2014年 · 第08卷第05期

With the continuous improvement of living standards, weight problems have gradually become prominent, and the relationship between weight and health has never been more widely valued than today. Inappropriate weight gain (obesity and overweight) is one of the main risk factors for chronic disease epidemics, while low weight (sarcopenia) and some normal weight but loss of muscle mass (sarcopenia obesity) in the elderly also contribute to health problems. In this expert forum, Sun Mingxiao discussed the characteristics of obesity and overweight, sarcopenia, sarcopenia obesity, and the relationship between abnormal weight and chronic diseases, and proposed that personalized weight evaluation and personalized weight management for different individuals are the key measures for the prevention and treatment of chronic diseases. For obesity and overweight, which cause the most concern, the most effective intervention at present is still reasonable diet control and regular aerobic exercise. Setting reasonable and achievable weight loss goals is the key. In the article "Long-term Small Weight Loss Can Improve Health" in the quick review column of foreign literature, the research conducted by the National Institute of Hygiene and Clinical Optimization (NICE) in the UK confirmed that even if the weight loss is small, as long as the weight loss can be maintained all the time, good results can be achieved.

With the continuous development of social economy, people's living standards are constantly improving, and the people's demand for health is also increasing day by day. The accompanying weight problem is gradually prominent. The relationship between weight and health has never been more widely valued than it is today. Inappropriate weight gain is one of the most important risk factors for chronic disease epidemics, and for a small number of people who attach great importance to health, excessive weight control can also cause health problems. Therefore, individualized weight management for different individuals is the key measure for the prevention and treatment of chronic diseases.

Atherosclerotic cardiovascular diseases, such as coronary atherosclerotic heart disease (CHD), cerebrovascular disease, claudication of lower limbs, etc., are the main causes of death and disability in Chinese residents. Dyslipidemia is one of the important risk factors leading to such diseases. In order to effectively prevent and treat cardiovascular and cerebrovascular diseases, in addition to actively changing bad living habits and actively preventing and controlling hypertension and hyperglycemia, full attention should also be paid to the prevention and treatment of dyslipidemia. In the past 30 years, with the continuous improvement of material living standards, the epidemic trend of adverse factors such as excess calories, lack of exercise, overweight or obesity among Chinese residents has become increasingly serious, and the number of patients with dyslipidemia has gradually increased, which poses an increasing threat to residents' health. Therefore, the prevention and control of dyslipidemia should become the top priority of the prevention and treatment of cardiovascular diseases in China. The diagnosis and treatment of dyslipidemia should be carried out under the guidance of a doctor, but the patient's self-management is equally important. Only the cooperation of doctors and patients can improve the prevention and treatment effect of dyslipidemia and reduce the occurrence of cardiovascular and cerebrovascular diseases caused by it.

It is well known that traditional anthropometric indicators of obesity include body mass index, waist circumference, waist-to-hip ratio, and their predictive value in various obesity-related diseases such as diabetes, hypertension, and lipid metabolism disorders have been affirmed^[1]。 However, these indexes still have some limitations, such as the lack of diagnostic efficacy of body mass index for abdominal obesity, the distribution of waist circumference in male and female population has a large difference^[2]。 In recent years, scholars at home and abroad have attached great importance to a new anthropometric index-waist to height ratio (WHtR), believing that it can not only make up for the shortcomings of traditional risk indicators, but also have greater significance in predicting metabolic diseases and cardiovascular and cerebrovascular diseases. Throughout the research on WHtR findings, its value is indeed not to be underestimated.

The concept of psychological stress originated from the theory of "fight-or-fligt responses" developed by an American psychologist^[1]Psychological stress is actually due to the external demand exceeding the scope of our psychological resources or actual ability. At the same time, due to the differences of each person's ability and resources, different individuals have great differences in the identification of stressors. Stressors may include a life event, such as the death of a loved one, long-term work stress, traffic accident, etc., or may be related to psychological resources, such as lack of social support, insufficient ability to cope with challenges, etc. Genetic factors will also greatly affect the response pattern of individuals to cope with stress^[2]。

Hypertension is the main risk factor of cardiovascular disease. Correct blood pressure measurement and evaluation are crucial to the diagnosis of hypertension^[1,2]。 In the process of physical examination, healthy physical examiners generally use indirect measurement method to routinely measure blood pressure. The measured blood pressure value is the reference value of hypertension detection, and its accuracy directly affects the screening, judgment, treatment and prevention of hypertension. We evaluated the value of retesting blood pressure in 280 patients with high blood pressure.

With the development of society and economy and the change of people's lifestyle, chronic diseases have become an important public health problem in China. Community-managed chronic diseases are particularly common in hypertension. 70% of strokes and 50% of myocardial infarctions are related to hypertension^[1]。 It is very urgent to strengthen the community management of hypertension and reverse the "three highs and three lows" in the prevention and treatment of hypertension. According to the National Basic Public Health Service Standards (2011 Edition)^[2]And related requirements, hypertension management has become one of the priorities of community health work in Taizhou. We evaluated and analyzed the effect of comprehensive management of hypertension in the community from December 2011 to December 2012 as follows.

Health management refers to the whole process of monitoring, analyzing and evaluating the health of individuals or groups, providing health consultation and guidance, and intervening and managing health risk factors^[1]。 Health management needs refer to the relevant measures and resources that individuals or groups want to receive to help them maintain and/or promote health, including awareness of needs, content of needs and form of needs. Professional people are the most valuable social resources with vitality, creativity and productivity. Their physical and mental health level will directly affect the survival and development of enterprises and the progress and stability of the country. However, occupational people are both harmed and affected by occupational hazards and public health problems. The long-term existence of these problems will bring great harm and burden to employees, enterprise organizations and even the whole society. Therefore, it is of great sociological and economic significance for occupational people to carry out enterprise health management^[2,3]。 The results show that there is a positive correlation between the health management effect of occupational population and the demand for health management. Providing health management services for occupational population can improve their compliance with health management, intervention effect and satisfaction^[4]。 Therefore, we do this research to provide reference for similar people to carry out enterprise health management services in a targeted way.

