目的 探讨家庭医生签约服务在健康村创建中的实践与成效。方法 于2017年9月—2018年2月对834例团星村35岁以上居民进行免费健康体检,分析居民的健康状况,并比较其中247例（170例高血压、77例糖尿病）患者开展家庭医生签约服务前后的疾病知晓率、自我控制情况、血压及血糖水平。结果 834例35岁以上居民中,家庭医生服务的签约率为（682/834）81.77%,有（170/834）20.38%例高血压,糖尿病（77/834）9.23%例;高脂血症（398/834）47.72%例;247例高血压、糖尿病患者签约后疾病的知晓率均高于签约前（P<0.05）,签约后患者自我控制情况优于签约前（P<0.05）,签约后患者的血压、血糖水平优于签约前（P<0.05）。结论 家庭医生签约服务能够利于慢性疾病的筛选与控制,提高居民对于疾病知识的认知,值得推广。

目的 对信息协作平台的社区结直肠癌三级防治及干预体系进行探索与实践。方法 对纳入本次研究的2 492名社区人群进行问卷调查,包括健康人群1 118人,1 374例肿瘤患者。分析健康人群和肿瘤患者关于肿瘤防治知识及途径的认知情况,比较健康人群和肿瘤患者就诊首选医院,了解肿瘤患者就诊流向和行为以及发现患癌的途径。结果 在肿瘤患者中知道癌前病变、早期肿瘤症状、高危人群的比例显著高于健康人群[26.93%(370/1 374)、39.96%(549/1 374)、46.00%(632/1 374)比14.49%(162/1 118)、21.91%(245/1 118)、26.92%(301/1 118)]。健康人群认为肿瘤三级防治网络可行、会参加三级防治网、有必要开展癌症筛查、会参加筛查的比率显著高于肿瘤患者[98.83%(1 105/1 118)、91.95%(1 028/1 118)、98.12%(1 097/1 118)、98.03%(1 096/1 118)比81.95%(1 126/1 374)、79.98%(1 099/1 374)、80.93%(1 112/1 374)、85.95%(1 181/1 374)],差异均有统计学意义(P<0.05)。健康人群把三甲医院视为就诊首选医院的比率显著低于肿瘤患者[32.56%(364/1 118)比86.97%(1 195/1 374)](P<0.05)。肿瘤患者中发现肿瘤及确诊医院、肿瘤复诊、康复医院的选取主要以三甲综合医院为主。在肿瘤患者中因身体不适到医院就诊发现患癌的比率显著高于单位员工体检、自检发现、社区卫生服务中心体检发现的比率。结论 我国目前肿瘤发病率和死亡率正处在快速上升的阶段,利用网络优势,加大肿瘤防治知识的宣传力度,建立社区、区域二级医院、三级医院优势互补的三级肿瘤防控体系,是当前我国肿瘤防治的迫切需求。

Objective To explore and practice the community tertiary prevention and intervention system for colorectal cancer based on information collaboration platform. Methods A questionnaire survey was conducted among 2 492 community residents which were included in this study, including the healthy crowd of 1 118 people, 1 374 cases of tumor patients. The study was to analyze the knowledge of cancer prevention and treatment in healthy people and cancer patients, to contrast the preferred hospital by healthy people and cancer patients, to acquaint the flow direction in seeking medical service, behavior and way to diagnosis cancer of tumor patients. Results In patients with cancer, the understanding proportion of patients with precancerous lesions, early tumor symptoms, and high risk groups was significantly higher than that in healthy people [26.93% (370/1 374), 39.96% (549/1 374), 46.00% (632/1 374) vs 14.49% (162/1 118), 21.91% (245/1 118), 26.92% (301/1 118)]. In healthy people, the proportion of identification of tumor three-grade prevention and control network, willing to participate in the tertiary prevention and control network, necessity to carry out cancer screening, willing to participate in screening was significantly higher than that in patients with cancer [98.83% (1 105/1 118), 91.95% (1 028/1 118), 98.12% (1 097/1 118), 98.03% (1 096/1 118) vs 81.95% (1 126/1 374), 79.98% (1 099/1 374) and 80.93% (1 112/1 374), 85.95% (1 181/1 374)]. There were significantly differences (P<0.05). Healthy people preferred to choose common hospital instead of 3A hospital as the first choice [32.56% (364/1 118) vs 86.97% (1 195/1 374)] (P<0.05). Discovery and diagnosis of cancer, further consultation, and rehabilitation were mainly carried out in 3A hospital. In patients with cancer, the cancer discovery ratio because of physical discomfort for medical attention was significantly higher than that in unit staff physical examination, self-inspection found, and physical examination in community health service center. Conclusion At present, the incidence and mortality of cancer in our country is in a stage of rapid rising. It's an urgent need for cancer prevention and control in China that making use of the advantage of network to improve the propaganda of the knowledge of cancer prevention and control, and establishing complementary advantages of the tertiary cancer prevention and control system by community, regional hospitals, and 3A hospitals.

