年度体检到底需要检查什么？| 南加州着名家庭科医生中钟国权博士

General Physical Examine

  Overview 

A routine physical examination ensures that you stay in good health. A physical can also be a  preventive step. It allows you to catch up on vaccinations or detect a serious condition, like  cancer or diabetes, before it causes problems. During a routine physical, your doctor can also  check vitals, including weight, heart rate, and blood pressure. 

概述 

例行体检可确保您保持健康。身体检 查也可以是预防步骤。它可以让您在引起问题之前赶上疫苗 接种或检测严重疾病，如癌症或糖尿病。在例行体检期间，您的医生还可以检 查生命体徵，包括体 重、心率和血压。

  What does a physical exam address? 

Your doctor will use a physical exam to see how your body is performing. Depending on your personal health history,  your doctor may choose to focus on certain areas. If you have a family history of heart disease, for example, you may  receive additional blood pressure checks, blood tests, and diabetes and cholesterol screenings.Based on test results,  

age, and personal health history, the exam is also an opportunity to discuss future prevention measures with your  doctor. 

体检的目的是什麽？ 

您的医生将通过体检来了解您的身体状况。根据您的个人健康史，您的医生可能会选择专注於某些领域。例如，如果您 有心脏病家族史，您可能会接受额外的血压检 查、血液检查以及糖尿病和胆固醇筛 查。 根据测试结果、年龄和个人健康 史，考试也是与您的医生讨论未来预防措施的机会。

  What does a physical exam entail? 

Updated health history Vital sign  checks Visual exam Physical exams 

体检需要什麽？ 

更新健康史 生命体徵检查 视觉检查 体 格检查

Physical exams: As the physical exam continues, the doctor will use tools to look in your eyes,  ears, nose, and throat. They’ll listen to your heart and lungs. This exam also includes: 

● touching, or “palpating,” parts of your body (like your abdomen) to feel for abnormalities ● checking skin, hair, and nails 

● possibly examining your genitalia and rectum 

● testing your motor functions and reflexes 

体格检查: 随着身体检查的继续，医生将使用工具检 查您的眼睛、耳朵、鼻子和喉咙。他们会倾听你的 心和肺。该考试还包括： 

● 触摸或“触诊”身体的某些部位（如腹部）以感觉异常 

● 检查皮肤、头发和指甲 

● 可能检查您的生殖器和直肠 

● 测试你的运动功能和反应

  Laboratory tests 

To complete the physical, your doctor may draw blood for several laboratory tests. These can include a  complete blood count and a complete metabolic panel (also called a chemistry panel). The panel tests  your blood plasma and can indicate any issues that exist in your kidneys, liver, blood chemistry, and  immune system. This helps detect irregularities in your body that might indicate a larger problem. Your  doctor may request a diabetes screen and a thyroid screen. If you have an increased risk of heart attack,  heart disease, or stroke, they may also request a lipid panel (cholesterol test). 

实验室测试 

为了完成身体检查，您的医生可能会抽血进行多项实验室检 查。这些可以包括全血细胞计数和完整的代谢 组（也称为化学组）。该小组会测试您的血浆，并可以指出您的肾脏、肝脏、血液化学和免疫系统中存在的任 何问题。这有助於检测您身体中可能表明存在更大问题的异常情况。您的医生可能会要求进行糖尿病筛 查 

和甲状腺筛查。如果您患心脏病、心脏病或中风的风险增加，他们可能还会要求进行血脂检 查（胆固醇测 ）

  Women: 

● Mammogram: In women with low or average risk for breast cancer, a mammogram is recommended every two  years between the ages of 50 and 74. Earlier and more frequent testing may be recommended based on your  personal history and family history of breast cancer. 

● Breast exam: A breast exam can be used to check for abnormal lumps or signs of breast cancer. ● Pap smear: The pap smear is a screening for cervical cancer. Women should begin screening at age 21. After  that, subsequent screenings are recommended every three years, as long as the woman has a healthy immune  system. After 30 years old, pap smears are recommended once every five years, until the age of 65. After age  65, the majority of women no longer require a pap smear. 

● Pelvic exam: This can be done with or without a pap smear. A pelvic exam includes examining the vagina,  cervix, and vulva for signs of a sexually transmitted infection (STI) or other conditions. 

● Cholesterol test: Most women should begin regular cholesterol checks at age 45. If you have a history of or  genetic predisposition to diabetes or heart disease, you may need to begin cholesterol checks as early as age  20. 

● Osteoporosis screening: Bone density scans should begin around age 65. They may begin sooner in certain  medical conditions.

  女性： 

● 乳房 X光检查： 对於乳腺癌风险较低或中等的女性，建议在 50 至 74 岁之间每两年进行一 次乳房 X 光检查。根据您的个人乳腺癌病史和家族史，可能会建议更早、更频繁地进行检 查。 

● 乳房检查：乳房检查可用於检查异常肿块或乳腺癌的迹象。 

● 子宫颈抹片检查：子宫颈抹片检查是一种宫颈癌筛查。女性应在 21 岁开始筛查。此后，只 要女性免疫系统健康，建议每三年进行一次后续筛 查。 30 岁后，建议每五年进行一次子宫 颈抹片检查，直至 65 岁。65 岁后，大多数女性不再需要子宫颈抹片检 查。 

● 骨盆检查：这可以在有或没有巴氏涂片的情况下进行。骨盆检 查包括检查阴道、子宫颈和 外阴是否有性传播感染 (STI) 或其他疾病的迹象。 

● 胆固醇测试：大多数女性应该在 45 岁时开始定期检查胆固醇。如果您有糖尿病或心脏病 的病史或遗传易感性，您可能需要早在 20 岁时开始进行胆固醇检查。 

● 骨质疏松症筛查：骨密度扫描应在 65 岁左右开始。在某些医疗条件下可能会更早开始

  Men: 

● Cholesterol test: Most men are advised to begin regular cholesterol checks at age 35. If  you have a history of or genetic predisposition to diabetes or heart disease, you may need  to begin cholesterol checks as early as age 20. 

