目次

1……基于互联网+ 医院社区健康管理联动战略与策略      鲍勇

9……信息化态势下医院职能科室绩效考核的探索与实践      王萍，鲍勇

21……智慧促进健康，健康利增智慧        王兴华，王光耀，盛良，等

27……运用传感器技术促进中医药研究    王光耀，王兴华，盛良，等

31……从检测中西药气味物质基础探中西药理论会通     王光耀，盛良，王兴华，等

35……“四气五味”物质基础研究中的问题与对策   王光耀，盛良，王兴华，等

39……电子鼻技术促进医药卫生事业发展     王兴华，王光耀，盛良，等

42……运用电子鼻检测活血化瘀中药物质基础研究    王光耀，盛良，王兴华，等

47……MRI 技术在缺血性脑卒中诊疗中的应用     张晓峥

52……MRI 在AD 中的应用研究进展     靳聪，林岚，付振荣，等

60……中医的本质和现代化之路     杨晓达

65……玄府理论探讨     龚轩，王庆国

71……点触式探针超声碎石清石治疗硬结石     黄永斌，王军起，聂锐志，等

基于互联网+ 医院社区健康管理联动战略与策略    

鲍勇

摘 要：本文介绍了基本概念和理论，分析了构建互联网+ 医院社区健康管理联动的背景，对互联网+ 医院社区健康管理联动提出了“12345 模式”，同时总结了美国的“凯撒医改模式”，最后对实施互联网+ 医院社区健康管理联动界定了机制。

关键词：互联网+；医院社区联动；医改

A study of linkagestrategy and strategy of hospitals and community in health management based onInternet +  

BAO Yong

Abstract: Thispaper introduces the basic concepts and theories, analyzes the background ofbuilding inkage strategy and strategy of hospitals and community in healthmanagement based on Internet + , and proposes the "12345 mode" of theinkage strategy and strategy of hospitals and community in health managementbased on Internet + , and summarizes the "Kaiser health

care reformmodel", and finally defines the mechanism for the implementation of inkagestrategy and strategy of hospitals and community in health management based onInternet + t.

Key words: Internet+; Hospital community linkage; Health care reform

信息化态势下医院职能科室绩效考核的探索与实践

王萍，鲍勇

资助项目： 1. 国家自然科学基金: 公立医院诊疗行为对患者信任影响: 基于PZB 模型的实证研究(71373159,2013)；2. 教育部：基于医疗质量改进的患者信任度评价指标体系构建以及实证研究（13YJAZH003）；3. 上海市浦东新区卫生局卫生（计生）科技项目：新医改形势下二级综合性医院内部绩效考核指标体系构建及应用（PW2013B-9）。

摘 要：为适应科学化、信息化发展需要，医院必须建立一套行之有效的职能部门绩效考核机制。本文对医院职能科室绩效考核的难点和目的进行分析，以上海市浦东新区人民医院为例，设计了职能科室绩效考核指标体系及其实施方法，并总结了该方法实施后所取得的成效，期待对一些医院的职能科室绩效考核工作带来一定的指导意义。

关键词：职能科室；绩效考核；上海市

The exploration andpractice of performance appraisal of functional departments under the situationof Information technology development

Wang Ping, Bao Yong

Abstract: In orderto meet the needs of scientific and information technology development, thehospital must establish a set of effective performance appraisal mechanism.Taking Shanghai Pudong New Area People’s Hospital as example, this article analysisthe difficulties and purposes of performance appraisal of functionaldepartments in hospitals, designs appraisal index system and implementationmethods, and summarizes the achievement of implementation. Look forward tobring certain directive significance to some hospitals.

Key words: FunctionalDepartments; Performance Appraisal; Shanghai

智慧促进健康，健康利增智慧——智慧健康引领医药卫生事业发展

王兴华， 王光耀， 盛 良， 汪 宇，Te Kian Keong，Teh Siew Hoon，Ooi Ciat Hui

基金项目：　 江苏省科学技术厅基础研究计划（自然科学基金）资助项目(BK2012857)。国家中医药管理局重点学科，江苏省重点学科。Centre for Research in Traditional ChineseMedicine，UTAR.

