BACKGROUND:Cardiovascular disease (CVD) represents a primary cause of mortality in China. A thorough comprehension of the relationship between dietary patterns and CVD risk, coupled with the identification of effective dietary interventions, constitutes a robust foundation for enhancing the primary prevention of CVD. OBJECTIVES:This study aimed to investigate the associations between plant-based dietary indices (PDIs) and risk of CVD events among individuals with varying levels of CVD risk in northern China. METHODS:The data from the China Patient-centered Evaluative Assessment of Cardiac Events Project was collected during 2017-2020 in Shanxi provinces. A total of 54,764 residents aged 35-75 y were eligible and enrolled in the cross-sectional study and divided into the high CVD risk population (HCRP) and the nonhigh CVD risk population according to the WHO prediction for CVD risk. The PDI was derived from data collected via the Food Frequency Questionnaire. We examined the relationship between PDI and risk of cardiovascular events (CVEs) utilizing generalized estimating equations, restricted cubic spline models, and mediation effect models, with adjustments for covariates. Subsequently, multivariate-adjusted Cox regression models were employed to analyze the association between PDI and the incidence risk of CVEs in the HCRP cohort over the follow-up. RESULTS:The cross-sectional analysis revealed a negative and linear association between PDI and CVEs risk [odds ratio (OR) = 0.98; 95% confidence interval (CI): 0.97, 0.99] mediated by diabetes (β = -0.001) within the HCRP, characterized by an L-shaped relationship with a cut-off point of 47. Follow-up analysis indicated the higher PDI scores were associated with a lower incidence risk of CVEs in the subgroup with body mass index <24 kg/m2 [P = 0.014; hazard ratio (HR) = 0.78; 95% CI: 0.56, 1.08]. CONCLUSIONS:The prevention and control of CVD should not exclusively emphasize plant-based diets. Instead, it is imperative to adopt a comprehensive dietary approach considering the diverse physical conditions.

目的 了解山西省高中生血压偏高现状,分析相关影响因素,为进一步制定干预策略提供科学依据.方法 于2020年10月采用分层整群抽样方法,在全省范围内选取42所高中的7291名学生进行体格检查和问卷调查,分析高中生血压偏高情况.采用Logistic回归分析高中生血压偏高的影响因素.结果 本次调查血压偏高者占总调查人数的17.08％.Logistic回归分析显示,不住校(OR=1.211,95％CI:1.054～1.392)、课间休息活动场所是教学楼内(OR=1.170,95％CI:1.024～1.338)、家长不限制使用电子产品(OR=1.224,95％CI:1.081～1.385)是山西省高中生血压偏高的危险因素;家庭经济情况好(OR=0.557,95％CI:0.429～0.725)、每周参加文化类补习班时长＜3 h(OR=0.817,95％CI:0.674～0.991)是山西省高中生血压偏高的保护因素.结论 山西省高中生血压偏高率较高,建议相关部门持续开展血压监测工作,对血压偏高学生早发现、早诊断、早治疗.同时,社会、学校及家长还应针对相关影响因素采取干预和防控策略,以降低儿童青少年高血压患病率.

目的:全面了解某市小学生用眼卫生知识态度行为与视力不良及相关影响因素,为进一步提出科学合理、行之有效的干预措施提供思路和依据.方法:采用分层整群随机抽样方法,抽取山西省某市 6～12 岁小学生 887 名进行视力筛查和视力不良影响因素专项调查.结果:调查小学生视力不良率为51.52％,城区视力不良率 54.65％;县区视力不良率48.28％.城区与县区的视力不良率相比,无统计学差异(P＞0.05).男女视力不良率分别为 52.05％,51.01％,视力不良率相比,无统计学差异(P＞0.05).与2019 年相比城区视力不良率增幅大于县区,增幅分别为22.57％和 16.08％;低年级组视力不良率增幅大于中高年级组.结论:本次调查与2019 年对比低年级组比中高年级组视力不良发生率增长幅度显著.学校、家庭综合近视防控措施落实不到位,特殊时期过长时间使用电子产品,户外活动持续减少等多种因素影响,需制定有效的干预措施在知、信、行各阶段长期干预.

