Objective:To investigate the differences and applicability of free silica detection methods of different crystal forms in dust, and to provide a basis for the selection of various methods.Methods:From December 2021 to June 2022, dust samples from 20 enterprises in different industries in 18 cities in Henan Province were randomly selected as the investigation objects. X-ray diffraction (XRD) method was used to analyze the samples and classify the samples. Based on GBZ/T 192.4-2007 "Determination of Dust in the Air of Workplace-Part 4: Content of Free Silica in Dust", pyrophosphate method and infrared spectrophotometry were used for quantitative determination. The measured results were analyzed by paired sample t test to evaluate the advantages and disadvantages of the two methods and their applicable scope. Results:The XRD results of 20 dust samples could be divided into α, β, γ crystal types and the mixed type of α and γ. There was no significant difference between pyrophosphate method and infrared spectrophotometry ( P=0.180). The pyrophosphate method results of β, γ and α, γ mixed crystalline free silica were significantly higher than those of infrared spectrophotometry, and the difference was statistically significant ( P<0.001) . Conclusion:Pyrophosphate method and infrared spectrophotometry are suitable for α-type free silica, while pyrophosphate method is suitable for β, γ and α, γ mixed crystalline free silica.

Objective:To investigate the differences and applicability of free silica detection methods of different crystal forms in dust, and to provide a basis for the selection of various methods.Methods:From December 2021 to June 2022, dust samples from 20 enterprises in different industries in 18 cities in Henan Province were randomly selected as the investigation objects. X-ray diffraction (XRD) method was used to analyze the samples and classify the samples. Based on GBZ/T 192.4-2007 "Determination of Dust in the Air of Workplace-Part 4: Content of Free Silica in Dust", pyrophosphate method and infrared spectrophotometry were used for quantitative determination. The measured results were analyzed by paired sample t test to evaluate the advantages and disadvantages of the two methods and their applicable scope. Results:The XRD results of 20 dust samples could be divided into α, β, γ crystal types and the mixed type of α and γ. There was no significant difference between pyrophosphate method and infrared spectrophotometry ( P=0.180). The pyrophosphate method results of β, γ and α, γ mixed crystalline free silica were significantly higher than those of infrared spectrophotometry, and the difference was statistically significant ( P<0.001) . Conclusion:Pyrophosphate method and infrared spectrophotometry are suitable for α-type free silica, while pyrophosphate method is suitable for β, γ and α, γ mixed crystalline free silica.

【Objective】 To analyze the causes of the failure of previous operations in female patients with stress urinary incontinence (SUI), and to evaluate the efficacy and safety of modified transobturator outside-in tape (TOT). 【Methods】 A total of 42 female SUI patients who had failed in previous anti-incontinence surgery during Aug.2016 and Jul.2022 were enrolled. The causes of failure were analyzed. All patients were treated with modified TOT, and the operation time, estimated blood loss, duration of catheterization, symptom improvement and complications were observed. The outcomes were evaluated with the International Consultation on Incontinence Questionnaire Short Form (ICI-Q-SF), pad test and urodynamic study. 【Results】 All operations were technically successful. The average operation time was (32.4±18.6) min, and estimated blood loss was (54.2±34.5) mL. There were no obvious complications. After operation, the ICI-Q-SF score significantly decreased (P<0.05), and the abdominal leak point pressure (ALPP) significantly increased (P<0.05), while the post-voided residual (PVR) and maximum urine flow rate (Qmax) remained unchanged (P>0.05). The overall effective rate was 88.1%. 【Conclusion】 Modified TOT can be used for the treatment of patients with failed anti-SUI surgery, which is simple and easy to perform, with a low complication rate and satisfactory postoperative results.

