Analysis of the Prevalence Characteristics of Lung Nodules and Their Influencing Factors in The Health Check-Up Population

Objective: To study the prevalence characteristics of pulmonary nodules and their influencing factors in the health check-up population. Methods: A total of 500 cases of health checkups were selected for the data study to analyze the detection and prevalence characteristics of pulmonary nodules. The influencing factors between the pulmonary nodules group and the no pulmonary nodules group were analyzed. Results: A total of 209 cases were detected, of which there were more males than females, and for female patients, the detection rate increased with age (P < 0.05). The distribution of gender, age, smoking, respiratory symptoms, and exposure to kitchen fumes between the two groups was compared (P < 0.05). The multifactorial analysis concluded that risk factors include, respiratory symptoms, older age, exposure to kitchen fumes, and smoking. In addition, patients who exercised more had a lower risk of developing lung nodules. Conclusion: The detection rate of pulmonary nodules was high in the health check-up population and the influencing factors analyzed involved the presence of respiratory symptoms, older age, kitchen fume exposure, and smoking, while the positive influencing factor was increased exercise.

Investigation and Analysis of Lung Cancer Risk Factors in the Health Check-Up Population

Objective: To investigate and analyze the risk factors of lung cancer in the population of health checkups. Methods: A total of 500 cases of the health check-up population were selected for data study. Surveyed showed that 19 cases of lung cancer were grouped as the lung cancer group and the remaining 481 cases made up the control group, and the risk factors were analyzed. Results: Among men, there was a significant proportion of individuals aged 60-69 years old, and women aged 30-39 years old. Additionally, individuals aged 60 and above were at increased risk of developing lung cancer. The results of the multifactorial analysis were that the risk factors affecting the detection of lung cancer in healthy people were smoking history, family history of lung cancer, secondhand smoke, history of respiratory diseases, psychosomatic factors, living environment, and kitchen fumes. Conclusion: People over 60 years of age were prone to early lung cancer, followed by individuals aged 30-39 years. It is important to identify the risk factors of lung cancer to strengthen the screening of high-risk groups for early detection and treatment.

Trends in age distribution of participants in a self-covered and a public expense-covered health check-up programs in Japan

Objective: In Japan, there are unique facilities (namely Ningen Dock) of health check-up, where asymptomatic participants undergo a medical examination at their own expense. The earlier occurrence of cervical cancer and the concern on screening prompted us compare to the age distribution in the self-covered system with that of free physical check-up programs at public expense. Methods: We analyzed medical records of Japanese women, who underwent gynecological examinations at self-covered expense and at public expense between for the periods 2002-2011 and 2005-2009, respectively, restricting examinee’s age group. Results: For self-covered system, approximately 80% of the overall examinee population was occupied with three age groups 30-39, 40-49 and 50-59. The participants was extremely fewer in the over 60 years age group accounting for 10%, compared to those for the public expense-covered system, the over 60 years age group being 25%. Participant under the age of 30 years seemed to increase in chronological order in both systems. Conclusion: The level of knowledge on sexually transmitted infections may contribute to screening promotion for the younger women, while the elderly over 60 years’ attitudes toward screening may be mainly related to social-economic status and/or public expense support.

Lower Incidence of Positive Gynecological Cancers in Examinees of a Unique Health Check-Up Institute, Ningen Dock in Japan, 2011-2016

The present study aims to determine the gynecologic health status of asymptomatic women at a unique Japanese Health Check-up Institute, Ningen Dock. Medical records of Japanese women, who underwent gynecological medical (health) examinations between January 2011 and December 2016, were retrospectively reviewed. Of the cervical smears from 8927 women aged 18 - 85 years, 50 (0.6%) were classified as dysplastic and malignant changes: 18 of low-grade squamous intraepithelial lesion, 10 high-grade squamous intraepithelial lesion, 21 atypical squamous cells of undetermined significance and 1 cervical squamous cell carcinoma. No case of cervical adenocarcinoma was found. Ultrasonographic examination detected uterus enlargements and ovary tumors in 2.0% and 0.9% of cases, respectively. Most of participants (95.6%) revealed no gynecologic abnormalities. The present study based on the records of Ningen Dock, where asymptomatic participants undergo a medical examination at their own expense, showed very low incidence of abnormal cytologic and/or ultrasonographic findings.

