2009年 · 第03卷第01期

History has no shortage of repeated and coincidental events.

Cardiovascular disease usually refers to a class of diseases caused by atherosclerosis, mainly including coronary heart disease, stroke and peripheral vascular disease. Recent studies suggest that the incidence of stroke in China is about 250/100,000 people, and the incidence of coronary heart disease events (including acute myocardial infarction and sudden death from coronary heart disease) is about 50/100,000 people^[1]。 Moreover, with the change of lifestyle and the rapid aging of the population in China, it is expected that the incidence and prevalence of cardiovascular diseases in China will continue to rise for a considerable period of time, becoming the primary cause of death and disability in China. Although new treatments and methods are constantly emerging, once cardiovascular disease occurs, its therapeutic effect is still limited. On the contrary, a large number of studies have confirmed that cardiovascular diseases are a class of preventable diseases, and the incidence of such diseases can be significantly reduced by adopting prevention and treatment strategies that combine the whole population, high-risk groups and patients^[2,3]。 It can be said that one of the most important goals of modern health management is to prevent, reduce and control the occurrence and development of cardiovascular diseases by controlling the level of risk factors.

hereditary nonpolyposis colon cancer (HNPCC), also known as Lynch syndrome, accounts for 2% to 3% of the total incidence of colorectal cancer^[1]。 Its pathogenesis is mainly caused by mutations in DNA mismatch repair genes (mainly MLH1, MSH2, MSH6, PMS2), and the risk of lifetime colorectal cancer in individuals carrying one HNPCC mutation gene is 80%^[2]。 The main clinical characteristics of HNPCC are that the age of tumor onset is early, and colon cancer usually occurs before the age of 50. It often occurs in the proximal colon (cecum, ascending colon and transverse colon), with simultaneous or metachronous primary colon cancer, and common extraintestinal malignant tumors. The most common site of extraintestinal malignant tumors is the endometrium, followed by the stomach, small intestine, hepatobiliary system, upper urinary tract and ovary. The main risk of HNPCC is that it is transmitted to offspring in an autosomal dominant manner, especially first-or second-degree relatives, which are prone to colon cancer. The clinical prognosis of HNPCC is good, and early detection and early treatment will greatly improve the prognosis of patients. Patients with HNPCC and their relatives must be closely monitored, NCCN guidelines^[3]Screening for HNPCC includes molecular diagnosis, genetic testing, follow-up monitoring and surgical treatment.

In the past 30 years, with the development of China's economy and the progress of science and technology, people's living and medical conditions have been greatly improved. On the whole, people's health level has improved significantly, and their life expectancy has increased year by year. However, studies in the past 30 years have shown that the morbidity and mortality of cardiovascular diseases (mainly hypertension, coronary heart disease and stroke) in Chinese population are increasing year by year, and the age of onset is advanced. This upward trend is mainly related to the following factors^[1]: (1) Population aging. (2) The level of cardiovascular risk factors in the population increased. (3) Effective control of infectious diseases leads to a relative rise in non-communicable diseases. Cardiovascular disease has become one of the most important public health problems in China due to its high disability and mortality rate. How to deal with and curb the rising trend of cardiovascular diseases in China is a severe challenge faced by every medical worker.

Early detection and intervention of the progression of subclinical vascular disease is the fundamental measure to delay and control cardiovascular events. To explore the method of detecting the early changes of arterial vessels without trauma and the correlation with the coexistence of multiple factors, so as to provide an objective index for detecting the high-risk population of cardiovascular diseases conveniently.

Food intolerance is that the body's immune system can't digest and absorb specific foods or food components well, thus producing food-specific IgG antibodies. IgG antibodies form immune complexes with food particles, which may cause inflammatory reactions in all tissues and manifest as symptoms and diseases of various systems in the whole body^[1,2,3]。 At present, many clinical investigations and studies have confirmed that some digestive, skin and nervous system diseases are related to food intolerance. With the development of medicine, the relationship between food intolerance and diseases has gradually attracted people's attention, and has become a hot spot at home and abroad. In this study, 14 kinds of food intolerance were tested in 1059 healthy people in Guangzhou to analyze and understand the food intolerance situation in this area, and to explore its possible influencing factors, which provided important guidance for clinical diagnosis and prevention of diseases.

In recent years, with the rapid development of social economy, the continuous improvement of people's living standard and the change of dietary habits, coupled with the aging of the population, the prevalence of Metabolic Syndrome (MS) is increasing. MS is a kind of cardiovascular and cerebrovascular disease directly, which is mainly manifested by the combined effects of central obesity, dyslipidemia, hypertension, hyperglycemia, insulin resistance and other metabolic abnormalities on individuals. It is a high risk factor of cardiovascular and cerebrovascular diseases, type 2 diabetes and other metabolic diseases^[1]Three-fold increased risk of coronary heart disease and stroke in MS patients^[2]All causes of death and cardiovascular mortality were also significantly increased^[3,4]The prevalence of MS in patients with type 2 diabetes is as high as 40% to 60%^[5]。 Health education plays a very important role in the prevention and control of diseases. This study preliminarily analyzes the prevalence, knowledge degree and ways of understanding MS in general population, in order to provide some reference for health education and prevention and treatment of MS.

