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Objective The rapid growth of data exchange and information volume in hospital information systems has brought significant challenges to the operation,maintenance,and service performance of the system.In order to overcome the performance bottleneck of the software and improve the response performance of the hospital information system,our hospital has tentatively introduced the Exadata database machine.Methods The machine was launched through hardware parameter selec-tion,high availability testing,and data migration.The benefits were evaluated by comparing the I/O operation time,SQL state-ment execution time,and business system module loading time before and after the launch.Results After using this machine,the overall waiting time of I/O operations decreased by 83.47% ,the execution time of the same statement decreased by over 22% ,and the average loadingtime of the business system decreased by43.74% .Conclusion The database machine can effec-tively reduce query time,accelerate the running speed of business modules,and help improve the performance of hospital infor-mation systems.
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In recent years,the release of policies such as"Performance Assessment of Public Hospitals"and"New Ver-sion of Grading Hospital Evaluation Standards"has made data quantification become an important means of comprehensive evalua-tion of hospitals.However,at present,many hospitals still face challenges like critical system deficiencies,manual reliance on a large number of indicators,inaccurate data,and lack of traceability except for a few hospitals with relatively complete manage-ment and good information system infrastructure.These issues not only directly affect the evaluation results of hospitals,but also bring huge workloads to relevant departments of hospitals.This article,combining the experience in hospital management and in-formatization of GAHA over the years,as well as the author's practical cases in advising on information development and data gov-ernance for several domestic hospitals in the past two years,expounds on the current status of management for indicator data in hospital evaluation,and puts forward specific suggestions on aspects such as the overall process of indicator data,organizational development,institutional systems,and system support.At last,the prospects for work related to future hospital data governance and application is proposed.
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The contents recorded in the rotation registration manual is not only the quantitative indicators for evaluating the quality of residency training, but also the important basis for training assessment and issuance of training certificates. In order to solve the problems of data authenticity, information delay, and repeated entry in the rotation registration manual for residency training, Shanghai East Hospital, Tongji University, launched a project to dock the electronic rotation registration manual with the hospital information system. Through the establishment of the project team, the development of working mechanisms, and the implementation of the project, data analysis was used for process reformation and system optimization, so as to continuously improve management efficiency and medical safety while solving problems and form a set of implementation system with reference significance in practice.
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Purpose/Significance Combined with flipped classroom and project-driven teaching mode,the curriculum reform is ex-plored to improve teaching effect,stimulate students to learn independently and participate deeply in class.Method/Process Taking the teaching of hospital information system course as an example,guided by the flipped classroom concept and combined with the project-driven method,the paper puts forward the reform plan of teaching design and applies it to the actual teaching process.Result/Conclusion The satisfaction degree of the students is higher,the initiative of students to study independently is improved,and the teaching quality is enhanced.
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In order to promote the high-quality development of public hospitals and ensure the safety and health of the people, it is important toachieve full traceability and refined management of high-value consumables throughout their entire life cycle.The author designed and implemented a refined management of high-value consumables in orthopedics based on one item, one code. In the closed-loop management process, hospital staff labelled high value orthopedic consumables, achieving the integration of disinfection traceability code, product qualification certificate, and billing traceability code; Three parties, including the chief surgeon, circulating nurse, and handwashing nurse, should sign and confirm the code, ensuring that the item code could not be separated; And real-time intraoperative billing, postoperative counting, and case tracking were used. At the same time, the design utilized a hospital consignment warehouse. The comprehensive promotion of this practice by the hospital saved costs, improved the overall efficiency of the entire business process of orthopedic high-value consumables, and met the requirements of relevant policy supervision and hospital refined management.