Role of routine check-up in the prognosis of patients with pancreatic cancer:A puzzling phenomenon

Background:The high coverage of annual routine health check-up in China is a unique phenomenon throughout the world.However,its clinical value is controversial.In this cohort study,we chose pancreatic cancer as a disease model to explore the role of routine check-up in the prognosis of patients with pancreatic cancer.Methods:Data from 157 patients who were diagnosed with pancreatic cancer between January 2010 and April 2014 were collected.Patients were divided into two groups depending on how their disease was detected.Group A(n=85):Patients were diagnosed with pancreatic cancer in clinic visits.Group B(n=72):Patients were diagnosed with pancreatic cancer in routine check-ups.We compared their prognosis.Results:The tumor stage in group B was earlier than that in group A.The 1-year survival rate in group B was significantly higher than that in group A(74.6%vs.42.4%,P<0.001),while the 3-and 5-year survival rates of the two groups showed no significant difference(P>0.05).The difference of overall survival time between the two groups was not significant(22.0 vs.9.0 months,P=0.078).Conclusions:The stage of pancreatic cancer diagnosed in routine check-ups was earlier and therefore,the intervention was earlier which improved short-term survival rate.However,early intervention did not improve overall survival in the long-term.

安徽省某三甲医院体检人群代谢综合征流行现状

目的 了解医院健康体检人群代谢综合征检出情况并分析其流行病学特征,为指导本地区防治工作提供依据。方法 本研究选取2022年安徽医科大学第一附属医院参加体检的成年人群共计8 381人为研究对象,收集年龄、性别、身高、体质量、空腹血糖、血脂、血压等体检数据,比较代谢综合征及其组成成分在不同性别以及各年龄段体检人群中的检出率。结果 研究对象代谢综合征的检出率为13.47%,其中男性18.18%,女性6.73%,男性高于女性(P <0.001),且随着年龄的增加呈增长趋势。代谢综合征4项组成成分的检出率分别为34.51%(肥胖)、33.06%(血脂紊乱)、26.27%(高血压)、17.79%(高血糖),血脂紊乱和肥胖检出率比高血压和高血糖更普遍。结论 安徽省某三甲医院成年健康体检人群代谢综合征的检出率不容小觑,应加大对高风险人群的干预力度,提倡健康生活方式,以期降低代谢综合征的发生。

产科门诊开展孕期系统健康教育对产检孕产妇健康知识掌握程度、分娩结局的影响

目的 探讨产科门诊中,孕期系统健康教育的应用。方法 取2022年1月至2023年2月漳州市第二医院妇产科门诊收入的124例孕妇,随机分为对照组(常规宣教)和观察组(孕期系统健康教育),就两组健康知识掌握度、心理状态评分、分娩结局和护理质量予以评估比较。结果 观察组健康知识掌握优良率、自然分娩率、母乳喂养率、护理质量各项评分均高于对照组、SDS、SAS评分低于对照组(均P <0.05)。结论 产科门诊中,孕期系统健康教育的开展,可提高孕妇对健康知识掌握度,改善分娩结局。

收放之间:解放战争时期中共军队的连队民主整军(1947—1948)

在全国土地会议做出整党决策后,中共亦于1947至1948年间在全军范围内开展了新式整军运动。作为该运动在基层的实践,连队整军与地方整党步调一致,致力于改善军队内部官兵关系。借助“上下结合”的群众运动,连队整军对部分基层干部进行了撤换,促成干部作风的改进。不过,直接民主导致了短暂的权力真空,连队内一度出现组织混乱。在政策转变与战局变化的大环境下,运动最终收束为集中领导下的整军练兵。作为中共民主建军理念在军队基层的一次实践,连队整军体现了中共军队建设中组织化与民主化的张力。

