Physical Examination Population Research Articles

Serum Heparanase: A New Clinical Biomarker Involved in Senile Metabolic Inflammatory Syndrome.

AimMetabolic inflammation syndrome (MIS) can lead to a series of complications, but its exact inflammatory mechanism is still unclear. The aim of this study was to explore the correlation between heparanase (HPA) and MIS, and the close relationship between HPA and other chronic low-grade inflammation index, such as C-reactive protein (CRP) and interleukin-6 (IL-6).MethodsA total of 105 patients with MIS in the physical examination population of Huashan Hospital affiliated to Fudan University from May to June 2018 were selected as the MIS group, and 52 patients who were relatively healthy during the same period were used as the control group. The basic clinical data of the selected candidates were collected, the levels of serum HPA, CRP and IL-6 were measured by ELISA, and the levels of blood glucose and blood lipids were also detected.ResultsCompared with the control group, the levels of HPA, CRP, IL-6, FBG, HbA1C, and TG of MIS group were all significantly elevated (all P<0.05), and HDL-C levels were considerably reduced (P<0.05). Correlation analysis showed that there was a noticeably positive correlation between serum HPA level and CRP, IL-6 levels (P<0.05).ConclusionHigher HPA levels might play a certain role in the occurrence and development of MIS. There was a certain close correlation between serum HPA level and CRP and IL-6 levels, and which indicated that HPA was involved in the chronic low-grade inflammatory reaction process of MIS.

Effect of Different Pollution Parameters and Chemical Components of PM2.5 on Health of Residents of Xinxiang City, China.

The present study was planned to explore the pollution characteristics, health risks, and influence of atmospheric fine particulate matter (PM2.5) and its components on blood routine parameters in a typical industrial city (Xinxiang City) in China. In this study, 102 effective samples 28 (April–May), 19 (July–August), 27 (September–October), 28 (December–January) of PM2.5 were collected during different seasons from 2017 to 2018. The water-soluble ions and metal elements in PM2.5 were analyzed via ion chromatography and inductively coupled plasma–mass spectrometry. The blood routine physical examination parameters under different polluted weather conditions from January to December 2017 and 2018, the corresponding PM2.5 concentration, temperature, and relative humidity during the same period were collected from Second People’s Hospital of Xinxiang during 2017–2018. Risk assessment was carried out using the generalized additive time series model (GAM). It was used to analyze the influence of PM2.5 concentration and its components on blood routine indicators of the physical examination population. The “mgcv” package in R.3.5.3 statistical software was used for modeling and analysis and used to perform nonparametric smoothing on meteorological indicators such as temperature and humidity. When Akaike’s information criterion (AIC) value is the smallest, the goodness of fit of the model is the highest. Additionally, the US EPA exposure model was used to evaluate the health risks caused by different heavy metals in PM2.5 to the human body through the respiratory pathway, including carcinogenic risk and non-carcinogenic risk. The result showed that the air particulate matter and its chemical components in Xinxiang City were higher in winter as compared to other seasons with an overall trend of winter > spring > autumn > summer. The content of nitrate (NO3−) and sulfate (SO42−) ions in the atmosphere were higher in winter, which, together with ammonium, constitute the main components of water-soluble ions in PM2.5 in Xinxiang City. Source analysis reported that mobile pollution sources (coal combustion emissions, automobile exhaust emissions, and industrial emissions) in Xinxiang City during the winter season contributed more to atmospheric pollution as compared to fixed sources. The results of the risk assessment showed that the non-carcinogenic health risk of heavy metals in fine particulate matter is acceptable to the human body, while among the carcinogenic elements, the order of lifetime carcinogenic risk is arsenic (As) > chromium(Cr) > cadmium (Cd) > cobalt(Co) > nickel (Ni). During periods of haze pollution, the exposure concentration of PM2.5 has a certain lag effect on blood routine parameters. On the day when haze pollution occurs, when the daily average concentration of PM2.5 rises by 10 μg·m−3, hemoglobin (HGB) and platelet count (PLT) increase, respectively, by 9.923% (95% CI, 8.741–11.264) and 0.068% (95% CI, 0.067–0.069). GAM model analysis predicted the maximum effect of PM2.5 exposure concentration on red blood cell count (RBC) and PLT was reached when the hysteresis accumulates for 1d (Lag0). The maximum effect of exposure concentration ofPM2.5 on MONO is reached when the lag accumulation is 3d (Lag2). When the hysteresis accumulates for 6d (Lag5), the exposure concentration of PM2.5 has the greatest effect on HGB. The maximum cumulative effect of PM2.5 on neutrophil count (NEUT) and lymphocyte (LMY) was strongest when the lag was 2d (Lag1). During periods of moderate to severe pollution, the concentration of water-soluble ions and heavy metal elements in PM2.5 increases significantly and has a significant correlation with some blood routine indicators.