摘　要：智慧健康是将人类的智慧应用于人民的健康，将智慧含有的综合知识、技能、思想、方法、仪器、设备、材料等应用于健康事业，应用于药物开发、医疗保健、疾病诊治、养生康复、卫生防疫等诸多方面，并产生前所未有的高效，较为轻松、容易、方便、灵活地实现人类的健康目标。为了加速健康事业的快速发展，当代“智慧健康”研究领域引入了人工智能系统，集合了医学、药学、保健、信息、网络、计算机、远程通信、信号处理等多学科的知识、技能、技术、设备，构成了“智慧健康”的统一体与集约化。智慧地感知、智慧地运用、智慧地运作、智慧地管理、智慧地互动等，已经成为“智慧健康”的基石，具体表现在智能化采集健康信息，智能处理、应用健康知识与健康信息，形成健康的智能决策过程，应用网络和计算机等现代技术，建立起健康资源与健康需求联系的通道，形成云服务系统。在智慧健康条件下，人们可以利用这些互联网和远程通讯设备，多渠道获得更多的卫生保健知识，提高预防疾病和治疗疾病的水平。在智慧健康的时代，可望破解“看病难”、“看病贵”的社会难题。有了智慧健康，社会人群的个性化需求也较易实现，能更好地满足特殊需求，实现医疗服务的多样性和层次性。卫生服务与信息科技紧密结合，将共同为医药产业的发展指路领航。运用智慧健康的思路和方法研究中西医和中西药，寻觅二者之间物质基础的共同点，实现中西药理论会通，为中医药现代化、中西医结合、中西药会通等研究探寻出路，寻找突破方向。

关键词：智慧；健康；医药；人工智能；现代化

Wisdom promoteshealth and health benefits wisdom—eading the development of medicine and health in wiseway

WANG Xing-hua,WANGGuang-yao, SHENG Liang,WANG Yu,Te Kian Keong, Teh Siew Hoon,Ooi Ciat Hui

Abstract: WisdomHealth is an advanced thinking mode and method to improve people’s health. The integrated knowledge，skills， ideas， methods， instruments and materials all embodytremendous wisdom， which can be applied for drug development，medical care， disease treatment， health management，epidemic prevention and many other aspects to achieve humanhealth objectives in a more relaxed， easy and flexible way with unprecedented efficiency.In order to accelerate the development of health course， the Artificial Intelligence（ AI） system is introduced into the research fields ofWisdom Health， which is an intensive unity ofmedical and pharmaceutical knowledge， and technology of health， computer， information，signal processing， remote communication and so on.“Smart”perception，application， operation， management and interaction have become the cornerstoneof the Wisdom Health，which manifests in the intelligent collection of health information， the intelligent management of healthinformation with medical knowledge，the intelligent process of forming health policy andthe application of modern technology to establish links for health resource anddemands. With Wisdom Health，people can make use of internet and remote service system to attainmedicinal knowledge and improve preventing and treating skills. In the era ofWisdom Health， the problem of“difficult and expensive to see a doctor”is hopefully to be solved. With the WisdomHealth，the individualized demand of population isalso easier to achieve，effectively reflecting the diversity of medical services. Health servicesand information technology are closely integrated to guide the development ofpharmaceutical industry. Using the idea and method of the wisdom of Chinese andWestern medicine to study the common ground of material basis between the two willfacilitated the interaction of Chinese medicine and Western medicine theory.This will help to find breakthrough for the modernization of Chinese medicineand integration of Chinese an d Western medicine.

Keywords：Intelligence; Health; Medicine; Artificialintelligence; Moder nization

运用传感器技术促进中医药研究

王光耀,王兴华,盛良,汪宇,Te Kian Keong, Teh Siew Hoon

基金项目： 江苏省科学技术厅基础研究计划（自然科学基金）资助项目(BK2012857)；国家中医药管理局重点学科；江苏省重点学科。

摘 要：传感器技术已被引入中医药研究领域，在脉诊、闻诊、辨证、疾病诊断、中药鉴别、四气五味、中西药汇通、中西医结合等方面显现出优势，并有广阔的应用前景和发展潜力。

关键词：传感器技术；脉诊；闻诊；辨证；诊断；中药

Applications ofSensor Technology Boost Chinese Medicine Research

WANG Guang-yao,WANGXing-hua,SHENG Liang,WANG Yu,Te Kian Keong,Teh Siew Hoon

Abstract: Sensortechnology has been introduced into the field of Chinese medicine research forincreasing advantages in a wide range of areas such as pulse diagnosis，auscultation and olfaction， syndrome differentiation，disease diagnosis，Chinese medicine identification，four properties and five tastes，integrative use of Chinese and westernmedicine，etc. Therefore，sensor technology has the broad application prospect and greatdevelopment potential.

