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In order to carry out the " Healthy China 2030″ initiative, accelerate the cloud-based transformation of hospital information platforms, promote the construction of smart hospitals, and improve hospital informatization service capabilities, a tertiary hospital launched a comprehensive cloud-based practice for hospital operations in November 2020. A high-availability medical cloud platform designed for large general hospitals was built, by renting from carriers the Internet data center, installing highly scalable infrastructure, building multi-loop self-healing fiber-optic private network, applying the cloud-based software architecture using microservices and distributed storage, and implementing distributed systems′ full-link log and performance monitoring. In February 2021, the hospital migrated its medical care and operation management services on the cloud, achieving unified management of multiple hospital campuses, and reducing manpower and capital investment in computer room constructions. This practice ensured the continuity of hospital business, promoted the regional medical cooperation and the sinking of high-quality medical resources, and provided a reference for speeding up the promotion of nationwide hospital business to the cloud.
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December of 2019 witnessed the outbreak of new coronavirus pneumonia in Wuhan city and a few localities. As a designated hospital, Tongji Hospital is designated as a hospital for the diagnosis and treatment of numerous patients of such a disease. Based on the medical cloud platform, the hospital has initiated a regional remote diagnosis center; based on its IT system, the hospital to operate its epidemic prevention and management mechanism, set up the self-service system for patients at the fever clinic, launched its online diagnosis and treatment services, and established a hospital epidemic supervision platform. By strengthening the informational support needed for epidemic prevention and control, the hospital has enhanced its efficiency of epidemic prevention and control, reducing the risk of cross-infection, and ensuring data security. Its experiences offer references for informationization support for other regions and hospitals in China.
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Novel coronavirus pneumonia, which has emerged in Wuhan since the end of 2019, has posed a huge challenge for medical institutions in the city. Rapid completion of a number of cabin hospitals plays a vital role in preventing further spreading of the epidemic, by means of collecting and treating mild patients of the disease. This paper presents the key process of Tongji Hospital in its rapid informatization since it took over a cabin hospital. Based on the network architecture of the Tongji cloud platform, the shared service center is used to share data and integrate services between the cabin hospital and Tongji hospital. This practice can prevent cross-infection and improve service efficiency as well, hence offering a reference for future information infrastructure development of cabin hospitals.
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December 2019 witnessed the outbreak of COVID-19 in Wuhan city and its rapid spread to other parts of China, and overseas as well. Tongji Hospital, as a designated hospital for treatment of critically ill patients, shoulders the diagnosis and treatment tasks of numerous critically ill patients of such a disease. For the purpose of handling their medical records and effectively preventing the nosocomial infection of the disease, the hospital puts in place both the electronic signature system of patients based on a Wechat applet and a paperless medical record total solution based on the data center. These measures overcome the challenges incurred by patients’ signature on paper-based records and medical records archiving during the epidemic. On the other hand, they can not only downsize the paper-based medical records, minimize the risk of infection caused by paper-based medical records via contacts, but also effectively save the hospital of its operating costs and improve its efficiency of clinical work.
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December 2019 witnessed the outbreak of COVID-19 in Wuhan city. Tongji Hospital, as a designated hospital for treatment of critical patients, shoulders the diagnosis and treatment tasks of numerous critical patients of COVID-19.For the purpose of handling their medical records and effectively preventing the nosocomial infection of the disease, the hospital put in place both the electronic signature system of patients based on a Wechat applet and a paperless medical record total solution based on the data center. These measures overcome the challenges incurred by patients′ signature on paper-based records and medical records archiving during the epidemic. On the other hand, they can not only downsize the paper-based medical records, minimize the risk of infection caused by paper-based medical records via physical contacts, but also effectively save the hospital of its operating costs and improve its efficiency of clinical work.