Clinical data mining on network of symptom and index and correlation of tongue-pulse data in fatigue population

BackgroundFatigue is a kind of non-specific symptom, which occurs widely in sub-health and various diseases. It is closely related to people's physical and mental health. Due to the lack of objective diagnostic criteria, it is often neglected in clinical diagnosis, especially in the early stage of disease. Many clinical practices and researches have shown that tongue and pulse conditions reflect the body's overall state. Establishing an objective evaluation method for diagnosing disease fatigue and non-disease fatigue by combining clinical symptom, index, and tongue and pulse data is of great significance for clinical treatment timely and effectively.MethodsIn this study, 2632 physical examination population were divided into healthy controls, sub-health fatigue group, and disease fatigue group. Complex network technology was used to screen out core symptoms and Western medicine indexes of sub-health fatigue and disease fatigue population. Pajek software was used to construct core symptom/index network and core symptom-index combined network. Simultaneously, canonical correlation analysis was used to analyze the objective tongue and pulse data between the two groups of fatigue population and analyze the distribution of tongue and pulse data.ResultsSome similarities were found in the core symptoms of sub-health fatigue and disease fatigue population, but with different node importance. The node-importance difference indicated that the diagnostic contribution rate of the same symptom to the two groups was different. The canonical correlation coefficient of tongue and pulse data in the disease fatigue group was 0.42 (P < 0.05), on the contrast, correlation analysis of tongue and pulse in the sub-health fatigue group showed no statistical significance.ConclusionsThe complex network technology was suitable for correlation analysis of symptoms and indexes in fatigue population, and tongue and pulse data had a certain diagnostic contribution to the classification of fatigue population.

Cone-beam CT evaluation of the Monson's spherical radius of young adults in Guangdong

Objective: To measure and analyze the spherical radius of Monson of normal young people in Guangdong province using cone-beam CT (CBCT), and to establish a personalized measurement method of the spherical radius of Monson to provide a reference for clinical application of Monson spherical radius in occlusal reconstruction. Methods: Sixty healthy young adults from physical examination population at Stomatology Hospital of Guangzhou Medical University [30 males and 30 females, aged (22.1±2.0) years 18-26 years) were recruited, and their CBCT were taken. Three-dimensional reconstruction of CBCT data was carried out, and the reconstructed models were fixed, traced and measured. The difference of Monson spherical radius between male and female was compared by using a single sample t-test. Results: The Monson spherical radius was (100.72±4.89) mm. The Monson spherical radius of male and female were (103.48±4.19) mm and (97.97±3.93) mm respectively. The difference between male and female was statistically significant (P<0.01). Conclusions: CBCT can be used to accurately measure the spherical radius of Monson and can be used as a reference for reconstruction of occlusal plane.

Correlation between Left Ventricular Hypertrophy in Electrocardiogram and Hypertension in Physical Examination Population

To explore the correlation between left ventricular hypertrophy in electrocardiogram and hypertension in the population underwent physical examination. A total of 96 patients who underwent physical examination in our hospital from February 2019 to February 2020 were selected as the research subjects. 48 patients with normal electrocardiogram were selected as the control group and 48 patients with left ventricular hypertrophy showed by electrocardiogram were selected as the observation group. 24 h systolic blood pressure, 24 h diastolic blood pressure, nocturnal systolic blood pressure, nocturnal diastolic blood pressure, the standard deviation of 24 h systolic blood pressure, the standard deviation of nocturnal systolic blood pressure and the standard deviation of nocturnal diastolic blood pressure were compared between the two groups. Compared with the control group, there were 20 patients with hypertension in the observation group and the detection rate was 41.67 %. There were 3 patients with hypertension in the control group and the detection rate was 6.25 %. The detection rate of hypertension in the observation group was significantly higher than that in the control group (p<0.05). Compared with the control group, 24 h systolic blood pressure, 24 h diastolic blood pressure, nocturnal systolic blood pressure, nocturnal diastolic blood pressure, the standard deviation of 24 h systolic blood pressure, the standard deviation of nocturnal systolic blood pressure and the standard deviation of nocturnal diastolic blood pressure in observation group were significantly increased (p<0.05). The incidence of myocardial infarction and sudden death in observation group was significantly higher than that in control group (p<0.05). The left ventricular hypertrophy shown by electrocardiogram is of great value to the detection rate of hypertension in physical examination. It can evaluate the blood pressure status of patients and has good clinical application value.

