2007年 · 第01卷第01期

Every golden autumn, is the harvest season; This October has been even more fruitful for us. With the establishment of the Health Management Branch of the Chinese Medical Association, with everyone's unremitting efforts and expectations, with the approval of the State Press and Publication Administration, the Chinese Journal of Health Management, supervised by the China Association for Science and Technology and sponsored by the Chinese Medical Association, was born, and became a member of the series of magazines of the Chinese Medical Association. As the founders of this new journal, we are sincerely delighted. On this occasion of celebration, as the first editor-in-chief, on behalf of the editorial board, I would like to express my sincere gratitude to Comrade Han Qide, vice chairman of the Standing Committee of the National People's Congress, who has always cared about China's health management cause and inscribed the title of this magazine! I would like to express my deep gratitude to all the friends who have paid their sweat and wisdom for the launch of the magazine!

Cardiovascular and cerebrovascular diseases are increasingly harmful to people's health in China, and the important risk factors leading to cardiovascular diseases and atherosclerosis have not been effectively controlled. The main reason is the lack of treatment practice under the guidance of health education theory in the current medical treatment and management model. Therefore, we should shift the focus of future medical work from the treatment of existing diseases to the field of disease prevention based on health management.

With the progress of society, the prevalence of many chronic diseases, such as hypertension, coronary heart disease, diabetes, cerebrovascular disease, chronic obstructive pulmonary disease, bronchial asthma, etc. is increasing year by year, and it has become one of the main causes of death in our population, causing a heavy social burden. However, many people have not fully realized this point, so there is no effective medical service model to solve this problem. Therefore, it is necessary to discuss this problem.

Hypertension is the most common, prevalent and representative of chronic diseases. Cardiovascular and cerebrovascular diseases caused by hypertension occupied the first place in the disease burden and cause of death in China. A large number of studies have shown that hypertension is the most important risk factor for cardiovascular and cerebrovascular diseases, and its complications such as stroke, coronary heart disease, heart failure, renal failure and other diseases have a high mortality and disability rate, which seriously endanger human health. Therefore, the prevention and treatment of hypertension is one of the important topics and central links in the comprehensive prevention and treatment of chronic diseases, especially cardiovascular and cerebrovascular diseases in China. Because of the high prevalence of hypertension, the close relationship with living habits, the great benefits brought by prevention and the lack of understanding of the importance of hypertension prevention by the general public, it is of great significance for the health management and comprehensive prevention and treatment of cardiovascular and cerebrovascular diseases to make people establish healthy living habits, prevent the occurrence of hypertension or control and delay its complications through health education and health promotion.

In recent years, China's economy has continued to develop at a high speed, people's living standards have been continuously improved, the health awareness of the general public has generally increased, and the health needs have increased, which has led to a surge in the number of various physical examination centers. According to incomplete statistics, there are more than 5,000 physical examination centers in China at present. Its form is the coexistence of a variety of physical examination institutions: the hospital physical examination center is established on the basis of the hospital, which is the most important physical examination institution in China at present, accounting for more than 90% of the number of physical examination institutions in China; Other forms of medical examination institutions include wholly-owned and joint-venture medical examination institutions and mobile medical examination teams in some areas.

Exercise can maintain and promote health. Many diseases, such as diabetes, hypertension, coronary heart disease, obesity and some tumors, are related to lack of exercise. The study found that people who exercise regularly have a lower incidence of coronary heart disease, slower age-related organ dysfunction and longer life span compared with people who exercise less; The greater the amount of exercise, the better the physiological effect, but with the increase of the amount of exercise, the risk of injury and even sudden death also increased^[1]。 Therefore, scientific campaigns should be carried out, that is, scientific methods should be used to instruct people to exercise for the benefit of health, while minimizing adverse events caused by exercise.

With the rapid development of society and economy, our people's living standards are constantly improving, especially after SARS, the people's attention to health problems and the demand for related services have increased greatly. At present, professional health examination medical institutions are booming, and health management companies have emerged. On the other hand, medical expenses have become one of the main burdens on the government and are increasing. Among them, the cost of chronic diseases is high. However, about 75% of chronic diseases can be effectively prevented and controlled through lifestyle changes and other health interventions. Through this article, we try to analyze the current situation of physical examination, and briefly explain how to effectively extend the follow-up service of physical examination under the current situation, provide diversified and systematic health services for the society, and provide practical and effective measures to improve health status for the masses at lower cost.

