[Objective] This study aimed to establish a physical examination method for artificial rainfall effect based on radar data. [Method] The radar base data of Shenyang was processed with interpolation by using the neares...[Objective] This study aimed to establish a physical examination method for artificial rainfall effect based on radar data. [Method] The radar base data of Shenyang was processed with interpolation by using the nearest neighbor in radial and oriental direction to establish corresponding response variables, and the effect of a precipitation enhancement case was analyzed. [Result] The trends of response variables showed that there was certain positive effect of the precipitation enhancement operation. [Conclusion] The analysis on a case was not sufficient enough, and statistical test should be the future direction of the study on the physical effect.展开更多
Because decompensated heart failure(HF)patients present primarily with symptoms of congestion,the assessment of volume status is of paramount importance.Despite the addition of new technologies that can predict intrac...Because decompensated heart failure(HF)patients present primarily with symptoms of congestion,the assessment of volume status is of paramount importance.Despite the addition of new technologies that can predict intracardiac filling pressures,the physical exam(PE)remains the most accessible and cost-effective tool available to clinicians.An elevated jugular venous pressure(JVP) is considered the most sensitive sign of volume overload,although the commonly used‘method of Lewis’has several limitations.A useful cutoff is that if the JVP is greater than 3 cm in vertical distance above the sternal angle,the central venous pressure is elevated.In addition to assessment of volume status,the PE in HF can reveal adverse prognostic signs,namely:elevated JVP,presence of third heart sound,elevated heart rate,low systolic BP,and low proportional pulse pressure(＜25%).This article will review the evidence for the diagnostic and prognostic utility of common PE findings in HF.展开更多
This paper studies the correlation between Traditional Chinese Medicine(TCM)Constitution discrimination and physical examination index based on BPNN algorithm.253cases of routine urine test were used to build a linkag...This paper studies the correlation between Traditional Chinese Medicine(TCM)Constitution discrimination and physical examination index based on BPNN algorithm.253cases of routine urine test were used to build a linkage model between TCM Constitution and physical indicators via BPNN algorithm.According to the test,the correct rate of learning and test group are60%and40%,respectively.A strong correlation was found between TCM Constitution and physical examination indexes.By applying cutting-edge knowledge and technologies,the development and modernization process of TCM can be greatly promoted.展开更多
Objective To establish correlation models between various physical examination indexes and traditional Chinese medicine(TCM)constitutions,and explore their relationships based on the radial basis function(RBF)neural n...Objective To establish correlation models between various physical examination indexes and traditional Chinese medicine(TCM)constitutions,and explore their relationships based on the radial basis function(RBF)neural network.Methods The raw data of physical examination indexes and TMC constitutions of 650 subjects who underwent a physical examination were cleaned,classified and sorted,on the basis of which valid data were retrieved and categorized into a training dataset and a test dataset.Subsequently,the RBF neural network was applied to the valid samples in the training set to establish correlation models between various physical examination indexes and TCM constitutions.The accuracy and the error margin of the correlation model were then verified using the valid samples in the test set.Results Of all selected samples,the highest accuracy rates were 80% for the blood lipid index-TCM constitution model;100% for the renal function index-TCM constitution model;100% for the blood routine(male)index-TCM constitution model;88.8% for the blood routine(female)index-TCM constitution model;84.1%for the urine routine index-TCM constitution model;and 100% for the blood transfusion index-TCM constitution model.Conclusions The samples selected in this study suggested that there is a strong correlation between physical examination indexes and TCM constitutions,making it feasible to apply the established correlation models to TCM constitution identification.展开更多
Objective Identification of one’s constitution based on a combination of features and back propagation neural network theory is needed in modern medicine and traditional Chinese medicine(TCM).We describe a method to ...Objective Identification of one’s constitution based on a combination of features and back propagation neural network theory is needed in modern medicine and traditional Chinese medicine(TCM).We describe a method to identify one’s constitution based on TCM constitution classification and a physical index model.Methods We created a constitution identification system based on neural network using Visio Studio development tool.We report the initial implementation of the system,the accuracy of which was verified using actual data.Results We found a relatively strong correlation between TCM constitution and physical indicators.Conclusion Finally,our report describes a possible application of the proposed system.展开更多
Background:Designing a simple and accessible approach to age estimation in children and youth is a great challenge in the fields of sports and physical activity(PA).This study was designed to develop and validate a ph...Background:Designing a simple and accessible approach to age estimation in children and youth is a great challenge in the fields of sports and physical activity(PA).This study was designed to develop and validate a physical-examination-based method of estimating age in young children.Methods:In a cross-sectional study conducted in 2014,we performed physical examinations and assessed PA among 14,970 elementary school children 7–12 years old in Shanghai,China.Additional biological information on the children's height and birth date was ascertained through their parents.Two indicators were applied to develop a gender-specific age estimation equation:The percentage of predicted mature height(PPMH) and the Tanner stage.The equation was validated through a k-fold cross-validation approach.To check for estimation accuracy,the association between the discrepancy of estimated age(EA) and chronological age and PA was examined.Results:The gender-specific equations of EA were as follows:EA_(boy) = –6.071 + 6.559 Tanner 2 + 13.315 Tanner 3 + 14.130 Tanner 4 + 0.190 PPMH – 0.071 Tanner 2 × PPMH – 0.146 Tanner 3 × PPMH – 0.155 Tanner 4 × PPMH;EA_(girl) = –4.524 – 1.251 Tanner 2 + 2.504 Tanner 3 + 8.752 Tanner 4 + 11.893 Tanner 5 + 0.158 PPMH + 0.017 Tanner 2 × PPMH – 0.024 Tanner 3 × PPMH – 0.087 Tanner 4 × PPMH – 0.118 Tanner5 × PPMH.The mean absolute error was 0.60 years for boys and 0.59 years for girls.The discrepancy score was negatively and weakly associated with self-reported moderate-to-vigorous PA in both genders(r_(boy) = –0.09,p < 0.001;r_(girl) = –0.12,p < 0.001).Conclusion:Findings suggest that physical examinations could provide a valid and reliable approach for estimating age in young Chinese children.展开更多
