2009年 · 第03卷第06期

As the whole country responds to influenza A (H1N1) in a rational and orderly manner, two important annual meetings of the medical field recently held in Beijing (the 6th Health Industry Forum of Chinese Medical Association and the 3rd Annual Meeting of Health Management Branch and the 3rd Academic Annual Meeting of Chinese Preventive Medicine Association) also focused on chronic non-communicable diseases (referred to as chronic diseases); This issue of the magazine highlights Professor Bai Shuzhong and others^[1,2]Articles exploring chronic disease management. The two messages that these actions want to send to peers and Chinese people are very clear:

At present, the incidence of various major chronic non-communicable diseases (referred to as chronic diseases) such as malignant tumors, cardiovascular and cerebrovascular diseases, metabolic diseases and mental diseases is increasing year by year, causing many risk factors of chronic diseases to soar and become the most important threat to people's health in China. China's disease spectrum has changed from infectious diseases to chronic non-communicable diseases, which is much faster than other countries. Moreover, with the increasing burden of chronic diseases, it will obviously have a significant negative impact on China's economic and social development, and even hinder the pace of China's sustainable development. The use of traditional clinical diagnosis and treatment technology and preventive medicine can not solve the problem of prevention and treatment of people in the early or recovery stage, which accounts for more than 80% of chronic diseases. Health management (including chronic disease management) has opened up a new and effective way for chronic disease prevention and treatment. Health management, as an innovation of modern medical service mode, will play an important role in the comprehensive prevention and treatment of chronic diseases.

With the progress of society and the development of science and technology, the acceleration of urbanization and aging, and the obvious changes of lifestyle, the harm scope and degree of early serious threats to human beings, such as infectious diseases, pregnancy and perinatal diseases, have decreased obviously, while chronic non-communicable diseases (chronic diseases) such as cancer, cardiovascular and cerebrovascular diseases, metabolic diseases and neurological diseases have become the main threats to human health^[1]。 At present, chronic diseases have become the main cause of death of urban and rural residents in China, and the proportion of chronic diseases deaths in urban and rural areas is as high as 85.3% and 79.5%; Various risk factors closely related to the occurrence and development of chronic diseases are prevalent and soaring^[2,3]。 Therefore, it has become an urgent task for us to study how to control chronic diseases and their risk factors through health management.

With China's reform and opening up and the rapid development of economy and society, a series of changes have taken place in social structure, economic structure and people's lifestyle. People' s health consciousness has also undergone great changes. Health consumption demand has changed from simple and single medical treatment to disease prevention, health care and health management. People pay more and more attention to health management, which aims at "individualized health needs" and solves personal health problems systematically, completely, continuously and lifelong.

Pregnancy complicated diabetes includes pre-pregnancy diabetes and diabetes that occurs or is first detected after pregnancy, the latter is also known as gestational diabetes. The incidence rate has shown an obvious upward trend in recent years. The whole course of health management was performed in 94 pregnant patients complicated with diabetes. Satisfactory results have been obtained, and the analysis report is as follows.

As people pay more and more attention to their own health, health examination, especially cancer prevention examination, is becoming more and more common. Many people choose¹⁸Fluorodeoxyglucose Positron Emission Computed Tomography-Computed X-ray Tomography (¹⁸fluorodeoxyglucose positron emission tomograply-computed tomography,¹⁸FDG PET-CT) as part of the imaging physical examination.¹⁸FDG PET-CT can perform whole body tomography and provide simultaneous image fusion of functional metabolism and anatomical structure^[1]It can fully understand the distribution of lesions throughout the body. However, due to the relatively high examination fee in our country, most people can't choose this physical examination method. In order to further evaluate its practical value in physical examination, 85 cases in our center were adopted¹⁸The results of the FDG PET-CT physical examination population were analyzed.

Sudden sports death is the most serious and practical problem in sports medicine. Although the incidence of sudden sports death is not high, it is a serious threat to human life, so it has been paid attention by scholars from all over the world for a long time. Relevant research at home and abroad^[1,2,3,4,5]It is suggested that 80% ~90% of sudden exercise deaths are attributed to cardiac diseases, including coronary heart disease, hypertrophic cardiomyopathy, congenital abnormalities of coronary arteries, myocarditis, cerebrovascular accidents, valvular heart disease, abnormalities of cardiac conduction system, idiopathic myocardial hypertrophy, aortic rupture caused by Marfan syndrome, acute pulmonary edema, etc. Therefore, in order to effectively prevent sudden sports death, all countries are making efforts to establish a scientific and efficient medical examination system, hoping to timely identify potential individuals prone to sudden sports death from seemingly healthy sports participants. Although the system of regular medical examination has been established in China, it cannot fully include all sports participants, and there is a lack of systematic medical examination for sudden cardiac exercise death. This paper introduces the international medical examination system and progress in recent years, hoping to help the prevention and treatment of sudden sports death in China.

hyperuricemia (HUA) refers to excessive production or decreased excretion of blood uric acid due to disorder of purine metabolism in the body, and excessive intake of exogenous purine causes increased blood uric acid level, which is often associated with traditional metabolic cardiovascular risk factors such as hypertension, hyperlipidemia, type 2 diabetes, obesity, insulin resistance, etc. With the in-depth research on HUA, it has been found that uric acid-lowering therapy is expected to become a new way to prevent and treat cardiovascular diseases. Therefore, 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 and prevent the occurrence of HUA through lifestyle management.

