Physical Examination Center Research Articles

Relationship between parenting stress and behavioral and emotional problems in preschool children: A mediation effect analysis.

Emotional reactions, such as anxiety, irritability, and aggressive behavior, have attracted clinical attention as behavioral and emotional problems in preschool-age children. To investigate the current status of family rearing, parental stress, and behavioral and emotional problems of preschool children and to analyze the mediating effect of the current status of family rearing on parental stress and behavioral/emotional problems. We use convenience sampling to select 258 preschool children in the physical examination center of our hospital from October 2021 to September 2023. The children and their parents were evaluated using a questionnaire survey. Pearson's correlation was used to analyze the correlation between child behavioral and emotional problems and parental stress and family rearing, and the structural equation model was constructed to test the mediating effect. The score for behavioral/emotional problems of 258 preschool children was (27.54 ± 3.63), the score for parental stress was (87.64 ± 11.34), and the score for parental family rearing was (31.54 ± 5.24). There was a positive correlation between the behavioral and emotional problems of the children and the "hostile/mandatory" parenting style; meanwhile, showed a negative correlation with the "support/ participation" parenting style (all P < 0.05). The intermediary effect value between the family upbringing of parents in parental stress and children's behavior problems was 29.89%. Parental family upbringing has a mediating effect between parental stress and behavioral and emotional problems of children. Despite paying attention to the behavioral and emotional problems of preschool-age children, clinical medical staff should provide correct and reasonable parenting advice to their parents to promote the mental health of preschool-age children.

The Relationship Between the Neighbourhood Environment and Mental Health: Integrating Subjective and Objective Perspectives.

To explore the relationship between neighbourhood environments and mental health by integrating subjective and objective perspectives. A cross-sectional study. From September 2023 to January 2024, adult residents at the physical examination centers of two public hospitals in China completed measurements of subjective neighbourhood environment, depressive and anxiety symptoms, psychological stress, and socio-demographic characteristics. Geographic information systems (GIS) were employed to extract objective environmental data including parks, bus stops, sports facilities, leisure facilities, residential housing, restaurants, food retail facilities, and street connectivity within a buffer zone of 500-m radius of the participants' residential areas. Data were analysed using univariate and multiple logistic regression analyses. This study included 438 participants (mean age, 36.98 ± 11.05 years; 55.3% female). The mean scores for depression, anxiety, and psychological stress were 3.55 ± 2.99, 3.16 ± 2.91, and 13.11 ± 4.88, respectively. The total score of the subjective neighbourhood environment was 78.33 ± 10.63, with the mean scores of each dimension ranging from 5.14 to 23.76. After adjusting for potential confounders, higher scores on street environment and higher density of sports facility were statistically significantly associated with reduced risk of depressive symptoms and psychological stress. Additionally, higher scores on walking environment and social cohesion were significantly associated with reduced risk of anxiety symptoms. This study found that street environments, walking environments, social cohesion, and density of sports facilities were independently associated with the mental health of adult residents in China. The findings provide valuable insights for healthcare providers to consider specific health-related environmental factors and develop tailored interventions to promote the mental health of the residents. Understanding the relationship between the subjective and objective environmental factors on mental health is crucial for developing effective intervention strategies, preventing psychological issues, enhancing the quality of care, and advancing public health policies and research. The study was reported following the strengthening of the reporting of observational studies in epidemiology (STROBE) guidelines. No patient or public contribution.

A retrospective analysis of the clinical characteristics of 63 patients with vestibular neuritis

