2012年 · 第06卷第03期

The principle of food intolerance is still divided at present, but the fact of its existence and its consequences are well-recognized. At present, in the clinical departments of Chinese hospitals, such as dermatology, allergy department, gastroenterology and pediatrics, the detection of food intolerance has certain applications. In 2008, the Physical Examination and Evaluation Group of Health Management Branch of Chinese Medical Association took the lead in organizing "Epidemiological Investigation and Research on Food Intolerance in Chinese Population". In 2011, Chinese Journal of Health Management organized an award-winning essay contest on food intolerance, aiming at promoting the research on food intolerance in healthy physical examination populations. This issue presents a series of articles on food intolerance for readers to learn from.

Food intolerance is a delayed immune response mediated by food-specific IgG antibodies. Theoretically, after food enters the digestive tract, it should be digested to the level of amino acids, glycerol and monosaccharides, so that it can be completely converted into energy to provide the body's needs. However, many foods cannot be completely digested by the human body because of the lack of corresponding enzymes. They enter the intestine in the form of peptides or other molecules, where they are recognized by the body as foreign substances, thus leading to the occurrence of immune reactions, producing food-specific IgG antibodies, forming immune complexes with intolerant foods, and depositing in the body. The immune complexes that cannot be cleared cause immune damage to the body, and the continuous accumulation of immune damage eventually leads to various chronic symptoms or diseases. The disease is often delayed, easily neglected and delayed diagnosis and treatment^[1,2,3]。

Congenital heart disease (CAD) is the most prevalent birth defect, accounting for about 7‰ ~8‰ of newborn surviving infants. In the past half century, with the continuous improvement and popularization of surgical and interventional treatment methods for congenital heart disease, the survival rate of congenital heart disease patients has been significantly improved, and the number of congenital heart disease patients who survive to adulthood has increased sharply. In order to establish an "orderly and effective standardized management model for patients with congenital heart disease in the transition from childhood to adulthood", the American Heart Association (AHA) invited 20 experts to collect data since 2008, and it took more than 2 years to write a scientific recommendation (referred to as the recommendation) on "the management of congenital heart disease in the transition from childhood to adulthood", which was published in Circulation in March 2011^[1]The main contents include the following aspects.

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease characterized by airflow restriction. Airflow restriction is not completely reversible and progressively developed. It is related to the abnormal inflammatory response of lung to harmful gas or harmful particles. It is a common and frequently occurring disease that seriously affects physical health. It has become an important public health problem due to a large number of patients and a heavy social and economic burden^[1]。 According to the survey in 2002, there are large regional differences in COPD among people over 40 years old in China. The total prevalence of COPD is 8.2%, of which only 3.9% in Shanghai; Clinical symptom detection rate was 64.5%; Diagnosis rate 32.2%^[2]。

Children's health management is the whole process of monitoring, analyzing and evaluating children's health status (including growth and development) and its influencing factors, providing health consultation and guidance, and intervening on health risk factors. In our country, there are several forms of children's health management, such as children's system health management, children's basic public health service management and early childhood development management. In recent years, with the promulgation of "Public Health Service Standards" (0~6 years old children) and "Children's Health Care Work Standards" of the Ministry of Health, children's health management has been paid widespread attention. However, the low management quality has become an important link that restricts the improvement of the overall level of children's health management in China. Improving management quality is an urgent problem to be solved at present. This study designs the quality control index system of children's health management, which aims to provide technical support for establishing an effective quality assurance system of children's health management and improving the management quality and management level.

Obesity is a common nutritional and metabolic disease. With the continuous improvement of people's living standards, obesity is widely prevalent not only in the developed countries, but also in the developing countries. Obesity has become one of the most important public health problems because it increases the incidence of hypertension, diabetes, hyperlipidemia, cardiovascular and cerebrovascular diseases and certain cancers, which are the most important causes of human death^[1]。

The concept of health management originated in the 1960s and 1970s, when it was first proposed by the American insurance industry. health management comes from the English health management, which refers to "a series of activities involving the development and implementation of policies of service organizations dedicated to improving health, with the focus on studying and improving service delivery and health changes in organizations related to population health"^[1]It refers to an activity process that comprehensively detects, evaluates and effectively intervenes on the health risk factors of individuals or people. Its main purpose is to achieve maximum health improvement effects by improving or changing the means of health services and product provision and minimal investment in effective organizational behavior with improvement of public health. In modern society, the diseases and sub-health state caused by lifestyle are on the rise, and the medical model is gradually changing from treatment-oriented to prevention-oriented. The use of scientific concepts and means of health management, combined with traditional Chinese medicine diagnosis and health preservation methods, such as massage, flower therapy, music therapy, exercise therapy, medicinal bath therapy, etc., is more and more favored by the public, and the establishment of Chinese medicine health management system has become an urgent need.

Health education is to help individuals and groups master health care knowledge, establish health concepts, and voluntarily take educational activities that are conducive to healthy behaviors and lifestyles through information dissemination and behavioral intervention^[1]Liver transplantation, which began in the 1960s, has been recognized as the most effective measure to treat many serious liver diseases. Foreign studies have proved that patient health education in clinical nursing not only helps patients actively participate and cooperate with treatment and nursing, but also promotes functional rehabilitation, which is an effective way to improve the quality of life^[2]。 The health education of liver transplantation patients is summarized as follows, which provides reference for the research and implementation of health education of liver transplantation patients.

