Objective:To construct a risk assessment index system for occupational disease hazards in the automotive repair industry using the Delphi method, providing a scientific basis and systematic evaluation framework for occupational hazard management in this sector.Methods:In January 2024, an expert survey method was employed to identify occupational hazard risk indicators through in-depth expert discussions. A multidimensional and hierarchical assessment system was designed based on the two core elements of "comprehensive prevention-on-site hazards."Results:The consultation results from 20 authoritative experts demonstrated that the expert authority coefficient (0.84), coordination coefficient (0.73), and reliability coefficient (0.83) all reached robust levels. The importance scores of the indicators (ranging from 3.47 to 5.59 points) exhibited clear discriminative validity. Ultimately, an assessment system comprising 2 first-level indicators, 5 second-level indicators, and 14 third-level indicators was established.Conclusion:The index system developed in this study demonstrates high scientific rigor and practical applicability. It provides a systematic evaluation tool for the hierarchical management and targeted prevention of occupational disease hazards in the automotive repair industry, offering both theoretical support and practical guidance for occupational hazard risk control in this field.

Objective:To construct a risk assessment index system for occupational disease hazards in the automotive repair industry using the Delphi method, providing a scientific basis and systematic evaluation framework for occupational hazard management in this sector.Methods:In January 2024, an expert survey method was employed to identify occupational hazard risk indicators through in-depth expert discussions. A multidimensional and hierarchical assessment system was designed based on the two core elements of "comprehensive prevention-on-site hazards."Results:The consultation results from 20 authoritative experts demonstrated that the expert authority coefficient (0.84), coordination coefficient (0.73), and reliability coefficient (0.83) all reached robust levels. The importance scores of the indicators (ranging from 3.47 to 5.59 points) exhibited clear discriminative validity. Ultimately, an assessment system comprising 2 first-level indicators, 5 second-level indicators, and 14 third-level indicators was established.Conclusion:The index system developed in this study demonstrates high scientific rigor and practical applicability. It provides a systematic evaluation tool for the hierarchical management and targeted prevention of occupational disease hazards in the automotive repair industry, offering both theoretical support and practical guidance for occupational hazard risk control in this field.

Abstract：Objective To investigate the morphological features of the Pneumocystis jirovecii, in order to facilitate early detection and rapid diagnosis of this rare pathogen from a morphology point of view by laboratory technicians. By analyzing the laboratory features and application value of different pathogen detection methods in the diagnosis of Pneumocystis jirovecii pneumonia, we aim to provide the most reliable diagnostic basis for rapid diagnosis of Pneumocystis jirovecii pneumonia.Methods A retrospective analysis was conducted on the test results of bronchoalveolar lavage fluid samples from a comprehensive hospital in Zhangqiu District, Jinan City, Shandong Province, and a hospital in Changde City from April 2022 to October 2022. Five confirmed cases of Pneumocystis jirovecii pneumonia were detected. Its clinical manifestations, laboratory results, and morphological characteristics of pathogens under different stains were analyzed to discuss the advantages and disadvantages of different detection methods. Results Cytological examination of bronchoalveolar lavage fluid found the trophozoites and cysts of Pneumocystis jirovecii by Wright's-Giemsa staining in 4 cases (80%), and the cysts of Pneumocystis jirovecii by Silver hexamine staining in 4 cases (80%), while the metagenomic next-generation sequencing confirmed all the 5 positive results. All 5 patients had different degrees of reduction in the absolute count of peripheral blood lymphocytes, and the serum lactic dehydrogenase and (1-3)-β-D-Glucan were increased. Among the 5 patients in this study, 4 were treated with sulfamethoxazole combined with caspofungin, and 1 was treated with sulfamethoxazole. Three patients were cured and discharged from hospital after treatment, but two died. Conclusions The method of Wright's-Giemsa staining for the cytological examination of bronchoalveolar lavage fluid to find Pneumocystis jirovecii has the unique and irreplaceable advantages as silver staining. Metagenomic next-generation sequencing can further increase the positive detection rate of Pneumocystis jirovecii. The combination of cytological examination of bronchoalveolar lavage fluid with metagenomic nextgeneration sequencing is a powerful diagnostic method for rapid diagnosis of Pneumocystis jirovecii pneumonia, which can diagnose accurately and reduce missed diagnosis.

Objective To investigate the feasibility of combined laparoscopic and thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity.Methods We retrospectively analyzed the clinical data of 38 patients who underwent esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity from October 2011 to August 2012.To remove the stomach in laparoscopic and the esophagus in thoracoscopy.The main portion of a gastric conduit is created using three to four firings of a linear stapler(Ethicon Endo-surgery,Cincinati,OH) and jejunum stoma.Gastric conduit was pulled into the chest cavity and anastomosed to the esophagus.Results The average operative time was 280 minutes,the mean operative blood loss was 120 ml.No patient required laparotomy.No pulmonary complications or anastomotic leaks occurred.One had gastric retention,another one had chylous hydrothorax.All patients were cured,no one dead in hospital.Conclusion Combined laparoscopic and thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity is technically feasible and safe,minimized trauma,less operative blood loss and quick recovery.

Objective To discuss the clinical values of virtual endoscopy (VE) using multislice computed tomography (MSCT) in diagnosis of the aorta and iliac artery diseases.Methods MSCT angiography in 36 cases suspected of the aorta and iliac artery diseases and 40 cases underwent abdominal examination were performed, then all CT virtual endoscopy (CTVE) were obtained at the vessel with suspected lesions on work-station, and the relations between the quality of images and scanning parameters were observed.Results All internal and dual-cavity were seen in 10 cases of aortic dissection; enlarged cavity of aneurysm were showed in 16 aortic aneurysms. Calcification plaques were displayed in 48 cases. One endograft and one postoperative aorta were seen the morphology and the location of stenosis. One case of iliac artery obstruction was displayed obstructive cavity on the image of CT virtual endoscopy.Conclusion The quality of CT virtual endoscopy is related to the scanning technique,scanning parameters, motion aritiact. CT vitrtual endoscopy is the important complementary to maximum intensity projection, multiplannar reformation, surface shadow display, and axial images, and has high value in the diagnosis, treatment, and follow-up of the aortic diseases

Objective To observe the therapeutic effect on the treatment of avascular necrosis of femoral head by core decompression with autograft of mesenchymal stem cells(MSCs).Methods Nineteen patients with avascular necrosis of femoral head,including 8 cases of phase I,6 cases of phase II and 5 cases of phase III based on ARCO classification,were treated with core decompression with autograft of MSCs.Results The patients were followed up for one year.The average ratio of necrosis zone diminished from 31.88% to 13.18%.The Harris hip score was increased significantly.Conclusion The treatment of core decompression with autograft of MSCs is safe and effective,and it deserves to application in early necrosis of femoral head.

Objective: To study the related factors of artery occlusion induced cardiac infarction. Methods: The coronary angiography data of 56 patients with total artery occlusion were retrospectively studied. The patients were divided into 2 groups: Group A with cardiac infarction, Group B without cardiac infarction, and the clinical features of the 2 groups were compared. Results: It was found that diabetes mellitus, anginal pectoris, hypercholesterolemia, high and low density lipoprotein, smoking, long term medication, collateral circulation, and changes of electrocardiogram presentation were all related factors of infarction( P 6 months), long term medication, well controlled blood glucose and lipoprotein, and non smoking, probably because these factors can improve the collateral circulation and induce ischemia preconditioning.