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La gestión de la información de salud del paciente, así como de los diferentes servicios que se brindan en los centros de atención de salud, constituyen elementos cruciales para prestar un servicio de salud de buena calidad. El Sistema de Información Hospitalaria XAVIA HIS, constituye una solución integral para la gestión médica de hospitales y centros de salud. En el módulo de Consulta externa se gestiona la información referente a la atención a pacientes ambulatorios en diferentes especialidades. El objetivo del presente trabajo es describir las principales funcionalidades y especialidades médicas incluidas en el módulo Consulta externa del sistema XAVIA HIS. El desarrollo estuvo guiado por la metodología de desarrollo Proceso Ágil Unificado. variante UCI y fueron empleadas las tecnologías, herramientas y lenguajes que forman parte de la arquitectura del sistema definida por el Centro de Informática Médica, entre las cuales se pueden mencionar: Java Enterprise Edition 6 como plataforma de programación para el desarrollo y la ejecución del sistema, como sistema gestor de base de datos se empleó PostgreSQL 10, como herramienta de modelado Visual Paradigm para UML, la notación BPMN 2.0 (Business Process Management Notation) y el Lenguaje Unificado de Modelado (UML) y el estándar HL7 CDA® (Clinical Document Architecture) para homogeneizar la arquitectura de los documentos clínicos. El desarrollo de este módulo refuerza la base de conocimientos necesaria para la toma de decisiones clínicas y administrativas, mejora el acceso a la información y la calidad de la asistencia a los pacientes.
The patient's health information management, as well as different services provided in health care centers, constitutes crucial elements to provide a good quality health service. The Hospital Information System XAVIA HIS establishes a comprehensive solution for hospitals and health centers medical management. The Outpatient module manages the information regarding outpatient care in different specialties. This paper aims to describe the main functionalities and medical specialties included in the Outpatient module of the XAVIA HIS system. The development was guided by the AUP development methodology (an UCI variant), and to achieve it, the technologies, tools and languages used are part of the system architecture defined by the CESIM and mentioned as follow: Java Enterprise Edition 6 platform as the Runtime Environment, PostgreSQL 10 as the database management system, Visual Paradigm as modeling tool for UML, the BPMN 2.0 notation (Business Process Management Notation), the Unified Modeling Language (UML) and the HL7 CDA® (Clinical Document Architecture) standard to standardize the architecture of clinical documents. This module development reinforces the knowledge base necessary for clinical and administrative decision-making, improves access to information and patients' care quality.
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Resumo Introdução As internações por condições sensíveis à atenção primária (ICSAP) têm sido utilizadas como um indicador do acesso à atenção primária e de monitoramento do seu desempenho. Objetivo Analisar a tendência de comportamento das ICSAP entre idosos de Minas Gerais, Brasil, de 2010 a 2015. Método Estudo ecológico utilizando dados do Sistema de Informações Hospitalares (SIH-SUS), referentes a hospitalizações de idosos entre 60 e 79 anos. Foram calculadas as taxas de ICSAP global por causa e regiões administrativas de saúde. Resultados Foram analisadas 126.757 ICSAP ocorridas no período (8,8% do total de internações pelo SUS). A taxa global diminuiu de 10,4 para 9,4 (por 1.000). Entre as causas de internação analisadas, foi observada redução nas taxas de internação por hipertensão, deficiências nutricionais e gastroenterites infecciosas, mas foi constatado aumento da taxa de internação por infecção do rim e trato urinário. As taxas variaram ainda em função das regiões de saúde, sendo que regiões com baixa densidade populacional, PIB per capita mais baixo e pior infraestrutura sanitária apresentaram taxas mais elevadas. Conclusão A variação do indicador entre as regionais de saúde pode refletir disparidades socioeconômicas, de organização e oferta de serviços de saúde. A elevação das taxas de internação por algumas condições sensíveis à atenção primária pode indicar a necessidade de os serviços de Atenção Primária à Saúde (APS) aumentarem os esforços para o cuidado da pessoa idosa que sofre a comorbidade com mais frequência.