Objective:To retrospectively analyze the results of auditory examination,vestibular function examination and laboratory examination of 63 patients diagnosed as vestibular neuritis.Methods:A total of 63 patients diagnosed with vestibular neuritis hospitalized in the Department of Otolaryngology, Head and Neck Surgery of the Third Affiliated Hospital of Sun Yat-sen University, from October 2012 to December 2022 were recruited. All patients met the diagnostic criteria for the 2022 Bárány association vestibular neuritis. Clinical data and the results of pure tone audiometry, electrocochleogram, video electronystagmogram, caloric test, cervical vestibuloevoked myogenic potential（cVEMP）, ocular vestibuloevoked myogenic potential（oVEMP）, video head impulse test（vHIT） was collected.A total of 63 age-and sex-matched healthy subjects in the physical examination center were randomly selected as the control group. The differences of blood indexs and lipid metabolism indexes between the two groups were compared. Results:In patients with vestibular neuritis, 50 out of 63 patients presented normal threshold in pure tone audiometry, 8 out of 63 patients had bilateral high-frequency sensorineural hearing loss and 5 out of 63 patients had unilateral mild high-frequency sensorineural hearing loss, 56 out of 63 cases completed the electrocochleogram, of which 3 cases had a binaural-SP/AP amplitude ratio≥0.4, 5 cases had monaural amplitude ratio ≥0.4. Fifty-five out of 63 patients completed the caloric test with CP values greater than 30% in all. The ratio of patients completed cVEMP, oVEMP and vHIT were 46 cases, 22 cases and 30 cases, respectively. 17 out of 63 cases completed all the four vestibular function tests. According to these tests, 49 patients could determine the extent of injury，including 27 cases with unilateral superior vestibular nerve injury, 21 cases with unilateral superior and inferior vestibular nerve injury and 1 case with unilateral inferior vestibular nerve injury. There were significant differences in neutrophil value（P<0.001）, lymphocyte value（P<0.005）, neutrophil/lymphocyte ratio（P<0.001） and apolipoprotein A1（P<0.001） between patient group and control group. Inflammatory markers were risk factors for patients with vestibular neuritis. The OR values of neutrophil value and blood neutrophil/lymphocyte ratio were 1.81（1.38-2.37, P<0.001） and 2.11（1.41-3.16, P<0.001）, respectively. Apolipoprotein A1 was a protective factor for patients with vestibular neuritis, and the OR value was 0.004（0.001-0.042, P<0.001）. Conclusion:Electrocochleogram could be used in vestibular neuritis patients with normal pure tone threshold to test whether there is hidden hearing loss in these patients. Neutrophil value, lymphocyte value, neutrophil/lymphocyte ratio and apolipoprotein A1 were correlated with vestibular neuritis. The Neutrophil value and neutrophil/lymphocyte ratio were risk factors for morbidity.

Characteristics of airway microbiome co-occurrence network in patients with type 2 and non-type 2 asthma

Objective: To study the characteristics of the airway microbiome co-occurrence network in patients with type 2 and non-type 2 asthma. Methods: In a prospective study based on a cohort of asthma patients, respiratory induced sputum samples were collected from 55 asthma patients [25 males and 30 females, with a median age of 47.7 years (age range 34.3-63.0 years)] admitted to the Department of Respiratory and Critical Care, Beijing Chaoyang Hospital, Capital Medical University and 12 healthy controls from the Physical Examination Centre of Beijing Chaoyang Hospital, Capital Medical University, from May 2021 to May 2022. According to the level of exhaled breath nitric oxide (FeNO), the asthma patients were divided into 22 cases in the high FeNO group (FeNO≥40 ppb, i.e., type 2 asthma group) and 33 cases in the low FeNO group (FeNO<40 ppb, i.e., non-type 2 asthma group). All induced sputum samples were subjected to second-generation macrogenomic sequencing and bioinformatic analyses of microbial community diversity, compositional characteristics, symbiotic network characteristics and metabolic function prediction. The Kruskal-Wallis rank sum test was used for between-group comparisons, and the linear discriminant analysis (LEfSe) method was used to compare the differences in flora composition between groups. The R language was used for microbial network analysis. In addition, PICRUSt was used to predict the metabolic-functional characteristics of the microbial communities. Results: The microbial communities in the healthy control group had a lower proportion of p_Firmicutes and p_Proteobacteria than asthma patients, 29% and 21%, respectively; 37% and 33% in the low FeNO group and 42% and 26% in the high FeNO group. The microbial network in the low FeNO group had 64 pairs of edges forming 16 communities, and about 75% of the nodes had eigenvector centrality values between 0 and 0.05, and 25% of the nodes had eigenvector centrality values between 0.10 and 0.45. There were four layers of κ-nucleosynthesis, and about 42% of the vertices were in the centre of the two layers. The microbial network of the high-FeNO group had 80 pairs of edges forming 18 clusters, and 81% of the nodes had eigenvector centrality values between 0 and 0.05, and 19% of the nodes had eigenvector centrality values between 0.10 and 0.35. The κ-nucleus decomposition had eight layers, and 21% of the vertices were located in the centre's two layers. The main functional differences between the low and high FeNO groups were shown in metabolic pathways (including sugar, lipid, amino acid, and energy metabolism), drug resistance, biofilm transport, signalling, intercellular communication, and cellular repair. Conclusions: Compared with non-type 2 asthmatics, type 2 asthmatics had a higher alpha diversity of respiratory microbiota, lower levels of microorganisms in the p_Proteobacteria, and a more aggregated microbial network. There was a significant difference in the predicted metabolic function of the two endotypes of asthmatics.