Rhizosphere microorganisms,as one of the most important components of the soil microbiota and plant holobiont,play a key role in the medicinal plant-soil ecosystem,which are closely related to the growth,adaptability,...Rhizosphere microorganisms,as one of the most important components of the soil microbiota and plant holobiont,play a key role in the medicinal plant-soil ecosystem,which are closely related to the growth,adaptability,nutrient absorption,stress tolerance and pathogen resistance of host plants.In recent years,with the wide application of molecular biology and omics technologies,the outcomes of rhizosphere microorganisms on the health,biomass production and secondary metabolite biosynthesis of medicinal plants have received extensive attention.However,whether or to what extent rhizosphere microorganisms can contribute to the construction of the quality evaluation system of Chinese medicinal materials is still elusive.Based on the significant role of rhizosphere microbes in the survival and quality formation of medicinal plants,this paper proposed a new concept of rhizosphere microbial markers(micro-markers),expounded the relevant research methods and ideas of applying the new concept,highlighted the importance of micro-markers in the quality evaluation and control system of traditional Chinese medicines(TCMs),and introduced the potential value in soil environmental assessment,plant pest control and quality assessment of TCMs.It provides reference for developing ecological planting of TCMs and ensuring the production of high quality TCMs by regulating rhizosphere microbial communities.展开更多
Background Accurate evaluation of response following chemotherapy treatment is essential for surgical decision making in patients with breast cancer. Modalities that have been used to monitor response to neo-adjuvant ...Background Accurate evaluation of response following chemotherapy treatment is essential for surgical decision making in patients with breast cancer. Modalities that have been used to monitor response to neo-adjuvant chemotherapy （NAC） include physical examination （PE）, ultrasound （US）, and magnetic resonance imaging （MRI）. The purpose of this study was to evaluate the accuracy of PE, US, and MRI in predicting the response to NAC in patients with breast cancer. Methods According to the response evaluation criteria in solid tumors guidelines, the largest unidimensional measurement of the tumor diameter evaluated by PE, US, and MRI before and after NAC was classified into four grades, including clinical complete response, clinical partial response, clinical progressive disease, clinical stable disease, and compared with the final histopathological examination. Results Of the 64 patients who received NAC, the pathologic complete response （pCR） was shown in 13 of 64 patients （20%）. The sensitivity of PE, US, and MRI in predicting the major pathologic response was 73%, 75%, and 80%, respectively, and the specificity was 45%, 50%, and 50% respectively. For predicting a pCR, the sensitivity of PE, US, and MRI was 46%, 46%, and 39%, respectively, and the specificity was 65%, 98%, and 92% respectively. Conclusions Compared with final pathologic findings, all these three clinical and imaging modalities tended to obviously underestimate the pCR rate. A more appropriate, universal, and practical standard by clinical and imaging modalities in predicting the response to neo-adjuvant chemotherapy in vivo is essential.展开更多
Cataract is a very common eye disease and the most significant cause of blindness.In consideration of its burden on society,the focus was put on testing the risk factors of cataract and building robust machine learnin...Cataract is a very common eye disease and the most significant cause of blindness.In consideration of its burden on society,the focus was put on testing the risk factors of cataract and building robust machine learning models in which these factors can be utilized to predict the risk of cataract.The data used herein was collected by a Chinese physical examination center located in Shanghai.It contains more than 120,000 examinees and about 500 physical examination metrics.Firstly,association rules were adopted to filter 39 abnormalities which are more likely to incur the risk of cataract,and the significance of these abnormalities was tested with univariate analysis and multivariate analysis.The test results indicate that age,diabetes,refractive error,retinal arteriosclerosis,thyroid nodules,and incomplete mammary gland degeneration significantly increase the possibility of cataract.Various machine learning models were compared in terms of their performance in predicting the risk of cataract based on these six factors,among which the logistic regression model and the decision-tree based ensemble methods outperform others.The test set A U C of these models can reach 0.84.展开更多
INTRODUCTIONRestoring mechanical alignment and soft tissue balance in total knee arthroplasty （TKA） for valgus knees depend on the origin of deformity and soft tissue status. Valgus deformity can exist during knee f...INTRODUCTIONRestoring mechanical alignment and soft tissue balance in total knee arthroplasty （TKA） for valgus knees depend on the origin of deformity and soft tissue status. Valgus deformity can exist during knee flexion besides extension, which could lead to patellofemoral joint instability and soft tissue imbalance in the flexion gap, and thus complicate the surgical procedures.展开更多
Objective:To elucidate the progression of angioedema of the head and neck with routine management and to assess the utility of serial physical exams and fiberoptic laryngos-copy in its management. Methods:This study ...Objective:To elucidate the progression of angioedema of the head and neck with routine management and to assess the utility of serial physical exams and fiberoptic laryngos-copy in its management. Methods:This study was a prospective observational research. From 2013 to 2014, a prospec-tive observational study was conducted at a tertiary referral center. Forty patient were ap-proached, 7 refused, 33 (18e90 years old) were enrolled. Patients presented with angioedema involving the head and neck over a 12 month period were asked to participate in the study. Physical examination and fiberoptic laryngoscopy were performed at presentation and then repeated at least 1 h later. Results:Thirty-three patients with head and neck angioedema from any cause were enrolled (mean age 58, range 23e89 years). The upper lip was the most commonly involved site (58%). On reevaluation, 82% of patients reported subjective improvement in symptoms. Theassociation between subjective improvement and the physical exam, including fiberoptic laryngoscopy findings, was statistically significant (P<0.001). Conclusion:In stable patients with angioedema of any head and neck subsite, self-reported symptoms are associated with clinical stability or improvement as assessed by physical signs and fiberoptic laryngoscopy. Patients’ symptoms may be an appropriate surrogate to monitor clinical status without the need for routine serial physical examinations or fiberoptic laryngos-copy, though further study is needed. Copyright a 2016 Chinese Medical Association. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).展开更多
