健康产业 大有可为

<正>在竞技场馆,看到的是生龙活虎的体育健儿;在医院病房,看到的是痛苦呻吟的各种病员,这是特定场景中的特定人群。就总体而言,健康人、病人和亚健康人群混杂并存是人类社会的常态。人有了病才会去医院,医生也只给到门诊挂号和住院的病人诊断治疗,这一切看起来似乎很正常。其实,按照社会医学的观点,医生应当对所有人的健康负责,可对照现行的卫生法规和医院职责分工,还没法要求临床医务工作者做到这一     

婚姻也有亚健康

在健康与疾病之间有一种“灰色状态”,主观上感觉不舒服,仪器检禽却没有异常,医学家称“亚健康”,这是20世纪80年代提出的一个医学概念。“亚健康婚姻”则是网络新词,指虽有法律架构却缺少情感基础的婚娴关系。初识亚健康婚姻一词,既敬佩创意者的智慧,也惊叹中华文字的精妙。婚姻以性生活为纽带,其稳定性柯赖于夫妻问情感与物质需求的双重满足,     

可溶性髓样细胞触发受体在感染性疾病的研究（综述）

髓样细胞触发性受体-1（triggering receptor-1 expressed on myeloid cells,TREM-1）在脓毒症等疾病的炎症级联扩大反应的过程中起着关键性作用,可溶性TREM-1（sTREM-1）在感染性疾病的诊断中具有重要意义。血浆sTREM-1水平在脓毒症的诊断价值有争议,但其动态变化能敏感地反映预后。支气管肺泡灌洗液中sTREM-1水平对呼吸机相关性肺炎诊断价值有争议。sTREM-1对细菌性脑膜炎鉴别诊断显示出较大价值,可能成为今后的研究发展方向。     

论加强健康教育机构建设的必要性

建国以来 ,机构改革搞过好几次 ,其间 ,健康教育专业机构不止一次被精简合并 ,分析内在原因 ,决策层对加强健康教育机构建设的必要性认识不足可能是一个重要因素 ,这个问题有必要从理论上进行研究。健康教育机构是面向社会实施健康教育的职能部门 ,它具有行政管理、业务指导和学术研究等多种职能。早在 2 0世纪 5 0年代 ,卫生部就对健康教育 (当时叫卫生宣传 )的组织机构、人员配备、工作任务及方法提出了具体要求 ,经过半个世纪的努力 ,初步形成了具有我国特色的健康教育体系 ,服务范围已融入社区卫生服务、公民道德建设等活动范畴。但是 ,…     

脓毒症患者血清可溶性髓系细胞表达的触发受体-1水平及与预后的关系

目的 探讨脓毒症患者血清可溶性髓系细胞表达的触发受体-1(sTREM-1)水平与疾病预后的关系.方法 采用前瞻性对照研究方法.选择2009年3月至12月天津医科大学第二医院重症监护病房(ICU)收治的50例脓毒症患者,按病情分为普通脓毒症组(28例)、严重脓毒症组(22例),按28 d转归分为生存组(34例)、死亡组(16例).于发病1、3、7 d检测血常规、血生化、血气分析、C-反应蛋白(CRP)、降钙素原(PCT),并进行急性生理学与慢性健康状况评分系统Ⅱ(APACHE Ⅱ)评分,采用酶联免疫吸附法(ELISA)检测血清sTREM-1浓度.对sTREM-1与APACHE Ⅱ评分、血白细胞计数(WBC)、CRP进行相关性分析,并进行Logistic回归分析.以同期30例健康体检者作为健康对照组.结果 50例脓毒症患者发病1 d血清sTREM-1浓度(ng/L)明显高于健康对照组(52.80±9.30比23.29±6.22,P＜0.01).严重脓毒症组发病1、3、7 d血清sTREM-1浓度(ng/L:58.25±10.59、65.75±13.57、50.18±21.73)均明显高于普通脓毒症组(48.55±5.20、42.85±8.54、34.02±12.86,P＜0.05或P＜0.01).生存组发病1、3、7 d sTREM-1浓度(ng/L)逐渐下降(53.07±10.47、45.04±9.89、32.84±8.42),7 d时接近正常水平;死亡组发病1、3、7 dsTREM-1浓度(ng/L)逐渐上升(52.27±6.42、69.67±12:12.83、75.705±10.55),3 d、7 d时明显高于生存组(均P＜0.01).血清sTREM-1浓度与APACHE Ⅱ评分呈显著正相关(r=0.657,P＜0.01),与血WBC无相关性(r=0.023,P＞0.05),与CRP有一定相关性(r=0.150,P＜0.10).Logistic回归分析显示sTREM-1[相对比值比(OR)=0.893,P=0.000]、APACHE Ⅱ评分(OR=0.771,P=0.000)为影响预后的死亡危险因素,受试者工作特征曲线下面积(AUC)分别为0.868、0.930;以sTREM-1为50 ng/L评价预后的敏感性为81.1%,特异性为74.5%APACHE Ⅱ评分20分的敏感性为83.8%,特异性为86.3%.结论 在脓毒症发病早期血清sTREM-1浓度升高,其变化趋势可能与疾病严重程度有关,与APACHE Ⅱ评分有显著的相关性,是影响预后的死亡危险因素之一.