Pepsinogen Serology and Gastritis OLGA Staging in Mucosal Atrophy Assessment: A Cross-Sectional Study Involving East China Endoscopy Population.

The histological gastric stage (OLGA) plays an important role in evaluating gastric atrophy, a symptom which suggests a risk of gastric cancer (GC). However, gastroscopy is an invasive examination, which has limited application in populations undergoing physical examination. Serum pepsinogen (PG) and gastin-17 (G-17) levels are noninvasive indexes which are recommended when screening for GC. We aim to explore the correlation between PG/G-17 and OLGA stage, in order to provide reliable indexes for GC screening. The study included 453 asymptomatic individuals from East China undergoing physical examination, who then underwent endoscopy including collection of biopsy samples. Assays for serum PG, G-17, and Helicobacter pylori (Hp) were performed. Atrophy of gastric mucosa was graded according to OLGA for each individual. 453 participants, average age 52.46 ± 10.30 years, 253 male and 200 female, were included. In the asymptomatic physical examination population, serum PGI, PGII, and PGR levels decreased with increasing OLGA scores. PGI and PGR were inversely correlated with increasing OLGA stage in both Hp-positive and Hp-negative groups. The levels of serum PGI, PGII, and G-17 in the Hp-positive group were higher than those in the Hp-negative group; conversely, the PGR levels were lower. Furthermore, OLGA scores increased with age in the Hp-positive group. In conclusion, there is a significant correlation between OLGA stage and serum PG in populations from East China undergoing physical examination. Serum PG and G-17 combined with Hp test plays an important role in evaluating gastric atrophy.

Validation of an approach using only patient big data from clinical laboratories to establish reference intervals for thyroid hormones based on data mining

BackgroundWhile many studies have established reference intervals (RIs) for thyroid hormones using patient data, this approach has not been validated. Therefore, in this study, we aimed to validate an approach for establishing RIs for thyroid hormones only using patient data from clinical laboratories. MethodsWe established two derived databases: derived database* and derived database#. Reference individuals in derived database* were selected using strict exclusion criteria, and the RIs established by the database were considered standard RIs (RIs*). Individuals in derived database# were the physical examination population, whose information was downloaded directly from the Laboratory Information System, and RIs established from this database were evaluated (RIs#). The comparative confidence interval (CI) method and consistency of the decision results based on external databases were used to compare RIs* and RIs#. ResultsRIs# and RIs* for the thyroid hormones tested were similar. The 90% CIs of the upper and lower limits of RIs for most thyroid hormones overlapped between RIs# and RIs*, and the limit of RIs# was within the 90% CI of RIs*. The consistency rates for the results of the RIs* and RIs# in the external database were greater than 98% for all thyroid hormones tested. ConclusionIt was possible to establish RIs for thyroid hormones using only patient data from clinical laboratories after adopting appropriate statistical methods.

Analysis of Risk Factors of Gastric Low-Grade Intraepithelial Neoplasia in Asymptomatic Subjects Undergoing Physical Examination.