Objective: To explore the effects of mothers' exposure to polycyclic aromatic hydrocarbons during pregnancy on their children's neurobehavioral development. Methods: In November 2009 to April 2010, a total of 221 pairs of mother-newborn pairs were recruited from two cooperative hospitals in Taiyuan, and their children were followed up at age two. High performance liquid chromatography was used to determine the level of BPDE-DNA in cord blood leukocytes. The Neonatal behavioral neurological assessment (NBNA) was used to assess the neurodevelopment of newborns, and the Gesell Development Scale was used to measure neurodevelopmental indexes of 2-year-old children. NBNA includes behavior, active and passive tone, primitive reflexes and general assessment, with a total score of 40 points. The Gesell Developmental Schedules consisted of four sub-scales: motor development, adaptive behavior development, language development and personal-social behavior development. We used mean and standard deviation to describe continuous variables with normal distribution, median (interquartile range) to describe continuous variables with skewed distribution, and frequency and proportion to describe categorical variables. Restricted cubic spline models were applied to assess the dose-response relationships between maternal prenatal polycyclic aromatic hydrocarbons exposure and children's neurobehavioral development at two years old. Generalized linear models were applied to evaluate the effect of exposure to maternal prenatal polycyclic aromatic hydrocarbons exposure on children's neurobehavioral development at 0 and two years old. Results: The NBNA score was 38.0±0.8, and the scores of 2-year-old children's motor, adaptive, language and personal-social were 111.6±15.0, 110.5±14.6, 108.8±17.2 and 111.7±14.5, respectively. After adjusting for confounding factors, there is no dose-response association between the cord blood BPDE of pregnant women and neonatal NBNA scores, but there were dose-response associations between BPDE and scores of 2-year-old children's motor, adaptive, language and personal-social. A unit increase in cord blood ln (BPDE-DNA), the score of motor, adaptive, language and personal-social of 2-year-old children decreased on average by 4.54、6.29、8.41 and 7.02 points. Conclusion: Maternal exposure to polycyclic aromatic hydrocarbons during pregnancy is associated with decreased children's neurobehavioral development at two years old.

目的 分析2020年山西省四至六年级小学生近视现状及影响因素,为预防学生过早近视提供科学依据.方法 采用多阶段分层整群随机抽样方法,抽取山西省的小学生作为研究对象,对抽取的小学生进行视力检查,采用问卷调查的形式收集学生基本信息和近视专项调查所需资料.采用χ2检验、Logistic回归模型分析近视发生的影响因素.结果 山西省四至六年级小学生的近视率为43.2％,多因素Logistic回归分析显示,郊县学生相对于城区学生近视率更低(OR=0.790,95％CI:0.720～0.867);座位一学期轮换一次的学生相对于座位从不轮换的学生近视率更低(OR=0.532,95％CI:0.011～0.890);做作业时长<2 h的学生近视率低于没有作业的学生(OR=0.756,95％CI:0.576～0.992);课间活动场所为户外的学生近视率低于教学楼的学生(OR=0.878,95％CI:0.810～0.951).经济中等地区的学生相较经济较好地区的学生近视率更高(OR=1.511,95％CI:1.270～1.798);女生近视率相对于男生较高(OR=1.297,95％CI:1.192～1.411);高年级学生相对于低年级学生近视率较高(五年级OR=1.511,95％CI:1.360～1.679;六年级OR=2.044,95％CI:1.839～2.272;);做作业仅使用台灯的学生相对于同时使用顶灯台灯的学生近视率更高(OR=1.812,95％CI:1.713～1.925);父母有近视情况的学生近视率高于父母没有近视情况的学生(父母有一方患近视OR=1.830,95％CI:1.668～2.007;父母双方均患近视OR=2.701,95％CI:2.365～3.084).结论 山西省四至六年级小学生近视发生率相对较高,建议卫生、教育等相关部门加强对低龄学生近视的监测和干预.

目的 以人群为基础,了解山西省消化性溃疡患病状况,探究胃溃疡和十二指肠溃疡发病的影响因素,为疾病防控策略的制定提供依据.方法 采用多阶段分层随机抽样的方法,在全省4个区/县选取18～64岁常住居民通过问卷调查、13C呼气试验和胃镜检查对消化性溃疡的流行状况及危险因素开展调查;采用单因素分析和多因素Logistics回归分析,确定相应的危险因素.结果 3456名调查对象中,共有胃溃疡131名,患病率为3.79％;十二指肠溃疡52名,患病率为1.50％.男性、工作性质中兼有体力劳动和脑力劳动、吸烟、饮酒和幽门螺杆菌感染和不良情绪是胃溃疡发病的危险因素(OR>1);吸烟、饮酒和不良情绪是十二指肠溃疡发病的危险因素(OR>1).结论 预防和控制消化性溃疡发病的措施包括从已确诊患者、疑似症状或家庭成员确认感染者、普通公众三个角度开展幽门螺杆菌的防控、加强吸烟、饮酒的健康教育力度、关注患者心理健康,改善家庭关系等.

