1.End-to-end anastomosis of esophagus after partial resection for early cervical esophageal carcinoma
Ziang CAO ; Qin YE ; Xiaozhe QIAN ; Erkang LIANG ; Jun TANG ; Jian TANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2012;28(5):257-264
Objective To investigate the feasibility of treatment mode of end-to-end anastomosis of esophagus(EAS) af ter partial resection for early-stage cervical esophageal carcinoma(ECEA).Methods 7 patients were substantially confirmed as squsmous cell carcinoma of cervical esophagus by endoscopy,the nearest distance of the lesion from the incisors was 17cm,and the furthest was 20 cm,the maximum extent was 2.5 cm,and the minimum was 1 cm.None of them with longitudinal muscularis invasion.Confirmed by PET/CT or chest enhancement CT examination preoperatively,intrathoracic and cervical lymphatic metastasis was excluded,cT1 -2 N0 M0.Incisal margin length was not less than 1 cm,the maximum was 5 cm and the minimum was 3 cm.Meanwhile,the cervical lymph node should be dissected,and the average number was 6.43 per case.After surgery,all the patients were fixed by plaster slab to release the tension of anastomosis.Postoperative adjuvant radiotherapy or chemotherapy was received.Results None of the patients had severe postoperative complications,and the average hospital stay was 14.5 days.All the patients are alive,the longest follow-up lasts for 3 years and 4 months,all of them can take normal food,without anastomotic stenosis.Conclusion Treatment mode of EAS after partial resection for ECEA significantly decrease the operative damage,apparently improve the patient's quality of life(QOL),so that the patients can better receive adjuvant treatment subsequently; it is a feasible and effective method for cervical esophageal carcinoma at the early stage.
2. A cost-benefit analysis of occupational disease reporting in China
Xiaozhe TANG ; Qiang ZENG ; Dongshan LIU
Chinese Journal of Industrial Hygiene and Occupational Diseases 2017;35(3):226-229
Objective:
To perform a cost-benefit analysis of the occupational disease reporting system in China, and to provide a basis for effective resource allocation.
Methods:
The data on the cost of occupational diseases were collected from China Health Statistics Yearbook 2013, the estimated benefit data were collected from published articles in China and foreign countries, and the probability data were collected from the occupational diseasereports published by health and family planning administrative departments. Adecision-making tree was used for the cost-benefit analysis.
Results:
The estimated cost of occupational disease reporting was about 102.47 million yuan/year, consisting of a cost of reporting in national medical institutions of 1.25 million yuan/year, a management cost of 30.35 million yuan/year, a management cost in local public health institutions of 69.80 million yuan/year, a management cost in national public health institutions of 370 thousand yuan/year, and a cost of construction and maintenance of reporting system of 700 thousand yuan/year. The results of the decision tree analysis showed that when an occupational disease monitoring system was established, the incremental input for occupational disease monitoring and prevention/control was 2.1 billion yuan/year, the output was 6.5 billion yuan/year, and the benefit of occupational disease reporting system was 4.4 billion yuan/year.
Conclusion
The benefit of occupational disease reporting system depends on the cost-benefit of occupational disease prevention and control measures, and proper prevention and control measures are extremely important for improving the benefit of occupational disease reporting system.
3.Current status about school health department settings and staff building of the centers for disease control and prevention in China
LIU Yao, TANG Xiaozhe, ZHANG Yujing, YANG Han, LIN Lin, ZHANG Qian, XU Juan, LIU Dongshan
Chinese Journal of School Health 2022;43(4):618-621
Objective:
To learn about the construction and staffing of the school health system in Chinese institutions for disease prevention and control, and to provide basic information for the school health system, team capacity building and work development.
Methods:
Electronic questionnaire was used to collect the setting and staffing of school health departments (including school health centers and departments/rooms) at the provincial, prefecture and county (district) levels in the centers for disease control and prevention. Statistical analysis was made on the proportion of school health, the number of staff and the characteristics such as age, education, major and working years in the provincial, prefecture and county (district) levels.