城市健康体检人群乳腺结节检出情况及影响因素

目的:探讨城市健康体检人群乳腺结节的检出情况及其影响因素.方法:选取2022年1—12月于柳州市中医医院体检中心行健康体检的女性1083例开展研究,纳入的研究者均进行乳腺超声检查和流行病学问卷调查,采用单因素分析及多因素Logistic回归分析乳腺结节的影响因素.结果:1083例健康体检者检出乳腺结节368例(33.98%);无乳腺结节715例(66.02%).多因素Logistic回归分析结果显示,大专及以上学历、生产史>2次、流产史及口服避孕药为乳腺结节的危险因素(P<0.05);哺乳史、就业情况(在岗)、经常锻炼为乳腺结节的保护因素(P<0.05).结论:乳腺结节的发生受多种因素影响共同影响,应根据可控的影响因素进行积极干预,以降低乳腺结节发生率.

欧标应答器报文编码算法优化与实现

针对欧标应答器报文编码耗时不确定问题,在分析应答器报文格式和编码算法流程的基础上,从2个重点方向对算法的多个步骤进行优化提升:一是提高计算效率,如通过查表法提高加扰、校验位、汉明距的计算效率;通过一个整型数存储2个11 bit字,从而有效减少移位操作,并且基于此使得有效字检查与移位操作可并行执行;借助整型数实现一次执行获得4 bit的漏取样操作等。二是避免大量无效计算,如调整同步偏离解析条件检查的左右移位执行顺序;通过贪心算法检查连续有效字;并行执行加扰与部分同步偏离解析条件有效字检查;并行执行校验位计算与字母表条件检查等。采用盐通高铁应答器报文进行性能测试,验证基于本编码优化算法的通用CPU代替专用编码单元的可行性,从而降低设备成本,提高系统可靠性。

煤矿地质液压钻机结构设计及校核

为解决人工上下杆的效率和安全问题,在原有液压钻机的基础上,就三种自动上下杆装置放置位置进行讨论,并决定实行方案。以此为前提对原有液压钻机结构进行改良,使新结构能更好地服务自动上下杆功能,然后再对重要零件进行校核,以防止在结构更改后受力改变导致零件过度疲劳造成安全事故。

教学医院药学本科实习考核体系的建立

目的建立系统全面的教学医院药学本科实习考核体系,为药学本科实习考核提供参考。方法选取2019年7—11月运用德尔菲法确立考核指标和评价标准,层次分析法计算指标权重,确定指标对考核体系的影响程度。结果两轮调查问卷回收率分别为88.5%和100%,专家权威系数大于0.7,满分频率K>0.8,变异系数CV<0.25,协调系数w>0.5,最终确立了5个一级指标,15个二级指标;各级矩阵CI为0.000~0.036,CR为0.000~0.032,一级指标权重为0.037~0.594,二级指标组合权重为0.005~0.475。结论研究专家积极性和权威程度较高,意见协调度和一致性好,可用于教学医院药学本科实习考核。

