The normal reference value of alanine aminotransferase is 0 ~ 40u/L. More than 40u/L is called alanine aminotransferase elevation. ALT reaches 80, which is equal to twice the normal value, and it is unqualified in the physical examination of teacher qualification certificate.
Alanine aminotransferase mainly exists in the cytoplasm of hepatocytes, and its intracellular concentration is 1000-3000 times higher than that in serum. As long as 1% hepatocytes are destroyed, serum enzymes can be doubled. Therefore, alanine aminotransferase is recommended by the World Health Organization as the most sensitive detection index of liver function damage.
Can alt70 pass the physical examination of Zhejiang teacher qualification certificate?
The "Standards and Operating Procedures for Physical Examination of Teachers' Qualification in Zhejiang Province" stipulates that those with chronic hepatitis and abnormal liver function are unqualified in physical examination. I can't pass the physical examination.
(3) Physical examination requirements for teacher qualification certificate identification
1, when is the physical examination?
When submitting the application information on the China Teachers' Qualification Online, there will be corresponding prompts when applying for the Education Bureau. Generally, it is required to submit the corresponding application materials, including the medical certificate, within the specified time. Therefore, you need to complete the physical examination and get the physical examination form before submitting the materials.
2. In which hospitals do physical examinations?
Each education bureau has designated hospitals in its own jurisdiction, and candidates need to complete physical examination in the designated hospitals, which is a valid proof. The specific hospitals are subject to the local review announcement, and are generally local top three hospitals.
3. How much is the medical examination fee?
The charging standards in different places are inconsistent, so you need to consult the medical examination hospital specifically, and the medical examination expenses should be taken care of by yourself.
4. Where can I get the physical examination form?
Some local physical examination forms are collected at the hospital site, while others need to download and print them themselves and take personal photos to the hospital.
5. What are the eligibility criteria for physical examination?
All provinces have corresponding physical examination standards for teacher qualification certificates, so the standards vary from place to place. The provinces in the standard, mainly refer to the following three documents:
1. Guiding Opinions on Physical Examination of College Admissions issued by the Ministry of Education, the Ministry of Health and the China Disabled Persons' Federation on March 3, 2003;
2. Notice of the General Office of the Ministry of Education and the General Office of the Ministry of Health on February 20, 20 10 on the cancellation of the detection of hepatitis B projects in colleges and universities (No.2010 of the Education Department). 20 102);
3. Measures for the Administration of Health Care in Nurseries and Kindergartens (Decree No.76 of the Ministry of Education) implemented by the Ministry of Education and the Ministry of Health on 2010+0/.
Common physical examination items
1. Cardiac auscultation: Systolic murmur is divided into six grades. When lying in a quiet position, auscultation in the pulmonary valve area reached Grade III, and other valve areas reached Grade II. If it is a physiological change, it can be judged as "normal" by repeatedly auscultating the heart murmur.
2. If the premature beats are more than 6 times per minute, you should do a squat test immediately. If the premature beats disappear after exercise, or the ECG is normal occasionally, the conclusion of "normal" can be drawn. If it is still more than 6 times per minute, make an "abnormal" conclusion (based on the measurement on the day of physical examination). Incomplete right bundle branch block can be judged as "normal" if there is no heart disease.
3. When blood pressure is measured by auscultation, diastolic blood pressure is influenced by sound changes. Due to mental stress, the blood pressure exceeds 65,438+08.66/65,438+02 kPa (65,438+040/90 mm Hg), and at the same time, patients with fast heart rate (such as acute hypertension) are instructed to rest 15 minutes to half an hour for the second measurement and take a low value.
4. Liver and spleen examination should be based on supine breathing.
5, color vision inspection with "Yu Ziping Color Blindness" or the color vision inspection chart published by the Ministry of Health, must be checked by a specialist nurse or doctor.
6. Monochrome recognition ability test (Monochrome recognition ability): (1), the doctor selects one of the four colors of wires or letters, numbers, geometric figures and signal lights for the subjects to recognize, and names the colors within 5 seconds; (2) The doctor will name a color at will, so that candidates can accurately find out from the four colors of red, yellow, green, blue and purple wires or letters, numbers, geometric figures and signal lights within 5 seconds. The above two methods are carried out alternately. Put a "+"sign on the name of the recognizable color and record it in the physical examination form (if you have normal ability to recognize the color pattern and color number, you can leave this option unchecked).
7. The standard logarithmic visual acuity chart should be used for visual inspection, and the inspection results should be recorded by 5-point recording method. Those whose naked eye vision is less than 4.8 in one eye should wear corrective lenses, and those whose correction degree is less than 4.8 should have fundus examination. If the fundus is only short-sighted and there are no other abnormalities, hyperopia can be improved by increasing the number of lenses, and the actual corrected vision and degree of correction are recorded in the physical examination table.
