Objective To explore teaching effects of case-based learning (CBL) in abdominal physical examination in diagnostics. Methods Among 83 undergraduates in grade 2007 and in major of 8-year clinical medicine were randomly divided into two groups. Under the same conditions, 41 in the CBL group were taught with CBL method, while the other 42 in the control group were taught with traditional teaching method. Their scores in standard patient (SP) practice assessment of abdominal physical examination, examination of abnormal abdominal signs, ability to analyze and write medical records, and right answers to abdominal examination in final exam were compared. Meanwhile, questionnaire surveys were distributed to them after class. Results There was no significant difference between the two groups in the scores of SP practice assessment or medical record writing and analyzing, but the CBL group was obviously superior to the control group in the tests of abnormal abdominal signs and the right answers to abdominal examination in final exam (Plt;0.05). The questionnaire surveys revealed that the CBL group obviously scored higher in the following 3 items: increase the learning interest and commitment, strengthen the ability to analyze and solve problems, and improve the ability to combine theory and practice (Plt;0.05). Conclusion CBL method has an obvious advantage to improve the teaching quality in abdominal physical examination in diagnostics.
摘要:目的：探讨成都地区体检人群中丙氨酸氨基转移酶（ALT）升高率与其升高的相关因素,为正确分析引起ALT升高的原因提供相关依据。方法:以参与体检的8734名体检人群为研究对象,收集身高、体重、血压、丙氨酸氨基转移酶、空腹血糖、高密度脂蛋白、低密度脂蛋白、总胆固醇、甘油三酯、血清HBsAg、脂肪肝及胆石症等相关资料进行分析。结果:在全部体检人群中,ALT升高率为1011%,男性ALT升高率为13.70%,女性ALT升高率为6.30%,男性明显高于女性（Plt;0001）；ALT升高组的年龄均数小于ALT正常组（Plt;0001）；在ALT升高的受检者中,脂肪肝、高脂血症、肥胖、糖尿病、胆囊结石、饮酒及乙肝等患病率均高于ALT正常组受检者（Plt;005）。结论:脂肪肝、糖脂代谢紊乱及乙肝是体检人员ALT升高的主要原因；男性和低龄也是体检者ALT升高的危险因素。Abstract: Objective: To investigate the prevalence and relative factors of elevated serum alanine aminotransferase(ALT) levels and providescientific bases for its causes analysis in physical examination people in Chengdu. Methods: Subjects who received medical examination in physical examination center of west China hospital were screened in this study. The information of height, body weight, blood pressure, serum ALT, fasting plasma glucose, highdensity lipoprotein cholesterol, lowdensity lipoprotein cholesterol, total cholesterol, triglyceride, hepatitis B surface antigen (HBsAg) statue, fatty liver and cholelithiasis were collected and analyzed. 〖WT5”HZ〗Results:〖WT5”BZ〗 A total of 8734 cases were included in this study. The total prevalence of elevated ALT was observed in 1011%, including 137% in man and 63% in woman, and this difference between man and woman was statistic significant (P＜0001). The mean age of ALT elevated group was obvious lower than that of normal ALT group (P＜0001). Interesting, the occurrence rates of fatty liver, hyperlipidemia, obesity, diabetes,gallstones, drinking and positive hepatitis B surface antigen in ALT elevated group were all significant higher than that in normal ALT group (P＜005). Conclusion: Fatty liver, glyeolipid metabolism disorder, and hepatitis B were main reasons of elevated ALT. Male and young cases were both high risk of elevated ALT in this study.
ObjectiveTo explore the application of positron emission computed tomography (PET)/computed tomography (CT) in health physical examination. MethodsWe retrospectively analyzed the data of 1 515 people who underwent physical examination in West China Hospital of Sichuan University from January 2012 to November 2013. Demographic data and results of PET/CT scan were analyzed statistically. Follow-up was performed. ResultsTwenty-one cases of malignant tumors were found by PET/CT, including 7 cases of lung cancer, 5 of colon cancer (3 of sigmoid colon cancer, 1 of ascending colon cancer, and 1 of transverse colon cancer), 4 of thyroid carcinoma, 2 of nasopharyngeal carcinoma, 1 of prostate cancer, 1 of ovarian cancer, and 1 of other kind of cancer. All of them were confirmed after further examinations. ConclusionPET/CT has a positive significance in physical examination for some specific population.
Objective To explore the strategies of improving the teaching quality of complete physical examination in diagnostics. Methods A total of 314 medical students' surveys relating to contents and skills of complete physical examination in Diagnostics were accomplished. Problems in the teaching quality of the complete physical examination were selected and countermeasures were determined by analyzing scores and performance of students. Results Among 192 items in a complete physical examination, students mastered poorly in 77 (40.1%) items, and especially poorly in 14. Skills of a comprehensive physical examination, including examination without repetition, inversion, omission and skills of palpation and percussion, were difficult to acquire. Conclusion It is helpful to improve the teaching quality of a complete physical examination by analyzing the problems in the physical examination to formulate the teaching objectives and optimize teaching methods.
