Clinical Evaluation of Two Interferon-Gamma Release Assays for Diagnostic Tests of Tuberculosis Infection in a Tertiary Hospital: Clinical Evaluation of Two IGRAs for TB Infection

Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) infection as supportive methods for diagnosing TB. Patients and Methods: The subjects consisted of 45 patients who required clinical differentiation of TB disease from June 2019 to August 2023. The final clinical diagnoses were: 14 patients with active TB disease, 4 with latent TB infection (LTBI), 17 with old (cured) TB disease, and 10 with pulmonary nontuberculous mycobacterial (NTM) disease. We used the two IGRAs for these patients and evaluated the data according to the manufacturer’s guidelines for interpretation or FDA-approved cutoffs. Results: Among the total of 14 patients with active TB disease (mean age: 64 years old, male: 9, and female: 5), a positive response was noted in 10 patients (71%) on QFT-plus and 9 (64%) on T-SPOT.TB. Four patients with a negative response on QFT-plus and T-SPOT.TB were elderly or cancer patients with lymphocytopenia or hypoalbuminemia. All four patients with LTBI showed a positive response (100%) on both QFT-plus and T-SPOT.TB. Among the seventeen patients with old (cured) TB disease, a positive response was noted in 8 patients (47%) on QFT-plus and 9 (53%) on T-SPOT.TB. All patients with pulmonary NTM disease showed a negative response on both QFT-plus and T-SPOT.TB. Conclusions: A false-negative response on QFT-plus as well as T-SPOT.TB was recognized in elderly patients and patients with an immunosuppressed condition, and half of patients with old (cured) TB showed no negative conversion after the completion of treatment through this study. Although it was recently reported that the positive response rate on QFT-plus of patients with active TB disease was high, we consider it necessary to be careful in diagnosing TB infection using IGRAs for patients with severe underlying diseases in a tertiary hospital based on the results.

Nosocomial Infection Surveillance in a Tuberculosis Specialized Hospital in China

Nosocomial infections（NIs） are a critical issue affecting the quality of healthcare. In this study, we performed a retrospective study to explore the incidence rates, mortality rates, and microbial spectrum of NIs in Beijing Chest Hospital, a tuberculosis（TB） specialized hospital in China. Our data demonstrate that the overall incidence rate of inpatients with NIs slightly decreased from 2012 to 2016, which may be associated with the implementation of hand hygiene measures, while the mortality rates associated with NI did not significantly change. In addition, the species distribution of NIs was quite different from that presented in previous reports, and Klebsiella pneumoniae was the most frequently isolated microorganism.

Exploration of Infection Prevention and Control Practice of Designated Hospitals in During Corona Virus Disease 2019 Epidemic Period

Corona Virus Disease 2019(COVID-19)is a new infectious disease that appeared in whan in December 2019 Since January23,the national health and fitmess commission has required hospitals to be designated in accordance with the principle of"concentrating patients,experts,resources and treatment".Designated hospitals are often the strength of the general hospital and general hospital complex layers of various kinds of personnel,campus area is large,multi-channel,ordinary outpatient accepts people more,for emergency and severe cases treatment in patients with normal difficulty pressuure big,suspected/confirmed cases,combined with the COVID-19 occurred when the traditional holiday,the country launched the emergency response since,process reform faces a difficult labor,shortage of mampower,protective shortages,short time limit,and many other difficulties,hospital infection prevention and control is facing unprecedented pressure.In this paper,the West China-Guang'an Hospital,Sichuan University(Guang'an people's hospital)as a designated hospital,on the basis of the relevant scheme of the national health committee,epidemic prevention and control of the actual,combined with comprehensive hospital leadership,mampower allocation,protection,security,patient management,disinfection isolation,preview triage,preventive measures,training,monitoring,etc.,with practical experience summary for the COVID-19 diring the hospital infection prevention and control to improve the practice exploration.

