CN111863168A - A hardware system with exchange protocol - Google Patents

Abstract

The invention belongs to the field of medical treatment, and particularly provides a hardware system with an exchange protocol, which comprises a data collection, storage and operation hardware system, and under the premise that a patient agrees or submits the account information and/or personal medical data and/or microbial infection condition and/or new crown pneumonia infection condition of the patient are/is recorded into the hardware system with the exchange protocol, so that doctor-patient information can be directly pushed mutually. Through the implementation of the invention, the barrier of information non-intercommunication between medical institutions is broken, and a tool capable of automatically managing the medical process is provided for patients and medical institutions.

Description

A hardware system with exchange protocol

Technical field:

The invention belongs to the field of medical treatment, and specifically the invention provides a system that breaks the barrier of non-communication of information among medical institutions, realizes a big data sharing platform system, and provides reliable support for patient monitoring.

Background technique:

AI-based big data management is widely used in various industries, but due to the particularity of the medical industry, which involves restrictions on professionalism, accuracy, and protection of personal privacy, it is difficult to collect and share big data. Electronic medical record systems are closed systems, and it is difficult to achieve information interconnection within the hardware system with exchange protocols, and it is even more impossible to connect with platforms outside the medical system. Therefore, the collection of big data becomes almost impossible.

Although the privacy and security of medical information is protected, the research on the overall national disease status can only be based on targeted cohort studies, and each study requires a lot of human, material and financial resources and time costs, and there is often a lag in research results. sex.

In addition, many research groups repeatedly collect information on different diseases, which greatly wastes scientific research resources; because of the lack of big data management of the overall disease, it is difficult to provide a strong supporting basis for the national medical strategy.

How to ensure the accuracy and reliability of medical information and protect the privacy of patients, and how to break the barriers of non-communication of information between medical institutions, realize the big data sharing platform, and provide a reliable basis for the national medical strategy. There is no perfect solution to this problem.

Invention content:

The object of the present invention is to provide a hardware system with an exchange protocol, including a hardware system for data collection, storage and operation, and the hardware system converts the patient's account information and/or the patient's account information and/or on the premise of the patient's informed consent or active submission. Personal medical data and/or microbial infection status and/or new coronary pneumonia infection status are entered into the hardware system, where the patient's account information and/or personal medical data and/or microbial infection status and/or new coronary pneumonia infection status. Encryption and/or decryption method.

The above hardware system, the patient's account information and/or personal medical data and/or microbial infection status and/or new coronary pneumonia infection status, with special emphasis on the microbial infection status and the new coronary pneumonia infection status, the sources of which are also It can be operating system, social media, taxi software, game software, home sharing software, navigation software, travel push software, video software or payment system, especially including IOS, Android, Youku, iQiyi, youtube, Airbnb, Weibo, Qunar, Ctrip, Kuaishou, Douyin, Baidu Map, AutoNavi Map, Google Map, Tencent Map, Toutiao, Facebook, Twitter, WeChat, Alipay, etc.

The above-mentioned hardware system, the hardware system and the wearable device perform information input and/or output according to the protocol interface; the wearable device is selected from one or more of earphones, speakers, bracelets or mobile phones.

The above hardware system is characterized in that the hardware system can input one or more of the patient's paper medical record, diagnosis report, doctor's voice diagnosis or medical image.

The above hardware system is characterized in that the paper medical records, diagnostic reports or medical images can be identified or stored after identification.

The above hardware system is characterized in that the patient's account information and/or personal medical data and/or microbial infection status and/or new coronary pneumonia infection status can be pushed to the first doctor and/or emergency doctor by grades.

The above hardware system is characterized in that the patient's account information and/or personal medical data and/or microbial infection status and/or new coronary pneumonia infection status are directly pushed to the first-visit doctor and/or emergency doctor during a severe emergency.

The above hardware system is characterized in that the patient's account information and/or personal medical data and/or microbial infection status and/or new coronary pneumonia infection status are directly pushed to the first-visit doctor and/or emergency doctor during a severe emergency, The above operations can be set in advance by the patient.

The above-mentioned hardware system is characterized in that the hardware system can compare or calculate the doctor's diagnosis and treatment plan, medication prescription or medical record with the patient's diagnosis report or clinical contraindications of past medical history; if there is any error or doubt, then Feedback to physicians without grading.

The above-mentioned hardware system is characterized in that the hardware system can disclose the importance of the patient to the doctor for diagnosis and treatment.

The above-mentioned hardware system is characterized in that it can push one or more of patient education information, medication frequency, medication prescription, exercise prescription, consultation reminder, review reminder or doctor's order information to the patient or guardian under the premise of user confirmation and authorization. .

The above-mentioned hardware system is characterized in that the hardware system can operate by itself according to the setting program.

The above-mentioned hardware system is characterized in that the result of the self-calculation can be pushed to the doctor.

The above-mentioned hardware system is characterized in that the result of the self-operation can be pushed to the patient.

The above hardware system is characterized in that the patient is a high-risk patient.

The above hardware system is characterized in that the patient is over 65 years old.

