目的 介绍双链笔记软件在突发公共卫生事件分析研判中的应用.方法 以2021年12月至2022年1月陕西省西安市暴发新冠感染疫情研判的实践经验为基础,应用双链笔记软件——Obsidian的跨文本检索、建立双链链接、绘制可视化关系图谱等功能,在海量流调报告中提取关键信息,研判疫情走向.结果 基于双链笔记软件的特有功能,能够快速从海量流调报告中提取关键信息,有助于快速理清传播链,研判聚集性疫情的发展趋势,发现潜在风险点位.结论 基于双链笔记软件的疫情分析研判,具有快速、精准、可视化等特点,可为今后突发传染病海量流调报告及时精准分析提供经验.

目的 了解西安市长安区中小学传染病防控工作现状,为强化中小学传染病防控策略提供依据.方法 对分层随机抽取的103所中小学校,采用问卷调查及现场检查的形式对传染病防控工作开展现状进行调研.结果 59.22％(61/103)的学校按照要求设立或单独设立卫生(保健)室,63.11％(65/103)的学校按照要求配备保健教师或者卫生专业技术人员,54.37％(56/103)的学校有教室、生活区域场所和物品消毒制度与记录.仅6.80％(7/103)的学校开展学校卫生监测评价工作,7.77％(8/103)的学校具有合格有效的教室环境监测报告.小学在传染病防控日常管理的5个方面达标率均优于中学(P均＜0.05).城镇学校传染病防控日常管理中的专人负责疫情报告、因病缺勤登记追踪制度与记录、复课证明查验制度与记录3个方面的达标率分别为98.18％、81.82％、83.64％,均高于农村学校的79.17％、60.42％、62.50％(x2=9.715、5.804、5.920,P均＜0.05).农村学校卫生人员配备率为75.00％,高于城镇学校的52.73％(x2=5.461,P=0.019).结论 长安区中小学校传染病防控管理工作现况不容乐观,在日常管理制度建设与落实情况、卫生人员配备率等方面,小学优于中学;在卫生人员配备率方面,农村学校高于城镇学校.

目的 了解产时抗菌药物预防(IAP)对婴儿肠道菌群多样性、丰度及组成的影响.方法 基于已有出生队列,采集婴儿 3 日龄内、2 月龄及 6 月龄粪便,采用 16S rRNA高通量测序技术,对样本进行 Alpha、Beta多样性比较,还比较了各组菌群丰度,并对差异菌群进行了分析.结果 65 名婴儿的 142 份粪便样本纳入分析(男 35 名,女 30 名).经分娩方式分层后,未观察到产时抗菌药物预防暴露组与非暴露组在婴儿 3 日龄内、2 月龄、6 月龄肠道菌群多样性方面的差异.在婴儿 3 日龄内,产时抗菌药物预防的使用均会增加Eggerthellaceae的丰度(阴道分娩:beta=-0.82;剖宫产:beta=-0.38),并增加机会致病菌的丰度.在2 月龄顺产婴儿中发现变形菌门(Proteobacteria)(P=0.017)和肠杆菌科(Enterobacteriaceae)(P=0.015)的相对丰度在产时抗菌药物预防非暴露组中更高.结论 产时抗菌药物预防会影响婴儿 6 月龄内肠道菌群的组成结构,可能产生潜在的健康风险.

Cohort study is one of the important research methods in analytical epidemiology because of its clear time sequence relationship, which is better than other observational studies in demonstrating causal association. However, screening diagnosis or other methods are often used to exclude the individuals with outcome events during the enrollment process of the subjects in cohort studies. The accuracy of screening diagnosis and the effectiveness of exclusion will affect the accuracy of the baseline status assessment of the subjects included in the study, which may lead to the causal time sequence reversal of exposure-outcome in the estimation of causal effect. Landmark analysis can be used to control reverse causality by excluding subjects with potentially unknown expose-outcome timing. In this paper, we describe the basic principles and analytical steps of landmark analysis, and use data from the Chinese Longitudinal Healthy Longevity Survey to explore the relationship between physical activity and frailty, and introduce the specific application of landmark analysis for the purpose of facilitating its application and inferring causal effects more accurately in cohort studies.