● Prostate cancer screening: In general, using the prostate-specific antigen test and digital  rectal exam for prostate cancer screening is not recommended, so talk to your doctor.  Screening may be advised for some men starting at age 50. It may start as early as age  40 for those with a strong family history. 

● Testicular exam: Your doctor may wish to check each testicle for signs of a problem,  including lumps, changes in size, and tenderness. 

● Abdominal Aortic Aneurysm screening: This is a one-time screening test done with an  ultrasound. It is recommended for all men ages 65-75 who have ever smoked.

  男士： 

● 胆固醇测试：建议大多数男性在35 岁时开始定期检查胆固醇。如果您有糖尿病 或心脏病的病史或遗传易感性，您可能需要早在 20 岁时开始进行胆固醇检 查。 

● 前列腺癌筛查：一般来说，不建议使用前列腺特异性抗原检测和直肠指检进行 前列腺癌筛查，因此请谘询您的医生。一些从50 岁开始的男性可能会被建议进 行筛查。对於那些有强烈家族史的人来说，它可能早在 40 岁时就开始了。 

● 睾丸检查：您的医生可能希望检查每个睾丸是否有问题的迹象，包括肿块、大小 变化和压痛。 

● 腹主动脉瘤筛查：这是一项使用超声波进行的一次性筛查测试。建议所有曾吸 烟的65-75 岁男性使用。

  Both men and women: 

● Colon (colorectal) cancer test: Tests for this cancer usually begin at age 50. It may be sooner based on personal health conditions and  family history. 

● Lung cancer screening: An annual low-dose CT scan of the lungs is recommended for both men and women ages 55-80 who have  smoked for a significant period of time or who are currently smoking. Talk to your doctor to see if your smoking history warrants a lung  cancer screen. 

● Depression: Many people aren’t aware of possible symptoms of depression because they can be easily attributed to other things.  However, a depression screening at each checkup can help your doctor to see if your symptoms are a result of depression. ● Diabetes: If you have a family history or risk factors for diabetes — such as being overweight or having high blood pressure or high  cholesterol — you should be screened for diabetes. Your doctor may use the fasting blood sugar test or the A1C test. ● Hepatitis C: All individuals born between 1945 and 1965 are recommended to have a one-time blood test to screen for hepatitis C. ● Vaccinations: All adults continue to need vaccinations throughout their lifetime. Talk to your doctor about which vaccinations are  recommended based on your age. 

● STI screening: Based on your personal sexual history, regular STI screenings during each routine physical exam may be suggested.  This can include HIV and syphilis testing. 

● HIV test: Your doctor may recommend taking a one-time HIV test for preventive purposes, or having it done more than once if you  regularly have unprotected sex. 

● Syphilis test: You may need to take this test if you’re pregnant or at risk for syphilis.

In the blood, PSA is either bound or free (unbound). Bound PSA means that it is attached to other proteins. PSA that is not attached to other proteins is called free PSA  because it circulates freely in the blood. 

What is a good free PSA percentage? 

A lower percent-free PSA means that your chance of having prostate cancer is higher and you should probably have a biopsy. Many doctors recommend a prostate biopsy for men whose percent-free PSA is 10% or less, and advise that men consider a biopsy if it is between 10% and 25%.Jan 4, 2021 在血液中，PSA 要么是结合的，要么是游离的（未结合的）。结合的 PSA 意味着它附着在其 他蛋白质上。 未与其他蛋白质结合的 PSA 称为游离 PSA，因为它在血液中自由循环。 

什麽是好的免费 PSA 百分比？ 

较低的游离 PSA 百分比意味着您患前列腺癌的机率较高，您可能应该进行活检。 许多医生建议游离 PSA 百 分比为 10% 或更低的男性进行前列腺活检，并建议男性在 10% 至 25% 之间考虑进行活检。 2021 年 1 月 4 日

   All About Blood Tests

  All About Blood Tests 

1. Complete blood count 1. 全血细胞计数

  2. Basic metabolic panel 

A basic metabolic panel (BMP) usually checks for levels of eight compounds in the blood: 

● calcium 

● glucose 

● sodium 

● potassium 

● bicarbonate 

● chloride 

● blood urea nitrogen (BUN) 

● creatinine 

This test may require you to fast for at least 8 hours before your blood is drawn, depending on the instructions  of your doctor and what the test is measuring.

  2.基础代谢面板 

基本代谢组 (BMP) 通常检查血液中八种化合物的水平： 

● 钙 

● 葡萄糖 

● 钠 

● 钾 

● 碳酸氢盐 

● 氯化物 

● 血尿素氮 (BUN) 

● 肌酐 

该测试可能要求您在抽血前至少禁食 8 小时，具体取决於您的医生的指示和测试测量的内容。

Two simple tests can help determine your kidney function: 

Urine test called ACR (Albumin to Creatinine Ratio): ACR stands for “albumin-to-creatinine  ratio.” It tests your urine for albumin, a type of protein. Your body needs protein. But it should be in  the blood, not the urine. Having protein in your urine may mean that your kidneys are not filtering  your blood well enough. Too much albumin in your urine is an early sign of kidney damage and can  be a sign of early kidney disease. If your urine test comes back “positive” for protein, the test should  be repeated to confirm the results. Three positive results over three months or more is a sign of  kidney disease. 

Blood test to estimate your GFR (glomerular filtration rate). GFR is a measure of kidney  function and can determine if you have kidney disease and what stage you’re at. To find the GFR,  healthcare professionals will test your blood for a waste product called creatinine. Creatinine comes  from muscle tissue. When the kidneys are damaged, they have trouble removing creatinine from  your blood. Testing for creatinine is only the first step. Next, your creatinine result is used in a math  formula to find out your glomerular filtration rate (GFR). Check with your doctor about having a GFR  test. Use the new eGFR calculator. 