Secondary prevention is an important strategy in gastric cancer. Low-grade intraepithelial neoplasia (LGIN) is the last stage of precancerous lesion, and its timely diagnosis can greatly improve the detection rate of early gastric cancer. We performed a prospective study to analyze the risk factors of gastric LGIN in asymptomatic subjects undergoing physical examination. A total of 3437 subjects were included in this study, and 2259 asymptomatic subjects were investigated from March 2015 to April 2018. Risk factors were evaluated, and the endoscopic features of LGIN and prognosis were described. The overall incidence of LGIN was 19.73% (678/3437), while the incidence of LGIN in the asymptomatic and symptomatic groups was 19.65% (444/2259) and 19.86% (234/1178), respectively (P = 0.884). The rate of Helicobacter pylori infection in this physical examination population was 39.13% (35.8% asymptomatic group, 45.5% symptomatic group; P ≤ 0.001). Risk factors including age, H. pylori infection, history of antibiotic misuse, and spicy and high-fat diet (all P < 0.05) were further verified by multivariate analysis as independent risk factors. History of antibiotic misuse and H. pylori infection showed significant associations with LGIN (odds ratio (OR) = 6.767, 95% confidence interval (CI) 3.873-11.825 and OR = 3.803, 95% CI 3.009-4.808, respectively). The most common endoscopic classification of LGIN was erosive gastritis (50.78%), and the major endoscopic appearance was Paris IIa (flat with slight elevation located mostly in the antrum). During the mean follow-up period of 15.02 months, 49.4% of LGIN regressed, 0.61% of LGIN progressed, and 50% of LGIN remained unchanged. History of antibiotic misuse and H. pylori infection were predominant risk factors of LGIN in asymptomatic subjects, and those individuals should consider early screening for gastric cancer.

Large-scale observation of age-related hearing impairment in physical examination population

Objective:To investigate the current situation of hearing and the changing trend of hearing loss in all age groups in Hunan Province, and to explore the incidence of age-related hearing impairment and the feasibility of early screening in aging people. Method:A total of 13 681 subjects were divided into different age groups of 31-40 years old, 41-50 years old, 51-60 years old, 61-70 years old, 71-80 years old, and >80 years old. The average value of speech frequency hearing threshold （0.5, 1.0 and 2.0 kHz frequency） was calculated as an average hearing threshold. 4.0 and 8.0 kHz were high frequency sounds, hearing threshold > 25 dB at 4.0 and 8.0 kHz is the high-frequency pure-tone hearing loss. Result:The proportion of hearing loss was the lowest in the 31-40 years old group （6.8%）, whereas the proportion of hearing loss was the highest in the >80-year-old group （91.6%）. The proportion and degree of hearing loss increased with the increase of age （P<0.05）; the proportion of people with normal speech frequency threshold but with the high-frequency pure-tone hearing loss also increased with the increase of age, the difference between the groups was statistically significant （P<0.05）; the proportion of the speech frequency hearing loss was significantly higher in >60 years old group than that of the 31-60 years old group, and the difference was statistically significant （P<0.05）. Conclusion:The proportion and degree of hearing loss in adult populations in Hunan Province significantly increased with age; hearing loss show up in the early age of the elderly; people with normal speech frequency hearing threshold should also routinely perform the high-frequency hearing test; speech frequency and high-frequency pure-tone hearing testing could be used in early detection of pre-sensual hearing loss, and its extent of routine hearing impairment screening will facilitate early intervention.

Evaluation of screening accuracy on osteoporosis self-assessment tool for Asians and its cut-off value in healthy physical examination population

To explore the screening value of osteoporosis self-assessment tool for Asians (OSTA) and the optimal cut-off value in Chinese healthy physical examination population. We selected a healthy physical examination population for bone mineral density screening at the Health Examination Center in Peking University Third Hospital from 2013 to 2016. Quantitative ultrasound (QUS) results were used as the gold standard, and T value ≤-2.5 was defined as osteoporosis patients. Diagnostic test methods were used to analyze the sensitivity, specificity, likelihood ratio and area under curve (AUC) of different cut points of OSTA. The screening accuracy of OSTA at different cut points was compared and the optimal cut-point value determined. A total of 5 833 subjects were included in the study, with an average age of (48.3±17.5) years and 2 594 women (44.5%). The QUS test showed 403 patients with osteoporosis (6.9% of the total population), 343 female osteoporosis patients (13.22% of the female population). In the whole age group, AUC at the international routine cut-off value (OSTA ≤-1) screening for osteoporosis was 0.815 (95%CI: 0.804-0.825), and screening accuracy was higher in the women (AUC=0.837, 95%CI: 0.823-0.851) than that in the men (AUC=0.767, 95%CI: 0.752-0.781; P<0.05). In the whole age group, when the optimal cut-off value was 0, its AUC 0.842 (95%CI: 0.832-0.851) was significantly higher than that when the cut-off value was -1 (P<0.01), and net reclassification improvement (NRI) increased by 5.5%. In the 40 to 65-year-old group, when OSTA cut-off value ≤0, the screening accuracy was significantly higher (NRI=19.5%, P=0.003) than that when it was -1. The OSTA screening tool had good osteoporosis screening value in healthy people, and the screening accuracy in women is higher than that in men. Increasing the screening cut-off value of OSTA would be helpful to improve the screening accuracy in the whole and 40 to 65-year-old population. There may be different optimal cut-off values for different age group population.