目的 探索糖尿病患者抑郁状况动态变化规律,为实现糖尿病患者心理问题的早期发现和预警提供依据.方法 基于中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,简称CHARLS)数据,通过倾向性得分匹配方法消除混杂因素,拟合线性增长模型、非线性二次增长模型和不定义曲线类型的增长模型.通过比较模型拟合效果来确定增长函数的最优解,建立合理的增长模型来发现糖尿病患者的抑郁发展变化.结果 共纳入样本有5711例(非糖尿病组5380例,糖尿病组331例),倾向性得分匹配后的样本有1621例(非糖尿病组1291例,糖尿病组330例),各混杂因素在两组之间均衡可比.通过拟合3种潜变量增长曲线模型,结果表明不定义曲线类型的增长模型较其他两种模型为较优模型.非糖尿病组和糖尿病组初始状况的平均抑郁评分分别为9.640和10.097,并且都存在显著的个体间差异.在追踪期内,两组的抑郁状况都呈现出先下降后上升的趋势,但是非糖尿病组的抑郁评分始终低于糖尿病组,同时两组的变化速度都不存在个体间差异,初始时抑郁评分的高低与后来的变化速度之间的相关性无统计学差异.结论 通过探究糖尿病患者抑郁状况随时间的变化规律,了解个体心理变化趋势并进一步解释个体间存在的差异,对患者不同阶段心理状况的干预具有重要意义.

目的:探讨甲状腺癌病人围术期真实的疾病感受和体验,为护理人员制定针对性干预措施和心理疏导方案提供参考依据.方法:采用目的抽样法,选取西安市某三级甲等医院普通外科16例甲状腺癌围术期病人为研究对象,采用质性研究中的描述现象学研究方法,对病人进行半结构式访谈,运用Novivo 12.0软件,根据Colaizzi现象学7步分析法分析、整理、提炼主题,并对主题及亚主题出现频次进行排序.结果:甲状腺癌病人围术期疾病感受和体验可提炼出3个主题,11个亚主题.术前焦虑情绪:术前心理紧张、生育忧虑、害怕术后出现并发症;术后症候群担忧:呼吸道症状、颈部不适、伤口愈合、喉返神经损伤、甲状旁腺功能减退;康复期多元需求:期待术后病理学诊断结果、担心术后复发、延续护理需求.11个亚主题中排序前3位的分别为:期待术后病理学诊断结果(93.7％)、担心术后复发(87.5％)、术前心理紧张(75％).结论:甲状腺癌病人围术期缺乏科学的疾病认知、存在多方面的感受和需求,护理人员应提高敏感度,准确评估和识别,并针对性地给予心理疏导,提供有效的情感支持和医疗信息,提高病人围术期生活质量,提升病人体验感.

目的 利用孕期膳食平衡指数DBI_P评价陕西省孕妇的膳食质量,并分析其影响因素.方法 采用分层多阶段随机抽样方法,通过结构化问卷调查陕西省30区(县)7375名妇女的孕期基本信息,运用半定量食物频率问卷收集孕期膳食资料.应用最新修订的DBI_P评估孕期膳食质量,运用多重线性回归分析孕期膳食质量的影响因素.结果 50％以上孕妇奶类、鱼虾类、畜禽肉类、蔬菜、蛋类、水果和食物种类摄入不足.69％以上孕妇食用油、谷薯类和食盐摄入过量.正端分(DBI_HBS)、负端分(DBI_LBS)和膳食质量距(DBI_DQD)平均得分分别为12.9、19.5和32.5,中度摄入不足、摄入过量和摄入不均衡的比例分别为20.3％、22.5％和40.8％.孕期DBI_LBS水平与生育年龄、教育程度、家庭人均年收入、产检次数和增补叶酸呈负相关,与居住在陕南和陕北、居住在农村、职业为农民和饮酒呈正相关;孕期DBI_HBS水平与居住在陕南和陕北呈负相关,与主/被动吸烟和喝浓茶呈正相关.孕期DBI_DQD水平与教育程度、家庭人均年收入、产检次数和增补叶酸呈负相关,与居住在陕南、居住在农村、职业为农民、经产、主/被动吸烟、喝浓茶和喝咖啡呈正相关.结论 陕西省孕妇膳食存在摄入不足及摄入不均衡的问题,且膳食质量受社会人口学和孕期生活行为因素的影响,应针对性制定营养干预措施.