The above hardware system can be implemented by the following methods:

(1) Encrypt the personal medical data with the personal key, and store it in a distributed storage space that can be addressed on the public network, and use the hash value of the personal medical data as the index key value of the data in the space;

(2) In the encrypted personal account information on the blockchain, record the public network storage address of personal medical data and the hash value of the data;

(3) When the networked medical hardware system needs to access personal medical data, a data access request can be sent to the patient through the smart contract of the blockchain. After the patient confirms the authorization, the hash value of the personal medical data allowed to be accessed will be As part of the smart contract with the public network access address, the third party can obtain it;

(4) The networked medical hardware system obtains the public network storage address and hash value of the user's personal medical data through the smart contract, and uses the hash value as the index key value in the storage space to obtain the encrypted medical data, and then can use the hash value as the index key value to obtain the encrypted medical data. Value comparison to verify its correctness.

(5) The networked medical hardware system operates on the obtained encrypted personal medical data through the homomorphic encryption algorithm, and obtains the operation result.

The above medical system can be realized by the following methods:

(1) Personal medical data is encrypted by the user's private key stored in the wearable device and stored on the Internet;

(2) The personal medical Internet index data is encrypted by the user's private key stored on the wearable device or mobile phone and stored on the blockchain;

(3) When the personal medical data has a read request from the networked medical hardware system, the user confirms the read request from the hardware system with the private key stored on the wearable device or mobile phone, and then decrypts the personal medical data;

(4) The decrypted personal medical data uses the cryptographic hash function SHA to generate a digest;

(5) The user re-encrypts the digest with his private key stored on the wearable device or mobile phone to form a digital signature;

(6) Simultaneously send the decrypted personal medical data and the encrypted digest to the read requesting hardware;

(7) The read request hardware decrypts the digest sent by the user’s public key stored on the public blockchain, obtains the digest generated by the client for the personal medical data, and encrypts the received personal medical data with SHA code. Generate another summary; if the two are consistent, it means that the information has not been damaged or tampered with during the transmission process;

(8) The user synchronizes the hardware reading request information of the personal medical data to the blockchain.

The above medical system can be realized by the following methods:

(1) The networked medical data intelligent analysis hardware system initiates an analysis request, and the information is divided into two parts into the smart contract. The first part contains the control parameters, and the other part describes the calculation and analysis tasks;

(2) The analysis request information from the smart contract is compiled into a basic computing instruction set that can directly analyze encrypted personal medical data through a compilation channel, combined with control parameters;

(3) The basic computing instruction set is sent to the user, and after obtaining authorization, the encrypted personal medical data of the user is calculated through the basic computing instruction set;

(4) During the calculation process, personal medical data is kept encrypted to ensure the confidentiality of personal data;

(5) The calculation result is decrypted by the user's private key and sent back to the networked medical data intelligent analysis hardware system; the user synchronizes the analysis request information of the personal medical data to the blockchain as an untamperable historical record.

The above-mentioned hardware system, the described homomorphic encryption algorithm, satisfies the following conditions:

(1) The Enc(PK,m) encryption function takes the user encrypted data public key PK and message m on the blockchain as input, and outputs encrypted personal medical data c;

(2) Dec(SK, c) decryption function takes user private key and encrypted personal medical data c as input, and outputs message m;

(3) The Eval(PK, f, c1, ..., cl) evaluation function uses the user encrypted data public key, analysis algorithm f and encrypted personal medical data c1 to cl on the blockchain to output the encrypted data cf;

(4) When c1=Enc(PK, m1),...,cl=Enc(PK,ml) Mf=f(m1,...,ml);

(5) Cf=Eval(PK, f, c1, ..., cl);

(6) Satisfy that for any analysis algorithm f, mf=Dec(SK,cf).

In the above-mentioned hardware system, the large amount of patient data, with the authorization of the patient, establishes a large-sample disease cohort, and completes research in related scientific research fields through targeted analysis or artificial intelligence algorithms.

Through the implementation of the present invention, the following advantages can be achieved:

1. Include people over 65 years old and high-risk groups, and establish the basic health records of patients.

2. Upload medical records of previous visits, and the system assists in sorting and sorting, so that patients have a set of electronic medical records with a complete timeline, clear classification and rich content. For the first time, it is applied to personal medical management data and privacy protection through the emerging blockchain technology.

3. External wearable devices can be attached to upload the medical data records of patients' daily monitoring in real time to realize abnormal monitoring and alarm.

4. Complete medical data integration to provide convenience for patients to seek medical treatment. Patients can decide by themselves to show their health records to the doctor, so that the doctor can quickly understand the patient's condition and give timely and accurate treatment.

5. According to the patient's condition, provide individualized reminder functions, including medication reminders, medical consultation reminders, review reminders, etc.

6. Establish a disease-specific community, and regularly push relevant authoritative medical-related patient education information, which is conducive to disease prevention and control.

7. Based on a large amount of patient data, with the authorization of patients, establish a large-scale disease cohort, and complete research in related scientific research fields through targeted analysis or artificial intelligence algorithms to provide scientific basis for the national medical strategy.

The main technical problems to be solved by the system of the present invention include: solving the information asymmetry between doctors and patients; and also solving the information asymmetry of the information, judgment and records of current medical staff and previous medical staff. The accuracy of diagnosis and treatment is based on the judgment of big data, rather than the ability of a single doctor, which is a major innovation in the medical model.