Objective:To investigate the efficacy and safety of transurethral Moses holmium laser enucleation of the prostate (MoLEP) in the treatment of small-volume benign prostatic hyperplasia (BPH).Methods:The clinical data of 132 patients with small BPH (prostate volume <40 ml) who underwent MoLEP from October 2017 to April 2020 in the First Affiliated Hospital of Nanjing Medical University were analyzed retrospectively.The age of the patients was (63.93±5.21) years old, including 12 patients with cystolithiasis. The prostate volume of 132 patients was (32.16±7.81) ml, the preoperative international prostate symptom score (IPSS) was 23.00(15.00-34.00), the quality of life score (QOL) was 5(2-6), the maximum urinary flow rate (Q max) was 7.80(0.80-9.80)ml/s and residual urine volume (PVR) was 158(51-409) ml. 89 patients had the preoperative maximum detrusor contractility (64.23±8.11) cmH 2O. Surgical methods: the 120 W Moses laser platform(Lumenis Inc)was used, the cutting power was adjusted to 80 W (2.0J×40Hz) (narrow pulse width mode), and the hemostatic power 24W (0.8J×30Hz) (wide pulse width mode). Patients with bladder calcifications underwent Moses laser bladder stone lithotripsy.After the initial resection by the level of verumontanum was performed, an anatomic plane was exposed and carried forward until the bladder neck. If prostate stones were found, Moses holmium laser lithotripsy can be performed directly. After operation, the bladder was continuously flushed with normal saline. The catheter was removed 24 hours after the operation. The operation status, intraoperative and postoperative complications were recorded. IPSS, QOL, Q max and PVR were followed up 3 months after surgery. Postoperative urinary incontinence is defined as the need for 2 pads or more within 24 hours. Results:The operations of 132 cases (including 12 cases with bladder stones) were successfully completed. 30 cases with prostate calcifications were found during the operation. The operation time (enucleation time) was (16.83±4.03) min. There were no perioperative complications such as blood transfusion, transurethral resection syndrome, urinary retention and venous thromboembolism. No bladder neck contracture or recurrence of bladder stones was found after surgery. Postoperative urethral stricture occured in 2 cases (1.5%), and postoperative urinary incontinence in 27 cases (20.5%). There were 102 cases (77.3%) with chronic interstitial inflammatory cell infiltration. Three months after operation, IPSS was 7(0-14), QOL was 2(0-5), Q max was 17.55(9.40-26.50)ml/s and PVR was 27(0-46) ml, which were significantly improved compared with preoperatively( P<0.05). Conclusions:MoLEP can significantly improve lower urinary tract symptoms (LUTS) and life quality of patients with small-volume BPH.At the same time, the incidence of complications such as urethral stricture and urinary incontinence is lower. The operation is safe and reliable, and bladder stone lithotripsy can be performed at the same time.

Objective:To explore the clinical efficiency evaluation and prognostic factors of aspiration guided by neuronavigation in the treatment of pediatric brain abscess (PBA).Methods:A total of 47 patients with PBA were treated with aspiration guided by neuronavigation between January 2013 and January 2019 at the First Affiliated Hospital of Zhengzhou University.All clinical data were retrospectively analyzed.According to Glasgow Outcome Scale on discharge, all children were divided into 2 groups, namely good prognosis group and poor prognosis group.Prognostic factors were analyzed by using univariate analysis and binary Logistic regression multivariate analysis. Results:Among the 47 children, 38 children (80.9%) were assigned to the good prognosis group, and 9 children (19.1%) were assigned to the poor prognosis group.Univariate analysis proved that abscess volume>4 cm( χ2=5.650, P=0.017), multiple or multilocular abscess ( χ2=3.258, P=0.027), and abscess located in functional areas ( χ2=6.187, P=0.013) were correlated with poor prognosis.Multivariate analysis revealed that abscess volume>4 cm( OR=5.913, 95% CI: 2.241-25.917, P=0.023) and abscess located in functional areas ( OR=10.519, 95% CI: 3.918-62.513, P<0.001) were independent risk factors for poor prognosis. Conclusion:The treatment of PBA with aspiration guided by neuronavigation is safe, effective and minimal invasive, and the clinical efficiency is satisfactory.Abscess volume>4 cm and abscess located in deepbrain/functional areas are independent risk factors for poor prognosis.

Objective:To explore the diagnosis, treatment and prognostic of pediatric intracranial atypical teratoid/rhabdoid tumor(AT/RT).Methods:A total of 15 pediatric patients with intracranial AT/RT were treated between January 2012 and June 2019 at the First Affiliated Hospital of Zhengzhou University.The clinical data were retrospectively analyzed.Overall survival (OS) rate and progression free survival (PFS) rate were calculated by adopting Kaplan- Meier method.The differences between the 2 groups were tested by performing Log- rank method, and the prognostic factors were analyzed by COX regression. Results:There were 12 males and 3 females, with the median age of 5.5 years (ranging from 8 months to 17.1 years). All patients underwent surgical resection.Gross-total resection (GTR) was achieved in 10 cases and subtotal resection (STR) was carried out in 5 patients.The conducted treatments were as follows: surgery+ radiotherapy+ chemotherapy+ intrathecal injection in 6 cases, surgery+ chemotherapy+ intrathecal injection in 4 cases, surgery+ radiotherapy in 2 cases, and surgery alone in 3 cases.Until January 2020, the median survival time of all the 15 patients was 18 months (ranged 1-27 months), and the survival rate was 33.3%.The 1-year OS rate and PFS rate for all 15 cases were 71.5% and 49.7%, respectively.The 2-year OS rate and PFS rate were 17.9% and 0, respectively. Log- rank analyses revealed that the 1-year OS rates of children less than 3 years old and those older than 3 years were 87.5% and 57.1%, respectively ( χ2=6.057, P=0.014). The 1-year OS rates of children with GTR and those with STR were 90.0% and 40.0%, respectively ( χ2=6.057, P=0.014). The 1-year OS rates of children with tumor dissemination and those without tumor dissemination were 100.0% and 33.3%, respectively( χ2=9.865, P=0.002). The 1-year OS rates of children in the standard-risk group and those in the high-risk group were 88.9% and 41.7%, respectively ( χ2=5.111, P=0.024). COX regression analyses proved that age, the extent of tumor resection, tumor dissemination and risk stratification are independent risk factors for prognosis [hazard radio( HR)=3.411, 3.795, 5.245, 3.397; P=0.025, 0.011, 0.001, 0.017]. Conclusions:Pediatric intracranial AT/RT is rare.The preliminary diagnosis and prognosis are difficult and poor, respectively.The complete resection of tumors with maximal safety remains the primary treatment.Age, the extent of tumor resection, tumor dissemination and risk stratification are independent prognostic factors for AT/RT children.