Cross-sectional and Mendelian randomization study of fibroblast growth factor 19 reveals causal associations with metabolic diseases.

Fibroblast growth factor 19 (FGF19) is an intestinal-derived factor that plays a role in metabolic diseases. We performed a differential study of circulating FGF19 levels and investigated the causal effects of FGF19 on metabolic diseases using Mendelian randomization (MR). Firstly, 958 subjects were included in the physical examination center of affiliated hospital from January 2019 to January 2021. Dividing the subjects into different subgroups to compare FGF19 levels. We conducted a two-sample MR analysis of genetically predicted circulating FGF19 in relation to alcohol, cardiovascular and metabolic biomarkers and diseases, and liver function biomarkers using publicly available genome-wide association study summary statistics data. The circulating FGF19 levels in nonalcoholic fatty liver disease (NAFLD) patients were lower than those without NAFLD (P<0.001). The FGF19 levels in participants with obese were lower than those without obese (P<0.001). In two-sample MR analyses, genetically predicted higher circulating FGF19 levels was significantly associated with lower aspartate aminotransferase, γ-glutamyltransferase, triglycerides, total cholesterol, low-density lipoprotein, and C-reactive protein concentrations (P<0.05) and a negative correlation with cardiovascular disease and cirrhosis whereas a positive association with type 2 diabetes mellitus (P<0.05). Our study found that circulating FGF19 levels were lower in NAFLD and obese populations. Additionally, our MR research results support the causal effects of FGF19 on improved liver function, lipids, and reduced the occurrence of inflammation, cardiovascular disease, and cirrhosis. We found a positive correlation with diabetes, which may indicate a compensatory increase in regulating above FGF19 resistance states in humans.

Association between triglyceride-glucose index and risk of kidney stone: a Chinese population-based case–control study

ObjectiveTo investigate the association between the triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance and the risk of kidney stones (KSs) in a Chinese population.DesignCase–control study.SettingThree Physical Examination Centers...

Correlation analysis of the risk of ischemic stroke with related risk factors in a health examination population.

To explore the correlation between the risk of ischemic stroke and related risk factors in a health examination population. This was a retrospective study. A total of 300 subjects undergoing health examination in the physical examination center of Baoding NO.1 Central Hospital were selected from January 2023 to December 2023, and divided into the normal group (Group-N) and the risk group according to the criteria of cerebral hemodynamic integral value(CVHI). The risk group was further subdivided into three groups, including the high-risk group(Group-H), the medium-risk population(Group-M), and the low-risk group(Group-L), with 75 subjects in each group. The general data, including BMI, smoking, and the incidence of hypertension, diabetes, and hyperlipidemia, were analyzed and compared between the two groups. Multivariable logistic regression analysis was conducted using stroke risk factors as the dependent variables after assignment, and it was found that BMI, smoking, hypertension, diabetes, hyperlipidemia, and hyperuricemia were independent risk factors for ischemic stroke (P<0.05); the incidence of obesity and overweight, smoking, hypertension, hyperlipidemia, and hyperuricemia were significantly increased in Group-H compared with those in groups M, L, and N, with statistically significant differences(P<0.05). The chi square test showed statistically significant differences in the stroke risk factors among different age groups (P<0.05). The incidence of ischemic stroke risk factors varies among different age groups in the health examination population, and is related to poor lifestyle and underlying diseases.

Association between multiple metals exposure and metabolic dysfunction-associated fatty liver disease among Chinese adults

BackgroundPrevious research has investigated the hepatotoxicity of single metal exposure. However, there is limited evidence about metal mixture and their association with metabolic dysfunction-associated fatty liver disease (MAFLD), particularly in the Chinese population. ObjectiveTo investigate the individual and combine effects of 20 metals on MAFLD in a large population in China. MethodsThis study included 3651 participants from the Medical Physical Examination Center of Tongji Hospital, Wuhan, China. MAFLD was identified based on ultrasonic graphic evidence of hepatic steatosis and the presence of overweight/obese, diabetes mellitus, or metabolic dysregulation. Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine urinary concentrations of 20 metals. Logistic regression was used to assess the relationship between individual metal and MAFLD, with results presented as odds ratios (ORs) and 95 % confidence intervals (CIs). Weighted quantile sum (WQS) regression was performed to evaluate the combine effect of metals. ResultsThe prevalence of MAFLD among the participants was 32.1 % (1173/3651). In singe-metal analysis, high exposure to zinc (OR =1.42; 95 % CI = 1.27, 1.59) and selenium (OR = 1.23; 95 % CI = 1.10, 1.39) were positively associated with MAFLD. No significant association was found for other metals. WQS regression analysis showed that urinary metal mixture was positively associated with MAFLD (OR = 1.32, 95 % CI: 1.15, 1.51), with zinc (50.4 %) being the largest contributor, followed by barium (10.8 %). ConclusionsIn conclusion, our finding suggested that exposure to the mixture of metals was positively correlated with MAFLD, with zinc being the major contributor.