目的 描述陕西省COVID-19确诊病例的空间流行病学特征,分析其相关因素,为陕西省新型冠状病毒肺炎的防控工作的开展提供参考依据.方法 收集陕西省COVID-19确诊病例信息及相关社会经济学数据,分析确诊病例的时间及空间分布特征,采用广义线性模型探索人群COVID-19发病与社会经济因素之间的关联.结果 2020年1月23日,陕西省首次报告4例,2月4日新增确诊病例最高达23例,2月19日后再无新增.输入型病例比本地病例更早出现并达到新增高峰,且更早进入归零期.空间分析结果显示,确诊病例数最多的地市为西安市(120例),占总数的48.98％,确诊病例较多的区县为莲湖区、雁塔区、新城区和未央区.与各区县确诊病例数相关的社会经济学因素为教育支出(IRR=0.287,95％ CI:O.134～0.612)、人均生产总值(IRR=1.143,95％ CI:1.049～1.245)及各区县与武汉市的距离(IRR=0.995,95％ CI:0.992～0.998).结论 应针对重点地区和人群在疫情出现早期积极采取相应的措施,及早控制疫情的发展蔓延.

目的 描述婴幼儿BMI生长轨迹,探讨母乳喂养对婴幼儿BMI生长轨迹的影响.方法 采用前瞻性队列研究设计,对符合纳入条件的1388名新生儿进行随访,于42d、3个月、6个月、9个月、12个月、18个月和24个月对婴幼儿进行体格测量,同时收集喂养、户外活动、患病等信息.运用潜变量增长模型拟合0～2岁BMI生长轨迹,采用多水平Logistic回归模型分析母乳喂养对不同BMI生长轨迹的影响.结果 纳入分析的1285名婴幼儿的BMI生长轨迹主要划分为6类:"正常平稳"(26.6％)、"正常-加速"(8.7％)、"正常-减缓"(11.7％)、"持续偏低"(6.6％)、"赶上生长"(26.8％)和"赶上生长-加速"(19.5％).以"正常平稳"组作为参考,多水平Logistic回归模型显示:至少纯母乳喂养3个月可显著降低"赶上生长"(OR=0.71,95％CI 0.51～0.98)和"赶上生长-加速"(OR=0.53,95％CI 0.37～0.75)模式发生的危险;调整混杂因素后,此关系仍然成立(OR=0.61,95％CI 0.41～0.89;OR=0.46,95％CI 0.31～0.68).半岁前断母乳可显著增加"赶上生长"(OR=1.76,95％CI 1.19～2.61)和"赶上生长-加速"(OR=2.08,95％CI 1.38～3.14)模式发生的危险;调整混杂因素后,此关系仍然成立(OR=1.69,95％CI 1.08～2.71;OR=1.88,95％CI 1.18～2.99).结论 中国西部农村地区婴幼儿BMI生长轨迹以"正常平稳"、"赶上生长"和"赶上生长-加速"3种模式为主;母乳喂养可降低婴幼儿追赶生长发生的危险.

