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In recent years, public hospitals have been facing pressure from the reform of medical insurance payment methods. It is urgent to strengthen the operation and management of public hospitals. In June 2022, a tertiary public hospital utilized hospital intelligent agents to carry out refined cost management practices for medical service charging projects, sorted out medical service charging projects, designed management paths, and calculated project costs. The hospital conducted refined management on the cost of medical service charging items from three control dimensions of project unit cost with manpower, equipment and consumables, and two comparative directions with horizontal and vertical. The refined cost management practice not only pointted out the direction for global refinement cost control within the hospital, but also reduced the proportion of hospital consumption, which provided reference for improving the level of refined operation and management of public hospital hospitals.
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Technical framework is centered on top-level design of smart hospitals. Guangdong Second Provincial General Hospital adopted hospital intelligent twins as its technical framework of the all-scenario intelligent construction. Its construction practices covered four layers of intelligent interaction, intelligent connection, intelligent hub and intelligent application. These practices can advance the construction of smart hospitals into the all-scenario intelligent stage, featuring intelligent medical treatment, intelligent service and intelligent management, thus providing reference for promoting the construction of smart hospitals and realizing the digital transformation of medical industry.
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Application of new technical means and methods and in-depth exploration in medical service scenarios, for improving the efficiency and quality of diagnosis and treatment, improving the operation and management level and patient′s medical experience are the goals aimed by smart hospitals. Guangdong Second Provincial General Hospital, based on the technical framework of hospital intelligent twins, was exploring to build an all-scenario smart hospital. The hospital built an intelligent operations center, all-scenario smart wards and a smart security and fire protection integrated management center. These practices promoted the service synergy, provided efficient internet of everything experience, and promoted the integrated linkage management of security and fire protection. The hospital effective resolved such deficiencies as insufficient data connectivity, fragmented application scenarios, limited coverage and poor mobility, hence providing reference for the construction and application of whole-scenario smart hospitals.
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In the new era, enhanced Party construction of public hospitals is the fundamental assurance for the success of Healthy China strategy. Based on field survey, in-depth interview, literature review and promotion of pilot practices, the Hospital Party Construction Guidance Committee of Guangdong Province staged a " Four Virtues" program to enhance Party construction at public hospitals in the healthcare system of the province. This program, featuring " leadership competency" , " Party branch capability" , " Party construction branding" , and " Unit showcases" , aims at the limited implementation and homogenization problems commonly found in Party construction at public hospitals. Promotion of successful pilot practices of several public hospitals effectively encouraged the " parallel development" of both medical service and Party construction, providing useful references for the hospitals in their reform/development and Party construction in the new era.
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Objective To analyze the relationship of neurocognitive impairments and 1 H MRS changes of the thalamus in patients with chronic hepatitis B virus related cirrhosis (HBV-RC).Methods Totally 28 patients with HBV-RC (cirrhosis group) and 28 well-matched healthy subjects (control group) were enrolled.All subjects underwent number connection test A (NCT-A) and the digit symbol test (DST) before MRS scanning.The ratios of peak area to each metabolite,including N-acetylaminosuccinic acid (NAA),choline (Cho),glutamine and glutamate (Glx),myoinositol (mI) and creatine (Cr) were calculated,respectively.Results Compared with control group,patients in cirrhosis group showed lower Cho/Cr and mI/Cr,higher Glx/Cr,prolonged NCT-A time and decreased DST scores (all P＜0.001).NCT-A completion time was negatively correlated with Cho/Cr and mI/Cr (r=-0.477,P =0.001;r=-0.695,P＜0.001) and positively correlated with Glx/Cr (r=0.665,P＜0.001).DST scores were positively correlated with Cho/Cr and mI/Cr (r =0.478,P =0.001;r=0.632,P＜0.001),and negatively correlated with Glx/Cr (r=-0.572,P＜0.001).Conclusion The neurocognitive impairments may be related to metabolic changes of the thalamus in patients with HBV RC.
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Objective To summarize the practices of national emergency medical rescue team in the fourth ASEAN regional forum disaster relief exercise.Methods The establishing principle and training mode of national emergency medical rescue team were introduced,and the advantages and disadvantages of the team were described in the preparation for exercise and rescue practice.Results The experience in Malaysia improved the team in emergency support.Conclusion The medical preparedness and rescue practice in transnational disaster relief are of great value for rapid response of national emergency medical rescue team.
