2013年 · 第07卷第02期

Advocate the concept of cardiovascular health management and reduce the burden of cardiovascular diseases. In this issue, we launched the Cardiovascular Health Key Number. Professor Gu Dongfeng of Beijing Fuwai Cardiovascular Hospital was specially invited to write a review. Professor Gu pointed out that under the current socio-economic conditions, it is urgent to explore the transformation of service mode from treating diseases and saving lives to integrated management of health and diseases, establish a comprehensive, continuous, coordinated and accessible service mode for general practitioners, constantly summarize the experience of chronic disease health management, and improve the management level of chronic diseases, so as to promote people's cardiovascular health and reduce the burden of diseases.

China's health management has experienced the initial development stage of "hard start and innovative practice", and is about to enter the standardized growth stage of "great development of disciplines and great prosperity of industry". In such an important turning period, health management is facing very good development opportunities, but it also faces many problems and challenges! At present, discipline construction has become a bottleneck restricting the development of health management. This article discusses the significance, connotation and requirements of the construction of health management discipline, and shares some views and opinions about the construction of health management discipline, which is only for criticism and reference.

In December 2012, the medical journal The Lancet published the Global Burden of Disease study, which compared global data on deaths, diseases and injuries by region, age, gender and national income in 187 countries through 2010^[1]。 Global life expectancy for men and women was 62.8 and 68.1 years in 1990, compared with 67.5 and 73.3 years in 2010. As human life expectancy increases, the proportion of patients with chronic diseases and disabilities in the population increases, and the burden of disease increases. The number of deaths from cardiovascular diseases and malignant tumors has increased. The global analysis of causes of death shows that although non-communicable diseases accounted for 50 percent of the causes of death in 1990, in 2010, the target had reached two-thirds, amounting to 34.5 million people. In 1990, ischemic heart disease and stroke accounted for only one-fifth of the world's deaths, while in 2010 they killed nearly 12.9 million people, or one-quarter of the world's deaths^[1]。 Similarly, cancer deaths have increased by 38 percent, causing up to 8 million deaths in 2010. Diabetes deaths doubled during the study period, reaching 1.3 million in 2010.

The most pressing challenge in health management is the prevention and control of cardiovascular diseases (in this case atherosclerotic diseases, including coronary heart disease and most strokes). This is not only because cardiovascular disease is the most serious disease that endangers the health of Chinese people, but also the cardiovascular health status of Chinese adults is worrying. If effective measures are not taken, it is expected that the incidence of cardiovascular disease in China will rise rapidly and become younger^[1,2]； It is also because, unlike other important chronic diseases, such as malignant tumors and chronic obstructive pulmonary disease, the risk factors of cardiovascular disease are relatively clear, and there are definite and effective measures for prevention at all levels (first, second and third levels).

Cardiovascular and cerebrovascular diseases have become a major disease that seriously threatens national life and health. At present, about 3.5 million residents in China die of cardiovascular and cerebrovascular diseases every year, accounting for about 40% of all the causes of death, and has become the number one killer of Chinese residents^[1]。

Health literacy refers to the ability of individuals to obtain, understand and process basic health information or services, and use these information and services to make correct judgments and decisions to maintain and promote their own health^[1]。 In January 2008, the Ministry of Health officially released "Health Literacy of Chinese Citizens-Basic Knowledge and Skills (Trial)"^[2]。 Research shows that health literacy plays an important role in improving public self-care awareness and self-care ability and improving population health status^[3,4], this study aimed to explore the relationship between health literacy and health-related work inproductivity.

Oral disease is one of the common diseases of college students, mainly including dental caries, oral ulcer, tooth inflammation, etc. It not only increases the economic burden, but also affects the students' quality of life and interferes with their learning. This study investigated medical college students under different backgrounds of oral health education, evaluated their understanding of oral health knowledge, explored the importance of popularizing health education in oral disease prevention and health care, and then took targeted measures to reduce the occurrence of oral diseases.

