1.Worksite survey of occupational disease diagnosis
China Occupational Medicine 2025;52(1):1-9
The worksite survey of occupational disease diagnosis is a series of occupational health investigations in the workplace initiated by the occupational disease diagnosis institution or the public health administrative department in order to understand whether there is a causal relationship between the workers' diseases and the workplace in the process of occupational disease diagnosis and verification. The main purpose of the worksite survey is to find out whether there are occupational hazards that cause health damage to workers in the workplace, and to analyze whether there is a causal relationship between the exposure to occupational hazards at the corresponding concentration (intensity) and the diseases suffered by workers. In actual work, it is necessary to determine whether it is necessary to organize worksite survey according to the legal situation and actual work of occupational disease diagnosis. The mainly works of worksite survey includes three aspects: preliminary preparation, survey implementation and survey report writing. It is necessary to pay attention to the key and difficult tasks such as preparation before survey, survey plan and questionnaire, complexity and uncertainty of worksite survey and sampling and detection of occupational hazard factors in workplace. After the worksite survey,it is necessary to write a written occupational disease on-site investigation report to provide objective, reliable and scientific evidence for occupational disease diagnosis.
2.The core issue of the management of occupational health technical service institutions in China under new circumstances
Xiaodong SHI ; Shijie HU ; Han ZHAO ; Dongshan LIU
China Occupational Medicine 2025;52(1):82-88
Occupational health technical service (OHTS) is one of the core contents in the technical support system of occupational disease prevention and control, and efficient management of OHTS institutions is necessary for improving the service ability. At present, OHTS institutions in China face several issues, such as uneven distribution in terms of quantity, function, unclear area coverage and roles and overlapping responsibilities among different types of institutions, and insufficient service capabilities with inconsistent service levels in some institutions. With the implementation of the national reform like the “separating permits from business license” and “delegate power, streamline administration and optimize government services"”policies, the management mode and operational approach of OHTS institutions have been profoundly changed. In light of this, five key recommendations are proposed to improve the management of OHTS institutions and enhance their management effectiveness, ensuring the sustainable development of national OHTS services. Firstly, it is necessary to clarify the relationship between national and provincial administrative levels in managing OHTS institutions to ensure their healthy and orderly development. Secondly, multiple measurements are taken to strengthen OHTS institutional capacity building to address regional disparities in technical capabilities and service quality. Thirdly, both technical capabilities and service quality should be focused on strengthening the supervision and management of OHTS institutions, preventing the decline of key conditions such as staffing, laboratories, equipment, and quality management after obtaining qualifications. Fourthly, “dual randomized- inspections and one open” and “internet+supervision” methods are used as basic tools for managing OHTS institutions operating across multiple provincial regions and enforcing cross-regional law. Fifthly, professional integrity of radiological health service institutions should be restored to effectively apply their technical advantages in their specialized fields.
3.Analyzing the influencing factors of work-related musculoskeletal disorders in passenger drivers
Xinyang YU ; Yingfei XIANG ; Yonglin LUO ; Meifang XU ; Xiao YIN ; Min YANG ; Huiqing CHEN ; Shijie HU
China Occupational Medicine 2025;52(2):155-159
Objective To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) in passenger drivers and its influencing factors. Methods A total of 951 passenger drivers in Guangdong Province were selected as the research subjects using the judgmental sampling method. A Musculoskeletal Injury Questionnaire was employed to assess the prevalence of WMSDs in the past year. Results The prevalence of WMSDs in passenger drivers was 41.11%. The result of multivariable logistic regression analysis showed that married drivers had a higher risk of WMSDs than single drivers (P<0.05). The lower the frequency of physical exercise, the longer the driving time per week, the longer the continuous driving time, the more restricted the driving working space, the poorer the foot comfort during driving, and the more affected the normal meal, the higher the risk of WMSDs (all P<0.05). The risk of WMSDs in drivers with sleep time ≤ 8.0 h/d was higher than that in drivers with sleep time > 8.0 h/d (P<0.01), and the risk of WMSDs in drivers with the same posture for a long time on the shoulder was higher than that in drivers without this poor working posture (P<0.01). Conclusion WMSDs were prevalent among passenger drivers, which was associated with demographic and adverse ergonomic factors. Intervention on lifestyle and adverse ergonomic factors could further reduce the risk of WMSDs of passenger drivers.
