling, birth-death MCMC, and Kullback-Leibler distance.     

Certain problems of the taxonomy of monogeneans of the order Dactylogyridea (Platyhelminthes: Monogenea)

Different taxonomic problems of the Dactylogyridea Bychowsky, 1937 are discussed. From the recent point of view, all old genera need a careful revision. Taxa of higher ranks should be analysed taking into account their host phylogeny and zoogeography. The order Tetraonchidea Bychovsky should be disband and all its families should be moved to the Dactylogyridea. The aberrant families Montchadskyellidae and Anoplodiscidae also belong to the Dactylogyridea. Dactylogyrideans are most similar to the primitive monogeneans.     

Boundary conditions at the cartilage-synovial fluid interface for joint lubrication and theoretical verifications

The objective of this study is to establish and verify the set of boundary conditions at the interface between a biphasic mixture (articular cartilage) and a Newtonian or non-Newtonian fluid (synovial fluid) such that a set of well-posed mathematical problems may be formulated to investigate joint lubrication problems. A "pseudo-no-slip" kinematic boundary condition is proposed based upon the principle that the conditions at the interface between mixtures or mixtures and fluids must reduce to those boundary conditions in single phase continuum mechanics. From this proposed kinematic boundary condition, and balances of mass, momentum and energy, the boundary conditions at the interface between a biphasic mixture and a Newtonian or non-Newtonian fluid are mathematically derived. Based upon these general results, the appropriate boundary conditions needed in modeling the cartilage-synovial fluid-cartilage lubrication problem are deduced. For two simple cases where a Newtonian viscous fluid is forced to flow (with imposed Couette or Poiseuille flow conditions) over a porous-permeable biphasic material of relatively low permeability, the well known empirical Taylor slip condition may be derived using matched asymptotic analysis of the boundary layer at the interface.     

Eccentric driving of a Rijlant's network (author's transl)]

As far as the central terminal does not interfere with the dipolar equivalent of the driving system, the zero isopotential line reaches the boundary of the network. Besides, if the emission level is at least five resistive layers "away" from the detection points, the proximity effects vanish. In these conditions the potential information available at the boundary becomes proper to be handled by the Gabor & Nelson's method. Calculating the location of the dipole leads to a fraction of the maximal "dimension" of the structure so that it directly expresses the eccentricity. The latter value may be compared with the corresponding one which is determined by the injection axis relative to the dodecahedral disposition of the connexions. From such quantitative comparisons, we conclude that an eccentricity simulating that of the heart in the thorax requires that the injection remains at least ten resistive layers "away" from the boundary if we want to view the generator through VCG leads which does not appreciably distort it.     

Physico-chemical and biological analysis of true combinatorial libraries

Combinatorial libraries offer new sources of compounds for the research of pharmacological agents such as receptor ligands, enzyme inhibitors or substrates and antibody-binding epitopes. The present review stresses the main roles played by both physico-chemical analysis, particularly when complex mixture of compounds are synthesized as libraries, and biological analysis from which active compounds are identified. After a brief discussion of semantic problems related to the designation of the product mixtures, the physico-chemical analysis of mixtures is reviewed with special emphasis on mass spectrometric techniques. These methods are able both to give a representative view of a library composition and to identify single critical compounds in large libraries. Then the biological screening of such combinatorial libraries is critically discussed with respect to the power and limitations of the methods used for the identification of the active components. Special attention is given to the complex process of library deconvolution. It is pointed out that while combinatorial techniques have evolved towards sophisticated high-tech methods, simple and robust biochemical tests should be used to deconvolute. From a large panel of published examples, a set of trends are identified which should help investigators to choose the most appropriate assay for the discovery of new entities.     

Material cycling and organic evolution

Intertwined cycles of matters are proposed to be one of the essential characteristics of life. The increase in the amount of recycled matters within biological groups and the complication of the cycling network are considered to be the early development of life soon after its appearance on the Earth. From this point of view, the origin of a cell alone can not sufficiently be regarded as the origin of life. The origin of a cell must be followed by a formation of material cycling among cells, if the cells are to stay on the Earth long enough so that they could be called life.This biogeochemical viewpoint leads to a quantitative analysis of life activity. A formula is presented to exemplify the potential utility of the viewpoint. It is applied to analyses of possible early developments of life and of an impact of present human activity on the global carbon cycle. Further application of the viewpoint to a variety of biogeochemical, sociogeochemical, ecological, and environmental problems should eventually show whether there is some utility in this view.     

Acritarchs,miospores and correlation of the Ludlovian-Downtonian and Silurian-Devonian boundaries

An attempt is made to use palynomorphs to correlate the Ludlovian-Downtonian and the Silurian-Devonian boudaries in successions from the British Isles, Estonia, Podolia and north Africa. Miospores are found to be of most use for this purpose: (a) the micronatus-newportensis zone can be recognised in the Anglo-Welsh area, in Podolia and in north Africa, and the base of this zone indicates a level above, but close to, the Silurian-Devonian boundary; (b) the Ludlovian-Downtonian boundary is well-defined in the Anglo-Welsh area on the basis of miospores and can be determined approximately in north Africa and Estonia since several miospore species appear at or close to this boundary. The lack of stratigraphically important acritarch and miospore species in the Silurian-Devonian stratotype at Klonk (Czechoslovakia) underlines the importance of the Podolian sequence for the recognition of the Silurian-Devonian boundary in continental sequences. Recognition of the Ludlovian-Downtonian boundary in Podolia is difficult since the miospores below the Borschov Horizon have not been systematically described and are probably rare. Further, there are difficulties in using acritarchs for interregional correlation since they appear to be considerably influenced by provinciality and local environmental factors. From the palynological point of view therefore the Ludlovian-Downtonian boundary should be chosen from a sequence in which miospores are common, since one based on acritarchs would involve two stratotypes, one from the Deunffia-Domasia, and one from the carminae, realms. Finally, some features of current palinspastic continental plate reconstructions are discussed in the light of acritarch provinciality.     

关于节肢动物系统分类与进化的分子佐证

从分子系统学方面就了肢动物系统进化及高级阶元分类研究中争论的关键问题进行比较分析。综述了该领域所取得的新进展,着重从分子水平来探讨节肢动物的起源与进化。