Objective:To investigate and analyze the annual physical examination results of retired employees from a unit in the civil aviation system,focusing on blood lipids,blood glucose,blood uric acid,and blood routine resul...Objective:To investigate and analyze the annual physical examination results of retired employees from a unit in the civil aviation system,focusing on blood lipids,blood glucose,blood uric acid,and blood routine results.The study aims to provide relevant references for formulating reasonable disease management measures for preventing and controlling hyperlipidemia,hyperuricemia,and other conditions in retired employees.Methods:The examination results of 231 participants were collected and analyzed.The participants were divided into four groups based on age:middle-aged group,young-old group,middle-old group,and old-old group.The blood test results were compared across these groups,and an assessment of atherosclerotic cardiovascular disease(ASCVD)risk levels was completed in conjunction with medical history.Blood test results were also compared by gender.Results:There were no significant statistical differences in blood test results when grouped by age.However,the prevalence of hyperuricemia was higher in males than in females,while the prevalence of hypercholesterolemia was higher in females than in males.The LDL-C target achievement rate was lower in the moderate-and-high-risk group as well as the very high-risk group as defined by ASCVD risk levels.Conclusion:Management of hyperuricemia and hyperlipidemia in retired employees(elderly patients)should be strengthened to reduce the risk of ASCVD events and alleviate the potential medical burden associated with disease progression.展开更多
AIM:To explore the correlation between diabetic retinopathy(DR)and Helicobacter pylori(Hp)infection,based on data from a physical examination population.METHODS:This cross-sectional retrospective analysis included dat...AIM:To explore the correlation between diabetic retinopathy(DR)and Helicobacter pylori(Hp)infection,based on data from a physical examination population.METHODS:This cross-sectional retrospective analysis included data of 73824 health examination participants from December 2018 to December 2019.Participants were divided into the diabetic group and non-diabetic group,nondiabetic retinopathy(NDR)group,non-proliferative diabetic retinopathy(NPDR)group,proliferative diabetic retinopathy(PDR)group,and Hp infection group.Gender,age,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),glycated hemoglobin A1c(HbA1c),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and Hp data were recorded to compare the degree of DR lesions and Hp infection.Logistic regression analysis was used to evaluate the correlation between DR and Hp infection.RESULTS:There was a statistically significant difference between the diabetic and non-diabetic group(χ2=94.17,P<0.0001).Logistic regression analysis showed that male sex,age,BMI,SBP,TG,LDL-C,and Hp infection were independent risk factors for DR.There was no correlation between the degree of DR lesions and Hp infection(ρ=-0.00339,P=0.7753).Age[odds ratio(OR)=1.035,95%CI:1.024,1.046,P<0.0001]and SBP(OR=1.009,95%CI:1.004,1.015,P=0.0013)were independent risk factors for the degree of DR.CONCLUSION:There is a significant correlation between DR and Hp infection in the physical examination population.Hp infection is a risk factor for DR,and there is no significant difference between Hp infection and DR of different pathological degrees.Actively eradicating Hp may be of help to prevent DR.展开更多
AIM: To study possible gynecological organ pathologies in the differential diagnosis of acute right lower abdominal pain in patients of reproductive age.
The study investigated the distribution of Epstein-Barr virus(EBV)EA-IgA,VCAIgA,and EBVNA-IgG antibodies in a local population of Wuhan,China.Chemiluminescence immunoassay(CL1A)was used to detect EBV EA-IgA,VCA-IgA,an...The study investigated the distribution of Epstein-Barr virus(EBV)EA-IgA,VCAIgA,and EBVNA-IgG antibodies in a local population of Wuhan,China.Chemiluminescence immunoassay(CL1A)was used to detect EBV EA-IgA,VCA-IgA,and EBVNA-IgG antibodies in 972 subjects undergoing physical examination in Wuhan,and the results were analyzed.The detection rate of EBV was positively correlated with age.In the 972 cases,there was significant difference between different genders in the positive rate of VCA-IgA and EBVNA-IgG.Moreover,the positive rate of VCA-IgA and EBVNA-IgG was higher in men>60 years old than in those<60 but no significant differences were found in three antibodies among various age groups.Our results suggested that the EBV infection should be intensively monitored in elderly people in Wuhan.展开更多
BACKGROUND: Diagnosing pericardial effusion is critical for optimal patient care. Typically, clinicians use physical examination ? ndings and historical features suggesting pericardial effusion to determine which pati...BACKGROUND: Diagnosing pericardial effusion is critical for optimal patient care. Typically, clinicians use physical examination ? ndings and historical features suggesting pericardial effusion to determine which patients require echocardiography. The diagnostic characteristics of these tools are not well described. The objective of this study is to determine the prevalence of historical features and sensitivity of clinical signs to inform clinicians when to proceed with echocardiogram.METHODS: A retrospective review of point-of-care echocardiograms performed over a two and a half year period in two emergency departments were reviewed for the presence of a pericardial effusion. Patient charts were reviewed and abstracted for presenting symptoms, historical features and clinical findings. The prevalence of presenting symptoms and historical features and the sensitivity of classic physical examination ? ndings associated with pericardial effusion and tamponade were determined.RESULTS: One hundred and fifty-three patients with pericardial effusion were identified. Of these patients, the most common presenting complaint was chest pain and shortness of breath. Patients had no historical features that would suggest pericardial effusion in 37.5% of cases. None of the patients with pericardial effusion or pericardial tamponade had all of the elements of Beck's triad. The sensitivity of Beck's triad was found to be 0(0%–19.4%). The sensitivity for one ? nding of Beck's triad to diagnose pericardial tamponade was 50%(28.0%–72.0%).CONCLUSION: History and physical examination findings perform poorly as tests for the diagnosis of pericardial effusion or pericardial tamponade. Clinicians must liberally evaluate patients suspected of having a pericardial effusion with echocardiography.展开更多