目的 探讨冠状动脉粥样硬化性心脏病(冠心病,CHD)经皮冠状动脉介入治疗(PCI)后患者抑郁状态的发生率及相关影响因素.方法 选取2017年7月至2017年12月于西安交通大学第一附属医院心血管内科接受PCI的438例冠心病患者为研究对象,完成基本人口社会学信息调查及疾病相关状况调查,收集相关资料并由患者本人完成中文版PHQ-9抑郁自评量表以评估患者心理状态.结果 119例(27.2％)患者存在不同程度的抑郁问题(轻度20.5％,中度5.9％,重度0.7％),其中女性患者抑郁发生率明显高于男性(35.5％vs.24.4％,P=0.019);CHD诊断分型中的不稳定型心绞痛(UAP)患者较ST段抬高型心肌梗死(STEMI)患者及非ST段抬高型心肌梗死(NSTEMI)患者抑郁发生率高(31.0％vs.17.1％vs.12.1％,P=0.006);合并短暂性脑缺血发作(TIA)/脑卒中患者较非脑卒中患者抑郁发生率高(39.6％vs.25.6％,P=0.040).术后1月抑郁状态有明显改善,术后6月抑郁状态较1个月随访时加重;急性心肌梗死(AMI)患者术后抑郁状态的改善明显低于UAP患者(9.2％vs.21.3％,P=0.015).结论 冠心病行PCI患者抑郁状态发生与性别、疾病状况有关.术后1月抑郁状态可改善,但随病程延长,抑郁状态又呈恶化趋势.CHD诊断分型中AMI患者术后抑郁状态改善较差,应关注术后远期心理状况.

Background: Microbiome is an important internal ecosystem closely related to host health. Most of the bacteria existed in the internal ecosystem cannot be isolated with laboratory bacteriological culture methods, while 16S rDNA sequencing is considered and used for the bacterial identification by through the high-throughput platforms. The aim of this study was to compare the microbiota analysis result using two next-generation sequencing platforms and bioinformatics pipelines. Results: 56 maternal-neonate fecal samples were sequenced and analyzed by 16S rRNA amplicon sequencing both by Ion Torrent S5-xl and Illumina Hiseq 2500 with standard protocols at same lab. For the richness and diversity of microbiota, index of chao1, observed_specise, PD_whole_tree, simpson and good_converage varied significantly except Shannon index at two platforms (P<0.05). The relative abundance of bacteria at different taxonomy levels is checked from phylum to species level, the more species of bacteria sequenced and annotated, the lower the correlation of the relative abundance of the bacteria founded between two platforms. The sequencing results are consistent between two platforms. Principal component analysis (PCA) results showed that more than 87% of samples were concentrated. According to principal coordinate analysis (PCoA), 56 samples of the two platforms were divided into two clusters, and the compliance rate of the two platforms is 71.43%. The differences between microbial community structures generated from two platforms were tested by multi-response permutation procedure (MRPP), which showed significant differences at family and genus levels separately (A=0.094, P=0.001; A=0.085, P=0.002). When maternal and neonate samples were considered, at family level, there was no difference in microbiota composition between two platform for maternal group (A=0.006, P=0.149), while in the neonate group, it showed significant differences (A=0.035, P=0.006). At the genus level, there existed significant differences in microbiota both in maternal and neonate group (A=0.0216, P=0.004; A=0.098, P=0.001). Conclusion: Although the relative abundance of microbiota sequenced at two different platforms is basically similar, the diversity and correlation coefficient are still quite different. To increase reproducibility and reliability in cohort studies, it is important to use the same sequencing platforms and the corresponding pipeline to reduce the systematic error in microbiome analysis.

