| Human health and social stability are threatened seriously with infection diseases. The ability of prevention and treatment of infection disease has become one of the most important factors evaluating the country's economic and health care development. In recent years, with the emerging of the origin infectious disease (EID) and the increasing incidence of the controlled infection disease, there are two focal points in the infection disease prevention and treatment in china: first is how to control the emerging infectious disease outbreak, second is how to improve the therapeutic efficacy of the main infectious diseases in china.The world have detected more than 40 kinds of EID, more than 30 kinds of EID have been detected in our country. With the international trade and tourism development and the more and more worming global climate, the threats of EID become heavily year by year. In addition, the uses of biological weapons and bio-terrorist incidents have made the threat of EID even more grievously. From the severe acute respiratory syndrome (SARS) breakout in 2003 till the bird flu and the H1N1flu breakout recently, we can feel that the EID has come nearby. These combats between the mankind and infectious diseases in china made us known the obvious deficiency in EID early warning and response capacity. EID Early warning is one of the most important factors to prevent EID breakout. Since most of the EID hardly ever occurred or even never occurred in china, it is hard for the clinicians to know the detail of each EID and diagnosis them correctly especially in the earlier period. The result is that EID will breakout and spread rapidly. How to improve the diagnosis and treatment level for the EID in clinical medical staff?Viral hepatitis incidence topped in the category A and B infectious diseases in china constantly besides 2005 little lower than pulmonary tuberculosis. In recent years viral hepatitis incidence increased significantly form 2002 to 2007(68.71/100,000～121.33/100,000). The increasing incidence of HBV is the main reason. Drug resistance is the major cause responsible for failure of HBV treatment and also acts as the heavy responsibility for HBV increasing. It takes time for clinicians to distinguish the drug resistance and change the effective drugs for the patience. Is there any method that can help the clinicians catch the drug resistance characteristics of each patience and give the effective treatment strategy in the earlier period of HBV infection?With the development of computer network information, molecular biology, evidence-based medicine, statistical analysis, data mining, J2EE and relational data base technology, it is achievable for us to establish an assistant diagnostic and therapeutic system or drug-resistance analysis system for some specific infection diseases. In view of the two aspects urgent tasks in the field of infectious disease in china, we designed and implemented an assistant computer system. This software can help the medical staff deal with two problems: 1) identify and therapy EID quickly and correctly, prevent EID breakout in the very early period; 2) get enough drug-resistance information for each HBV patient in the early stage and prescribe an effective recipe.1. Design and implement the assistant diagnostic and therapeutic system for EID based on the clinical informationAnalysis all the EIDs world-wide, we choose 23 EIDs which have not been detected or seldom been detected in china to establish the computer identification system. The researches have been done as follows:(1)Estbalish the infection diseases information data baseCollect the data of 23 EIDs and 50 differential diagnosis related diseases, establish a knowledge base. Evidence-based medicine theory, Meta statistical analysis, data mining technology was used for data sorting, analyzing, optimizing and summarizing;According to the experience from the clinical and epidemical experts and the authoritative diagnostic standard, we compiled 8600 terms related to diagnosis. Constructed a set of index system of clinical diagnosis, the stability and veracity of this system were tested by a lot of clinical cases.(2)Establish the assistant diagnostic and therapeutic system for EID based on the information data baseJ2EE and relational database technology were used to establish the general EIDs database which has the interaction, inquirable and renewable functions. Extract the clinical features of EIDs effectively and to establish digitizing diagnostic evolution system which could be identified by computer. Enlightened by the doctor's clinical experience and thinking, the step by step guiding and analyzing and feedback interaction methods were used to develop the computer-assisted expert intelligent system of EID. Multivariate statistical analysis, information entropy theory and Bayesian network were used to settle the problem of J2EE and R language connection. Thus the software accomplish the conformity of clinical message input system and mathematical evaluation system.(3)Retrospective research and prospective research were used to verify the accuracy of the established systemTo verify the accuracy of the established system, we collected 314 case for retrospective research and 186 cases for prospective research. The result showed that 61.8% and 59.7% coincided with the first diagnosis, 78.1%and 77.9% coincided with the first three diagnosis, 86.6% and 85.4% coincided with the first five diagnosis respectively. The EID assistant diagnostic and therapeutic system was the first clinical thinking embedded software in china. It can help the clinicians identify the EID in time and treat it correctly. It can also act as an interactive platform among the clinicians, the service and the patients. That will play an important role in infection diseases diagnosis and treatment, popularizing infection disease knowledge and epidemic prevention. The significant compatibility of the software can help it connect with the national epidemic situation net directly. This will perfect the national epidemic monitoring and warning system. We can expect that the software can produce the huge economic performance and social performances.2. Design and establish a multifunctional Hepatitis B Virus (HBV) Sequence and Drug Resistance Analysis Information PlatformThere are 4 ORF and correlated regulative sequences in HBV. HBV mutation can induce the biological changes including the copy rate, protein expression quantity, epitope and drugs sensitivities. Based on the large-scale HBV gene sequencing, we try to establish a multifunctional HBV sequence and drug resistance analysis information platform. The researches have been done as follows:(1)Establish HBV related information data baseCollected the blood samples and related clinical information from 6880 HBV patients. It deposited 516 HBV complete genomes,11456 gene fragments,and 613 representative cloned genes. Combined with the gene analysis and HBV whole sequences download from GeneBank, we settled the first HBV seqBJ data base in china, which also have enriching ability by receiving data transfer.Established clinical information data base, sample data base, sequence data base, document data base, biology data base and HBV related knowledge consulting system. The system has a powerful consulting, navigating, analyzing and summarizing functions. It can meet the demand of medical information collection and individuation research requirement.(2)Establish a personal information system based on HBV sequence ananlysisEstablished HBV drug resistance information platform, which fulfilled functions comprised HBV sequence comparison, HBV genotyping/serotyping, the amino acid sequence prediction of S/C/P/X proteins, antigenic epitope analysis and drug resistance analysis. It is a opened data base which made it convenient for the patients and doctors to find the better individual treatment strategies.VirusBlast groupware has the follow functions: sequence comparison, genotyping, antigenic epitope analysis and drug resistance analysis. Comparability numeration was used in sequence comparison for finding novel mutation. Evolutional analysis combined with comparability numeration used in genotyping were helpfully in analysis speeding. Antigenic epitope analysis including the influenced between overlapped ORF in HBV. Drug resistance analysis will be renewed by the updating researches.The study settled a specially HBV gene sequences data base which has the independent intellectual property rights in china for the first time. Based on the data base we established a multifunctional HBV sequence and drug resistance analysis information platform. The platform has advantage to make full use of HBV sequences and related data of Chinese patients for HBV drug-resistant analysis in clinic and HBV virologic study.
|
PDF Full Text Request