2008年 · 第02卷第04期

If people are asked to answer what the purpose and task of medicine is now, people will often say in unison without thinking that the object of medicine is the diseased people, and the task of medicine is to treat the diseased people, so medicine is medicine about diseases. The definition of Western medical classics also believes that medicine is a scientific system that studies the process of human life and the fight against diseases, and believes that medicine is a science that studies the law of human body deviating from the health state and showing abnormal state.

According to a 2005 national sample of one percent of the population, there are more than 100 million people over the age of 65 in China, accounting for 7.7 percent of the total population. The elderly population over the age of 60 will reach 10.5 percent and will rise to over 28 percent by 2050. China has become the country with the fastest aging rate and the largest elderly population, accounting for one fifth of the world's elderly people over 60 years old^[1]。 The aging of the population makes the problem of safe medication for the elderly more prominent. The incidence of adverse drug reactions (ADR) in the elderly is much higher than that in other age groups because of the decline of metabolism and the function of major organs in the body. In addition, irrational drug use and multiple drugs combined with other factors have increased the ADR of the elderly, which has become a major problem affecting the healthy life of the elderly. Some data show that the incidence of ADR in the elderly ranges from 4. 8% to 24. 0%, which is twice that in the young^[2]。 In addition, 15% ~30% of elderly patients in China are admitted to hospital due to improper medication, and the more types of medication, the higher the incidence of adverse reactions. According to the statistics of the cadre clinic of a hospital in Beijing, the average number of diseases aged 61-70 years old is 5.6, and the number of diseases aged 71-80 years old has increased to 7.2. The more diseases, the more types of drugs and the more ADR events. At the same time, in a prospective study of a cohort of 3,000 elderly people in Beijing, 410‰ of the elderly suffered from more than two diseases, and it is common for the elderly to take 5 to 6 drugs every day. According to some statistics, the incidence of ADR in patients who use three drugs at the same time is 18.6%; With the combined use of 5 drugs, the ADR rate increased to 81.4%^[3]。 Statistics in Beijing also show that the medical expenses of the elderly are far greater than the average medical expenses of employees, and the medical expenses of retirees are three times that of employees. At present, the amount of antibiotics used in Chinese hospitals accounts for 35% of the total amount of drugs, and the combined use of antibiotics makes the cost of antibiotics for hospitalized patients too high; At the same time, irrational drug use accounts for 12% ~32% of drug users in China, especially the elderly drug abuse and irrational drug use are more serious. The above sets of data show that the elderly have serious drug abuse and ADR, especially the irrational drug use such as antibiotic abuse, which increases the economic burden of the country, unit and individual, and damages the health of the elderly. Therefore, attaching importance to the ADR of the elderly, publicizing and popularizing the knowledge of medication safety of the elderly is of great significance to strengthen the medication monitoring of the elderly and promote the health of the elderly.

hepatitis B virus (HBV) infection is highly prevalent in China, and the positive rate of HBsAg in general population is 9. 09%. If the infants born to HBsAg positive pregnant women do not carry out effective health management, the infection rate of vertical transmission is higher. Therefore, it is of great significance to control HBV infection in China to block mother-to-child transmission as much as possible through health education and effective health management intervention.

NCCN (national comprehensive cancer network) is a non-profit academic alliance composed of 21 top cancer centers in the world. Its "NCCN Clinical Practice Guidelines for Oncology" has become the most widely used guidelines in global oncology clinical practice. 2008 NCCN Colorectal Cancer Screening Guidelines published by NCCN^[1]It is formulated through systematic research, which can not only help doctors assess the risk of colorectal cancer in the population, but also help doctors make appropriate screening, treatment and post-treatment monitoring plans in a specific clinical environment, so as to finally achieve the purpose of reducing the incidence and mortality of colorectal cancer. Now, a summary interpretation of the screening protocol for general risk groups in the 2008 NCCN Colorectal Cancer Screening Guidelines is made.