Abstract Background Hospitalizations due to Ambulatory Care Sensitive Conditions (ACSC) have been used as an indicator of access to primary care and monitoring of its performance. Objective To analyze the behavioral trend of ACSC among elderly in Minas Gerais, Brazil, from 2010 to 2015. Method Ecological study based on data from the Hospital Information System (SIH) of the Unified Health System (SUS), concerning the hospitalization of the elderly aged 60-79 years. ACSC rates were calculated, global, specific by ACSC and by health administrative region. Results A total of 126,757 ACSC occurred in the period (8.8% of all hospitalizations by SUS). The overall rate decreased from 10.4 to 9.4 (p /1,000). The causes of hospitalization showed a reduction in the risk of hospitalization for hypertension, nutritional deficiencies, and infectious gastroenteritis, but increased the risk of hospitalization for kidney and urinary tract infection. The ACSC rates also varied according to the health regions: regions with low population density, lower per capita GDP and worse health infrastructure showed higher rates. Conclusion The variation of the indicator among health regions may reflect socioeconomic disparities and the organization and supply of health services. Raising inpatient rates for some of the ACSC may indicate the need for PHC services to increase efforts to care for the elderly who suffer from comorbidity more often.
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Objective:To establish a IgA nephropathy (IgAN) standard dataset for the structured and standardization of IgAN clinical information, which will be beneficial to the integration and utilization of clinical information among different medical institutions. Therefore, the IgAN Expert Collaboration Group composed the "IgA Nephropathy Standard Dataset".Methods:Referring to the domestic information standards, guidelines, data standard and consensus of related fields, based on electronic medical history, the patient identification number was used as the primary key of the system to collect information. By standardizing each data element in the data set, the standardization of the management system in data and information exchange, data collaboration and sharing was ensured, and a quality control system was developed.Results:This standard dataset included 607 data elements and 8 business domains, which were patient information, medical history information, physical examination, laboratory examination, assistant examination, renal pathology, drug treatment, and follow-up, respectively. Each module was composed of module name, data element name, English name, definition, range, reference standard, etc. At the same time, a corresponding quality control system was formulated to evaluate data quality from multiple dimensions such as completeness, standardization, accuracy, timeliness, and security for ensuring the high quality and security of the data.Conclusion:The IgAN standard dataset is established, which will contribute to the structuration and standardization of clinical information of IgAN patients.
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Means of information technology can achieve information sharing and optimize the management process, and tackle the challenges encountered in the process of ophthalmic day surgery, namely surgery appointment, patient education, ward management and patient follow-up. The authors analyzed the current situation and challenges of day surgeries at an ophthalmic hospital, and presented its practices in building and using the day ophthalmic surgery informationized management system by such information technology means as cloud computation, artificial intelligence and face recognition. This system comprised the day surgery pre-hospitalization management system, Internet platform for wards, follow-up management platform, electronic medical archiving of day surgery, and specialized nursing robot for day surgery process. As compared with the data one year before and after the system in place, the rate of missed surgery, unplanned secondary surgery and patient satisfaction before and after, fell from 2.40% and 0.24% before to 1.00% and 0.08% after. In addition, patient satisfaction increased from 94.5% before to 99.1% after. All the differences were significant statistically( P<0.01). This system can help patients in medical access, and ensure the medical safety and efficiency of day surgeries, serving as a good reference for ophthalmic departments of other hospitals in building their informationized system for ophthalmic day surgeries.
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Under the guidance of national policies on Internet medical services, the scope of medical information services provided by the hospital information system is growing all the way, the interaction with external information is more and more frequent, and the network security risk is higher and higher. The authors analyzed the business types of the hospital′s external information service, the way to connect with the external network and the existing network security problems.Following the principles of information system security level protection 2.0, the authors built a unified extranet secure channel for the hospital under the principles of top-level design, formed an all-round network security protective barrier with strict management measures and technical means, then ensured the stable operation of hospital information system and data security.