Hypertension is one of the common diseases that endanger human health. Cardiovascular and cerebrovascular diseases with hypertension as the main risk factor have become the main cause of disability and death of Chinese residents, which brings a heavy burden to society and families. In order to improve the control level of blood pressure of hypertensive patients, improve the poor lifestyle of residents, reduce the pressure of medical staff in community health service institutions, and explore the formation of a disease management mode of group prevention and control of "doctor-patient cooperation, patient mutual assistance and self-management", Shuangyushu Community Health Service Center in Haidian District, Beijing has established a new mode of self-management of patients with chronic diseases.

Cirrhosis is an advanced stage in the development of various chronic liver diseases^[1]。 The disease is repeated and prolonged, repeated hospitalization, heavy family burden, and poor disease prognosis. Patients and their families lose confidence in treatment, resulting in poor medication compliance. At the same time, patients feel that they are a burden on their families and society, resulting in a series of negative emotions, which seriously affect the quality of life and treatment effect of patients. From December 2012 to December 2013, we implemented health education intervention simultaneously before and after discharge for the families of patients with decompensated liver cirrhosis, and implemented continuous care after discharge, and observed the psychological status of patients, medication compliance, rehospitalization rate and the impact on family quality of life. The report is now as follows.

Osteoporosis is a systemic skeletal disease characterized by bone mass reduction and bone microstructure degeneration, resulting in increased bone fragility and easy fracture. The clinical manifestations are multiple soreness, hunchback and easy fracture, which seriously affects personal daily life and brings heavy economic burden to family and society^[1]。 With the development of economy and society, human life expectancy is continuously prolonged, and the problem of osteoporosis in the elderly is increasingly serious. Menopausal women are the high incidence of osteoporosis. It is of practical significance to analyze the effects of age, fertility, protein diet and physical exercise on osteoporosis in menopausal women.

The English word for health management is "health management". However, the English word "health" has many meanings. When translated into Chinese, it is most commonly translated as "health", but sometimes it is also translated as "health". Therefore, in English, health management can be understood as health management, or for health management. However, in the United States, the same English vocabulary (health management) has different academic connotations and industry definitions.

At present, most hospital websites are mostly in the information release stage, and it is rare to provide patients with dynamic and complete health information. They have a single function in providing services, and seldom mention the tracking and evaluation system. Moreover, there is a lack of effective integration of all kinds of medical information resources, and at the same time, there is a lack of deep-level and distinctive services; e Jiantong public medical and health service platform is based on the digital integration of various diagnosis and treatment information of patients in electronic medical records, hospital information systems, inspection systems, imaging systems and physical examination systems that have been running for many years in Dushanzi Petrochemical Hospital; Share personal medical information with patients in real time through this platform; Radiate the concept of health management beyond the hospital wall through information technology, establish an information interaction platform between residents and medical staff, realize the benign interaction between doctors and patients, and promote health without limits; It is one of the important ways to improve the medical experience to change the object of medical service from patient to society and the medical service from passive to active^[1]。 Provide patients with in-hospital diagnosis and treatment information, health monitoring and evaluation, doctor-patient interaction of various disease groups, and follow-up evaluation of medical services; Seamlessly integrate medical resources with regional medical care, realize the dynamic health records of local residents, and make health management more distinctive. This paper analyzes the operation status and functional modules through the application of e-health public health service platform. Realization of Public Health Interactive Platform Based on WEB Technology^[2]。

Health management refers to the whole process of comprehensive monitoring, analysis, evaluation, health consultation and guidance, and intervention on health risk factors of individuals and groups. Quality control is an important link of health management. In 2011, we referred to the academic guidelines and consensus formulated and promulgated by relevant societies and associations, introduced the framework and idea of ISO9001: 2008 standard, and established quality control standards according to the actual situation of hospitals, mainly including: quality control guidelines, quality control objectives, quality control organizations, quality control documents, quality control links and continuous improvement, etc^[1,2]。

In recent years, people have taken regular health screenings as an important health investment. Our physical examination center receives a large number of health examinations from government agencies, institutions, schools and other groups every year, and the number of individuals who come to our center for physical examination at their own expense is also increasing day by day. As an emerging service industry, the general process of physical examination consists of several different service processes. The efficiency, quality and satisfaction of any process directly affect the overall service quality^[1]。 Our physical examination center designed and applied an intelligent inspection system to solve the problems existing in the waiting process of physical examination in the past.

With the development of China's economy and the improvement of people's living standards, more and more attention has been paid to the health needs of individuals and groups. People are not just staying in health examination for their own health needs, but also paying more attention to the follow-up intervention and health guidance of professional medical staff after examination. The collation and analysis of health examination data is the prerequisite and foundation of health intervention and health management service.

"Perinatal Management of Obese Pregnant Women" was published in the 3rd issue of Chinese Journal of Health Management in 2013^[1]One article (hereinafter referred to as "the article"). Combined with clinical experience, this paper introduces the influence of obesity on pregnancy, the treatment methods of obese pregnant women in pregnancy, early pregnancy, second pregnancy, late pregnancy, labor and delivery, and postpartum, so as to provide reference for perinatal management of obese pregnant women. However, the use of the term "comorbidity" in this article is questionable.

The National Institute for Health and Care Excellence (NICE) has concluded that in a weight management program with diet, activity and lifestyle as the main interventions, even if participants lose very little weight, as long as the loss can be maintained, the program can achieve a good cost-effectiveness ratio.