Integrating VAI-Assisted Quantified CXRs and Multimodal Data to Assess the Risk of Mortality.

To address the unmet need for a widely available examination for mortality prediction, this study developed a foundation visual artificial intelligence (VAI) to enhance mortality risk stratification using chest X-rays (CXRs). The VAI employed deep learning to extract CXR features and a Cox proportional hazard model to generate a hazard score ("CXR-risk"). We retrospectively collected CXRs from patients visited outpatient department and physical examination center. Subsequently, we reviewed mortality and morbidity outcomes from electronic medical records. The dataset consisted of 41,945, 10,492, 31,707, and 4441 patients in the training, validation, internal test, and external test sets, respectively. During the median follow-up of 3.2 (IQR, 1.2-6.1) years of both internal and external test sets, the "CXR-risk" demonstrated C-indexes of 0.859 (95% confidence interval (CI), 0.851-0.867) and 0.870 (95% CI, 0.844-0.896), respectively. Patients with high "CXR-risk," above 85th percentile, had a significantly higher risk of mortality than those with low risk, below 50th percentile. The addition of clinical and laboratory data and radiographic report further improved the predictive accuracy, resulting in C-indexes of 0.888 and 0.900. The VAI can provide accurate predictions of mortality and morbidity outcomes using just a single CXR, and it can complement other risk prediction indicators to assist physicians in assessing patient risk more effectively.

When do people switch queues? An empirical study of discretionary queue switching at a physical examination center

AbstractAutomatic queueing systems have been applied in many practical settings to guide customers through a sequence of service stages and achieve efficient queueing. However, our field observations of queueing from a large‐scale physical examination center, which adopts an automatic assignment system with the option of discretionary switching, reveal a relatively high likelihood of queue‐switching requests. That is, many queuers request overriding the algorithm's sequence and ask for a different one, leading to increased total waiting times. Motivated by these observations, this study investigates the behavioral mechanisms behind driving queuers’ switching decisions. Specifically, we examine the roles of two competing mechanisms as the waiting progresses: the motivation to explore a better opportunity (to reduce waiting time) and the consumption of cognitive resources for self‐control to adhere to the assigned queue. Our empirical results reveal a U‐shaped relationship between the examinees’ tendency to switch and the service progress. This U‐shaped relationship steepens when more (vs. less) queuers are ahead of the focal examinee and when the time is (vs. is not) “on an hour” (e.g., 9:00 and 10:00). This study contributes to the behavioral theory of queueing systems through a novel perspective highlighting the competing mechanisms driving individuals’ algorithm aversion behavior (i.e., queue switching) during the progress of multiple services, providing insights into how to design efficient queueing systems.

Construction and evaluation of two nomograms for screening major depressive disorder and subthreshold depression individuals based on anxiety, depression, and sleep items

BackgroundCurrent evidence is insufficient to support specific tools for screening Major Depressive Disorder (MDD). Early detection of subthreshold depression (SD) is crucial in preventing its progression to MDD. This study aims to develop nomograms that visualize the weights of predictors to improve the performance of screening tools. MethodsParticipants were recruited from Peking University Sixth Hospital and Beijing Physical Examination Center between October 2022 and April 2024. The Mini-International Neuropsychiatric Interview (MINI) 5.0.0 was employed as the diagnostic gold standard, and Generalized Anxiety Disorder questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Pittsburgh Sleep Quality Index (PSQI) were employed to assess anxiety, depression, and sleep state. The nomograms were constructed by incorporating optimal predictors, selected through the Least Absolute Shrinkage and Selection Operator (LASSO), into a multivariate logistic regression model to estimate the probability of MDD and SD. ResultsAfter matching age and education, 164 participants were included in each group for analysis. Both nomograms demonstrated superior discrimination, calibration, and clinical applicability compared to PHQ-9. Anxiety emerged as a most significant predictor for SD, while sleep problems exhibited high rankings for both SD and MDD. The two predictors subsequently affect concentration and daytime functioning. LimitationsWith a lack of external validation data, the performance of nomograms may be overestimated. ConclusionsThis study is the first attempt to develop a nomogram for predicting SD, while also providing a nomogram for MDD. The crucial predictors offer valuable insights into potential variables for clinical intervention.