According to the research fields, research directions and reporting contents of this journal during the 12th Five-Year Plan period^[1]"Blood Pressure and Arteriovascular Health Management" or "Cardiovascular Health and Arteriovascular Health Management" as one of the important contents has attracted the attention of readers and many health management institutions. According to incomplete statistics, since October 2011, more than 10 national or regional academic seminars on "cardiovascular health" and "blood pressure and arteriovascular health management" have been held and have had a good academic impact. In order to further lead and promote the standardized implementation of the project of "Cardiovascular Health and Arteriovascular Health Management", this paper systematically introduces the basic concepts, evaluation methods and index system, project implementation scheme and process, evaluation of related research results and future prospects of cardiovascular health and arteriovascular health management around the theme of "Cardiovascular Health and Arteriovascular Health Management" on the basis of reviewing relevant literature at home and abroad, combining with the research results of my own team. It is hoped that this paper will inspire academic discussion and "draw bricks and bricks".

Hypertension is one of the most important risk factors for cardiovascular and cerebrovascular diseases. Blood pressure starts at 110/75 mm Hg (1 mm Hg =0.133 kPa) and as its level increases, the risk of cardiovascular disease occurring increases accordingly. 50% to 60% of strokes and 40% to 50% of myocardial infarctions are related to increased blood pressure, and hypertension also accounts for 6% of the causes of labor loss. Every year, the number of premature deaths caused by elevated blood pressure in China is as high as 2 million, and the direct medical expenses reach 36.6 billion yuan every year. It is of great significance to know the prevalence of hypertension in time and accurately for the prevention and treatment of cardiovascular diseases.

Health management refers to the process of comprehensive monitoring, analysis and evaluation of the health status of individuals or groups, providing health consultation and guidance, and intervening on health risk factors^[1]。 To carry out scientific, reasonable and effective health management for patients in hospitals is to focus on the characteristics of patients, pay attention to their physical, psychological and social adaptability and other aspects of health, that is, closely focus on various health problems of patients, from the perspective of life care, truly care, care and care for their health, so that they can establish healthy values. Its core is to cultivate personal good living habits, develop self-care awareness and ability, and maintain good lifestyle and psychological condition^[2,3]。 Health management personnel should adapt to the development of the situation, analyze and think about ethics in all aspects of health management, and integrate ethical ideas into the whole process of health management. Analyzing and thinking about each link of health management from the perspective of ethics is not only helpful to strengthen the ethical concept of health management institutions, but also conducive to the communication between health management institutions and management objects, and can improve the effect of health management.

With the acceleration of industrialization and modernization, people's living and working style has changed greatly, the number of patients with mental illness has increased obviously, and the scope of mental health services is also gradually increasing^[1]。 The World Health Organization put forward a community-based rehabilitation policy in the late 1970s. Community management of patients with mental illness is the requirement of modern medical model^[2]。 In 2009, severe mental illness was included in the national basic public health service, and doctors engaged in the prevention and treatment of mental illness in communities (townships) (hereinafter referred to as "precise prevention doctors") need to regularly follow up patients with severe mental illness in their jurisdiction. The overall number of professional teams in community health service institutions in China is insufficient. In order to better solve the contradiction between the increase of workload and the lack of personnel, Dongfeng Community Health Service Center in Chaoyang District, Beijing has explored the working mechanism of general practice teams to manage patients with severe mental illnesses. The report is as follows.

As we all know, ovarian cancer is a malignant disease that is difficult to diagnose and treat, and early prevention is extremely critical. There is growing evidence that breastfeeding prevents the development of ovarian cancer. A recent case-control study conducted an in-depth study of this, with 493 women diagnosed with ovarian cancer and 472 healthy women as controls, with an average age of 59 years. The questionnaire included information such as the number of children given birth and the time the children received breastfeeding. Logistic regression analysis of the relationship between breastfeeding and ovarian cancer. The results showed that both the duration and frequency of breastfeeding were negatively correlated with the occurrence of ovarian cancer. Women who breastfed for more than 31 months in total were less likely to develop ovarian cancer than women who breastfed for less than 10 months (OR=0.09, 95% CI: 0.04-0.19), women who breastfed three times had a lower cancer rate than women who breastfed once (OR=0.38, 95% CI: 0.27-0.55). Therefore, breastfeeding is beneficial to mother's health and needs to attract the attention of the majority of women. (Am J Clin Nutr, 2013, 97:354-359)