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Exploration of reform and development of public health system in new era

Shanghai Journal of Preventive Medicine.2020;32(10):784-. doi:10.19428/j.cnki.sjpm.2020.20012

There are many risks for public health and safety such as new outbreaks, imported and unknown contagious diseases, although the incidence of communicable diseases has been controlled well in general.This represents many opportunities and challenges in the development of public health with Chinese socialist characteristics in new era."Healthy China" is part of the national strategic plan and an important ingredient of "Chinese Dreams" for the rehabilitation of Chinese Nation.The functions of Center for Disease Control and Prevention (CDC), as a very important part of public health system, should be clarified and defined again.CDC needs to be modernized under the contents and balanced in the following aspects:public welfare and professionalism, wartime or peacetime, hierarchy with provincial/municipal county tiers.The new technologies such as internet+, big data, artificial intelligence, precision medicine, health insurance should be applied and combined in innovative models, be developed in multiple directions, and be collaborated broadly.The aims are to develop a new and reasonable way to meet the new era requirement and the needs of developing public health law.Then public health will greatly contribute to the building of "Healthy China".

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Dental caries and oral cleaning behavior of 3-year-old children in Jing′an District, Shanghai

Qi-wen CHEN ; Le SHI ; Jia-qi LU ; Shuang YUAN

Shanghai Journal of Preventive Medicine.2020;32(10):788-. doi:10.19428/j.cnki.sjpm.2020.20003

Objective To investigate dental caries in 3-year-old children in Jing′an District of Shanghai and analyze the influence of oral cleaning behavior on caries in children. Methods Six hundread 3-year-old children from 12 kindergartens in Jing′an District, Shanghai were randomly selected by cluster sampling method for oral examination, and a self-administered questionnaire survey on children′s oral cleaning behavior was completed by parents.SPSS 22.0 software package was used for statistical analysis. Results Among the 600 children, the prevalence of dental caries was 42.50%, and the average dmft index was 1.76±2.92.Children who did not brush their teeth had a statistically significant increase in rate of dental caries(χ²=29.995, P < 0.001).Children who brushed their teeth for more than three minutes each time had a statistically significant lower rate of caries(χ²=3.918, P=0.048).Children whose parents helped their children brush their teeth every day had a lower rate of caries than those who brushed teeth by themselves, and the difference was statistically significant (χ²=8.718, P=0.013).Logistic regression analysis showed that age of beginning brushing teeth, times of brushing teeth per day and length of brushing teeth per time were all influence factors for caries in children (P < 0.05). Conclusion For the prevention and control of dental caries in 3-year-old, proper oral cleaning behavior is very important.We should make parents as a priority group for doing oral hygiene in children.Schools should strengthen oral health education for parents.Medical institutions should guide and monitor the effectiveness of oral hygiene in children.It is important to reduce the rate of dental caries in preschool children from three aspects:family, school and medical institutions.

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Effect of fluoride varnish on primary teeth in children aged 3-6 years in Huangpu District of Shanghai

Xiao-dan LIU ; Jia-xi SUN ; Wei-xing XU

Shanghai Journal of Preventive Medicine.2020;32(10):793-. doi:10.19428/j.cnki.sjpm.2020.19961

Objective To evaluate the implementation process, and cost-effectiveness of fluoride varnish in preventing primary caries project for children aged 3-6 years in Huangpu District.This would provide the basis for the popularization of fluoride varnish project in preschool children as a basic measure of caries prevention in community health service. Methods From 2016 to 2017, children aged 3-6 years old from 12 kindergartens in Huangpu District were varnished by fluoride twice a year.Three-years-old children in 12 kindergartens were divided into intervention group and control group according to the baseline survey results.The intervention group was implemented according to the established norms, while the control group was implemented according to the routine requirements.Follow-up examinations were conducted after 4 interventions to monitor primary caries increment among these children. Results Caries rate, average caries index and SiC in children aged 3, 4, 5 and 6 years were all dropped after fluorination in year of 2018.The caries rate of 5-year-old deciduous teeth decreased from 58.8% in 2015 to 45.0% in 2018.The dental caries rate in the intervention group was lower than that in the control group, and the frequency of fluoride application per capita was higher than that in the control group, showing a statistically significant difference (P < 0.05), but there was no significant difference in the rate of fluoride application and average caries index between the two groups (P > 0.05).The direct input-output ratio of the project is 1 : 5.16. Conclusion Fluorinated caries prevention project using fluoride varnish for preschool children can effectively reduce the incidence of dental caries in deciduous teeth and has good economic benefits.The application of standard fluorine coating on preschool children′s deciduous teeth can affect caries prevention.

