2017年 · 第11卷第04期

Osteoporosis, like hypertension and diabetes, is the most common chronic disease in modern society. It involves a wide range of people and is harmful to society. In this review, Lin Hua proposed to pay attention to the health management of osteoporosis people. The health management of osteoporosis and its high-risk groups involves the whole process of bone health knowledge education, bone health behavior maintenance, intervention of osteoporosis high-risk groups and diagnosis and treatment of osteoporosis patients. It is very important and urgent to pay attention to and strengthen the health management of osteoporosis and its high-risk groups. How to further scientifically, professionally and standardizedly carry out the health management of osteoporosis people in an all-round way is an important topic for the prevention and control of chronic diseases.

osteoporosis is the most common systemic skeletal disease characterized by low bone mass, microstructural damage of bone tissue, increased bone fragility and prone to fracture^[1]。 The 2003 annual report of the International Osteoporosis Foundation (IOF) states that^[2]Osteoporosis has more impact on human quality of life than chronic obstructive pulmonary disease, stroke and other diseases, and has become the most harmful chronic non-communicable disease (chronic disease) in the world after cardiovascular and cerebrovascular diseases. In European and American countries, the incidence of osteoporotic fractures in postmenopausal women over 50 years old exceeds that of breast cancer, stroke and myocardial infarction combined. The 2013 IOF annual report is even more alarming. As of 2012, one osteoporotic fracture occurred every 3 seconds worldwide^[3]。

Participation and adherence to physical activity is the focus of blood sugar and overall health management in people with diabetes and pre-diabetes. Individual characteristics and health status are the basis for formulating recommendations and preventive measures. This position statement is clinically oriented, based on research evidence, and proposes physical activity and exercise recommendations for patients with type 1 diabetes, type 2 diabetes, gestational diabetes, and prediabetes.

In 2008, the National Osteoporosis Guideline Group (NOGG) first issued guidelines for the prevention and treatment of Osteoporosis, which were updated in 2013. In 2017, commissioned by the National Institute for Health and Care Excellence (NICE), the guideline writing working group once again conducted an extensive evidence-based evidence review and synthesis on the assessment and management of osteoporosis, and updated the contents including osteoporosis diagnosis, fracture risk assessment, lifestyle management, drug intervention, course and monitoring of bisphosphonate therapy, glucocorticoid-induced osteoporosis, male osteoporosis and post-osteoporotic fracture intervention management, etc. The new guidelines highlight the importance of fracture risk assessment and lifestyle interventions, the assessment and management of osteoporosis in postmenopausal women and men over the age of 50, and the prevention of fragile fractures. The 2017 edition of the UK Clinical Guidelines for the Prevention and Treatment of Osteoporosis (hereinafter the 2017 edition of the Guidelines) has been published in the journal Arch Osteoporos^[1]。 Compared with the 2013 edition, the 2017 edition of the Guide involves a wider management level, stronger academic professionalism, better practical operability, and is more suitable for the application needs of different professional medical staff for osteoporosis prevention, diagnosis and treatment. Due to the large content of the 2017 edition of the Guide, this issue will first interpret the risk assessment of osteoporotic fracture and lifestyle intervention management.

Bronchiectasis is a chronic inflammation of the airway with repeated suppurative infections caused by various factors^[1], mainly manifested as persistent or repeated cough and expectoration, accompanied by aggravation of infection^[2]。 It is a common chronic respiratory diseases^[3]The disease course is long and the lesions are irreversible, which seriously affects the quality of life of patients and causes a heavy economic burden to society^[1]。 Self-management is a health care activity in which individuals carry out prevention and treatment under the guidance of medical staff^[4]The purpose of self-management is not to cure the disease, but to maintain a satisfactory health status by implementing effective interventions^[5]。 Self-management education for patients with bronchiectasis can effectively improve the level of self-efficacy and quality of life^[6]。 This study aims to explore the self-management model of bronchiectasis.

Tuberculosis is still a serious public health problem in the world. According to the estimates of the World Health Organization, there were 10.4 million new tuberculosis patients in the world in 2015, and 1.8 million people died of tuberculosis; China is one of the countries with a high burden of tuberculosis in the world, with more than 900,000 new cases of tuberculosis every year, ranking third in the world. This shows that the task of tuberculosis prevention and control is very arduous^[1]。 The key to control tuberculosis is early detection and standardized treatment of tuberculosis patients, so as to improve the early detection rate and cure rate^[2]。 Early detection and diagnosis of tuberculosis not only requires supportive policies and environments, but also depends on the increase of knowledge of tuberculosis prevention and control among the people. The fundamental reason for improving the cure rate is that tuberculosis patients can follow doctor's advice and complete the whole course of treatment^[3]。 From October to December 2015, we conducted a survey on the awareness rate, attitude and behavior of TB prevention and control knowledge of the public in Wenzhou, so as to understand the knowledge of TB prevention and control of the public in Wenzhou, and provide scientific basis for more effective TB health education in the future.

According to data from the China Health Nutrition Survey, the prevalence of overweight/obesity among adults increased from 13.4% to 26.4% between 1993 and 2009, with an overall linear increase. Obesity is a potential risk factor for diabetes, cardiovascular disease and other metabolic diseases and tumors^[1]。 Medical nutrition health management is not only an important measure to prevent chronic diseases, but also an important means of health management. In order to further explore the influence of medical nutrition on chronic non-communicable diseases and explore the promotion mode of medical nutrition health management, our center has applied the medical nutrition health management information system since 2015 to intervene in medical nutrition health management for physical examination clients, and compared the changes of risk indicators before and after the intervention.

One study found that rectal bleeding and changes in bowel habits in patients under the age of 50, coupled with abnormalities in hematological indicators, strongly predicted the development of colorectal cancer and inflammatory bowel disease^[1]。

General practitioner contract service is based on community health service institutions as the platform, general practitioners as the main body, general practitioner contract service team as the support, community as the scope, family as the unit, and comprehensive implementation of health management as the specific goal. Through the form of responsibility contract service, health records are established for community residents, basic medical and health services and basic public health services are provided for family members, and comprehensive, efficient, continuous, comprehensive and personalized health management services are provided for residents under the jurisdiction of community health service institutions according to the specific conditions of the community.