Objectives:This study aimed to describe cardiovascular risk and cardiovascular disease(CVD)knowledge among older adults,and further explore the association between knowledge and risk.Methods:In this cross-sectional st...Objectives:This study aimed to describe cardiovascular risk and cardiovascular disease(CVD)knowledge among older adults,and further explore the association between knowledge and risk.Methods:In this cross-sectional study,we enrolled 1120 older adults who received physical examination in health centers.The participants were interviewed to obtain their behavioral risk factors related to CVD and clinical characteristics.A risk prediction chart was used to predict participants'cardiovascular risk based on clinical characteristics and behavioral risk factors.Participants'CVD knowledge was collected with a pretested knowledge questionnaire.Results:Among the 1120 participants,240(21.4%)had low cardiovascular risk,353(31.5%)had moderate cardiovascular risk,527(47%)had high and very high cardiovascular risk.The knowledge level about CVD among 0.8%of the 1120 participants was good while that of 56.9%was poor.Lower CVD knowledge level,older age,lower income,and lower educational level were the independent factors of higher cardiovascular risk level.Conclusions:This study highlights the need to reduce the cardiovascular risk among older adults.CVD knowledge should be considered when developing health interventions.展开更多
AIM To extend our previously-published experience in estimating pressure gradients(PG) via physical examination in a large patient cohort. METHODS From January 1, 1997 through December 31, 2009, an attending pediatric...AIM To extend our previously-published experience in estimating pressure gradients(PG) via physical examination in a large patient cohort. METHODS From January 1, 1997 through December 31, 2009, an attending pediatric cardiologist compared clinical examination(EXAM) with Doppler-echo(ECHO), in 1193 patients with pulmonic stenosis(PS, including tetralogy of Fallot), aortic stenosis(AS), and ventricular septal defect(VSD). EXAM PG estimates were based primarily on a murmur's pitch, grade, and length. ECHO peak instantaneous PG was derived from the modified Bernoulli equation. Patients were 0-38.4 years old(median 4.8).RESULTS For all patients, EXAM correlated highly with ECHO: ECHO = 0.99(EXAM) + 3.2 mm Hg; r = +0.89; P < 0.0001. Agreement was excellent(mean difference =-2.9 ± 16.1 mm Hg). In 78% of all patients, agreement between EXAM and ECHO was within 15 mm Hg and within 5 mm Hg in 45%. Clinical estimates of PS PG were more accurate than of AS and VSD. A palpable precordial thrill and increasing loudness of the murmur predicted highergradients(P < 0.0001). Weight did not influence accuracy. A learning curve was evident, such that the most recent quartile of patients showed ECHO = 1.01(EXAM) + 1.9, r = +0.92, P < 0.0001; during this time, the attending pediatric cardiologist had been > 10 years in practice.CONCLUSION Clinical examination can accurately estimate PG in PS, AS, or VSD. Continual correlation of clinical findings with echocardiography can lead to highly accurate diagnostic skills.展开更多
AIM:To assess the prevalence of meibomian gland dysfunction(MGD)in staffs and faculty members of Sichuan University,China.METHODS:The records of the annually systemic physical examination of 4404 consecutive staffs an...AIM:To assess the prevalence of meibomian gland dysfunction(MGD)in staffs and faculty members of Sichuan University,China.METHODS:The records of the annually systemic physical examination of 4404 consecutive staffs and faculty members of Sichuan University were analyzed retrospectively.Ocular symptoms and signs of ocular surface were evaluated.RESULTS:MGD was diagnosed in 1424 participants(32.3%),with a mean age of 43.0±9.6 y.Of these,718(50.4%)were females and no significant difference was found between males and females.The highest prevalence was found in the age 50-59 y(36.0%).Logistic regression analysis showed that age is an impact factor of MGD(P<0.001,odds ratio=1.014).CONCLUSION:The prevalence of MGD in staffs and faculty members of a Chinese university is 32.3%,and increases with age.展开更多
BACKGROUND Shoulder maneuvers and magnetic resonance imaging(MRI)are performed to diagnose supraspinatus tendon tears regardless of arthroscopy exam.Although there are many studies on this subject,there is a lack of s...BACKGROUND Shoulder maneuvers and magnetic resonance imaging(MRI)are performed to diagnose supraspinatus tendon tears regardless of arthroscopy exam.Although there are many studies on this subject,there is a lack of studies comparing the sensitivity(Se)and specificity(Sp)of shoulder maneuvers and MRI to arthroscopic findings(intact,partial,or full thickness supraspinatus tendon tear).AIM To compare the diagnostic values of shoulder maneuvers with MRI for supraspinatus tendon tears in patients undergoing shoulder arthroscopy.METHODS A total of 199 consecutive patients from four orthopedic centers met the eligibility criteria of shoulder pain persisting for at least four weeks.They were prospectively enrolled in this study from April 2017 to April 2019.Seven clinical tests(full can,empty can,drop arm,Hawkins’,painful arc,Neer’s sign and resisted external rotation)and MRI were performed,and all were compared with surgical findings.Full can,empty can and resisted external rotation tests were interpreted as positive in the case of pain and/or weakness.We assessed the Se,Sp,accuracy,positive predictive value(PPV)and negative predictive value(NPV),positive and negative likelihood ratio and diagnostic odds ratio for overall,partial and fullthickness supraspinatus tears.RESULTS MRI had the highest Se for overall(0.97),partial(0.91)and full-thickness(0.99)tears;moreover,MRI had the highest NPV:0.90,0.88 and 0.98 for overall,partial and full-thickness tears,respectively.For overall supraspinatus tears,the Se and PPV were:Painful arc(Se=0.85/PPV=0.91),empty can(pain)(Se=0.80/PPV=0.89),full can(pain)(Se=0.78/PPV=0.90),resisted external rotation(pain)(Se=0.48/PPV=0.87),drop arm(Se=0.19/PPV=0.97),Neer’s sign(Se=0.78/PPV=0.93)and Hawkins’(Se=0.80/PPV=0.88).MRI had the highest PPV(0.99).The Hawkin’s test had the highest false positive rate in patients with intact tendons(0.36).The Sp of the empty can and full can(both tests positive for pain and weakness),drop arm and MRI were:0.93,0.91,0.98 and 0.96,respectively.For partial and full-thickness tears,the empty can test(positive for pain and weakness)had a Sp of 0.93,and the drop arm and MRI had the same Sp(0.98).CONCLUSION Physical examination demonstrated good diagnostic value,the drop arm test had a Sp as good as MRI for supraspinatus tears;however,MRI was more accurate in ruling out tears.The Hawkins’test had high false-positive findings in patients with intact tendons.展开更多
基金Supported by the Key Scientific and Technological Project of Liaoning Province during the 12~(th) Five-Year Plan Period(201102383)~~
文摘[Objective] This study aimed to establish a physical examination method for artificial rainfall effect based on radar data. [Method] The radar base data of Shenyang was processed with interpolation by using the nearest neighbor in radial and oriental direction to establish corresponding response variables, and the effect of a precipitation enhancement case was analyzed. [Result] The trends of response variables showed that there was certain positive effect of the precipitation enhancement operation. [Conclusion] The analysis on a case was not sufficient enough, and statistical test should be the future direction of the study on the physical effect.
