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Objective: To understand the diagnosis of suspected occupational diseases reported in Guangzhou from 2014 to 2019, so as to provide theoretical basis and technical support for the supervision of suspected occupational disease reports. Methods: By cluster sampling, the suspected occupational disease report card, occupational disease report card and pneumoconiosis report card reported by Guangzhou from January 1, 2014 to December 31, 2019 in the occupational disease and occupational health information monitoring system were collected for matching analysis to understand the diagnosis of suspected occupational disease patients. Results: From 2014 to 2019, a total of 1426 suspected occupational cases in 7 categories and 32 species were reported in Guangzhou. The average number of reported cases per year was about 240. The main diseases of suspected occupational diseases were suspected occupational noise deafness (68.44%, 976/1426) , suspected occupational chronic benzene poisoning (16.48%, 235/1426) , suspected occupational other pneumoconiosis (4.84%, 69/1426) , suspected occupational silicosis (3.23%, 46/1426) and suspected occupational welder pneumoconiosis (1.82%, 26/1426) . The diagnostic rate required to enter the occupational disease diagnostic program is 36.61% (522/1426) , and the diagnostic rate is 59.20% (309/522) . In 2019, the diagnosis rate of suspected occupational diseases was the lowest (23.92%, 61/255) , Huadu District was the lowest (8.33%, 9/108) , suspected occupational pneumoconiosis was the lowest (28.03%, 44/157) , the diagnosis rate of suspected occupational diseases reported by the Centers for Disease control and prevention was the lowest (17.43%, 19/109) , and the diagnosis rate of suspected occupational diseases reported by outpatient treatment was the lowest (22.22%, 2/9) . The suspected occupational diseases reported by institutions outside Guangzhou did not enter the occupational disease diagnosis procedure. Suspected occupational skin diseases, suspected occupational diseases caused by physical factors and suspected occupational tumors were diagnosed, and the diagnosis rate of occupational disease prevention and control institutions was the highest (94.87%, 37/39) . Conclusion: The main types of suspected occupational diseases reported during these six years are noise deafness, chronic benzene poisoning and pneumoconiosis. The overall diagnosis rate and diagnosis rate of suspected occupational diseases are not high. It is suggested to improve the network direct reporting system of suspected occupational diseases and strengthen the follow-up management and supervision of suspected occupational diseases.
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Humans , China/epidemiology , Noise, Occupational , Occupational Diseases/epidemiology , Physical Examination , Pneumoconiosis/epidemiology , SilicosisABSTRACT
Objective:To investigate the significant effects of enhanced whole-body computed tomography (EWBCT) and non-enhanced whole-body computed tomography (N-EWBCT) on the missed diagnosis rate, renal function and prognosis of patients with severe trauma.Methods:Clinical data of trauma patients admitted from January 1, 2017 to December 31, 2020 were collected from the trauma database of the Trauma Center of the Second Affiliated Hospital of Soochow University. All patients included in this study were divided into the EWBCT group and N-EWBCT group according to whether they underwent enhanced whole-body computed tomography examination. The differences in baseline data, missed diagnosis rate, renal function and prognosis of the two groups of patients were compared.Results:A total of 459 patients were included in this study, including 184 patients in the EWBCT group and 275 patients in the N-EWBCT group. The missed diagnosis rate of the N-EWBCT group was significantly higher than that of the EWBCT group (18% vs. 5%, P < 0.01). The risk ratio of acute kidney injury (AKI) in the EWBCT group and N-EWBCT group was 9% and 7%, respectively, and there was no statistical difference between the two groups ( P >0.05). The mortality rate of patients in the N-EWBCT group was higher than that in the EWBCT group (23% vs. 12%, P=0.002). Conclusions:Compared with N-EWBCT, EWBCT does not significantly increase the risk of renal damage in patients with severe trauma. For patients with severe trauma, early EWBCT can reduce the missed diagnosis rate and improve the clinical prognosis.