Disease risk assessment is a technique and method to study the quantitative dependence and regularity between disease risk factors and disease morbidity or mortality, and to describe the probability of morbidity or mortality^[1,2]。 The effective way to prevent and control chronic non-communicable diseases (chronic diseases) such as coronary heart disease is to insist on moving the gate forward, discover the risk of diseases in advance and prevent them before they happen. This article tries to briefly summarize the theories and methods of risk assessment of coronary heart disease at home and abroad, in order to provide reference for the prevention and treatment of chronic diseases such as coronary heart disease.

With the continuous improvement of living standards of Chinese residents, people's consciousness of health and fitness is increasing day by day. Exercise prescription has attracted more and more attention because it can carry out planned and purposeful scientific exercise for the objects implementing exercise prescription to achieve the effects of enhancing physique, recovery and preventing and treating diseases. Exercise prescription as a way of follow-up service for health examination is gradually widely accepted by people. This article reviews the application of exercise prescription in post-examination health intervention.

Smoking is a preventable and important risk factor that causes many major human diseases and early death^[1]。 The World Health Organization 2008 Global Tobacco Epidemic Report clearly points out that the number of deaths from various diseases caused by smoking reached 100 million worldwide in the 20th century. At present, at least 5.4 million people die from smoking-related diseases worldwide every year^[2]。 In addition, if governments and social groups continue to neglect to formulate and strictly implement comprehensive tobacco control policies and measures as soon as possible, and according to the current tobacco epidemic pattern, it is estimated that 8 million people will die of various tobacco-related diseases worldwide every year by 2030, of which 80 percent will occur in developing countries. Ultimately, the number of deaths from tobacco-related diseases in the 21st century will exceed 1 billion worldwide^[2]。 Therefore, the harm of tobacco has become a serious public health problem affecting the health of people in the world today, and eliminating the harm of tobacco has become a worldwide trend and a historical trend.

The new profession of health manager was officially promulgated in China in October 2005. In this short period of time, many provinces and cities across the country have carried out the training of health managers, the Talent Exchange Service Center of the Ministry of Health has organized several assessments and appraisals, and academic groups such as Chinese Preventive Medicine Association and Chinese Medical Association have also set up health risk assessment or health management branches. A group of scholars and experts dedicated to health management have also actively introduced and promoted the concepts and methods of health management in medical and health institutions and societies all over the country, especially the Chinese Journal of Health Management founded by Chinese Medical Association, which has provided a platform for academic exchanges for the majority of health management workers and played a huge role in promoting the development of health management as a major and discipline. These factors promote the development of health management, which makes health management rapidly popularized. At present, many hospital health examination centers, community health service centers and disease prevention and control departments are trying to apply the concept and method of health management to their own work. They have accumulated certain experience in practice, enriched the theory and practice of health management, and made this subject, which was still vague and naive four years ago, gradually clear and grow up. Although the major and discipline of health management are developing rapidly, after all, it has only been practiced for a few years, and there are many contents that need to be enriched and improved in terms of theory and skills. It is particularly obvious that health managers or related professionals lack some standardized and operational skills knowledge, tools and business guidance in the actual work of implementing health management; If you want to consult literature and books, it is difficult to find relevant answers in one or two books. Because health management is an interdisciplinary subject formed by the combination and refinement of epidemiology, clinical medicine, health education, nutrition, psychology, health sports science and management science. According to the needs of health management practice in recent years and the experience of health managers in teaching, training, assessment and appraisal, this series of lectures will select several basic and important professional skills issues that have not been standardized and guided at present, and write and provide instructional lectures on professional skills for everyone through the joint efforts of relevant experts.

Dyslipidemia is usually referred to as total cholesterol (TC), low density lipoprotein cholesterol (LDL-CH), triglyceride (TG) in the blood exceeding normal or high density lipoprotein cholesterol (HDL-CH) is low. Dyslipidemia plays a very important role in the occurrence and development of atherosclerosis, and the resulting vascular events such as myocardial infarction and stroke have the characteristics of disability and high mortality. The incidence of ischemic cardiovascular and cerebrovascular diseases based on atherosclerosis is increasing year by year in China, and it has become the first cause of death in urban and rural populations^[1]。 Dyslipidemia usually has no obvious symptoms, and is often found through physical examination or corresponding cardiovascular and cerebrovascular events. Therefore, early recognition and active intervention of dyslipidemia are of great significance for the prevention and treatment of arteriosclerosis, reduction of vascular events and reduction of mortality.