文摘Because decompensated heart failure(HF)patients present primarily with symptoms of congestion,the assessment of volume status is of paramount importance.Despite the addition of new technologies that can predict intracardiac filling pressures,the physical exam(PE)remains the most accessible and cost-effective tool available to clinicians.An elevated jugular venous pressure(JVP) is considered the most sensitive sign of volume overload,although the commonly used‘method of Lewis’has several limitations.A useful cutoff is that if the JVP is greater than 3 cm in vertical distance above the sternal angle,the central venous pressure is elevated.In addition to assessment of volume status,the PE in HF can reveal adverse prognostic signs,namely:elevated JVP,presence of third heart sound,elevated heart rate,low systolic BP,and low proportional pulse pressure(＜25%).This article will review the evidence for the diagnostic and prognostic utility of common PE findings in HF.
基金funding support from the Young Talents for research on Traditional Chinese Medicine Science and Technology in Sichuan (No.2016Q065)
文摘This paper studies the correlation between Traditional Chinese Medicine(TCM)Constitution discrimination and physical examination index based on BPNN algorithm.253cases of routine urine test were used to build a linkage model between TCM Constitution and physical indicators via BPNN algorithm.According to the test,the correct rate of learning and test group are60%and40%,respectively.A strong correlation was found between TCM Constitution and physical examination indexes.By applying cutting-edge knowledge and technologies,the development and modernization process of TCM can be greatly promoted.
基金the funding support from the National Key Research and Development Project of China(No.2018YFC1707606)National Natural Science Foundation of China(No.81904324)Youth Foundation of Sichuan Administration of Traditional Chinese Medicine(No.2016Q065).
文摘Objective To establish correlation models between various physical examination indexes and traditional Chinese medicine(TCM)constitutions,and explore their relationships based on the radial basis function(RBF)neural network.Methods The raw data of physical examination indexes and TMC constitutions of 650 subjects who underwent a physical examination were cleaned,classified and sorted,on the basis of which valid data were retrieved and categorized into a training dataset and a test dataset.Subsequently,the RBF neural network was applied to the valid samples in the training set to establish correlation models between various physical examination indexes and TCM constitutions.The accuracy and the error margin of the correlation model were then verified using the valid samples in the test set.Results Of all selected samples,the highest accuracy rates were 80% for the blood lipid index-TCM constitution model;100% for the renal function index-TCM constitution model;100% for the blood routine(male)index-TCM constitution model;88.8% for the blood routine(female)index-TCM constitution model;84.1%for the urine routine index-TCM constitution model;and 100% for the blood transfusion index-TCM constitution model.Conclusions The samples selected in this study suggested that there is a strong correlation between physical examination indexes and TCM constitutions,making it feasible to apply the established correlation models to TCM constitution identification.
基金funding support from the Traditional Chinese Medicine of Sichuan Province Youth Science and Technology Research Special Fund (No.2016Q065)Chengdu University of TCM Fund for Development of Science and Technology (No.ZRQN1790)
文摘Objective Identification of one’s constitution based on a combination of features and back propagation neural network theory is needed in modern medicine and traditional Chinese medicine(TCM).We describe a method to identify one’s constitution based on TCM constitution classification and a physical index model.Methods We created a constitution identification system based on neural network using Visio Studio development tool.We report the initial implementation of the system,the accuracy of which was verified using actual data.Results We found a relatively strong correlation between TCM constitution and physical indicators.Conclusion Finally,our report describes a possible application of the proposed system.
基金supported by National Natural Science Foundation of China(81422040,81172685)Ministry of Education New Century Excellent Talents(NCET-13-0362)+3 种基金Shanghai Science and Technology Commission(12411950405,14441904004,13QH1401800)The fourth round of Three-Year Public Health Action Plan(2015–2017)(GWIV-36)Shanghai Municipal Education Commission(D1502)The Ministry of Science and Technology(2010CB535000)
文摘Background:Designing a simple and accessible approach to age estimation in children and youth is a great challenge in the fields of sports and physical activity(PA).This study was designed to develop and validate a physical-examination-based method of estimating age in young children.Methods:In a cross-sectional study conducted in 2014,we performed physical examinations and assessed PA among 14,970 elementary school children 7–12 years old in Shanghai,China.Additional biological information on the children's height and birth date was ascertained through their parents.Two indicators were applied to develop a gender-specific age estimation equation:The percentage of predicted mature height(PPMH) and the Tanner stage.The equation was validated through a k-fold cross-validation approach.To check for estimation accuracy,the association between the discrepancy of estimated age(EA) and chronological age and PA was examined.Results:The gender-specific equations of EA were as follows:EA_(boy) = –6.071 + 6.559 Tanner 2 + 13.315 Tanner 3 + 14.130 Tanner 4 + 0.190 PPMH – 0.071 Tanner 2 × PPMH – 0.146 Tanner 3 × PPMH – 0.155 Tanner 4 × PPMH;EA_(girl) = –4.524 – 1.251 Tanner 2 + 2.504 Tanner 3 + 8.752 Tanner 4 + 11.893 Tanner 5 + 0.158 PPMH + 0.017 Tanner 2 × PPMH – 0.024 Tanner 3 × PPMH – 0.087 Tanner 4 × PPMH – 0.118 Tanner5 × PPMH.The mean absolute error was 0.60 years for boys and 0.59 years for girls.The discrepancy score was negatively and weakly associated with self-reported moderate-to-vigorous PA in both genders(r_(boy) = –0.09,p < 0.001;r_(girl) = –0.12,p < 0.001).Conclusion:Findings suggest that physical examinations could provide a valid and reliable approach for estimating age in young Chinese children.