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Objective@#To estimate the total number of people infected with HIV and to calculate the diagnosis rate of HIV in Dehong Prefecture, Yunnan Province.@*Methods@#Through the comprehensive AIDS prevention and treatment information system, we collected and analyzed the relevant information of the new diagnosis report of HIV in Dehong Prefecture, Yunnan Province in 2006-2015, mainly including age, sex, infected transmission, CD4+ T-lymphocyte counts, diagnostic time and so on. The content of the study was to establish a model method for estimating the diagnosis rate of HIV in Dehong. First, used the first CD4+ T-lymphocyte count after HIV diagnosis to estimate the date of infection. Then based on the estimated time from HIV infection to diagnosis we can estimate the diagnosis delay distribution which in turn can be used to account for individuals infected but not yet diagnosed and thus estimated the total number of HIV infections (diagnosed and undiagnosed). Finally, the number of new infections in each year was added to estimate the total number of infected people, and the number of people who had been diagnosed was divided by the total number of infected persons to obtain the proportion of HIV diagnosis rate.@*Results@#There were 8 215 reported cases in Dehong from 2006 to 2015, of which 1 297 cases were reported in 2007 (15. 8%) and 361 cases (4.4%) in 2015. The diagnosis rate of newly infected persons were 88% in 2005 and before. And from 2006 to 2015, the diagnosis rate of newly infected persons were 75%, 71%, 68%, 66%, 61%, 58%, 53%, 45%, 40% and 33%, respectively. The total number of newly infected persons in 2005 and before was 11 197 cases. The annual new infected number from 2006 to 2015 was 653, 671, 723, 640, 509, 468, 369, 375, 285 and 224 cases. The total number of people infected with HIV in Dehong was 16 114 cases, and the diagnosis rate was 87.7%.@*Conclusion@#The diagnosis rate of HIV in Dehong was at a high level. Since 2008, the annual number of new infections in Dehong has been declining.
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Objective To explore the diagnostic value of radial ultrasound (EBUS) combined with virtual navigation (VBN) in peripheral pulmonary nodules.Methods Two hundreds and forty cases of peripheral pulmonary nodules(0.8 cm≤diameter≤3 cm) in the respiratory department of our hospital from July 2014 to July 2015 were included and according to the different guide de vices,which were divided into the radial ultrasound combined with virtual navigation group (EBUS+ VBN group),radial ultrasound group (EBUS group),virtual navigation group (VBN group) and control group.The diagnostic rates were compared among the four groups and among different sizes of lesion.The time of lesion location and operating time were also compared between the EBUS+ VBN group and EBUS group.Results Among 240 cases,the diagnostic rate in the EBUS+VBN group was highest(81.67％),and the diagnostic rates had statistically significant difference among the four groups (x2=19.344,P=0.00);the diagnostic rates of lesions less than 2 cm in diameter were lower than that of lesions ＞2 cm in the EBUS+-VBN group and EBUS group,but without statistically significant difference (x2 =2.04,3.40,P =0.15,0.07);the locating lesions time and operating times in the EBUS+ VBN group were shorter than those in the EBUS group,but the difference between them was not statistically significant (P=0.03,0.04).Conclusion EBUS combined with VBN could improve the diagnostic rate of peripheral pulmonary nodules and shorten the time of lesion location and operating time.
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Objective To explore the diagnostic value of virtual bronchoscopic navigation (VBN) for peripheral pulmonary lesions. Methods 200 cases with peripheral pulmonary lesions (0.8 cm < diameter < 4.0 cm) were divided into VBN and control group from June 2014 to June 2015. VBN group: VBN guided ultrafine bronchoscope to the target bronchus, control group: ultrafine bronchoscopy with chest CT as a reference guided to the target bronchus. Results There were no significant differences in the diagnosis rates between VBN group and control group in 200 patients (χ2 = 3.31, P = 0.069); But, the diagnosis rates with diameter more than 2.0 cm and less than or equal to 2.0 cm had statistically significant differences of VBN group and control group (χ2 = 13.45, 5.31, P = 0.000, 0.021, respectively); We also found that the mean time of biopsy tool reach to the lesions had significant differences between the two groups (P = 0.047). There were no significant differences in total checking time and complications (P = 0.230, 0.960, respectively). Conclusions Virtual bronchoscopic navigation did not improve the diagnosis rate of pulmonary peripheral lesions, but shortened the time to locate the lesions.