Keywords: Sensortechnology; Pulse diagnosis; Auscultation and olfaction; Syndromedifferentiation; Diagnosis; Chinese medicine

从检测中西药气味物质基础探中西药理论会通

王光耀,盛良,王兴华,汪宇,TeKian Keong，TehSiew Hoon,OoiCiat Hui

基金项目：江苏省科学技术厅基础研究计划（自然科学基金）资助项目(BK2012857)。

摘　要：西药和中药都有化学成分，气味是由药品的化学成分产生的，气味检测是研究药品物质成分的基本方法之一。中西药研究都应该重视药品成分、气味、性质与疗效之间的关系，寻找两者物质基础与化学成分的共同规律。应用电子鼻与电子舌技术，能够检测中西药的气味，该技术检测所得到的图形，可视可辨，能够用于二者之间的比较与鉴别，方法简单快速。量化西药的Pka 值，也可以用于量化中药气味。通过检测中西药气味，研究二者之间物质基础的共同点，实现中西药理论会通，以促进中西药理论的结合与创新。

关键词：四气五味；物质基础；量化；中药；西药；电子鼻；电子舌

Study on theCombination of OdorTheory about Material Basis of Chemical Medicine and NaturalMedicine

WANG Guang-yao,SHENG Liang, WANG Xing-hua, WANG Yu1, TeKian Keong, TehSiew Hoon, OoiCiat Hui

Abstract: Chemicalsare chemical, and the natural medicine is also a chemical. Odor is produced bythe chemical constituents of the medicine, so the testing“smell” is one of the basic methods to detect the chemicalcomposition of drugs. It should pay attention to the relationship between thecomposition, smell, character and effect of both chemical medicine and naturalmedicine. The technology of electronic nose and electronic tongue can detectthe smell of chemical medicine and natural medicine. Simple and fast asit is,thistechnologycan be used for the comparison and identification ofthe smell ofmedicine via studying the graphics that reflectchemical basis. The Pkavalue ofchemicals can also be used to quantify the smell of natural medicine. Bydetecting the odor of chemical agents and nature medicines, the common materialbasis can be studied for theinnovation and fusion of modern medicine andtraditional Chines e medicine theory.

Key words: Fournature and Five taste; Material base; Quantification; Natural drugs;Chemicaldrugs; Electronic nose; Electronic tongue

“四气五味”物质基础研究中的问题与对策

王光耀, 盛良,王兴华,汪宇,Te Kian Keong，Teh Siew Hoon，Ooi Ciat Hui

基金项目：江苏省科学技术厅基础研究计划（自然科学基金）资助项目(BK2012857)。国家中医药管理局重点学科，江苏省重点学科。Centre for Research in Traditional ChineseMedicine，UTAR.

摘 要：指出“四气五味”研究中存在的问题：三个认识不足，三个研究误区，三个研究难题。提出解决问题的对策：引进新技术与新方法，应用电子鼻和电子舌检测中药“四气五味”的物质基础，探析作用机理，并由此促进中西医药理论会通。

关键词：四气五味；问题；对策；电子鼻；电子舌

Problems andStrategies in the Research of Four Properties and Five Tastes

WANG Guang-yao,SHENG Liang, WANG Xing-hua, WANG Yu, Te Kian Keong, Teh Siew Hoon, Ooi Ciat Hui

Abstract: Thisarticle pointed out problems in the research of four properties and five tastesin Chinese medicine and concluded into three insufficient understandings, threemisunderstandings and three challenges in research. Strategies in solving theseproblems were proposed as introducing new technologies and methods, applyingelectronic nose and tongue to detect material basis of four properties and fivetastes, exploring and analyzing mechanism of action and further promotingintegrative use of Chinese and western medicine.