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COVID-19 has posed a huge challenge for medical institutions in the city. Rapid completion and operation of a number of cabin hospitals has played a vital role in preventing further spreading of the epidemic, by means of collecting and treating mild patients of the disease. This paper presented the key process of Tongji Hospital in its rapid informationization since it took over a cabin hospital. Based on the network architecture of the Tongji cloud platform, the shared service center is used to share data and integrate services between the cabin hospital and Tongji Hospital. This practice can prevent cross-infection and improve service efficiency as well, hence offering a reference for future information infrastructure development of cabin hospitals.
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As a designated hospital, Tongji Hospital shoulders the task of diagnosis and treatment of numerous patients of the disease. Based on the medical cloud platform, the hospital has initiated a regional remote diagnosis center; leveraging its IT system, the hospital initiates its epidemic prevention and management mechanism, sets up a self-service system for patients at the fever clinic, launches its online diagnosis and treatment services, and establishes a hospital epidemic supervision platform. By strengthening the informational support needed for epidemic prevention and control, the hospital has enhanced its efficiency of epidemic prevention and control, reducing the risk of cross-infection, and ensuring data security. Its experiences offer references for informationization support for other regions and hospitals in China.
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Control of the qualifications and behaviors of medical practitioners in branches of a hospital group has become imperative to guarantee medical quality and safety.We have explored a development program of the information platform to meet the needs of unified authorization and closed-loop management of hospital groups,constructed a medical qualifications authorization management and control platform based on private clouds,established a specialized medical qualifications and authorization model,standardized the approval process,and reduced the approval time.At the same time,we work with a human resources management platform,to develop qualifications assessment tools for supervision,for the purposes of dynamic renewal and withdrawal of medical qualifications.We have set up a centralized medical behavior authority database and an authority verification interface,selected key business steps,and readapted the business system for authority verification.These measures can effectively control practitioners' medical behavior and ensure medical safety.
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The paper discussed the information platform construction plan of branches Tongji Hospital Group platform, which is designed to achieve homogeneous healthcare and integrated management mode. An information system based on private cloud has achieved a unified service center for patient resources, a clinical sharing service center and an operation sharing service center, for integrated hospital operation and management. Core business systems are integrated and integrated platform has been built, while unified management of public resources and system users′ authorized control have been realized. As a result, the management and control of several hospital campuses have been unified, which can minimize financial risk, reduce human error, improve medical quality and reduce operation costs.
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By reviewing the pilot experiences of drugs payment standard under basic medical insurance in Sanming(Fujian),Chongqing and Fujian,it pointed out that the drug payment standard system should be designed following the principle of classification management.It was necessary to rationally divide payment standard group,select the appropriate method for payment standard,establish dynamic adjustment mechanism and solve problems of the belonging and burden of price difference so as to ensure the effective implementation of medical insurance cost control policy.
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An integration of medical data management system based on WEB and data mining tool is reportedly in this paper. In the application process of this system, web-based medical data mining user sends requests to the server by using client browser with http protocol, the commands are then received by the server and the server calls the data mining tools remote object for data processing, and the results are sent back to the customer browser through the http protocol and presented to the user. In order to prove the feasibility of the proposed solution, the test is done under the NET platform by using SAS and SPSS, and the detail steps are given. By the practical test, it was proved that the web-based data mining tool integration solutions proposed in this paper would have its broad prospects for development, which would open up a new route to the development of medical data mining.
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Minería de Datos , Internet , Informática Médica , Programas InformáticosRESUMEN
Objective:Telemedicine financial operation mechanism was researched to promote long-term operation of the telemedicine in Hubei. Methods: Telemedicine operator was built to manage telemedicine services; the construction costs of the telemedicine system were analyzed to develop service prices; telemedicine services income distribution programs and cost clearing methods were analyzed. Results: The financial operaton models, including the price-setting, income distribution and the cost clearing methods were developed. Conclusion:The reasonable financial operation system ensured the involved parties ’ interests of telemedicine and it could promote long-term development of telemedicine.