Sex differences in Helicobacter pylori infection and recurrence rate among 81,754 Chinese adults: a cross-sectional study

ObjectiveTo compare the sex differences of Helicobacter pylori (HP) infection rate and 1-year recurrence rate.MethodsA cross-sectional study was conducted on the prevalence of HP infection in 81,754 people who underwent physical examination in physical examination centers and outpatient clinics of the Affiliated Hospital of Gansu University of Traditional Chinese Medicine, the Second People’s Hospital of Zhangye City, Tianshui City Hospital of Integrated Chinese and Western Medicine, the First and Second Department of The First Hospital of Lanzhou University Physical Examination Center, from March 2010 to December 2019. Among them, 53,771 (65.77%) were males (18–91 years old) and 27,983 (34.23%) were females (18–94 years old). According to age, they were divided into young group, middle-aged group and old group. 1448 asymptomatic infected patients were selected and treated with bismuth-containing quadruple drug eradication therapy for 2 weeks. The eradication rate and recurrence rate after 1 year were compared between males and females.ResultsThe overall infection rate was 49.59%, including 49.74% in males and 49.3% in females. The risk of infection in young women was lower than that in men (OR = 0.908, 95%CI: 0.868–0.95, P < 0.01), the risk of infection in older women was higher than that in men (OR = 1.137, 95%CI: 1.041–1.243, P < 0.01). The female infection rate was positively correlated with age from 18 to 60, and Spearman’s correlation coefficient was 0.825 (P < 0.01). The overall eradication rate was 84.67% in intention-to-treat analysis (ITT) and 88.46% in protocol analysis (PP). The eradication rates of ITT and PP in the older group were 78.38% and 82.27%, respectively, which were lower than 87.25% and 89.39% in the male group (P < 0.05). The 1-year overall recurrence rate was 3.86%, including 2.82% in males and 5.44% in females (P < 0.05), female was a risk factor for recurrence after eradication after controlling for age (OR = 2.177, 95%CI 1.166–4.066, P < 0.05). There were no obvious adverse reactions during the treatment.ConclusionThere is a positive linear correlation between HP infection rate and age increase in women. Older women have the characteristics of high HP infection rate, low eradication rate and high recurrence rate.

Correlation between the TyG-BMI index and carotid plaque characteristics in middle-aged and elderly patients with acute myocardial infarction.

The aim of this study is to investigate the correlation between the triglyceride-glucose-body mass index (TyG-BMI) and the characteristics of various carotid plaques in middle-aged and elderly patients with acute myocardial infarction (AMI). A retrospective study was conducted on 380 patients with AMI hospitalized in the Cardiology Department of Kaifeng Central Hospital. Based on carotid ultrasound results, patients were divided into the following two groups: the stable plaque group and the unstable plaque group. Additionally, a control group comprising 380 healthy individuals visiting the hospital's physical examination center during the same timeframe was established. Fasting venous blood samples were collected from all participants to measure blood glucose and triglyceride. The baseline TyG-BMI index was calculated using the formula Ln [fasting triglyceride (mg/dL)×fasting blood glucose (mg/dL)/2]×BMI. The correlation between different plaque groups and the TyG-BMI index was analyzed. The TyG-BMI index was significantly higher in the unstable plaque group compared to the stable plaque group, with values of 252.81±29.99 and 201.92±28.72, respectively (P = 0.034). Spearman's correlation analysis showed a positive correlation between the instability of carotid plaques and the TyG-BMI index in patients with AMI (r = 0.521, P = 0.003). Logistic regression analysis indicated that the TyG-BMI index was an important risk factor for unstable carotid plaques in patients with AMI (OR = 2.691, 95% CI: 1.169-4.123). The findings of this study suggest that an elevated TyG-BMI index significantly increases the risk of unstable carotid plaques in patients with AMI, making it an important risk factor for carotid plaque instability.

The Association Between Changes in Body Mass Index and the Risk of Depression.