4.Diagnostic analysis of an occupational heat illness case caused by part-time work
Ruiyan HUANG ; Bin LI ; Xijin SHE ; Xiaoyi LI ; Shijie HU
China Occupational Medicine 2025;52(2):212-215
This study analyzes the legal application of a dispute over employer identification in a case of occupational heat illness caused by part-time work to clarifying matters related to employer determination in occupational disease diagnosis using a case analysis method and factual reconstruction. The analysis is based on relevant civil laws and regulations, occupational disease diagnosis laws and regulations, and jurisprudential theories. The occupational disease diagnostic institution identified the part-time employer as responsible for the patient′s heat illness, which was both reasonable and lawful. This attribution safeguarded the rights of the worker, the primary employer, and the part-time entity. In occupational disease diagnosis, attention should be paid to de facto employment relationship, and the principle of "accountability lies with the actual employer at the time of the incident" should be followed to standardize employer identification. The health administrative department has supervisory responsibilities over occupational disease diagnoses. Workers′ compensation rights can be protected through the advance payment mechanism for work-related injury insurance. It is recommended to further improve internal procedures for occupational disease diagnosis, strengthen the dissemination of relevant laws and regulations and enhance the capabilities of occupational disease diagnosis physicians, to further protect workers' occupational health and their associated legal rights.
5.Peptide-based immuno-PET/CT monitoring of dynamic PD-L1 expression during glioblastoma radiotherapy.
Yong WANG ; Kewen HE ; Yang ZHANG ; Yunhao CHEN ; Shijie WANG ; Kunlong ZHAO ; Zhiguo LIU ; Man HU
Journal of Pharmaceutical Analysis 2025;15(3):101082-101082
Real-time, noninvasive programmed death-ligand 1 (PD-L1) testing using molecular imaging has enhanced our understanding of the immune environments of neoplasms and has served as a guide for immunotherapy. However, the utilization of radiotracers in the imaging of human brain tumors using positron emission tomography/computed tomography (PET/CT) remains limited. This investigation involved the synthesis of [18F]AlF-NOTA-PCP2, which is a novel peptide-based radiolabeled tracer that targets PD-L1, and evaluated its imaging capabilities in orthotopic glioblastoma (GBM) models. Using this tracer, we could noninvasively monitor radiation-induced PD-L1 changes in GBM. [18F]AlF-NOTA-PCP2 exhibited high radiochemical purity (>95%) and stability up to 4 h after synthesis. It demonstrated specific, high-affinity binding to PD-L1 in vitro and in vivo, with a dissociation constant of 0.24 nM. PET/CT imaging, integrated with contrast-enhanced magnetic resonance imaging, revealed significant accumulation of [18F]AlF-NOTA-PCP2 in orthotopic tumors, correlating with blood-brain barrier disruption. After radiotherapy (15 Gy), [18F]AlF-NOTA-PCP2 uptake in tumors increased from 9.51% ± 0.73% to 12.04% ± 1.43%, indicating enhanced PD-L1 expression consistent with immunohistochemistry findings. Fractionated radiation (5 Gy × 3) further amplified PD-L1 upregulation (13.9% ± 1.54% ID/cc) compared with a single dose (11.48% ± 1.05% ID/cc). Taken together, [18F]AlF-NOTA-PCP2 may be a valuable tool for noninvasively monitoring PD-L1 expression in brain tumors after radiotherapy.
6.Thoughts on studying the relationship between the implementation effect and influencing factors of the occupational disease prevention legislation
China Occupational Medicine 2025;52(4):361-367
The legislative purpose of the Law of the People′s Republic of China on the Prevention and Control of Occupational Diseases is to safeguard the health, related rights and interests of workers, and to promote economic and social development. The remarkable achievements in occupational disease prevention and control indicate the implementation effect of the legal system for prevention and control of occupational diseases. The implementation effect of laws is influenced by various factors, including legislation, law enforcement, and law compliance. This study proposes a methodology to study the relationship between the implementation effect and influencing factors of the legal system for prevention and control of occupational diseases, based on the implementation theory of the law and the actual implementation of the legal system for prevention and control of occupational diseases, so as to further improve the level of legislation, law enforcement, and law compliance, and to promote the realization of the legislative purpose. The results of this study show that the law enforcement dimension of prevention and control of occupational diseases can be examined by retrospective analysis of the incidence of occupational diseases, or the relationship between other illegal situations and the intensity of supervision and punishment. The compliance dimension can focus on the application of enforcement principles (legality principle, rationality principle, and efficiency principle) and attribution diagnosis principles for occupational diseases. The legislative dimension should prioritize the appropriateness of the legal system′s content, implementation status, and clarity and acceptability of legal expressions. In addition, research should be conducted on issues such as opportunities for violations, motivations for compliance, social atmosphere, and legal awareness campaigns. Relevant research data can be obtained by collecting management statistics, media reports and special subject design observations. Only when laws are well-established, well-enforced, well-applied, and when law-abiding becomes the conscious choice of employers and law enforcement agencies, can workers′ occupational health rights be effectively protected and the authority of the law fully realized.
