Objective To investigate the current distribution of radiotherapy resources in Gansu Province, evaluate the equity of resource allocation, and provide a scientific basis for optimizing regional resource allocation. Methods A questionnaire survey was carried out to assess radiotherapy resources in medical institutions across Gansu Province, China. The equity of radiotherapy resource distribution and associated disparities were assessed using the Gini coefficient, Lorenz curve, and Theil index. Results A total of 23 medical institutions in Gansu Province provided radiotherapy services, comprising 39 radiotherapy devices and 438 professionals, of whom medical physicists accounted for 16.9%. The radiotherapy frequency was 0.47 cases per thousand population. The Gini coefficients for radiotherapy resource distribution ranged from 0.38 to 0.56 by population and from 0.52 to 0.70 by geography. The Theil index for radiotherapy resources ranged from 1.36 to 3.67. Conclusion Radiotherapy resources in Gansu Province were insufficient, and the capacity of radiotherapy service was suboptimal. The equity of radiotherapy resource allocation by geography was worse than that by population. Therefore, it is imperative to address the shortage of radiotherapy resources, strengthen the professional workforce, enhance the capacity radiotherapy service and resource utilization, optimize resource allocation, and promote regional equity in radiotherapy provision in Gansu Province.

Background Health literacy is closely related to mental health, and improving health literacy has been shown to promote mental well-being. However, whether occupational stress among workers in mining and manufacturing is associated with their occupational health literacy remains inconclusive. Objective To study the levels of occupational health literacy and occupational stress among workers in three industrial sectors (metal ores mining, metal smelting, and manufacture of non-metallic mineral products) in Gansu Province, and to analyze the correlation between them. Methods Between May and December 2024, a stratified cluster random sampling method was employed to survey workers from 73 large, medium, and small and micro sized enterprises across the aforementioned industries in Gansu Province. Participants’ occupational health literacy and occupational stress levels were assessed. The LASSO regression model was applied to identifykey factors influencing occupational stress, and subsequently a multilevel random intercept mixed-effects logistic model was used to study factors influencing occupational stress and to explore the relationship between occupational health literacy and occupational stress. Results A total of 3611 workers across the three industries were surveyed, among whom 1031 (28.55%) experienced occupational stress. Workers with adequate occupational health literacy—whether assessed in terms of overall literacy or specific dimensions—demonstrated a significantly lower prevalence of occupational stress compared to those without adequate literacy (P<0.05). Through the LASSO regression analysis, it was found that the factors closely related to occupational stress were dimension one (occupational health legal knowledge), dimension two (basic knowledge of occupational health protection), and dimension four (healthy working methods and behaviors) of occupational health literacy, gender, average monthly income, and night shifts. The results from the three-level random intercept mixed-effects logistic regression model indicated that dimensions one (OR=0.69, 95%CI: 0.58, 0.82), two (OR=0.71, 95%CI: 0.58, 0.87), and four (OR=0.81, 95%CI: 0.67, 0.98) of occupational health literacy were negatively correlated with the risk of occupational stress. Workers with an average monthly income of 3001–≤5000, 5001–≤7000, and ≥7001 yuan reported occupational stress risks that were 61% (OR=0.61, 95%CI: 0.45, 0.81), 56% (OR=0.56, 95%CI: 0.41, 0.78), and 36% (OR=0.36, 95%CI: 0.24, 0.53) of those with an average monthly income ≤3000 yuan, respectively. Male workers (OR=1.66, 95%CI: 1.32, 2.10) and those on night shifts (OR=2.29, 95%CI: 1.90, 2.76) had a higher risk of occupational stress. The random effects variance showed that the intraclass correlation coefficient was 0.12. Conclusion There is a negative correlation between occupational stress and occupational health literacy among workers in mining and manufacturing. Being male, having a low income, and working night shifts are risk factors affecting workers' occupational stress. It is recommended to focus on these groups of workers and incorporate occupational health literacy into workplace mental health promotion.

