Objective:To investigate the Prevalence of hyperuricemia and the relationships between hyperuricemia and the chronic kidney disease in adult residents of Pudong New Area,Shanghai.Methods:1 024 residents were randomly selected from a community of Pudong district.Questionnaires and laboratory test were taken.Risk factors for hyperuricemia was analyzed by multivariate logistic.Hyperuricemia was defined by gender-specific criteria of serum UA ＞ 420 μmol/L in males and ＞ 360 μmol/L in females.Results:We included 1 024 residents.The average age was 56 ± 14 years old.The male to female ratio was 1∶ 1.53.The overall prevalence of hyperuricemia was 17.77％ and CKD was 81.42％.Participants with HUA typically had higher age [(60 ± 15)vs (55 ±13) years old,P＜0.01],higher SBP[(135 ±13)vs (128 ±15) mmHg,P＜0.01],DBP[(85.55 ±8.31) vs (82.99±8.55) mmHg,P＜0.01],BMI[(26.26 ±3.47) vs (23.91 ±3.64) kg/m2,P＜0.01],WHR[(0.88 ±0.05) vs (0.86 ±0.06),P＜0.01],BUN[(5.41 ±1.50) vs (4.87±1.27) μmol/L,P＜0.01],Scr[(127.83 ±36.56) vs (143.17 ±38.46)μ mol/L,P ＜ 0.01],lower eGFR [(127.83 ± 36.56) vs (143.17 ± 38.46) ml · min-1 · 1.73 m-2,p ＜ 0.01].Also,they had higher percentage of hypertension(P ＜ 0.01),hyperlipidemia(P =0.04) and cardiovascular diseases(P ＜ 0.01).Univariate analysis showed that HUA was associated with age,SBP,DBP,BMI,WHR,BUN,Scr,Hb and eGFR.Multivariate logistic regression analysis showed that gender,SBP,BMI and Scr were independent factors for HUA.Conclusion:The prevalence of HUA in community of Shanghai was 17.77％.With the CKD progression,the prevalence of HUA increased.The risk factor for HUA included gender,SBP,BMI,WHR and Scr.

Objective:To understand the prevalence of cataract and the effect of the prevention and treatment for blindness with center of cataract operation treatment in the elderly of sanlin community.Methods:We carried out the questionnaire investigation for all the elderly aged 65 and above in the community,to understand the prevalence of cataract and operation status.Results:The number of subjects was 13 010 cases,and the prevalence of cataract was 41.27% .Along with the increase of age,cataract prevalence was significantly increased.In women and illiterate,the prevalence of cataract was higher,and the prevalence respectively was 44.67% and 53.41%.The coverage rate of operation in cataract blind person was 80.54%,compared with those under the age of 70,the coverage rate of operation in cataract blind person above the age of 70 was high,which was 82.42% and 66.67% respectively.The social burden rate of cataract blind person was 3.7%.They were 4.65%,5.72% and 9.46% respectively in women,over the age of 80 and the illiteracy.Conclusion:Cataract was still the major blinding eye disease with age dependence.In sanlin community,social burden of cataract blind person was heavier.Curing cataract blindness was still the focus for the prevention and treatment for blindness,especially in people with low operation coverage for cataract blind person.

家庭医生责任制是以社区为载体、家庭为单位、个人为目标,以契约服务的形式为家庭及其每个成员提供连续性、协调性、可及性的综合医疗保健服务模式.本文对2005年来上海市浦东新区三林社区卫生服务中心先后建立的5支全科服务团队开展社区家庭责任制服务进行回顾性分析,了解开展情况及存在问题.