7.On the re-diagnosis of occupational diseases
China Occupational Medicine 2024;51(6):601-605
China's occupational disease diagnosis and identification system has the working mode of "one-time diagnosis, two-level identification", with the provincial-level identification serving as the final judgment. The re-diagnosis of occupational disease refers to the re-application for an occupational disease diagnosis, which is submitted to the occupational disease diagnosis institution by the party, after the initial occupational disease diagnosis or identification has become effective. It is a special procedure for legal remedy that allows the party involved to better ensure the fairness of the occupational disease diagnosis and protect their rights. China's occupational disease diagnosis system has not specifically outlined the initiation conditions for initiating an occupational disease re-diagnosis. The conditions for initiating occupational disease re-diagnosis can be determined by referring to the initiation conditions of retrial in judicial litigation procedures. The "new evidence" for the re-diagnosis of occupational disease includes: i) "formal" new evidence, meaning evidence discovered after the completion of the occupational disease diagnosis or identification, or evidence that was not submitted during the diagnosis or identification process but is not the responsibility of the party to submit it; ii) "substantial" new evidence, meaning evidence that, upon preliminary judgment, could change the original occupational disease diagnosis or identification conclusion. The initiating entities for occupational disease re-diagnosis should be considered firstly to stakeholders such as employees and employers. Occupational disease re-diagnosis of current occupational disease diagnosis system content is only listed in departmental document. Because of its low legal status and lack of specific implementation regulations, it is difficult to execute in practice. It is necessary for the country to legislate the entity and procedural legalization of occupational disease re-diagnosis within the occupational disease diagnosis system to effectively protect the legitimate rights and interests of employees and employers.
8.Application of excellence-performance management model in macro-quality management for occupational medical examination institutions
Ruiyan HUANG ; Xiaoyi LI ; Minghui XIAO ; Aichu YANG ; Jiabin CHEN ; Shijie HU
China Occupational Medicine 2024;51(6):688-693
As the management system of Occupational Medical Examination (OME) institutions is moving to a record-filing model, the traditional management approach might not fulfill the current policy requirements. There is a pressing need for development of high-quality occupational health management system. In this context, the Guangdong Provincial Occupational Health Examination Quality Control Center (hereinafter referred to as the "Provincial Quality Control Center") pioneered the integration of the Performance Excellence Model (PEM) framework into the macro-quality management of OME institutions in Guangdong Province. In light of the current research gaps in the field of macro-quality management for OME institutions, the Provincial Quality Control Center, based on the core principles and standards of PEM, has closely aligned with the professional characteristics of occupational health examinations. The established macro-quality management innovation in OME institutions in Guangdong Province consists of seven dimensions: strategic direction, leadership development, identification of key management subjects, data analysis and management, human resources allocation, process optimization, and the application of quality control outcomes. This system has provided a robust impetus for the ongoing improvement of quality control efforts. The initial implementation of PEM demonstrated notable improvements in macro-quality management for OME institutions. Moving forward, the Provincial Quality Control Center will continue to strengthen the development of key technical personnel, innovate training models, harness the advantages of big data technology, restate and upgrade the system continuously, and refine the macro-quality management mechanisms of OME institutions to ensure that the health rights and interests of workers and employers are effectively safeguarded and enhanced.
9.Instructions for the Guangdong Province Occupational Health Engineering Ventilation Inspection Work Specification (Trial)
Xia WU ; Shibiao SU ; Danying ZHANG ; Xiaoliang LI ; Shijie HU
China Occupational Medicine 2024;51(6):694-699
At present, China has not yet established a comprehensive standard and evaluation system specifically for occupational health engineering ventilation inspection. In order to meet the requirements for the design of occupational-disease-prevention facilities, the evaluation of occupational disease hazard control effectiveness, and the protective facilities, the Guangdong Provincial Occupational Health Technical Quality Control Center developed the Guangdong Province Occupational Health Engineering Ventilation Inspection Work Specification (Trial) by referring domestic and international standards and norms related to occupational health engineering, industrial ventilation design manuals and professional literature, using brainstorming and experience-based methods. The work specification covers the key detection indicators of ventilation systems, and comprehensively covers the core links of occupational health engineering ventilation testing. The relevant indicators mainly include: detection of air velocity control; wind speed and air volume of exhaust hoods and exhaust vents of ventilation facilities; detection of wind pressure, wind speed and air volume inside the ventilation duct; fresh air volume detection; and calculation and evaluation of ventilation frequency. The specification is highly practical, indicting scientific and advanced principles, and ensures the fairness and reliability of the testing process and results. Its implementation will effectively promote the standardization and professionalism of occupational health engineering ventilation testing, providing robust technical support for safeguarding workers' health.