Pulmonary and Extra-Pulmonary Tuberculosis: Epidemiological and Diagnostic Aspects at Sominé DOLO Hospital in Mopti

Despite the efforts made to fight the tuberculosis, Mycobacterium tuberculosis still remains a public health problem, particularly for low-income countries. According to the World Health Organization data, our country, Mali has detected only half of the 10,385 cases of tuberculosis expected for 2014 for a population of 17,309,000 inhabitants. The objective of this present work was to describe the different clinical aspects and the epidemiology of tuberculosis at Hospital Sominé Dolo in Mopti. We performed a retro-prospective and descriptive of tuberculosis cases diagnosed in our department of medicine between May 2016 and August 2018. A total of 96 tuberculosis cases were recorded, i.e. 4.6% and 1.0% for hospitalizations and consultations patterns, respectively. The median of age was 41 with extremes from 5 to 80 years. The age group [31 - 40 years] was the most affected with 20.8%. Men and women were affected in identical proportions, i.e. 50%. Pulmonary locations were the most frequent with 55.2%. Pleural tuberculosis was far the most frequent of the extra-pulmonary forms with 24.0% followed by the peritoneal and bone localization with 6.3% each. The majority of patients were followed on an outpatient basis, i.e. 90.6%. The disease lethality was 7.3%. Our data show that the cases of extra-pulmonary tuberculosis are in an increasing proportion and their diagnosis confirmation remains difficult in our context.

Study of Tuberculosis in Children Aged 1 Month to 15 Years in the Pediatric Ward of the Hospital of Mali 2015-2021

Introduction: In 2020, an estimated 9.9 million people are living with tuberculosis worldwide, including 1.1 million children. Tuberculosis is the 2nd leading cause of death from infectious disease after COVID-19 and the 13th leading cause of death worldwide. Objective: To collect cases of tuberculosis in children aged 1 month to 15 years in order to study the epidemio-clinical aspects in the pediatric department of the Mali Hospital during the period 2015-2021. Materials and Methods: This was a descriptive, retrospective study from January 1, 2015, to December 31, 2020, and a prospective study from January 1 to December 31, 2021, among children aged 1 month to 15 years admitted for suspected tuberculosis in the pediatric ward of the Mali Hospital. Results: From January 2015 to December 2021, we collected 69 cases of tuberculosis among 9438 hospitalized children, i.e. a frequency of 0.73%. The average age was 6.16 years with extremes of 3 months and 15 years. The sex ratio was 1.1% in favor of boys. The majority of children were vaccinated against tuberculosis (88.4%). The most frequent symptoms were fever (76.8%) and weight loss (73.9%). The pulmonary form was the most frequent (54.9%). Bacteriological confirmation was done in 43.5% of our children. It was Mycobacterium tuberculosis in all confirmed cases. More than half of our children (65.2%) were treated with first-line anti-tuberculosis drugs for 6 months. We observed a cure in 42.0% of our patients and a case fatality rate of 39.1%. Conclusion: Tuberculosis in children is frequent in Mali Hospital despite good BCG vaccination coverage. Its mortality remains high and is maintained by malnutrition, HIV, and the emergence of resistant strains of bacilli.

Characterization of Defaulters from Tuberculosis Treatment in a Tertiary Hospital in South Eastern Nigeria

Background: Tuberculosis is second only to HIV/AIDS as the greatest killer worldwide, due to a single infectious agent. Directly Observed Treatment Short-Course (DOTS) is presently the WHO recommended programme to fight tuberculosis worldwide. There is a need to understand the characteristics of patients who default from treatment for tuberculosis. This will help modify the strategies to reduce such default to the barest minimum and achieve higher levels of adherence. Objective: The aim of this study was to describe the characteristics of patients that defaulted from treatment for TB at Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi DOTS clinic for the period 1st January 2011 to 31st December 2012. Materials and Methods: This was a retrospective study conducted at the DOTS clinic at Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. The records of patients who received treatment from the clinic from 1st January 2011 to 31st December 2012 (2 years) were reviewed. The data collected include patients’ demographic characteristics, treatment category, patient type, baseline sputum smear result, and retroviral status. From the data, default rate was calculated and its relationship with other variables noted. Associations between patients’ characteristics were determined using chi square test of independence. The significance level was set at p = 0.05. Results: A total of 765 patients enrolled for TB treatment in the DOTS clinic of the study area within the study period of 1st January 2011 and December 31st 2012. The mean age at commencement of the treatment was 33.14 years (±18.09). The outcome of treatment showed that 260 (34%) had treatment completed, 230 (30.1%) cured, 120 (15.7%) defaulted, 103 (13.5%) died, 40 (5.2%) were transferred-out, and 12 (1.6%) failed in the treatment, giving a treatment success rate of 64.1%. Among the 120 (15.7%) patients that defaulted from treatment, majority 80 (66.7%) were males, and most 30 (25.0%) were in the 30 - 39 years age group. Conclusion: Defaulting starts with treatment interruption hence prompt management of interruption of treatment and default will largely help in preventing drug-resistant TB.