Application of Serum Thymidine Kinase-1 in Cancer Risk Detection in Healthy Population

The purpose of this study was to evaluate the application of serum thymidine kinase 1 (STK1) in cancer risk detection in health general investigation. Using the method of dot-blot immunofluorescence enhancement, the data of STK1 of 12600 people were selected, and were carried out simultaneously with routine physical examination items. The results showed that the positive rate of STK1 (STK1&gt; 2 pmol/L) was 2.10% with 2 pmol/L as the threshold, and the positive rates of male and female were 2.01% and 2.19%, respectively. There was no significant difference between male and female (χ2 = 0.46, P &gt; 0.05). Compared with other age groups, both male and female between 40–59 years old had the highest detection rate in the age group of STK1 elevation, and twelve cases of malignant tumors were detected in the group of STK1 elevation, accounting for 4.55%. Compared with the normal group, it has significant significance. In the cases of benign tumors/cell dysplasia, 2194 cases detected were in normal group (17.78%) and 120 cases were in elevated group (45.45%). There was significant difference between normal group and elevated group (χ2 = 74.44, P &lt; 0.01). There was no significant difference between the normal group and the elevated group in inflammatory, viral, fatty liver disease, other diseases and no special clinical conditions (P &gt; 0.05). In the screening of cancer risk of general health investigation, STK1 can be applied to truly evaluate the abnormal proliferation of cells in vivo, and to screen a variety of tumors. It is suitable for early cancer risk screening of physical examination population.

Clinical characteristics and association analysis of persistent low-level HBsAg expression in a physical examination population with HBV infection.

Certain patients with hepatitis B virus (HBV) infection present with persistently low levels of serum hepatitis B surface antigen (HBsAg) and have been indicated to have low rates of HBV nucleic acid replication. To explore the serological and molecular epidemiological characteristics of HBV population with low-level HBsAg in the present study, associated serum markers and virologic genotype detection were performed accordingly. Determination of HBV markers was performed using a chemiluminescence immunoassay from which 2,544 out of 45,256 adults who underwent routine health examination were tested positive for HBsAg. HBV DNA was detected by real-time fluorescent quantitative PCR. The patients were divided into low-level and high-level groups, according to their HBsAg levels (cut-off value, 10 IU/ml). The prevalence and levels of HBsAg positivity and HBV DNA in patients with HBV infection were analyzed by age, sex, serological pattern and clinical type. The fibrosis status of patients with low-level HBsAg was assessed by determining the aspartate aminotransferase-to-platelet ratio (APRI), and sequencing was employed to determine serotypes and genotypes. HBV-infected patients with low-level HBsAg (<10 IU/ml) accounted for 15.41% of the 2,544 HBsAg-positive patients, and the prevalence of HBsAg positivity exhibited a tendency to increase with age. The male-to-female ratio was ~1.9:1, and the average age was 54.98±16.28 years among HBV-infected patients with low-level HBsAg. The major serological pattern and clinical types were HBsAg/antibody against hepatitis Be antigen (anti-HBe)/antibody against hepatitis B core antigen (anti-HBc)-positive (94.90%) and chronic asymptomatic (ASC) (97.95%), respectively. HBV DNA exhibited a low-level of replication and the prevalence of HBV DNA positivity assessed by the routine method and by the enrichment method was 27.74% (97/392) and 45.92% (180/392), respectively. No significant differences among the age groups were identified in the different HBsAg level groups (P>0.05). The prevalence of HBV DNA positivity was associated with HBsAg only in patients with serological pattern HBV-M2 (HBsAg/anti-HBe/anti-HBc-positive) in the low-level HBsAg group (odds ratio: 1.30; 95% CI: 1.15–1.47; P<0.05). The APRI had no association with age, HBsAg, HBV DNA level or liver function index in ASC patients in the low-level HBsAg group (P>0.05). The prevalence of the serotype adw and genotype B was 85.53 and 89.47%, respectively. Further improvement in the systematic study of populations with low-level HBsAg has important clinical and epidemiological significance for improving the detection of HBV serological markers, elucidating the mechanisms leading to low-level HBsAg, overcoming immune tolerance to eliminate HBV infection and preventing HBV transmission.

