Objective To investigate the characteristics of 136 patients with occupational diseases,to summarize key techniques used in field investigation,and to provide a scientific basis for the development of standard operating procedures for field investigation of occupational disease diagnosis.Methods Field investigation and routine data analysis were performed to analyze the cases diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from January 2009 to December 2014.Results A total of 136 cases of occupational diseases were diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014,and there were 66 cases of leukemia,18 cases of suspected occupational benzene poisoning,12 cases of suspected occupational hand-arm vibration disease,and 11 cases of suspected pneumoconiosis.Of all these patients,41.91％ were engaged in at least three types of work,70.59％ were exposed to at least three types of chemicals,25.74％ experienced changes in technical processes and chemicals,and 47.06％ had disputes on the chemicals they were exposed to during verification by both parties.Occupational hazard factors were detected.Most samples (358) were used to measure benzene concentration in workplace air,among which 11.7％ had a benzene concentration of ＞6.00 mg/m3 (exceeding standard),13.41％ had a benzene concentration of 3.26～6.00 mg/m3,75.42％ had a benzene concentration of＜ 0.03 to ＜3.25 mg/m3.The samples of suspected occupational hand-arm vibration disease,suspected pneumoconiosis,and suspected occupational noise-induced hearing loss had high over-standard rates (100％,93.8％,and 83.3％,respectively).Conclusion Field investigation of occupational disease diagnosis reveals large numbers of cases of leukemia,suspected occupational benzene poisoning,suspected occupational handarm vibration disease,and suspected pneumoconiosis.The key aspects of field investigation include confirmation of the history of occupational exposure,identification of occupational hazard factors,confirmation of the changes in technical processes and chemicals,detection of occupational hazard factors,sampling and analysis of raw materials,and epidemiological investigation of workers with the same type of work.

Objective To explore the application effect of quality control circle in the quality management improvement of the occupational disease diagnostic and code.Methods To established across departmental team of medical record QCC,we Select 132 cases of the occupational disease departmentin specialized Hospital from May 1,2022 to June31,2022,Analyze the reasons of inaccurate that main diagnosisselection and code mapping.After formulating a series of improvement measures,we Se-lect 71 cases of occupational disease department from November 1,2022 to December 31,2022.To compared effect that before and after the implementation of QCC.Results After6 months of improvement,The utilization rate of main diagnosis mapping Z-code was decreased from 36.3%to 12.7%,goal achievement rate of 106.3%,improvement rate of 65.0%.Enrollment rate of major diagnostic was increased from 53.0%to 86.3%,goal achievement rate of 116.4%,Improvement rate of 62.8%.Conclu-sion We have changed the quality control management mode of diagnosis and coding by the QCC,implement targeted feedback,supervision,and training,establish a reward and punishment mechanism that matches indicators to improved accuracy of enroll-ment.Upgrading the quality management level of medical records and medical safety at the same time.Should continue to pro-mote theimplementation.

ObjectiveTo investigate the effects of acupuncture combined with Du-Moxibustion (ADM) on peripheral blood cell count and levels of immune factors in patients with occupational chronic benzene poisoning. Methods A total of 70 patients with occupational chronic benzene poisoning (leukopenia and neutropenia) were selected as the research subjects by judgement sampling method. They were randomly divided into a control group and an ADM group using a random number table method, with 35 cases in each group. Patients in the control group were treated with conventional Western medicine such as leukocyte boosting and symptomatic treatment. While patients in the ADM group were treated with ADM treatment in addition to treatments of the control group, once per week for five consecutive weeks. Peripheral blood samples of patients were collected before and after treatment from both groups, to detect cell counts and serum levels of immune factors. Results The white blood cell count, red blood cell count, absolute lymphocyte count, absolute neutrophil count, platelet count, and levels of hemoglobin, immunoglobulins (Ig) A, IgM, IgG, complement C3 and complement C4 of patients in both groups improved after treatment compared with those before treatment (all P<0.05). The white blood cell count, levels of IgA, IgM, IgG, complement C3 and complement C4 of patients in the ADM group were higher than those in the control group after treatment (all P<0.05). Conclusion ADM treatment can increase peripheral blood white blood cells and serum levels of immune factor in patients with occupational chronic benzene poisoning (leukopenia, neutropenia), which helps improve patient recovery and can be promoted clinically.

Objective To investigate the characteristics of 136 patients with occupational diseases,to summarize key techniques used in field investigation,and to provide a scientific basis for the development of standard operating procedures for field investigation of occupational disease diagnosis.Methods Field investigation and routine data analysis were performed to analyze the cases diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from January 2009 to December 2014.Results A total of 136 cases of occupational diseases were diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014,and there were 66 cases of leukemia,18 cases of suspected occupational benzene poisoning,12 cases of suspected occupational hand-arm vibration disease,and 11 cases of suspected pneumoconiosis.Of all these patients,41.91％ were engaged in at least three types of work,70.59％ were exposed to at least three types of chemicals,25.74％ experienced changes in technical processes and chemicals,and 47.06％ had disputes on the chemicals they were exposed to during verification by both parties.Occupational hazard factors were detected.Most samples (358) were used to measure benzene concentration in workplace air,among which 11.7％ had a benzene concentration of ＞6.00 mg/m3 (exceeding standard),13.41％ had a benzene concentration of 3.26～6.00 mg/m3,75.42％ had a benzene concentration of＜ 0.03 to ＜3.25 mg/m3.The samples of suspected occupational hand-arm vibration disease,suspected pneumoconiosis,and suspected occupational noise-induced hearing loss had high over-standard rates (100％,93.8％,and 83.3％,respectively).Conclusion Field investigation of occupational disease diagnosis reveals large numbers of cases of leukemia,suspected occupational benzene poisoning,suspected occupational handarm vibration disease,and suspected pneumoconiosis.The key aspects of field investigation include confirmation of the history of occupational exposure,identification of occupational hazard factors,confirmation of the changes in technical processes and chemicals,detection of occupational hazard factors,sampling and analysis of raw materials,and epidemiological investigation of workers with the same type of work.

