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:美国众议长选举“连续剧”暴露美式民主痼疾****** 中新网北京1月9日电(蒋鲤)在15轮投票表决后,美国众议院议长选举这场“连续剧”终于落下帷幕,众议院共和党领袖凯文·麦卡锡最终成功当选第55任美国众议院议长。这是美国国会过去164年来耗时最久的一次议长选举记录,将美国“对抗式民主”的弊端暴露无遗。 资料图:美国众议院共和党领袖麦卡锡。中新社记者 沙晗汀摄 由于两党对立加剧、党派内斗、利益分配不均等因素,众议长选举陷入一场拉锯战。在此次众议长竞选中,美国民主党议员继续抱团,多轮投票中,一票不投麦卡锡,共和党右翼“强硬派”领头的约20人小团体也拒绝投票麦卡锡。 麦卡锡的当选之路一波三折,除了本人的“政治投机派”角色在国会不受欢迎外,与共和党内部政治分歧关系密切。 一方面,共和党党内反对者认为,麦卡锡对民主党态度过于软弱,无力对抗民主党控制的参议院和拜登政府,另一方面,因为共和党的多数优势微弱,党内一些影响力较小的派系的政治力量则被放大,有利于他们巩固自己的选票。 此外,党内反对者也认为,自己的选票没有换取更多利益,希望以此作为筹码换取麦卡锡更大的让步,比如让他们获得众议院重要委员会中的职务。 作为仅次于美国总统、副总统的政坛三号人物,众议院议长通常由众议院多数党领袖担任,选举几乎没有悬念。然而,麦卡锡此次为当选,不得不做出多个关键让步,其中可能包括恢复一项罢黜议长动议机制,使得众议长的权力被削弱,难以掌控众议院。 美国有线电视新闻网CNN称,麦卡锡在这场不合时宜的政治勒索中作出让步,这种绥靖政策只会让极端主义势力更加强大。 这场引发全世界围观的尴尬选举暴露出美国政治存在严重的对立和分化。在权力博弈思维的裹挟下,党派利益凌驾于国家和人民利益之上,美国两党相互拆台,陷入“为反对而反对”的无脑对垒。而即便是一党内,也会因为利益分配问题产生不同的小派系,相互对抗,选票变成了谋利益的工具。 从国会山骚乱到打破记历史记录的15轮众议长选举,“对抗式民主”让美国政治陷入瓶颈,长期对抗势必会让政客们丧失客观公正的判断能力,其政治阶层是否有能力治理国家也会引发质疑。 两党之争和党派内斗进一步放大了美国政治体制弊病,美国所谓的“民主”形象,让全世界大跌眼镜。鼓吹以选民利益为先的美式选举,变成了政客们利益置换的游戏,进一步彰显出美国“民主政治”日渐失能,不断极化的党争已使美国政治制度陷入死循环。 House speaker election reveals deep-rooted problems in U.S. democracy (ECNS) -- The Republican leader Kevin McCarthy was elected as the 55th speaker of the U.S. House of Representatives after 15 ballots. As the most grueling House speaker election in the past 164 years, the election has highlighted the defects of the country’s "confrontational democracy". The election once reached a stalemate due to intense partisan strife, inner-party struggle among the Republicans, uneven distribution of interests, and more. Democratic Party members forged a close alliance, refusing to vote for McCarthy, while about 20 Republicans also declined to cast ballots for the GOP leader. Except for his unpopular role as a "political speculator" in Congress, McCarthy’s hard-won election can be attributed to turmoil within the Republican Party. On the one hand, opponents in the Republican Party believe that the GOP leader's attitude toward the Democrats is too weak to confront the Senate controlled by Democrats and the Biden administration. On the other hand, the political power of some less influential factions in the Republican Party has been amplified due to the Party’s weak majority advantage in the House of Representatives, which is conducive to consolidating their ticket warehouses. Meanwhile, these opponents believe that their votes failed to win them more benefits, hoping to use this as a bargaining chip for McCarthy's further concessions, such as getting them positions in important House Committees. As the third political figure after the President and Vice President of the U.S., the speaker, by tradition, is the head of the majority party in the House of Representatives. But McCarthy has made many concessions in order to bring the ultra conservatives along, involving what’s known as the “motion to vacate,” a mechanism by which members can force a vote to depose the speaker. The reported concessions will empower individual members at the expense of McCarthy’s sway as speaker. CNN thought the concessions he made during this unseemly political shakedown would only make the extremist faction more powerful. This embarrassing election, which has drawn global attention, exposed the serious opposition and polarization in American politics. Both Democrats and Republicans put their interests before that of the country and its people, attacking and opposing each other irrationally. Besides, different factions arise within a single party and confront each other because of the distribution of interests. Votes have become a tool to win more benefits. From Capitol riots to the House Speaker election with record-breaking ballots, "confrontational democracy" has become a bottleneck of American politics. Long-term confrontation will surely impede politicians to think objectively and fairly while their capacity of governing the country will also raise doubts among the public. Both parties’ struggle and infighting among the Republicans have further amplified the defects of the American political system, with its "democratic" image shocking the world. The U.S.-style election, which advocates putting voters' interests first, has become a game of interest exchange among politicians. In addition, it further demonstrates the malfunction of American "democratic politics" and the constantly polarized party struggle that has trapped the American political system into an infinite cycle. (文图:赵筱尘 巫邓炎) [责编:天天中] 阅读剩余全文() |