In recent years, the risk of depression has increased among young people, and changes in body mass index (BMI) during childhood may be important factors in their development. However, the relationship between changes in BMI during childhood and the risk of depression needs further research and exploration. The annual health examination data were collected from Physical Examination Center of Wuhan Mental Health Center Hospital, including 1226 students. The height and weight of students at the age of 11, 14, and 17 were recorded in sequence, and at 18 years old, these students were followed up according to the Hamilton Depression Scale (HAMD) to evaluate the depression. The relationship between BMI trends and depression was analyzed through Logistic regression analysis. The growth trend of BMI was divided into normal growth, slow growth, and excessive growth. The odds ratio (OR) value for depression in the slow growth was 1.218 (95% CI, 0.995-1.493) compared to the normal growth, which was no significant difference (P = .056). The OR value for depression in the excessive growth was 1.982 (95% CI, 1.243-3.177) compared to the normal growth, which was significant difference (P = .003). The rapid growth of BMI is correlated with the occurrence of depression in young individuals and may be a contributing factor to the development of depression in this demographic.

Knowledge, attitude, and practice toward sarcopenia among older adults in two cities in Zhejiang province, China

ObjectiveTo explore the knowledge, attitudes, and practice (KAP) towards sarcopenia among older adults in Zhejiang province, China. MethodsThis cross-sectional study was conducted between April 2023 and January 2024 among older community residents who participated in a physical examination in Shaoxing People’s Hospital Physical Examination Center, Shaoxing Yuecheng District Fushan Street Community Health Service Center, Shaoxing Yuecheng District Beihai Street Community Health Service Center, Shaoxing City, and Outpatient Department of Yongkang First People’s Hospital. Their demographic characteristics and KAP towards sarcopenia were collected by a self-designed questionnaire. Structural equation modeling (SEM) was used to explore the relationship among KAP dimensions. ResultsA total of 1092 valid questionnaires were included. The median knowledge, attitude, and practice scores were 0 (0, 0) (possible range: 0–22), 31 (30, 31) (possible range: 8–40), and 17 (15, 21) (possible range: 6–30), respectively. The SEM showed that knowledge directly positively influenced attitude (β = 0.121, P < 0.001) and practice (β = 0.171, P < 0.001). Attitude directly positively influenced practice (β = 0.116, P < 0.001); therefore, the knowledge showed an indirect influence on practice via attitude. ConclusionOlder adults in two cities in Zhejiang province, China, showed insufficient knowledge but moderate attitude and practice towards sarcopenia. It is imperative to design interventions to improve knowledge about sarcopenia and improve self-management and patient outcomes.

Diagnostic Value of Interleukin 6, Interleukin 12P70, Serum Amyloid A, and Procalcitonin for Rheumatoid Arthritis and Their Relationship With the Disease Activity

To observe the diagnostic value of four serum inflammatory biomarkers, including interleukin 6 (IL-6), interleukin 12P70 (IL-12P70), serum amyloid A (SAA), and procalcitonin (PCT), in rheumatoid arthritis (RA) and to analyze their relationship with the disease activity. The study included 60 RA patients admitted to the Department of Rheumatology at Anhui Provincial Hospital of Traditional Chinese Medicine between December 2022 and December 2023. Thirty healthy individuals from the hospital's physical examination center served as the control group. Serum levels of IL-6 and IL-12P70 were detected using flow cytometry. SAA levels were determined by immunoturbidimetry, and PCT levels were assessed by chemiluminescence. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), and anticyclic citrullinated peptide (ACCP) were detected using an automated biochemical analyzer. The 28-joint disease activity scores (DAS28-ESR) based on ESR were observed. Statistical analysis included t-tests, rank-sum tests, and Kruskal-Wallis H tests to compare the expression differences of the biomarkers among different groups. The diagnostic value of these biomarkers for RA was analyzed by ROC curve analysis. Spearman correlation analysis was performed to assess the relationships between the four inflammatory biomarkers and CRP, ESR, RF, ACCP, and DAS28-ESR. 1) The expression levels of SAA, IL-6, and IL-12P70 in the RA group were significantly higher than those in the control group (P<0.01). 2) ROC curve analysis showed that the area under the curve (AUC) for PCT was 0.611 (95% confidence interval [CI]: 0.488-0.735, P>0.05), for SAA, it was 0.819 (95% CI: 0.733-0.906, P<0.01), for IL-6, it was 0.875 (95% CI: 0.803-0.946, P<0.01), and for IL-12P70, it was 0.832 (95% CI: 0.746-0.917, P<0.01). The combined index of IL-6, IL-12P70, SAA, and PCT had an AUC of 0.973 (95% CI: 0.942-1.000, P<0.01). This indicates that the four inflammatory biomarkers can assist in the diagnosis of rheumatoid arthritis. 3) The expression levels of PCT and SAA varied significantly among the high, moderate, and low activity RA groups (P<0.01). 4) In RA patients, CRP was positively correlated with SAA (rs =0.75, P<0.01), and IL-6 (rs =0.52, P<0.01). ESR was positively correlated with SAA (rs =0.36, P<0.01). DAS28-ESR was positively correlated with PCT (rs =0.34, P=0.01), SAA (rs =0.51, P<0.01) and IL-6 (rs =0.33, P=0.01). The four inflammatory biomarkers (PCT, SAA, IL-6, and IL-12P70) are closely related to rheumatoid arthritis disease activity and can serve as serum indicators to assist in the diagnosis and assessment of RA.