  两个简单的测试可以帮助确定您的肾功能： 

称为 ACR（白蛋白与肌酐比率）的尿液测试： ACR代表“白蛋白与肌酐比率”。它测试 您尿液中的白蛋白，一种蛋白质。你的身体需要蛋白质。但它应该存在於血液中，而 不是尿液中。尿液中含有蛋白质可能意味着您的肾脏无法充分过滤血液。尿液中白蛋 白过多是肾脏受损的早期徵兆，也可能是早期肾脏疾病的徵兆。如果您的尿液检测结 果为蛋白质“阳性”，则应重复检测以确认结果。三个月或更长时间的三个阳性结果是 肾脏疾病的徵兆。 

验血以估计您的 GFR（肾小球滤过率） 。 GFR是衡量肾功能的指标，可以确定您是否 患有肾脏疾病以及您处於哪个阶段。为了找到 GFR，医疗保健专业人员将测试您的 血液中是否存在一种叫做肌酐的废物。肌酐来自肌肉组织。当肾脏受损时，它们无法 从您的血液中去除肌酐。肌酐检测只是第一步。接下来，您的肌酐结果会用在数学公 式中，以确定您的肾小球滤过率 (GFR)。向您的医生谘询有关进行 GFR 测试的信 息。 使用新的 eGFR 计算器。

  3. Comprehensive metabolic panel 

A comprehensive metabolic panel (CMP) includes all the measurements of a BMP as well as additional proteins and substances related to liver function, such as: 

● albumin 

● total protein 

● alkaline phosphatase (ALP), an enzyme mostly found in the bones and liver that’s involved in several  bodily processes 

● alanine aminotransferase (ALT), an enzyme found in the liver 

● aspartate aminotransferase (AST), an enzyme found in the liver and other tissues within the body ● bilirubin, which is waste resulting from the breakdown of red blood cells that the liver filters out 

The same conclusions can be drawn from a CMP as from a BMP for the same substances that a BMP covers.  Other abnormal levels can also indicate underlying conditions, such as:

  3. 综合代谢面板 

综合代谢组 (CMP) 包括 BMP 的所有测量值以及与肝功能相关的其他蛋白质和物质，例如： 

● 白蛋白 

● 总蛋白 

● 硷性磷酸酶 (ALP) ，一种主要存在於骨骼和肝脏中的酶，参与多种身体过程 ● 丙氨酸氨基转移酶 (ALT) ，一种在肝脏中发现的酶 

● 天冬氨酸氨基转移酶 (AST) ，一种存在於肝脏和体内其他组织中的酶 ● 胆红素，是肝脏过滤掉的红细胞分解产生的废物 

对於 BMP 涵盖的相同物质，可以从 CMP 和从 BMP 中得出相同的结论。其他异常水平也可以指 示潜在状况，例如：

  4. Lipid panel 

This test checks levels of two types of cholesterol: high-density lipoprotein (HDL), or “good”  cholesterol low-density lipoprotein (LDL), or “bad” cholesterol 

HDL is “good” because it removes harmful substances from your blood and helps the liver break  them down into waste. LDL is “bad” because it can cause plaque to develop in your arteries,  increasing your risk of heart disease. You may need to fast for at least 8 hours before this test.

  4. 脂质面板 

该测试检查两种可信来源的级别胆固醇： 

● 高密度脂蛋白 (HDL)或“好”胆固醇 

● 低密度脂蛋白 (LDL)或“坏”胆固醇 

HDL 是“好”的，因为它可以去除血液中的有害物质，并帮助肝脏将它们分解成废物。低密度脂蛋白是 “坏的”，因为它会导致 动脉 斑块形成，增加患心脏病的风险。在此测试之前，您可能需要至少禁食 8 小时。

  What are triglycerides 

Triglycerides are a type of fat found in your blood. Triglycerides are not a fat you eat. Instead, your body makes triglycerides from what we eat and drink. Measuring the amount of triglycerides in the blood is one way to monitor the risk for heart disease. Fat is an important part of a healthy diet and plays many essential roles in your body. At the same time, higher levels of some fats may lead to a greater risk of developing heart disease. Triglycerides are a type of fat that can increase this risk. Making healthy lifestyle choices is the best way to keep your heart healthy. 

Too many triglycerides in the blood can lead to hardening and narrowing of the arteries. This can increase your risk for developing heart disease. This is why it is important to keep triglyceride levels in your blood at a healthy level. 

There are different reasons for high triglyceride levels, but these reasons are often related to one another. 

Being overweight, especially if you have excess weight around your waist. Eating a high calorie diet that is rich in fat, sugar or sweet foods. Having high blood pressure or diabetes. Triglyceride levels are higher than normal for people with these conditions when they are not managed well. Drinking too much alcohol. The extra calories alcohol provides can turn into fat which increases triglyceride levels.

  什麽是甘油三酯 

甘油三酯是血液中的一种脂肪。甘油三酯不是你吃的脂肪。相反，您的身体会从我们的饮食中产生甘油三 酯。测量血液中甘油三酯的含量是监测心脏病风险的一种方法。 

脂肪是健康饮食的重要组成部分，在您的身体中起着许多重要作用。同时，某些脂肪含量较高可能会导致患 心脏病的风险增加。甘油三酯是一种会增加这种风险的脂肪。选择健康的生活方式是保持心脏健康的最佳 方式。 

血液中过多的甘油三酯会导致动脉硬化和变窄。这会增加您患心脏病的风险。这就是为什麽将血液中 的甘油三酯水平保持在健康水平很重要的原因。 

高甘油三酯水平有多种原因，但这些原因通常相互关联。 

● 超重，特别是如果你的腰部有多余的重量。 

● 吃富含脂肪、糖或甜食的高热量饮食。 

● 患有高血压或糖尿病。如果管理不善，患有这些疾病的人的甘油三酯水平会高於正常水平。 ● 饮酒过多。酒精提供的额外卡路里可以转化为脂肪，从而增加甘油三酯水平。

  5. Thyroid panel 

A thyroid panel, or thyroid function test, checks how well your thyroid is producing and reacting to certain hormones, such as: Your thyroid is a tiny gland in your neck. It helps  regulate bodily functions like your mood, energy level, and overall metabolism. 

