2011年 · 第05卷第02期

Dear leaders, experts, friends at home and abroad and friends from the press, good morning. I am delighted to participate in the 2011 Health Management Work Conference of our institution. At the same time, I want to tell you that the evidence-based health management center of Chinese Academy of Medical Sciences/Peking Union Medical College will be established soon, and preparations are being made now.

Academically speaking, health management can be divided into macro and micro. Micro-health management is the discovery, control and management of risk factors to prevent diseases. Macro-health management is the management of the whole life process from no disease to disease occurrence^[1]。 The so-called big health model and the social-psychological-biological-environmental medical model are actually the result of the development of modern medicine with social economy to today.

The management of chronic non-communicable diseases (chronic diseases) is one of the important contents of health management. In recent years, peers in China's health management circles have made many useful explorations in the aspects of status assessment, theoretical framework, suitable technology and management platform of chronic disease management^[1,2,3,4]。 However, so far, there are no successful cases that are generally recognized and can be used for reference in the industry. The progress of chronic disease management theory and practice is slow, with a lot of investment and little effect. Plans are comprehensive and thoughtful, and concrete implementation is often half the result. The current situation is: the epidemic of chronic diseases is basically out of control, and the risk factors of chronic diseases are widespread. The reason is that, in addition to institutional, resource and technical factors, I think the key is that our current thinking on chronic disease management has not jumped out of the framework of traditional diagnosis and treatment. China has grown so fast over the past three decades that we are not mentally, materially and methodologically prepared for the massive industrialization, urbanization and aging that has emerged across the country and the resulting chronic disease pandemic. Old thinking and old methods cannot solve the new problems arising under the new situation.

Nowadays, chronic non-communicable diseases are a major threat to human health. In the past 20 years, based on the in-depth epidemiological research of chronic kidney disease (CKD) and the discussion of its relationship with chronic diseases such as cardiovascular and cerebrovascular diseases, the medical community has paid more and more attention to CKD, a common chronic non-communicable disease. People have gradually realized that CKD has become a heavy burden on the public health system, and it is urgent to prevent and treat it at an early stage. Health management is an emerging field which has attracted increasing attention in our country. Foreign experiences have proved the effectiveness of comprehensive health management. This article aims to briefly explain the epidemiological characteristics of CKD and the possible role and potential of health management in the early prevention and treatment of CKD.

Cancer screening and early detection play a very important and central role in the health management of people at high risk of cancer. In addition to the detection of early tumors, the awareness and intervention of risk factors should also be an important part of this work^[1]。 In the field of medicine, consent to be informed implies that the patient has the right to decide whether or not to make a medical treatment on his or her body or what kind of medical treatment to receive. From the point of view of practical work, combined with the relevant theories of consent right to know, this paper puts forward the content and scope of consent right to know of medical workers in basic medical practice activities such as tumor screening, and how to better implement the consent right to know within the scope of legal requirements under the increasing trend of public demand to respect patients' autonomy, and discusses the relationship between them from the ethical perspective.

Metabolic syndrome is a group of clinical syndromes that seriously affect human health with insulin resistance as the common pathophysiological basis and multiple metabolic abnormalities as the clinical characteristics^[1]。 According to the results of the 2002 China Nutrition and Health Survey, the prevalence of hypertension in China reached 160 million. Among them, nearly 50% are accompanied by central obesity, hyperlipidemia and abnormal glucose tolerance, that is, accompanied by metabolic syndrome. Metabolic syndrome increases the risk of coronary heart disease, myocardial infarction and stroke by 3 to 5 times, and the risk of death from cardiovascular disease increases by 2 to 4 times^[2]。 In this study, the patients with hypertension and metabolic syndrome found in physical examination were used as the subjects to understand the effect of comprehensive intervention on hypertension and metabolic syndrome by implementing health management.

Health examination market has developed rapidly in recent years, and how to standardize management and improve the quality of physical examination has attracted extensive attention from people in the industry. Physical examination is an important part of physical examination, but it is neglected by some people with the application of modern instruments, and there is no uniform standard for specific operation. It is necessary to discuss and formulate the operating norms of physical examination for health physical examination to improve the quality and efficiency of physical examination.

Health literacy is an important component of citizens' health quality and an important symbol of social civilization and progress^[1]。 Health literacy refers to the ability of individuals to obtain, understand and process basic health information and services, and use these information and services to make correct judgments and decisions, maintain and promote health^[2]。 In order to understand the health literacy status of different occupational groups in Xicheng District and provide a basis for carrying out health education in the future, Xicheng District Health Education Institute is in the financial industry in Xicheng District; Real Estate Industry; Scientific research, technical services and geological exploration; The survey was conducted among five occupational groups: culture, sports and entertainment and public administration and social organizations, and the results are reported as follows:

Health management is the whole process of monitoring, analyzing, evaluating, providing health counseling and guidance and intervening on health risk factors of individuals or groups^[1]。 Therefore, it is important to identify the risk factors that affect health. Risk factors refer to the etiology at the epidemiological level, which is the factor that increases or increases the probability (risk) of disease occurrence. The determination of risk factors is the basis of health intervention, which is a complicated process. At present, when the personnel engaged in health management in physical examination centers or community hospitals in China summarize the collected physical examination data or health records and analyze the distribution of health problems and the main risk factors, it is often unscientific to use the cross-sectional data of a physical examination or survey to make conclusions on health risk factors. This paper mainly discusses the thinking and evaluation criteria of risk factors (etiology) inference, analyzes the main bias and confusion in risk factors research and their control methods, and provides reference for the majority of peers engaged in health management work or research.

In recent years, the concept of health management has been gradually accepted by the public and the government. How to make the concept of health management operable and practical is an urgent problem that people need to solve. Finding scientific, practical and effective health management methods and means is the way out to solve this difficult problem. Functional medicine, as a new medical model from 1970s to 1980s, will play a positive role in promoting the implementation of our health management.

The first successful kidney transplantation in the world is kinship living donor kidney transplantation. Today, with the increasing shortage of kidney donors, kinship living donor kidney transplantation has become the focus of the transplantation community again. Relative living donor kidney transplantation has better human/kidney survival than cadaver kidney transplantation^[1]； However, the relative living donor kidney transplant recipients are under greater psychological pressure, and they are more worried about the success rate and prognosis of surgery. In order to make them get personalized health management and maintain a high quality of life, the author investigated the health education needs of 26 living donor kidney transplant recipients and put forward corresponding management measures. Now, the management experience and experience are summarized as follows.

With the development of social economy and the improvement of people's living standards, people pay more and more attention to health. The so-called health industry refers to the general term of the industry that provides production, academic and research products and related health services for the purpose of maintaining, improving, promoting and managing health and preventing diseases^[1]。 Health industry includes two aspects: health products and health services. The health service industry includes the contents of "health management" such as health examination, health consultation, body maintenance and fitness planning. Health personnel resources to implement health management include: health managers, medical rescuers, psychological counselors, public nutritionists, nutrition health practitioners, catering workers, emergency rescuers, pedicure therapists, masseurs, aromatic health practitioners (SPA), mental health counselors, etc. Hebei is surrounded by Beijing and Tianjin, and facing the vast demand of health industry in Beijing and Tianjin, it has the convenient conditions to provide the population of Beijing and Tianjin with various health services including leisure and fitness, traditional Chinese medicine health care, health care and nutrition for the disabled, which can open up a huge market space in the development of health industry.