基金funded by Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(No.ZYYCXTD-D-202005)the CAMS Innovation Fund for Medical Sciences(CIFMS)(ID:2021-I2M-1-071 and 2022-I2M-2-001).
文摘Rhizosphere microorganisms,as one of the most important components of the soil microbiota and plant holobiont,play a key role in the medicinal plant-soil ecosystem,which are closely related to the growth,adaptability,nutrient absorption,stress tolerance and pathogen resistance of host plants.In recent years,with the wide application of molecular biology and omics technologies,the outcomes of rhizosphere microorganisms on the health,biomass production and secondary metabolite biosynthesis of medicinal plants have received extensive attention.However,whether or to what extent rhizosphere microorganisms can contribute to the construction of the quality evaluation system of Chinese medicinal materials is still elusive.Based on the significant role of rhizosphere microbes in the survival and quality formation of medicinal plants,this paper proposed a new concept of rhizosphere microbial markers(micro-markers),expounded the relevant research methods and ideas of applying the new concept,highlighted the importance of micro-markers in the quality evaluation and control system of traditional Chinese medicines(TCMs),and introduced the potential value in soil environmental assessment,plant pest control and quality assessment of TCMs.It provides reference for developing ecological planting of TCMs and ensuring the production of high quality TCMs by regulating rhizosphere microbial communities.
文摘Background Accurate evaluation of response following chemotherapy treatment is essential for surgical decision making in patients with breast cancer. Modalities that have been used to monitor response to neo-adjuvant chemotherapy （NAC） include physical examination （PE）, ultrasound （US）, and magnetic resonance imaging （MRI）. The purpose of this study was to evaluate the accuracy of PE, US, and MRI in predicting the response to NAC in patients with breast cancer. Methods According to the response evaluation criteria in solid tumors guidelines, the largest unidimensional measurement of the tumor diameter evaluated by PE, US, and MRI before and after NAC was classified into four grades, including clinical complete response, clinical partial response, clinical progressive disease, clinical stable disease, and compared with the final histopathological examination. Results Of the 64 patients who received NAC, the pathologic complete response （pCR） was shown in 13 of 64 patients （20%）. The sensitivity of PE, US, and MRI in predicting the major pathologic response was 73%, 75%, and 80%, respectively, and the specificity was 45%, 50%, and 50% respectively. For predicting a pCR, the sensitivity of PE, US, and MRI was 46%, 46%, and 39%, respectively, and the specificity was 65%, 98%, and 92% respectively. Conclusions Compared with final pathologic findings, all these three clinical and imaging modalities tended to obviously underestimate the pCR rate. A more appropriate, universal, and practical standard by clinical and imaging modalities in predicting the response to neo-adjuvant chemotherapy in vivo is essential.
基金the National Key R&D Program of China under Grant No.2020AAA0103800.
文摘Cataract is a very common eye disease and the most significant cause of blindness.In consideration of its burden on society,the focus was put on testing the risk factors of cataract and building robust machine learning models in which these factors can be utilized to predict the risk of cataract.The data used herein was collected by a Chinese physical examination center located in Shanghai.It contains more than 120,000 examinees and about 500 physical examination metrics.Firstly,association rules were adopted to filter 39 abnormalities which are more likely to incur the risk of cataract,and the significance of these abnormalities was tested with univariate analysis and multivariate analysis.The test results indicate that age,diabetes,refractive error,retinal arteriosclerosis,thyroid nodules,and incomplete mammary gland degeneration significantly increase the possibility of cataract.Various machine learning models were compared in terms of their performance in predicting the risk of cataract based on these six factors,among which the logistic regression model and the decision-tree based ensemble methods outperform others.The test set A U C of these models can reach 0.84.
文摘INTRODUCTIONRestoring mechanical alignment and soft tissue balance in total knee arthroplasty （TKA） for valgus knees depend on the origin of deformity and soft tissue status. Valgus deformity can exist during knee flexion besides extension, which could lead to patellofemoral joint instability and soft tissue imbalance in the flexion gap, and thus complicate the surgical procedures.
