具有强大功能的OrCAD Capture CIS软件

OrCAD Capture CIS软件集成了具有器件信息系统(Component Information System,简称CIS)的OrCAD Capture原理图设计应用功能。该软件的设计着重考虑了降低花在查询现有重复采用的器件上面的时间,以及减少手工登记元器件的信息内容和元器件数据库的维护。对元器件的查询是基于它们所拥有的电性能参数,通过采用OrCAD Capture CIS软件可以自动地检索相关联的器件情况。

房地产业运用 CIS 理论的对策

强调ＣＩＳ理论的核心是ＭＩ，ＢＩ，指出房地产业运用的对策应是：强化ＭＩ的宣传和研究；遵循以人为本的原则塑造ＢＩ；ＶＩ设计要紧密围绕ＭＩ，ＢＩ展开．

Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis out

AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.

Using Geographic Information Systems (GIS) for Targeted National Recruitment of Community-Dwelling Caregivers Managing Dementia-Related Behavioral and Psychological Symptoms: A Recruitment Approach for a Randomized Clinical Trial

Over 16 million caregivers of people living with dementia require support in a range of issues, including self-care, disease education, and guidance for how to manage behavioral and psychological symptoms of dementia (BPSD). Non-pharmacological interventions are needed to address these areas, and online applications have been shown to be safe and effective. To ensure the efficacy of such interventions, racially, ethnically, geographically, and socioeconomically diverse participants must be recruited to increase the generalizability of study outcomes. This protocol paper describes a recruitment plan using Geographic Information Systems (GIS) to reach a representative sample of caregivers across the United States for a national Phase III clinical study. Using publicly available census data from the American Community Survey (ACS), combined with location data for local aging resources such as Area Agencies on Aging (AAA), recruitment will be derived from data analysis conducted in ESRI ArcGIS v10.7.1. Datasets including age, gender, income, and education will be assessed nationally at the county and census tract spatial scale in a nine-step process to develop recruitment priority areas containing high concentrations of eligible participants living in the community. Overall, the current protocol will demonstrate the value of GIS in tailoring targeted outreach strategies to recruit community-dwelling populations through local resource institutions. This novel approach may have far-reaching implications in future recruitment initiatives and help to secure racially/ethnically diverse samples.

Study on Clinical Thinking of Traditional Chinese Medicine Based on Wang Yongyan＇s MedicalRecord Information System

Medical record information system engineering technology is used to set professor Wang Yongyan5s medical record as the master system, and model the disease, syndrome, treatment and prescription. According to the experience of doctors, we will combine them according to the procedure of ＂problem-solution＂, to study Professor Wang＇s treatment experience and his clinical thinking.

MANAGEMENT OF SPATIO-TEMPORAL DATA OF CADASTRAL INFORMATION SYSTEM IN CHINA

Cadastral Information System (CIS) is designed for the office automation of cadastral management. With the development of the market economics in China, cadastral management is facing many new problems. The most crucial one is the temporal problem in cadastral management. That is, CIS must consider both spatial data and temporal data. This paper reviews the situation of the current CIS and provides a method to manage the spatiotemporal data of CIS, and takes the CIS for Guangdong Province as an example to explain how to realize it in practice.

Clinical decision support for drug related events: Moving towards better prevention

Clinical decision support(CDS) systems with automated alerts integrated into electronic medical records demonstrate efficacy for detecting medication errors(ME) and adverse drug events(ADEs). Critically ill patients are at increased risk for ME, ADEs and serious negative outcomes related to these events. Capitalizing on CDS to detect ME and prevent adverse drug related events has the potential to improve patient outcomes. The key to an effective medication safety surveillance system incorporating CDS is advancing the signals for alerts by using trajectory analyses to predict clinical events, instead of waiting for these events to occur. Additionally, incorporating cutting-edge biomarkers into alert knowledge in an effort to identify the need to adjust medication therapy portending harm will advance the current state of CDS. CDS can be taken a step further to identify drug related physiological events, which are less commonly included in surveillance systems. Predictive models for adverse events that combine patient factors with laboratory values and biomarkers are being established and these models can be the foundation for individualized CDS alerts to prevent impending ADEs.