Structure-based design,synthesis of novel inhibitors of Mycobacterium tuberculosis FabH as potential anti-tuberculosis agents

Mycobacterium tuberculosis FabH, an essential enzyme in mycolic acids biosynthetic pathway, is an attractive target for novel anti-tuberculosis agents. Structure-based design, synthesis of novel inhibitors of mtFabH was reported in this paper. A novel scaffold structure was designed, and 12 candidate compounds that displayed favorable binding with the active site were identified and synthesized. 2009 Song Li. Published by Elsevier B.V. on behalf of Chinese Chemical Society. All rights reserved.

Incidence and Predictors of Tuberculosis among HIV/AIDS Infected Patients: A Five-Year Retrospective Follow-Up Study

Background: Despite increased deliverance of antiretroviral therapy (ART), morbidity and mortality from TB are still predominant among HIV/AIDS infected patients in Ethiopia. Thus, current study aimed to determine magnitude and predictors of tuberculosis among cohort of HIV infected patients at Arba Minch General Hospital, Ethiopia, 2015. Methods: Hospital based retrospective follow-up study was conducted among study population which was HIV/AIDS infected individuals registered from September 2007 to 2013. The data were collected using structured data abstraction form and four ART trained nurses were used to abstract the data. The data were checked for completeness, cleaned and entered into Epi Info 7.0 and analyzed using SPSS version (IBM-21). Results were summarized by using table of frequency, graph, and measure of central tendency. Statistical significance was inferred at P-value ≤ 0.05. Adjusted odd ratio (AOR) with 95% confidence interval (CI) was used to determine predictors. Result: Four hundred ninety six patient’s charts were abstracted. Cumulative and incidence density of tuberculosis were 21.4% (95% CI: 21.3, 21.44) and 5.36 per 100 person year respectively. Cigarette smokers (AOR: 2.82, 95% CI (1.27 - 6.27)), household with family size of 3 - 4 (AOR: 2.26, 95% CI (1.14 - 4.50)), baseline WHO clinical stage III (AOR: 20.26, 95% CI (7.09 - 57.6)) and IV (AOR: 22.9, 95% CI (6.91 - 76.4)) and heamoglobin level of <10 (AOR: 2.56, 95% CI (1.22 - 5.33)) were important predictors (risk factors) of tuberculosis among HIV infected patients. Conclusion and recommendation: Relatively high incident tuberculosis cases were established among HIV infected patients and history of cigarette smoking;family size;hemoglobin level and base line WHO clinical stage were responsible for this incidence. Therefore;early initiation of HAARTas per current guideline should get stressed, and the finding that smoking was important predictors for TB in Ethiopia had obvious TB control implication which required high attention focused on fighting against cigarette smoking among HIV infected cohort.

Information technology and artificial intelligence support in management experiences of the pediatric designated hospital during the COVID-19 epidemic in 2022 in Shanghai

Objective:To describe the information technology and artificial intelligence support in management experiences of the pediatric designated hospital in the wave of COVID-19 in Shanghai.Methods:We retrospectively concluded the management experiences at the largest pediatric designated hospital from March 1st to May 11th in 2022 in Shanghai.We summarized the application of Internet hospital,face recognition technology in outpatient department,critical illness warning system and remote consultation system in the ward and the structed electronic medical record in the inpatient system.We illustrated the role of the information system through the number and prognosis of patients treated.Results:The COVID-19 designated hospitals were built particularly for critical patients requiring high-level medical care,responded quickly and scientifically to prevent and control the epidemic situation.From March 1st to May 11th,2022,we received and treated 768 children confirmed by positive RT-PCR and treated at our center.In our management,we use Internet Information on the Internet Hospital,face recognition technology in outpatient department,critical illness warning system and remote consultation system in the ward,structed electronic medical record in the inpatient system.No deaths or nosocomial infections occurred.The number of offline outpatient visits dropped,from March to May 2022,146,106,48,379,57,686 respectively.But the outpatient volume on the internet hospital increased significantly(3,347 in March 2022 vs.372 in March 2021;4,465 in April 2022 vs.409 in April 2021;4,677 in May 2022 vs.538 in May 2021).Conclusions:Information technology and artificial intelligence has provided significant supports in the management.The system might optimize the admission screening process,increases the communication inside and outside the ward,achieves early detection and diagnosis,timely isolates patients,and timely treatment of various types of children.

