Objective To build a regional cooperative healthcare system in order to make the best use of the limited medical resources,reduce the cost,and improve the quality of medical treatment.Methods Data warehouse and virtual database were used to build regional data center and realize data integration of hospital information system.Upon this foundation,a web service integration of hospital information system based on SOA was realized.Results This design scheme realized the effective management and integration of huge information resources,and managed the medical workflow effectively.Conclusion This design scheme provides the regional cooperative healthcare system with the characteristics of modularization and expansibility.Hierarchy architecture enhances the stability of the system.

Objective To build high availability cluster using VMware to improve availability of hospital information system.Methods Virtual machines were installed in VMware server to act as backup servers.High availability software continuously detected status of physical servers using heartbeat signals.Results When physical servers failed,high availability cluster switched services automatically.The business switched to virtual machine quickly and smoothly.Conclusion High availability cluster based on VMware can improve HIS availability and lower implementation costs effectively.

Objective To monitor the hospital computer room in real time; ensure the normal running of hospital information system; overcome the disadvantages of wired monitor system. Methods Zigbee was used to build a wireless sensor network. Wireless monitor system for hospital computer room was realized. Results By exerting the advantages of zigbee, hospital computer room was monitored more effectually and the workload of the computer room keeper was reduced. Conclusion Using Hospital computer wireless monitor system based on zigbee can achieve the uniform management and monitoring effectually.

Objective To investigate the risks and benefits of different surgical treatments for cystic neoplasms of the pancreas (CNP).Methods The clinical data of 243 CNP patients were reviewed retrospectively.Different surgical treatments were adopted according to the site,size and invasiveness of the tumors.A long term follow-up was carried out for patients with small benign CNP,and a surgical excision is proposed if tumors progressed during the observation.Results 58 outpatients with no evidence of malignancy was followed up and had long-term survival,in which 4 patients received a surgical resection in case of tumor progression,and all of them were confirmed benign tumors.185 cases received surgical treatments,with a resection rate of 97.3％ (180/185),including 127 non-invasive tumors,and 58 cases of invasive tumors.Perioperative mortality was 2/185,and morbidity rate was 41/185.Pancreatic fistula was the most frequent complication,which was significantly associated with tumor site and excision extension.All patients with non-invasive CNP acquired a long term survival after surgical treatments.The postoperative 1,3,5 year survival rates for patients with invasive lesions were 89.6％,52.1％ and 29.2％,respectively.Conclusions Long term follow-up and observation is feasible for asymptomatic patients with benign CNP.A radical resection should be performed for malignancy,and a combined multi-organ resection may improve the prognosis for local advanced tumors.

Objective To evaluate the diagnostic effect of intro-operative tissue puncture biopsy and find its influential factors.Methods The clinical data of 94 patients with pancreatic mass treated in our hospital from July 1994 to December 2007 and undergoing intro-operative tissue puncture biopsy were retrospectively analyzed.Results The sensitivity,the specificity,the positive predictive value and the negative predictive value were 74.6%,93.8%,98.0%and 46.9%,respectively.The single factor analysis showed that the size of pancreatic mass,the number of puncture and complicating with pancreatic fibrosis or not were related to the diagnosis of tissue puncture.The multiple factor analysis showed that the size of pancreatic mass(P=0.014)and the number of puncture(P=0.020)were crucial to the diagnosis of puncture.The sensitivity and specificity of intro-operative tissue puncture biopsy for the pancreatic mass less than 25 mm were lower than that for the mass larger than 25 mm (P=0.000).The sensitivity and specificity would be increased as the number of puncture increased (P=0.000).For the mass less than 25 mm,increasing the humber of puncture would improve the sensitivity(P=0.002).Conclusion Intro-operative tissue puncture biopsy is a simple and accurate procedure for differentiating the pancreatic mass.The sensitivity and specificity could be improved by increasing the number of puncture,especially for the patients with pancreatic mass less than 25 mm.