目的 描述婴幼儿体重指数(BMI)生长轨迹,探讨辅食添加的时间和质量对婴幼儿BMI生长轨迹的影响.方法 采用队列研究设计,对符合纳入条件的1388名新生儿进行随访,1岁内每三个月一次,1～2岁每半年一次,随访内容包括:体格测量、喂养、户外活动、患病等.采用潜变量增长混合模型拟合0～2岁BMI生长轨迹,运用多水平Logistic回归模型分析辅食添加对不同BMI生长轨迹的影响.结果 纳入分析的1255名婴幼儿的BMI生长轨迹主要划分为六类:"正常平稳"(6.5％)、"正常-加速"(4.8％)、"正常-减缓"(28.0％)、"持续偏低"(32.9％)、"追赶生长"(17.8％)和"追赶生长-加速"(10.0％).以"正常平稳"组作为参考,多水平Logistic回归模型显示:辅食添加早于6个月可显著增加"追赶生长"(OR=2.16,95％CI 1.01～4.83)和"追赶生长-加速"(OR=3.13,95％CI 1.35～7.25)模式发生的危险;调整混杂因素后,此关系仍成立(OR=2.41,95％CI 1.03～5.63;OR=3.46,95％CI 1.41～8.48).1岁时较低的喂养指数得分可显著增加"追赶生长"(OR=2.50,95％CI 1.23～5.05)模式发生的危险;调整混杂因素后,此关系仍然成立(OR=2.35,95％CI 1.10～5.07).结论 研究地区婴幼儿BMI生长轨迹以"正常-减缓"、"持续偏低"和"追赶生长"三种模式为主;辅食添加的时间和质量会对婴幼儿BMI生长轨迹产生影响.

目的 应用SAS CAUSALMED过程步进行反事实因果分析,为探讨考虑混杂因素及交互作用下的中介作用及因果关系提供依据.方法 以"父母鼓励是否影响儿童认知发展,父母鼓励的效果是否受儿童学习动机的调节"为例,详细介绍了使用SAS CAUSALMED过程步进行中介分析的步骤和结果的解释.结果 通过实例,SAS CAUSALMED过程步可以便捷地对中介作用及其大小进行估计,包括对混杂因素的控制.结论 SAS CAUSALMED过程步可实现各类变量下的中介分析,特别是考虑混杂因素及交互作用下的中介分析.

目的 探讨冠心病(CHD)经皮冠状动脉介入治疗(PCI)术后患者焦虑状态的发生率及影响因素.方法 选取438例接受PCI治疗的冠心病患者,收集不同人口社会学特征(性别、年龄、教育水平、居住情况、居住地及年收入)、既往不良生活方式(吸烟、饮酒)、超重/肥胖、CHD诊断分型、合并慢性病(高血压、糖尿病、高血脂)、TIA/脑卒中及手术情况(PCI史、冠脉造影史)等资料,于入组时、术后1个月及6个月时,采用广泛性焦虑量表(GAD-7)评估所有患者的焦虑状况,分析PCI术后焦虑状态改善与不同人口社会学特征关系和不同疾病状况的关系;针对PCI术后6个月时患者焦虑状态改善、稳定和恶化3种结局,分析患者既往不良生活方式(吸烟、饮酒)、超重/肥胖、CHD诊断分型、合并慢性病(高血压、糖尿病、高血脂)、TIA/脑卒中及手术情况(PCI史、冠脉造影史)等因素对于焦虑状态发展的影响.结果 438例患者中106(24.4％)例患者存在不同程度的焦虑问题(轻度16.0％、中度2.7％及重度5.5％),其中女性患者焦虑发生率明显高于男性患者(P=0.019);随着教育水平的升高,患者焦虑发生率呈现下降趋势(P=0.017);术后1个月患者的焦虑状态较入组时有明显改善,术后6个月患者的焦虑状态较1个月时加重;术后6个月时焦虑状态的改善与高龄(P=0.016)、TIA/脑卒中呈负相关(P=0.043).结论 冠心病行PCI患者焦虑发生与性别、受教育水平有关;PCI术后1个月焦虑状态可明显改善、但术后6月时呈现增加趋势;应特别关注TIA/脑卒中心梗患者PCI术后的心理状况.