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Objective To investigate the emotional distress and coping style during acute stage in patients following acute traumatic injury, and the relationship in different coping patterns and emotional distress. Methods A total of 118 patients with acute traumatic injury were included in our investigation.Emotional distress was assessed with the Hospital Anxiety and Depression scale. Coping style was measured with the Medical Modes Questionnaire. Descriptive analysis, independent samples t test and multiple linear regression analysis were used. Results Emotional distress occurred in 50.00% of the patients with acute traumatic injury,22.40% patients only presented anxiety, 17.30% patients only presented depression, and 10.20% patients presented both anxiety and depression. Yielding and avoidance coping styles were more frequently used in patients with depression. Conclusions Incidence of emotional distress was highly fre-quently, many factors were associated with patients" affection reaction.
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Objective To investigate the characteristics of distribution and the changes in drug resistance of Enterococci,providing reference for clinical treatment.Methods The distribution and drug resistance in 2547 clinical isolates of Enterococci from 2001 to 2007 in Huzhou Central Hospital and the First People's Hospital of Huzhou were retrospectively analyzed.Results A total of 2547 strains of Enterococci were isolated from 94876 clinical specimens(2.68%),in which Enterococcus faecalis wag primary and Enterococcus faecium Wag ranking the second.The positive rate of Enterococci in urine specimens was the highest,and that in sputum specimens was increasing recently.Enterococci showed higg resistance to erythromycin,rifampin,ciprofloxacin and levofloxacin;Enterococcus faecalis Wag more sensitive to penicillin,ampiciilin and ndtrofurantoin than Enterococcus faecium,while Euterococcus faecium was more sensitive to chloramphended and tetracycline than Enterococcus faecalis;both of them were sensitive to vaneomycin and teicoplanin.Conclusions Enterococcus faecalis and Enterococcus faecium are the common pathogen in Enterococci infections.Enterococci show high drug resistance,so the clinical use of antibiotics should be based on the resuhs of drug sensitivity test.
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OBJECTIVE:To establish an RP-HPLC method for determination of plasma concentration of glimepiride (GM) in Beagle dogs. METHODS: Plasma sample was separated on Agilent Eclipse XDB-C8 column with column temperature kept at 30 ℃,and the mobile phase consisted of acetonitrile-methanol-10 mmol?L-1 potassium dihydrogen phosphate (65∶40∶95,pH value adjusted to 7.2) at a flow rate of 1.0 mL?min-1. The UV detection wavelength was set at 227 nm. Plasma sample were pretreated by liquid-liquid extaction with gemfibrozil as an internal standard. Plasma concentrations of GM in 6 Beagle dogs at different time points were determined after a single sublingual dosing of 2 mg GM spray. RESULTS: The linear range of GM was 50～2 500 ng?mL-1 with a lowest detection limit of 20 ng?mL-1. The intra-day RSD and inter-day RSD were all less than 15%. The extraction recovery rate was 71.27%～103.5%,and the methodological recovery rate was 87.97%～ 98.95%. CONCLUSION: This method is simple in sample treatment and sensitive,and it is applicable for analysis of GM in biological sample.
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OBJECTIVE In order to supply the basis of reasonable use of antibiotics,investigation of the change in distribution and drug-resistance of isolated enterococci was made in our hospital.METHODS Enterococci were cultured,isolated and identified with ATB Expression microbe identification system.Drug-resistance was detected with ATB ENTEROC and was statistically analyzed.RESULTS A total of 1 354 strains of enterococci were isolated from 50 148 clinical specimens,the isolation rate was 2.7%.The main strain of enterococci was Enterococcus faecalis.E.faecium was the second one.The isolation rate of enterococci,which were the highest in urine specimens,was increasing in sputum specimens year by year.The drug-resistance rate of enterococci to erythromycin,rifampin,ciprofloxacin and levofloxacin was high,but it was still sensitive to vancomycin and teicoplanin.CONCLUSIONS Great changes have taken place in bacterial distribution and drug-resistance of isolated enterococci,and the drug-resistance of strains of enterococci differed greatly.To insure effective treatment and decrease the infection of enterococci in hospital,the antibiotics sensitive to enterococci should been used on the basis of drug-resistance test when the infection of enterococci was treated clinically.