Key words: Fourproperties and five tastes; Problem; Strategy; Electronic nose; Electronictongue

电子鼻技术促进医药卫生事业发展

王兴华,王光耀,盛良, 汪宇,Te Kian Keong，Teh Siew Hoon,Ooi Ciat Hui

基金项目：江苏省科学技术厅基础研究计划（自然科学基金）资助项目(BK2012857)。国家中医药管理局重点学科，江苏省重点学科。Centre for Research in Traditional ChineseMedicine，UTAR.

摘 要：电子鼻技术是一种人工嗅觉系统，在环境保护、火灾监控、食品安全、药物鉴别、疾病诊断等诸多领域中均有应用。所需耗材较少，检测速度较快，数据误差较小，灵敏度与精准度较高，重复性较好，样品无破坏性，费用也相对便宜。预测电子鼻技术将促进医药卫生事业进步，具有广阔的应用前景和发展潜能。

关键词：电子鼻技术；环境保护；火灾监控；食品安全；药物鉴别；疾病诊断

Electronic NoseBoosts the Development of Medical and Health Undertakings

WANG Xing-hua, WANGGuang-yao, SHENG Liang, WANG Yu, Te Kian Keong, Teh Siew Hoon, Ooi Ciat Hui

Abstract: Electronicnose technology is a kind of artificial olfactory system, which has been appliedin many fields such as environmental protection, fire monitoring, food safety,drug identification, disease diagnosis and so on.The material is less, the detectionspeed, data error is small, the sensitivity and accuracy is higher, therepeatability is good, the sample is not destroyed, the cost is relativelycheap.Prediction of electronic nose technology will promote the progress ofmedical and health services, has broad application prospects and developmentpotential.

Key words：Electronic nose technology; Environmentalprotection; Fire monitor; Food safety; Drug identification; Disease diagnosis

运用电子鼻检测活血化瘀中药物质基础研究

王光耀,盛良,王兴华, 汪宇,Te Kian Keong,Teh Siew Hoon,Ooi Ciat Hui

基金项目：江苏省科学技术厅基础研究计划（自然科学基金）资助项目(BK2012857) 。国家中医药管理局重点学科，江苏省重点学科。Centre for Research in Traditional ChineseMedicine，UTAR.

摘　要：目的 探讨具有相同功效的中药材是否具有共同的物质基础，运用电子鼻能否对中药的药性进行初步量化。方法 运用电子鼻检测常用具有活血化瘀功效的12 种中药材，分析其PCA 图和特征指纹图谱的相似性，并通过差异指数和判别指数对其作用作进一步说明。结果 检测的12 种具有活血化瘀功效的中药材具有相似的PCA 图和特征指纹图谱。结论 12 种活血化瘀的中药具有共同的物质基础。

关键词：电子鼻；活血化瘀；中药材；实验研究

Study on theMaterial Foundation of Stasis-removing Chinese Medicine by Electronic NoseDetection

WANG Guangyao,SHENG Liang, WANG Xinghua, WANG Yu, Te Kian Keong, Teh Siew Hoon, Ooi Ciat Hui

Abstract: Objective:To investigate whether there is a common material basis among Chinese medicineswith similar effects, and whether the electronic nose can be used to quantifythe property of Chinese medicines. Methods: Twelve kinds of Chinese medicinalherbs, which have the effect of promoting blood circulation and removing bloodstasis, were tested by electronic nose. Principal component analysis(PCA) andthe characteristic fingerprint were analysed together with differential indexdi and discriminant index. Results: The 12 kinds of Chinese medicinal herbswith the function of promoting blood circulation and removing blood stasis hadsimilar PCA map and characteristic fingerprint. Conclusion: The 12 kinds ofChinese medicines have a common material basis.

Key words: Electronicnose; Activating blood circulation and removing blood stasis; Chinese herbalmedicine; Experimental study

MRI 技术在缺血性脑卒中诊疗中的应用

张晓峥

基金项目:福建省康复技术协同创新中心资助项目(X2012004- 协同).