国外华法林抗凝治疗的管理主要通过设立抗凝门诊实现[1-3]。自1968年抗凝门诊在美国出现以来，日趋成熟的抗凝门诊工作模式相继扩展到了英国、法国、加拿大、澳大利亚等发达国家。研究证实抗凝门诊的建立有以下好处：降低了抗凝并发症的发生率[4]；显著降低了医疗费用和去急诊室的次数；药师可以为患者提供更加直接而详细的用药指导。此外，在美国、韩国等国家从事AC工作的药师已取得了有限的处方权，药师有华法林处方权并可以进行必要的剂量调整等。

Objective:To explore the two or three grade hospitals how to cooperate with the community health service center to create the blindness prevention model community,and reduce the prevalence of blindness.Methods:Department of Ophthalmology of two or three grade hospital,eye protection center cooperated with Sanlin community health service center to carry out the work of prevention and cure blindness,the intervention objects were residents in sanlin community of pudong new area.Results:The prevention and cure for blind showed that,sustainable development of the work of prevention and cure for blindness can reduce the prevalence of blindness.2014 survey shows that DR and macular degeneration had gradually become important causes of blindness.Conclusion:Department of Ophthalmology of two or three grade hospital,eye protection center cooperated with community health service center to carry out the work of prevention and cure blindness can promote the prevention of blindness and penetration depth,and reverse the increasing trend.

Objective To evaluate the clinical efficacy of community strengthen management on type 2 diabetes melli-tus.Methods 289 subjects with type 2 diabetes visiting in our center from Jan 2011 to Feb 2011 were selected as the study sub-jects, who were randomly divided into strengthen management group ( treatment group ) with 141 subjects and general manage group ( control group ) with 148 subjects.The control group was adopted the traditional community manage model , while besides that, the treatment group was taken the community strengthened administration pattern such as setting complete health records , giving health education lectures , setting quantified follow-up files and so on.And after two -year follow -up, the two groups were compared on blood glucose , blood lipid and the risks of the occurrence of many complications such as diabetic ketoacidosis , diabetic nephropathy , diabetic foot , diabetic foot , and diabetic retinopathy during the follow -up.Results 272 subjects finally finished the treatment with 17 out of followed and lost of follow up rate was 5.9% (17/289) .Before the management , there was no statistical difference on body mass index , blood glucose and blood lipid between the two groups ( P>0.05 ) .After two years of follow-up, the mean fasting plasma glucose and 2 hours after meal plasma glucose in the treatment group was much lower than that in the control group and the difference was significant (P<0.05) .During the 2-year follow-up, 12 and 24 diabetes-re-lated complications were observed in the treatment group and control group , respectively.And this demonstrated that patients with type 2 diabetes receiving strength management in the community suffered lower risk of development of diabetes -related complica-tions ( HR =0.68 , P=0.04 ) .Conclusion Significant advantages of community strengthen management for type 2 diabetes were found in this study , which could significantly reduce the incidence of diabetic complications.

家庭医生责任制是以社区为载体、家庭为单位、个人为目标,以契约服务的形式为家庭及其每个成员提供连续性、协调性、可及性的综合医疗保健服务模式.本文对2005年来上海市浦东新区三林社区卫生服务中心先后建立的5支全科服务团队开展社区家庭责任制服务进行回顾性分析,了解开展情况及存在的问题.

上海市三林社区有70岁以上老年人9760例,三林社区卫生服务中心从2000年7月开始为老年人建立健康档案,以便了解老年人的健康需求和健康状况及老年人对社区医疗收费的看法.笔者于2008年10月对社区内3164名老年人的需求意愿进行了调查,旨在人口老龄化不断加剧,社会保障还未完善的情况下,阐明构建一个社区老人服务体系的必要性,为拓展社区卫生服务的内容提出依据,并根据社区老年人的需求开展各项服务及延伸服务.

乙型病毒性肝炎(乙肝)已成为严重危害我国居民生命健康的重要疾病之一.目前接种乙肝疫苗仍然是预防乙肝最有效和最经济的手段.上海市从1992年起将乙肝疫苗的接种纳入计划免疫管理,对新生儿开展了预防接种工作.1993-1995年间对全市学龄前儿童及中小学生开展了乙肝疫苗接种工作,本地儿童乙肝发病率及乙肝病毒感染率大幅下降.