【Objective】 To develop an assay to determine β-lactam antibiotics using microcolumn gels and to study the β-lactam antibiotics present in the blood of patients and their clinical significances. 【Methods】 446 patients with a history of taking β-lactam antibiotics from January 2019 to June 2019 were randomly selected from Trauma Emergency Center, Department of Arthrosis, Department of Spine and Department of Bone Oncology of our hospital, and 4 mL(per capita) venous blood was collected. Irregular antibody screening, anti-globulin detection and drug antibody determination were performed by microcolumn gel method. The data of gender, age, disease, blood transfusion history and medication were collected. The test results and clinical data were retrospective analyzed. 【Results】 The yielding rate of antibody was 0.45%(2/446) in patients with a history of taking β -lactam antibiotics. 16.38%(73/446) of the samples were positive in direct antiglobulin test, and 64.38%(47/73) of them did not agglutinate with RBCs treated with drugs. The yielding rate of specific antibodies against drug was 4.93%(22/446), and the titer ranged from 2 to 128(8). 1 case of auto-IgM antibody, 1 case of blood group related antibody and 2 cases of non-specific protein adsorption were detected. The yielding rate of drug antibody in patients with blood transfusion history reached to 12.10 %(22/124), so it was also high in patients with bone tumor. 【Conclusion】 Direct antiglobulin assay is helpful for the detection of β-lactam antibodies. The negative results of antibody screening cannot completely exclude the presence of drug antibodies. The yielding rate of drug antibody can be greatly improved by specific drug antibody detection, and it was higher in transfused patients relative to non-transfused one.

Objective:To find the risk assessment model of [di (2-ethylhexyl) phthalate, DEHP] fitting well for producing companies.Methods:The Cluster Sampling method was used in selecting a DEHP producing company in the occupational health and workplace environment monitoring study conducted between July and August in 2017. Data was collected by site evaluating and workplace environment monitoring. According to GBZ/T 298-2017《Technical Guidelines for Occupational Health Risk Assessment of Chemical Hazards in the Workplace》, a qualitative assessment method and a semi-quantitative comprehensive index method were chosen as the models and were compared.Results:The occupational health risk of the two methods rated 4 (high risk) and 2 (negligible risk) .Conclusion:The semi-quantitative comprehensive index method is more comprehensive and accurate when used to assess the occupational health risk caused by DEHP.

Objective:To find the risk assessment model of [di (2-ethylhexyl) phthalate, DEHP] fitting well for producing companies.Methods:The Cluster Sampling method was used in selecting a DEHP producing company in the occupational health and workplace environment monitoring study conducted between July and August in 2017. Data was collected by site evaluating and workplace environment monitoring. According to GBZ/T 298-2017《Technical Guidelines for Occupational Health Risk Assessment of Chemical Hazards in the Workplace》, a qualitative assessment method and a semi-quantitative comprehensive index method were chosen as the models and were compared.Results:The occupational health risk of the two methods rated 4 (high risk) and 2 (negligible risk) .Conclusion:The semi-quantitative comprehensive index method is more comprehensive and accurate when used to assess the occupational health risk caused by DEHP.

Objective: Improvement the method of nitrogen oxide sampling, analysis and detection in workplace air. Methods: Absorption and collection with sodium carbonate-sodium bicarbonate buffer solution, analysised by ion chromatography, anion column AS23, column temperature 30 ℃. Results: The linearity of the nitrite ion in the corresponding mass concentration range 0~90.0 μg/ml was good (Nitrogen dioxide in 0~120.0 mg/m³) , correlation coefficient>0.999 5. The detection limit was 0.16 μg/ml, The minimum detection concentration was 0.11 mg/m³ with the sampling volume 7.5 L. Conclusion The method has good accuracy, high sensitivity, with directing injection and no pre-treatment, and can popularize in general laboratories, and can satisfy the determination of nitrogen oxides in the air of workplace.