Research on Public Space Area Indicators of Physical Examination Centers

With the increasing demand for medical checkups, problems such as overcrowding and confusion in the public spaces of physical examination centers are becoming prominent. This seriously affects the efficiency of medical checkups and the satisfaction of patients. Because of the lack of reference norms and standards, spatial resources are allocated blindly in physical examination centers. Therefore, the reasonable prediction of demands for space and the allocation of areas for public space are problems we need to explore. This study aims to establish a foundation for spatial resource allocation by analyzing the relationship between area allocation and volume of medical checkups and spatial comfort. The objective is to balance service quality and construction costs in physical examination centers. Utilizing AnyLogic, this research simulates pedestrian flow characteristics during peak hours based on empirical data. Additionally, it provides statistics on and analysis of such areas in 30 physical examination centers. The findings reveal that the average per capita allocation of public space ranges from 6.90 to 7.10 m2. The functional relationship between the area of public space (y) and the total area (x) is y = 0.3649x − 57.096. This paper also proposes a relationship between the waiting space and the daily volume of medical checkups according to two comfort levels. The percentages of waiting space in public space ranges from 10% to 12.5% (comfort level) and 7% to 10% (general comfort level). This research provides architects with a specific and operable foundation for space planning, enhancing the standardization and scientification of physical examination center construction. Furthermore, the methodology used in this study proves valuable for future analyses of the interrelationships among functional units in medical buildings. It can also be applied during the postuse evaluation phase, enabling continuous assessment and iterative improvement in the design.

Investigation of prevalence rate of osteoporosis and analysis of its influencing factors in older adults in Jiuting Town, Songjiang District, Shanghai City

To explore the prevalence and related risk factors of osteoporosis (OP) in the elderly ≥60 years old in Jiuting Town, Songjiang District, Shanghai City. A total of 2 175 local residents aged ≥60 years old who participated in the questionnaire survey at the physical examination center of Jiuting Community Health Service Center, Songjiang District, Shanghai City from July 2021 to December 2022 were selected by a cross-sectional study with multi-stage sampling method. Questionnaire survey, blood test and bone mineral density (BMD) test were conducted.The differences in all the parameters among the elderly with different bone mass level were analyzed using t-test, chi-square test, binary logistic regression was used to screen the potential risk factors of OP.The results showed that the prevalence of OP in the elderly aged≥60 years old in Jiuting Town was 45.89%.The prevalence of OP increased gradually with the advanced age. The prevalence rate of male was significantly lower than that of female(χ2=211.94, P<0.01).Single factor analysis showed that Dairy products(χ2=9.01, P<0.05), taking calcium(χ2=42.88, P<0.05), physical exercise(χ2=24.73, P<0.05), exercise time(χ2=76.40, P<0.05) and sun exposure(χ2=55.71, P<0.05) were the protective factors for osteoporosis. Multifactor analysis showed that female(wald χ2=71.46, P<0.001) were the risk factors for osteoporosis. The age of the osteoporosis group was older than that of the non-osteoporosis group [osteoporosis group (72.47±6.89) years old, non-osteoporosis group (68.73±6.34) years old, and the difference was statistically significant, t=-11.67, P<0.05]. The waist circumference, alanine aminotransferase (ALT), creatinine (CR), blood urea nitrogen (BUN) and uric acid (UA) in the non-osteoporosis group were higher than those in the osteoporosis group, and the difference was statistically significant (all P<0.05). The levels of high-density lipoprotein (HDL)[osteoporosis group (1.34±0.35) mol/L, non-osteoporosis group (1.41±0.35) mol/L, t=-4.51, P<0.05] and alkaline phosphatase (ALP)[osteoporosis group (88.46±25.65) mol/L, osteoporosis group (94.56±32.32) mol/L, t=-4.79, P<0.05] in the osteoporosis group were lower than those in the non-osteoporosis group.Low awareness of the knowledge of osteoporosis risk factors(smoking, drinking coffee, high salt and drinking alcohol are 47.28%, 24.15%, 47.79% and 44.90%, respectively), diagnosis and treatment(The symptoms, prognosis, screening methods, medication time and follow-up screening time of osteoporosis were 26.87%, 17.88%, 21.77%, 6.65% and 15.99%, respectivel) and prevention(exercise mode, high calcium food, optimal age of calcium supplementation, the effect of vitamin D on OP, and the appropriate amount of milk to prevent osteoporosis were 33.16%, 42.01%, 13.27%, 12.07%, 9.01%, respectively) were in Jiuting Town. In conclusion, the prevalent rate of OP in the elderly ≥60 years old in Jiuting Town is 45.89%.The main risk factors are female and advanced age. Drinking tea, dairy products, combination of meat and vegetable, taking calcium, physical exercise and sun exposure were the protective factors for osteoporosis. The awareness rate of osteoporosis related knowledge is low, and health education should be strengthened in order to control and prevent the occurrence and development of osteoporosis.