摘 要：近年来, 随着磁共振成像技术的发展, 缺血性脑卒中的早期诊断和治疗已成为可能。利用MRI 技术可在卒中早期准确的检出缺血和梗死组织，及时挽救半暗带, 有利于指导临床治疗，减少损害, 改善预后和转归。本文对缺血性卒中检查常用的MRI 序列进行综述, 概述其在临床中的不同应用。

关键词：核磁共振成像技术；缺血性脑卒中；缺血半暗带

The clinicalapplication of magnetic resonance imaging in ischemic stroke

ZHANG Xiao-zheng

Abstract: The earlydiagnosis and therapy of ischemic stroke has become possible with thedevelopmentof magnetic resonance imaging (MRI) in recent years. For the usingof MRI techniques, ischemic and infracted tissues can be detected accuratelyduring early period, and ischemic penumbra can be saved in time, which isbeneficial for guiding clinical treatment, reducing impairment and improvingprognosis. This article reviews the common MRI sequences in the diagnosis ofischemic stroke, summarizes its different application in clinical pract ice.

Keywords: MRI;Ischemic Stroke; Ischemic Penumbra

MRI 在阿尔茨海默氏病中的应用研究进展

靳聪，林岚，付振荣，周著黄，高宏建，吴水才

基金项目：北京市自然科学基金（7143171）资助。

摘 要：阿尔茨海默氏病（AD）作为一种神经退行性疾病，已成为老人健康的一种主要威胁。当前医学界的一个迫切任务是研究AD 的发生、发展过程以及指导治疗。磁共振成像（MRI）目前已被广泛用于AD 的研究中，它可以检测与疾病相关的功能和解剖结构的微小变化。MRI 作为AD 研究的一种重要影像学标记，本文就其在AD 早期诊断的研究发展及可能的未来方向进行综述。

关键词：磁共振；阿尔茨海默氏病

Research Advancesof magnetic resonance imaging in Alzheimer’s disease

JIN Cong , LIN Lan,FU Zhen-rong, ZHOU Zhu-huang, GAO Hong-jian, WU Shui-cai

Abstract: Neuropathologicalresearch consistently revealed the brain to undergo degenerative changes inAlzheimer’s disease (AD) and it has become one of the main diseases thatthreats the healthy of the elderly people. There is an urgent need to study thedevelopment of AD and improve its treatment. Magnetic Resonance Imaging (MRI)are now widely used in the studies of AD and it provides the potential fordetect the functional and anatom ical change related to dis ease. This reviewillustrates current research and possible future directions of MRI as animportant biomarker for the early diagnosis and prognosis of AD.

Key words: MRI;Alzheimer’s disease

中医的本质和现代化之路

杨晓达

基金项目：博士点基金（20090001110068）。

摘 要：自20 世纪初以来，中医变革经历的“中西汇通”或“中西医结合”、“中医科学化”和“中医现代化”等运动的洗礼。然而，尚未发现一条成功的路线。从理论结构和逻辑上分析，笔者认为，中医本质上是一种基于“自然自愈力the healing power of nature”的唯象医学体系。在疾病治疗策略的六种层次中，中医中药主要在高层次（③ ~ ⑥）阶段发挥治疗作用。中医的本质决定了中医现代化不可能是用现代科学的方法对中医进行解构和解析，而是应当采取一种在中医先验“假设”的指导下、从西医出发“建构”创新的医学体系。目前，研究建立科学性的脏腑关系、基于经络调节的新神经免疫学和基于细胞信号传导的中药活性评价系统是可为之工作。本文提供了一个能够在坚持中医特色的基础上推进中医的现代化成功的路线图。

关键词：中医本质；中医现代化；路线图

Chinese TraditionalMedicine: the Nature and the Roadmap to Modernization

YANG Xiao-da

Abstract: Since thebeginning of 20th century, Chinese Traditional Medicine (TCM) has experiencedefforts of changes including Combination/ Integration of TCM and WesternMedicine, Scientifization of TCM and Modernization of TCM, etc.  Unfortunately, all these efforts have provento be invalid. In light of the logic structure of TCM theory, TCM is in naturea phenomenological therapeutic system by use of the healing power of nature. Inthe six levels of disease treatment strategies, TCM methods function at thehigh levels (Levels ③ ~ ⑥ ). Subsequently, TCM cannot be analyzed orrebuilt by deconstruction. Construction of an innovative medicine can beachieved starting from modern western medicine by using TCM theories as prior presuppositions.Establishment of scientific correlation among inner organs, neuroimmologicalresearches based on Channel of Qi, and establishment of novel evaluationsystems for TCM drugs based on regulation of cell signal transduction arepractical words at present. This paper provides a new view on the roadmaptowards the success of TCM modernization while keeping the features of TCM.