文摘Objective:To elucidate the progression of angioedema of the head and neck with routine management and to assess the utility of serial physical exams and fiberoptic laryngos-copy in its management. Methods:This study was a prospective observational research. From 2013 to 2014, a prospec-tive observational study was conducted at a tertiary referral center. Forty patient were ap-proached, 7 refused, 33 (18e90 years old) were enrolled. Patients presented with angioedema involving the head and neck over a 12 month period were asked to participate in the study. Physical examination and fiberoptic laryngoscopy were performed at presentation and then repeated at least 1 h later. Results:Thirty-three patients with head and neck angioedema from any cause were enrolled (mean age 58, range 23e89 years). The upper lip was the most commonly involved site (58%). On reevaluation, 82% of patients reported subjective improvement in symptoms. Theassociation between subjective improvement and the physical exam, including fiberoptic laryngoscopy findings, was statistically significant (P<0.001). Conclusion:In stable patients with angioedema of any head and neck subsite, self-reported symptoms are associated with clinical stability or improvement as assessed by physical signs and fiberoptic laryngoscopy. Patients’ symptoms may be an appropriate surrogate to monitor clinical status without the need for routine serial physical examinations or fiberoptic laryngos-copy, though further study is needed. Copyright a 2016 Chinese Medical Association. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
文摘Objective:To investigate and analyze the annual physical examination results of retired employees from a unit in the civil aviation system,focusing on blood lipids,blood glucose,blood uric acid,and blood routine results.The study aims to provide relevant references for formulating reasonable disease management measures for preventing and controlling hyperlipidemia,hyperuricemia,and other conditions in retired employees.Methods:The examination results of 231 participants were collected and analyzed.The participants were divided into four groups based on age:middle-aged group,young-old group,middle-old group,and old-old group.The blood test results were compared across these groups,and an assessment of atherosclerotic cardiovascular disease(ASCVD)risk levels was completed in conjunction with medical history.Blood test results were also compared by gender.Results:There were no significant statistical differences in blood test results when grouped by age.However,the prevalence of hyperuricemia was higher in males than in females,while the prevalence of hypercholesterolemia was higher in females than in males.The LDL-C target achievement rate was lower in the moderate-and-high-risk group as well as the very high-risk group as defined by ASCVD risk levels.Conclusion:Management of hyperuricemia and hyperlipidemia in retired employees(elderly patients)should be strengthened to reduce the risk of ASCVD events and alleviate the potential medical burden associated with disease progression.
基金Supported by The Project of National Key Research and Development(No.2018YFC1106103)。
文摘AIM:To explore the correlation between diabetic retinopathy(DR)and Helicobacter pylori(Hp)infection,based on data from a physical examination population.METHODS:This cross-sectional retrospective analysis included data of 73824 health examination participants from December 2018 to December 2019.Participants were divided into the diabetic group and non-diabetic group,nondiabetic retinopathy(NDR)group,non-proliferative diabetic retinopathy(NPDR)group,proliferative diabetic retinopathy(PDR)group,and Hp infection group.Gender,age,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),glycated hemoglobin A1c(HbA1c),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and Hp data were recorded to compare the degree of DR lesions and Hp infection.Logistic regression analysis was used to evaluate the correlation between DR and Hp infection.RESULTS:There was a statistically significant difference between the diabetic and non-diabetic group(χ2=94.17,P<0.0001).Logistic regression analysis showed that male sex,age,BMI,SBP,TG,LDL-C,and Hp infection were independent risk factors for DR.There was no correlation between the degree of DR lesions and Hp infection(ρ=-0.00339,P=0.7753).Age[odds ratio(OR)=1.035,95%CI:1.024,1.046,P<0.0001]and SBP(OR=1.009,95%CI:1.004,1.015,P=0.0013)were independent risk factors for the degree of DR.CONCLUSION:There is a significant correlation between DR and Hp infection in the physical examination population.Hp infection is a risk factor for DR,and there is no significant difference between Hp infection and DR of different pathological degrees.Actively eradicating Hp may be of help to prevent DR.
文摘AIM: To study possible gynecological organ pathologies in the differential diagnosis of acute right lower abdominal pain in patients of reproductive age.
基金grants from the Natural Science Foundation of Hubei Province(No.2018CFB749 and No.2018ADC073)the Scientific Research Fund of Union Hospital,Tongji Medical College,Huazhong University of Science and Technology(No.02.03.2017-292 and No.02.03.2017-327)General Project of Hubei Health Committee(No.02.07.19030018).
文摘The study investigated the distribution of Epstein-Barr virus(EBV)EA-IgA,VCAIgA,and EBVNA-IgG antibodies in a local population of Wuhan,China.Chemiluminescence immunoassay(CL1A)was used to detect EBV EA-IgA,VCA-IgA,and EBVNA-IgG antibodies in 972 subjects undergoing physical examination in Wuhan,and the results were analyzed.The detection rate of EBV was positively correlated with age.In the 972 cases,there was significant difference between different genders in the positive rate of VCA-IgA and EBVNA-IgG.Moreover,the positive rate of VCA-IgA and EBVNA-IgG was higher in men>60 years old than in those<60 but no significant differences were found in three antibodies among various age groups.Our results suggested that the EBV infection should be intensively monitored in elderly people in Wuhan.
文摘BACKGROUND: Diagnosing pericardial effusion is critical for optimal patient care. Typically, clinicians use physical examination ? ndings and historical features suggesting pericardial effusion to determine which patients require echocardiography. The diagnostic characteristics of these tools are not well described. The objective of this study is to determine the prevalence of historical features and sensitivity of clinical signs to inform clinicians when to proceed with echocardiogram.METHODS: A retrospective review of point-of-care echocardiograms performed over a two and a half year period in two emergency departments were reviewed for the presence of a pericardial effusion. Patient charts were reviewed and abstracted for presenting symptoms, historical features and clinical findings. The prevalence of presenting symptoms and historical features and the sensitivity of classic physical examination ? ndings associated with pericardial effusion and tamponade were determined.RESULTS: One hundred and fifty-three patients with pericardial effusion were identified. Of these patients, the most common presenting complaint was chest pain and shortness of breath. Patients had no historical features that would suggest pericardial effusion in 37.5% of cases. None of the patients with pericardial effusion or pericardial tamponade had all of the elements of Beck's triad. The sensitivity of Beck's triad was found to be 0(0%–19.4%). The sensitivity for one ? nding of Beck's triad to diagnose pericardial tamponade was 50%(28.0%–72.0%).CONCLUSION: History and physical examination findings perform poorly as tests for the diagnosis of pericardial effusion or pericardial tamponade. Clinicians must liberally evaluate patients suspected of having a pericardial effusion with echocardiography.
基金The study was funded by a grant from the National Natural Science Foundation of China(NSFC,contract grant number:81641112)Hunan Excellent Young Teachers Fund(contract grant number:2018191RQG010).
