Analysis on the diagnosis of suspected occupational diseases in Guangzhou from 2014 to 2019 / 中华劳动卫生职业病杂志

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.

A study on the clinical application of different diagnostic criteria for bronchopulmonary dysplasia / 中国新生儿科杂志

Objective:To compare the results of clinical diagnosis and severity grading in preterm infants with bronchopulmonary dysplasia (BPD) using three different diagnostic criteria and the consistency of two new diagnostic criteria.Methods:From January to December, 2020, infants with gestational age <32 w admitted to neonatal intensive care unit of our hospital were retrospectively enrolled in this cohort study. The patients were diagnosed and graded according to the 2001, 2018 and 2019 criteria of BPD. Chi-square test was used to compare the differences of BPD diagnostic rate and mortality rate using three criteria and Kappa coefficient test was used to compare the consistency between the two new criteria of 2018 NICHD and 2019 NRN.Results:A total of 231 preterm infants were enrolled, including 130 males (56.3%) and 101 females. 9 patients were dead. According to 2018 NICHD criteria, 97 cases (42.0%) were diagnosed with BPD, including 16 gradeⅠ, 44 grade Ⅱ, 31 grade Ⅲ and 6 grade ⅢA. The remaining 134 cases were not BPD (58.0%). No significant differences existed ( P>0.05) among the diagnostic rates of 2001 criteria (112/231, 48.5%), 2018 criteria (97/231, 42.0%) and 2019 criteria (91/231, 39.4%). For grade Ⅲ BPD, the diagnostic rate of 2001 criteria was significantly higher than the 2018 criteria (including grade Ⅲ and grade ⅢA, 16.0%) and 2019 criteria (6.5%) and the diagnostic rate of 2018 criteria was also significantly higher than 2019 criteria ( P<0.05). No significant differences existed in the overall mortality rate of BPD among three criteria ( P>0.05), however, the case mortality rate of grade Ⅲ BPD of 2001 criteria (3.9%) was significantly lower than 2018 criteria (24.3%) and 2019 criteria (20.0%) ( P<0.05). The 2018 and 2019 criteria were highly consistent in the overall diagnostic rate of BPD (Kappa value = 0.946), the positive consistency rate was 93.8% (95% CI 85.5%~97.5%) and the negative consistency rate was 100.0% (95% CI 96.5%~100.0%). But the consistency of severity grading for BPD was weak (Kappa value = 0.597) between the two criteria. Conclusions:The 2001 NICHD BPD criteria is no longer valid because it tends to overdiagnose severe BPD, thus underestimate the case mortality. The 2018 NICHD criteria is comprehensive and detailed and the 2019 NRN criteria is simple and practical. The two new criteria are highly consistent in the overall diagnosis of BPD, but the consistency of severity grading is weak.

Study the impacts of diagnosis on occupational noise-induced deafness after bring into the different high frequency hearing threshold weighted value / 中华劳动卫生职业病杂志