The present invention is a decentralized distributed data encryption storage method based on blockchain technology, which utilizes the technical advantages of distributed ledger of blockchain technology to record personal account information and medical data usage records to ensure that these records cannot be tampered with, and at the same time chain The index address of the encrypted personal medical data stored in the distributed storage system meets the actual needs of storing encrypted personal medical data of large data volume, realizes the sharing of personal medical data under the controllable authority of the individual, and provides data for data based on homomorphic encryption technology. Statistical analysis provides the basic platform.

However, the blockchain of electronic money only saves account and transaction information, and the amount of data is very small. It is easy to achieve distributed storage and synchronization, but it is not suitable for storing personal medical data with a large amount of data, so there is no completely similar block-based data. Chain technology's solution for distributed storage of large amounts of data, as well as a solution for overall statistical analysis based on these data.

At present, single systems and even cloud databases are highly centralized, which makes them easy targets for hackers, and may also be leaked artificially, and are easily affected (such as power outages), not guaranteeing users’ personal medical data. Reasonable technical solutions for storage privacy and self-controllability. In contrast, blockchain-based distributed encrypted storage does not suffer from these problems because it utilizes regional or global nodes that are distributed off-site.

If a single point is attacked or there is a power outage, the impact will not be catastrophic, as nodes elsewhere will continue to function. At the same time, the distributed ledger of the blockchain also ensures that all personal medical data usage records are not easily tampered with compared to centralized storage solutions.

Through the implementation of the present invention, the speed of information exchange between doctors and patients is accelerated, an effective way is provided for accurate diagnosis of disease, rapid treatment, and reduction of disputes and friction between doctors and patients;

Description of drawings

1 is a schematic diagram of the system operation of the present invention

2 is a schematic diagram of the operation of homomorphic encryption in the system of the present invention

Detailed ways

The experimental illustrations of the present invention are intended to illustrate the invention and not to limit it.

The present invention specifically provides a hardware system with an exchange protocol, including a hardware system for data collection, storage and operation, under the premise of the patient's informed consent or active submission, the patient's account information and/or personal medical data and/or microbial infection The status and/or COVID-19 infection status is entered into a hardware system with an exchange protocol, and doctor-patient information can be directly pushed to each other. Through the implementation of the present invention, the barrier of non-communication of information between medical institutions is broken, and a tool for self-management of medical procedures is provided for patients and medical institutions.

The introduction of homomorphic encryption technology to analyze the user's personal medical data in encrypted distributed storage solves the personal data privacy problem in the process of big data scientific research and analysis by third parties.

Example 1

Combining blockchain technology with data distributed storage technology, it meets the needs of decentralized encrypted storage, controllable sharing, and immutable usage records of epidemic investigation data of the general population.

The medical data of the general population has a very large amount of data storage and is not suitable for full chain synchronization on the blockchain. Therefore, distributed encrypted storage is required, and the stored address index is recorded in the personal account information on the blockchain. Encrypted personal medical data storage for on-chain and off-chain synchronization. The main implementation steps are:

(1) Encrypt the epidemic investigation data of the general population with a personal key, and store it in a distributed storage space that can be addressed on the public network, and use the hash value of the personal medical data as the index key value of the data in the space;

(2) In the encrypted personal account information on the blockchain, record the public network storage address of the general population epidemic investigation data and the hash value of the data;

(3) When other third parties need to access the epidemic survey data of the general population, they can send data access requests to the patients through the smart contract of the blockchain. After the patient confirms the authorization, the hash value of the personal medical data allowed to be accessed will be As part of the smart contract with the public network access address, the third party can obtain it;

(4) The third party obtains the public network storage address and hash value of the epidemic investigation data of the general population of the user through smart contracts, and uses the hash value as the index key value in the storage space to obtain the encrypted medical data, and then can use the hash value as the index key value to obtain the encrypted medical data. Compare and verify its correctness.

(5) The third party operates the obtained encrypted personal medical data through the homomorphic encryption algorithm, and obtains the operation result.

The introduction of homomorphic encryption technology to analyze the encrypted distributed storage of the general population epidemic survey data has solved the severe infection and epidemic monitoring problems of the new crown pneumonia.

Example 2

The above-mentioned hardware system, the personal account information of the hardware system and the encrypted personal medical data Internet address index, must be authenticated by the private key in the user's mobile phone, in order to be read, managed and shared, and each time the record is read and shared , will be recorded in the personal medical data usage record, and synchronized on different user nodes on all blockchains in the entire network; the following are the encryption and decryption steps for personal medical data reading:

(1) The general population epidemic investigation data is encrypted by the user's private key stored in the wearable device and stored on the Internet;

(2) The personal medical Internet index data is encrypted by the user's private key stored on the wearable device or mobile phone and stored on the blockchain;

(3) When there is a request to read the epidemic investigation data of the general population, the user decrypts the personal medical data with the private key stored on the wearable device or mobile phone;

(4) Use the cryptographic hash function SHA to generate a digest of the decrypted general population epidemic investigation data;

(5) The user re-encrypts the digest with his private key stored on the wearable device or mobile phone to form a digital signature;

(6) Send the decrypted general population epidemic survey data and the encrypted summary to the reading requester at the same time;

(7) Read and decrypt the digest sent by the requester using the public key stored in the public blockchain by the user, obtain the digest generated by the client for the personal medical data, and encrypt the received personal medical data with SHA code. Generate another summary; if the two are consistent, it means that the information has not been damaged or tampered with during the transmission process;

(8) The user synchronizes the read request information of the general population epidemic survey data to the blockchain.