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Effect of family oral health management on prevention of dental caries among preschool children in Huangpu District

Ru-yu CHEN ; Yi-jun WANG ; Wen-qi HU ; Hong-xia QU ; Ting-ting PAN

Shanghai Journal of Preventive Medicine.2020;32(10):797-. doi:10.19428/j.cnki.sjpm.2020.19560

Objective To evaluate the effectiveness of prevention of dental caries in preschool children by family-based oral health management. Methods A total of 144 families with 3 years old children in Huangpu District were randomly divided equally into intervention group and control group.The intervention period was 2 years.Semi-annual oral health guidance was given to families in the intervention group(including oral examination, children′s deciduous teeth coating with fluoride, dental caries filling, oral health lectures for families, distribution of family oral health brochures, etc.)Families in the control group received annual oral examination.After the intervention, the parents completed their child′s oral health questionnaire. Results In the 2-year oral monitoring period, the incidence of dental caries in the intervention group and the control group was 9.72% and 22.22%, respectively within one year, and the difference between the two groups was statistically significant(χ²=4.19, P < 0.05).The incidence of dental caries was 12.50% and 36.11% within two years, and the difference between the two groups was also statistically significant(χ²=10.91, P < 0.01).Result of the questionnaire survey showed that children in the intervention group had better eating and oral health habits than the control group, and the differences between the two groups were statistically significant(P < 0.05). Conclusion Regular and professional family oral health management can effectively reduce the incidence of dental caries and improve the oral health in preschool children.

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Influence of preschool children′s habits at home on the prevalence of caries in Huangpu District(Eastern Part)

Hong-xia QU ; Yi-jun WANG ; Ru-yu CHEN

Shanghai Journal of Preventive Medicine.2020;32(10):801-. doi:10.19428/j.cnki.sjpm.2020.19905

Objective To provide supporting evidence to prevention and controlling of caries in preschool children in Huangpu District(Eastern Part), by studying the influence of their habits at home on the prevalence of caries. Methods The oral health of preschool children in Huangpu District was examined, and their habits at home were recorded through survey questionnaire, including sugary diet, tooth brushing, parents′ attitude for oral health. Results Sugary diet could affect the prevalence of caries.There was no association between dental caries and times of tooth brushing.Parents′ attitude for oral health is the risk factor for the children′s caries. Conclusion Because of the higher prevalence of caries in the children in our district, effective measures should be taken.In addition, policy should consider how to ensure that children with high-risk dental caries receive adequate prevention and early care.

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Oral health status in elderly residents in Songjiang District of Shanghai

Li HUANG ; Zhi-xia HAN ; Dong-xin DA ; Chun-xia YAO ; Yong-gen JANG ; Ying ZHANG

Shanghai Journal of Preventive Medicine.2020;32(10):805-. doi:10.19428/j.cnki.sjpm.2020.19830

Objective To understand oral health of the elderly in nursing home in Songjiang District, Shanghai, and to provide references for improving their oral health. Methods A total of 375 elderly people in 15 nursing homes in Songjiang District were investigated by questionnaires and oral examination.Tooth loss, denture repair, periodontal condition and oral hygiene habit were analyzed. Results The rate of the tooth loss reached 94.13%.The tooth loss rate in females (96.09%) was significantly higher than that in males (91.03%) (P < 0.01).The rate of complete edentulous jaws was 28.27%.There was a significant difference between the rate of complete edentulous jaws in females (34.35%) and in males (18.62%)(P < 0.05).The rate of denture restoration was 91.51% (97/106).The number of existing teeth per capita was 11.54, and the number of teeth per capita in males (14.48 per person) was significantly higher than that in females (9.70 per person) (P < 0.05).Both the rate of the tooth loss of upper and lower posterior teeth were significantly higher than that of upper and lower anterior teeth (P < 0.01).Thirty-three percent (33.33%) of the elderly brushed their teeth more than twice a day, and almost 20.53% of them didn′t brush their teeth. Conclusion The oral health of the elderly in the nursing homes in Songjiang District is not satisfactory at present.It is necessary to strengthen the publicity and education of oral health care for the elderly in nursing homes in cooperation with multiple departments to improve their awareness of oral health care including appropriate tooth repair for the quality of life.

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Correlation between glucose and lipid metabolism and body mass index in patients with chronic respiratory diseases in Urumqi

Hua-lian PEI ; Wen-hui FU ; Tian TIAN ; Ze-wen ZHANG ; Tao LUO ; Jiang-hong DAI

Shanghai Journal of Preventive Medicine.2020;32(10):810-. doi:10.19428/j.cnki.sjpm.2020.20045

