<!DOCTYPE HTML>
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<html xmlns:th="http://www.thymeleaf.org">
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<head>
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<meta charset="utf-8">
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<META HTTP-EQUIV="Pragma" CONTENT="no-cache">
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<meta name="renderer" content="webkit|ie-comp|ie-stand">
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<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
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<meta name="viewport"
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content="width=device-width,initial-scale=1,minimum-scale=1.0,maximum-scale=1.0,user-scalable=no" />
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<meta http-equiv="Cache-Control" content="no-siteapp" />
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<!-- 本框架基本脚本和样式 -->
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<script type="text/javascript"
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th:src="@{/js/plugin/jquery-2.1.4.min.js}"></script>
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<script type="text/javascript"
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th:src="@{/js/systools/MBase.js}"></script>
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</head>
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<body>
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<div class="ibox-content">
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<form class="form-horizontal" id="dataform" onsubmit="javascript:return false;">
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<!--基本信息-->
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<div class="row">
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<div class="col-sm-12">
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<div class="ibox-content">
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<div class="panel panel-default">
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<div class="panel-heading"><h3>一、基本信息</h3></div>
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<div class="panel-body">
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<div class="form-group">
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<label class="col-sm-2 control-label">姓名:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.userName}" >
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</div>
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<label class="col-sm-2 control-label">性别:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.sex}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">年龄:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.age}" >
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</div>
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<label class="col-sm-2 control-label">身高:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.height}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">体重:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.weight}" >
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</div>
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<label class="col-sm-2 control-label">BMI:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.bmi}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">腰围:
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.waistline}" >
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</div>
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<label class="col-sm-2 control-label">工作性质/体力活动强度:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.jobNature}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">家族病史:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.familyHistory}" >
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</div>
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<label class="col-sm-2 control-label">既往病史:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.medicalHistory}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">药物治疗史:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.medicationHistory}" >
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</div>
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<label class="col-sm-2 control-label">有无过敏情况:
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.anaphylaxis}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">联系电话:
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.phone}" >
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</div>
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<label class="col-sm-2 control-label">联系地址:
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.address}" >
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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<!--基本信息end-->
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<!--生命体征指标-->
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<div class="row">
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<div class="col-sm-12">
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<div class="ibox-content">
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<div class="panel panel-default">
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<div class="panel-heading"><h3>二、生命体征指标</h3></div>
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<div class="panel-body">
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<div class="form-group">
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<h3 class="col-sm-2 control-label">1、血糖
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<span class="text-danger">*</span>
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</h3>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">空腹血糖:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.fbg}" >
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</div>
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<label class="col-sm-2 control-label">餐后2h血糖:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.twoHoursBlood}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">糖化血红蛋白:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.glycosylatedHemoglobin}" >
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</div>
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<label class="col-sm-2 control-label">C肽:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.cPeptide}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">低血糖发生情况:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.downBlood}" >
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</div>
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</div>
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<div class="form-group">
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<h3 class="col-sm-2 control-label">2、血压
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<span class="text-danger"> </span>
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</h3>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">收缩压:
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.systolicPressure}" >
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</div>
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<label class="col-sm-2 control-label">舒张压:
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.diastolicPressure}" >
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</div>
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</div>
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<div class="form-group">
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<h3 class="col-sm-2 control-label">3、血脂
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<span class="text-danger"> </span>
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</h3>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">血脂是否正常:
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.bloodFat}" >
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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<!--生命体征指标end-->
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<!--生活方式、饮食-->
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<div class="row">
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<div class="col-sm-12">
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<div class="ibox-content">
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<div class="panel panel-default">
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<div class="panel-heading"><h3>三、生活方式、饮食</h3></div>
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<div class="panel-body">
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<div class="form-group">