● Triiodothyronine (T3). Along with T4, this regulates your heart rate and body temperature. 

● Thyroxine (T4). Along with T3, this regulates your metabolism and how you grow. 

● Thyroid-stimulating hormone (TSH). This helps regulate the levels of hormones your thyroid releases. 

● Here are normal results: 

● T3: 80–180 nanograms per deciliter of blood (ng/dL) 

● T4: 0.8–1.8 ng/dL in adults. 

● TSH: 0.5–4 milli-international units per liter of blood (mIU/L) 

Abnormal levels of these hormones can indicate numerous conditions, such as: 

● low protein levels 

● thyroid growth disorders 

● abnormal levels of testosterone or estrogen

  5.甲状腺面板 

甲状腺面板或甲状腺功能测试可检查您的甲状腺对某些激素的产生和反应情况，例如： 

● 三碘甲状腺原氨酸（T3） 。与 T4 一起，它可以调节您的心率和体温。 

● 甲状腺素（T4） 。与 T3 一起，它可以调节您的新陈代谢以及您的成长方式。 

● 促甲状腺激素（TSH） 。这有助於调节甲状腺释放的激素水平。 你的甲状腺是你脖子上的一个小腺体。它有助於调节身体机能 ，如情绪、能量水平和整体新陈代谢。以下是正常结果： 

● T3：每分升血液 80–180 纳克 (ng/dL) 

● T4：成人 0.8–1.8 ng/dL。 

● TSH：每升血液 0.5–4 毫国际单位 (mIU/L) 

这些激素的异常水平可能表明许多情况，例如： 

● 低蛋白质水平 

● 甲状腺生长障碍 

● 睾酮或雌激素水平异常

T7 指数是T4 x T3 摄取量除以 100 的乘积。它也称为游离甲状腺素指数。 

T7=（T4 x T3-摄取）/100 

该计算试图校正甲状腺素结合蛋白的变化

  6. Cardiac biomarkers 

Enzymes are proteins that help your body accomplish certain chemical processes, such as breaking down food and clotting blood. They’re  used throughout your body for many vital functions. 

Common enzymes tested include: 

● Creatine kinase (CK). This is an enzyme primarily located in the brain, heart, and skeletal muscle. When muscle damage happens, CK  seeps into the blood in growing amounts. 

● Creatine kinase-MB (CK-MB). These enzymes are found in your heart. They often increase in your blood after a heart attack or other  heart injury. 

● Troponin. This is a heart enzyme that can leak into your blood and results from heart injury. 

Here are the normal ranges for the enzyme listed above: 

● CK: 30–200 U/L 

● CK-MB: 0–12 IU/L 

● troponin: <1 ng/mL

  6. 心脏生物标志物 

酶是帮助您的身体完成某些化学过程的蛋白质，例如分解食物和凝血。它们在您的整个身体中用 於许多重要功能。 

● 肌酸激酶 (CK)。这是一种主要存在於大脑、心脏和骨骼肌中的 酶。当肌肉损伤发生时， CK 会越来越多地渗入血液。 

● 肌酸激酶-MB (CK-MB)。这些酶存在於您的心脏中。在心脏病发作或其他心脏损伤后，它 们通常会在您的血液中增加。 

● 肌钙蛋白。这是一种心脏 酶，可能会渗入您的血液并由心脏损伤引起。 

● CK：30–200 U/L 

● CK-MB：0–12 IU/L 

● 肌钙蛋白：<1 ng/mL

  7. Sexually transmitted infection tests 

Many sexually transmitted infections (STIs) can be diagnosed using a blood sample. These tests are  often combined with urine samples or swabs of infected tissue for more accurate diagnoses. 

The following STIs can be diagnosed with blood tests: 

● chlamydia 

● gonorrhea 

● herpes 

● HIV 

● syphilis 

Blood tests aren’t always accurate right after contracting an infection. For an HIV infection, for  example, you may need to wait at least a month before a blood test can detect the virus.

  7. 性传播感染检测 

许多性传播感染 (STI) 可以使用血液样本进行诊断。这些测试通常与尿液样本或感染组织的拭子结合使用 ，以进行更准确的诊断。 

以下性传播感染可以通过血液检查进行诊断： 

● 衣原体 

● 淋病 

● 疱疹 

● 艾滋病病毒 

● 梅毒 

感染后验血并不总是准确的.例如, 对於 HIV 感染,您可能需要至少等待一个月才能通过验血检测出病毒。

  Key facts 

● More than 1 million sexually transmitted infections (STIs) are acquired every day worldwide,  the majority of which are asymptomatic. 

● Each year there are an estimated 374 million new infections with 1 of 4 STIs: chlamydia,  gonorrhoea, syphilis and trichomoniasis. 

● More than 500 million people aged 15 to 49 years are estimated to have a genital infection  with herpes simplex virus (HSV) . 

● HPV infection is associated with 570 000 cases of cervical cancer in 2018, and over 311 000  cervical cancer deaths each year. 

● Almost 1 million pregnant women were estimated to be infected with syphilis in 2016,  resulting in over 350 000 adverse birth outcomes including 200 000 stillbirths and newborn  deaths . 

● STIs have direct impact on sexual and reproductive health through stigmatization, infertility,  cancers and pregnancy complications and can increase the risk of HIV. 

● Drug resistance, especially for gonorrhoea, is a major threat to reducing the burden of STIs  worldwide.