Example 3

With the above hardware system, medical institutions can send personal epidemic credit requests to the general population through the blockchain. After the individual confirms the authorization, the analysis algorithm of homomorphic encryption is used to send it to the user's personal medical data. The data is operated in an encrypted state, and the personal medical data remains encrypted throughout the operation process; the following are the analysis steps based on the homomorphic encryption algorithm:

(1) The medical institution initiates an analysis request, and divides the information into two parts into the smart contract. The first part contains control parameters, and the other part describes the calculation and analysis tasks;

(2) The analysis request information from the smart contract is compiled into a basic computing instruction set that can directly analyze encrypted personal medical data through a compilation channel, combined with control parameters;

(3) The basic computing instruction set is sent to the user, and after obtaining authorization, the encrypted personal medical data of the user is calculated through the basic computing instruction set;

(4) During the calculation process, personal medical data is kept encrypted to ensure the confidentiality of personal data;

(5) The calculation result is decrypted by the user's private key and sent back to the medical institution; the user synchronizes the analysis request information of the personal medical data to the blockchain as a historical record that cannot be tampered with.

The above-mentioned hardware system, the described homomorphic encryption algorithm, satisfies the following conditions:

(1) The Enc(PK,m) encryption function takes the user encrypted data public key PK and message m on the blockchain as input, and outputs encrypted personal medical data c;

(2) Dec(SK, c) decryption function takes user private key and encrypted personal medical data c as input, and outputs message m;

(3) The Eval(PK, f, c1, ..., cl) evaluation function uses the user encrypted data public key, analysis algorithm f and encrypted personal medical data c1 to cl on the blockchain to output the encrypted data cf;

(4) When c1=Enc(PK, m1),...,cl=Enc(PK,ml) Mf=f(m1,...,ml);

(5) Cf=Eval(PK, f, c1, ..., cl);

(6) Satisfy that for any analysis algorithm f, mf=Dec(SK,cf).

In the above-mentioned hardware system, the information of the hardware system is disclosed in stages according to the authorization of the patient or his guardian.

Example 4

Combining blockchain technology with data distributed storage technology, it meets the needs of decentralized encrypted storage, controllable sharing, and immutable usage records of personal medical data.

The amount of data storage of the patient's personal medical data is very large, and it is not suitable to be placed on the blockchain for full-chain synchronization. Therefore, distributed encrypted storage is required, and the stored address index is recorded in the personal account information on the blockchain. Encrypted personal medical data storage for on-chain and off-chain synchronization. The main implementation steps are:

(1) Encrypt the personal medical data with the personal key, and store it in a distributed storage space that can be addressed on the public network, and use the hash value of the personal medical data as the index key value of the data in the space;

(2) In the encrypted personal account information on the blockchain, record the public network storage address of personal medical data and the hash value of the data;

(3) When the networked medical hardware system needs to access personal medical data, a data access request can be sent to the patient through the smart contract of the blockchain. After the patient confirms the authorization, the hash value of the personal medical data allowed to be accessed will be As part of the smart contract with the public network access address, the networked medical hardware system can obtain it;

(4) The networked medical hardware system obtains the public network storage address and hash value of the user's personal medical data through the smart contract, and uses the hash value as the index key value in the storage space to obtain the encrypted medical data, and then can use the hash value as the index key value to obtain the encrypted medical data. Value comparison to verify its correctness.

(5) The networked medical hardware system performs intelligent analysis and operation on the obtained encrypted personal medical data through the homomorphic encryption algorithm, and obtains the operation result.

The introduction of homomorphic encryption technology to analyze the encrypted distributed storage of users' personal medical data solves the problem of personal data privacy in the process of intelligent analysis of big data by networked medical hardware systems.

Example 5

The above-mentioned hardware system, the personal account information of the hardware system and the encrypted personal medical data Internet address index, must be authenticated by the private key in the user's mobile phone, in order to be read, managed and shared, and each time the record is read and shared , will be recorded in the personal medical data usage record, and synchronized on different user nodes on all blockchains in the entire network; the following are the encryption and decryption steps for personal medical data read by the networked medical hardware system:

(1) Personal medical data is encrypted by the user's private key stored in the wearable device and stored on the Internet;

(2) The personal medical Internet index data is encrypted by the user's private key stored on the wearable device or mobile phone and stored on the blockchain;

(3) When the networked medical hardware system has a read request for personal medical data, the user decrypts the personal medical data with the private key stored on the wearable device or mobile phone;

(4) The decrypted personal medical data uses the cryptographic hash function SHA to generate a digest;

(5) The user re-encrypts the digest with his own private key stored on the wearable device or mobile phone to form a digital signature;

(6) Send the decrypted personal medical data and the encrypted digest to the networked medical hardware system at the same time;

(7) The networked medical hardware system decrypts the digest sent by the user’s public key stored on the public blockchain, obtains the digest generated by the user for personal medical data, and encodes the received personal medical data with SHA. Encryption generates another digest; if the two are consistent, it means that the information has not been damaged or tampered with during transmission;

(8) The user reads the request information from the hardware system of the personal medical data and synchronizes it to the blockchain.