8. Sense of smell: With vinegar, alcohol and water, it can be judged that all aspects are normal, 1-2 is dull, and all three aspects are lost (for those who catch a cold during physical examination, it is agreed to review after one week).
9. Listening test: whisper, the left and right ears are separated and the listening distance is 5 meters. If the hearing of both ears is less than 2 meters, you should wear a hearing aid for a second interview, and those who are less than 5 meters for a second interview are unqualified. Wear an audiometer to measure the hearing distance, and record the "+"sign in the physical examination form.
6. Is there anything special about kindergarten teachers?
According to the "Measures for the Management of Health Care in Nurseries and Kindergartens" (Order No.76 of the Ministry of Education of the Ministry of Health) implemented by the Ministry of Education and the Ministry of Health on 20/kloc-0+1,those who apply for kindergarten teacher qualification, in addition to other physical examination items, increase gonococcus, Treponema pallidum, trichomonas and Candida vulvae. The specific inspection measures shall be determined by the local education administrative department and the local medical and health department through consultation.
7. What if pregnant women can't have a chest X-ray?
At present, there are special provisions for pregnant women in the physical examination standards in many areas, and pregnant women can be exempted from the relevant examinations of radiology, but there are still some places that are across the board. Therefore, candidates must first understand whether there are relevant regulations. If there are no exceptions for pregnant women, they will only miss this appraisal and wait until the next time. In some areas, the time for issuing certificates is postponed until the pregnant woman recovers after giving birth.
The requirements of individual provinces may be slightly different, but they are all the same, and there will not be much deviation. Please check the specific requirements and precautions announced by your province.
(a) one of the following circumstances, as a teacher qualification examination.
1. Anyone with one of the following medical histories: epilepsy, hysteria, sleepwalking at night, malignant tumor, severe hematological diseases, severe neurosis, psychosis, psychoactive substance abuse and dependence.
2. Anyone who suffers from one of the following diseases and has not been cured: tuberculosis, bronchiectasis, chronic nephritis, leprosy, hepatitis A and advanced schistosomiasis.
(two) who suffer from the following diseases, as a teacher qualification examination.
1. Organic heart disease: rheumatic heart disease, congenital heart disease, cardiomyopathy, frequent premature beats and other organic heart diseases.
2. Various connective tissue diseases (collagen diseases), Takayasu arteritis, endocrine system diseases (such as diabetes, diabetes insipidus, acromegaly, etc. ) with complications.
3. Rheumatoid spinal rigidity and severe chronic osteomyelitis.
4. The liver is large and the hardness is above medium; Liver and spleen are touched at the same time, the liver is less than 2 cm below the ribs (except for physiological ptosis of the liver), and the spleen is less than 2 cm below the ribs, and the liver function is abnormal; Simple splenomegaly over 2 cm, hypersplenism; Simple spleen is more than 3 cm.
5. Patients with gonorrhea, syphilis, chancre, venereal granuloma, nongonococcal urethritis, genital herpes, condyloma acuminatum and AIDS.
6 other serious diseases that affect health and teaching work that are not included in the medical examination standards.
(three) one of the following circumstances, as a teacher qualification examination.
1. pneumonectomy with more than one lobe; More than one lobe is atelectasis.
2. If the blood pressure is greater than 140/90mmHg or less than 90/60mmHg, accompanied by organic changes, the specific situation can be determined by the physical examination hospital.
3. Glaucoma; Retinal and optic nerve diseases (except old or stable fundus diseases); Color blindness, color weakness, applying for kindergarten, special education or related professional teacher qualification.
4. The sum of binocular corrected vision is less than 5.0 (in this case, the sum of binocular corrected vision is recorded in the standard logarithmic visual acuity chart with the corresponding decimal recording method, and then converted into a recorded value of 5 points) or eye diseases with obvious visual impairment.
5. Binaural hearing is less than 3 meters or one ear is less than 5 meters, and the other ear is completely deaf.
6. Both upper limbs or lower limbs cannot be used; The unequal length of both lower limbs is more than 5 cm; Scoliosis is more than 4 cm, muscle strength is grade 3, and thoracic deformity is obvious.
7. Serious stuttering, hoarseness, oral physical defects and an ear, nose and throat disease hinder educators.
8. Scars, pockmarks, hemangioma or vitiligo, moles or obvious tattoos with facial deformities of more than 3cm.
(four) in any of the following circumstances, it should be further tested.
1. If the pronunciation is abnormal, further check the vocal cords.
2. If the electrocardiogram is abnormal or the heart rhythm is seriously abnormal or the heart murmur is obvious, the electrocardiogram or color Doppler echocardiography should be done again.