  关键事实 

● 全世界每天有超过 100 万例性传播感染 (STI) 感染，其中大多数是无症状的。 ● 每年估计有 3.74 亿人新感染 4 种性传播感染中的一种：衣原体、淋病、梅毒和滴虫 病。 

● 据估计，超过 5 亿 15 至 49 岁的人患有单纯疱疹病毒 (HSV) 的生殖器感染 。 ● HPV 感染与 2018 年 570 000 例宫颈癌相关，每年有超过 311 000 例宫颈癌死亡。 ● 2016 年估计有近 100 万孕妇感染梅毒，导致超过 35 万例不良分娩结局，包括 20 万 例死产和新生儿死亡 . 

● 性传播感染通过污名化、不孕症、癌症和妊娠并发症直接影响性健康和生殖健康，并 可能增加感染艾滋病毒的风险。 

● 耐药性，尤其是对淋病的耐药性，是减少全球性传播感染负担的主要威胁。

What STDs Cannot be cured? 

Of these, 4 are currently curable: syphilis, gonorrhoea, chlamydia and trichomoniasis. The other 4 are incurable viral infections: hepatitis B, herpes simplex virus (HSV), HIV and human papillomavirus (HPV).Aug 22, 2022 

Are there more than 30 different STDs? 

There are more than 30 different bacteria, viruses and parasites known to be transmitted through sexual contact. Based on WHO latest estimates, approximately 38 million sexually active people aged 15-49 in the Americas have an easily curable STI (Chlamydia, gonorrhea, syphilis and/or trichomoniasis). 

What is the most contagious sexually transmitted disease? 

HUMAN PAPILLOMAVIRUS (HPV) The human papillomavirus (HPV) is the most common sexually transmitted infection in America. In fact, almost every sexually active person catches it at some point in his or her life.Feb 25, 2015

  哪些性病不能治愈？ 

其中，目前有 4 种可以治愈：梅毒、淋病、衣原体和滴虫病。其他 4 种是无法治癒 的病毒感染 ： 乙型肝炎、单纯疱疹病毒 (HSV)、HIV 和人乳头瘤病毒 (HPV) 。 2022 年 8 月 22 日 

有超过 30 种不同的性病吗？ 

已知有 30 多种不同的细菌、病毒和寄生虫可通过性接触传播。根据世界卫生组 织的最新估计，美洲约有 3800 万 15-49 岁的性活跃人群患有易於治癒的性传播 感染（衣原体、淋病、梅毒和/或滴虫病）。 

传染性最强的性病是什麽？ 

人乳头瘤病毒 (HPV) 人乳头瘤病毒 (HPV) 是美国最常见的性传播感染。事实上 ，几乎每个性活跃的人都会在他或她生命中的某个时刻感染它。 2015 年 2 月 25 日

  男女皆宜： 

● 结肠（结直肠）癌测试：这种癌症的测试通常从 50 岁开始。根据个人健康状况和家族史，可能会更早。 ● 肺癌筛查：对於长期吸烟或目前吸烟的 55-80 岁男性和女性，建议每年进行一次肺部低剂量 CT 扫描。与您的医 生交谈，看看您的吸烟史是否需要进行肺癌筛 查。 

● 抑郁症：许多人没有意识到抑郁症可能的症状，因为它们很容易归因於其他事情。但是，每次检 查时进行抑郁症 筛查可以帮助您的医生了解您的症状是否是抑郁症的结果。 

● 糖尿病：如果您有糖尿病家族史或风险因素（例如超重或患有高血压或高胆固醇），您应该接受糖尿病筛 查。您的 医生可能会使用空腹血糖测试或 A1C 测试。 

● 丙型肝炎：建议所有 1945 年至 1965 年间出生的人进行一次性血液检 查以筛查丙型肝炎。 ● 疫苗接种：所有成年人终生都需要接种疫苗。与您的医生讨论根据您的年龄推荐哪些疫苗接种。 ● STI 筛查：根据您的个人性史，可能会建议在每次例行体检期间定期进行 STI 筛查。这可能包括 HIV 和梅毒检 测。 

● 艾滋病毒检测：您的医生可能会建议您进行一次性艾滋病毒检测以进行预防，或者如果您经常进行无保护性行 为，则进行多次检测。 

● 梅毒测试：如果您怀孕或有梅毒风险，您可能需要进行此测试。

American Cancer Society Guidelines for the Early Detection of Cancer 

美国癌症协会癌症早期检测指南 

https://www.cancer.org/healthy/find-cancer-early/americ an-cancer-society-guidelines-for-the-early-detection-of-c ancer.html

  ( A ) Breast cancer Screening 

● Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms (x-rays of the breast) if they wish to do so. 

● Women age 45 to 54 should get mammograms every year. ● Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening. 

● Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer. 

● All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening.

  (A) 乳腺癌 

● 如果愿意， 40 至 44 岁的女性应该可以选择开始每年进行一次乳房 X 光检查（乳房 X 光检查）的乳腺癌筛查。 

● 45 至 54 岁的女性应每年进行乳房 X 光检查。 

● 55 岁及以上的女性应每 2 年进行一次乳房 X 光检查，或者可以继续每 年进行一次筛查。 

● 只要女性身体健康并且预计能活 10 年或更长时间，就应该继续进行筛 查。 

● 所有女性都应该熟悉与乳腺癌筛查相关的已知益处、局限性和潜在危 害。

  (B) Colon and rectal cancer and polyps 

For people at average risk for colorectal cancer, the American Cancer Society recommends starting regular screening at age 45. This can be done either with a sensitive test that looks for signs of cancer in a person’s stool (a stool-based test), or with an exam that looks at the colon and rectum (a visual exam). Talk to your health care provider about which tests might be good options for you, and to your insurance provider about your coverage. No matter which test you choose, the most important thing is to get screened. If you’re in good health, you should continue regular screening through age 75. For people ages 76 through 85, talk with your health care provider about whether continuing to get screened is right for you. When deciding, take into account your own preferences, overall health, and past screening history. People over 85 should no longer get colorectal cancer screening. If you choose to be screened with a test other than colonoscopy, any abnormal test result needs to be followed up with a colonoscopy.