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<h3 class="col-sm-2 control-label">1、饮食模式
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<span class="text-danger">*</span>
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</h3>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">饮食模式:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.dietaryPattern}" >
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</div>
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<label class="col-sm-2 control-label">奶类摄入:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.milkIntake}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">豆类/豆制品:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.beansIntake}" >
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</div>
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<label class="col-sm-2 control-label">鸡蛋:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.egg}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">口味:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.flavor}" >
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</div>
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<label class="col-sm-2 control-label">有无喝茶/咖啡习惯:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.teaCoffee}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">
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<span class="text-danger">24小时饮食回顾:</span>
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</label>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">早餐:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.breakfast}" >
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</div>
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<label class="col-sm-2 control-label">加餐:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.snacksOne}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">午餐:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.lunch}" >
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</div>
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<label class="col-sm-2 control-label">加餐:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.snacksTwo}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">晚餐:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.supper}" >
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</div>
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</div>
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<!--生活方式-->
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<div class="form-group">
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<h3 class="col-sm-2 control-label">2、生活方式
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<span class="text-danger">*</span>
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</h3>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">吸烟情况:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.smoke}" >
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</div>
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<label class="col-sm-2 control-label">有无喝酒习惯:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.drink}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">运动情况:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.exercise}" >
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</div>
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<label class="col-sm-2 control-label">运动形式/时间/频率:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.exerciseType}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">睡眠时间:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" id="sleepTimeStart" >
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</div>
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<label class="col-sm-2 control-label">是否熬夜:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.stayUpLate}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">睡眠质量:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.sleepQuality}" >
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</div>
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<label class="col-sm-2 control-label">备注睡眠差的具体情况:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.remark}" >
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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<!--生活方式、饮食end-->
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<!--其他健康状况-->
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<div class="row">
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<div class="col-sm-12">
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<div class="ibox-content">
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<div class="panel panel-default">
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<div class="panel-heading"><h3>四、其他健康状况</h3></div>
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<div class="panel-body">
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<div class="form-group">
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<label class="col-sm-2 control-label">主诉:
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<span class="text-danger">*</span>
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.chiefComplaint}" >
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</div>
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<label class="col-sm-2 control-label">皮肤情况:
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.skin}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">头部情况:
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.head}" >
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</div>
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<label class="col-sm-2 control-label">胃肠功能:
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.gastrointestinal}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">四肢/肌肉:
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</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.muscle}" >
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</div>
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<label class="col-sm-2 control-label">精神心理:
|
|
</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.mental}" >
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</div>
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</div>
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<div class="form-group">
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<label class="col-sm-2 control-label">数据采集人:
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</label>
|
<div class="col-sm-4">
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<input autocomplete="off" type="text" class="form-control" th:value="${obj.dataCollector}" >
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</div>
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<label class="col-sm-2 control-label">采集日期:
|
|
</label>
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<div class="col-sm-4">
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<input autocomplete="off" type="text" id="collectDate" class="form-control" >
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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</div>
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<!--其他健康状况end-->
|
<div class="navbar navbar-fixed-bottom" style="background:#F5F5F5">
|
<div class="col-sm-12 text-center" style="margin-top:12px;">
|
<a class="btn btn-danger radius" href="javascript:;" onclick="MTools.closeForm()"><i
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class="fa fa-close"></i> 关闭</a>
|
</div>
|
</div>
|
</form>
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</div>
|
</body>
|
<script type="text/javascript" th:src="@{/js/systools/MJsBase.js}"></script>
|
<script th:inline="javascript">
|
|
/*<![CDATA[*/
|
var obj=/*[[${obj}]]*/
|
/*]]>*/
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|
var myForm=MForm.initForm({
|
invokeUrl:invokeUrl,
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afterSubmit:function(){
|
parent.myGrid.serchData();
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},
|
});
|
</script>
|
<script>
|
$(function(){
|
$('input[type=text]').attr("disabled","disabled");
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var sleepTime = "( "+obj.sleepTimeStart+" )点-( "+obj.sleepTimeEnd+" )";
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$("#sleepTimeStart").val(sleepTime);
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$("#collectDate").val(obj.collectDate);
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});
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</script>
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</body>
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</html>
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