Noncommunicable chronic diseases have become the most important public health problem in the world today,so the focus of public health services should be shifted from the traditional area of communicable diseases to t...Noncommunicable chronic diseases have become the most important public health problem in the world today,so the focus of public health services should be shifted from the traditional area of communicable diseases to the prevention and control of chronic diseases.Since bad living habits are the most direct cause of chronic diseases,the most effective measure to prevent and control chronic diseases is to promote healthy lifestyles for the individual citizen.The theories of equal health opportunity,the right to health from the perspective of human rights,and determinants of a healthy society provide justified reasons for the intervention of public power in individual health choices.In the current legal system,the intervention of public power is limited to flexible measures such as health education,which shows respect for individual autonomy.However,it is inconsistent with the needs of current public health practice.We should expand diversified intervention means to encourage individuals to make healthy choices under the guidance of the management model.The“ladder of intervention”outlines a panoramic view of the intervention measures available.However,for the selection of specific measures,it is necessary to consider the public health objectives and the invasion of individual freedom,introduce the“legal reservation principle”and“proportionality principle”as policy analysis tools,and reasonably choose intervention measures at different levels on the ladder to properly handle the tension between public power and private rights.展开更多
目的了解国内外干预项目的内容及成果经验,为以后在我国慢性病防控从业群体中推广循证慢性病防控提供参考。方法检索知网、万方、维普、PubMed、Web of Science和Scopus数据库中1995年1月1日—2019年11月31日发表的与慢性病防控循证能...目的了解国内外干预项目的内容及成果经验,为以后在我国慢性病防控从业群体中推广循证慢性病防控提供参考。方法检索知网、万方、维普、PubMed、Web of Science和Scopus数据库中1995年1月1日—2019年11月31日发表的与慢性病防控循证能力干预相关的文献,最终纳入45篇文献进行分析。结果国内极为缺乏针对提升公共卫生从业者慢性病防控循证能力的干预项目。发达国家较早实践提升医务人员慢性病能力的干预措施,包括各类面对面课程、研讨会、网络课程、书籍等,但干预课程设置普遍遇到的问题包括慢性病防控机构缺乏数据库权限,未对不同循证认知层次和工作环境的从业者进行有针对性的分类。结论我国应积极借鉴慢性病防控的国外经验,开发各类干预途径并加以推广和应用。展开更多
Objective To investigate the changes in respiratory and circulatory functions in chronic obstructive pulmonary disease (COPD) patients during sequential invasive-noninvasive mechanical ventilation therapy,and evaluat...Objective To investigate the changes in respiratory and circulatory functions in chronic obstructive pulmonary disease (COPD) patients during sequential invasive-noninvasive mechanical ventilation therapy,and evaluate the effects of this new technique.Methods Twelve COPD patients with type Ⅱ respiratory failure due to severe pulmonary infection were ventilated through an endotracheal tube. When the pulmonary infection control window (PIC-Window) occurred,the patients were extubated and were ventilated with a facial mask using pressure support ventilation combined with positive end-expiratory pressure. The parameters of hemodynamics,oxygen dynamics,and esophageal pressure were measured at the PIC-Window during invasive mechanical ventilation,one hour after oxygen therapy via a naso-tube,and three hours after non-invasive mechanical ventilation. Results The variation in esophageal pressure was 20.0±6 cmH 2O during naso-tube oxygen therapy,and this variation was higher than that during non-invasive mechanical ventilation (10±6 cmH 2O, P <0.01). The changes in respiratory and circulatory parameters were not significantly different between invasive mechanical ventilation and noninvasive mechanical ventilation ( P >0.05).Conclusions The respiratory and circulatory functions of COPD patients remained stable during sequential invasive-noninvasive mechanical ventilation therapy using PIC-Window as a switch point for early extubation. The COPD patients can tolerated the transition from invasive mechanical ventilation to noninvasive mechanical ventilation.展开更多
基金the phased research result of the major research project “Global Health and Human Rights Education” of humanities and social sciences of the Ministry of Education in 2020 (Project No. 20JJD82005)。
文摘Noncommunicable chronic diseases have become the most important public health problem in the world today,so the focus of public health services should be shifted from the traditional area of communicable diseases to the prevention and control of chronic diseases.Since bad living habits are the most direct cause of chronic diseases,the most effective measure to prevent and control chronic diseases is to promote healthy lifestyles for the individual citizen.The theories of equal health opportunity,the right to health from the perspective of human rights,and determinants of a healthy society provide justified reasons for the intervention of public power in individual health choices.In the current legal system,the intervention of public power is limited to flexible measures such as health education,which shows respect for individual autonomy.However,it is inconsistent with the needs of current public health practice.We should expand diversified intervention means to encourage individuals to make healthy choices under the guidance of the management model.The“ladder of intervention”outlines a panoramic view of the intervention measures available.However,for the selection of specific measures,it is necessary to consider the public health objectives and the invasion of individual freedom,introduce the“legal reservation principle”and“proportionality principle”as policy analysis tools,and reasonably choose intervention measures at different levels on the ladder to properly handle the tension between public power and private rights.
文摘目的了解国内外干预项目的内容及成果经验,为以后在我国慢性病防控从业群体中推广循证慢性病防控提供参考。方法检索知网、万方、维普、PubMed、Web of Science和Scopus数据库中1995年1月1日—2019年11月31日发表的与慢性病防控循证能力干预相关的文献,最终纳入45篇文献进行分析。结果国内极为缺乏针对提升公共卫生从业者慢性病防控循证能力的干预项目。发达国家较早实践提升医务人员慢性病能力的干预措施,包括各类面对面课程、研讨会、网络课程、书籍等,但干预课程设置普遍遇到的问题包括慢性病防控机构缺乏数据库权限,未对不同循证认知层次和工作环境的从业者进行有针对性的分类。结论我国应积极借鉴慢性病防控的国外经验,开发各类干预途径并加以推广和应用。
文摘Objective To investigate the changes in respiratory and circulatory functions in chronic obstructive pulmonary disease (COPD) patients during sequential invasive-noninvasive mechanical ventilation therapy,and evaluate the effects of this new technique.Methods Twelve COPD patients with type Ⅱ respiratory failure due to severe pulmonary infection were ventilated through an endotracheal tube. When the pulmonary infection control window (PIC-Window) occurred,the patients were extubated and were ventilated with a facial mask using pressure support ventilation combined with positive end-expiratory pressure. The parameters of hemodynamics,oxygen dynamics,and esophageal pressure were measured at the PIC-Window during invasive mechanical ventilation,one hour after oxygen therapy via a naso-tube,and three hours after non-invasive mechanical ventilation. Results The variation in esophageal pressure was 20.0±6 cmH 2O during naso-tube oxygen therapy,and this variation was higher than that during non-invasive mechanical ventilation (10±6 cmH 2O, P <0.01). The changes in respiratory and circulatory parameters were not significantly different between invasive mechanical ventilation and noninvasive mechanical ventilation ( P >0.05).Conclusions The respiratory and circulatory functions of COPD patients remained stable during sequential invasive-noninvasive mechanical ventilation therapy using PIC-Window as a switch point for early extubation. The COPD patients can tolerated the transition from invasive mechanical ventilation to noninvasive mechanical ventilation.