ObjectiveTo investigate the current status of visual disability in people with opportunistic diabetes based on the physical examination center, and explore its related factors. MethodsPeople who went to West China Hospital of Sichuan University (West China Hospital district and Wenjiang hospital district) for physical examination between January 2019 and March 2020 were selected. The subjects were those who had a history of diabetes or fasting blood glucose≥7 mmol/L or glycosylated hemoglobin≥6.5%. They were divided into two groups according to visual acuity. The physical examinees with low vision were the observation group, and the physical examinees with normal vision were the control group (the number of cases was twice that of the observation group). The relevant data of the two groups were observed and compared, and the risk factors of low vision were analyzed by logistic regression. ResultsA total of 1 636 physical examinees with diabetes were included. There were 158 cases in the observation group and 316 cases in the control group. 158 cases (203 eyes) had low vision, and the incidence was 6.20% (203/3272). The main diseases leading to low vision were cataract (92 cases, 58.23%), high myopia (32 cases, 20.25%) and diabetes retinopathy (20 cases, 12.66%). Logistic regression analysis showed that the independent risk factors for low vision were age of diabetes patients, diabetes retinopathy, systolic blood pressure and glycosylated hemoglobin. ConclusionsThe incidence of low vision in diabetes population based on physical examination centers in Chengdu is low. Visual acuity examination should be strengthened for diabetes patients, especially the elderly, with diabetes retinopathy, high systolic blood pressure and glycosylated hemoglobin. Early effective prevention and treatment can reduce the damage to vision caused by diabetes.
Objective To analyze the current status of metabolic syndrome (MetS) and its influencing factors among physical examination population aged 60 years old and above in Chengdu, and to provide evidence for the screening and management of MetS in people aged 60 years old and above. Methods Retrospective analysis of the data of people aged 60 years old and above who participated in physical examination in the North District of the Department of Health Management of Sichuan Provincial People’s Hospital between January 2018 and December 2020. According to whether the elderly occurred to have MetS, they were divided into MetS group and non-MetS group, to observe the distribution of MetS in different genders and different age groups, and to analyze the influencing factors of MetS by multivariate logistic regression. Results A total of 10 335 elderly were enrolled, 2 769 cases (26.79%) in MetS group and 7 566 cases (73.21%) in non-MetS group. Except for gender and low-density lipoprotein cholesterol (LDL-C) (P>0.05), there were significant differences in other general data between the two groups (P<0.05). There was a statistically significant difference in the detection rate of MetS among different age groups (χ²=64.332, P<0.001). In MetS group, 951 cases (34.34%) of abdominal obesity, 716 cases (25.86%) of high fasting blood glucose (FBG), 1 938 cases (69.99%) of hypertension, 1 011 cases (36.51%) of high triglycerides (TG) and 303 cases (10.94%) of low high-density lipoprotein cholesterol (HDL-C) were detected. Except hypertension and high TG (P>0.05), there were statistically significant differences in the detection rates of abdominal obesity, high FBG and low HDL-C among different genders in MetS (P<0.05). Except hypertension (P<0.05), there was no significant difference in the detection rates of MetS abdominal obesity, high FBG, low HDL-C and high TG in different age groups (P>0.05). Logistic regression analysis showed that body mass index [odds ratio (OR)=1.055, 95% confidence interval (CI) (1.014, 1.097), P=0.008], systolic blood pressure [OR=1.032, 95%CI (1.027, 1.037), P<0.001], diastolic blood pressure [OR=0.992, 95%CI (0.985, 1.000), P=0.049], FBG [OR=1.853, 95%CI (1.764, 1.947), P<0.001], TG [OR=3.787, 95%CI (3.352, 4.278), P<0.001], hemoglobin [OR=0.991, 95%CI (0.986, 0.996), P<0.001], waist circumference [OR=1.158, 95%CI (1.141, 1.175), P<0.001], HDL-C [OR=0.243, 95%CI (0.170, 0.346), P<0.001], total cholesterol [OR=0.615, 95%CI (0.490, 0.773), P<0.001], LDL-C [OR=1.594, 95%CI (1.303, 1.948), P<0.001], and uric acid [OR=1.001, 95%CI (1.000, 1.002), P=0.042] were related to MetS. Conclusions The prevalence of MetS is high among people aged 60 years old and above who undergo physical examination. Routine screening should be carried out during physical examination to take measures to intervene the controllable risk factors, so as to improve the health level of the region.