Objective@#Study of the results and the degree on occupational noise-induced deafness in-to the different high frequency hearing threshold weighted value, in order to provide theoretical basis for the re-vision of diagnostic criteria on occupational noise-induced deafness.@*Methods@#A retrospective study was con-ducted to investigate the cases on the diagnosis of occupational noise-induced deafness in Guangdong province hospital for occupational disease prevention and treatment from January 2016 to January 2017. Based on the re-sults of the 3 hearing test for each test interval greater than 3 days in the hospital, the best threshold of each frequency was obtained, and based on the diagnostic criteria of occupational noise deafness in 2007 edition, Chi square test, t test and variance analysis were used to measure SPSS21.0 data, their differences are tested among the means of speech frequency and the high frequency weighted value into different age group, noise ex-posure group, and diagnostic classification between different dimensions.@*Results@#1. There were totally 168 cases in accordance with the study plan, male 154 cases, female 14 cases, the average age was 41.18 ±6.07 years old. 2. The diagnosis rate was increased into the weighted value of different high frequency than the mean value of pure speech frequency, the weighted 4 kHz frequency increased by 13.69% (χ2=9.880, P=0.002) , 6 kHz increased by 15.47% (χ2=9.985, P=0.002) and 4 kHz+6 kHz increased by15.47% (χ2=9.985, P=0.002) , the difference was statistically significant. The diagnostic rate of different high threshold had no obvious differ-ence between the genders. 3. The age groups were divided into less than or equal to 40years old group (A group) and 40-50 years old group (group B) , there were higher the diagnostic rate between high frequency weighted 4 kHz (A group χ2=3.380, P=0.050; B group χ2=4.054, P=0.032) , weighted 6 kHz (A group χ2=6.362, P=0.012; B group χ2=4.054, P=0.032) , high frequency weighted 4 kHz+6 kHz (A group χ2=6.362, P=0.012; B group χ2=4.054, P=0.032) than those of speech frequency average value in the same group on oc-cupational noise-induced deafness diagnosis rate, the difference was statistically significant. There was no sig-nificant difference between age groups (χ2=2.265, P=0.944) . 4. The better ear's mean value of pure speech fre-quency and the weighted values into different high frequency of working years on each group were compared, working years more than 10 years group was significantly higher than that of average thresholds of each frequen-cy band in 3-5 group (F=2.271, P=0.001) , 6-10 group (F=1.563, P=0.046) , the difference was statistically significant. The different high frequency weighted values were higher than those of the mean value of pure speech frequency, and the high frequency weighted 4 kHz+6 kHz had the highest frequency difference, with an average increase of 2.83 dB. 5. The diagnostic rate into weighted different high frequency was higher in the mild, moderate and severe grades than in the pure speech frequency. In the comparison of diagnosis for mild occupational noise-induced deafness, in addition to the weighted 3 kHz high frequency (χ2=3.117, P=0.077) had no significant difference, the weighted 4 kHz (χ2=10.835, P=0.001) , 6 kHz (χ2=9.985, P=0.002) , 3 kHz+4 kHz (χ2=6.315, P=0.012) , 3 kHz+6 kHz (χ2=6.315, P=0.012) , 4 kHz+6 kHz (χ2=9.985, P=0.002) , 3 kHz+4 kHz+6 kHz (χ2=7.667, P=0.002) were significantly higher than the diagnosis rate of the mean value of pure speech frequency. There was no significant difference between the two groups in the moderate and se-vere grades (P>0.05) .@*Conclusion@#Bring into different high frequency hearing threshold weighted value in-creases the diagnostic rate of occupational noise-induced deafness, the weighted 4 kHz, 6 kHz and 4 kHz+ 6 kHz high frequency value affects the result greatly, and the weighted 4 kHz+6 kHz high frequency hearing threshold value is maximum the effect on occupational noise-induced deafness diagnosis.

The changes of main upper gastrointestinal diseases and Helicobacter pylori infection status in the past thirty five years / 中华内科杂志

Objective To study the spectrum of upper gastrointestinal diseases and infection rate of Helicobacter pylori(Hp) in our hospital during the past 35 years.Methods Patients who were 16 or older with duodenal ulcer,gastric ulcer,reflux esophagitis,gastric cancer and esophageal cancer diagnosed by gastroscopy and pathology were retrospectively enrolled in our study from January 1980 to December 2014.Patients with chronic superficial gastritis,chronic atrophic gastritis or Hp infection from January 1989to December 2014 were also included in our study according to the same diagnostic criteria.The incidences of diseases and the infection rates of Hp were studied.Results A total of 213 495 patients underwent gastroscopy in our department during the past 35 years.The overall diagnostic rates of duodenal ulcer,gastric ulcer,reflux esophagitis,gastric cancer and esophageal cancer were 9.87％,3.79％,6.66％,1.59％ and 0.66％ respectively.There were 183 426 patients receiving gastroscopy in our department from January 1989to December 2014.The overall endoscopic diagnosis rates of chronic superficial gastritis and chronic atrophic gastritis were 49.83％ and 22.43％ respectively.The overall infection rate of Hp was 36.18％,which had a declining trend consistent with peptic ulcer (all P =0.000).Yet,the prevalence of reflux esophagitis,chronic superficial gastritis and chronic atrophic gastritis were increasing (all P =0.000).The diagnostic rates of gastric cancer and esophageal cancer were persistent (P =0.266,P =0.156).Conclusions The Hp infection during years has been decreasing,consistent with the declining tendency of peptic ulcer.On the other hand,reflux esophagitis,chronic superficial gastritis and chronic atrophic gastritis show an ascendant trend.The proportion of patients with gastric cancer and esophageal cancer is relatively stable.

