2018年 · 第12卷第03期

This issue is the key number of "Physical Examination Quality Control", and 6 related articles have been published, of which 4 are discussed around the main examination report. The main examination report is the core and soul of the health examination report. It is not a repeated copy of the running records and abnormal results of positive findings, but a systematic combing, analysis and induction of health information, and a scientific classification and summary evaluation of positive findings. In the expert forum column, Zhao Peng and Zeng Qiang wrote an article, discussing how to standardize the writing of the main examination report to improve the quality of health examination; In the dissertation column, Wu Jianrong and others wrote an article analyzing the current situation of the main health examination report of a top three hospital in Urumqi; In the experience exchange column, Lin Yong and others put forward suggestions for improvement of the quality management method of health examination report, and Zhang Huajun and Mo Dongai discussed the research status of quality control of health examination report. The quality control of health examination has just started, and there are still many areas to be improved. Li Jing put forward the construction and thinking of regional health examination quality control center in the expert forum. In the short essay column, Zhong Li et al. explored the application of case tracking method in the management of adverse events in physical examination.

The main examination report is the core and soul of the health examination report. It is not a running record of positive findings and a repeated copy of abnormal results, but a systematic combing, analysis and induction of health information, and a scientific classification and summary evaluation of positive findings. The main examination report is not only an important basis for formulating and implementing individualized and accurate health management plans for subjects after examination, but also a comprehensive consideration and embodiment of the business level, service ability and management ability of health examination institutions. Therefore, how to standardize the writing of the main examination report, so as to improve the quality of health examination is particularly important.

Healthy China is a grand blueprint drawn by * for China, a guiding light leading the direction of China's medical reform, and the basic behavior of the majority of medical staff. China's economy should shift from high-speed development to high-quality development, which is a new requirement put forward by President Xi under the new situation. As colleagues engaged in health management, we should earnestly study, deeply understand and implement these requirements into our actual work, so as to contribute to a healthy China. In the past ten years, China's health management has developed vigorously, showing a prosperous and prosperous scene. However, in the face of people's increasing demand for a better life, there are still many problems in the services provided in the field of health management, such as imbalance and inadequacy. As an important part of health management, the quality management of health examination institutions is also very important. In 2016, the former National Health and Family Planning Commission promulgated the "Medical Quality Management Measures"^[1]In recent years, the National Health Commission has also set up a number of professional quality control centers, aiming at improving medical quality, ensuring medical safety and realizing the homogenization requirements of medical institutions in different regions and levels through the joint efforts of administration and professionalism. It is under such a background and situation that the regional quality control of health examination has also emerged. So far, 18 provinces have set up health examination quality control centers, and another 3 provinces are actively preparing for them, which fully reflects everyone's emphasis and determination on health examination quality control. Not long ago, at the 2018 National Health Examination Quality Control Conference held in Tianjin, physical examination quality control centers in many regions introduced their active exploration and valuable experience, which gave people enlightenment and reference. Now, the construction of regional quality control center will be discussed from the following aspects.

This standard specifies the standardized process of weight management for overweight or obese people and related supporting contents. This standard is applicable to the relevant departments of hospitals or other weight management institutions to carry out weight management services.

According to the definition of medical adverse events, physical examination adverse events are a special embodiment in the field of physical examination services. They are any factors and events in physical examination services that may affect the diagnosis and treatment results of physical examiners, increase the pain and burden of physical examiners, and may cause medical disputes or medical accidents, as well as affect the normal operation of physical examination work and the personal safety of medical staff. In the busy physical examination work, if the practice behavior is not standardized enough, it is easy to lead to unstable physical examination quality^[1]。 Tracking methodology is a patient-centered evaluation method, which has become an international hospital evaluation method in recent years, including case tracking and systematic tracking^[2]。 Case tracking can be used to follow up all aspects of the medical process, especially those that seriously affect patient safety and quality of medical services^[3]。 In order to improve the quality of physical examination and implement continuous improvement, starting from January 2017, we introduced the case tracking method into the management of adverse events of physical examination, and tracked the adverse events of physical examination for continuous improvement. The report is as follows.

Hypertension is a "cardiovascular syndrome" characterized by continuously increasing arterial blood pressure, usually without self-conscious symptoms. It is the most important risk factor of cardiovascular and cerebrovascular diseases in China and the main cause of death from cardiovascular and cerebrovascular diseases^[1]。 Hypertension is a chronic high-incidence disease affected by complex factors. Social, psychological, environmental, genetic factors and lifestyle have different degrees of influence on the onset of hypertension. Hypertension does not exist independently, but is combined with multiple risk factors, such as obesity, insulin resistance, hyperlipidemia, high uric acid, high homocysteine, etc^[2]。 Studies show that the prevalence of hypertension in China is 29.6%, and the control rate is only 9.3%^[3]。 The consensus in the medical field is that in order to improve the control rate of hypertension, the work should be focused on community primary medical institutions, and the key is to comprehensively manage the level of hypertension and its risk factors^[1]。 We explore the establishment of a standardized management mode of hypertension in community outpatient departments, and evaluate the management effect, so as to provide reference for the comprehensive prevention and treatment of hypertension at the grass-roots level. The results are now reported below.