  ( B ) 结肠癌和直肠癌和息肉 

对於结肠直肠癌的平均风险人群，美国癌症协会建议在45 岁时开始定期筛查。这可以 通过在人的粪便中寻找癌症迹象的敏感测试（基於粪便的测试）或通过检查结肠和直 肠的检查（视觉检查）来完成。与您的医疗保健提供者讨论哪些测试可能是您的好选择 ，并与您的保险提供者讨论您的承保范围。无论您选择哪种测试，最重要的是接受筛 查。 如果您身体健康，您应该在75 岁之前继续进行定期筛查。 对於76 至 85 岁的人， 请与您的医疗保健提供者讨论继续接受筛查是否适合您。在决定时，请考虑您自己的 偏好、整体健康状况和过去的筛查历史。 85 岁以上的人不应再接受结直肠癌筛查。 如果您选择接受结肠镜检查以外的检查，则任何异常检查结果都需要进行结肠镜检 查。

  ( C ) Cervical cancer 

● Cervical cancer screening should start at age 25. People under age 25 should not be tested because cervical cancer is rare in this age group. 

● People between the ages of 25 and 65 should get a primary HPV (human papillomavirus) test* done every 5 years. If a primary HPV test is not available, a co-test (an HPV test with a Pap test) every 5 years or a Pap test every 3 years are still good options. (*A primary HPV test is an HPV test that is done by itself for screening. The US Food and Drug Administration has approved certain tests to be primary HPV tests.) 

● People over age 65 who have had regular cervical cancer testing in the past 10 years with normal results should not be tested for cervical cancer. Once testing is stopped, it should not be started again. Those with a history of a serious cervical pre-cancer should continue to be tested for at least 25 years after that diagnosis, even if testing goes past age 65. 

● People whose cervix has been removed by surgery for reasons not related to cervical cancer or serious pre-cancer should not be tested. 

● People who have been vaccinated against HPV should still follow the screening recommendations for their age groups.

  ( C ) 宫颈癌 

● 宫颈癌筛查 应该从 25 岁开始。25 岁以下的人不应该接受检查，因为宫颈癌在这个年龄组 中很少见。 

● 25 至 65 岁的人应每 5 年进行一次初级 HPV（人乳头瘤病毒）检测*。如果无法进行主要 HPV 检测，则每 5 年进行一次联合检测（ HPV 检测和巴氏试验）或每 3 年进行一次巴氏试 验仍然是不错的选择。 （*初级 HPV 测试是一种自行进行的 HPV 测试，用於筛查。美国食 品和药物管理局已批准某些测试为初级 HPV 测试。） 

● 65 岁以上且在过去 10 年中定期进行宫颈癌检测且结果正常的人不应接受宫颈癌检测。一 旦停止测试，就不应再次开始。那些有严重宫颈癌前病变病史的人应在诊断后继续进行至 少 25 年的检测，即使检测已超过 65 岁。 

● 因与宫颈癌或严重癌前病变无关的原因 通过手术切除宫颈的人不应接受检测。 ● 接种过 HPV 疫苗的人仍应遵循针对其年龄组的筛 查建议。

Human papillomavirus (HPV) subtypes and their relationships with cervical smear results in cervical cancer screening: a community-based study from the central Anatolia region of Turkey 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947064/ 

There are more than 40 sexually transmitted types of HPV that infect the skin and mucous membranes. In infected individuals, the immune system normally eliminates the virus within two years, but in some individuals, persistent HPV infection causes cervical cancer and genital warts [9]. HPVs are divided into three groups as low, potentially high, and high-risk types. HPV6, HPV11, HPV40, HPV42, HPV43, HPV44, HPV54, HPV61, HPV70, HPV72, HPV81, and CP6108 are low risk; HPV26, HPV53, and HPV66 are potentially high risk, and HPV16, HPV18, HPV31, HPV33, HPV35, HPV39, HPV45, HPV51, HPV52, HPV56, HPV58, HPV59, HPV68, HPV73, and HPV82 are high-risk types .

  人乳头瘤病毒 (HPV) 亚型及其与宫颈涂片的关系导致宫颈癌筛查：来自 土耳其中部安纳托利亚地区的社区研究 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947064/ 

有40 多种性传播类型的 HPV 会感染皮肤和粘膜。在受感染的个体中，免疫系统通常会在两 年内消除病毒，但在某些个体中，持续的 HPV 感染会导致宫颈癌和生殖器疣 [ 9 ]。 HPV 分为三组，即 低危型、潜在高危型和高危型。 HPV6、HPV11、HPV40、HPV42、HPV43、HPV44、HPV54、HPV61、 HPV70、HPV72、HPV81和CP6108为低风险； HPV26、HPV53、HPV66为潜在高危型， HPV16、 

HPV18、HPV31、HPV33、HPV35、HPV39、HPV45、HPV51、HPV52、HPV56、HPV58、HPV59、 HPV68、HPV73、HPV82为高危型。

  CDC 建议 11 至 12 岁的儿童每隔 6 至 12 个月接种两剂 HPV 疫苗。 

● 第一剂通常建议在 11-12 岁时使用。疫苗接种可在 9 岁时开始。 

● 如果第一剂是在 15岁生日之前接种的，则只需接种两剂。 

在 15 至 26 岁之后开始该系列的青少年和年轻人需要三剂 HPV 疫苗。 

● 9 至 14 岁的儿童在间隔不到 5 个月的时间内接种了两剂 HPV 疫苗，将需要接种第三剂。 ● 还建议 9 至 26 岁免疫系统较弱的人服用三剂。 

不建议 26 岁以上的所有人接种疫苗。 

● 一些尚未接种疫苗的27 至 45 岁的成年人可能会在与他们的医生讨论他们感染新 HPV 的风险以及接种疫苗对他们可能带来的好处后决定接种 HPV 疫苗。 

● 这个年龄段的 HPV 疫苗接种提供的益处较少，因为这个年龄段的更多人已经接触过 HPV。

CDC recommends that 11- to 12-year-olds receive two doses of HPV vaccine 6 to 12 months apart. 