Correlation between bone mineral density and type 2 diabetes mellitus in elderly men and postmenopausal women

The relationship between bone mineral density and type 2 diabetes is still controversial. The aim of this study is to investigate the relationship between type 2 diabetes mellitus (T2DM) and bone mineral density (BMD) in elderly men and postmenopausal women. The participants in this study included 692 postmenopausal women and older men aged ≥ 50 years, who were divided into the T2DM group and non-T2DM control group according to whether or not they had T2DM. The data of participants in the two groups were collected from the inpatient medical record system and physical examination center systems, respectively, of the Tertiary Class A Hospital. All data analysis is performed in SPSS Software. Compared with all T2DM group, the BMD and T scores of lumbar spines 1–4 (L1–L4), left femoral neck (LFN) and all left hip joints (LHJ) in the non-T2DM group were significantly lower than those in the T2DM group (P < 0.05), and the probability of major osteoporotic fracture in the next 10 years (PMOF) was significantly higher than that in T2DM group (P < 0.001). However, with the prolongation of the course of T2DM, the BMD significantly decreased, while fracture risk and the prevalence of osteoporosis significantly increased (P < 0.05). We also found that the BMD of L1-4, LFN and LHJ were negatively correlated with homeostatic model assessment-insulin resistance (HOMA-IR) (P = 0.028, P = 0.01 and P = 0.047, respectively). The results also showed that the BMD of LHJ was positively correlated with indirect bilirubin (IBIL) (P = 0.018). Although the BMD was lower in the non-T2DM group than in the T2DM group, the prolongation of the course of T2DM associated with the lower BMD. And the higher prevalence of osteoporosis and fracture risk significantly associated with the prolongation of the course of T2DM. In addition, BMD was significantly associated with insulin resistance (IR) and bilirubin levels in T2DM patients.Registration number: China Clinical Trials Registry: MR-51-23-051741; https://www.medicalresearch.org.cn/search/research/researchView?id=c0e5f868-eca9-4c68-af58-d73460c34028.

Diagnostic Value of Superb Microvascular Imaging of the Rotator Cuff Interval for the Early Diagnosis of Frozen Shoulder.

To explore the early diagnostic value of superb microvascular imaging (SMI) features within the rotator cuff gap for frozen shoulder. This prospective study enrolled patients with acute early-stage frozen shoulder seeking treatment at Zhabei Central Hospital in Jing'an District, Shanghai, between July 2021 and December 2022 were enrolled in this study. Healthy controls were collected in a 1:1 ratio from the same hospital's physical examination center. All participants underwent SMI and power Doppler ultrasound (PDUS) of the rotator cuff gap. The study included 79 patients with frozen shoulder and 77 healthy controls. Compared with the healthy control group, the patient group had a higher proportion of hypoechoic rotator cuff gap (81.0% vs 48.1%, P<0.001), a thicker coracohumeral ligament (2.60±1.01 vs 2.03±0.97, P<0.001), a thicker glenohumeral joint capsule (3.10±0.99 vs 2.46±1.17, P<0.001), and elevated blood grading using SMI (P<0.001) and PDUS (P=0.014). The highest area under the curve (AUC) was observed for SMI blood flow grading (AUC=0.824, 95% CI: 0.755-0.880, P<0.001), resulting in 82% sensitivity and 77% specificity when using a cutoff of 1. SMI blood flow grading was associated with external rotation <30° (P=0.007) and abduction <30° (P=0.013) but not with internal rotation <30° (P=0.630) or flexion <30° (P=0.562). The grading of SMI blood flow may emerge as a valuable predictive indicator for the early stages of frozen shoulder. This simple ultrasound technique holds the potential to enhance the diagnostic process, enabling early initiation of treatment and potentially improving patient outcomes.