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OBJECTIVE To study the mechanism of drug-resistance of multi-resistant Pseudomonas aeruginosa,and provide the guideline for treatment and control of P.aeruginosa infection in hospital.METHODS Fifty strains of multi-resistant P.aeruginosa were selected with K-B susceptibility method.The three-dimensional method was taken to differentiate the various beta-lactamases.The relative drug-resistance gene was detected by polymerase chain reaction(PCR).RESULTS Among 50 strains of multi-resistant P.aeruginosa,there were 2 strains(4%)producing ESBLs,20 strains(40%)producing AmpC beta-lactamases,and 11 strains(22%) producing ESBLs and AmpC beta-lactamases at the same time.There were 8 positive genes in the detected drug-resistance gene,the most common sources of gene were CTX(56%),OprD(60%) and aac(6′)-Ⅱ(60%),respectively.CONCLUSIONS The main beta-lactamases are AmpC beta-lactamases and the main genotype is CTX in the multi-resistant P.aeruginosa cultured in our area.The main course of imipenem-resistance was deletion of outer membrane proteins,and the aminoglycoside modifying enzyme gene and disinfectant-resistance gene in multi-resistant P.aeruginosa are acquired.In order to reduce the drug-resistance strains and control the infection of P.aeruginosa,antibiotics should be used reasonably according to drug susceptibility testing clinically.
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Objective:To study effect of SC-LK on the immune function of immunosuppressive mice and to seek the relationship between drug property of SC-GS and immunoenhancement activity. Methods:The immunosuppressive mice models were established by CTX and administrated with four groups of drugs. The phagocytic ability of macrophage,serum hemolysin level,and proliferative response of T lymphocyte induced by PHA were measured. The activity of in vitro M? and the phagocytizing of CRBC by M? were measured. Results:SC-LK could significantly improve immunological function inhibited by CTX in mice. Conclusion:The improving of immunological function was a common effect in drug effect spectrum(drug property) of SC-LK,but it was not characteristic effect as compared with the other three groups of drugs.
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Objective In order to promote service lever,hospitals started to use mobile phone text messages to construct short message platform. Methods Based on mobile phone text message services provided by China Mobile Inc. and China Unicom Inc,hospitals formulated platform service procedures including the service on demand system,booking a whole month and broadcasting; designed a variety of interactive processes of short message for business. Results Such platform can be used to apply reservation,notification for PACS,LIS reports,services for in-patient,information for managers and transaction among employees. Conclusion With such platform,hospitals will build up friendly relationship between doctors and patients,improve office automation system,and upgrade service lever. Along with this event,the future will open out bright prospects for us.
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AIM To study the effect of astragalosides (AST) on pr ol iferation and collagen production of hepatic stellate cells (HSC). METHO DS The proliferation and collagen production of rat hepatic stellate cell s, HSC-T6, stimulated with Kupffer cell-conditioned medium (KCCM), mixed sera containing new bovine serum (NBS) and rat serum (RS) were measured with 3H -TdR and 3H-proline incorporation. RESULTS Both of the p roliferation and collagen production of HSC-T6 stimulated with KCCM at the dilu tion of 1∶4 were suppressed after being treated with AST (16, 32, 64, 128 and 2 56 mg?L -1 ). When HSC-T6 cells were stimulated with mixed sera containing 10% NBS and 3% RS, their proliferation was suppressed after being treated with AST(32, 64, 128 and 256 mg?L -1 )for 48 h and so was the collagen produ ction after being treated with AST(16, 32, 64, 128 and 256 mg?L -1 )for 72 h. CONCLUSION The suppression of hepatic stellate cell prolif eration and collagen production by astragalosides may be one of the mechanisms f or the depression of hepatic fibrosis by astragalosides.