2018年 · 第12卷第04期

The prevalence of hypercholesterolemia among Chinese residents has increased rapidly in recent 10 years, and the disease burden caused by it cannot be ignored. Dyslipidemia is seriously harmful to the health of Chinese people, but it has not been fully recognized and effectively managed. This issue organizes a key number with the theme of "Blood Lipid Health Management" to discuss blood lipid management. Zhao Wenhua and others wrote a review emphasizing that dyslipidemia should become the core content of health management of chronic diseases at the grassroots level. Four related treatises and one short paper discussed the dyslipidemia and its management from the perspectives of medication compliance and influencing factors of patients with dyslipidemia, the change trend of blood lipids in urbanized communities, the evaluation of community health management cost-effectiveness of dyslipidemia, the epidemiology of adult dyslipidemia in southern mountainous areas of Ningxia, and the evaluation of the intervention effect of family doctor's contract service on dyslipidemia.

According to the 2015 Report on Nutrition and Chronic Diseases of Chinese Residents, the mortality rate of cardiovascular and cerebrovascular diseases among Chinese residents in 2012 was 271.8/100,000, 218.8/100,000 in urban areas and 310.7/100,000 in rural areas, which is the first cause of death among Chinese residents^[1]。 In recent years, the blood lipid level of Chinese population has continued to rise. The "2002 Survey of Nutrition and Health Status of Chinese Residents" and "China Chronic Disease Surveillance (2010)" found that the levels of total cholesterol (TC), triacylglycerol (TG) and low density lipoprotein cholesterol (LDL-C) in the population increased in the past 10 years from 2002 to 2010^[2,3]。 In contrast, in the United States, adult TC and LDL-C levels have declined significantly over the past 30 years^[4]。 Hypercholesterolemia has a higher effect on death from ischemic heart disease than ischemic stroke. According to the World Health Organization's Global Burden of Disease Report 2004, around 56 percent of deaths and burden of disease from ischemic heart disease worldwide are associated with cholesterol levels above 3.8 mmol/L, resulting in 3.6 million deaths in 2000^[5]。 The largest contribution of cholesterol control to reducing cardiovascular death in the United States was 24%^[6]； Chinese research shows that the 77% increase in mortality from coronary atherosclerotic heart disease (CHD) is attributed to elevated cholesterol^[7]。 Because the prevalence of hypercholesterolemia among Chinese residents has increased rapidly in the past 10 years, the disease burden caused by it can not be ignored. Dyslipidemia is seriously harmful to the health of Chinese people, but it has not been fully recognized and effectively managed. The awareness rate, treatment rate and control rate of dyslipidemia in Chinese population are at a low level. Only 11.0% of the total number of people with dyslipidemia were aware of their dyslipidemia, compared with 8.5% in rural areas. Only 3.9% of people took treatment for dyslipidemia. However, only 3.5% of people can effectively control dyslipidemia^[3]。 Compared with the 3.2% awareness rate of dyslipidemia in 2002^[2], hardly improved in 2010. It should be noted that the blood lipid awareness, treatment and control status of people with major chronic diseases are also at a low level. However, for various reasons, dyslipidemia management cannot be included in the national basic public health service project like hypertension and diabetes.

The 2017 edition of the UK Clinical Guidelines for the Prevention and Treatment of Osteoporosis (hereinafter referred to as the 2017 edition of the Guidelines) was published in the journal Arch Osteoporos^[1]。 Due to the large content of the 2017 edition of the Guide, we will interpret it in three issues. In Issue 4, 2017, we interpreted the background of the guidelines update, applicable subjects and users, osteoporotic fracture risk assessment and lifestyle intervention management, etc.^[2]； In Issue 1, 2018, we interpreted the intervention management of anti-osteoporosis drugs^[3]。 This issue will interpret the diagnosis and treatment intervention management of glucocorticoid-induced osteoporosis (GIOP) and male osteoporosis, as well as post-osteoporotic fracture intervention and liaison services.