With the continuous rapid development of China's economy and the acceleration of social rhythm, people need not only relevant knowledge and skills, but also a healthy body. Physical examination has become a demand of the current society, and the Ministry of Health and other relevant national institutions have also paid attention to it^[1]。 "Assess health and disease risk factors of individuals or groups, provide counseling and guidance on individual or group health, and intervene in response to health risk factors"^[2], is the central content of this work. Electrocardiogram is the most commonly used non-invasive examination method of cardiovascular system. Many information about electrocardiogram changes can be an important basis for health assessment. The electrocardiogram data of some healthy physical examiners in our center were observed and analyzed.

The data of health risk factors of retired cadres, senior professional titles and division-level cadres who have undergone physical examination in 2007 are summarized and analyzed. It is found that even among the dominant population in medical units, there are still many health problems.

The Third Agricultural Construction Division of Xinjiang Production and Construction Corps carried out a general survey of women's diseases from March 8, 2007 to September 5, 2008, and conducted a general survey of common women's diseases for 36,227 married Uyghur (hereinafter referred to as Uyghur) and Han women of childbearing age. The main disease that endangers the health of women in Uygur and Han Dynasties is cervicitis, followed by pelvic inflammatory disease and vaginosis, uterine fibroids, ovarian cysts, etc. It is suggested that people should strengthen the health education for women, raise the consciousness of disease prevention, and do the general examination of gynecological diseases consciously and regularly, which can achieve early detection, early diagnosis and early treatment, reduce the incidence of gynecological diseases, and improve women's health level and quality of life.

From January 2005 to December 2006, the physical examination center conducted physical examination on the workers of Karamay Oilfield. The screened patients with chronic metabolic disorders were analyzed in groups, and health education was carried out according to the characteristics of regional lifestyle, so as to reduce the prevalence of chronic metabolic disorders. The report is as follows.

Research in the 1980s and 1990s established a relationship between employee health status and their medical expenses^[1,2,3]。 These studies clearly show that workers with worse health have greater medical expenses^[3]。 From the late 1990s to the early 2000s, new research has found that the health of employees is not only related to the expense of employers on their medical care, but also affects the productivity of enterprises (productivity, which is currently not normally translated in China, this paper intends to translate it as "productivity", which means the ratio of input to output)^[4,5]。 Moreover, the economic losses caused by reduced productivity due to poor health are much greater than the direct costs of medical care^[6]。 According to the study, in 1997, each of the 120 million workers in the United States spent $3,510 per year on medicine, while the economic loss caused by reduced productivity due to health problems was $10,530^[7]。 At the beginning of the century, health-related productivity declines were already costing the U.S. economy $468 billion a year, or 5 percent of U.S. gross domestic product annually^[8]。

As a discipline, anti-aging is both ancient and trendy. It can be said that there has been a need and research on anti-aging since the day humans have medicine. In the Western academic circles, from different cultural, ethical, social, nutritional and medical perspectives, they have made long and non-stop efforts towards the same goal-anti-aging. Since the 20th century, anti-aging science has gradually formed a variety of theories such as free radical theory, immune anti-aging theory, gene aging theory, neuroendocrine theory and anti-aging theory of traditional Chinese medicine. It is in such a scientific and innovative environment that we try to establish the polypeptide anti-aging (or delaying aging) theory on the basis of polypeptide nutrition. Its theoretical basis is that the oral small molecule polypeptide protein explained in polypeptide nutrition can be directly used by cells, tissues and organs through the transport channel of small intestine. This paper mainly introduces the research and application of albumin peptides obtained by biodirectional enzyme digestion technology on antioxidant, immune function and neuroendocrine regulation.