In the 1970s, with the rapid development of medical technology, the overall cost of health care in Canada grew rapidly, which led the Canadian government to begin a systematic evaluation of health services. In 1974, Health and Welfare Canada released the Lalonde report^[1]Calling for the federal government to play a more important role in the field of public health, especially should pay attention to the impact of environmental and behavioral factors on national health. In September 1976, the Canadian government established the Canadian task force on the periodic health examination (CTFPHE). At that time, policymakers relied more on subjective inference than scientific evidence, which caused a waste of medical resources and brought a lot of pain to patients. The first task of the Working Group since its establishment was to establish the world's first evidence grading standard for assessing medical examination measures. The working group spent two years establishing this standard, and issued the first evidence-based guideline for physical examination in 1979, which improved the scientific nature of health decision-making and better guided the practice of physical examination. The guideline has been issued in more than 40,000 single copies, and the guideline has been continuously revised and improved for decades since then.

The ideas and practices of health management originated from the United States^[1]During the 10 years since the introduction of health management in China, its development has shown great vitality, and advanced health management concepts have led and driven the rapid development of health industry^[2]。 However, at present, China's health management is still in the primary development stage, and there are many problems to be solved urgently. The innovative service system and operation mode of health management with Chinese characteristics have not yet been established. Based on the characteristics of military hospitals, our center has explored and established a digital health management mode, and achieved good military, social and economic benefits through practice and application.

In the 21st century, modern medicine is entering the "3P" era. As a new medical service mode, health management can usually be divided into health information collection, health status assessment, health risk prediction, health intervention and promotion from the business level. Its organization and provision is an information-intensive work. Health management informatization can be positioned as a comprehensive application process of information science and information technology in health management disciplines and industries^[1]。 In the research and practice of overall medical management mode in our hospital^[2]Integrate the research of health management services with the development of hospital informatization construction, pay attention to the integrity of services, and emphasize the need to provide all-round and multi-level services such as medical treatment, prevention, health care, rehabilitation and health management for patients, sub-healthy people and healthy people^[3]。

In May, 2011, Xuhui District, Shanghai began to trial the service responsibility system of family doctors for the whole population. As one of the first batch of pilot units, our center, based on the principle of "reflecting service efficiency, highlighting service transparency, moving the prevention gate forward, and reflecting the convenience service function", relied on information technology to establish an information platform for family doctors, and gradually formed an information health management system for family doctors for the whole population.

The health management service process includes health management physical examination, health assessment, personal health management consultation, personal health management follow-up services, and special health and disease management services^[1]It is a highly systematic healthcare service process. At present, with the increase of physical examination customers, due to problems in the hospital health management process, the number of reports not generated in time or missed inspections and missed reports is also increasing, causing complaints or complaints from customers, and even medical disputes, which seriously affects the comprehensive service level and service capability of health management institutions. As a national health management demonstration base, our hospital independently developed an "information health management process monitoring system".

According to the survey of Shanghai Health Examination Quality Control Center, there are 19 tertiary medical institutions in Shanghai that provide health examination services, all of which can carry out their work in accordance with the requirements of the Basic Work System of Shanghai Health Examination Institutions (2010). According to the logical assumption of health management, early screening can reduce the total cost of medical services and improve patient health. Unfortunately, the existing literature does not provide sufficient data to support this hypothesis^[1]But there is clear evidence that the doctor-patient relationship has improved and that the patient's mood can be soothed^[2,3,4]。

With the implementation of tort liability law, people's awareness of rights protection is increasingly strengthened, medical disputes involving tort liability are gradually increasing, and the issue of patients' rights protection for medical treatment is paid more and more attention by the society^[1,2]。 Physical examination centers have the responsibility to safeguard the rights and interests of guests and serve them better in the health examination, but they also face many new problems and new situations in their work^[3]。 This paper discusses how to safeguard the rights and interests of guests in the health examination, combined with the actual work of the center, so as to facilitate the physical examination department to conduct in-depth research on how to better abide by the tort liability law in daily work.

With the rapid development of economy and society, the incidence of various mental illnesses and psychological disorders is increasing year by year^[1]。 Our country is undergoing a major transformation in economic transformation. High-rhythm life and work burden bring pressure to people in all aspects^[2]Many surveys show that more than 60% of Chinese people are under various pressures from society, work and family. In the future, the number of patients with depression, severe mental illness, alcohol abuse and suicide will increase sharply in China. The aging of the population will also greatly increase the number of patients with Alzheimer's disease. Psychological diseases, such as essential hypertension, arteriosclerosis (coronary heart disease), stroke, malignant tumors, etc^[3]It is rising year by year. People seek how to maintain good mental health when their material life is guaranteed. The demand for mental health services is increasing day by day^[4]。

Hypertension and hyperlipidemia are important risk factors for coronary heart disease and stroke^[1]Seriously endanger human life and health. Effective prevention and control of hypertension and hyperlipidemia is the key to prevent and treat cardiovascular and cerebrovascular diseases and improve the quality of life of people^[2]。 Island residents have unique living environment and living habits, but there are few reports on the analysis of hypertension and hyperlipidemia in island residents. This study selected the residents of Dalian island area as the research object to explore the epidemic status of hypertension and hyperlipidemia in this area, and provide scientific basis for further carrying out the prevention and control of cardiovascular and cerebrovascular diseases in the island residents.