Example 6

The above hardware system, the networked medical data intelligent analysis hardware system can send a request for personal medical data analysis to the patient or guardian through the blockchain. After the patient or guardian confirms the authorization, the analysis algorithm of homomorphic encryption is used. For medical data, the encrypted personal medical data is operated in an encrypted state, and the personal medical data remains encrypted throughout the operation process; the following are the analysis steps based on the homomorphic encryption algorithm:

(1) The networked medical data intelligent analysis hardware system initiates an analysis request, and the information is divided into two parts into the smart contract. The first part contains the control parameters, and the other part describes the calculation and analysis tasks;

(2) The analysis request information from the smart contract is compiled into a basic computing instruction set that can directly analyze encrypted personal medical data through a compilation channel, combined with control parameters;

(3) The basic computing instruction set is sent to the user, and after obtaining authorization, the encrypted personal medical data of the user is calculated through the basic computing instruction set;

(4) During the calculation process, personal medical data is kept encrypted to ensure the confidentiality of personal data;

(5) The calculation result is decrypted by the user's private key and sent back to the networked medical data intelligent analysis hardware system; the user synchronizes the analysis request information of the personal medical data to the blockchain as an untamperable historical record.

The above-mentioned hardware system, the described homomorphic encryption algorithm, satisfies the following conditions:

(1) The Enc(PK,m) encryption function takes the user encrypted data public key PK and message m on the blockchain as input, and outputs encrypted personal medical data c;

(2) Dec(SK, c) decryption function takes user private key and encrypted personal medical data c as input, and outputs message m;

(3) The Eval(PK, f, c1, ..., c1) evaluation function uses the user encrypted data public key, analysis algorithm f and encrypted personal medical data c1 to c1 on the blockchain to output the encrypted data cf;

(4) When c1=Enc(PK, m1),...,cl=Enc(PK,ml) Mf=f(m1,...,ml);

(5) Cf=Eval(PK, f, c1, ..., cl);

(6) Satisfy that for any analysis algorithm f, mf=Dec(SK,cf).

In the above-mentioned hardware system, the information of the hardware system is disclosed in stages according to the authorization of the patient or his guardian.

Example 7

A patient with very low hemoglobin, gender: male, discharge date: May 2019, age: 73 years old, length of hospitalization; 18 days.

Admission and treatment: Main symptoms and signs: Anorexia for 3 months, anemia was found for more than 2 months. Consciousness, mental weakness, anemia, blood pressure 90/50mmHg, pale conjunctiva, no yellow sclera, superficial lymph node enlargement, clear breath sounds in both lungs, no dry or wet rales, heart rate 80bpm, rhythmic, The abdomen was soft, without tenderness and rebound tenderness, the liver and spleen were not under the ribs, the bowel sounds were normal, and the lower extremities were not swollen.

The main laboratory X-ray examination results and others: Hb45g/L in the outer hospital, no obvious abnormality in the peripheral blood morphology in the hospital, and abdominal CT in the hospital: abnormal calcification in the liver, and stones in the gallbladder.

Admission diagnosis: chronic atrophic gastritis with severe anemia? Gastrointestinal cancer? Myelodysplastic Syndrome? Cholecystolithiasis after lumbar spine surgery.

Diagnosis and treatment: complete laboratory examinations after admission, check for hemoglobin 50g/L, platelets 59*109/L, first-level nursing, red blood cell transfusion, supplementation of hematopoietic raw materials, fluid replacement, intravenous nutrition, digestive enzymes and other symptomatic and supportive treatments.

In the morning, fever and inflammatory indexes increased, Tmax was 39.4℃, and the effect of symptomatic antipyretic treatment was not good. Scleral yellow staining, abdominal pain, mild cough and white sputum, abdominal color Doppler ultrasound showed cystic solid area in the right lobe of liver, abscess? Fluid around the gallbladder? Chest X-ray showed enlarged lung markings and atelectasis.

Consider abdominal organ infection, lung infection. Blood bilirubin and urobilinogen were increased in laboratory tests, reticulocytes were significantly increased, and "tear drop" red blood cells were seen on peripheral blood smears. Considering the possibility of acute hemolysis, anti-infection, sodium bicarbonate alkalization, washing Red blood cell correction of anemia and other treatments. Perfect abdominal CT prompt acute cholecystitis, liver abscess?

Please consider general surgery consultation: acute cholecystitis, liver abscess? There is no indication for liver abscess puncture and drainage, and it is recommended to continue conservative medical treatment. After treatment, the infection was gradually controlled, and there was no new hemolysis.