Objective:To investigate the work engagement among nurses in stomatology hospital and to analyze its influencing factors.Methods:From September 2018 to October 2018, we selected 229 medical and nursing personnel from a Class Ⅲ Grade A public stomatology hospital as the research object by convenience sampling. All medical and nursing personnel were investigated with the self-designed Work Engagement Scale for Dental Specialist Outpatient Nurses to analyze the current status and influencing factors of work engagement among outpatient nurses in stomatology hospital.Results:134 doctor questionnaires were distributed and 126 valid questionnaires were returned; 113 nurse questionnaires were distributed and 103 valid questionnaires were collected.Totals of 50.8% (64/126) of doctors and nurses were reasonably staffed; 45.6% (47/103) of nurses were satisfied with the professional status and development. The three items with the highest engagement evaluated by doctors included mixing materials, use of instruments and disinfection of products after use; the three items with the lowest engagement evaluated by doctors were medical record data management, assisting doctor-patient communication and return visits. Univariate analysis showed that there was a statistical difference in the engagement among nurses with different departments ( P<0.05) . Correlation analysis indicated that the staffing status of nurses is positively correlated with the clinical cooperation of nurses and the degree of participation in hospital prevention and control ( P<0.05) ; the professional status and development of nurses are positively correlated with the degree of patient participation management ( P<0.05) ; the degree of salary satisfaction is positively correlated with the degree of patient participation and clinic management. Conclusions:Nurses of public stomatology hospital have low overall work engagement during diagnosis and treatment for patients. We need to strengthen dental nursing training. Nurse staffing in place and perfecting performance evaluation methods can promote nurses to fully perform their duties and promote the improvement of patient safety.

目的 探讨类风湿关节炎(RA)全身骨量丢失及其与骨转换、抗环瓜氨酸蛋白抗体(ACPA)的相关性.方法纳入确诊的RA患者并设立健康对照,酶联免疫吸附法测定血清核因子κB受体活化因子配体(RANKL)和骨保护素(OPG),电化学发光法检测血清I型胶原羧基端交联肽(I-CTX)和I型胶原氨基端前肽(PINP),双能X线吸收法测定腰椎和髋部骨密度,Spearman's相关系数进行相关性分析.结果入组RA患者95例,男性35例,女性60例,平均年龄(53.63±13.88)岁.RA患者腰椎和髋部骨密度均显著低于健康对照(-1.2±1.4,-0.6±0.8,P=0.002;-0.1±1.4,0.8±0.8,P<0.001),血清I-CTX和PINP与髋部骨密度显著负相关(r=-0.225,P=0.032;r=-0.299,P=0.004),血清ACPA与RANKL、OPG、I-CTX、PINP、腰椎和髋部骨密度均无显著相关性(P>0.05).结论RA患者腰椎和髋部骨密度显著低于健康人群,高骨转换可能引起RA髋部骨量丢失,而ACPA可能不是引起RA患者全身骨量丢失的主要原因.

目的 通过问卷调查形式了解普通民众在新冠肺炎的心理状态,为今后突发公共卫生事件的心理健康教育提供依据和方向.方法 使用PHQ-9和GAD-7量表,通过网络平台进行匿名式调查,获得数据后应用SPSS18.0软件进行统计分析.结果 焦虑发生率为19.2％,其中轻度、中度、重度分别为14.8％、3.8％、0.6％;抑郁发生率为21.7％,其中轻度、中度、重度分别为15％、4.5％、2.1％.其中不同性别的抑郁发生差异具有统计学意义(χ2=7.922,P=0.048),在得知新冠肺炎人传人后有76.6％人员害怕,经统计显示不同年龄、不同性别、不同文化程度和不同职业P值均小于0.05,差异均有统计学意义;害怕与不害怕的心理状态导致不同程度焦虑(χ2=24.099,P<0.01),不同程度抑郁(χ2=13.993,P=0.003)的差异均有统计学意义.结论疫情期间民众出现不同程度的焦虑及抑郁心理问题,抑郁与焦虑呈高度相关,且焦虑和抑郁情绪的影响因素不完全相同,相关部门应对民众进行精准心理健康教育.