Type 1 diabetes (T1DM) specifically refers to the absolute deficiency of insulin caused by the destruction of pancreatic islet cells, which must be treated with insulin for life^[1,2]。 T1DM can be roughly divided into autoimmune T1DM and idiopathic T1DM according to its etiology, among which the etiology of idiopathic T1DM is unclear; There are islet autoantibodies in the body of autoimmune T1DM patients, which can cause autoimmune reaction to destroy islet β cells. Therefore, islet autoantibodies can be used as key markers for the diagnosis of autoimmune T1DM, mainly including zinc transporter-member 8 autoantibody (ZnT-8A), glutamic acid decarboxylase antibody (GADA), insular cellular antibody (ICA), protein tyrosine phosphatase-like IA-2 autoantibody (IA-2A) and insulin autoantibody (IAA). Compared with other autoantibodies, ZnT-8A is a later discovered T1DM-specific autoantibody, which is a mediator in regulating glucose and insulin secretion. This study aims to analyze whether ZnT-8A has advantages over the other four antibodies in the detection of T1DM, and the clinical value of the combined detection of five antibodies in the diagnosis of T1DM.

With the increase of the average life expectancy and the increase of the aging population, osteoporosis has become a global public health problem. As a common complication, spinal fracture seriously affects the quality of life of patients. How to diagnose osteoporosis early is the key to prevent and treat osteoporotic fractures. The reduction of bone density is a specific manifestation of bone mass reduction, and the examination of bone density is an important means to diagnose osteoporosis. quantitative computed tomography (QCT) measures the volume bone mineral density (vBMD) of vertebral cancellous bone, which avoids the influence of adjacent tissues and can reflect the true bone density. QCT is more sensitive and accurate than the traditional dual energy X-ray absorptiometry (DXA) method in the diagnosis of osteoporosis^[1]。 Low-dose CT examination of chest is very helpful in early detection, early treatment and reducing mortality of lung cancer^[2]It is also used for the diagnosis and efficacy evaluation of non-neoplastic lung lesions, such as pneumothorax, pneumonia, emphysema and trauma. With the enhancement of public health awareness and the improvement of imaging technology, more and more people choose low-dose chest CT for physical examination and screening. In this study, low-dose chest CT combined with spinal QCT examination was used to explore the feasibility of QCT for bone mineral density measurement and osteoporosis screening in physical examination population.

In recent years, with the improvement of people's living standard and the increasing awareness of disease prevention, health examination has been widely paid attention to by the society, and the rate of health examination has increased year by year, which has become the main way of prevention and health care^[1,2]。 Physical examination report is an important document for physical examiners, which records the relevant physical examination information and examination data of physical examiners in detail, and provides an important basis for the diagnosis, treatment and prevention of related diseases^[3]。 Therefore, the quality of physical examination reports is directly related to physical examination disputes, customer loyalty, institutional reputation, etc. However, physical examination items often involve multiple departments and disciplines, and their contents are complicated and abnormal situations are diverse. Current computer software can't replace doctors' logical thinking in diagnosing and treating diseases^[4]It is difficult to avoid errors in health examination reports. According to the literature, the complaints in health examination mainly concentrate on the errors in physical examination reports, accounting for more than 50% of the complaints^[5]。 In order to reduce the error rate of physical examination reports and improve the satisfaction of physical examination customers, our hospital has achieved satisfactory results since 2015 by improving the workflow, establishing a quality control system, strengthening effective communication between departments, and encouraging physical examination customers to participate in verification. The report is as follows.

Since 2000, China's health management (physical examination) institutions have grown rapidly every year, but health management has developed in China for more than ten years and is still in its infancy. The relevant policies, systems and regulations are not perfect and sound, and the institutions providing health management services are uneven. In recent years, the health management industry has gradually stepped into the track of standardization, which includes physical examination items, physical examination procedures, physical examination methods, physical examination results recording and analysis^[1]。 Among them, the recording and analysis of physical examination results is the health physical examination report.

Realizing the Chinese dream and creating a better and healthier life for all people has a long way to go, which requires every health manager of us to continue to work hard and hard. Jointly initiated by the Health Management Branch of Chinese Medical Association, China Health Promotion Foundation and Chinese Journal of Health Management, the "China Health Management Doctoral Alliance", which is closely linked with health management industry, academia, research and application, was established in Beijing on January 20, 2018, with doctors engaged in health management and related work as the main body and people with lofty ideals at home and abroad who are enthusiastically devoted to health management. Announced the formal establishment of China's first high-level health management pioneer team and brand-new communication platform.