Treatment outcomes of tuberculosis patients under directly observed treatment short-course at Debre Tabor General Hospital,northwest Ethiopia:nine-years retrospective study

Background:Data regarding tuberculosis(TB)treatment outcomes,proportion of TB/HIV co-infection and associated factors have been released at different TB treatment facilities in Ethiopia and elsewhere in the world as part of the auditing and surveillance service.However,these data are missing for the TB clinic offering directly observed treatment short-course(DOTs)at Debre Tabor General Hospital(DTGH).Methods:The authors analysed the records of 985 TB patients registered at the DTGH from September 2008 to December 2016.Data on patients’sex,age,type of TB,and treatment outcomes were extracted from the TB treatment registration logbook.The treatment outcome of patients was categorized according to the National TB and Leprosy Control Program guidelines:cured,treatment completed,treatment failed,died,and not evaluated(transferred out and unknown cases).Results:Around half of the registered patients were males(516,52.4%).In terms of TB types,381(38.7%),241(24.5%),and 363(36.9%)patients had smear-negative pulmonary TB,smear-positive pulmonary TB,and extra pulmonary TB,respectively.Six hundred and seventy-two patients(90.1%)had successful treatment outcomes(cured and treatment completed),while 74 patients(9.9%)had unsuccessful treatment outcomes(death and treatment failure).TB treatment outcome was not associated with age,sex,type and history of TB,or co-infection with HIV(P>0.05).The proportion of TB/HIV co-infection was at 24.2%,and these were found to be significantly associated with the age groups of 25-34,35-44 and≥65 years:(aOR:0.44;95%CI:0.25-0.8),(aOR:0.39;95%CI:0.20-0.70),(aOR:4.2;95%CI:1.30-12.9),respectively.Conclusions:The proportion of patients with successful treatment outcomes was above the World Health Organization target set for Millennium Development Goal of 85%and in line with that of the global milestone target set at>90%for 2025.Relatively higher proportions of transfer-out cases were recorded in the present study.Similarly,the proportion of TB/HIV co-infection cases was much higher than the national average of 8%.Thus,the health facility under study should develop strategies to record the final treatment outcome of transfer-out cases.In addition,strategies to reduce the burden of TB/HIV co-infection should be strengthened.

Tuberculosis among School Age (6 - 18 Years) Children Seen in University of Port Harcourt Teaching Hospital: A Need for Effective School Health Services

Introduction: Tuberculosis (TB) still causes significant morbidity and mortality amongst adults and children despite all the efforts which have been put into the control of the disease. However, the prevalence of the disease in school age children is unknown because of scarcity of TB screening surveys in Nigerian schools. The aim of this study was to evaluate the proportion of school age children treated for TB in the Directly Observed Treatment Short Course (DOTS) clinic of University of Port Harcourt Teaching Hospital (UPTH). Methods: The records of all children 6 to 18 years who were treated in the DOTS clinic from 2011 to 2014 were reviewed. Information sought included age, sex, sputum Acid Fast Bacillus (AFB) status, Human Immunodeficiency Virus (HIV) status and treatment outcome. Results: One hundred and forty children aged 6 to 18 years were treated in the University Port Harcourt Teaching Hospital DOTS clinic, representing 41.79% of childhood TB cases seen over the study period. Seventy one (50.71%) patients were males and 69 (49.29%) were females. Their mean age was 12 ± 3.86. Thirty-one (22.14%) had smear positive TB. Sputum smear positivity was commonest (54.84%) among those who were 16 years and above compared to the other age groups and this is statistically significant (x2 = 17.72, p = 0.001). Forty-one (35%) patients were HIV positive and 6 (4.29%) were positive for both HIV and AFB. Ninety (64.29%) patients recovered fully following treatment, 48 (34.29%) were referred to other DOTS centres and 2 (1.43%) died. Gender, age group, AFB and HIV status showed no relationship with treatment outcome. Conclusion: School age children 6 to 18 years made up a large proportion of childhood TB cases seen within the study period in the DOTS clinic. More than one third of them were HIV/TB co-infected. An effective School Health Services should be established in schools in Port Harcourt to curb the spread of TB and other communicable diseases within the schools.