Supplemental Digital Content is available in the text Introduction: People with severe hypertension have high risk of target organ damage, yet few studies focus specifically on this population. We sought to assess the characteristics, prevalence, awareness, and treatment patterns of severe hypertension among middle-aged adults in China. Methods: We enrolled 2 660 666 participants aged 35–75 years from 31 provinces between 2014 and 2018 in the cross-sectional China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project. Severe hypertension was defined as SBP of at least 160 mmHg or DBP of at least 100 mmHg. Awareness and treatment were defined as self-reported diagnosis of hypertension and current use of antihypertensive medication, respectively. Analyses were completed in 2019. Results: Our sample included 2 618 757 adults with a mean age of 55.6 years (SD 9.8), 59.6% of whom were women. A total of 378 457 (14.5%) participants had severe hypertension, of whom 222 533 (58.8%) were untreated. The age--sex-standardized rate of severe hypertension was 11.6% based on the 2010 Chinese Census data. Advanced age, female sex, current drinking, obesity, lower income, diabetes, and prior cardiovascular events were associated with higher risk of severe hypertension (all P < 0.01). Of untreated participants with severe hypertension, only 60 484 (27.1%) were aware of their conditions. Among participants with severe hypertension despite treatment, 84.7% reported taking one class of antihypertensive medication; only 15% reported taking guideline-recommended combination therapy. Conclusion: Many millions of people in China have severe hypertension and the vast majority are unaware of their condition and undertreated. There are immense opportunities to improve outcomes in this high-risk group.

目的 探究烟草烟雾的暴露水平与血细胞计数的关系,寻找与吸烟相关的健康监测指标.方法 本研究的受试者是在山西省776名体检人员,采用问卷调查以收集研究人群的基线资料,同时收集血常规检查结果.高效液相色谱-串联质谱法测定工人尿中尼古丁及其代谢物可替宁、反式3'-羟基可替宁水平.应用广义线性模型和Logistic回归模型分析尼古丁、可替宁、反式3'-羟基可替宁与血细胞计数的关系.结果 尿样中尼古丁及其代谢物可替宁、反式3'-羟基可替宁三者之间高度相关;尼古丁及其代谢物可替宁、反式3'-羟基可替宁的增加均与白细胞计数、中性粒细胞计数、淋巴细胞计数的增加有关.以尿中可替宁浓度为代表,四分位数间距每增加1个单位,白细胞计数超出正常值范围的危险性增加3.75倍(OR=3.75),中性粒细胞计数超出正常值范围的危险性增加2.41倍(OR=2.41).结论 尿中尼古丁及其代谢物可替宁、反式3'-羟基可替宁均可作为生物标志物探讨烟草烟雾对血液系统的影响;暴露于烟草烟雾主要引起血液系统中白细胞计数的增加,白细胞计数的升高可以作为与烟草烟雾暴露相关的较稳定的健康监测指标.

视力是反映儿童青少年体质健康和预示未来生活质量的重要指标[1],国家卫健委2018年6月公布的数据显示,目前中国学生青少年近视率高居世界第一.世界卫生组织研究报告称,目前中国近视患者人数多达6亿,几乎是中国人口总数的一半,其中小学生近视比例已达45.7％.学生视力不良问题突出.为了解山西省中小学生视力不良情况,为进一步干预提供依据,现对2019年山西省中小学生视力现状进行分析.

龋病是牙体硬组织发生破坏的一种疾病,是人类的常见病、多发病之一.现有研究已证实龋病发生的四联因素包括致病菌、糖、宿主和时间.龋病不仅表现为牙齿疼痛,还会影响颌面部骨组织、软组织生长发育及咀嚼功能[1].全世界60％～90％儿童患有龋病,早期预防龋病可减少约30％的发病率[2],龋病的预防控制形势不容乐观.为了解山西省12～15岁汉族学生恒牙龋病患病和流行情况,于2020年对山西省12～15岁中学生进行调查,为龋病防治提供科学依据.

宋明锁教授为山西省名医,临证经验丰富,有着自己的一套对于治疗小儿疾病的理论体系,曾提出多种辨治思路,尤以"调脾八方"为著,从脾入手治疗小儿杂病的特色临床思路应用广泛,诊治脾胃系病经验尤为丰富,笔者有幸跟随宋明锁教授学习多年,受益匪浅,近两年的跟诊中发现宋明锁教授治疗慢性小儿疾病多加用活血化瘀之品,加用后临床疗效更为明显,现简要介绍运用活血化瘀之品治疗小儿疾病经验如下.

呼吸道感染是儿科临床常见病症之一,小儿具有肺常不足的生理特点,如调护不当或感受外邪,导致肺失宣肃,易发生感冒、咳嗽、肺炎喘嗽等呼吸系统疾病,儿科门诊60％以上患儿均为呼吸道感染.中医认为呼吸系统疾病多是由于外感六淫、内伤脏腑,致使肺络受损,痰饮内生,肺气失宣所引起,病位在肺,其发病常以"风邪为患",《素问·太阴阳明论》曰:"伤于风者,上先受之".本病一年四季均可发生,以冬、春二季发病率高.部分患儿,由于体质因素,或治疗不规范、不彻底,可反复发作、迁延不愈,或病情加重,发展为肺炎喘嗽.而宋明锁老师在临床中,对呼吸道感染后的恢复期应用调脾和中汤加减以杜生痰之源,子病治母之意,经临床验证后,可明显缩短病程,愈后良好,现报告如下.