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[Objective]To investigate the micro-structural alterations within whole brain white matter(WM) in cough syrup abuse addiction patients containing codeine,and to explore the correlation between aberrant WH and abuse time of cough medicine abuse patients.[Methods]Thirty cough syrup abuse addiction patients containing codeine and 30 controls participated in the study. Structural changes in FA and(mean diffusivity)MD were examined in cough syrup abuse addiction patients containing codeine which derived from DTI tractography. Pearson correlation analysis was performed to compare the mean FA value and duration of cough syrup abuse addiction in patients.[Results]Cough syrup abuse addiction patients containing codeine had lower FA value in bilateral anterior limb of internal capsule(ALIC)and higher MD in the bilateral hippocampus and insula,right anterior cingulate cortex(ACC)and superior temporal gyrus,compared to the controls. Cough syrup abuse addiction group also had positive correlation between mean FAvalues and duration of cough syrup abuse addiction in patients.[Conclusion]Micro-structural alterations within whole brain white matter(WM)are found in cough syrup abuse addiction patients containing codeine. This disturbance progresses as duration increases of cough syrup abuse addiction in patients.
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Objective To assess the application value of NCE-MRA using iMSDE prepared bSSFP sequence in lower limb in patients with diabetes. Methods This prospective study included a total of 35 patients with type II diabetes who underwent CE-MRA on the 1.5T MR scanner after the NCE-MRA. The obtained MIP images were independently rated by two radiologist with a four score table and using CE-MRA as a reference standard to evaluate the diagnostic accuracy of NCE-MRA for the narrowed arteries. The difference of the percent age of diagnostic arterial segments between NCE-MRA and CE-MRA on diabetic patients was evaluated by the χ2 test. Results Compared with CE-MRA, the diagnostic-value arterial segment ratio of pelvic arteries on NCE-MRA is decreased significantly. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of two readers in NCE-MRA were 95%/87%, 96%/95%, 57%/72%, 99%/99%, and 96%/95%(k=0.76), respectively. Conclusions The NCE-MRA using iMSDE prepared bSSFP sequence is capable of depicting vascu-lar lesions for the lower extremities in diabetic patients with the advantages of contrast agent free, short scan times and good diagnostic value in the thigh and calves.
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Objective To investigate w hether the iterative reconstruction (iDose 4 ) technique improves imaging quality of the low-radiation-dose w hole brain CT perfusion (CTP). Methods Thirty-five consecutive patients w ith clinical y suspected ischemic stroke w ere col ected. Bril iance 256 iCT w as used to perform low-radiation-dose w hole brain CTP, and the filtered back projection (FBP) and iDose 4 algorithm w ere used to conduct image reconstruction. The noise and signal to noise ratio of the 2 kinds of reconstruction algorithms, as w el as the imaging quality of each parameter map w ere compared. Results The effective dose of the w hole brain CTP w as 2.2 mSv. Compared w ith FBP, the noise of each region of interest in the iDose4 Tmax map was decreased significantly ( P<0.05) and the signal to noise ratio was increased significantly (P<0.05). The imaging quality scores (median, interquartile range) reconstructed by FPB group w ere significantly low er than by iDose 4 for cerebral blood flow (CBF) map ( 5.00 [3.00-6.00]vs. 6.00 [5.00-6.00]; Z= -2.784, P=0.005), cerebral blood volume (CBV) map ( 6.00 [5.00-6.00] vs. 6.00 [6.00-7.00]; Z= -3.674, P<0.001), and mean transit time (MTT) map (4.00 [3.00-5.00] vs. 5.00 [4.00-6.00]; Z=3.394, P=0.001). The proportions of the poor quality in CBF map ( 34.3%vs. 11.4%;χ2 =7.036, P=0.030), CBV map (11.4%vs.2.9%; χ2 =7.485, P=0.024 ) and MTT map (28.6%vs.11.4%;χ2 =5.318, P=0.070) reconstructed by FBP w ere significantly higher than by iDose 4 . Conclusions The iDose4 technique may improve imaging quality of low er-radiation-dose CTP.
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Objective To evaluate the effect of intravenous administration of gadolinium-DTPA on diffusion weighted imaging (DWI)of breast lesions and apparent diffusion coefficient(ADC)values,and to evaluate the diagnostic performance of post-contrast ADC for differentiating benign from malignant lesions in breast.Methods Thirty-eight histopathologically-confirmed breast lesions were analyzed.We examined the signal to noise ratio(SNR)of normal breast tissue and lesions and evaluated the contrast to noise ratio(CNR)of each lesion.We also assessed the relation between pre-and post-contrast ADC values.Results SNRs and CNRs of DWI before and after contrast were not significantly different.The mean post-contrast ADC values for malignant lesions significantly decreased after contrast injected (mean of -1 1.6%),while ADC values in the benign lesions were not significantly different before and after contrast.Conclusion Post-contrast ADC values may be a better indicator of potential breast tumors than pre-contrast ADC values.