The establishment of the Health Management Branch of Chinese Medical Association and the founding of Chinese Journal of Health Management indicate that health management as a discipline has been recognized and strongly supported by the Chinese government and related societies and associations, and has been approved and responded by medical science and technology workers and medical health and health service personnel. As a professional academic journal on academic theory and practice of health management in China, Chinese Journal of Health Management has a glorious mission and responsibility. At the beginning of its publication, the industry attracted attention. At the beginning of the chapter, a hundred schools of thought argue. How to speed up the academic theoretical research and discipline construction of health management is the primary task faced by the Health Management Branch of Chinese Medical Association and Chinese Journal of Health Management, especially those engaged in academic theoretical research and education and training of health management, and health management technical service workers.

The concept of health management, which was introduced into China in the early 21st century, has spread throughout China and begun to be put into practice in less than 10 years. In 2005, the state announced the new occupation of health managers. In the same year, the Chinese Medical Doctors Association established the Professional Committee of Physician Health Management and Physician Health Insurance. In 2006, the Chinese Association of Preventive Medicine established a health risk assessment and control professional committee. In 2007, the Chinese Medical Association established the Health Management Branch. Although according to incomplete statistics, there are currently over 10,000 health management-related institutions in China; Although health management has become a word that attracts high attention from urban elites and media in China, the theoretical research on health management has just started, and the services of health management are still being explored. There are different opinions on the source, definition and content of health management. We try to trace the theory and practice of health management to the roots through literature review and analysis, with a view to helping interested people to deepen their understanding of the connotation and denotation of health management.

With the care and support of the Ministry of Health, the Ministry of Civil Affairs, China Association for Science and Technology and other relevant departments, and with the joint efforts of comrades, the long-awaited Health Management Branch of Chinese Medical Association was officially established today. Here, on behalf of all colleagues of Health Management Branch, I would like to express my heartfelt thanks to all leaders and comrades! I would like to express my sincere gratitude to the old leaders and experts who have paid close attention to the development of China's health management for many years and given great help! Thank you to the guests who attended today's meeting!

Uterine fibroids are the most common benign tumors in women, and their incidence is the first among all benign tumors in women^[1]。 Many women don't know that they have uterine fibroids for the rest of their lives. Most patients with uterine fibroids are found during health examinations, gynecological examinations or imaging examinations, and some are found during autopsies for other reasons. Because the malignant rate of uterine fibroids is very low, most of them can be carried for life without clinical symptoms, so they are called "healthy people" who survive with disease. However, uterine fibroids often lead to symptoms and signs such as vaginal bleeding, anemia, abdominal pain, abdominal mass, frequent urination, constipation, infertility, miscarriage, premature delivery, dystocia, postpartum bleeding, etc. In severe cases, they have to receive treatment, and some will lose their uterus, which affects women's mental and physical health and even family harmony to varying degrees. Therefore, it is extremely important and practical to classify and manage patients with uterine fibroids, minimize the negative impact in treatment, maximize the preservation of female reproductive organs and protect female physiological functions, so as to promote their mental and physical health, improve the quality of life and build a harmonious family. The management of patients with uterine fibroids has become one of the responsibilities that gynecologists must pay attention to.

At present, diabetes has become a major disease that threatens human health worldwide. According to the data of the international diabetes federation (IDF) at the end of 2006, by 2007, the prevalence of diabetes among adults worldwide was about 6%, and the number of patients reached 246 million, while the prevalence of impaired glucose tolerance (IGT) was as high as 7. 5%, and the number of patients was about 308 million. It is estimated that by 2025, the prevalence of diabetes and IGT among adults worldwide will rise to 7. 3% and 8.0%, and nearly 800 million people worldwide will have abnormal blood sugar (including diabetes and IGT). There are nearly 40 million diabetic patients in China. Diabetes and its complications have brought a heavy burden to individuals, families and society. Therefore, it is crucial to identify the prediabetic population early and intervene with high-risk factors, so as to prevent the occurrence of diabetes and its complications.