With the development of economy, all kinds of diseases, especially chronic non-communicable diseases (chronic diseases), have become a major public health problem that endangers our people's health. China's Ministry of Health "China Chronic Disease Report" pointed out^[1]In 2005 alone, the number of deaths due to chronic diseases in China reached as high as 7.5 million, accounting for more than 21.4% of the world's chronic disease deaths. Chronic diseases bring a heavy economic burden to households and individuals, especially to rural residents. The vicious circle of chronic diseases and poverty will make people fall into the predicament of "poverty due to illness and return to poverty due to illness". Hospitalization for common chronic diseases generally costs more than half of the per capita annual income of urban residents. At present, the loss of disability adjusted life years (DALYs) caused by chronic diseases in China has reached 70%. In 2001, among the top ten leading causes of death in China, chronic diseases such as cardiovascular and cerebrovascular diseases, chronic obstructive pulmonary disease and malignant tumors ranked the top three in DALYs. The aging of the population and the increase of various chronic diseases have directly driven the rapid rise of medical expenses in China, which has brought a heavy burden of diseases to the country and families. To reduce the burden of diseases in the country, we must control the occurrence of diseases at the source and reduce the risk of diseases in the population. Therefore, the Outline of National Medium and Long-term Science and Technology Development Plan puts forward the decision of "moving the focus of disease prevention and treatment forward, insisting on prevention as the first priority, promoting health and combining disease prevention and treatment" from the overall perspective^[2]。

According to the basic content of the "central rule" of molecular biology, biological information ranges from DNA to RNA to protein; Proteins are the ultimate manifestation of life phenomena. Therefore, to study life phenomena, especially to find molecular markers related to diseases, theoretically, the molecular markers searched by proteomics theory and methods are the ideal markers that can best explain life phenomena. Because the research based on proteomics is still obviously lagging behind compared with the research based on genomics. For example, the two-dimensional electrophoresis method commonly used in proteomics can only effectively separate 2,000 to 3,000 proteins at the highest resolution, and the resolution of finding protein expression differences on this basis is relatively low. After the completion of the human genome project, it has been predicted that there are about 30,000 genes in the human genome according to the sequence characteristics of the human genome. A gene chip can carry all the gene sequence information, so that the expression of all human genes mRNA can be detected through a gene chip experiment. Although the expression level of RNA and the expression level of protein are not completely consistent, from a global perspective, there is a correlation between mRNA expression and protein expression of about 0.6 to 0.7. In particular, mRNA expression has exceeded the category of simple DNA level susceptibility. Genetic, environmental, living habits and other factors can affect the mRNA expression level of genes. Therefore, the technical methods of screening disease-related molecular markers from mRNA expression have been increasingly used. For example, the food and drug administration (FDA) approved MammaPrint, developed and manufactured by Agendia in the Netherlands, in 2007^®The breast cancer prognosis risk assessment chip can be used for clinical diagnosis. This chip is to assess the prognosis risk of breast cancer patients by analyzing the expression level of 70 genes^[1]； 2008 US FDA approved Pathchip ™ The chip is used to analyze the primary tumor tissue. The chip uses the expression of 1550 genes to analyze the location of the primary tumor^[2]。 Some researchers also take advantage of analytical methods at the genomic level to first find genes differentially expressed in solid tumors from high-throughput screening at the mRNA level, and then screen genes encoding secreted proteins from these differentially expressed genes. The proteins encoded by these genes, especially the protein products that can be secreted into the blood, will become the focus of observation and research, and finally achieve the goal of early diagnosis of diseases by detecting the changes of these special protein products in serum^[3]。

Follow-up service after physical examination is an important step for physical examination center to improve service function and implement health intervention plan, and it is the core link of health management. In practice, doctors generally report that the subjects have "poor compliance" and are difficult to manage^[1]； The subjects felt that the health intervention plan was too dogmatic and difficult to implement. From the perspective of service, the main reason why doctors and subjects have far different feelings about health management lies in the lack of personalization of services provided by doctors.

As the saying goes: The beauty of people lies in the eyes, and the beauty of literature lies in the title. The title is not only the soul of the article, but also the window for readers to read and retrieve, which plays a pivotal role in the article. It is extremely important for an article to draw up a title that accurately reflects the theme of the article, is concise and focused. However, after reviewing the English titles of some medical papers in Chinese Journal of Health Management, the author found that many authors of medical papers regard English titles as "leftovers" of the papers, which despise the practical significance of English titles to a great extent. In addition, they lack in-depth understanding of their specific writing requirements, and the level of medical English writing is very limited. Writing English titles is often perfunctory, and the phenomenon of inconsistent titles, complicated and lengthy, confusing logic, irregular professional terminology, and misuse of segmentation or preposition is common, which brings great negative impact to the revision and processing of editors, the widespread dissemination of papers and the overall quality of journals. In order to change this situation and deepen the understanding of English titles by the authors of medical papers, the author will briefly introduce the concept, classification, function, requirements and common mistakes of titles.