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Objective To understand the impairment and compensation mechanism of brain function in pa-tients with non-fluent aphasia after ischemic stroke. The fractional amplitude of low frequency fluctuation (fALFF) method was used to analyze the functional magnetic resonance imaging (fMRI) data in the resting state between the aphasia patients and the normal controls. Methods The scans of the resting state of fMRI were performed in 17 aphasia patients and 19 age-, education-, and sex-matched healthy control subjects. The scan sequence was single-shot echo planar image,DPARSF software was used to analyze fALFF data of the aphasia patients and the healthy controls. Results Compared to the control group, the value in right superior temporal gurus, inferior parietal lob-ule, frontal lobe cortex, and postcentral gurus were significantly increased in the aphasia group. The fALFF in bilat-eral cerebellum and right thalamus were also decreased in the aphasia group. Conclusions The fALFF values in some brain region in the aphasia group were abnormal in the resting state , indicating a few pathological change of brain function in patients with non-fluent aphasia after ischemic stroke.
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Objective To establish an assay for the detection of Streptococcus pneumoniae by real-time fluorescence quantititive polymerase chain reaction (PCR).Methods Special primers and probe for the autolysin A (lytA)gene were designed.The sensitivity and specificity of primers and probe were studied,and cut-off of cycle threshold was assayed.158 clinical specimens were confirmed by real-time fluorescence quantitative PCR and bacterial culture method.Results Primer and probe design for LytA gene could sensitively detect serotype Streptococcus pneumoniae strains of common pathogenic,and the sensitivity was 100 copies.Among 35 strains of Streptococcus pneumoniae,34 cases were detected to be positive for Streptococcus pneumoniae by real-time fluorescence quantitative PCR,while 1 case was detected to be negative;among 15 strains of non-Streptococcus pneumoniae, all were detected to be negative.Among the 158 clinical sputum specimens,34 cases with Streptococcus pneumoniae were detected by real-time fluorescence quantitative PCR,while only 10 cases with Streptococcus pneumoniae were detected by the culture method.White blood cells count and time in hospital of cases with Streptococcus pneumoniae were higher than those of cases without Streptococcus pneumoniae (P <0.05 ). Conclusion Real-time fluorescence quantitative PCR is a sensitive and specific assay for the detection of Streptococcus pneumoniae.It can be used for the diagnosis of Streptococcus pneumoniae.
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<p><b>OBJECTIVE</b>To investigate the changes in orbitofrontal cortex (OFC) functional connectivity and its association with decision-making deficits in chronic heroin-dependent individuals (HDIs) and explore the neural mechanisms of heroin addiction and relapse.</p><p><b>METHODS</b>Fourteen male chronic HDIs and 14 healthy subjects matched for age, education, and nicotine consumption participated in this study. Resting state functional magnetic resonance imaging (fMRI) was performed using a 1.5 T MR scanner. Functional connectivity of the OFC and the rest of the brain were calculated using REST software. Voxel-based analysis of the functional connectivity maps between the control and HDI groups was performed with two-sample t test. The Iowa gambling task (IGT) was used to assess the participants' decision making during uncertainty.</p><p><b>RESULTS</b>Compared with the control group, the HDIs showed significantly decreased functional connectivity of the OFC and the right inferior parietal lobule (rIPL) (t=3.5, P<0.05). A significant negative correlation was noted between the functional connectivity of the OFC-rIPL and performance level at the IGT.</p><p><b>CONCLUSION</b>The OFC-rIPL functional connectivity is significantly disrupted in HDIs, which may be the neural basis for decision-making deficits.</p>
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Adult , Humans , Male , Case-Control Studies , Decision Making , Frontal Lobe , Heroin Dependence , Psychology , Magnetic Resonance ImagingABSTRACT
Objective To evaluate the valuations of the intracranial vertebrobasilar arteries using CT angiography (CTA) in order to improve the understanding of various variants in intracranial vertebrobasilar arteries.Methods The CTA images of 435 subjects were analyzed retrospectively.The data were collected by a 16-slice CT scanner.All the CTA images were processed technically by the maximum intensity projection and volume rendering.The intracranial vertebrobasilar arteries were measured and analyzed.Results Among the 435 subjects,bilateral intracranial vertebral arteries (V4) showed symmetry in 183 (42.07％) and dissymmetry in 252 (57.93％).Hypoplasia were found in 27 subjects (6.21％) on the left V4 segments and 36 (8.28％) on the right V4 segments,and a total of 21 (4.83％) were directly continued as the ipsilateral posterior inferior cerebellar arteries on the unilateral V4 segments.There were 2 subjects (0.46％) with vertebrobasilar dolichoectasia.There were 32 subjects (7.36％) had fenestration variation,3 of them (0.69％) were on the V4 segments,10 (2.30％) at the junctions,and 19 (4.37％) in the basilar arteries.Two subjects (0.46％) had persistent trigeminal arteries.Conclusions The variations of intracranial vertebrobasilar arteries mainly include angiodysplasia,vertebrobasilar dolichoectasia,fenestration variation,and persistent trigeminal artery.As a noninvasive vascular imaging method,CTA may accurately and visually assess the anatomic variation of intracranial vertebrobasilar artery,and provide imaging guidance for the preoperative evaluation of posterior fossa surgery.
