目的:分析新型冠状病毒肺炎严防严控阶段保健对象的医疗需求，提出相应的保健管理应对策略。方法:收集并分析2020年2月1日至4月30日和2019年同期解放军总医院第六医学中心保健对象的门诊、住院数据。结果:疫情严防严控阶段医院干部门诊量较2019年同期下降37.94%，健康查体明显下降，康复、口腔等科室仍有需求。干部病房收治、出院人数分别下降59.89%、56.29%，危重患者占比明显上升。通过门诊诊疗"前移化"、"远程化"、"多维化"，构建起保健医-保健办-保健专家-专科专家的四级诊疗网络。结论:根据疫情严防严控阶段保健对象的诊疗特点，及时调整保健策略，可减少其在高危场所的暴露机会，确保医疗安全。

Objective:To observe the effect of exercise preconditioning with different intensities and durations on early kidney injury indicators in rats by constructing a rat model of kidney injury induced by one-off high intensive and exhaustive military training, and to provide guidance on implementing scientific training plans.Methods:A total of 70 male Sprague Dawley (SD) rats were divided into seven groups with 10 rats in each group according to the random number table method, namely, model group with kidney injury induced by one-off high-intensive military training (M group), low-intensive and short-term exercise preconditioning group (LS group), low-intensive and long-term exercise preconditioning group (LL group), medium-intensive and short-term exercise preconditioning group (MS group), medium-intensive and long-term exercise preconditioning group (ML group), high-intensive and short-term exercise preconditioning group (HS group), and high-intensive and long-term exercise preconditioning group (HL group). After treadmill exercise preconditioning in different modes, the rats were trained as the kidney injury model group receiving one-off high intensive and exhaustive military training. The behavioral characteristics of rats after each training and when they were trained to exhaustion, the time to exhaustion, the levels of blood urea nitrogen (Bun), serum creatinine (SCr), cystatin C (Cys-C), kidney injury molecule-1(KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL), the activities of Na + K + -ATPase in kidney tissues, the levels of total superoxide dismutase (SOD), and malondialdehyde (MDA), and the semi-quantitative scores of renal tubules were observed. Results:The rats in the HL group had indifferent expressions, slow responses, glossless fur, and weak responses for evading capture, while the rats in other groups had glossy fur and were alert to surrounding stimuli. In terms of the length of the time to exhaustion, the groups were ranked as ML>HS>MS>LL>LS>M>HL. There was no statistically significant difference in the time to exhaustion between the LS group and the M group ( P>0.05); but there were statistically significant differences in the time to exhaustion among other groups, and the time to exhaustion in the HL group was significantly shorter than those in other groups ( P<0.05). In terms of serum Bun, SCr, Cys-C, KIM-1, and NGAL levels, there was no statistically significant difference between the LS group and the M group ( P>0.05), but there were statistically significant differences among other groups ( P<0.05). In terms of the expressions of Na + , K + -ATPase activities and total SOD activity in renal tissues of rats, the groups were ranked as ML>HS>MS>LL>M>LS>HL. In terms of the expressions of Na + , K + -ATPase activities and total SOD activity in renal tissue of rats, there was no significant difference between the M group and the LS group ( P>0.05), but there were statistically significant differences among other groups ( P<0.05). The MDA levels from low to high were ranked as ML0.05), but there were statistically significant differences among other groups ( P<0.05). The renal tubules scores from low to high were ranked as ML

目的 分析海军师以上干部人群尿白蛋白/肌酐比值(urinary albumin to creatinine rate,ACR)异常率及初步干预效果.方法 2013年820名海军师以上干部接受病史采集、体格检查,留尿,酶联免疫吸附法(ELISA)检测尿微量白蛋白,碱性苦味酸法(Jaffé reaction-rate method)检测尿肌酐,计算ACR.随后对受检者开展饮食宣教、社区讲座健康教育及临床干预随访.2年后(2015年)同一样本人群复测ACR.用SPSS 16.0统计软件分析白蛋白尿率、ACR异常率的变化.结果 2015年,该人群总体ACR异常率和微量白蛋白尿率分别为10.89％、9.88％,均较2013年(ACR异常率和微量白蛋白尿率分别为13.14％,12.8％)显著降低,P＜0.05,而临床白蛋白尿患病率为0.85％,显著高于2013年(0.34％),P＜0.05.ACR异常率最高的年龄段为81～90岁(异常率42.86％),71～ 80岁(19.76％),61～ 70岁(14.67％).结论 ACR异常人群,采取早期诊断及综合宣教,可有效逆转病程,降低发生率;而临床白蛋白尿期患者病程呈不可逆、缓慢进展趋势.在分析人群ACR异常率时,要充分考虑年龄因素.