The first dose is routinely recommended at ages 11–12 years old. The vaccination can be started at age 9 years. Only two doses are needed if the first dose was given before 15th birthday. 

Teens and young adults who start the series later, at ages 15 through 26 years, need three doses of HPV vaccine. Children aged 9 through 14 years who have received two doses of HPV vaccine less than 5 months apart will need a third dose. 

Three doses are also recommended for people aged 9 through 26 years who have weakened immune systems. 

Vaccination is not recommended for everyone older than age 26 years. 

Some adults age 27 through 45 years who are not already vaccinated may decide to get HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination for them. HPV vaccination in this age range provides less benefit, because more people in this age range have already been exposed to HPV.

  ( D ) Endometrial cancer 

The American Cancer Society recommends that at the time of menopause, all women should be told about the risks and symptoms of endometrial cancer. Women should report any unexpected vaginal bleeding or spotting to their doctors. Some women – because of their history – may need to consider having a yearly endometrial biopsy. Please talk with a health care provider about your history. 

( D ) 子宫内膜癌 

美国癌症协会建议，在绝经期，应告知所有女性子宫内膜癌的风险和症状。女性应向医生报 告任何意外的阴道出血或发现。 一些女性——由於她们的病史——可能需要考虑每年进行 一次子宫内膜活检。请与医疗保健提供者谈谈您的病史。

  ( E ) Lung cancer The most recent version of the American Cancer Society 

(ACS) lung cancer screening guideline [from 2018] is being taken down while we review new scientific evidence to be included in the next update. While this important update is being completed, the ACS advises that health care providers, and people at increased risk for lung cancer, follow the recently updated recommendations for annual lung cancer screening from the US Preventive Services Task Force (USPSTF), the American Academy of Family Physicians (AAFP), or the American College of Chest Physicians. These organizations recommend yearly lung cancer screening with LDCT scans for people who: 

● Are 50 to 80 years old and in fairly good health, 

and 

● Currently smoke or have quit in the past 15 years, 

and 

● Have at least a 20 pack-year smoking history. (This is the number of packs of cigarettes per day multiplied by the number of years smoked. For example, someone who smoked 2 packs a day for 10 years [2 x 10 = 20] has 20 pack-years of smoking, as does a person who smoked 1 pack a day for 20 years [1 x 20 = 20].)

  ( E ) 肺癌 最新版本的美国癌症协会 (ACS) 肺癌筛查指南 [自 2018 年起] 

正在被删除，同时我们将审 查新的科学证据以包含在下一次更新中。在完成这一重要更新的同时 ，ACS 建议医疗保健提供者和肺癌风险增加的人遵循美国预防服务工作组 (USPSTF)、美国科学 院院士最近更新的年度肺癌筛 查建议。家庭医师 (AAFP)，或美国胸科医师学会。这些组织建议每 年对以下人群进行 LDCT 肺癌筛查： 

● 年龄在 50 至 80 岁之间，身体状况良好， 

和 

● 目前吸烟或在过去 15 年内戒菸， 

和 

● 至少有 20 包年的吸烟史。 （这是每天吸烟的包数乘以吸烟的年数。例如，每天吸烟 2 包， 持续 10 年的人 [2 x 10 = 20] 有 20 包年的吸烟量，一个人也是如此。每天抽 1 包烟 20 年 的人 [1 x 20 = 20]。）

  ( F ) Prostate cancer 

The American Cancer Society recommends that men make an informed decision with a health care provider about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. We believe that men should not be tested without first learning about what we know and don’t know about the risks and possible benefits of testing and treatment. Starting at age 50, men should talk to a health care provider about the pros and cons of testing so they can decide if testing is the right choice for them. If you are African American or have a father or brother who had prostate cancer before age 65, you should have this talk with a health care provider starting at age 45.  If you decide to be tested, you should get a PSA blood test with or without a rectal exam. How often you’re tested will depend on your PSA level.

  ( F ) 前列腺癌 

美国癌症协会建议男性与医疗保健提供者就是否接受前列腺癌检测做出明智的决 定。研究尚未证明检测的潜在好处大於检测和治疗的危害。我们认为，在没有 首先了解我们所知道和不知道的测试和治疗的风险和可能的好处之前，不应 该对男性进行测试。从 50 岁开始，男性应该与医疗保健提供者讨论测试的利 

弊，以便他们决定测试是否是他们的正确选择。如果您是非裔美国人或有一 个在 65 岁之前患有前列腺癌的父亲或兄弟，您应该从 45 岁开始与医疗保健 提供者进行此谈话。如果您决定接受检测，您应该与或没有直肠检查。您接受 检测的频率取决於您的 PSA 水平。

There is no specific normal or abnormal level of PSA in the blood. In the past, PSA levels of 4.0 ng/mL and lower were considered normal. However, some individuals with PSA levels below 4.0 ng/mL have prostate cancer and many with higher PSA levels between 4 and 10 ng/mL do not have prostate cancer .A percent-free PSA above 25% is considered normal. Some doctors recommend that if you have a percent-free PSA of 18% or less you should have a prostate biopsy. Other doctors recommend having a biopsy if the percent-free PSA is around 12% or less. 