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Multiple methods should be incorporated into the research on pharmacovigilance of traditional Chinese medicine(TCM for a comprehensive and objective evaluation. The arrival of the era of medical big data allows it to be deeply integrated into medical research. The real world study(RWS) represented by hospital information system(HIS) provides a data basis for exploring the pharmacovigilance of TCM. Prescription sequence analysis(PSA) and prescription sequence symmetry analysis(PSSA) developed based on the former serve as a methodological basis for clinical safety evaluation of Chinese patent medicines after marketing. By collating the related studies of HIS, PSA and PSSA and employing the propensity score matching( PSM) method and nested case-control study(NCCS), this paper formed a HIS-, PSA-and PSSA-based technical system for clinical safety evaluation of Chinese patent medicines in the real world, in order to provide a methodological demonstration for the future research on the pharmacovigilance of TCM.
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Estudios de Casos y Controles , Medicamentos Herbarios Chinos , Medicina Tradicional China , Farmacovigilancia , Prescripciones , Análisis de SecuenciaRESUMEN
El Centro de Informática médica (CESIM) de la Universidad de las Ciencias Informáticas (UCI) desarrolla el Sistema de Información Hospitalaria XAVIA HIS. El éxito en la implantación es de gran importancia para el CESIM, no obstante, los proyectos de implantación se han visto incididos por un conjunto de insuficiencias. El objetivo de la investigación es desarrollar una estrategia que contribuya a aumentar el éxito en la definición del alcance de los proyectos de implantación del sistema XAVIA HIS, en instituciones de salud. Se realizó un estudio descriptivo, que incluyó como escenario de aplicación el Centro Nacional de Cirugía de Mínimo Acceso, entre 2015 y 2017. Como resultado se obtuvo una estrategia para la implantación del sistema XAVIA HIS en instituciones de salud, que impacta positivamente en la disminución del tiempo necesario para este fin(AU)
University of Computer Sciences (UCI) develops the XAVIA HIS Hospital Information System. The implement success of the system is of great importance for CESIM, however, this stage have been affected by a set of insufficiencies. The objective of the research is to develop a strategy that contributes to increasing success in defining the scope of projects to implement XAVIA HIS system in health institutions. A descriptive study was carried out, which included as an application scenario the National Center for Minimally Access Surgery, between 2015 and 2017. As a result, a strategy to implement XAVIA HIS system in health institutions was obtained, which positively impacts the decrease of time necessary for this purpose(AU)
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Humanos , Aplicaciones de la Informática Médica , Diseño de Software , Epidemiología Descriptiva , Sistemas de Información en Hospital/normasRESUMEN
In order to explore the characteristics of traditional Chinese medicine(TCM) syndromes and medications in patients with colonic malignant tumors in China, the clinical data of patients with colonic malignant tumors from the information system of 33 Grade-A tertiary hospitals in China from 2001 to 2016 were extracted and a descriptive analysis was conducted on their disease characteristics, syndrome distribution, drug characteristics and treatment status. A total of 22 691 patients with colonic malignancies nationwide were included in the analysis, with male to female ratio of 1.59∶1, median age of 62 years, susceptible age of 50-79 years. Postoperative patients with colonic malignant tumors accounted for 47.10%, and patients with liver metastases reached 36.02%. Among the 520 patients with colonic malignant tumors, the top three TCM syndromes were: spleen deficiency syndrome(21%), Qi and Yin deficiency syndrome(17%) and liver and stomach disharmony syndrome(15%). The most frequently used Western medicine for patients with colonic malignant tumors was anti-metabolite cytotoxicity(61.23%), most frequently used in combination with platinum-based cytotoxic drugs(support degree 42.40%).The top three Western medicines were oxaliplatin(42.26%), leucovorin injection(38.58%) and dexamethasone(34.67%). The most frequently used traditional Chinese medicine type was heat-clearing and detoxifying drugs(39.59%), most frequently used in combination with Qi replenishing and body resistance strengthening drugs(support degree 12.72%). The top three traditional Chinese medicines were compound Kushen Injection(14.62%), Shenqi Fuzheng Injection(10.18%) and Aidi Injection(6.48%). This study shows that spleen and Qi deficiency may be the dominant syndrome of colonic malignant tumor, and chemotherapy is one of the main treatment methods. Traditional Chinese medicine has shown unique advantages in alleviating the toxic and side effects of chemotherapy and preventing recurrence and metastasis, so integrated TCM and Western medicine can significantly improve the clinical efficacy.