Cardiovascular and cerebrovascular diseases have become the first cause of death in urban and rural populations in China. Dyslipidemia is the most important risk factor for atherosclerotic cardiovascular disease (ASCVD), including coronary atherosclerotic heart disease, ischemic stroke, intermittent claudication, and symptomatic carotid stenosis. In May 2012, 15 ministries and commissions, including the former Ministry of Health, the National Development and Reform Commission, and the Ministry of Finance, jointly issued the Work Plan for the Prevention and Control of Chronic Diseases in China (2012-2015), which clarified the principles, objectives and safeguard measures of chronic disease work in China, and put forward clear quantitative index requirements for the awareness rate, management rate and control rate of hypertension and diabetes among the population. Dyslipidemia is one of the primary risk factors of acute myocardial infarction and stroke. Many large-scale clinical studies have confirmed that while managing cardiac and cerebral risk factors such as blood pressure and blood sugar, if blood lipids can be included in an equally important position for comprehensive management, it will produce a synergistic effect of "1+1+1>3", which can greatly increase the effect of original risk factor management. Therefore, in order to build a comprehensive prevention and treatment model of dyslipidemia and cardiovascular and cerebrovascular disease risk factors in adults in China, under the leadership of the former National Health and Family Planning Commission, the International Exchange and Cooperation Center of the National Health and Family Planning Commission organized, implemented, managed and carried out the "Pilot Project of Health Management Service for Dyslipidemia in Adults in China" (referred to as "Lipid Management Project", project number IHECC2013DLM), systematically reviewed and analyzed the risk factors of dyslipidemia and cardiovascular and cerebrovascular diseases, studied and preliminarily formulated the technical guidelines and service specifications for comprehensive prevention and treatment of dyslipidemia and cardiovascular and cerebrovascular diseases in community populations, designed and developed the knowledge management system (KMS) for comprehensive prevention and treatment of dyslipidemia and cardiovascular and cerebrovascular diseases in adults in China suitable for grassroots medical staff and the public, and simultaneously carried out pilot exploration of comprehensive management of dyslipidemia and cardiovascular and cerebrovascular diseases in more than 130 community health service centers/community health service centers in Beijing, Hangzhou and Shenzhen.

According to the national survey in 2012, the total prevalence rate of dyslipidemia among Chinese adults is as high as 40.40%, which is a sharp increase compared with 2002^[1]。 Dyslipidemia is an important risk factor for atherosclerotic cardiovascular disease (ASCVD)^[2]。 ASCVD is the first cause of death in China. This study aims to explore the intervention effect of community family doctor contracted intervention service model on dyslipidemia in the elderly population.

The childbearing age period is an important stage in women's life. The childbearing age women are women aged 15~49 years old. The childbearing age women can play an important role in supporting the stability and harmony of family and production construction. Their health condition can indirectly reflect the overall health condition of women in a region, and it is also an important index to measure the political, economic and cultural level in a region^[1]。 In order to grasp the death situation of women of childbearing age in Cixi, Zhejiang Province, analyze their death causes and life reduction, and explore intervention measures to reduce mortality, we analyzed the death situation of women of childbearing age in Cixi, Zhejiang Province from 2007 to 2016.

Physical examination is an important means to understand one's own health status and detect health hazards and disease clues early, so as to detect, diagnose and treat early. With the improvement of living standard and health awareness, more and more people participate in health examination, and the competition in health examination industry is increasingly fierce^[1,2,3]。 Whether it is a public hospital health examination department or a private physical examination institution, it is the core and key for the survival and development of physical examination institutions to promote customer relationship management with the value of physical examination subjects as the center, and finally realize the improvement of satisfaction and loyalty of subjects^[4,5]。 The satisfaction and loyalty of subjects can not only reflect the service level of physical examination, but also be an important link in the quality control system of health physical examination. At the same time, it can also be used as one of the important assessment indicators to evaluate the level of hospital management. Therefore, we conducted a survey on customer satisfaction and loyalty of our health management center to understand the current situation and existing problems, hoping to provide suggestions and references for our center to promote subject relationship management, enhance sustainable development and core competitiveness.