Application of contrast-enhanced ultrasonography in improving the success rate of percutaneous biopsy for peripheral pulmonary lesions / 介入放射学杂志

Objective To investigate the clinical application of contrast enhanced ultrasonography (CEUS) in performing percutaneous biopsy for peripheral lung lesions. Methods A total of 132 patients with peripheral lung lesions underwent ultrasonography-guided percutaneous biopsy. Of the 132 patients, 72 received CEUS examinations before biopsy (CEUS group), and 60 received simple biopsy with no CEUS examination (control group). The ultrasonography imaging characteristics, the times of puncture biopsy, the diagnostic accuracy rate and the incidence of complications were recorded , and the results were compared between the two groups. The clinical value of CEUS in improving the success rate of percutaneous biopsy for peripheral pulmonary lesions was analyzed. Results Necrosis(areas of echoless) was demonstrated in 44.4%of the patients (32/72) in CEUS group, while it was displayed in only 6.7% of the patients (4/60) in the control group. The demonstration rate of necrosis in CEUS group were statistically higher than that in the control group (P <0.01). In CEUS group coexisting local pulmonary atelectasis was found in 12.5%of the patients (9/72), and the pulmonary lesion within the atelectasis could be clearly displayed. In the control group, local pulmonary atelectasis was demonstrated only in 1.7% of patients (1/60), the difference between the two groups was statistically significant (P<0.05). The diagnostic accuracy rate of CEUS group and the control group was 95.8% (69/72) and 80% (48/60) respectively, the difference was significant (P<0.01). The average number of punctures in CEUS group and the control group was (2.4 ± 0.6) and (2.6 ± 0.6) times respectively, the difference was not significant. The incidence of complications in CEUS group and the control group was 2.8% and 3.3%respectively, the difference was not significant. No severe complications occurred in both groups. Conclusion CEUS examination that is carried out before percutaneous pulmonary biopsy can effectively demonstrate the inner structure of the lesion, thus the diagnosis can be correctly made. Therefore, CEUS is of great value in guiding percutaneous pulmonary biopsy.

Changes in Indications and Diagnostic Rates of Capsule Endoscopy in a Single Center / 대한소화기내시경학회지

BACKGROUND/AIMS: The aim of this study was to investigate changes with time in indications for capsule endoscopy examinations (CEs) and diagnostic rates. METHODS: We retrospectively reviewed medical records of 425 CEs (417 patients), which were done for several different indications between March 2003 and May 2009. Indications, bowel cleansing, complete CEs, and diagnostic rates were compared between the first half (2003~2005) and the second half (2006~2009) of the study period. RESULTS: Overt bleeding and occult bleeding, respectively, accounted for 31% and 5.8% in the first half; and 45.4% and 12.4% in the second half. The differences were significant (p<0.05). Other indications were significantly decreased in the second half compared to the first half (29.6% and 7.7% respectively). Bowel cleansing was considered "adequate" in 48% in the first half vs. 61.6% in the second half (p<0.05). No significant difference was found in complete CE rates. There was a significant difference in diagnostic rates between the first half and the second half (23.8% and 43.9%, respectively). CONCLUSIONS: Cumulative experience and knowledge with CEs has led to an increased number of CEs for obscure bleeding and a decreased number of CEs for other indications in which the role of CEs was unclear. Improved diagnostic rates of CEs were accompanied by these changes in CEs indications.