目的:利用临床决策支持系统(Clinical Decision Support System, CDSS),辅助医生提高诊疗水平,减少误诊及漏诊率。方法:通过对全院海量优质历史病历的机器学习,构建医院临床最佳实践库;在此基础上,融合BMJ循证医学最佳实践库,形成诊疗...目的:利用临床决策支持系统(Clinical Decision Support System, CDSS),辅助医生提高诊疗水平,减少误诊及漏诊率。方法:通过对全院海量优质历史病历的机器学习,构建医院临床最佳实践库;在此基础上,融合BMJ循证医学最佳实践库,形成诊疗标准框架;利用随机森林、神经网络等人工智能算法,生成决策支持模型,实现对临床诊疗的辅助支持。结果:系统基于优质历史病历和BMJ循证医学证据的决策模式,使推荐结果更具针对性,更符合医院实际;大大提高了诊疗模型的准确率(最高可达91.7%),使结果更加可靠。结论:临床决策支持系统的应用,将为医生在诊疗过程中提供切实、有效的帮助。展开更多
In this study,the colonization and distribution of Helicobacter pylori（Hp） in patients with chronic gastric diseases were investigated and the relationship between the periodontal initial treatment and presence of H...In this study,the colonization and distribution of Helicobacter pylori（Hp） in patients with chronic gastric diseases were investigated and the relationship between the periodontal initial treatment and presence of Hp in oral cavity was examined to better understand the connection between Hp infection and chronic diseases.Primers for PCR amplification were designed according to ureC gene and cagA genes of Hp.Specimens were harvested from different sites of 96 patients with chronic gastric diseases and the specimens of dental plaques,gargles and dorsal mucosa were tested for Hp.The 96 patients were treated by bismuth triple therapy and among them,52 subjects were additionally given periodontal initial therapy.The eradication rate of gastric Hp and oral Hp detection rate were determined 4 weeks and 1 year after the treatment.The results showed that the detection rates of oral specimens were in the order of dental plaques（82.3%）,gargles（51.1%） and scrapings of dorsal mucosa of tongue（37.5%）.One year after bismuth triple therapy or the triple therapy in combination with periodontal initial treatment,the eradication rate of gastric Hp was significantly higher in the combination treatment group than in group treated by the triple therapy alone（62.8% vs.32.4%,P0.05）.Moreover,the Hp detection rate was significantly lower in the combination group than in the group treated only with the triple therapy.We are led to conclude that Hp is present at various parts of oral cavity,oral Hp might be an important source of gastric Hp and the triple therapy plus periodontal initial treatment can enhance the long-term eradication rate of gastric Hp in patient with both chronic gastric diseases and chronic periodontitis.展开更多
文摘目的:利用临床决策支持系统(Clinical Decision Support System, CDSS),辅助医生提高诊疗水平,减少误诊及漏诊率。方法:通过对全院海量优质历史病历的机器学习,构建医院临床最佳实践库;在此基础上,融合BMJ循证医学最佳实践库,形成诊疗标准框架;利用随机森林、神经网络等人工智能算法,生成决策支持模型,实现对临床诊疗的辅助支持。结果:系统基于优质历史病历和BMJ循证医学证据的决策模式,使推荐结果更具针对性,更符合医院实际;大大提高了诊疗模型的准确率(最高可达91.7%),使结果更加可靠。结论:临床决策支持系统的应用,将为医生在诊疗过程中提供切实、有效的帮助。
基金supported by a grant from the Bureau of Science and Technology under Tai'an Municipal Govern-ment(No.TKJ2002-9)
文摘In this study,the colonization and distribution of Helicobacter pylori（Hp） in patients with chronic gastric diseases were investigated and the relationship between the periodontal initial treatment and presence of Hp in oral cavity was examined to better understand the connection between Hp infection and chronic diseases.Primers for PCR amplification were designed according to ureC gene and cagA genes of Hp.Specimens were harvested from different sites of 96 patients with chronic gastric diseases and the specimens of dental plaques,gargles and dorsal mucosa were tested for Hp.The 96 patients were treated by bismuth triple therapy and among them,52 subjects were additionally given periodontal initial therapy.The eradication rate of gastric Hp and oral Hp detection rate were determined 4 weeks and 1 year after the treatment.The results showed that the detection rates of oral specimens were in the order of dental plaques（82.3%）,gargles（51.1%） and scrapings of dorsal mucosa of tongue（37.5%）.One year after bismuth triple therapy or the triple therapy in combination with periodontal initial treatment,the eradication rate of gastric Hp was significantly higher in the combination treatment group than in group treated by the triple therapy alone（62.8% vs.32.4%,P0.05）.Moreover,the Hp detection rate was significantly lower in the combination group than in the group treated only with the triple therapy.We are led to conclude that Hp is present at various parts of oral cavity,oral Hp might be an important source of gastric Hp and the triple therapy plus periodontal initial treatment can enhance the long-term eradication rate of gastric Hp in patient with both chronic gastric diseases and chronic periodontitis.