Key words: ChineseTraditional Medicine (TCM); Western Medicine; A phenome nological therapeuticsystem

玄府理论探讨

龚轩，王庆国

摘 要：玄府理论起源于《内经》，建立于金代刘河间《素问玄机原病式》，散见于明清各医学著作，成为中医理论重要的组成部分。现代医家亦从不同角度，探讨玄府概念的内涵及外延，并利用现代医学技术，进一步阐述玄府理论的物质基础，用以指导临床。本文从玄府的概念、功用、开通玄府的治则治法及用药，介绍玄府理论的发展、建立与展望。

关键词：玄府；现代认识；临床应用；展望

Xuan-Fu Theory inTraditional Chinese Medicine

GONG Xuan, WANGQing-guo

Abstract: Xuan-Futheory origined from Neijing and was established in Jin Liu Hejian“Suwen Xuanji original disease -type” scattering in the Ming and Qing Dynastiesmedical literature, which became an important component of Chinese medicine theory.Modern physicians also discuss the connotation and extension of the concept ofXuanfu from different angles by the modern medical technology. Further, thematerial basis of Xuanfu theory was elaborated to guide clinical treatment.This article was from Xuanfu’s concept, the function, the opening of Xuan-fu therapy and medicationand introduced Xuanfu theory development, establishment and prospects.

Key words: Xuan-Futheory; modern medical technology; medication; prospects

点触式探针超声碎石清石治疗硬结石的临床研究

黄永斌，王军起，聂锐志，张海涛，刘兆飞，徐向军，黄金辉

基金项目：市政度社会发展基金，编号SH1417.

摘 要：目的：探讨点触式探针与平面探针超声碎石清石效率的安全性和点触式探针的优越性。方法：将72 例含钙尿路结石随即分成2 组，观察组35 例，对照组37 例。两组分别用点触式超声探针和原平面超声探针行经皮肾镜和经尿道超声碎石清石术。对坚硬结石，先用气压弹道将结石碎成小块，再用超声探针碎石清石。术中准确记录碎石时间，并观察两种探针对尿路黏膜损伤情况。术后测量每例结石的体积，并计算各探针的碎石速度。结果：平面探针对坚硬结石击碎困难，8 例需要先用气压弹道将结石碎成小块后，再行超声碎石清石。

点触式探针对坚硬结石仍可击碎，其碎石清石速度明显高于平面探针（P<0.05），是原超声探针的2.2 倍。对照组出现多例轻微的黏膜吸附伤，无需处理，观察组未出现尿路黏膜吸附伤和刺伤。结论：点触式探针比平面探针碎石清石速度快，可不借助于气压弹道辅助碎石，碎石清石效率高，安全性好，值得推广应用。

关键词：结石；碎石术；超声探针

Clinical study ofpoint contact probe ultrasound lithotripsy in treatment of hard

Stone HUANGYong-bin*, WANG Jun-qi, NIE Rui-zhi,ZHANG Hai-tao, LIU Zhao-fei, XUXiang-jun,HANG Jinhui

Abstract: Objective:The objective of this research is to examine the safety of lithotripsy usingultrasound sector probe and the superiority of point contact probe.Method Inthe study, 72 patients with calcium urolithiasis were divided into 2 groups, ofwhich 35 cases are in the observation group. Patients in both groups aretreated with point contact probe and sector probe

throughpercutaneous nephrolithotomy and transurethral. For hard stone, they are brokeninto small fragments with pneumatic ballistic lithotripsy at first, followingultrasound probe lithotripsy. The exact time in every treatment was recorded,and urinary mucosa injury was examined. The volumes of stone were measured andspeeds of probe were calculated. Results It is found that sector probe is lesseffective treating hard stones, with 8 cases pneumatic ballistic lithotripsybeing conducted at first. Compare to this, operations using point contact probecan break hard stones effectively and the speeds are much faster ( P ＜ 0.05),2.2 times faster than ultrasoundsector probe. Light urinary mucosa injuries in the control group have beenfound while none appears in the observation group. Conclusion In conclusion,point contact probe is faster than the plane probe, and no pneumatic ballistic lithotripsyin advance is needed. It is more efficient and safer; and is worthy ofpopularization and application.

Key words: Lithiasis;Lithotripsy; Ultrasound probe