血液中的 PSA 没有特定的正常或异常水平。过去，4.0 ng/mL 及更低的 PSA 水平被 认为是正常的。然而，一些 PSA 水平低於 4.0 ng/mL 的人患有前列腺癌，而许多 PSA 水平在 4 至 10 ng/mL 之间的人则没有前列腺癌 高於 25% 的游离 PSA 百分比 被认为是正常的。一些医生建议，如果您的游离 PSA 百分比为 18% 或更低，您应该 进行前列腺活检。如果游离 PSA 百分比约为 12% 或更低，其他医生建议进行活检。

  US, CT, MRI

ULTRASOUND 

Diagnostic ultrasound, also called sonography or diagnostic medical sonography, is an imaging  method that uses high-frequency sound waves to produce images of structures within your body.  The images can provide valuable information for diagnosing and treating a variety of diseases and  conditions. 

Ultrasound is used for many reasons, including to: 

● View the uterus and ovaries during pregnancy and monitor the developing baby's health ● Diagnose gallbladder disease 

● Evaluate blood flow 

● Guide a needle for biopsy or tumor treatment 

● Examine a breast lump 

● Check your thyroid gland 

● Detect genital and prostate problems 

● Assess joint inflammation (synovitis) 

● Evaluate metabolic bone disease

 诊断超声 

也称为超声检查或诊断医学超声检查，是一种使用高频声波 产生体内结构图像的成像方法。这些图像可以 为诊断和治疗各种疾病和病症提供有价 值的信息。 

使用超声波的原因有很多，包括： 

● 在怀孕期间查看子宫和卵巢并监测发育中的婴儿的健康状况 

● 诊断胆囊疾病 

● 评估血流 

● 引导针进行活检或肿瘤治疗 

● 检查乳房肿块 

● 检查你的甲状腺 

● 检测生殖器和前列腺问题 

● 评估关节炎症（滑膜炎） 

● 评估代谢性骨病

CT, CAT 

A computerized tomography (CT) scan combines a series of X-ray images taken from different angles around your body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels and soft tissues inside your body. CT scan images provide more-detailed information than plain X-rays do. 

A CT scan has many uses, but it's particularly well-suited to quickly examine people who may have internal injuries from car accidents or other types of trauma. A CT scan can be used to visualize nearly all parts of the body and is used to diagnose disease or injury as well as to plan medical, surgical or radiation treatment.

CT, CAT 

计算机断层扫描 (CT) 扫描结合了从您身体周围不同角度拍摄 的一系列 X 射线图像，并使用计算机处理来创建您体内骨骼、 血管和软组织的横截面图像（切片）。 CT 扫描图像提供比 通 X 射线更详细的信息。 

CT 扫描有很多用途，但它特别适合快㏿检查可能因车祸或其他 类型外伤而内伤的人,CT 扫描可用於可视化身体的几乎所有部 位，用於诊断疾病或损伤以及计划医疗、手术或放射治疗。

  5,000 mrem per year 

Consequently, to protect health and safety, the U.S. Nuclear Regulatory Commission (NRC) has established standards that allow exposures of up to 5,000 mrem per year for those who work with and around radioactive material, and 100 mrem per year for members of the public (in addition to the radiation we receive from … 

每年 5,000 mrem 

因此，为了保护健康和安全，美国核管理委员会 (NRC) 制定了标准，允许从事放射性 物质工作和在放射性物质周围工作的人员每年暴露高达 5,000 mrem，公众成员每年 暴露高达 100 mrem （除了我们从...接收到的辐射

1 mSv = 0.1 rem; 1 rem = 10 mSv

  How much radiation is safe in a lifetime? 

5,000mrem (50 mSv )-(Since 1957) Occupational limit per year for adult radiation workers, including soldiers exposed to radiation. It is "as low as reasonably achievable; however, not to exceed 5,000 millirems." It is recommended that lifetime cumulative exposure is not to exceed the age multiplied by 1,000 millirems.Jan 5, 1994 

一生接受多少辐射是安全的？ 

5,000mrem (50mSv )自 1957 年起）成年辐射工作者（包括暴露於辐射的 士兵）每年的职业限制。它是“合理可实现的最低值；但是，不超过 5,000 毫雷姆。”建议终生累积暴露量不超过年龄乘以 1,000 毫雷姆。 1994 年 1 月 5 日

Radiation Doses for Common CT Scans 

Common types of CT scans and the amount of radiation you would absorb from them include: 

● Belly and pelvis: 10 mSv, equal to about 3 years of background radiation 

● Colonography: 6 mSv, equal to about 2 years of background radiation 

● Head: 2 mSv, equal to about 8 months of background radiation 

● Spine: 6 mSv, equal to about 2 years of background radiation 

● Chest: 7 mSv, equal to about 2 years of background radiation 

● Lung cancer screening: 1.5 mSv, equal to about 6 months of background radiation 

● Coronary angiography (CTA): 12 mSv, equal to about 4 years of background radiation ● Cardiac (for calcium scoring): 3 mSv, equal to about 1 year of background radiation ● Belly and pelvis: 20 mSv, equal to about 7 years of background radiation 

● Head: 4 mSv, equal to about 16 months of background radiation

  常见 CT 扫描的辐射剂量 

常见的 CT 扫描类型以及您从中吸收的辐射量包括： 

● 腹部和骨盆：10 mSv，相当於大约 3 年的背景辐射 

● 结肠造影：6 mSv，相当於大约 2 年的背景辐射 

● 头部：2 mSv，相当於大约 8 个月的背景辐射 

● 脊椎：6 mSv，相当於大约 2 年的背景辐射 

● 胸部：7 mSv，相当於大约 2 年的背景辐射 

● 肺癌筛查：1.5 mSv，相当於大约 6 个月的背景辐射 

● 冠状动脉造影 (CTA)：12 mSv，相当於大约 4 年的背景辐射 

● 心脏（用於钙评分）：3 mSv，相当於大约 1 年的背景辐射 

● 腹部和骨盆：20 mSv，相当於大约 7 年的背景辐射 

● 头部：4 mSv，相当於大约 16 个月的背景辐射

Radiation Dose in X-Ray and CT Exams https://www.radiologyinfo.org/en/info/safety-xray