Results:
Among the 3 313 institutions, the proportion of independent school health departments was 10.8%, and those of the provincial, prefecture and county (district) levels were 74.2%, 15.0%, and 9.6%, respectively. Among the institutions with separated department, the average number of staff members was 4.4, while the number of staff was 2.5. The average age of school health workers was 40.4 years old, and the proportion of male and female employees was 45.2% and 54.8%. The proportion of personnel who have been engaged in school health work for less than 5 years on average was as high as 65.1%. The majors of the staff were mainly public health ( 40.4 %), 54.0% of the provincial staff had a master s degree or above, and 47.8% and 58.7% of the staff at the prefecture and county (district) levels were junior college or below respectively.The proportion of provincial level personnel with intermediate and senior titles was 69.6%, and the proportion of municipal and countylevel personnel at the junior level and below was 52.2% and 56.2% respectively.
Conclusion
The proportion of independent school health departments within centers of disease control and prevention across China was low. There is a serious shortage of school health personnel, and there are problems such as low levels of education and professional titles, especially in county (district) level institutions. It is urgent to strengthen the construction of the school health system of the centers for disease control and prevention in China.
4.Current status on independent school health department in the centers for disease control and prevention across China
LIU Yao, ZHANG Yujing, YANG Han, TANG Xiaozhe, LIN Lin, ZHANG Li, ZHAO Chenshan, LIU Dongshan
Chinese Journal of School Health 2023;44(4):612-616
Objective:
To understand the current status of main professional work in independent school health departments of Chinese centers for disease control and prevention, so as to provide reference and suggestions for the further development of school health work in China.
Methods:
Electronic questionnaire was used to collect the basic work of school health, the monitoring work, the intervention action of common diseases and the development of health intervention among students in independent school health departments of centers for disease control and prevention in China.
Results:
Among the 357 institutions that have set up independent school health departments, the implementation rates of school mental health work, safety emergency and risk avoidance health intervention were low, which were 11.8% and 11.5%, respectively. Relying on the project "national monitoring and intervention of common diseases and health influencing factors of students", the overall implementation of health monitoring in schools nationwide was successful, but the overall implementation rate of students nutritional status monitoring and "healthy parents action" were low, accounting for 44.5% and 24.4%, respectively. At the same time, there were still as many as 27.2% institutions that had not carried out the intervention action for common diseases of students which advocated in the monitoring program. The failure rate of county level institutions was higher than that of provincial level and prefecture level institutions, and the failure rate of the central and western institutions was much higher than that of the eastern institutions; the difference was statistically significant( χ 2=30.1, 41.6, P <0.05).
Conclusion
We should increase support including policy preference, fund guarantee, technical guidance and so on for the school health work of disease control institutions at the grass roots level and in economically underdeveloped areas, so as to ensure the healthy growth of children and adolescents in all respects.
5.Results of class A qualification assessment of occupational health technical service institutions
Xiaozhe TANG ; Li ZHANG ; Kuke DING ; Lin LIN ; Yao LIU
Chinese Journal of Radiological Health 2022;31(3):328-335
Objective To analyze the current situation and problems of personnel, workplaces, instruments and equipment, reference materials, technical service capabilities, and quality management systems of occupational health technical service institutions with class A qualification in China, and to provide countermeasures and suggestions for improving the capacity of occupational health technical service in China. Methods We analyzed the technical assessment results of 84 class A institutions that applied for renewal or changing of class A qualification or expanding the scope of business from March to April 2021. Results The eastern region of China had a relatively large number of class A institutions. The institutions applying for category I business, category II business, and both accounted for 68%, 4%, and 27.85%, respectively. The approval rates of physical factors and ventilation projects were relatively low. The pass rates were below 90% in the on-site technical assessment of instruments and equipment, reference materials, technical service capabilities, and quality management systems, showing no significant differences between the eastern, central, and western regions. There were a total of 617 passes in professional technical ability assessment. Conclusion We recommend strengthening supervision during and after the processin occupational health technical service institutions, improving the ability to detect and evaluate occupational hazards, and strengthening the construction of professional technical personnel.