10.Value of multi-slice spiral CT enhanced scanning combined with CT texture analysis in preoperative International Federation of Gynecology and Obstetrics staging of ovarian cancer
Qiang YUE ; Jian'an WEI ; Shijie LIU ; Xiaochun HU
Journal of Xinxiang Medical College 2024;41(8):776-782
Objective To investigate the value of multi-slice spiral CT enhanced scanning combined with CT texture analysis in preoperative International Federation of Gynecology and Obstetrics(FIGO)staging of ovarian cancer.Methods A total of 126 ovarian cancer patients admitted to the Tongzhou District Maternal and Child Health Hospital and Beijing Friendship Hospital,Capital Medical University from March 2021 to September 2023 were selected as the research subjects.All patients underwent multi-slice spiral CT enhanced scanning,and their CT values were measured.Kinetics software was employed for CT texture analysis,and the texture feature-related parameters,including skewness,kurtosis,variance,entropy,and inverse difference,were calculated.The CT values and CT texture feature-related parameters among patients with different FIGO stages were compared.The diagnostic efficacy of CT enhanced scanning,CT texture analysis,and their combination in preoperative FIGO staging of ovarian cancer was evaluated by receiver operating characteristic(ROC)curve,and the consistency between the diagnosis of FIGO stage of ovarian cancer based on CT enhanced scanning,CT texture analysis,and their combination and the pathological diagnosis of FIGO stage of ovarian cancer was evaluated by Cohen's Kappa coefficient analysis.Results The CT value and entropy value of FIGO stage Ⅳ patients were significantly higher than those of FIGO stage Ⅰ,Ⅱ,and Ⅲpatients,and the CT value and entropy value of FIGO stage Ⅲ patients were significantly higher than those of FIGO stage Ⅰand Ⅱ patients(P<0.05);there was no statistically significant difference in the CT value and entropy value between FIGO stage Ⅰ and stage Ⅱ patients(P>0.05).There was no statistically significant difference in skewness,kurtosis,variance,and inverse difference among patients with different FIGO stages(P>0.05).The ROC curve analysis showed that with reference to FIGO stages Ⅰ and Ⅱ,when the cut-off values of CT value and entropy value were 74.645 and 9.540,respectively,the area under the curve(AUC)of CT value and entropy value in diagnosing FIGO stage Ⅲ was 0.733 and 0.743,respectively,the specificity was 0.760 and 0.800,respectively,and the sensitivity was 0.605 and 0.674,respectively;the area under the curve(AUC)of CT value combined with entropy value in diagnosing FIGO stage Ⅲ was 0.818,the specificity was 0.820,and the sensitivity was 0.721.When the cut-off values of CT value and entropy value were 77.095 and 10.020,respectively,the AUC of CT value and entropy value in diagnosing FIGO stage Ⅳ was 0.817 and 0.797,respectively,the specificity was 0.820 and 0.820,respectively,and the sensitivity was 0.545 and 0.667,respectively;the AUC of CT value combined with entropy value in diagnosing FIGO stage Ⅳ was 0.926,the specificity was 0.900,and the sensitivity was 0.758.The consistency between CT enhanced scanning and pathology in diagnosing FIGO stage of ovarian cancer was moderate(Kappa=0.580,P<0.05),with an accuracy rate of 72.22%(91/126);the consistency between CT texture analysis and pathology in diagnosing FIGO stage of ovarian cancer was moderate(Kappa=0.598,P<0.05),with an accuracy rate of 73.81%(93/126);the combination of CT enhanced scanning and CT texture analysis in the diagnosis of FIGO stage of ovarian cancer had a high consistency with pathological diagnosis(Kappa=0.868,P<0.05),with an accuracy rate of 91.27%.Conclusion Multi-slice spiral CT enhanced scanning and CT texture analysis are both reliable methods for the diagnosis of FIGO stage of ovarian cancer.The combination of CT enhanced scanning and CT texture analysis in the diagnosis of FIGO stage of ovarian cancer has a high consistency with pathological diagnosis.The combination of the two can improve the diagnostic efficiency for FIGO stage of ovarian cancer.

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