Distribution of serum creatinine and establishment of reference interval in healthy adults of Lianyungang, Jiangsu province

Objective To preliminarily establish the reference interval for serum creatinine in healthy adults aged 20-79 years in city of Lianyungang. Methods A total of 34 577 cases of reference individuals were selected from physical examination population by using the principle of complete randomization, and the concentration of serum creatinine was detected by AU5821 automatic biochemical analyzer with its matching reagents.According to the standards of CLSI C28-A3 and WS/T 402-2012 Clinical Laboratory Test Project Reference Interval Formulation , the reference interval of serum creatinine was established. Results There was statistically significant difference of serum creatinine in gender and age between healthy adults in this area (male group: 78[72-84]μmol/L, female group: 61[56-66]μmol/L; aged 20-59 of male group: 78[72-84]μmol/L, aged 60-79 of male group: 77[70-85]μmol/L; aged 20-59 of female group: 60[56-65]μmol/L, aged 60-79 of female group: 63[58-69]μmol/L) (Z=120.93, Z=31.53, Z=28.45; all P<0.05). Therefore, the reference interval of serum creatinine was established based on gender and age, and its reference interval was 61-97μmol/L (aged 20-59 of male), 60-106μmol/L (aged 60-79 of male), 47-76μmol/L (aged 20-59 of female) and 49-86μmol/L (aged 60-79 of female), respectively. Conclusion Establishment of reference interval in serum creatinine plays an important role in the auxiliary diagnosis, progression and prognosis evaluation of various kidney diseases. Key words: Creatinine; Gender; Age; Reference interval

Salt intake assessed by spot urine samples initiated in the physical examination population in Hunan, China

Background and Objectives: Excessive salt intake is a major public health problem in several countries, especially in China. However, few people are aware of their salt intake. The purpose of this study is to carry out salt intake test in routine physical examination, and to explore the salt intake of different populations and their correlation with diet. Methods and Study Design: Spot urine sample was collected to test urinary sodium and creatinine excretions for each participant recruited from physical examinations at the Third Xiangya Hospital. The Tanaka formula was used to estimate 24-h urinary sodium excretion, which reflects salt intake. In addition to physical and laboratory examination, information including personal details, health-related habits, and self-reported disease histories was obtained from the National Physical Examination Questionnaire. Results: In total, 26,406 people completed the salt intake evaluation. After data cleansing, the average salt intake was 8.39±1.80 g/d. Male, middle-aged, overweight and obese, hypertensive, and dyslipidaemic populations, as well as those with non-cardiovascular diseases were more likely to have excessive salt intake. Dietary sources had an effect on salt intake. Salt intake was lower in those who consumed more milk and fruit (both p and p trend＜0.01) but was higher in those who consumed more lean meat (both p and p trend＜0.05), fatty meat (both p and p trend＜0.01) and animal organs (both p and p trend＜0.01). Conclusions: The results showed that the salt intake in this population far surpasses the recommended amount. We strongly recommend salt intake assessment as routine test into physical examination center.

Research on the application of health management model based on the perspective of mobile health.

The aim of the present study was to explore the application and its effect of mobile medical treatment to chronic disease health management in physical examination population, and to provide references for comprehensive intervention and management of chronic diseases.From January to December 2016, 300 medical examiners in a general hospital health management center were randomly divided into health management group (155 cases) and control group (145 cases). The control group completed routine physical examination and health-risk assessment and provided corresponding reports, repeated annual physical examination and health-risks assessment. In addition to the routine physical examination and health-risk assessment, the health management group reminded the examiners to pay attention to their lifestyle and dietary habits by moving online and offline dynamic health interventions and provide targeted guidance for high-risk population such as diabetes, obesity, hypertension, etc. A review was made after 2 years. The clinical indexes and chronic disease behavior of patients before and after management were compared, and the effect was evaluated by statistical analysis.After management, all the clinical indexes were significantly improved, and the patients’ dietary structure, bad living habits, psychologic state, and other chronic disease behaviors were obviously improved. The proportion of patients with high risk of hypertension, diabetes, and obesity in health management group was significantly lower than that before intervention and control group (P < .05).Using mobile network online, offline dynamic health intervention model can reduce the risk of common chronic diseases in health management objects, this health management model of chronic disease is worth popularizing.