文摘Objectives:This study aimed to describe cardiovascular risk and cardiovascular disease(CVD)knowledge among older adults,and further explore the association between knowledge and risk.Methods:In this cross-sectional study,we enrolled 1120 older adults who received physical examination in health centers.The participants were interviewed to obtain their behavioral risk factors related to CVD and clinical characteristics.A risk prediction chart was used to predict participants'cardiovascular risk based on clinical characteristics and behavioral risk factors.Participants'CVD knowledge was collected with a pretested knowledge questionnaire.Results:Among the 1120 participants,240(21.4%)had low cardiovascular risk,353(31.5%)had moderate cardiovascular risk,527(47%)had high and very high cardiovascular risk.The knowledge level about CVD among 0.8%of the 1120 participants was good while that of 56.9%was poor.Lower CVD knowledge level,older age,lower income,and lower educational level were the independent factors of higher cardiovascular risk level.Conclusions:This study highlights the need to reduce the cardiovascular risk among older adults.CVD knowledge should be considered when developing health interventions.
文摘AIM To extend our previously-published experience in estimating pressure gradients(PG) via physical examination in a large patient cohort. METHODS From January 1, 1997 through December 31, 2009, an attending pediatric cardiologist compared clinical examination(EXAM) with Doppler-echo(ECHO), in 1193 patients with pulmonic stenosis(PS, including tetralogy of Fallot), aortic stenosis(AS), and ventricular septal defect(VSD). EXAM PG estimates were based primarily on a murmur's pitch, grade, and length. ECHO peak instantaneous PG was derived from the modified Bernoulli equation. Patients were 0-38.4 years old(median 4.8).RESULTS For all patients, EXAM correlated highly with ECHO: ECHO = 0.99(EXAM) + 3.2 mm Hg; r = +0.89; P < 0.0001. Agreement was excellent(mean difference =-2.9 ± 16.1 mm Hg). In 78% of all patients, agreement between EXAM and ECHO was within 15 mm Hg and within 5 mm Hg in 45%. Clinical estimates of PS PG were more accurate than of AS and VSD. A palpable precordial thrill and increasing loudness of the murmur predicted highergradients(P < 0.0001). Weight did not influence accuracy. A learning curve was evident, such that the most recent quartile of patients showed ECHO = 1.01(EXAM) + 1.9, r = +0.92, P < 0.0001; during this time, the attending pediatric cardiologist had been > 10 years in practice.CONCLUSION Clinical examination can accurately estimate PG in PS, AS, or VSD. Continual correlation of clinical findings with echocardiography can lead to highly accurate diagnostic skills.
基金Supported by the National Natural Science Foundation of China(No.81870665)。
文摘AIM:To assess the prevalence of meibomian gland dysfunction(MGD)in staffs and faculty members of Sichuan University,China.METHODS:The records of the annually systemic physical examination of 4404 consecutive staffs and faculty members of Sichuan University were analyzed retrospectively.Ocular symptoms and signs of ocular surface were evaluated.RESULTS:MGD was diagnosed in 1424 participants(32.3%),with a mean age of 43.0±9.6 y.Of these,718(50.4%)were females and no significant difference was found between males and females.The highest prevalence was found in the age 50-59 y(36.0%).Logistic regression analysis showed that age is an impact factor of MGD(P<0.001,odds ratio=1.014).CONCLUSION:The prevalence of MGD in staffs and faculty members of a Chinese university is 32.3%,and increases with age.
文摘BACKGROUND Shoulder maneuvers and magnetic resonance imaging(MRI)are performed to diagnose supraspinatus tendon tears regardless of arthroscopy exam.Although there are many studies on this subject,there is a lack of studies comparing the sensitivity(Se)and specificity(Sp)of shoulder maneuvers and MRI to arthroscopic findings(intact,partial,or full thickness supraspinatus tendon tear).AIM To compare the diagnostic values of shoulder maneuvers with MRI for supraspinatus tendon tears in patients undergoing shoulder arthroscopy.METHODS A total of 199 consecutive patients from four orthopedic centers met the eligibility criteria of shoulder pain persisting for at least four weeks.They were prospectively enrolled in this study from April 2017 to April 2019.Seven clinical tests(full can,empty can,drop arm,Hawkins’,painful arc,Neer’s sign and resisted external rotation)and MRI were performed,and all were compared with surgical findings.Full can,empty can and resisted external rotation tests were interpreted as positive in the case of pain and/or weakness.We assessed the Se,Sp,accuracy,positive predictive value(PPV)and negative predictive value(NPV),positive and negative likelihood ratio and diagnostic odds ratio for overall,partial and fullthickness supraspinatus tears.RESULTS MRI had the highest Se for overall(0.97),partial(0.91)and full-thickness(0.99)tears;moreover,MRI had the highest NPV:0.90,0.88 and 0.98 for overall,partial and full-thickness tears,respectively.For overall supraspinatus tears,the Se and PPV were:Painful arc(Se=0.85/PPV=0.91),empty can(pain)(Se=0.80/PPV=0.89),full can(pain)(Se=0.78/PPV=0.90),resisted external rotation(pain)(Se=0.48/PPV=0.87),drop arm(Se=0.19/PPV=0.97),Neer’s sign(Se=0.78/PPV=0.93)and Hawkins’(Se=0.80/PPV=0.88).MRI had the highest PPV(0.99).The Hawkin’s test had the highest false positive rate in patients with intact tendons(0.36).The Sp of the empty can and full can(both tests positive for pain and weakness),drop arm and MRI were:0.93,0.91,0.98 and 0.96,respectively.For partial and full-thickness tears,the empty can test(positive for pain and weakness)had a Sp of 0.93,and the drop arm and MRI had the same Sp(0.98).CONCLUSION Physical examination demonstrated good diagnostic value,the drop arm test had a Sp as good as MRI for supraspinatus tears;however,MRI was more accurate in ruling out tears.The Hawkins’test had high false-positive findings in patients with intact tendons.