Bone biopsy and bone marrow biopsy, the results report MDS/myeloproliferative tumor? , after consultation with the hematology department, it is recommended to review the bone puncture after infection control, and continue to give supplementary hematopoietic raw material treatment. 48 hours after the body temperature was normal, the antibiotics were downgraded to the combination of Ornidazole. The infection did not worsen, the abdominal pain was relieved, the yellow staining of the sclera subsided, there was no cough and sputum, and the abdominal CT was reviewed. The red pigment was reduced to normal, the urobilinogen was normal, and the spirit and diet improved.

During the hospitalization, the stool frequency increased, and the Clostridium difficile toxin was negative, and the stool culture showed dysbacteriosis, which improved after treatment with intestinal probiotics.

Perfect gastroscopy prompts chronic atrophic gastritis. At present, the general condition is acceptable, but the extremely low hemoglobin status of the patient cannot rule out the tumor of the digestive tract or blood system. Although the bone marrow aspiration is performed, the tumor cannot be completely ruled out.

After the informed consent of the family members, the paper case information was entered and identified in the system, and the patient's personal information was encrypted and cleaned by the system.

Admission diagnosis: 1. Circulatory ischemia after dizziness to be investigated? 2. Iron deficiency anemia 3. Anorexia causes to be investigated 4. Anxiety and depression 5. Vitamin deficiency 6. Folic acid deficiency 7. Peripheral neuropathy 8. Microcirculation disorder.

Discharge diagnosis 1. Posterior circulation ischemia 2. Iron deficiency anemia 3. Anorexia causes to be investigated 4. Anxiety and depression state 5. Vitamin deficiency 6. Folic acid deficiency 7. Peripheral neuropathy 8. Microcirculation disorder.

The main reason of hospitalization was "intermittent dizziness with food deficit for more than 40 days". Physical examination on admission: T36.5℃, P70 beats/min, R20 beats/min, BP120/80mHig (left side=right side).

Shen Qing, physical examination cooperation, into the ward, the whole body skin, mucous membranes and sclera without yellow staining and bleeding spots, pale, superficial lymph nodes in the body are not palpable and swollen. Symmetrical thorax without deformity, clear lungs percussion, clear breath sounds, no dry or moist rales, small cardiac border, HR: 70 beats/min, regular rhythm, no pathological murmurs were heard in the auscultation areas of each valve, abdominal Soft, no tenderness, no rebound tenderness and muscle tension.

The liver and spleen were not under the ribs, there was no percussion pain in the liver and kidney areas, no deformity of the spine and limbs, and no swelling of the lower limbs. Nervous system examination: clear mind, good language, normal memory, computing power, and orientation, no ptosis of both eyelids, bilateral pupils of equal size, 3mm in diameter, sensitive to light reflex, normal eye position, sufficient eye movement, no See nystagmus. Symmetrical bilateral flank lines, strong eyes closed; bilateral masseter muscles symmetrical and powerful, no air leakage on both sides of bulging cheeks, bilateral nasolabial folds symmetrical, no deviated corners of the mouth, centrally protruding tongue, soft palate can be raised, gag reflex exists, no tongue muscle Atrophy and fibrillation, normal hearing, bilateral neck turning and shoulder shrug force. The muscle strength of the limbs was grade 5, the muscle volume of the limbs was full, the muscle tension was moderate, the tendon reflexes were symmetrically decreased, and the bilateral pathological signs were positive. The sensory system examination was normal. Freemasonry is normal. The neck was soft without resistance, and Kerning's sign and Brudzinski's sign were negative. No obvious murmur was heard in the bilateral carotid and subclavian auscultation areas. Auxiliary examination: blood routine: red blood cells 1.45*1012/L, hemoglobin 57g/L.

Diagnosis and treatment: After admission, patients were given a low-salt and low-fat diet, and blood pressure was monitored; After admission, he was given symptomatic treatment to improve blood supply to the heart and brain (Ginkgo biloba), improve microcirculation (alprostadil), nourish nerves (adenosylcobalamin), give fat emulsion, amino acid intravenous nutrition, and improve mood at the same time.

Clinical inspection report:, *red blood cell 1.29*10 ¹² /L↓, *hemoglobin 51g/L, *hematocrit 14.7%↓, *average red blood cell volume 114.2flt, *average hemoglobin content 39.4pgt, *platelet 11*10～ 9/L↓.

CT scan showed high-density calcifications in the right lateral fissure with clear and sharp borders. The density of white matter at the junction of gray and white matter near the bilateral ventricle body was slightly reduced, showing a symmetrical change, the ventricle was slightly enlarged, and the sulcus fissure was slightly widened. , deepened, no displacement of midline structure, no abnormal skull bone, scalp: no swelling of the tissue. The second scan of the paranasal sinuses and bilateral mastoid cells showed acceptable, and the remaining (-).

CT: Symmetrical outline, no abnormal rib course, mediastinal trachea in the middle, clear vascular shadow in the mediastinum, high-density calcification in the aortic wall and coronary running area, small lymph node shadow in the vascular space, unobstructed tracheal opening, double The texture of the lower lobe of the lung is slightly thickened, and cords can be seen in the left lung.