Objective To assess the quality of gross α and β radioactivity measurements conducted by radiological health service institutions and disease prevention and control centers in Gansu Province, China, and regulate their measurement methods. Methods The samples were distributed by Gansu Provincial Center for Disease Control and Prevention as the organizer of the inter-comparison through mail. The institutions participated in the inter-comparison carried out the measurements in accordance with national standards, and submitted the inter-comparison reports in the form required by the inter-comparison scheme. Results A total of 13 institutions participated in the 2023 inter-comparison of gross α and β radioactivity measurement capabilities, and all measurement results met the required standards. The absolute Z-scores for gross α inter-comparison ranged from 0 to 1.21, and the absolute Z-scores for gross β inter-comparison ranged from 0.08 to 1.85. The comprehensive scores ranged from 74.5 to 93.0. Conclusion The measurement capacities of the institutions participated in the 2023 inter-comparison showed improvement compared with the previous year. However, 12 institutions participated in the inter-comparison showed issues in data processing, report formatting, and laboratory quality control. It is necessary to strengthen technical training, standardize the measurement procedures, and improve the measurement capabilities and skills to ensure the quality of services.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective To investigate the effects of occupational exposure to ionizing radiation on blood indicators of radiation workers, and to provide evidence for occupational health monitoring. Methods This study included 3853 radiation workers who participated in occupational health examination in Gansu Provincial Center for Disease Control and Prevention from January 1, 2021 to December 31, 2022. The results of fasting blood glucose, renal function, liver function, white blood cell count, platelet count, and lymphocyte micronucleus were analyzed. Results The detection rates of abnormal fasting blood glucose and liver function were significantly higher in males than in females (P < 0.05), and the detection rates of abnormal renal function, white blood cell count, platelet count, and lymphocyte micronucleus were significantly lower in males than in females (P < 0.05). The detection rates of abnormal fasting blood glucose, liver function, and lymphocyte micronucleus were significantly higher in radiation workers with ≥ 21 years of working experience than those with ≤ 10 years of working experience (P < 0.05). The detection rate of abnormal fasting blood glucose was significantly higher in the non-medical group than in the diagnostic radiology, radiation therapy, and interventional radiology groups (P < 0.05). The detection rate of abnormal fasting blood glucose was significantly higher in the primary medical institution group than in the tertiary medical institution group (P < 0.05). The detection rate of abnormal liver function was significantly higher in the primary medical institution group than in the secondary and tertiary medical institution groups (P < 0.05). Conclusion Long-term occupational exposure to ionizing radiation may cause radiation damage to the human body. Health education should be strengthened for non-medical and male radiation workers to prevent the occurrence of chronic metabolic diseases.

Objective To investigate the effects of occupational exposure to ionizing radiation on blood indicators of radiation workers, and to provide evidence for occupational health monitoring. Methods This study included 3853 radiation workers who participated in occupational health examination in Gansu Provincial Center for Disease Control and Prevention from January 1, 2021 to December 31, 2022. The results of fasting blood glucose, renal function, liver function, white blood cell count, platelet count, and lymphocyte micronucleus were analyzed. Results The detection rates of abnormal fasting blood glucose and liver function were significantly higher in males than in females (P < 0.05), and the detection rates of abnormal renal function, white blood cell count, platelet count, and lymphocyte micronucleus were significantly lower in males than in females (P < 0.05). The detection rates of abnormal fasting blood glucose, liver function, and lymphocyte micronucleus were significantly higher in radiation workers with ≥ 21 years of working experience than those with ≤ 10 years of working experience (P < 0.05). The detection rate of abnormal fasting blood glucose was significantly higher in the non-medical group than in the diagnostic radiology, radiation therapy, and interventional radiology groups (P < 0.05). The detection rate of abnormal fasting blood glucose was significantly higher in the primary medical institution group than in the tertiary medical institution group (P < 0.05). The detection rate of abnormal liver function was significantly higher in the primary medical institution group than in the secondary and tertiary medical institution groups (P < 0.05). Conclusion Long-term occupational exposure to ionizing radiation may cause radiation damage to the human body. Health education should be strengthened for non-medical and male radiation workers to prevent the occurrence of chronic metabolic diseases.

In environmental epidemiological research, extensive non-random environmental exposures and complex confounding biases pose significant challenges when attempting causal inference. In recent years, the introduction of causal inference methods into observational studies has provided a broader range of statistical tools for causal inference research in environmental epidemiology. The instrumental variable (IV) approach, as a causal inference technique for effectively controlling unmeasured confounding factors, has gradually found application in the field of environmental epidemiological research. This article reviewed the basic principles of IV and summarized the current research progress and limitations of applying IV for causal inference in environmental epidemiology. IV application in the field of environmental epidemiology is still in the initial stage. Rational use of IV and effective integration with other causal inference methods will become the focus of the development of causal inference in environmental epidemiology. The aim of this paper is to provide a methodological reference and basis for future studies involving causal inference to target population health effects of environmental exposures in China.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.