Health management is a model of providing comprehensive medical and health services, including a series of assessments on the health status and disease risk of individuals or specific groups; Guide and help individuals or groups to avoid and change health-affecting behaviors and control health risk factors according to scientifically-founded guidelines issued by professional institutions; And in the course of certain chronic non-communicable diseases (chronic diseases), through coordination and communication with relevant professionals, caregivers of patients and patients, assisting and guiding patients in self-management, and conducting cost-effectiveness evaluation of diagnosis and treatment measures^[1]。 Taking the prevention and control of chronic diseases as the starting point, changing the mode of health service and reducing the occurrence of diseases through active and high-quality prevention services have become the main tasks of health examination at present^[2]。 Now exchange experience with peers on applying health management theory to guide health examination in our hospital.

Health management is a process of comprehensively managing the health risk factors of individuals and people^[1]It is the examination and monitoring of health risk factors (finding health problems) → evaluation (recognizing health problems) → intervention (solving health problems) → re-monitoring → re-evaluation → re-intervention. Among them, health evaluation is the key, health intervention is the means, health promotion is the purpose, the continuous operation of the health management cycle makes the management object on the road of health, if the effective health cycle cannot be formed, it cannot become the health management^[2]。

Diabetes is a kind of chronic metabolic disease, which is mainly susceptible to middle-aged and elderly people, and more than 90% of them are type 2 diabetes^[1]。 According to data released by the World Health Organization, diabetes has become the third chronic non-communicable disease in the world that threatens human health^[2]。 The concept and practice of health management originated from the United States, which has been more than 20 years, while the theory and practice of health management in China is less than 10 years old^[3,4]。 Chen Junshi and Huang Jianshi define health management as "the whole process of comprehensive monitoring, analysis, evaluation, health counseling and guidance, and intervention on health risk factors of an individual or group"^[5]。 Therefore, the connotation of health management is to fully evaluate and effectively manage the health risk factors, so as to maintain, improve and promote the health of groups and individuals, improve the quality of life and prolong the healthy life^[6]。 How to manage diabetes, especially type 2 diabetes, has become an important issue for physicians to think about. We only summarize our experience and experience in the management of type 2 diabetes and its high-risk populations in clinical work as follows.

Pilot convalescence is to improve and strengthen the adaptability of the body, adjust the abnormal biological rhythm, improve the health level of pilots and prolong the flight years by formal and scientific convalescence methods, make them receive the comprehensive effects of various beneficial biological and chemical factors and social and psychological environmental factors in the convalescence process, and cooperate with physical training and scientific and reasonable balanced diet. Humanized nursing pays attention to the content arrangement and regularity of nursing work, and realizes the nursing work mode with the nursing staff as the center and the modern nursing concept as the guide^[1]。 We have achieved satisfactory convalescent results by carrying out humanized nursing care in nursing homes. The specific practices are as follows.

The main components of blood lipids are cholesterol and triglyceride (TG). cholesterol and triglycerides are hydrophobic molecules, which must be combined with proteins and other lipids (such as phospholipids, etc.) in the blood to form a hydrophilic spherical macromolecule complex-lipoprotein, so that it can be transported in the blood. Therefore, dyslipidemia usually refers to an increase in total cholesterol (TC), low density lipoprotein cholesterol (LDL-ch), and TG levels in the blood, or a decrease in high density lipoprotein cholesterol (HDL-ch). Previously, the concept of hyperlipidemia or hyperlipoproteinemia was used, mainly referring to elevated levels of TC, LDL-ch, and TG. In recent years, because the decrease of HDL-ch in plasma is also a disorder of blood lipid metabolism, it is collectively referred to as dyslipidemia in order to comprehensively and accurately reflect the state of blood lipid metabolism disorder.

Vascular health assessment and risk prediction of cardiovascular and cerebrovascular diseases are one of the hot topics in current health risk assessment research^[1,2]Our previous research work has shown^[3,4,5]Carotid artery ultrasonography can not only be used for subclinical carotid arteriosclerosis and cardiovascular and cerebrovascular risk prediction in natural population, but also for vascular health evaluation and health management consultation and guidance. This paper focuses on the carotid artery ultrasound detection technology and its application in health examination and health risk assessment.