On information field of clinical diagnosis

“Field” is a universal phenomenon existing in both nature and society, and determines the existence and significance of all materials or information. The man being has always been generating and carrying a large quantity of life information in his whole life. Each piece of life information has an independent information field. The life information field includes such three subfields as bioinformation field, psychoinformation field and psycho-bioinformation field. The clinical diagnosis information field which is a specific information field within the information field of human activities consists of all information concerning man’s health. Only after we have cognized and ascertained the clinic diagnosis information field, can we accurately utilize its function to serve the human being.

Problems and Instruction Needed in Relation to Nursing Students’ Handling of Patient Information—From a Survey of Nurses Coordinating Clinical Practicums in Japan

The purpose of this study was to clarify and consider the instruction that is needed in relation to nursing students’ handling of patient information, as felt by the people in charge of student clinical practicums in hospitals. Semi-structured interviews were conducted with 7 people in charge of organizing practicums at hospitals where they are carried out. These subjects were asked about problems they had experienced in relation to nursing students’ handling of patient information and the instruction that is needed so that problems related to nursing students’ handling of information do not occur. Various problems were shown to occur in relation to nursing students’ handling of patient information, such as handling the information outside of the practicum setting. Many students receive no instruction with regard to the ethics of handling patient information in their classroom work, and their awareness regarding information is cannot be considered high, indicating the need for more consistent and reliable education in this area. The findings also suggest that instruction is needed with regard to the handling of sensitive information in accordance with the circumstances of individual patients.

Epidemiological, Clinical, and Therapeutic Characteristics of Acute Appendicitis at the Reference Health Center in Commune I of the District of Bamako Mali

Acute appendicitis is the most common abdominal surgical emergency. This work is a prospective study from January 2012 to December to analyze the epidemiological, clinical and therapeutic aspects of acute appendicitis in the Cs ref of commune I of the district of Bamako and the results obtained were then compared with those reported in other countries. Our study included 72 patients. The appendectomy surgical specimens were the subject of an anatomical pathology study at Point G University Hospital in Bamako in Mali, 1.4% of cases of which were healthy. All our operated patients received antibiotics (mono or dual antibiotics) with a post-operative hospitalization duration of 1.5 (36 hours) days on average. We recorded 6 complications such as parietal suppuration, i.e. 8.33% of cases. No 5th day syndrome or late complications were noted. The average length of hospitalization was 36 hours. Abdominal ultrasound;used as an additional examination was carried out in 55 of our patients or 76.39% of cases. We have not recorded any deaths. Raising awareness among patients about the dangers of complications motivated patients to undergo surgery as soon as possible.

肠造口患者临床护理路径护理信息系统的设计与应用

目的:构建基于临床护理路径的肠造口患者护理信息系统,并分析其应用效果,为临床提升造口患者生活质量提供参考。方法:采用文献分析、小组会议法构建肠造口患者临床护理路径,将其嵌入护理信息系统,并于2023年2月在我院普通外科应用。对比系统应用前后肠造口患者入院评估、风险评估、健康教育、疼痛评估、出院评估的完成率及造口自我护理能力,同时调查护士对临床护理路径信息系统的满意度。结果:应用系统后,干预组肠造口患者的入院评估率(100.0%)、风险评估率(94.5%)、健康教育率(100.0%)、疼痛评估率(96.4%)、出院评估率(100.0%)均较系统应用前提高,差异有统计学意义(P<0.05);患者的造口自我护理能力各条目中除使用必要的辅助产品外均有提高,差异有统计学意义(P<0.05),护士的满意度大于90.0%。结论:应用肠造口患者临床护理路径护理信息系统能够有效提高护理措施的落实率,提升肠造口患者的自我护理能力,增进护士对工作的满意度,进而改善患者生活质量。