Brain scan: straight cerebral infarction, it is recommended to combine the clinical history, compare with the original film, follow up and assist the diagnosis if necessary, abnormal calcification in the sylvian fissure area, demyelinating changes, and senile brain changes. It is recommended to combine clinical and related laboratory examinations for aortic and coronary atherosclerosis, and if necessary, combine relevant CTA examinations to assist in diagnosis.

However, the case review did not rule out the possibility of tumor.

After the informed consent of the family members, the paper case information was entered into the system and identified, and the patient's personal information was encrypted and cleaned by the system.

Records: Sex: Male, Age: 65 (at the time).

Statements from the patient himself and his family: the chief complaint was nausea and vomiting with anemia for more than 1 month. Patients with a history of present illness started to have nausea and vomiting without obvious incentives before 1 month. The vomiting is non-projective, and it is more common after eating. And visual dizziness, no fever, chills, abdominal pain, diarrhea, abdominal distension, then went to the outpatient clinic of our hospital, the carbon 13 breath test showed Hp(+), hemoglobin 75g/L, red blood cell count 1.84×10″/L , Hematocrit 0.217, drug treatment, the effect is not good, the original symptoms of nausea and vomiting did not improve significantly.

In order to seek further treatment, the patient visited the outpatient department of our hospital again today. The outpatient department was admitted to the hospital with "nausea and vomiting with anemia to be investigated". During the course of the disease, the patient had no obvious chills, fever, dizziness, headache, palpitations, Chest tightness, chest pain, no cough, expectoration, hemoptysis, no abdominal pain, diarrhea, no blood in the stool, melena, jaundice. Since the onset of the disease, the patient's spirit and appetite have been normal, sleep well, normal urination, and self-reported weight loss of about 5Kg.

Past history: In 1997, he underwent surgery in a foreign hospital for "lumbar disc herniation"; he was allergic to "seafood"; denied the history of chronic diseases such as "high blood pressure, diabetes, and coronary heart disease"; denied the history of infectious diseases such as "hepatitis, tuberculosis"; denied History of trauma and blood transfusion; denied history of drug allergy; vaccination with local. Personal history Born in the place of origin, living in the local area for a long time, denying the history of exposure to epidemic water and epidemic areas, denying the history of exposure to industrial poisons, dust and radioactive substances, no bad habits of smoking and drinking; history of marriage and childbirth: married for more than 30 years, with 2 sons, lovers and The son is healthy.

No deformity of the head, normal facial features, no edema of bilateral conjunctiva, no yellowing of sclera, bilateral pupils of equal size and circle, about 3 mm in diameter, sensitive to light reflex, and normal spirit. There was no abnormal discharge from the ear and nose. The lips are rosy, without cyanosis, the nasolabial groove is symmetrical on both sides, the mouth of the teeth is skewed, the tongue is centered, and there is no congestion in the pharynx. The neck is soft without resistance, the jugular vein is not distended, the trachea is centered, and the thyroid is not large. The bilateral thorax was symmetrical, the respiratory movement was normal, and the chest wall was free of varicose veins and tenderness. The breathing movements were consistent on both sides, the breathing movement was normal, the speech tremors on both sides were symmetrical and consistent, and there was no feeling of snow on the skin and pleural friction. The percussion was unvoiced, the breath sounds of both lungs were slightly coarse, and no obvious dry and wet rales and pleural friction rubs were heard. The apex of the heart is located 0.5cm medial to the midclavicular line of the fifth intercostal space on the left side, there is no bulge in the precordial area, no pericardial friction, no enlargement of the cardiac dullness circle, heart rate 78 beats/min, regular rhythm, strong heart sounds, none of the valve auscultation areas and pathological murmurs. Soft abdomen, no varicose veins in the abdominal wall, no intestinal type, peristalsis and abnormal pulsation, no obvious tenderness, rebound tenderness and muscle tension in the whole abdomen, no palpable liver and spleen under the ribs, no mass on abdominal palpation, hepatic jugular vein The reflux sign was negative, the Murphy's sign was negative, the moving dullness was negative, the percussion was tympanic, the bowel sounds were 2-4 times/min, and the sound of passing water and high-pitched metallic sound was not heard.

Anus and external genitalia were not checked. The spine is physically curved. There was no deformity of the limbs, no edema of both lower limbs, no varicose veins and ulcers. There was no deformity of the limbs, no clubbing of fingers (toes), and the pulse of the dorsal artery of the foot was normal. The muscle strength of the limbs was V, the muscle tone was normal, the biceps and triceps reflexes were normal, the bilateral knee reflexes were normal, the bilateral Hoffmann's sign (-), and the bilateral Babinski's sign (-).

Hospitalization process: The patient was admitted to the hospital for more than 1 month due to nausea, vomiting and anemia. Allergic to "seafood".

Physical examination on admission: no obvious abnormality was found in the heart and lung examination, the abdomen was flat and soft, there was no obvious tenderness, rebound tenderness and muscle tension in the whole abdomen, and bowel sounds were 2-4 times/min. Auxiliary examination: carbon 13 breath test showed Hp(+); gastroscope showed gastric mucosal anemia, chronic superficial gastritis; single allergen detection: IgG antibody food group showed no abnormality. The mixed group of IgE antibodies showed dog fur (3+), house dust (2+), mites (+), and crabs (+). The diagnosis was 1) megaloblastic anemia, 2) chronic superficial gastritis, and 3) nausea and vomiting.