Background Characterizing and assessing the prevalence, awareness, and treatment patterns of patients with isolated diastolic hypertension (IDH) can generate new knowledge and highlight opportunities to improve their care. Methods and Results We used data from the China PEACE (Patient‐centered Evaluative Assessment of Cardiac Events) Million Persons Project, which screened 2 351 035 participants aged 35 to 75 years between 2014 and 2018. IDH was defined as systolic and diastolic blood pressure of <140 and ≥90 mm Hg; awareness as self‐reported diagnosis of hypertension; and treatment as current use of antihypertensive medications. Of the 2 310 184 participants included (mean age 55.7 years; 59.5% women); 73 279 (3.2%) had IDH, of whom 63 112 (86.1%) were untreated, and only 6512 (10.3%) of the untreated were aware of having hypertension. When compared with normotensives, participants who were <60 years, men, at least college educated, had body mass index of >28 kg/m2, consumed alcohol, had diabetes mellitus, and prior cardiovascular events were more likely to have IDH (all P<0.01). Among those with IDH, higher likelihood of awareness was associated with increased age, women, college education, body mass index of >28 kg/m2, higher income, diabetes mellitus, prior cardiovascular events, and Central or Eastern region (all P<0.05). Most treated participants with IDH reported taking only 1 class of antihypertensive medication. Conclusions IDH affects a substantial number of people in China, however, few are aware of having hypertension and most treated participants are poorly managed, which suggests the need to improve the diagnosis and treatment of people with IDH.

哨点监测男男性行为者(MSM)是艾滋病传播的重要高危人群[1]. 近年来,我国新发现人类免疫缺陷病毒(HIV)感染者中MSM所占比例越来越高[2]. 为了解山西省MSM艾滋病相关人口学特征、艾滋病知识知晓情况、行为特征、HIV感染状况,为制定干预措施提供依据. 对2015年山西省MSM哨点监测资料进行分析,现将结果报告如下.

目的:探讨健康宣教对艾滋病的防治效果.方法:选择辖区内360例艾滋病高危人群,包括180例暗娼和180例男同人员,随机分为两组,干预组和对照组,各180例,对照组成员不进行健康宣教,干预组成员进行健康宣教指导,比较两组人员艾滋病防治的效果.结果:接受监控时间内,对照组感染艾滋病的有21例,感染率为11.7%,干预组有3例,感染率为1.7%,干预组低于对照组(P<0.001).接受监控后干预组与对照组相比,艾滋病防治知识掌握评分高于对照组,有明显的差异(P<0.001).结论:采用健康宣教方式,对于艾滋病高危人群有着良好的预防效果,并且能够显著降低艾滋病感染率,还能有效提高对艾滋病防治的相关只是情况,可将其广泛地推广至疾病预防控制中心中去.

糖尿病是一种常见的内分泌代谢疾病,是由于人体内胰岛素缺乏或相对缺乏所致的一种慢性内分秘代谢性疾病,以糖代谢紊乱为突出表现,未治疗状态下高血糖为主要特征,并伴有蛋白质和脂肪代谢异常.随着生活方式的改变和老龄化进程的加速,我国糖尿病的患病率正在呈快速上升趋势,成为继心脑血管疾病、肿瘤之后的另一个严重危害人民健康的重要慢性非传染性疾病.它的急、慢性并发症,尤其是慢性病并发症累及多个器官,致残、致死率高,严重影响患者的身心健康,并给个人、家庭和社会带来沉重的负担[1].

<正>手足口病是由肠道病毒[以柯萨奇A组16型(CoxA16)、肠道病毒71型(EV71)多见]引起的急性传染病,多发于学龄前儿童,尤以3岁以下年龄组发病率高。少数病例(尤其是<3岁者)病情进展迅速,极少数病例病情危重,可致死亡。笔者于2011年5月至8月对我辖区内的某幼儿园利用晨间检查和指导性消毒措施有效地控制了手足口病的传播,现报告如下。

<正>铅是以神经毒性为主的重金属元素,对中枢和周围神经系统有明显的损害作用,儿童之所以对铅毒的易感性特别高,除了铅在体内的代谢特点之外,儿童的神经系统处于快速的生长发育时期,而血脑屏障发育不健全也是重要原因。从添加辅食开始对儿童进行早期持续的健康教育、营