常规出凝血检验自动审核规则的建立与验证

目的:建立常规出凝血检验项目结果自动审核规则,为临床实验室提高检验结果审核质量和效率提供参考。方法:收集2020年1-3月期间解放军总医院第一医学中心等8家医院检验科的24510份枸橼酸钠抗凝常规出凝血检测标本,根据随机抽样法将其分为规则建立组和规则验证组,规则建立组血标本6670份,其中差值检查2056份;规则验证组血标本17840份,其中差值检查3210份。使用StagoSTARMax全自动血凝分析仪及配套试剂检测凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、凝血酶时间(TT)、D-二聚体(DD)和(或)抗凝血酶(AT)活性。以人工审核结果为标准,计算两组自动审核与人工假阴性率(无效审核)、假阳性率(无效拦截)、通过率、阳性符合率、阴性符合率、审核一致率和标本周转时间(TAT)。结果:建立的自动审核规则及规则应用流程,涉及室内质量控制、报警信息、自动审核范围、危急值和差值检查。规则建立组单个项目通过率为82.6%~92.4%,总体通过率为73.8%,自动审核与人工审核结果一致率为98.2%,阳性符合率和阴性符合率分别为24.4%和73.8%。规则验证组单个项目通过率为86.4%~91.5%,总体审核通过率为71.5%。模拟应用自动审核规则,8家医院中两家医院单位的平均TAT分别缩短1.5 h和2.1 h。结论:应用常规出凝血自动审核规则能够使人工审核工作量减少,明显缩短TAT,提高实验室工作效率。

临床护理教师教学能力与护理信息能力及循证实践能力关系模型的研究

目的:分析临床护理教师的教学能力、护理信息能力及循证实践能力的现状,明确三者的关系,为提高临床护理教师教学能力提供参考。方法:采用方便抽样法,于2022年10月至2024年3月在广东省5个城市15家三级医院选取具有本科生带教经验的740名临床护理教师作为研究对象。用一般资料调查表、护理信息能力量表、中文版循证实践能力评估量表及护理本科生临床带教老师教学能力问卷进行调查,运用Person相关分析和结构方程模型进行数据分析。结果:临床护理教师护理信息能力、循证实践能力及教学能力条目均分分别为(3.60±0.55)分、(3.16±0.74)分、(3.05±0.58)分,护理信息能力对教学能力具有直接效应(β=0.368,P<0.05);循证实践能力对教学能力有直接效应(β=0.590,P<0.05);护理信息能力可以通过循证实践能力间接影响教学能力(β=0.238,P<0.05)。结论:临床护理教师护理信息能力、循证实践能力处于中等水平,护理管理者应采取多项措施提升临床护理教师护理信息能力、循证实践能力,进而提高临床护理教师教学能力。

基于临床需求的重症医学临床信息系统设计与应用

目的针对急诊重症患者临床管理需求,构建重症医学临床信息系统,并对其临床应用效果进行评价。方法系统以临床需求为导向,采用面向服务架构设计,服务端和客户端之间松耦合,并采用有线无线深度融合的网络架构,实现了多系统信息共享、病情数据自动采集记录和信息可视化等功能。选择系统应用前后各100例患者的病历资料对系统应用效果进行分析评价。结果重症医学临床信息系统应用后,各类医疗文书处理耗时和患者ICU入住时长均显著缩短(P<0.05);医护人员满意度显著提升(P<0.05)。结论基于临床需求构建的重症医学临床信息系统可提高临床管理效率,对提升临床管理和治疗质量有积极意义;系统的开发与应用也为各类医疗信息系统的建设工作提供了参考。

基于信息平台的发热门诊就诊模式优化实践

通过医院信息化建设整合患者诊疗数据,并用于智能服务设备、信息自动采集、信息区域共享。实现基于医院信息平台的发热门诊就诊模式,优化资源配置,减少患者候诊时长,提高患者满意度,同时强化发热门诊在新型病毒监测方面的哨点作用。该模式为发热门诊的整体诊疗流程提供了有力的支持,在改善患者就医体验、节约医院成本、院感防控方面均具有一定意义。