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Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , China , Neoplasias del Colon/tratamiento farmacológico , Medicina Tradicional China , Deficiencia YinRESUMEN
From 2001 to 2015, medical data of 16 856 elderly patients aged 65 years and over who used Suxiao Jiuxin Pills in the information system of 37 tertiary A-level hospitals were collected. After standardized analysis, it was found that the average age of 16 856 elderly patients was 72.48 years, and the main admission departments were department of cardiology(19.30%) and geriatric department(9.77%). Generally, 61.96% of the degree of illness is average, and the average hospitalized days were 16.16 days; 47.97% of the patients were diagnosed as coronary heart disease by Western medicine, and 5.86% of the patients were diagnosed as Qi deficiency and blood stasis; The more common combination of Western medicine was isosorbide nitrate(61.15%), Aspirin Enteric Coated Tablets(50.77%) and Gansu(36.88%), the combination of traditional Chinese medicine is Compound Danshen Dropping Pills/Tablets(19.13%), Xuesaitong Capsules/Injection(15.01%), Shexiang Baoxin Pills(12.29%); the commonly used Western medicine is vasodilator(78.39%), Chinese medicine is Huoxue Huayu(82.04%), and the commonly used Western medicine is Aaspirin Enteric Coated Tablets+Isosorbide Nitrate. The author intends to explore the valuable clinical characteristics and the clues of the combined medication scheme, and find that the application of Suxiao Jiuxin Pills basically conforms to the instructions, conforms to the characteristics of the elderly with many common diseases and complicated concurrent diseases; the combination of drugs and the indications-coronary heart disease guidelines are consistent, with certain rules to follow, and expand the recognition of the clinical application of Suxiao Jiuxin Pills, and provide clinical diagnosis and treatment ideas.
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Anciano , Humanos , Aspirina , Enfermedad Coronaria , Medicamentos Herbarios Chinos , Medicina Tradicional China , Salvia miltiorrhiza , VasodilatadoresRESUMEN
To investigate the clinical characteristics and the rule of administration of Ciwujia Injection in patients with cardiovascular disease by correlation analysis and frequency analysis. The information of 5 904 patients who used Ciwujia Injection to treat cardiovascular disease for at least three times in the hospital information system(HIS) of 19 comprehensive tertiary hospitals nationwide. The frequency analysis method was used to analyze the higher frequency variables, and the algorithm of Apriori correlation analysis method was used to analyze the clinical characteristics and medication laws of Ciwujia Injection in treating patients with cardiovascular disease. Among the 5 904 patients, the median age of the patients was 70 years, and the number of patients between 65-75 years old was up to 2 096(35.5%). There were more women than men in terms of diagnosis and treatment, and the women at age of 45-65 and 65-75 years old were more than men. The top three diagnoses by Western medicine were coronary heart disease in 8 104 cases(65.66%), dyslipidemia in 2 515 cases(20.38%), and cardiac function grade Ⅱ-Ⅲ in 581 cases(4.71%), while the largest number of syndromes in traditional Chinese medicine(TCM) at discharge was 1 109(21.37%) in other type, followed by 739 cases(14.24%) of Qi deficiency and blood stasis syndrome, and 698(13.46%) of liver and kidney Yin deficiency syndrome. The most frequently used Western medicine in combined use was Nifedipine in 2 567 cases(7.21%), and most frequently used TCM was Compound Xianzhuli Liquid leachate in 766 cases(3.53%). From the results of pharmacological analysis, the frequency of using Ciwujia Injection + stasi-seliminating agent + calcium channel blocking drugs was highest when using 1 Chinese medicine combined with 1 or 2 Western medicines. In the use of 2 Chinese medicines combined with 1 Western medicine, Ciwujia Injection + heat-clearing agent + stasis-eliminating agent + calcium channel blocker was the most common. This study demonstrated that Ciwujia Injection was more common in middle-aged and elderly patients and more in women than men. Treatment should be based on different cardiovascular disease treatment guidelines to reduce complications caused by underlying diseases, and attention should be paid to the prevention and treatment of cardio-vascular disease risk factors such as hypertension, diabetes and abnormal lipid metabolism. According to the analysis of frequency distribution and association rules, it was concluded that Ciwujia Injection was mainly used in combination with calcium channel blockers and stasis-eliminating agents in the treatment of cardiovascular disease. In the treatment of cardiovascular diseases by Ciwujia Injection in combination with other Chinese and Western medicines, in order to avoid pharmacological changes and avoid affecting the efficacy of the drug, it is necessary to closely observe whether adverse reactions occur and ensure that the medication is safe and effective. This study provides a good reference for the follow-up clinical guidance of Ciwujia Injection.