The "Outline of the Eleventh Five-Year Plan for the Development of Health Undertakings" formulated by the Ministry of Health was officially approved by the State Council on May 30, 2007. It is very clear that safeguarding the health rights and interests of the masses should be regarded as the ultimate goal of reform. The new rural cooperative medical system, county, township and village medical and health service system, and urban community health service system provide safe, convenient and inexpensive public health services and basic medical services for urban and rural people. The vehicle-mounted mobile physical examination system is a better mode, which will play a certain role in solving the problem of "expensive and difficult medical treatment". It will send doctors and four modern basic medical diagnosis equipment (X-ray machine, electrocardiograph machine, B-ultrasound machine, blood test biochemical instrument) to the village entrance and the community, which is very civilian.

augumentation index (AI) is an index to evaluate arterial elasticity. In the central arterial pressure waveform, the ratio of the overlapping height of reflected waves to the overall systolic pressure height is called AI. AI can reflect the elasticity of the arterial system. The arterial elasticity function of the elderly and various high-risk groups decreases and AI increases. AI has similar clinical significance to the commonly used pulse pressure difference in clinic.

With the continuous reform of medical system, people's living standard and health care awareness are constantly improving, health examination as a new medical industry is developing rapidly. In the past five years, the number of physical examination centers set up by medical institutions, CDC, social capital, etc. has increased exponentially every year. It has made contributions in improving people's health care awareness, early prevention and control of diseases, optimizing the allocation of medical resources, alleviating the contradiction of urban medical treatment, and saving social medical expenses. There is no doubt that the health examination industry will gradually become the hottest cultural and health industry after the tourism industry, and it has entered the "post-tertiary production period". Through research and practice, we try to analyze the types and advantages and risks of health examination institutions for colleagues to discuss.

Molecular epidemiology has developed rapidly at home and abroad, and achieved leapfrogging research results. The relationship between genetic testing and genetic risk of diseases has attracted more and more people's attention. Although genetic testing has not been generally accepted by the society, it is of great social significance to detect genetic risk of diseases early and in time. This paper puts forward how to implement personalized health management from the analysis of specific cases, and summarizes the relationship between genetic testing and genetic risk of diseases.

Chronic obstructive pulmonary disease (COPD) is a common and important respiratory disease. The prevalence of American adults is 4% to 6% in men and 1% to 3% in women. The prevalence of people over the age of 15 in my country is about 3%. A recent survey of 20 245 adults in seven regions of China showed that the prevalence of COPD accounted for 8. 2% of people over 40 years old^[1]。 The World Health Organization projects that COPD will become the fifth most economically burdensome disease globally by 2020.

With the development of chemistry, biology and other human science, people have a deeper understanding of the function of human body and related influencing factors. Traditional Western medicine or traditional medicine has nothing to do with many difficult diseases or can only cure the symptoms rather than the root causes. Therefore, people begin to look for answers to the functional changes of the human body itself. Functional medicine as a theoretical system was put forward in the 1970s. As a means of health protection based on science, functional medicine emphasizes the biochemical uniqueness of human body, that is, everyone has unique physiological and biochemical metabolism due to different genetics and environment. It also emphasizes that health management should be patient-centered rather than disease-centered. Functional medicine believes that the relationship between human body and environment should maintain dynamic balance, or internal and external balance. The typical representative of applied functional medicine theory is that according to the network relationship of various physiological systems of human body, many unique diagnosis and treatment methods have been developed. The understanding of health in functional medicine is not "health without disease", but focuses on "health is a state full of vitality for the human body". Therefore, when the digestive system, endocrine system and nervous system of the human body are disordered, the person's vitality will be reduced. Although the symptoms of the disease referred to by traditional western medicine have not yet appeared, functional medicine believes that treatment is already necessary and relevant health care measures need to be used. The very fashionable healthcare industries in the United States today, such as nutrition products, health care centers, and even medical saunas, make extensive use of the fundamentals of functional medicine.