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Objective To explore the application of transbronchial needle aspiration biopsy (EBUS-TBNA) combined with ultrasound bronchoscopy under the general anesthesia (intravenous anesthesia combined with laryngeal mask). Methods 103 patients with EBUS-TBNA from June 2015 to October 2016 were randomly divided into local anesthesia group and general anesthesia group. The anesthesia group was anesthetized with intravenous anesthesia combined with laryngeal mask, local anesthesia group with conventional tetracaine local anesthesia. The differences in the average number of puncture needles, the diagnosis rate, the operation time, the complications and the comfort of each group were analyzed retrospectively. Results The average number of puncture needle in each group was 5.6 times, and the local anesthesia group was 3.1 times. The diagnosis rate of general anesthesia group was 94.12% and local anesthesia group was 78.85%. There was significant difference between the two groups (χ2 = 5.11, P = 0.024). The average operation time in the general anesthesia group was (14.61 ± 1.52), the local anesthesia group was (32.52 ± 4.14), they had significant difference (t = 29.01, P = 0.000). The number of patients in bleeding and cough of the general anesthesia group were lower than those in the local anesthesia group (χ2 = 4.31, 103.00, P = 0.038, 0.000, respectively). Conclusions EBUS-TBNA under general anesthesia has high diagnostic rate, shortoperating time, painlessness, high comfort and reduce operational risk, worthy of promoting clinical application.
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Objective To explore the application of transbronchial needle aspiration biopsy (EBUS-TBNA) combined with ultrasound bronchoscopy under the general anesthesia (intravenous anesthesia combined with laryngeal mask). Methods 103 patients with EBUS-TBNA from June 2015 to October 2016 were randomly divided into local anesthesia group and general anesthesia group. The anesthesia group was anesthetized with intravenous anesthesia combined with laryngeal mask, local anesthesia group with conventional tetracaine local anesthesia. The differences in the average number of puncture needles, the diagnosis rate, the operation time, the complications and the comfort of each group were analyzed retrospectively. Results The average number of puncture needle in each group was 5.6 times, and the local anesthesia group was 3.1 times. The diagnosis rate of general anesthesia group was 94.12% and local anesthesia group was 78.85%. There was significant difference between the two groups (χ2 = 5.11, P = 0.024). The average operation time in the general anesthesia group was (14.61 ± 1.52), the local anesthesia group was (32.52 ± 4.14), they had significant difference (t = 29.01, P = 0.000). The number of patients in bleeding and cough of the general anesthesia group were lower than those in the local anesthesia group (χ2 = 4.31, 103.00, P = 0.038, 0.000, respectively). Conclusions EBUS-TBNA under general anesthesia has high diagnostic rate, shortoperating time, painlessness, high comfort and reduce operational risk, worthy of promoting clinical application.
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Aim: Psychiatric disorders are common in society, particularly among patients in hospitals and emergency departments. Physicians may overlook psychiatric disorders. Improper diagnosis and treatment of psychiatric disorders may have harmful effects on patients and society. Depression and anxiety may be present in emergency room patients, but prevalence of attention deficit hyperactivity disorder are unknown. We aimed determine whether it is possible to increase the rates of diagnosis of depression, anxiety disorders and Adult Attention Deficit Hyperactivity Disorders (ADHD), which are common in society, using psychiatric rating scales for patients. Materials and Methods: Sociodemographic data form, Hospital Anxiety Depression Scale, Adult Attention Deficit Hyperactivity Disorder (ADHD) Self-Report Scale and Emergency Department Patient Satisfaction Survey were administered to randomly selected patients on randomly selected days over a 3-month period. Diagnoses in the hospital records and scale cutoff scores were compared. Results: Depression was identified in 99 patients, anxiety disorder in 21, and ADHD in 11 of 223 patients. With these scales, the diagnosis rates of depression, anxiety, and ADHD increased from 0% to 49%, 25.2%, and 5.4%, respectively. Conclusion: Scales that can be filled out by patients in emergency departments are useful for diagnosing psychiatric disorders. With the help of these scales, with a psychiatric assessment rates of diagnosis and treatment could be increased. We may expect personal, social, and economic improvement with an increase of diagnosis and treatment rates.