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Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Cardiovasculares , Medicamentos Herbarios Chinos , Eleutherococcus , Medicina Tradicional China , Deficiencia YinRESUMEN
To analyze the clinincal application characteristics of Xiyanping Injection in real world. The data of the patients came from the hospital information systerm(HIS) of 29 tertiary hospitals in China from 2006 to 2016. It included three parts about basic information, Western medicine diagnosis information, and doctor advice information. The exploration was conducted for the characteristics of the patients and disease distribution as well as the therapeutic regimen. Apriori algorithm was adopted to establish the models, and Clementing 12.0 was used for a correlation analysis of the comprehensive therapeutic regimen of Xiyanping Injection. There were 194 873 cases in the study. The male to female ratio was 1.44∶1. The median age was 4 years old. The median daily dosage was 200 mg. 46.68% of the patients were administered with 250-500 mg, and 33.07% were 50-100 mg one day. 47.08% of the patients were administered for 4-7 d, and 32.65% of the patients were 1-3 d. In the doctor advice information, the most frequently types of Western medicine, traditional Chinese medicine were mucilagin, heat-clearing agent. Second generation cephalosporins, third generation cephalosporins, compound penicillin were the most common types of antibiotic. Interferon, nucleoside and nucleotide, human immunoglobulin were the most common types of antiviral drug. The mining association rules results were analyzed, finding the application of Xiyanping Injection in severe infectious diseases. To improve respiratory symptoms, Xiyanping Injection treaments were Budesonide + Ipratropium Bromide + Ambroxol. To severe pulmonary infection, the treaments were Dopamine + Ambroxine. To severe hand, foot and mouth disease, the treatments were Namefen + Mannitol. To pulmonary heart failure, the treatments were Dobutamine + Heparin. Based on the results of the real world HIS, we could provide clinical application the idea, and a reference for further excavation of the applicable diseases of Xiyanping Injection.
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Preescolar , Femenino , Humanos , Masculino , China , Medicamentos Herbarios Chinos , Usos Terapéuticos , Inyecciones , Medicina Tradicional China , Infecciones del Sistema Respiratorio , QuimioterapiaRESUMEN
To explore the population characteristics and clinical application characteristics of patients with cerebral hemorrhage treated with Xingnaojing Injection in real world. The model was established by Apriori algorithm, and the general information and medication information of 8 369 patients with cerebral hemorrhage treated with Xingnaojing Injection were analyzed by using Clementine 12.0 in the databases of information systems of 33 class Ⅲ grade A hospitals in China. The results showed that among the 8 369 patients with cerebral hemorrhage treated with Xingnaojing Injection, the median age was 59 years old. And the male to female ratio was about 1.74∶1. Most of them did manual labor(31.26%), and were hospitalized in winter(27.46%), especially during the Cold Dew(5.1%). The majority of the patients were in a stable condition(50.94%), and preferred neurosurgery department(48.82%). 29.03% of patients were hospitalized for 15-28 days, and 42.47% of patients spent 10 000-50 000 Yuan of hospitalization expenses. The single dose of Xingnaojing Injection was 10-20 mL at most(46.03%). And the course of medication was mostly 3 days or less(68.60%). Lidocain was the most frequently used Western medicine in drug combination(5.05%), and Huayu Tongmai Ji was the most frequently used traditional Chinese medicine in drug combination(10.73%). The most frequently used one type of traditional Chinese medicine combined with one type of Western medicine was Huayu Tongmai Ji + Dexamethasone(8.08%). The most frequently used two Western medicines in drug combination were Omeprazole + Dexamethasone(5.07%). Prilosec + Dexamethasone + Lidocaine(3.35%) were three Western drugs with the most frequent combination. When the dosage was 10-20 mL and the number of days of treatment was > 15 days, the largest number of the patients was cured and improved(44.78%, 45.85%). The results showed that cerebral hemorrhage patients treated with Xingnaojing Injection were mostly middle-aged and elderly people, with more males than females. Brain hemorrhage often occurred in winter and spring. Xingnaojing Injectiont was often combined with glucocorticoids, proton pump inhibitors and cardiovascular drugs to prevent cerebral hemorrhage complications. The clinical medication met the guidelines for the treatment of cerebral hemorrhage. Some patients had over-treatment use, which can provide a reference for clinicians in treating cerebral hemorrhage.