Retrospective Analysis of the Correlation between Uric Acid and Thyroid Hormone in People with Normal Thyroid Function.

Objective This study adopts the method of retrospective analysis to collect general information and laboratory results of physical examination population, hoping to clarify the correlation between uric acid and thyroid hormone. Methods The subjects of the study were healthy subjects who underwent physical examination at the Sir Run Run Shaw Hospital affiliated to the Medical College of Zhejiang University from January 2016 to December 2018. Demographic information and medical history of all subjects were recorded through an electronic health system. Serum uric acid (SUA) was grouped by quartiles. Statistical analyses were performed with R version 3.5.1. Results A total of 48,526 subjects were included in the analysis. Gender ratio, age, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, FBG, HbA1c, TG, HDL-C, ALT, AST, FT3, FT4, and TSH were significantly different among the uric acid groups. The regression coefficients of SUA in the TSH, FT3, and FT4 regression models were B = 1.000 (95% CI 1.000-1.000, p = 0.009), B = 0.999 (95% CI 0.999-0.999, p < 0.001), and B = 1.001 (95% CI 1.001-1.001, p < 0.001), respectively. There was a significant dose-dependent relationship between FT4, FT3, and SUA gradient. Conclusions Under normal thyroid function, there were significant differences in TSH, FT3, and FT4 between groups with different uric acid levels. Uric acid levels were linearly correlated with FT3 and FT4, but not with TSH.

Construction of "Internet +" health management model for physical examination population

Objective To construct the Internet + based health management model for physical examination population. Methods From September 2016 to September 2017, we constructed the primary Internet + health management model by literature review. Two rounds of consultation with 25 experts were carried out with the Delphi method to construct the Internet + health management model for physical examination population. Results Among two rounds of consultation, the recovery rate of questionnaire was all 100%. The expert authority coefficient (Cr) was 0.87. The final Internet + health management model included 3 first-level indicators, 7 second-level indicators and 26 third-level indicators. Conclusions The Internet + based health management model is reliable which can be intervention for health management model of physical examination population. Key words: Internet; Physical examination; Health management; Analytical hierarchy process

The influence of continuous nursing with collaborative nursing as the core concept on the quality of life and self-management of patients with Maintenance Hemodialysis

Objective To explore the influence of continuous nursing with collaborative nursing as the core concept on the quality of life and self-management of patients with Maintenance Hemodialysis (MHD). Methods From January 2016 to August 2017, the center continuously collected clinical data of 154 patients receiving MHD treatment as the research objects.The patients were divided into control group and intervention group according to the single or double days of patients coming to the hospital for dialysis week, with 77 cases in each group.The control group received routine nursing, while the intervention group received continuous nursing with collaborative nursing as the core concept on the basis of routine nursing.The application value of collaborative nursing model in MHD patients from physiological indicators, quality of life score and other aspects were disscussed. Results ①Compared with the physical examination population, scores of all dimensions of MHD patients' quality of life were significantly lower, with statistically significant differences (P<0.05). ②Patients with depression, albumin less than 3.5g/L, and dialysis greater than or equal to 6 years had significantly lower overall scores, with statistically significant differences (P<0.05). Economic status had no significant effect on patients' physical health assessment, but it was correlated with their mental health assessment, and the difference was statistically significant(P<0.05). The lower the income, the lower the mental health score. ③Before intervention, MHD patients were scored for self-management behavior. Among the four dimensions, the scores were ranked from high to low for partnership, self-care behavior, problem solving and emotional processing(P<0.05). ④Compared with the control group, patients in the intervention group showed significant improvement in SBP, SCr, BUN, K+ , P3+, HB, AIb and other indicators at the two time points of 3 months and 6 months after the intervention, while Ca2+ showed significant improvement only at 6 months after the intervention, with statistically significant differences(P<0.05). ⑤The total life quality score, GH, SF, BP, EF, MH and other indicators in the intervention group were significantly better than those in the control group at 3 and 6 months after the intervention, with statistically significant differences(P<0.05). Conclusion Depression, albumin level and dialysis duration are the main risk factors affecting the quality of life of MHD patients.Compared with conventional nursing, the improved collaborative nursing model can effectively improve the physiological indicators of patients, improve the quality of life of patients and treatment compliance, worthy of clinical application. Key words: Hemodialysis; Quality of life; Nursing

Prevalence of Hyperuricemia and its Correlation with Serum Lipids and Blood Glucose in Physical Examination Population in 2015 - 2018: a Retrospective Study.