中医馆健康信息平台应用现状与思考

本文基于中医馆健康信息平台应用现场调研和问卷调研结果,发现中医馆健康信息平台推广应用过程中存在后续经费投入不足、与医院信息系统对接困难等一系列问题。笔者基于调研结果,就如何更好地推广应用中医馆健康信息平台提出相关建议,以期更有效地提升基层中医馆信息化水平和诊疗能力。

系统辨证脉学对《黄帝内经》脉诊命题的继承创新

系统辨证脉学遵循《黄帝内经》脉诊“可诊有过之脉”原则建立脉象信息系统,对传统脉诊定义模糊及歧义之处进行明晰,完善了脉诊信息采集的维度,形成了5个维度、25对脉象要素信息描述系统。遵循《黄帝内经》“凡诊者,必知终始”,建立脉象分析系统,依据脉象要素与机体状态的映射关系,耦合形成脉象系统。脉象系统包括体质、病因、病机、西医疾病等,各个脉象系统通过脉象要素之间的联系能够反映疾病过程中的重要节点、责任因素及内在动力学,即中医临床脉诊的“心智模型”。在脉象系统的指导下,能够灵活、准确地制定临床治疗原则,形成内在逻辑严密的临床综合治疗服务包,实现多层次、多维度指导下的综合治疗。

CIM/CIS互操作细则在多级电网调度中的应用

IEC61970/IEC61968系列标准的制定为电网调度自动化系统之间的互操作提供了标准。给出了基于IEC61970/IEC61968制定的公共信息模型(CIM)/组件接口规范(CIS)互操作细则,包括明确规定系统间交换涉及的模式、使用的接口方法和涵盖图元细化定义的图形交换规范,以及基于互操作细则的调度自动化模型互导、拆分和合并。细则的定义消除了标准应用的理解偏差,其有效实施对电网调度自动化系统的建设、维护和升级,以及各级电网调度自动化系统模型共享、信息共用起到促进作用。

住院受试者临床试验费用区隔方法探讨与实践

目的探讨如何通过信息化建设实现住院受试者临床试验费用与普通医疗费用的隔离。方法通过分析当前医疗机构多种区隔临床试验费用的方法及其优缺点,认为在不占用医疗保险(医保)基金的同时保证受试者正常享受医保报销的权益是各种方法应遵循的共同原则。基于住院医生工作站开发一种临床试验费用区隔信息模块。结果通过该模块,受试者可以根据实际医疗情况选择就医身份,研究医生可根据正常医疗或试验需求在医院信息系统(HIS)中开立医嘱,通过增删临床试验标记改变医嘱性质,系统自动拦截临床试验医嘱进行医保报销,其他费用按医保规则正常报销。结论该区隔模块能够降低受试者垫付临床试验费用的经济负担和保障其享受医保报销的权益,提高受试者参加试验的积极性、依从性,可为新备案的机构提供参考。

临床试验中实现受试者诊疗过程信息化管理的探索与实践

目的探索临床试验开展过程中对受试者诊疗过程的信息化管理方法,提升临床试验效率及质量,确保临床试验的开展符合现行版《药物临床试验质量管理规范》。方法2021年起,笔者在海南省人民医院医院信息系统(HIS)中对临床常规诊疗流程根据临床试验开展需求进行功能改造,探索实践内容包括建立临床试验集中随访诊区模块、项目字典库及对应的记账结算方式、研究者及受试者信息关联试验项目、专用电子病历模板、自动生成相应查询报表等。结果实现受试者在就诊随访中相关诊疗医嘱的信息化开具、执行及结算,并与普通诊疗相关医嘱区分。结论通过实践临床试验相关诊疗操作的信息化管理,解决由于多科室合作、多人员参与、多项目并举的特点带来的诸多困难,使管理流程更加规范,推动临床试验的合规高效实施。