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Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Hemorragia Cerebral , China , Medicamentos Herbarios Chinos , Medicina Tradicional ChinaRESUMEN
To explore the real world clinical application characteristics and the drug combination regularity of Ciwujia Injection, 12 554 cases of patients with Ciwujia Injection were extracted from the information systems of 24 class Ⅲ grade A hospitals in China, and a standardized analysis was carried out. Most of the patients were middle-aged and old-aged, and the main departments were cardiovascular department(22.50%) and neurology department(17.92%). Before 2008, 93.77% of the patients were single overdose users, which reduced to only 2.07% after 2011. The course of treatment was mostly between 8-14 days(32.98%). The top three di-seases diagnosed by Western medicine were hypertension(11.78%), cerebral infarction(9.47%), and coronary heart disease(8.15%), and the most common traditional Chinese medicine syndrome was the deficiency of liver and kidney(18.59%). The most commonly used Western medicine was Acetylsalicylic Acid(51.07%), and the most commonly used traditional Chinese medicine was Danshen Injection(9.67%). The most commonly used Western medicine in combined application was calcium channel blocker(46.88%), and the most commonly used traditional Chinese medicine in combined application was stasis removing agent(93.21%). And the drug combination with the highest support was Isosorbide Mononitrate + Acetylsalicylic Acide, with a high recovery rate after discharge(96.81%). The results showed that Ciwujia Injection had certain regularity. It considered underlying concurrent diseases, anticoagulation and blood circulation, with a wide range of effects in strengthening the body and regulating the mind. The results could expand the understanding of Ciwujia Injection and provide a more detailed real world basis and reference for optimizing therapeutic regimen in clinic.
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Anciano , Humanos , Persona de Mediana Edad , Aspirina , China , Combinación de Medicamentos , Medicamentos Herbarios Chinos , Eleutherococcus , Medicina Tradicional ChinaRESUMEN
Kidney malignant tumor is a type of primary renal cell carcinoma, and mainly refers to renal cancer. The incidence of kidney cancer and the number of hospital cases in China have been increasing. Based on the clinical medicine information of patients in the hospital information system(HIS) database of 37 hospitals in China, the combined medication of patients with kidney malignant tumor were analyzed by Tabu search algorithm, so as to analyze the combined medication of patients with kidney malignant tumor in real world. A total of 7 095 patients with kidney malignant tumor were included, the ratio of males to females was 2.11∶1, and the ratio of male patients increased gradually with age. About 3 933 patients(55.43%) showed a superior effect among those patients. The common therapies of patients with kidney malignant tumor were anti-tumor therapies and symptomatic therapies, including anti-infection, regulation of electrolyte balance, sedation and analgesia, analgesic, regulation of gastrointestinal function. The whole population of patients with kidney malignant tumor were mostly treated with anti-tumor drugs combined with more symptomatic therapies, while the anti-tumor therapies of the superiority population of patients were less combined with other drugs, with less combined medication. The result may be related to the stage of tumor or individual response to the therapeutic regimen. No matter for the whole population or for the superiority population of patients with kidney malignant tumor, the therapies was mainly Western medicines. Based on the pathogenesis of deficiency in origin and excess in superficiality with kidney malignant tumor, Chinese subgroups with formula for clearing heat and removing toxicity, formula for vigorate Qi and replenish the blood, formula for regulate Qi and invigorate the blood, laxative and hemostatic were more commonly used. In the future, further studies shall be conducted for combined therapies for patients of different stages, so as to play the advantages of multi-target, overall regulation, toxicity reduction and efficacy enhancement of traditional Chinese medicine, improve the life quality of patients with kidney malignant tumor, prolong their life time, and improve the survival rate of patients.
