上海社区卫生服务中心持续扩容增能 殷立勤 摄
新版诊疗方案进一步丰富诊断和治疗手段
国家卫生健康委医疗应急司司长郭燕红介绍,在诊断标准上,将新冠病毒的抗原检测阳性纳入了诊断标准,主要考虑是抗原检测对病毒载量高的感染者有非常好的检测灵敏度,特别是随着抗原检测技术不断优化和成熟,因此新冠病毒感染者特别是病毒载量高的感染者检出率比较高。同时,抗原检测非常方便,简单易行,方便感染者在家里进行自测。
在临床救治方面,国家卫健委充分借鉴三年来取得的宝贵经验,一是加强关口前移;二是进一步规范重症救治;三是坚持中西医结合;四是进一步强化新冠病毒感染与基础疾病共治理念。
医护人员为市民进行氧饱和度检测。 殷立勤 摄临床分型为何取消普通型,增加中型
郭燕红解释,中型定义是持续高热大于3天,在静息状态下吸空气的指氧饱和度要大于93%,影像学可见特征性的新冠病毒感染肺炎表现,但是它比重型,也就是氧饱和度小于93%的程度要轻,这类病例归类于中型。
她表示,第十版诊疗方案的调整是根据感染者病情的严重程度,分为轻型、中型、重型和危重型,更加符合临床实际。临床分型调整以后,也更加有利于医务人员对患者的病情进行综合研判,并给予综合的治疗措施。
医护人员在CT扫描室帮助市民进行拍片。 殷立勤 摄高危人群为何由60岁以上调为65岁以上
第十版诊疗方案中的重型和危重型高危人群的判定标准,年龄从第九版的大于60岁改成了大于65岁。
对此,北京大学第一医院感染疾病科主任王贵强解释,关于这次微调,在临床实践中,确实发现65岁以上的患有基础病、尤其没有打疫苗的人群重症化和危重症比例更高,目前临床上也发现了这样的现象,所以这次诊疗方案进行了微调。
“不管60岁还是65岁,我们都要强调伴有基础病的、没有打疫苗的更需要关注。”王贵强表示,希望在临床实践中将这些高风险人群纳入管理,早期干预和观察,发现问题及时转送上级医院进行进一步救治,最大限度降低重症和死亡的风险。
村卫生员在卫生室准备中药与县乡医务人员及村干上门开展巡诊服务。 吴德军 摄针对“阳康”后不适,提出三种治疗方案
首都医科大学附属北京中医医院院长刘清泉提到,每一位患者都十分关注“阳康”后的不适,第十版方案根据奥密克戎变异株的临床特征提出了三个状态的治疗方案。
他介绍,一是针对乏力伴有脾胃功能虚弱,提供了经典名方六君子汤治疗;二是针对乏力伴易出汗,心慌胸闷等不适,推荐了沙参麦门冬汤、竹叶石膏汤等经典名方;三是针对目前最常见的咳嗽痰少等不适,方案推荐了射干麻黄汤。
刘清泉表示,第十版方案非常关注核酸、抗原转阴后的诸多不适,尤其是更加适用于奥密克戎变异株感染转阴后的康复治疗。(完)
中新网评:处理核污水绝不是日本自家私事****** 中新网北京1月19日电(蒋鲤)日本政府近日称,将于2023年春夏期间开始向海洋排放经过处理的福岛第一核电站核污水。日本罔顾国内民众及周边国家的屡屡反对,企图将核污水“一倒了之”,把一件关乎全球海洋生态环境和公众健康的事当成了自家私事。 资料图:日本福岛第一核电站。2011年,福岛核电站事故发生后,大量放射性物质泄漏到大气层和太平洋,对周围环境造成了难以逆转的伤害,数十万人被迫撤离该地区。时至今日,作为日本邻国之一的韩国仍未解除福岛海鲜禁令。 日本以核污水存储能力即将达到上限为由,在2021年4月13日,正式决定将福岛第一核电站核污水排入太平洋。过去一年多,日本政府和东京电力公司一直在持续推进核污水排海计划。 日本政府辩称,这些核污水经多核素处理系统(ALPS)处理后很安全,甚至“可以喝”,这样的表态无疑在愚弄大众。 事实上,经过处理的核污水仍含有多种放射性物质,核污水一旦排放入海就无法回收,长期来看,将会给海洋生态带来难以估量的潜在威胁,最终危害人类健康。 因此,核污水排海计划推出后,遭到日本民众强烈反对。日本《朝日新闻》2022年3月公布的问卷调查显示,福岛县、宫城县和岩手县受访的42个市町村长中,约六成反对东京电力公司福岛第一核电站核污水排放入海。日本全国渔业协会联合会也多次申明立场,反对该计划。 日本政府认为,核污水排海是最便宜、最省事的解决方案,但此举却将周边国家乃至全世界置于核污染风险中。太平洋非日本一家之海,核污水会随着洋流流动,其影响势必会跨越国界,危害周边国家乃至整个国际社会的公共福祉和利益。 《韩国经济新闻》发文称,相关研究认为,福岛核污水如果排放入海,约7个月后将到达济州等韩国海域,该国水产业和旅游业将遭受相当大的损失。 德国南极海洋机构也曾发出警告,若日本将所有核污水排入海中,不到半年,整个太平洋都将面临高度辐射威胁,包括远在大洋另一端的美国。太平洋地区人民更是对日本该计划持反对意见。 日本作为《联合国海洋法公约》缔约国,有义务保护海洋环境。然而,在核污水排海方案的正当性、核污水数据的可靠性、净化装置的有效性、环境影响的不确定性等问题上,日本未能作出科学、可信的说明。 国际原子能机构技术工作组虽已三次赴日实地考察评估,但尚未就日排海方案的安全性给出结论,并且对日本提出诸多澄清要求和整改意见。在此情况下,日本仍执意推进核污水排海工程建设,这是极不负责任的行为。 太平洋不是日本的下水道,日本必须正视各方合理关切,在与周边国家等相关利益方和国际原子能机构充分协商后,制定合理的核污水处理方案。日本也要着眼长远,若只顾眼前,执意将核污水排放入海,不仅其自身,周边国家乃至全世界都将为之买单,其后果必将会危害数代人。 Fukushima water disposal by no means Japan’s own business By John Lee (ECNS) -- Japan has announced it will release treated wastewater from the wrecked Fukushima Daiichi Nuclear Power Plant into the Pacific Ocean this year. Although Fukushima wastewater disposal affects global marine ecological environment protection and public health, Japan has turned a deaf ear to domestic and international opposition to dumping the contaminated water into the sea, treating the "global" matter as its own business. The Fukushima accident in 2011 had sent large quantities of radiation into the atmosphere and the Pacific Ocean, causing irreversible damage to the surrounding environment, and hundreds of thousands of people were forced to evacuate the area. South Korea still maintains its import ban on Japanese seafood from areas affected by the Fukushima nuclear disaster. On April 13, 2021, Japan announced it had decided to discharge contaminated radioactive wastewater in Fukushima Prefecture