In 2008, the State Council launched two major scientific and technological projects in the field of medicine and health, namely, "Major New Drug Creation" and "Prevention and Treatment of Major Infectious Diseases such as AIDS and Viral Hepatitis" (hereinafter referred to as "Prevention and Treatment of Infectious Diseases"). As a member of the Implementation and Management Office of Major Special Projects for Prevention and Treatment of Infectious Diseases, I have participated in the management of scientific and technological projects of major special projects for prevention and treatment of infectious diseases. Now, I discuss the basic concepts, classifications, characteristics and existing problems of major medical scientific and technological projects, and put forward preliminary suggestions on their management.

Modern Japanese medicine began to relearn Chinese medicine. In recent years, the application of TCM tongue diagnosis has been carried out. This paper searched the literature databases of Japanese medical journals Science and Technology Medical Literature Information Retrieval Service, Central Journal of Medicine, National Institute of Information Science Paper Information Retrieval Service, National National Library of Parliament and other literature databases from 2000 to 2008, and investigated and analyzed the current application of tongue diagnosis in Japan.

In recent years, the per capita oral diseases such as caries, periodontal disease and dental endodontic disease in China are gradually rising. According to the data published by the World Health Organization in recent years, the current distribution of caries in the world is characterized by a higher prevalence of caries in highly industrialized countries than in developing countries, and the prevalence of caries in North America and Europe is as high as 99%^[1]However, due to the effective oral prevention and control measures, the caries prevalence rate has decreased significantly, and the prevalence trend has developed from high to low; However, with the improvement of living standards in China, the caries rate is gradually rising^[2]。 This urgently requires the intervention of oral preventive measures, especially oral health education for pregnant women and their families. Educating a mother is equivalent to educating the whole nation. Therefore, it is urgent for community oral health care doctors to provide oral health education, guidance, examination and treatment for these key groups.

At present, whether health management is cold or hot, and how the public understands health management, although these issues have been widely discussed, there has always been no unanimous voice. It is difficult for individuals to accurately analyze the degree of attention to health management based on experience. Therefore, this study attempts to demonstrate the degree of attention to health management in China from three aspects: public, media and academics.

In recent years, with China's reform and opening up and the rapid development of economy, people's demand for health maintenance services is increasing day by day. The medical and health service system has shifted from concentrating high-quality resources on disease and even terminal treatment to early disease prevention and healthy lifestyle promotion. Community health service is the bottom of China's medical and health system, playing an important role, so community health management came into being. This paper will expound the preliminary practice of community health management to explore more effective ways of maintaining residents' health.

Zhang Jingbo, professor of Peking Union Medical College, is currently the editor-in-chief of Acta Anatomica Sinica and the editor-in-chief of Basic Medicine and Clinics. Engaged in amateur popular science writing for many years, as one of the executive editors, "Interpretation of Life Series" has won five One Project Awards, including the volume of "How to Overcome Disease" edited by him.

[Case]Patient, male, 44 years old. In the past year, the patient's chest tightness and precordial discomfort have recurred, which are related to fatigue and poor sleep, and are accompanied by asthma when climbing or climbing ladders in a hurry. However, the symptoms can be relieved after rest or sublingual nitroglycerin tablets. In the past, no abnormalities were found in the physical examination of heart and lung every year, and the history of hypertension, diabetes and congenital heart disease was denied. Physical examination: body temperature 36.2 ℃, pulse 65 bpm (beats/min), respiration 22 bpm, blood pressure: 140/90 mm Hg (1 mm Hg =0.133 kPa), body mass index: 25.4 kg/m²There were no abnormalities in auscultation, electrocardiogram (ECG) was normal, and no abnormalities in cardiovascular and cardiac function were found in chest X-ray and color Doppler ultrasound. Blood lipids: total cholesterol: 4.8 mmol/L, triacylglycerol: 0.74 mmol/L, high density lipoprotein: 1.36 mmol/L, low density lipoprotein: 3.78 mmol/L, dynamic electrocardiography (DCG) on 5 May 2008 showed 22 premature ventricular beats/24 h, ventricular tachycardia (seeFigure 1), showed 127 premature ventricular beats/24 h and 1 transient complete left bundle branch block on 24 Nov 2008 (seeFigure 2), STv5~ v8 showed a downward oblique depression of 0.05~0.1 mv at the heart rate of 140 bpm under exercise at 17:2 on the same day. emission computed tomography (ECT) showed a decrease in the distribution of radioactivity in the myocardium of the left ventricular posterior lateral wall, posterior interstitial wall, apex and localized anterior wall near the apex, and the cardiac function activity treadmill exercise test was negative. 64-slice volume CT showed that the distribution of coronary arteries was dominant in the right coronary artery. The main trunk, diagonal branch and posterior descending branch of the left coronary artery were well filled, low density plaque was seen at the proximal end of the anterior descending branch, and the most severe stenosis of the lumen was about 43%, and the circumflex branch was absent (seeFigure 3)。