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Femenino , Humanos , Masculino , Pueblo Asiatico , China , Medicamentos Herbarios Chinos , Sistemas de Información en Hospital , Neoplasias Renales , Medicina Tradicional ChinaRESUMEN
During pregnancy, women undergo several physiological body changes. However, there are some pathologies that can interfere in this period. In Brazil, the main cause of maternal mortality stems from hypertensive disorders. The increased blood pressure gestational period may be due to a preexisting chronic hypertension or Gestational hypertension. Therefore, the hypertension during pregnancy may evolve to preeclampsia, eclampsia or HELLP Syndrome. Each of these disorders has consequences for the mother and the fetus, which can be fatal, in the most serious cases. The objective of this study is to recognize the profile of pregnant women hospitalized with eclampsia, whereas the knowledge of the signs that the pathology presents and the most frequent epidemiological profile to help in the early diagnosis, which directly impacts on the efficacy of the treatment, reducing morbidity and mortality. This study aimed to evaluate the information available in the Sistema de Internações Hospitalares (SIH) of the Sistema de Informações da Secretaria do Estado de Saúde de Mato Grosso and to analyze the increase of pregnant women with eclampsia, in addition to the epidemiological profile of this group. After analyzing the data, it was verified that Afro- Brazilian women, aged between 20-24 years old, are the most affected by eclampsia. In addition, most cases have been reported by private hospitals and more than 50 percent remain hospitalized for up to 3 days. Despite the limitations in the database, the recognition of the most frequent conditions during hospitalization contributes to a better approach to these cases. (AU)
Durante o período gestacional, a mulher passa por diversas mudanças fisiológicas. Entretanto, existem algumas patologias que podem interferir nesse período. No Brasil, a principal causa de mortalidade materna decorre das síndromes hipertensivas. O aumento dos níveis pressóricos na gravidez pode ser originada por hipertensão crônica prévia ou pela Doença Hipertensiva Específica da Gestação (DHEG). Sendo que, essa última pode evoluir para pré-eclâmpsia, eclampsia ou Síndrome HELLP. Cada uma dessas variações gera consequências para a mãe e o feto, podendo levar à morte, nos casos mais graves. O objetivo desse trabalho é reconhecer o perfil de internações das gestantes acometidas com eclâmpsia, uma vez que o conhecimento dos sinais que a patologia apresenta e o perfil epidemiológico mais frequente auxiliam na identificação precoce dos casos, o que impacta diretamente na eficácia do tratamento, reduzindo a morbimortalidade. Esse estudo, buscou avaliar informações disponíveis no Sistema de Internações Hospitalares (SIH) do Sistema de Informações da Secretaria do Estado de Saúde de Mato Grosso e analisar, por meio deste, a progressão das gestanteacometidas com eclampsia, além do perfil epidemiológico desse grupo. Após a análise das informações, verificou-se que as mulheres afro brasileiras, com idade entre 20 e 24 anos, são as mais acometidas pela patologia em estudo. Além disso, a maioria dos casos, foram notificados por hospitais particulares e mais da metade, permanece internada por até 3 dias. Apesar das limitações presentes no banco de dados, o reconhecimento das características mais frequentes durante a internação, contribui para uma melhor abordagem desses casos. (AU)