基于China-PAR模型的不同体重指数体检人群的心血管病风险评估

目的研究不同体重指数体检人群动脉粥样硬化性心血管疾病(ASCVD)的风险分层以及危险因素状况。方法采用横断面调查方法,选择2018年1月至2020年12月于三家三级甲等综合性医院健康管理中心进行年度健康体检的受试者30281例,采用China-PAR模型进行心血管事件风险评估,分析不同性别、年龄和体重指数(BMI)人群的心血管病风险及相关影响因素。结果入组受检者中超重11191例(36.96%)、肥胖3774例(12.46%)。其中,男性超重、肥胖比例显著高于女性,年龄≥45岁者超重、肥胖比例显著高于年龄<45岁者。该人群心血管病10年心血管病风险高危、中危和低危比例分别为2.03%、7.46%、90.51%。男性中、高危人群比例显著高于女性。随着年龄、BMI水平的增长,中危、高危人群比例逐渐增加(P<0.001)。该人群心血管疾病终生发病风险为高危和低危的比例分别为2.61%、97.39%。其中,BMI>28 kg/m2组终生ASCVD风险高危比例显著高于BMI<24 kg/m2组和24 kg/m2≤BMI<28 kg/m2组(P<0.001)。年龄升高、收缩压升高、吸烟史是超重者未来10年ASCVD风险的独立危险因素(P<0.001);男性、高龄、收缩压升高、空腹血糖升高、总胆固醇升高、吸烟史是肥胖者未来10年ASCVD风险的独立危险因素(P<0.05)。结论体检人群中超重、肥胖检出率较高,超重、肥胖是ASCVD的危险因素。对于高龄男性且合并超重或肥胖的体检人群尤其需要关注ASCVD的发病风险。

2005-2020年我国婚前医学检查的时空差异研究

目的:分析2005-2020年我国婚前医学检查率的变化趋势与空间分布格局,为进一步提高婚育质量和出生人口素质提供参考依据。方法:描述性分析我国婚前医学检查率变化趋势,采用空间自相关分析方法分析我国婚检水平的空间分布格局。结果:2005-2020年,我国婚检率由2.9%上升至68.4%,疾病检出人数由38958人增加至783337人,疾病检出率由10.19%下降至8.57%;婚检率高-低异质区域(该地区的婚检率高于其邻接地区)仅增加四川省,低-高异质区域由青海转变为西藏,高-高聚集区域由新疆转变为安徽,低-低聚集区域已不存在。结论:2005年以来我国婚检率逐年上升,但总体增长缓慢;疾病检出人数增加,疾病检出率有所下降,地区患病现况各异;婚检水平整体聚集现象不显著,局部地区聚集态势缓和。

健康体检人群胃肠镜检查的常见疾病危险因素分析

目的 探讨健康体检人群行胃肠镜检查所检出常见疾病与年龄、性别、收缩压、舒张压、脉搏、体质指数、腰围、臀围、腰臀比以及有无贫血、高血压、血脂异常、糖尿病、高尿酸血症等的相关关系,探究疾病危险因素。方法 回顾性分析2019年2月至2022年9月西南医科大学附属医院健康体检人群同时完善胃镜与结肠镜检查者检查结果,对常见疾病与年龄、性别、收缩压、舒张压、脉搏、体质指数、腰围、臀围、腰臀比以及有无贫血、高血压、血脂异常、糖尿病、高尿酸血症等资料进行相关因素Logistic单因素及多因素回归分析,探索所检出胃肠道常见疾病的相关危险因素。结果 共1188人同时完善胃镜、结肠镜检查,经Logistic回归法分析疾病危险因素,高血压、高尿酸血症、年龄、体质指数为慢性非萎缩性胃炎的独立危险因素;年龄、舒张压、男性、高尿酸血症为胃粘膜糜烂的独立危险因素;舒张压、臀围、腰围、腰臀比、体质指数、男性为十二指肠炎的独立危险因素;年龄、收缩压、舒张压、男性为胃肠息肉的独立危险因素。结论 多种因素为慢性非萎缩性胃炎、胃黏膜糜烂、十二指肠炎、胃肠息肉、痔疮的危险因素,积极控制相关因素可早期预防和缓解相关疾病,防止疾病进一步进展。