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Objective To evaluate the clinical application value of a new type of Bard Max-Core coaxial biopsy system and com-pare the effectiveness and safety of different diameter biopsy guns.Methods This retrospective study included 286 patients who re-ceived CT-guided percutaneous lung biopsy using Bard MC disposable biopsy system.We divided patients into three groups:1 6G, 18G,and 20G group.Then,we evaluated the biopsy effectiveness,histological diagnosis rate and complication incidence of this new type of Bard Max-Core coaxial biopsy system.Results All lung biopsy specimens were successfully obtained.The total histological diagnosis rate was 80.8%.Patients with malignant lesions had higher histological diagnosis rate than patients with benign lesions. The histological diagnosis rate in 1 6G group was the highest among three groups.There was no significant difference among three groups regarding to the rate of diagnosis of malignant lesions.Group with 1 6G had the highest histological diagnosis rate among three groups in diagnosing begin lesions.The incidences of pneumothorax in three groups had no significant difference.The incidence of bleeding in 1 6G group was the highest among three groups.Conclusion The new Bard MC disposable coaxial biopsy system is a safe and effective instrument for lung biopsy.We should select the biopsy needles with appropriate diameter according to the fully as-sessment of patients'preoperative conditions.
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Objective To observe the changes in the pathological diagnosis rate of Graves'disease(GD) and Hashimoto's thyroiditis(HT)in the past 28 years and to probe its relationship to the environmental factors. Methods Statistic analysis was performed on data of thyroid disease,GD,HT and the complications of HT in Department of Pathology(1978-2005)in General Hospital of Tianjin Medical University with Run test,Cox-stuart test,ANOVA,t or t'test and Chi-square test.Results In 28 years there were 243 403 biopsies(average 8 693/ year)including 6 771 cases of thyroid disease(27.8‰),216 cases of GD(0.89‰),352 cases of HT (1.45‰).The biopsy rate of thyroid disease and GD showed a descending tendency since 1982 but an ascending tendency from 1995,furthermore,with GD it showed a descending tendency from 2001 to 2005 once more.While the biopsy rate of HT and GD+HT showed a descending tendency from 1986 and an ascending tendency after 1996,being 1-4 years later than thyroid disease and GD.The biopsy rate of GD+HT and the proportion of HT showed a descending tendency in 2002-2005 and 2003-2005 respecitvely.The average age of total and female patients with GD showed a descending tendency from 1997.The average age of GD was 13.7 years younger than HT,the patients of GDⅠ-type andⅡ-type being younger thanⅢ-type.The average age of lymphoid type(L), oxyphilie epithelium type(O),pronounced epithelium destruction type(P)in HT increased sequentially.In 28 years,there were more female patients with GD and HT,especially with HT.There existed 7.95% hyperthyroidism,6.25% nodular goiter,2.27% carcinoma in HT(more in L-type)and 2.56% hypothyroidism in HT(more in P-type).Conclusion Within 28 years,according to the pathological diagnosis rate,GD,HT,and GD+HT showed phasic tendencies related to drinking low iodine water and the implement of universal salt iodization policies in 1994 and 2000.Therefore,on the levels of genetics and environment,the factors that influence autoimmunity of thyroid gland could not exclude the variations of iodine intake,infection,affection or emotional stress.The mechanism of the changes in the pathological diagnosis rate needs further study.