into the sea due to dwindling storage space, with the Japanese government and plant operator Tokyo Electric Power Company Holdings Inc. promoting the release plan over the past year. The Japanese government argues that the water treated by an advanced liquid processing system, or ALPS, is safe and drinkable, which is undoubtedly fooling the public. In fact, the treated wastewater still includes a variety of radioactive substances and can’t be recycled once discharged into the sea, which will pose a great threat to marine ecology and ultimately endanger human health in the long run. Therefore, the discharge plan has been strongly opposed in Japan. According to a questionnaire conducted by The Asahi Shimbun, nearly 60 percent of mayors of 42 municipalities in Iwate, Miyagi and Fukushima prefectures oppose the discharge plan. The National Fisheries Cooperative Federation of Japan has also repeatedly stated its opposition in public. The Japanese government believes that dumping Fukushima wastewater into the sea is the cheapest and most convenient solution, but neighboring countries and even the whole world will be at risk of nuclear pollution. The Pacific Ocean doesn’t belong to Japan and the wastewater flow along oceanic currents will surely break boundaries and endanger public welfare and the interests of neighboring countries and even the international community. The Korea Economic Daily reported that related research concluded that if contaminated water from Fukushima is released into the ocean, it would only take seven months for the contaminated water to reach the shores of Jeju Island, with the country's aquaculture and tourism suffering considerable losses. According to the calculation of a German marine scientific research institute, radioactive materials will spread to most of the Pacific Ocean within half a year from the date of discharge, and the U.S. and Canada will be affected by nuclear pollution. People in the Pacific region also oppose the discharge plan. As a participant of the United Nations Convention on the Law of the Sea, Japan has the obligation of protecting the marine environment. However, it hasn’t offered a full and convincing explanation on issues like the legitimacy of the discharge plan, the reliability of data on the nuclear-contaminated water, the efficacy of the treatment system or the uncertainty of environmental impact. Though the IAEA has yet to complete a comprehensive review after three investigations in Japan, the Japanese side has been pushing through the approval process for its discharge plan and even started building facilities for the discharge. It is rather irresponsible for Japan to act against public opinion at home and concerns abroad. The Pacific Ocean is not a private Japanese sewer. The country must seriously heed the voices of the international community and make a reasonable plan for the Fukushima wastewater disposal after full consultation with stakeholders and international agencies. If it only seeks instant interest and insists on discharging the contaminated water into the sea, not only itself, but also its neighboring countries and the entire world will pay for the decision and several generations will be forced to bear the consequence.
|