OBJECTIVETo investigate the efficacy of mouse nerve growth factor (mNGF) in treating occupational hand-arm vibration disease (HAVD).

METHODSSixty-four patients with HAVD were equally and randomly divided into treatment group and control group. The control group was given Salvia miltiorrhiza Bunge and deproteinized extract of calf blood to improve circulation, and also given methylcobalamin tablets and vitamin B6 for neurotrophic treatment. In addition to the above treatments for the control group, the treatment group was also given 30 µg/d mNGF by intramuscular injection for two courses (4 weeks for each course) with a 15-day interval.

RESULTSBoth the treatment group and the control group showed significant improvements in clinical symptoms and signs (hand numbness and pain, and reduced senses of touch, pain, and vibration), cold water loading test (CWLT), and electroneuromyography (ENMG) after treatments (P < 0.05). And the treatment group had significantly more improvements than the control group (P < 0.05).

CONCLUSIONmNGF can significantly improve hand numbness and pain, reduced senses of touch, pain, and vibration, CWLT, and ENMG, so it has better clinical effect and safety in treating HAVD. Early diagnosis and treatment can improve the outcome of patients with HAVD.

Animals ; Hand-Arm Vibration Syndrome ; drug therapy ; Humans ; Mice ; Nerve Growth Factor ; pharmacology ; Occupational Diseases ; Treatment Outcome ; Vibration

Objective     To explore the causes of conversion to thoracotomy in patients with minimally invasive esophagectomy (MIE) in a surgical team, and to obtain a deeper understanding of the timing of conversion in MIE. Methods     The clinical data of patients who underwent MIE between September 9, 2011 and February 12, 2022 by a single surgical team in the Department of Thoracic Surgery of the Fourth Hospital of Hebei Medical University were retrospectively analyzed. The main influencing factors and perioperative mortality of patients who converted to thoracotomy in this group were analyzed. Results     In the cohort of 791 consecutive patients with MIE, there were 520 males and 271 females, including 29 patients of multiple esophageal cancer, 156 patients of upper thoracic cancer, 524 patients of middle thoracic cancer, and 82 patients of lower thoracic cancer. And 46 patients were converted to thoracotomy for different causes. The main causes for thoracotomy were advanced stage tumor (26 patients), anesthesia-related factors (5 patients), extensive thoracic adhesions (6 patients), and accidental injury of important structures (8 patients). There was a statistical difference in the distribution of tumor locations between patients who converted to thoracotomy and the MIE patients (P<0.05). The proportion of multiple and upper thoracic cancer in patients who converted to thoracotomy was higher than that in the MIE patients, while the proportion of lower thoracic cancer was lower than that in the MIE patients. The perioperative mortality of the thoracotomy patients was not significantly different from that of the MIE patients (P=1.000). Conclusion     In MIE, advanced-stage tumor, anesthesia-related factors,extensive thoracic adhesions, and accidental injury of important structures are the main causes of conversion to thoracotomy. The rate varies at different tumor locations. Intraoperative conversion to thoracotomy does not affect the perioperative mortality of MIE.

OBJECTIVE: To investigate the asthma control status of occupational sensitizer-induced asthma(OSIA) and explore the influencing factors. METHODS: A total of 50 OSIA patients were selected as study subjects by judgment sampling method. Asthma Control Test(ACT) and Asthma Quality of Life Questionnaire were used to investigate the asthma control status and the quality of life of patients. The fractional exhaled nitric oxide(FeNO) level, pulmonary function, peripheral blood eosinophil ratio(EOS%)and serum total immunoglobulin E(IgE) level of the patients were measured. RESULTS: Among the 50 cases of OSIA patients, 27(54.0%) cases were well controlled, and 23(46.0%) cases were non-fully controlled. The patients with allergic rhinitis, with no inhaled corticosteroids treatment and with poor compliance were risk factors of the non-fully controlled OSIA(all P<0.05). The scores of ACT and the quality of life, and the percentage of the first second forced expiratory volume(FEV_1%) decreased(all P<0.05), while the level of FeNO increased(P<0.05) in the non-fully controlled group compare with the well-controlled group. There was no statistical significance in EOS% and serum total IgE level between the two groups(both P>0.05).CONCLUSION: Allergic rhinitis, lack of inhaled corticosteroids treatment and poor compliance are the influencing factors that affect the control of OSIA. The combinational scores of ACT and quality of life, FeNO, FEV_1% and other indicators can reflect the status of OSIA and assess the level of asthma control, and help guiding OSIA diagnosis and treatment plans.