目的 探讨回授法在慢性牙周炎患者口腔卫生自我管理中的应用效果,为改善慢性牙周炎患者的护理模式提供理论依据.方法 选取在我院牙周科就诊的202例慢性牙周炎患者为研究对象,采用同期对照研究设计,初次单数日就诊的患者为纳入对照组共102例,双数日初次就诊的患者纳入观察组共100例.对照组采用常规健康教育方式,观察组基于回授法健康教育.干预前和干预3个月末评估2组口腔卫生自我管理能力和菌斑指数.结果 干预前2组慢性牙周炎患者口腔卫生自我管理能力各维度、总体得分及菌斑指数比较差异无统计学意义(P>0.05);干预3个月末2组口腔卫生自我管理能力各维度、总体得分及菌斑指数比较差异有统计学意义(P<0.001).结论 对慢性牙周炎患者健康教育实施回授法,可提高患者口腔卫生自我管理能力,降低牙菌斑指数,使患者养成良好的口腔卫生习惯.

Objective:To explore the clinical effects of systematic oral hygiene guidance in patients with periodontal disease, and provide a theoretical basis for improving the nursing model of patients with periodontal disease.Methods:Totally 150 patients with periodontal disease attending the Department of Periodontics & Oral Medicine, Hospital of Stomatology, Xi'an Jiaotong University from July 2018 to July 2019 were selected. Systematic oral hygiene guidance was provided to the patients, and the patients' plaque index, periodontal questionnaire scores, the percentages of positive bleeding in palpation and periodontal pockets ≥4 mm were compared before and after the intervention.Results:Totally, 150 patients finished the study. After the intervention, the plaque index of the 150 patients with periodontitis decreased, and the difference was statistically significant ( F=169.98, P<0.01) . After the intervention, the oral hygiene behavior, knowledge, attitude scores and total scores of the 150 patients with periodontitis were higher than those before the intervention, and the difference was statistically significant ( P< 0.01) . The percentages of positive bleeding in palpation and periodontal pockets≥ 4 mm after intervention in the 150 patients with periodontitis were lower than those before the intervention, and the difference was statistically significant ( P< 0.01) . Conclusions:Systematic oral hygiene guidance applied to patients with periodontal disease can enable the patients to better grasp the methods of oral hygiene maintenance, which is of great significance to the maintenance period of periodontal disease.

目的 了解陕西镇巴县居民慢性病患病情况及其影响因素.方法 采用分层整群随机抽样,对镇巴县15～69岁的常住居民进行慢性病现患情况和相关因素调查.结果 共获得有效调查问卷2479份,其中患慢性病963人,慢性病患病率为38.8％.前5位的慢性病分别是高血压(10.1％)、风湿性关节炎(8.0％)、胆结石/胆囊炎(7.0％)、慢性支气管肺炎(6.6％)和消化道溃疡(3.4％).不同年龄、家庭人口数、婚姻情况、教育程度、职业、收入、饮酒、自我健康评价、健康素养水平的调查对象间慢性病现患率差异有统计学意义.控制其他因素的影响后,55～69岁的人群患慢性病的风险是15～34岁人群的5.34倍(95％CI:3.62～7.84);肉食为主的膳食模式可增加慢性病患病风险(OR=1.36,95％CI:1.04～1.78);自我健康评价差者其慢性病患病风险是自我评价好者的16.41倍(95％CI:10.17～23.33).结论 镇巴县居民慢性病患病率较高,应重点关注自我健康评价较差的老年人,加强两病筛查及改变不良的膳食模式,将有助于改善当地居民的慢性病防控现状.