目的 了解脑卒中患者对社区康复的认知和需求情况。方法 对广州市从化区街口街社区475例脑卒中患者进行问卷调查,调查患者对社区康复认知和需求等相关内容。结果 对脑卒中社区康复知晓者293人,知晓率为61.7%。对社区康复有需求者258人,需求率为54.3%。在对社区康复知晓人群中,文化程度在中学以上、家庭经济≥5000元/月、付费方式为非自费者知晓率较高(P<0.05); 年龄及性别因素无差异(P>0.05)。在对社区康复有需求的人群中,年龄<60岁、男性、文化程度中学以上、家庭经济≥5000元/月、付费方式为非自费者需求率较高(P<0.05)。需求内容最多的是日常活动支持,达100%,需求内容最少的为专业器械支持,仅为26.0%。功能障碍程度越高的脑卒中患者对心理支持、药物支持、专业人员及专业器械支持的需求越高(P<0.05)。结论 脑卒中患者对社区康复的知晓和需要情况一般,仍需多方面的共同努力,促进脑卒中社区康复的开展和发展。

目的 检测年轻原发性高血压病患者(≤40岁)血清中D-二聚体(D-Dimer)、超敏C反应蛋白(CRP)的表达水平并观察两者的相关性。方法 收集原发性高血压病的年轻患者40例作为观察组,无高血压病等心脑血管疾病的社区居民40例作为对照组,晨起空腹抽血,电化学发光法测定血清D-Dimer、CRP表达量,同时行Pearson检验分析两者关联性。结果 观察组血清D-Dimer、CRP表达量较对照组均升高(P＜0.05),结果存在统计学意义;观察组D-Dimer、CRP阳性率较对照组均升高(P＜0.05);且两者相关,相关系数r=0.71,P＜0.01。结论 年轻原发性高血压病患者血清D-Dimer及CRP的表达量较无高血压病居民提高,且D-Dimer与CRP在机体内的表达存在相关性,上述两种血清标记物作为高血压疾病发生、发展评价指标的相关价值值得探究。

Objective To detect the serum D-Dimer and C-reactionprotein expression levels in essential hypertension patients and observe the correlation between both of them. Methods 40 young essential hypertension patients as observer group; and 40 persons without hypertension as control group. After taking the fasting blood, the serum level of D-Dimer and CRP was detected using electrochemiluminescence method. Simultaneously, the correlation of D-Dimer with CRP was tested using Pearson correlation coefficient. Results The serum level of D-Dimer and CRP was higher in young essential hypertension patients than those in the control group. And the difference was statistically significant (P<0.05). In 80 patients, the serum levels of D-Dimer and CRP were significantly correlated, and correlation coefficient r=0.71, there was significant difference (P<0.01). Conclusion D-Dimer and CRP are significantly increased in the serum of advanced young essential hypertension patients. And the serum level of D-Dimer is significantly correlated with the serum level of CRP in young essential hypertension patients. D-Dimer as an indicator of essential hypertension after review of the value worthy of further study.