Metabolic syndrome (MetS) is a group of complex metabolic diseases dominated by obesity, hypertension, elevated circulating triacylglycerides (TG), decreased high-density lipoprotein cholesterol (HDL-C), and elevated fasting blood glucose^[1], is an important factor that causes atherosclerosis (AS) and the increased morbidity and mortality of cardiovascular diseases caused by it^[2,3]。 The prevalence of MetS and cardiovascular diseases in the Uyghur population in Xinjiang is much higher than that of other ethnic groups in the same region^[4,5]Some patients in remote areas are delayed in diagnosis and treatment due to insufficient attention to diseases and inconvenient transportation. It is of great value to find quick, convenient and economical indicators for screening AS. Although ultrasound examination of carotid plaque is the most direct and simple, for Xinjiang, due to the large differences in ultrasound equipment and the subjective characteristics of ultrasound examination, this method often can't fully reflect the real situation. TG/HDL-C ratio is an important indicator of insulin resistance, which is significantly correlated with the risk of cardiovascular disease and mortality^[6]。 However, there are clear ethnic differences in the prediction of insulin resistance by TG/HDL-C ratios^[7,8]Whether it can be used to screen for AS in Uyghur patients with MetS is unclear. Therefore, this study explored the relationship between TG/HDL-C ratio and carotid plaque in Xinjiang Uyghur patients with MetS, and attempted to determine the predictive cutoff value of this ratio.

The incidence and mortality of gastric cancer rank second among malignant tumors in China, while chronic atrophic gastritis (CAG) is a common digestive system disease characterized by the decrease or disappearance of the number of intrinsic glands in the gastric mucosa^[1]。 CAG is considered a precancerous disease. The risk of gastric cancer in patients with gastric antrum is 18 times higher than that in normal people, and the risk of CAG in patients with gastric body is 4.6 times higher than that in normal people. However, the risk of gastric cancer in patients with gastric antrum and gastric body is as high as 90 times that in normal people^[2,3]。 In the past, atrophic lesions of the stomach were diagnosed based on endoscopic mucosal biopsy. Because gastroscopy is an invasive examination and is limited by many conditions, the examination rate of gastroscopy in China is much less than that in western countries, and China is in a high incidence area of gastric cancer. Therefore, people have been exploring early screening methods for gastric cancer. Serum gastric function is a non-invasive examination, which is convenient and quick for assessing gastric mucosal atrophy, and is suitable for large-scale physical examination and screening. To evaluate the value of serum pepsinogen (PG) Ⅰ, PG Ⅱ, serum pepsinogen ratio (PG Ⅰ/PG Ⅱ, PGR) and gastrin-17 (G17) levels as diagnosis of atrophic gastritis, analyze the relationship between PG and G17 levels and gastric mucosal injury, and judge their role in diagnosis and disease assessment of atrophic gastritis.

Nowadays, more than ever, China has deeply recognized the importance of health, because the promotion of all-round human development and economic and social development must be based on national health. In order to comprehensively improve the health quality of the Chinese nation and realize the coordinated development of people's health and economy and society, in October 2016, the Central Committee of the Communist Party of China and the State Council upgraded the construction of a healthy China to a national strategy. Accelerating the health management of the whole population is "integrating health into all policies, speeding up the transformation of the development mode in the health field, maintaining and protecting people's health in an all-round and full-cycle way, greatly improving health standards and significantly improving health equity".^[1]Important initiatives. However, health management started late in China, and has not yet formed a perfect and systematic service system. To give full play to the important role of health management in all-round and whole life cycle maintenance and protection of people's health, we must innovate the service mode of health management. "Relying on existing preventive health care and disease prevention and control networks, and integrating existing resources to form a complete and systematic health management service network"^[2]The thinking provides a useful exploration for innovating the health management service model, improving the health status from the source, and preventing the occurrence of diseases. However, with the further standardization of basic public health services and the widespread development of family doctor contracting services, there are still many topics that need to be explored and researched by people in the industry. We explored the feasibility of integrating health management with basic public health services and family doctor contracted services.

The results of an 18-year follow-up study showed that women who received hormone replacement therapy (HRT) for 5 to 7 years had no increased long-term all-cause mortality and mortality from special diseases such as cardiovascular diseases and cancer^[1]。