2014年 · 第08卷第02期

Physical examination or health examination refers to the medical service behavior and process of medical examination and evaluation of the health status of asymptomatic individuals and groups. Its emphasis is on screening and risk screening evaluation of chronic non-communicable diseases and their risk factors, and providing health guidance, suggestions and health intervention programs^[1,2]。 Physical examination is one of the basic and effective ways to implement early disease prevention and health management^[3]。 In order to implement the "Several Opinions on Promoting the Development of Health Service Industry" of the State Council^[4]The spirit of the document and the Interim Provisions on the Administration of Physical Examination promulgated by the former Ministry of Health of China (hereinafter referred to as "Physical Examination Provisions")^[2]Lead and promote China's health management (physical examination) institutions and industries to carry out health examination services in a standardized and orderly manner. Since the beginning of 2009, the Health Management Branch of Chinese Medical Association and the Chinese Journal of Health Management have organized experts in relevant fields across the country to investigate and demonstrate the basic items of health examination on the basis of the work of some experts in the previous stage. On the basis of extensively soliciting the opinions of various health examination institutions, experts, scholars and health examination practitioners at all levels across the country, after repeated discussions and many revisions, the Expert Consensus on Basic Items of Health Examination (hereinafter referred to as the "Consensus on Physical Examination") has been formed. The consensus is basically followed by relevant national policies and regulations, guided by the innovation theory of health management, and based on evidence-based medical evidence, fully learning from the successful experience of health examination in developed countries in Europe and America, closely combining with China's actual situation and the urgent needs of industry/industry development, highlighting the pertinence, practicality and guidance. The formulation of basic health examination items follows the following principles: (1) for the purpose of health evaluation and health risk screening, focusing on grasping the health status of subjects and early detection of disease clues; (2) The technical methods or means adopted in physical examination should be scientific and appropriate, and have good accessibility and acceptability; (3) In order to ensure the quality and safety of health examination, the instruments, equipment and reagents used in physical examination items must be certified by SFDA and have an official approval number; (4) Physical examination items should fully reflect the principle of best cost-effectiveness, and avoid giving priority to some high-precision medical technology equipment, so as not to increase the economic burden of the subjects.

The full name of "chronic disease" is chronic non-communicable disease, which is a general term for a class of diseases with hidden onset, long course and prolonged disease, complex etiology, and some diseases that have not been fully confirmed. The harm of chronic diseases is mainly the damage of important organs such as brain, heart and kidney, which can easily cause disability, affect the labor ability and quality of life, and the medical expenses are extremely expensive, which increases the economic burden of society and families. Health management uses information and medical technology, on the scientific basis of health care and medical treatment, to establish a set of perfect, thorough and personalized service procedures, to monitor, analyze and evaluate the health of individuals or groups, provide health consultation and guidance, and intervene on health risk factors.

In the past two years, we have found that there are some writing quality problems in more than 100 physical examination reports from a professional physical examination institution in Beijing, several large tertiary hospitals and the physical examination center of the Central Hospital of China National Petroleum Corporation, which also belongs to the tertiary hospitals. This paper collects, sorts and classifies, and extracts examples and analyzes them briefly as follows.

Medical research laboratory is a workplace for medical education and scientific research. Experimental specimens, equipment, reagents, medical wastes, pressure vessels, gases, etc. may bring damage to the health of experimenters. This paper discusses the health management of laboratory workers from the aspects of establishing laboratory rules and regulations, safety education system, laboratory fire safety, experimental reagents, medical waste and equipment, and standardizing experimental operation, and briefly describes the treatment methods when laboratory workers' health injuries occur, so as to realize the effective management of laboratory workers.

Professor Susann Bluher and her team at the University Medical Center in Leipzig, Germany, conducted a study to analyze the relationship between body mass index (BMI), waist-to-height ratio (WtHR), or waist circumference (WC) and cardiovascular metabolic risk markers. The study selected 1278 patients (11-18 years old, 53% men) from the German/Austrian/Swiss APV registry to retrospectively assess BMI, WtHR, and WC. The main evaluation measures were the parameters related to insulin resistance, fasting insulin, blood pressure, transaminases, blood lipids and uric acid evaluated under the steady-state model. A modified regression model with age group, adolescent stage and sex as covariates was applied. The findings suggest that insulin resistance and fasting insulin assessed under the steady-state model are most strongly associated with BMI and are independent of age group and sex. Blood lipids, transaminases, and uric acid were most strongly associated with WC, more pronounced in boys. The correlations between BMI and WC and metabolic indicators and systolic blood pressure showed only minor differences. During pubertal development, the correlation was strongest in adolescent children. No parameters have shown better dependence on WtHR than BMI or WC. Therefore, BMI and WC are the best predictors of cardiovascular and metabolic comorbidities in obese adolescents. WtHR does not appear to outperform BMI or WC in predicting childhood obesity-related metabolic or cardiovascular risks (J Clin Endocrinol Metab, 2013, 98:3384-3393).