Objective To determine the value of preoperative clinical, biochemical, cross-sec-tional imaging features and results of fine-needle aspiration for predicting malignancy in cystic neo-plasms of the pancreas (CNP). Methods The medical records of 69 patients receiving operations for CNP between 1994 and 2008 in our hospital were reviewed retrospectively. The predictive effect of va-rious preoperative factors such as sex, location, clinical manifestation, maximum diameters, tumor marker, pancreatic duct obstruction and calcification on the malignant potential of CNP was evaluated by Single and multi-factor analysis, fine needle aspiration (FNA) and intraoperative frozen-section ex-amination of the pancreatic transection margin was investigated. Results All the 69 patients were con-firmed pathologically. Of the 69 patients, 13 suffered from serous cystic neoplasms, 30 from mucinous cystic neoplasms,7 from intraductal papillary mucinous neoplasms,12 from solid pseudopapillary neo-plasms and 7 from cystic neoplasms. Forty-four lesions were diagnosed as malignant or borderline.Univariate analysis should that jaundice, raised CEA and/or CA19-9, maximum diameters and solid component of cystic neoplasmshad were of statistical significance for the risk of malignancy in CNP.The sensitivity was 34.1% (15/44), 47.7 % (21/44), 88.6%(39/44),72.7%(32/44) and specificity 96% (24/25), 84% (23/25), 68% (17/25),72% (18/25), respectively. The last three were identified as independent predictive factors for malignancy by multivariate analysis. Three cases were accurately diagnosed out of the 9 undergoing FNA preoperatively. One of 7 patients with intraductal papillary mucinous neoplasms (IPMN) undenwent total pancreatetomy for transection margin positivity.Conclusion Most malignant CNP can be accurately diagnosed preoperatively from a typical clinical,biochemical and cross-sectional imaging picture. FNA is only used in the patients who are potential candidates for nonoperative management. Margin analysis is necessary for pancreatic resection.

Objective To study the causes of pancreatic fistula following pancreatioduodenectomy, and evaluate the effect of total pancreatic uncinate process resection on the prevention of pancreatic fistula by analyzing the potential aetiology of pancreatic fistula after pancreaticoduodenectomy.Methods The clinical data of 68 patients, who were admitted into the No. 1 ward of Surgical Department of Peking University First Hospital during the period from Jan. 2004 to Jun. 2009, were retrospectively analyzed. The day-average level of amylase higher than 3 times of normal value, as measured from the drainage of peritoneal cavity, serves as the diagnostic criterion of the postoperative pancreatic fistula.Factors relevant to fistula, which result in the abnormal increase of the amylase in the drain, such as the extent of resection of pancreatic uncinate process, the anastomotic manners of pancreas and digestive tract, and the pancreatic fibrosis were statistically analyzed. Results The incidence of pancreatic fistula was 33. 8% according to the diagnostic criterion mentioned above; Single factor analysis showed that the resection extent of uncinate process (P = 0. 000) and the level of serum glucose ( P = 0. 045 ) were correlated with the occurrence of pancreatic fistula. Multivariate analysis identified that the independent risk factor for pancreatic fistula was the resection extent of uncinate process(P =0. 000). Pancreatic fibrosis, the manners of the anastomosis of pancreas and digestive tract were not independent risk factors. Conclusion Total resection of uncinate process could prevent pancreatic fistula from residual pancreatic uncinate process, hence reduce the incidence of pancreatic fistula following pancreaticoduedenectomy.

Objective To build an architecture for medical information integration based on SOA(Service-Oriented Architecture)by analyzing the characters of medical information integration and the integration technology of SOA. Methods Virtual database was built by XML Schema mapping for conform share of medical data based on XML technology. The method and principle of Web Services for medical information were researched and built. Results Medical information systems could uniformly exchange information based on standards of Web Services, and the conform medical information share mode was realized. Conclusion The integration of medical information systems based on SOA not only has the characteristics of loose-coupling and customization agility but also makes information share possible because of conform mode.

Objective To apply the techniques of network isolation and secure data exchange network to hospital information system.Methods Network isolation and secure data exchange were used to do data exchange and synchronization between two networks.Results A LIS result query system was designed and realized based on this technology.Conclusion Secure data exchange in HIS can be realized effectively by using the techniques of network isolation and secure data exchange and it has good foreground in hospital information system.[Chinese Medical Equipment Journal,2008,29(2):45-47]

Objective To avoid medical mistake,improve service quality of medical care,insure the security of patients. Methods The wireless Lan was deployed in ward to implement the scheme of using wireless Lan and avoid medical mistake,and then use wireless nursing system to prove it. Results This scheme can reduce the work intensity of medical staff,decrease the probability of medical mistake,and improve the service quality of medical care. Conclusion The wireless technology can avoid medical mistake effectively.