Because the patient signed and refused to undergo further examinations such as head CT, chest CT and bone marrow aspiration to clarify the cause of anemia, only symptomatic treatment such as vitamin B12 supplementation and nutritional support was given after admission. At present, the general condition of the patient is normal. The blood routine examination shows that hemoglobin is 81.0g/L, vitamin B12 is normal, and there is no more nausea and vomiting. The patient and his family have requested to be discharged from the hospital, and he will be discharged after consulting the superior doctor.

2011.10.12 Discharge diagnosis: 1. Megaloblastic anemia 2. Chronic superficial gastritis. 1) Megaloblastic anemia 2) Chronic superficial gastritis 3) The cause of nausea and vomiting remains to be investigated. Discharge precautions 1) Pay attention to rest after discharge, strengthen nutrition, and regularly review blood routine; 2) Go to the hematology department for further treatment for megaloblastic anemia; 3) Avoid contact with dog fur, house dust, mites, crabs, etc., to avoid allergies; 3) If you feel unwell, follow up in the outpatient department.

Continuing to encrypt and clean the patient's personal information, it was found that the patient's same father and sister also developed "megaloblastic anemia" in 2017. The course of the disease is close to the time and the prognosis is good.

Combined with the data access and family medical history survey after personal information cleaning in October 2011 and April 2019, suspected tumors were excluded, and the patients recovered slowly after nutritional enhancement.

Therefore, in June 2019, the patient was diagnosed with megaloblastic anemia, and it is estimated that there is a high possibility of familial inheritance. The current patient's follow-up survey shows that he is in good condition, and he regularly supplements folic acid and B vitamins (2020.4.10).

It is extremely difficult for physicians to rule out the possibility of malignancy in a patient without the investigation of the past medical history of the individual case. However, the retrospective investigation after the encryption and cleaning of the personal information of the big data can accurately exclude malignant tumors and make accurate treatment, and can also conduct epidemiological and genetic status investigations, continue to track the health status of patients after discharge, prompt medication, and achieve Full disease control.

Claims (15)

1. a hardware system with an exchange agreement, comprising data collection, storage and a hardware system for computing, is characterized in that: under the premise of patient informed consent or active submission, the patient's account information and/or personal medical data and/or or microbial infection status and/or new coronary pneumonia infection status are entered into the hardware system, wherein the patient's account information and/or personal medical data and/or microbial infection status and/or new coronary pneumonia infection status are entered or called using encryption and/or decryption. Way. 2. hardware system according to claim 1 is characterized in that: the information input and/or output that described hardware system and wearable device carry out according to protocol interface; Described wearable device is selected from earphone, sound box, bracelet or One or more of the cell phones. 3 . The hardware system according to claim 1 , wherein the hardware system can record one or more of a patient's paper medical record, a diagnosis report, a doctor's voice diagnosis, or a medical image. 4 . 4 . The hardware system according to claim 3 , wherein the paper medical records, diagnostic reports or medical images can be identified or stored after identification. 5 . 5. The hardware system according to any one of claims 1-4, wherein: the patient's account information and/or personal medical data and/or microbial infection status and/or new coronary pneumonia infection status and/or new crown pneumonia The pneumonia infection status can be pushed to the first doctor and/or emergency doctor by grade. 6. The hardware system according to any one of claims 1-4, characterized in that: the patient's account information and/or personal medical data and/or microbial infection status and/or new coronary pneumonia infection status are in a critical emergency Push directly to the first doctor and/or emergency doctor. 7. The hardware system according to any one of claims 1-4, wherein the patient's account information and/or personal medical data and/or microbial infection status and/or new coronary pneumonia infection status are in a critical emergency Push directly to the first doctor and/or emergency doctor, and the above operations can be set by the patient first. 8. The hardware system according to any one of claims 1-7, characterized in that: the hardware system can carry out a doctor's diagnosis and treatment plan, medication prescription or medical record with the patient's diagnosis report or clinical contraindications of past medical history. Comparison or calculation; if there is any error or doubt, it will be fed back to the doctor without grading. 9. The hardware system according to any one of claims 1-7, wherein the hardware system can disclose the importance of the patient to the doctor for diagnosis and treatment. 10. The hardware system according to any one of claims 1-7, characterized in that: under the premise of user confirmation and authorization, the patient or guardian can be pushed with patient education information, medication frequency, medication prescription, exercise prescription, medical appointment reminder, One or more of a review reminder or a doctor's order message. 11. The hardware system according to claim 10, wherein the hardware system can operate by itself according to a set program. 12. The hardware system according to claim 10, wherein the result of the self-operation can be pushed to a doctor. 13. The hardware system according to claim 10, wherein the result of the self-operation can be pushed to the patient. 14. The hardware system according to any one of claims 1-13, wherein the result of the self-calculation can be pushed to the surrounding hardware of other medical devices supporting the same protocol through the short-range communication technology, so as to realize the communication between the medical devices. Patient data is automatically shared between the two, as well as potential device use risk alerts. 15. The hardware system according to any one of claims 1-13, wherein the patient is a high-risk patient or the patient is over 65 years old.

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