Objective To determine the relationship between abnormal blood glucose and lipid levels and body mass index in patients with chronic respiratory diseases. Methods This research was conducted in Urumqi baseline survey population from "Xinjiang multi-ethnic cohort study" in which patients with chronic bronchitis, emphysema and chronic obstructive pulmonary disease (COPD) were screened.The patients were defined as angular, normal, overweight, obesity groups according to body mass index (BMI), and were compared with blood levels of lipid and glucose, and rate of abnormal metabolism. Results A total of 6 046 subjects were included in the 2018 Urumqi cohort study, including 545 patients with chronic respiratory diseases.The prevalence of chronic respiratory diseases in different age groups and at different physical activity levels was different, and the prevalence of emaciation group was significantly higher than that of the other three groups.However, there were no statistically significant differences among people with different genders, nationalities, educational levels and whether they smoked or not.There were statistically significant differences in fasting glucose, serum cholesterol (TC) and serum high-density lipoprotein (HDL) levels among respiratory patients with different BMI (P < 0.05).The detection rates of hyperglycemia, high TG and low HDL increased with the increase of BMI.The result of multi-factor analysis showed that blood glucose, TG and HDL were the influencing factors of BMI. Conclusion Increase of body mass index in patients with chronic respiratory diseases is associated with abnormal glucose and lipid metabolism, which is not significantly different from that in patients with non-respiratory diseases.However, the body mass index and nutritional status of patients with long-term diseases should be closely monitored, and timely intervention measures should be taken to delay the disease process.

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The effect of systematic group music therapy on social living function and life quality in patients with schizophrenia

Yi-ying SUN ; Wei-zhong FU ; Xi-rong SUN ; Fa-zhan CHEN ; Hong-yun QIN ; Jie ZHANG ; Ting-ting JIANG

Shanghai Journal of Preventive Medicine.2020;32(10):816-. doi:10.19428/j.cnki.sjpm.2020.19908

Objective To study the effect of systemic group music therapy (SGMT) on social living function and life quality in patients with schizophrenia. Methods By systematic sampling, 160 patients were divided into intervention group (80 patients) and control group (80 patients).Patients in the intervention group were treated by SGMT, and the control group was treated by general care.Comparison was made before intervention and 18 months after intervention on the following:scores of social living function as determined by the Activity of Daily Living Scale (ADL), Social Disability Screening Schedule (SDSS), and Social Maladjustment (SOC) scale.The WHO quality of Life-BREF scale was used to analyze score changes of patients′ life quality. Results ADL, SDSS and SOC scores of the patients in intervention group were significantly lower than those in control group (P values all 0.05).In comparison of the life quality scores, physical health, mental health and social relationship scores were higher in intervention group than those in control group(P values all < 0.05).There was no significant difference between two groups in environment scores(P>0.05). Conclusion Implementation of SGMT intervention can efficiently improve patients′ social living function and quality of life.

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The effect of sunshine on blood level of Vitamin D and microalbuminuria in early stage diabetic nephropathy patients

Xiao-hong JIANG ; Shan HUANG ; Xiao-chen TAI ; Yu-bin TANG

Shanghai Journal of Preventive Medicine.2020;32(10):821-. doi:10.19428/j.cnki.sjpm.2020.19636

Objective To evaluate the effect of increasing sunshine time or 1, 25(OH)₂D₃ supplement on improving Vitamin D blood level and reduction of microalbuminuria in early stage diabetic nephropathy (DN) patients. Methods A total of 150 early stage type 2 DN patients with serum 25(OH)D₃ lower than 15 mg/L were included.The patients were divided into sunshine group (n=50), 1, 25(OH)₂D₃ supplement group (n=50), and control group (n=50).After three-month treatment, serum 25(OH)D₃ level and urinary albumin to creatinine ratio(ACR)were compared among these three groups. Results Before treatment, there were no differences in serum 25(OH)D₃, ACR, HbA1c among the three groups.After three-month treatment, serum 25(OH)D₃ level was significantly improved in sunshine group, and ACR was reduced significantly in both sunshine group and 1, 25(OH)₂D₃ group. Conclusion Increasing sunshine time can improve Vitamin D level and reduce microalbuminuria in early stage diabetic nephropathy patients.

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Awareness rate of cognitive impairment and memory clinic needs in middle-aged and elderly residents in Shanghai suburbs

Yu-hui FENG ; Jian-wen TAO ; Yan-yan HUANG

Shanghai Journal of Preventive Medicine.2020;32(10):825-. doi:10.19428/j.cnki.sjpm.2020.19525

Objective To investigate the awareness rate of cognitive impairment and the needs for memory clinic in middle-aged and elderly residents in Shanghai suburb area. Methods A convenient sampling method and questionnaire survey were used in 289 outpatients in the No.1 Community Health Service Station of Dachang Community Health Service Center, Baoshan District in March 2019. Results Residents generally had less knowledge about their cognitive impairment, only 7.61% of residents were familiar with the disease.These residents who took part in the questionnaire survey showed higher interest about memory problems occurring in themselves and/or their relatives, 78.55% of them agreed that the memory test should be added in the annual physical examination for elders, and 91.35% thought that further mental examination should be taken if they had memory problems.Contrary to the large demands for memory clinic(65.05%), there was a lower awareness rate (19.03%) for medical institutions which had memory clinic. Conclusion The health promotion work related to cognitive impairment should be comprehensively carried out, and the publicity channels about memory clinic in local area or district should be increased so that residents in need can see a doctor in time.

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