Hyperuricemia (HUA) is a metabolic disease caused by a disorder of purine metabolism, which increases the risk of cardio-cerebrovascular disease. Serum lipids and blood glucose are risk factors for metabolic syndrome. Thus, this study aimed to assess the prevalence of HUA and its relationship with serum lipids and blood glucose. A total of 59,074 cases (32,623 males and 26,451 females) from three hospitals in Lanzhou city from January 2015 to December 2018 were grouped according to serum uric acid (SUA) level to analyze the differences in age, total cholesterol (TC), triacylglycerol (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), fasting blood glucose (FBG), creatinine (Cr), and blood urea nitrogen (BUN). The changes of prevalence of HUA among different age and gender groups was analyzed. Pearson's correlation analysis was used to analyze the correlation of SUA level with clinical indicators. The risk factors of HUA were analyzed by using binary logistic regression analysis. ROC curve was used to analyze the independent risk factors of elevated SUA. The overall prevalence rate of HUA was 19.87% and the prevalence rate of males was significantly higher than that of females (28.35% vs. 9.41%, χ2 = 3,289.143, p < 0.01). The prevalence rates of HUA from 2015 - 2018 were 19.54%, 19.31%, 18.64%, and 21.81%, respectively. Compared with the normal SUA group, TC, TG, and LDL significantly increased in the HUA group. The correlation analysis showed that SUA was negatively correlated with gender and HDL, and positively correlated with age, FBG, TC, TG, and LDL. The logistic regression analysis revealed that TG, TC, and LDL were risk factors for HUA. The ROC curve analysis showed that the risk of HUA significantly increased when TG was above 1.645 mmol/L. The overall prevalence of HUA in physical examination population has generally been at a high level in the past 4 years. Serum lipids and blood glucose may be independent risk factors for predicting HUA.

The investigation of the positive rate of intrinsic factor antibody and deficiency rate of vitamin B(12) in normal physical examination population

目的观察健康查体人群血清内因子抗体（IFAb）阳性率、维生素B12缺乏率，并分析其与年龄、性别、HGB、RBC、平均红细胞体积（MCV）等的相关性。方法以2015年5−6月北京协和医院健康查体人群共计1 427人为研究对象，采用化学发光免疫学方法，使用Beckman DxI800全自动免疫分析仪及其配套试剂检测上述个体血清IFAb和维生素B12水平，比较查体人群中不同性别、不同年龄个体IFAb阳性（IFAb≥1.2 Au/ml）率和维生素B12缺乏（≤145 ng/L）率的差异与相关性。结果1 427例正常查体人群中，共检出IFAb阳性者66例（4.63%）；≥40岁人群IFAb阳性率显著高于<40岁人群（5.66%对1.48%，χ2=7.46，P=0.006）。≤40岁、40~59岁和≥60岁组维生素B12缺乏率分别为2.22%、2.51%和5.50%（χ2=8.55，P=0.014）。查体人群中男性和女性组IFAb阳性率（5.15%对4.04%，χ2=0.99，P=0.320）和维生素B12缺乏率（3.83%对2.69%，χ2=1.44，P=0.230）差异均无统计学意义。多元线性回归结果显示IFAb阳性者HGB比IFAb阴性者平均低3.05 g/L，但是IFAb对RBC和MCV均无影响。而维生素B12是否缺乏与查体人群的HGB、RBC和MCV均无明显相关性。结论查体人群中IFAb阳性率和维生素B12缺乏率均随着年龄的增长而增加，但维生素B12缺乏的发生晚于IFAb阳性的出现。IFAb阳性与否对HGB有显著影响，可以一定程度上弥补维生素B12检测的局限性。在中、老年人群中开展IFAb和维生素B12水平筛查是必要的。