Building a healthy city is a global action strategy advocated by the World Health Organization in the 1980s to face the challenges posed by urbanization to human health. The aim is to build a city that continuously develops and develops the natural and social environment and expands social resources so that people can support each other in enjoying life and realizing their full potential^[1,2,3,4]。

The morbidity and mortality of colorectal cancer in China are on the rise^[1]But can be prevented^[2]It mostly follows the evolution process from adenoma to cancer and is suitable for screening in asymptomatic people^[3], mass screening is an important means to improve survival^[4]。 The high risk factors of colorectal cancer are related to genetics, diet, activities and psychology, etc. There are certain advantages in carrying out prevention and treatment of colorectal cancer in the community. For two years, we have been studying and investigating and conducting screening in a residential area^[5]Have some experience.

On June 23, 2008, 61 trainees from more than 50 health management institutions all over the country gathered at Tsinghua University to attend the first one-week "Advanced Training Course for Leading Cadres of Health Management (Health Care) Institutions" of Tsinghua University. The health management professional training course jointly organized by the Health Management Branch of the Chinese Medical Association and Tsinghua University has given full play to the advantages of the academic brand and authoritative expert resources of the Chinese Medical Association and the education and training resources of Tsinghua University, aiming at building China's first-class leading talents in health management industry, taking the practical technical training of the health management discipline system of the Chinese Medical Association as the main body, and cooperating with the knowledge of management, management, informatics and other aspects, to implement the national health management education and training project, so as to meet the needs of the rapid development of the health management industry as soon as possible, change the constraints brought by the relative lack of professional senior management talents, and train high-end management talents who understand professional and refined management for the healthy development of the industry. Cultivating an excellent health management professional team and managing health resources with strategic significance are related to the overall situation of health work, the coordinated development of society and economy, and the fundamental interests of the people. It will have far-reaching social significance for promoting the development of health industry, improving and improving China's national health literacy and building a harmonious society in an all-round way.

Traditional Chinese medicine believes that health is a dynamic balance state of "yin and yang secret" maintained by human beings in the natural and social environment, while subclinical states or diseases are due to various reasons caused by the exuberance and decline of yin and yang in the body. For the treatment of subclinical state, starting from the idea of "treating before disease", traditional Chinese medicine advocates preventing slight changes and preventing them from further developing into the direction of disease. For the prevention and treatment of subclinical state, TCM pays more attention to the treatment of TCM, but also pays more attention to the role of health care methods in promoting the transformation of subclinical state to health, emphasizing that it must be guided by TCM theory, and its principles have the following aspects:

On May 31st, 2007, James Watson, the American Nobel Prize winner "Father of DNA", was presented with a DVD recording all the information of his own genome, becoming the first person in the world to obtain his own genome map. On September 4 of the same year, Craig Venter, a pioneer in genetic research, published his most complete personal genome map for the first time in the journal PLoS Biology^[1]。 The map discloses diseases that Venter may suffer from in the future. For example, his ABCC11 gene sequence indicates that Venter may produce damp earwax in his ears; His APOE sequence and SORL1 gene suggest that he may be at greater risk for Alzheimer's disease and cardiovascular disease. Because personal genome carries all its own genetic secrets, it has an important relationship with the susceptibility of future diseases, the development and outcome of diseases, and the treatment methods. At the same time, it plays an important role in personal medical insurance, identity identification, personal privacy and medical ethics. Therefore, from the first day of the birth of personal genome map, it has aroused extremely wide attention of the whole society.

The Health Examination and Health Management Center of Sichuan Academy of Medical Sciences and Sichuan People's Hospital is the first large-scale medical service center engaged in professional health examination and health management in Sichuan Province, with distinctive characteristics and technical service advantages.

Reader survey is an important channel for magazines to communicate with readers, and it is also an important way for magazines to understand readers' needs. It helps magazines to adjust the direction of running journals and reporting emphasis according to readers' needs in a timely and appropriate manner, so as to be closer to readers and more welcome by readers. There are many ways of reader survey, such as questionnaire survey, small symposium, etc.