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Background Occupational pneumoconiosis is the most common occupational disease in Qinghai Province and China. From the perspective of public health, it is important to assess the disease burden using disability-adjusted life years (DALY) and economic losses. Objective To evaluate the disease burden of occupational pneumoconiosis in Qinghai Province, and to provide a basis for the formulation and implementation of relevant prevention and control strategies. Methods Based on the registered data, a database of occupational pneumoconiosis cases confirmed and reported in Qinghai Province was established. The survival status and death dateof occupational pneumoconiosis patients from 2015 to 2019 were confirmed by on-site visit, telephone survey, matching search of Death Information Registration and Management System, and consulting other departments. The life loss due to occupational pneumoconiosis from 2015 to 2019 was assessed using DALY as an indicator and data from the Global Burden of Disease 2019 (GBD 2019) study. Inpatients with officially diagnosed occupational pneumoconiosis from a hospital in Qinghai Province in 2019 were selected as study subjects, the direct economic loss was evaluated with hospitalization expenses, and the indirect economic loss due to occupational pneumoconiosis in Qinghai Province in 2019 was calculated by human capital approach. Results From 2015 to 2019, 505 new cases of occupational pneumoconiosis were reported in Qinghai Province, and there were 348 death cases. Prevalent cases and years lost due to disability (YLD) due to occupational pneumoconiosis were increased, while DALY and years of life lost (YLL) due to occupational pneumoconiosis decreased firstly and then increased. In each year, there were 87% or more of the DALY, YLL, or YLD attributed to silicosis and coal workers' pneumoconiosis. In 2019, the occupational pneumoconiosis-associated DALY was 2173.55 person years. The total hospitalization expense incurred by 42 inpatients with occupational pneumoconiosis was 1256345.19 yuan. The total hospitalization expense and average daily cost of the inpatients with stageⅡand Ⅲ pneumoconiosis were higher than that of the inpatients with stageⅠ (P<0.05), and the hospitalization expense was higher in the ≥60 years age group than in the <60 years age group (P<0.05). In 2019, the indirect economic burden incurred by occupational pneumoconiosis in Qinghai Province was 44108581.65 yuan, and accounted for 0.15‰ of the gross domestic product (GDP) of the province. Conclusion The disease burden associated with occupational pneumoconiosis in Qinghai Province are outstanding. Silicosis and coal workers' pneumoconiosis are the key contributors. Targeted intervention measures including dust hazard control, enterprise management, follow-up and rehabilitation management of pneumoconiosis should be taken to prevent and control the occurrence and progression of pneumoconiosis and alleviate disease burden of pneumoconiosis.
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Objective@#To summarize the perioperative nursing measures and effects of 3D printed artificial cervical vertebrae for lower cervical spine fractures.@*Methods@#Treatment of 15 cases of lower cervical spine fracture with 3D printed artificial cervical vertebrae. Preoperative cervical spine fixation to prevent spinal cord injury, strict observation of clinical symptoms, assist the doctor to perform CT three-dimensional reconstruction of the cervical spine, and calculate the physiological height of the injured vertebrae; maintain the surgical position fixed during surgery, carefully prepare the supporting equipment, familiar with the surgical related steps, accurate delivery of all types of surgical instruments to assist with intraoperative fluoroscopy. Postoperative focus on the neck to see if there is swelling, effectively maintain the airway patency, observe changes in spinal nerve function, develop a personalized functional exercise program to promote rehabilitation, and actively prevent complications.@*Results@#The JOA score increased from (9.23±1.62) points before surgery to (14.09±1.35) points after surgery, and the improvement rate was 62.55%. There were no complications such as difficulty swallowing, hoarseness, and difficulty breathing.@*Conclusions@#Through targeted perioperative care, surgical complications can be reduced and the quality of life of patients improved.
ABSTRACT
Objective To summarize the perioperative nursing measures and effects of 3D printed artificial cervical vertebrae for lower cervical spine fractures. Methods Treatment of 15 cases of lower cervical spine fracture with 3D printed artificial cervical vertebrae. Preoperative cervical spine fixation to prevent spinal cord injury, strict observation of clinical symptoms, assist the doctor to perform CT three-dimensional reconstruction of the cervical spine, and calculate the physiological height of the injured vertebrae; maintain the surgical position fixed during surgery, carefully prepare the supporting equipment, familiar with the surgical related steps, accurate delivery of all types of surgical instruments to assist with intraoperative fluoroscopy. Postoperative focus on the neck to see if there is swelling, effectively maintain the airway patency, observe changes in spinal nerve function, develop a personalized functional exercise program to promote rehabilitation, and actively prevent complications. Results The JOA score increased from (9.23 ± 1.62) points before surgery to (14.09 ± 1.35) points after surgery, and the improvement rate was 62.55%. There were no complications such as difficulty swallowing, hoarseness, and difficulty breathing. Conclusions Through targeted perioperative care, surgical complications can be reduced and the quality of life of patients improved.
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Objective Compare the clinical efficacy between anterior cervical decompressions, internal fixation with steel plate and zero profile interbody fusion system (Zero-P) in the treatment of cervical spondylotic myelopathy.Methods From October 2010 to May 2013, a total of 47 patients with cervical myelopathy were included in prospective randomized controlled study.All patients were randomly divided into two groups, respectively using plate fixation (screw plate system group, 26 cases)and Zero-P (Zero-P group, 21 cases).Compared operation time, intraoperative blood loss, postoperation flow and the incidence of postoperative discomfort swallowing.Evaluated the Japanese Orthopaedic Association (JOA) score of nerve function and calculated improvement rate;measured cervical Cobb Angle on X-ray film, observed abnormal activity of surgical clearance, evaluated degree of bone graft fusion and related internal fixation complications.Results The average operation time of screw plate system group was 71.2±26.8 min, which was 53.4±28.6 min in Zero-P group, significant difference was found in two groups.The average bleeding volume was 78.1 ±46.7 ml, and average volume of postoperation drainage was 63.3±37.7 ml in screw plate system group;the average bleeding volume was 77.5±50.4 ml, and the average volume of postoperation drainage was 60.7±28.6 ml in Zcro-P group, no significant difference was found.5 cases in screw plate system group remained swallowing discomfort 3 weeks after operation, but non in Zero-P group.Followed-up lasted for 24-42 months, an average of 23±2.16 months, nerve function were significantly improved at the end of the follow-up of both two groups, the JOA score of screw plate system group was 14.28±2.96, the improvement rate was 68.91％±7.9％, and Zero-P group was 14.32±2.87, the improvement rate was 69.79％±11.2％, there were no significant difference;curvature of cervical vertebrae of screw plate system group was 15.2°±5.7° at the end of follow-up;Zero-P group was 18.1°±7.9°, which with significant difference.Bone graft fusion were found in all patients at the end of follow-up, and no abnormal activities and fixation loosening was found during follow-up period.Conclusion Zero-P compared with traditional fracture-fixation techniques in treating single or double segments of cervical spondylotic myelopathy, can shorten operation time, reduce the incidence of postoperative chronic discomfort swallowing, and maintain in favour of cervical curvature.