四种肺癌预测模型对体检人群孤立性肺结节预测效能的比较

目的比较四种肺癌预测模型对孤立性肺结节(SPN)的预测效能。方法以健康体检中被诊断为SPN的体检者为研究对象,四种肺癌预测模型分别对SPN进行风险评估,前瞻性追踪随访SPN患者的临床结局。对四种肺癌预测模型中的风险因素进行统计描述及单因素分析,绘制ROC曲线及比较模型的检验效能。结果最终纳入479例SPN体检者,82例确诊为肺癌,恶性概率为17.12%。恶性组患者年龄、结节直径、吸烟、恶性肿瘤家族史、肺外肿瘤5年及以上、位于上叶、边界不清和毛刺比例高于良性结节组(P<0.05)。Brock模型预测效能最好,AUC为0.833,灵敏度80.49%,特异度74.31%,约登指数、阳性似然比、阳性预测值及阴性预测值最高,阴性似然比最低。Mayo模型AUC为0.815,灵敏度81.71%,特异度67.51%;PKUPH模型AUC为0.754,灵敏度69.51%,特异度73.55%;VA模型AUC为0.738,灵敏度68.29%,特异度67.55%。结论Brock模型对健康体检人群SPN风险预测效能提示最好,VA模型预测效能最差,Brock、Mayo和PKUPH三种模型的联合应用有待进一步研究。

经理层成员任期制和契约化管理思考

文章阐述了经理层成员任期制和契约化管理的本质内涵,分析了开展任期制和契约化管理的基础工作。在理清董事会和经理层权责界面的基础上,进一步落实董事会职权,建立向经理层授权制度,明确任期制和契约化管理实现刚性考核应把握的关键环节,提出加强日常监管的有关建议。

天津市体检人群甲状腺结节检出率及其与代谢综合征关系的横断面研究

目的调查天津市体检人群甲状腺结节(TNs)患病情况,分析代谢综合征(MetS)与TNs间的相关性。方法选择2019年1月1日至2020年12月31日在天津市武清区第二人民医院体检者进行回顾性横断面研究。收集研究对象一般检查、实验室检查、多普勒超声检查等资料。采用Logistic回归模型分析MetS与TNs发生风险的关系。结果本研究共纳入12359例研究对象。TNs总患病率为46.8%(5781例),其中高危结节309例(5.3%),非高危结节5472例(94.7%)。女性患病率(48.6%)明显高于男性(44.9%)(χ^(2)=17.01,P<0.001)。多因素Logistic回归模型显示性别(OR=1.511)、年龄(OR=1.472)、MetS(OR=1.272)是TNs独立危险因素(P<0.05)。女性高血糖和高血压患者在高危结节组(高血糖OR=2.59,高血压OR=1.805,P<0.05)显示出比非高危结节组(高血糖OR=1.527,高血压OR=1.309,P<0.05)更高的患病风险。结论体检人群TNs患病率较高,女性、高龄、MetS是TNs发生的独立危险因素。此外,高血糖和高血压等代谢性因素进一步增加了女性甲状腺高危结节的患病风险。

优质服务管理应用于综合性医院健康体检中心的效果分析

目的针对综合性医院健康体检中心使用优质服务管理的具体方法展开分析,并研究其实施效果。方法选取2020年6月—2021年12月青岛市胶州中心医院体检中心的42名医务人员为研究对象,按照不同管理方法分为对照组(21名)和观察组(21名),对照组采取常规服务管理,观察组采取优质服务管理,两组各选取58名受检者实施满意度调查分析,对比两组管理效果评分、管理质量评分、管理价值评分、体检总满意度、不良事件发生率。结果观察组优化体检流程、美化体检环境、细化服务管理、提升业务素质评分均高于对照组,差异有统计学意义(P<0.05)。观察组服务礼仪、交流沟通、健康宣教、主动服务评分均高于对照组,差异有统计学意义(P<0.05)。观察组可行性、可评价性、科学性、有效性评分均高于对照组,差异有统计学意义(P<0.05)。观察组体检总满意度高于对照组,差异有统计学意义(P<0.05)。观察组不良事件发生率低于对照组,差异有统计学意义(P<0.05)。结论优质服务管理可以显著提升综合性医院健康体检中心管理质量,受检者体检满意度更高,整体应用效果突出。