3. If hepatosplenomegaly or abdominal mass occurs, abdominal B-ultrasound or CT should be done.
4. Liver function ALT and AST are higher than normal, and hepatitis-related tests are required, and hepatitis-related tests are not allowed (except those prohibited by national laws, administrative regulations and the provisions of the Ministry of Health).
5. If the blood sugar is abnormal, further check whether there is diabetes.
(5) Additional inspection items.
1. For those who apply for kindergarten teacher qualification certificate, the examination items of Neisseria gonorrhoeae, Treponema pallidum and Trichomonas vaginalis (the last two items refer to gynecology) will be added.
2. Increase chest X-ray examination items for those suspected of respiratory symptoms.
(4) What are the liver function ALT and AST in physical examination? I don't understand what these two items need to be checked in the physical examination of teacher qualification certificate. Can you find out if it is a hepatitis B virus carrier?
ALT is alanine aminotransferase and AST is aspartate aminotransferase. It has nothing to do with hepatitis B virus detection. Hepatitis B virus is a bivalve virus, which is equivalent to a larger soap bubble outside and a smaller soap bubble inside, and the DNA of hepatitis B virus is wrapped in a small soap bubble. There are surface antigens on the outer shell of hepatitis B virus and E antigens on the underwear shell, which are involved in two and a half tests. So if you want to know whether it is a carrier of hepatitis B virus, you have to test it for two and a half days to know.
Regarding the health examination of teacher qualification certificate, there are generally no hepatitis patients. Please think briefly. If the researcher is a hepatitis patient, there will be obvious symptoms of discomfort. As far as the current medical conditions are concerned, he will go to the hospital immediately. If the liver inflammation is serious, it is estimated that you will be hospitalized. It is impossible to have any health examination, right? A minor illness can be examined, just like a cold, and it will be fine in a few days. Therefore, the textual research on health examination is of little substantive significance. What's more, generally speaking, the policy makers of health examination evaluation may not be doctors, and they simply don't understand the market. Just out of a heart for the working people, I want to show my humanistic care for the workers. However, good intentions have caused trouble. Because I want to play a humanistic care, I can have a free physical examination. But in fact, these health checks must be paid by individuals.
Just like a blessing in disguise, the development of things always has two sides. Although physical examination can't play a substantial role in finding patients, it indirectly promotes the development and understanding of medicine. In the past, medical conditions were poor, so it was impossible to have any large-scale health examination. So doctors only know about this disease through patients. But this understanding is one-sided. Lack of data on healthy people for comparison. Give an example to illustrate. Hepatitis patients go to the hospital to see a doctor, of course, they have to do some auxiliary diagnostic tests to make a definite diagnosis. If the patient has typical hepatitis symptoms, the correct diagnosis rate of hepatitis attack can be greatly improved by combining the detection results of ALT and AST exceeding the standard. At this time, it is understood that staying in hepatitis will lead to excessive ALT and AST test results. Over time, this sufficient condition has become a sufficient and necessary condition because it only satisfies patients but not healthy people, and it has become that hepatitis can be diagnosed as long as the test results of ALT and AST exceed the standard. This is the medical support of ALT and AST in health examination. With the extensive development of health examination, more and more cases have completely proved the mistakes of necessary conditions. Because a large part of people whose ALT and AST test results exceed the standard are not hepatitis patients. Because the mainstream people who have health checkups will not have any uncomfortable performance only when they are in a state of illness. Moreover, from the biochemical principle, the detection of these two enzymes can not be completely used to prove liver inflammation. Because not only liver cells can synthesize these two enzymes, but other cells in the human body can also produce these two biochemical products as long as they have nuclei. Moreover, because the liver is equivalent to a biochemical product processing factory in human body, the ratio of these two enzymes is higher than that of other organs, so the practical significance of ALT and AST test results exceeding the standard can only be that the "suspicion" of liver failure has increased. But this kind of "suspicion" is only applicable to the diagnosis of diseases. For healthy people who have no uncomfortable performance, there is no practical significance of "suspecting" that there is something wrong with the liver.
To sum up, the significance of physical examination is not to "suspect" that there is something wrong with an organ, but to provide a powerful statistical reference for the disease diagnosis of healthy people. In this respect, it is the same as donating blood for free. "I am for everyone and everyone is for me." After all, people always get sick, and only with strong reference data can the correct rate of medical diagnosis be improved.
5] What are ALT and AST of liver function in physical examination? I don't understand that these two items should be checked in the physical examination of teacher qualification certificate.
ALT and AST are two indexes reflecting the liver, mainly to see if there is any damage to the liver.