Tuberculosis in Children: Epidemio-Clinical Aspects in the Paediatric Department of the Gabriel TouréUniversity Hospital Center

Introduction: Globally, tuberculosis is the leading cause of death from a single infectious agent ahead of HIV/AIDS. Approximately 10 million people contracted TB in 2017, 10% of whom were children aged 0 - 15 years, or about 1 million with 250,000 deaths in 2016 (including children with HIV-associated TB). The signs of TB in children are not always specific and diagnosis remains difficult unlike in adults. According to a study conducted in 2011 in the paediatric department of the CHU-Gabriel Touré, only seventeen cases of all forms of tuberculosis were found, or approximately 0.2% of hospitalised children. The objective of our study was to investigate the epidemiological and clinical aspects of tuberculosis in children. Materials and Method: This was a prospective, cross-sectional and descriptive study that took place from 24 October 2017 to 23 October 2018, or 12 months in children aged 0-15 years. Data were collected from an individual medical record opened for each patient and an individual survey form established for each child. Results: During the study period, 40,434 children were consulted. Tuberculosis was suspected in 91 children, with a frequency of 0.22%. The age range of 1 to 4 years was 36.3% with a median age of 72 months. The sex ratio was 1.8. Chronic cough with 84.6% and malnutrition with 24.17% were the most frequent symptoms. Chest X-ray revealed bilateral pulmonary lesions in 52.7% and mediastinal adenopathy in 12.1%. TST was positive in 10.9% of patients, microscopy in 26.4%, Gene Xpert in 18.7%, and culture in 16.5%. The biological diagnosis of tuberculosis was retained in 48.4% of the patients, the pulmonary form represented 93.2%. The therapeutic regime (2RHZE/4RH) was used in 81.6% of cases and the evolution was favourable in 65.9% of patients. Conclusion: The diagnosis of tuberculosis in children remains difficult in our context. The clinical signs are not always specific, and further studies are needed to further elucidate this disease.

2018—2023年某结核病专科医院专业技术人员入离职情况分析

目的探讨结核病专科医院专业技术人员队伍不稳定的因素,为医院人才引进、稳定专业队伍提供科学决策依据。方法对我院2018—2023年专业技术人员入职和离职情况,就编制类型、专业类别、学历和职称状况进行分层分析。结果6年间,入职人员374人,绝大多数为公开招聘入职,其中:编内、编外、劳务派遣各150、214、10人,中专、大专、本科、硕士、博士各2、115、183、66、8人,初级、中级、副高、正高职称各313、47、8、6人,临床、公卫、护理、医技专业人员各84、16、231、43人。在此期间,离职员工216名,包括解除聘用/劳动合同131人、退休73人、调出8人、病故4人,因解除聘用/劳动合同的离职者占入职人数的百分比分别为:编内人员4.67%、编外人员34.58%,其中临床医师25.00%、公卫医师18.75%、护理人员24.68、医技人员0%;大专学历33.04%、本科13.66%、硕士25.76%、博士12.50%;初级职称21.73%、中级职称19.15%、副高职称25.00%、正高职称33.33%。结论在结核病专科医院,新入职的博士及高级职称人才占比偏少,高层次人才引进、稳定专业人员队伍为医院亟待解决的问题。

OBE-CDIO双维导向下儿科护理学校院合作式课程设计与实践研究

选取辽宁中医药大学2022年2—7月同一时间学习儿科护理学课程的2019级护理本科生和2020级专升本护生为研究对象,采用OBE-CDIO双维导向下的校院合作式教学,评价护生的超星平台学习成绩、期末理论成绩、教学满意度,并对比教学前后护生的自主学习能力、评判性思维能力,探讨OBE-CDIO双维导向下的校院合作式教学的实践应用效果。实践表明,OBE-CDIO双维导向下的校院合作式教学在儿科护理学课程中应用取得了较好的效果,课堂教学与临床实际接轨,能提高护生学习成绩、自主学习能力、评判性思维能力和教学满意度,值得推广应用。