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This paper analyzed the economic background,contents and effects of the existing business model of the hospital.On this basis,further study and reform are made on optimal business model of the hospital.The authors recommended that appropriate regional health scale,appropriate technical service,appropriate pricing for charges,appropriate operating cost and appropriate incentive constraints be adopted.These measures will safeguard state assets,public benefit nature of the hospital,enhanced hospital power in general,and compliance in operations,making the people satisfied and healthy.
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Objective To design the coding User Interface of DICOM SR based on PACS and introduce the coding func- tion.Methods 1 000Mb trunk net was adopted in PACS and 100Mb was exchanged on tabletop.To exploit SQLServ- er2000 database and take the PingYingJiaJia and WuBiJiaJia as Chinese input methods.To exploit optical disk edition of ACR and ICD-10 coding system to construct coding database.To adopt the system of DICOM SR explored ourselves. Results User Interface referred to the rule and definition of DICOSR.To make report disposal and case management and statistics query and imagine teaching and HIS connection in one windows and can manipulate each other.ACR and ICD-10 coding key were set in right of diagnosis report interface.Hitting ACR and ICD-10 coding key would spring the relating coding window.Conclusion User Interface of DICOM SR was friendly.It was powerful and utility.
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Objective To explore the interactive teaching model for CT imaging based on PACS, and provide the clinician and young radiologist with continued medical education. Methods 100 M trunk net was adopted in PACS and 10 M was exchanged on desktop. Teaching model was installed in browse and diagnosis workstation. Teaching contents were classified according to region and managed according to branch model. Text data derived from authoritative textbooks, monograph , and periodicals. Imaging data derived from cases proved by pathology and clinic. The data were obtained through digital camera and scanner or from PACS. After edited and transformed into standard digital image through DICOM server, they were saved in HD of PACS image server with file form. Results Teaching model for CT imaging provided kinds of cases of CT sign, clinic characteristics, pathology and distinguishing diagnosis. Normal section anatomy, typical image , and its notation could be browsed real time. Teaching model for CT imaging could provide reference to teaching, diagnosis and report. Conclusion PACS based teaching model for CT imaging could provide interactive teaching and scientific research tool and improve work quality and efficiency.
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Objective To evaluate MR imaging diagnosis in acute suppurative osteomyelitis at early stage. Methods The axis, sagittal and coronal planes were performed with Philips 0.5 T superconduct MR scanner on 12 cases of acute suppurative osteomyelitis in lower extremity proved by clinical data 2 to 14 days after onset. Results Abnormal signals in marrow were displayed in all 11 cases 3 to 14 days after onset. No abnormality was found in 1 case 2 days after onset. The interface between normal and abnormal marrow became clear as time going on. The lesion presented as patchy low intensity on T 1WI and high signal on T 2WI. The signal changes were marked especially on STIR. Conclusion MRI was superior to other imaging methods in diagnosis of acute suppurative osteomyelitis.
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Guided by the innovation theory and ideology, the authors'hospital saw to it that the main line of innovative progress ran through the entire process of its development and set up a management engineering framework for innovation in six chief aspects. It managed to achieve “three firsts”, viz. the first to put forward in the domestic medical industry the suggestion of taking strategic actions so as to promote the construction of a clean and honest administration in the hospital; the first among hospitals of the armed forces to cultivate an “experimental plot” that partook of no money earmarked for national defense; and the first among large general hospitals at home to develop into a non profit hospital without government subsidies. It also attained remarkable results in the fight against SARS.
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The hospital the authors work with succeeded in achieving three sublimations of the idea of hospital management control in the course of hospital management control innovation, viz. sublimations from one-sided development concept to scientific development concept, from people-oriented management of human resources to ability-oriented management of human resources, and from emphasizing comprehensive strength to stressing developmental ability in hospital accreditation.