Abstract：

Objective To approach the relationship between the contents of soluble form of triggering receptor expressed on myeloid cells-1 (sTREM-1) and prognosis in patients with sepsis. Methods Using prospective, control study design, a total of 50 patients with sepsis who were admitted in intensive care unit (ICU) of the Second Hospital of Tianjin Medical University from March to December in the year of 2009 were enrolled. Firstly, the patients were divided into sepsis (n=28) and severe sepsis (n=22) groups according to the patients' condition. Then the patients were divided into survival group (n = 34) and death group (n = 16)according to the clinical outcome at 28 days after onset of sepsis. Clinical and laboratory data including blood routine tests, blood chemistry, blood gas analysis, C-reactive protein (CRP) and procalcitonin (PCT) were collected on the 1st, 3rd and 7th day after onset. Acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ ) score was determined. sTREM-1 levels were determined using enzyme linked immunosorbent assay (ELISA) method. Correlation analysis of the sTREM-1, APACHE I score, white blood cell count (WBC) and CRP, using Logistic regression analysis. A total of 30 healthy persons were enrolled into the control group. Results The sTREM-1 levels (ng/L) in 50 septic patients on the 1st day were higher than those of the healthy persons (52. 80±9. 30 vs. 23. 29±6. 22, P＜0. 01). The sTREM-1 levels (ng/L) in severe sepsis group on the 1st, 3rd and 7th day (58. 25±10. 59, 65. 75±13. 57, 50.18±21. 73) were higher than those of the sepsis group (48.55±5.20, 42.85±8.54, 34.02±12.86, P＜0.05 or P＜0.01). The sTREM-1 levels (ng/L) of the survival group on the 1st, 3rd and 7th day (53. 07± 10. 47, 45. 04±9. 89,32. 84 ±8. 42) were decreased with the progression of the ailment. The sTREM-1 levels did not differ significantly between the control group and survival group on the 7th day (P＞0. 05). The sTREM-1 levels (ng/L) in the death group on the 1st, 3rd and 7th day were increased with the progression of the ailment (52.27±6.42, 69.67±12.83, 75. 70± 10. 55), and the level was significantly higher than that in survival group on the 3rd and 7th day (both P＜0. 01). The contents of sTREM-1 were positive correlated with APACHE Ⅱ score (r= 0.657, P＜0. 01), but not correlated with WBC (r= 0.023, P＞0. 05), whilesomewhat correlated with CRP (r=0. 150, P＜0.10). Logistic regression analysis showed that sTREM-1 [odds ratio (OR) = 0. 893,P = 0. 000] and APACHE I score (OR = 0.771, P = 0.000) might be potential prognostic factors for septic patients. The area under the receiver operator characteristic curve was 0. 868 and 0.930. The sensitivity of prognostic evaluation was 81.1% and specificity was 74.5% with sTREM-1 50 ng/L, and the sensitivity was 83. 8% and specificity was 86. 3% with APACHE Ⅱ score 20 to estimate the outcome. Conclusion The serum sTREM-1 are elevated at early stage in sepsis patients. It can reflect the severity of the condition. The sTREM-1 level, which might be considered as a potential prognostic factor for septic patients, is significantly correlated with APACHE Ⅱ score.     

互联网与健康

<正>首届世界互联网大会在素有"枕水人家"之称的浙江乌镇拉开帷幕,业界精英云集一堂,热闹非凡。央视纪录频道同步推出多集专题片《互联网时代》推波助澜,烘托气氛。一时间,互联网话题成为社会关注热点。电子邮件、QQ聊天、微信、网购等浸润到人们工作、生活的每个环节,极大方便了人际间的交流,深刻改变着我们的生活形态。笔者注意到互联网时代的来临,为健康事业也带     

从《韩熙载夜宴图》说起

《韩熙载夜宴图》是北京故宫博物院珍藏的一幅传世名画,画家顾闳中通过听乐、观舞、暂歇、清吹、散席等场景,栩栩如生地描绘了五代南唐大臣韩熙载奢华的夜生活。画面上韩大人宴前洗手的“镜头”,从民俗学视角很有观赏价值,不仅折射出中华饮食文化的文明,也为宴前洗手提供了直观的佐证。其实,我们的祖先早在2000多年前就非常讲究洗手的方法和仪式感,在祭祀、宴饮、结婚等活动时,必须先洗手,否则视为失礼。洗手,古人称为“沃盥”。     

学会理性面对传染病暴发疫情

2003年的"非典"还记忆犹新,谁会料到今年又突遇"新冠肺炎"的肆虐。生活秩序被打乱,迫使人们蜗居在家度过了一个异乎寻常的春节。数月来,国家举全国之力部署抗疫,群众关注疫情动态,心情纠结。大疫情如临大考,考验着各级政府的决策能力,考验着亿万民众的自我保健意识。人类历史上传染病暴发流行屡见不鲜。     

未雨绸缪话养老

表弟和弟媳都是企业退休职工,俩人工资不高,平时生活精打细算,日子过得蛮滋润的。不料,5年前弟媳罹患"脑萎缩",虽经多家医院诊治,下肢瘫痪仍逐步加重,已成轮椅人,不得不请住家保姆24小时陪护,家庭经济拮据起来。好在地方政府对失能老人提供了专项补贴,这如同雪中送炭。     

迈动双腿走向健康

<正>一位同窗发来参加苏州市老干部局组织的"百团千人万步走"活动的视频。春风拂面,老人们健步行走在树木葱茏、绿草如茵的郊外道路上,人人精神焕发,其乐融融,令人好生羡慕。创建"健康中国"的愿想如此深入人心,值得点赞。南宋田园诗人陆游有四首以《晚步》为题的诗作,其中一首写道:"不如且消摇,出门随意