家庭医生签约服务与肺结核患者临床特征的关联性研究

目的:通过比较已签约家庭医生和未签约家庭医生的肺结核患者临床特征的相关数据,为社区结核病管理模式提供依据。方法:选取2022年1月至2023年12月在“结核病管理信息系统”中住址登记为广州市海珠区的肺结核患者作为研究对象,共1479例。其中,已签约并接受家庭医生服务者为管理组(844例,57.06%),未签约家庭医生服务者为对照组(635例,42.94%)。收集并比较两组研究对象的人口学特征和临床特征信息。结果:管理组平均年龄为(48.48±18.38)岁,明显低于对照组的平均年龄[(50.73±18.91)岁],差异有统计学意义(t=-2.303,P=0.021)。管理组流动人口、病灶范围≥3个肺野、有空洞、合并糖尿病、合并高尿酸血症者分别占54.27%(458/844)、58.65%(495/844)、32.11%(271/844)、12.56%(106/844)、8.18%(69/844),均明显高于对照组[分别占48.50%(308/635)、48.50%(308/635)、26.93%(171/635)、8.98%(57/635)、3.78%(24/635)],差异均有统计学意义(χ^(2)值分别为9.638、15.030、4.640、4.744、11.883,P值均<0.05)。管理组合并高血压、合并肿瘤、发生药物不良反应及首诊住院治疗者分别占6.40%(54/844)、3.32%(28/844)、10.90%(92/844)、27.49%(232/844),均明显低于对照组[分别为10.71%(68/635)、5.51%(35/635)、15.12%(96/635)、36.22%(230/635)],差异均有统计学意义(χ^(2)值分别为8.896、4.278、5.809、12.864,P值均<0.05)。结论:家庭医生签约服务与肺结核患者的临床特征之间存在着明显的关联性,这为进一步改善肺结核患者的医疗管理提供了重要的参考和指导。

新一代快速部署方舱医院配套医疗设备的定制化设计方案

方舱医院被广泛用于灾害救援、战场救治、突发公共卫生事件防控等场景。目前,我国已进入第三代方舱医院的研制阶段。方舱医院的整体效能与配套医疗设备的性能直接相关。在研制阶段探讨方舱医院配套医疗设备的定制化设计方案,可保证医疗设备的配置与方舱医院的功能相匹配,从而更好地发挥方舱医院的整体效能。该研究针对方舱医院中占主体地位的急救设备、检验设备和影像设备,详细分析定制化设计方案。定制化设计的重点在于有限空间适应性、功能集成性、可快速部署、轻便性、抗震性、极端环境适用性、以及影像设备的低剂量高品质成像,并注重智能化功能融入。该研究可用于指导方舱医院配套医疗设备的定制化研制、选型及升级改造。

新冠疫情期间某三级甲等医院北京冬奥会医疗保障模式案例分析

冬季运动会项目特定环境及运动本身的特性,决定了冬季大型运动会医疗保障是极具特殊性的工作。北京冬奥会是我国承办国际体育竞技的盛事,举办期间恰逢新冠病毒大流行,这使得传染病防控成为今后冬季大型运动会医疗保障的重要课题。文章介绍了某三级甲等医院探索建立“促、防、诊、控、治、康”连续一体化医疗照护,同时依靠多学科会诊提供高质量照护的基本模式,为大型医院参与冬季运动会医疗保障提供经验参考。

某肿瘤医院营养食堂厨房空间设计分析及建议

结合某新建肿瘤医院食堂建设情况,梳理了建设要点,对肿瘤医院食堂建设项目的选址、布局、内部动线、设备配置、人性化、智能化、安全卫生措施等进行全面分析,总结经验,提出建议。

关于医院建筑机电工程创新的思考

现今医院建筑机电工程模式与当今快速发展的时代背景不协调,妨碍了机电工程实现功能需求和“双碳”目标的要求,需要创新。分析了现今医院建筑机电工程模式的弊病;提出了在完成机电系统综合的基础上,与建筑工程剥离,作为完整独立的工程项目单独实施,在整个过程中以运维作引导,充分发挥设计龙头作用;基于医院建筑电气化、电力需求响应,探讨了医院建筑机电工程实现功能目标且经济低碳的运维策略;最后指出医院建筑机电工程创新的直接受益者和主导者是医院。

基于节能导向的寒冷地区医院建筑形态多目标寻优技术研究

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