[6] The transaminase in the physical examination of the teacher qualification certificate is on the high side, which requires a second interview. Does it affect the application for the qualification certificate?
That's true. If not, you won't be re-examined. If it is pathological, some applications for teacher qualification certificates will not pass. Have a good rest and recheck.
transaminase
Transaminase is an essential "catalyst" in human metabolism, which mainly exists in liver cells. Inflammation, necrosis and poisoning. Occurs in liver cells, causing liver cells to be damaged, and transaminase will be released into the blood, thus increasing serum transaminase. Usually, alanine aminotransferase is the main transaminase in physical examination. 1% hepatocyte injury can increase the concentration of ALT in blood by 1 fold. Therefore, ALT level can sensitively monitor whether the liver is damaged.
Elevated transaminase [1] is a very common condition, not necessarily a liver problem. Because transaminase is very sensitive, many factors will cause the normal value of transaminase to fluctuate up and down. Healthy people may be examined at different times of the day, and the results of transaminase measurement may be different.
The reasons are non-pathological and pathological.
Non-pathological
1. If healthy people check the transaminase after strenuous exercise, they will find that the transaminase is elevated.
2, if you are too tired, it will lead to an increase in transaminase.
3. If you eat greasy food or drink too much before the examination, the transaminase will increase.
4. Pregnant women can also lead to endocrine disorders and elevated transaminase;
5, malnutrition diet structure is unreasonable, such as low-protein diet, especially when food lacks cystine and vitamin E, it can also increase ALT.
6. The side effects of daily taking drugs will also lead to the increase of transaminase, such as erythromycin, sleeping pills, antipyretic and analgesic drugs, contraceptive cream and traditional Chinese medicines such as Pinellia ternata, Areca catechu and indigo naturalis.
pathological
1, viral hepatitis This is a common disease that causes high transaminase, and other types of hepatitis can also cause high transaminase.
2, a variety of drugs and chemicals can cause transaminase to rise, but it can return to normal after stopping the drug.
3. When liver cirrhosis and liver cancer cirrhosis are active, transaminase is generally high.
4. Acute attack of biliary tract diseases such as cholecystitis and gallstones, in addition to fever, abdominal pain, nausea, vomiting and jaundice, can also cause the increase of serum bilirubin and transaminase. Transaminase is excreted from bile duct. If there are diseases of bile duct, gallbladder and pancreas and bile duct obstruction, transaminase can also be increased. Cholecystitis, biliary ascaris, hepatolithiasis, gallbladder and bile duct tumors, periampullary carcinoma, congenital biliary dilatation, acute and chronic pancreatitis, pancreatic headache and hemorrhagic necrotizing pancreatitis are common diseases in hospital beds.
5, heart disease acute myocardial infarction, myocarditis, heart failure, can cause transaminase increase.
6. Other infectious diseases: In addition to the liver, other organs and tissues in the body such as heart, kidney, lung, brain, testis, muscle, etc. also contain this enzyme. Therefore, when patients with myocarditis, pyelonephritis, lobar pneumonia, tuberculosis, polymyositis, hyperthyroidism, acute septicemia, typhoid fever, meningitis, malaria, leptospirosis, influenza, measles, schistosomiasis and crush syndrome, we can also see the increase of transaminase in the blood.
7. Have you ever taken drugs harmful to your liver? If so, we must pay attention to the possibility of drug-induced hepatitis;
8. Women should also pay attention to the possibility of autoimmune hepatitis and check autoimmune antibodies (antinuclear antibodies, anti-smooth muscle antibodies, etc.). ) are all positive;
9. Whether there are diseases such as cholecystitis, heart disease and nephritis that can also cause the increase of transaminase in the past;
To sum up, there are many reasons for the increase of transaminase, so we must check it carefully, make clear the cause and treat it according to the cause.
It is normal for transaminase levels to be between 0 and 40. If it is beyond the normal range, the doctor will recommend a second inspection to eliminate the possibility of errors caused by laboratory equipment failures and operational errors. If the level of transaminase is still high, it is mostly caused by viral hepatitis or other liver diseases. However, in order to determine whether it is viral hepatitis, other tests are needed, combined with comprehensive analysis of medical history, symptoms and signs.
Once the functions ALT and AST were teachers' qualifications for physical examination.
Teachers' qualification certificates should be checked.
The values of ALT and AST indicate whether there is a problem with liver function. The high value may be caused by liver diseases such as chronic hepatitis or fatty liver, or it may be caused by emergency or drinking. The specific reasons need to be based on the color ultrasound of the liver. I suggest you rest for a few days, and then check again to see if you can get back to normal. If not, you need to check the liver color ultrasound to determine whether it is hepatitis or other diseases.
Acute and chronic hepatitis will affect the physical examination of teacher qualification certificate.