The core idea of occupational health risk assessment models is to systematically evaluate occupational health risks according to target hazard characteristics and relevant exposure levels of workers. Occupational exposure assessment is based on concentration, frequency, exposure time, and other indicators that indicate actual exposure of workers to occupational hazards, which is a critical component of health risk assessment. However, the accuracy and comparability of assessment results are affected by differences in parameter assignment for exposure assessment across different studies, as well as insufficient emphasis on multiple occupational hazard exposure. This review aimed to explore the assignment and standardization of exposure assessment parameters for occupational health risk assessment modeling, and systematically sorted out the meaning, assignment methods, and sources of exposure assessment related parameters in commonly used occupational health risk assessment models, with the goal of providing researchers with standardized assessment tools to enhance the scientific rigor and practicality of occupational health risk assessments. Considering the individual differences and temporal fluctuations in occupational exposure, it is recommended that researchers should adopt appropriate sampling strategies, reasonably select sample subjects and time based on the division of similar exposure group (SEG), and conduct statistical inference on the obtained data to derive representative exposure parameters. For combined exposure to chemicals with similar toxic effects, the health risk assessment methods are relatively mature. However, the assessment of combined exposure to hazards with different properties and health effects still lacks scientific authority and needs further research and discussion.

Objective:To investigate the relationship between the expression of microtubule-associated protein light chain 3B (LC3B), Beclin-1, and p62 in serum CD 4+ T lymphocytes of patients infected with varicella-zoster virus (VZV) and viral replication. Methods:This study used a cross-sectional design. A total of 106 patients with VZV who received treatment at The First People's Hospital of Huzhou between October 2018 and October 2019 were included in the study group. Additionally, 50 healthy individuals who underwent health examinations during the same period were included in the control group. The expression levels of LC3B, Beclin-1, and p62 in serum CD 4+ T lymphocytes among patients with different VZV DNA copy numbers were compared. The effects of different levels of LC3B, Beclin-1, and p62 on disease severity were evaluated. Spearman correlation analysis was performed to investigate the relationship between the expression of LC3B, Beclin-1, and p62 in the peripheral blood CD 4+ T lymphocytes of VZV-infected patients, viral replication, and disease duration. Results:The relative expression levels of LC3B and Beclin-1 in peripheral blood CD 4+ T lymphocytes of the study group were (60.19 ± 7.59)% and (34.99 ± 4.34)%, respectively, which were significantly higher than those in the control group [(37.71 ± 4.33)%, (16.18 ± 1.92)%, t = 19.48, 29.29, both P < 0.001]. The relative expression level of p62 in the study group was significantly lower than that in the control group [(5.81 ± 0.58)% vs. (10.11 ± 1.24)%, t = -29.57, P < 0.001]. The peripheral blood VZV DNA copy number in the study group was (4.28 ± 0.47). In patients with a VZV DNA copy number ≥ 4.28, the expression levels of LC3B [(72.22 ± 8.83)%] and Beclin-1 [(40.09 ± 5.56)%] were significantly higher than those in patients with a VZV DNA copy number < 4.28 [LC3B: (51.23 ± 6.88)%, Beclin-1: (29.67 ± 3.12)%, t = 13.57, 11.77, both P < 0.001]. The expression level of p62 in patients with a VZV DNA copy number ≥ 4.28 [(4.77 ± 0.36)%] was significantly lower than that in patients with a VZV DNA copy number < 4.28 [(6.98 ± 0.79) %, t = -18.76, P < 0.001]. The expression levels of LC3B and Beclin-1 in patients at moderate or advanced stages were significantly higher than those in patients with early-stage VZV ( P < 0.05), while the expression levels of p62 in patients with moderate- or advanced-stage VZV were significantly lower than those in patients with early-stage VZV (both P < 0.05). Additionally, the expression levels of LC3B and Beclin-1 were positively correlated with viral replication ( r = 0.817, 0.839) and disease duration ( r = 0.849, 0.822, all P < 0.001). The expression level of p62 was negatively correlated with viral replication and disease duration ( r = -0.850, -0.822, both P < 0.001). Conclusions:In patients infected with VZV, the autophagy levels in peripheral blood CD 4+ T lymphocytes were significantly upregulated, as evidenced by increased expression of LC3B and Beclin-1 and decreased expression of p62. Autophagy positively influences viral replication, with elevated autophagy levels promoting viral replication.

Objective To observe the value of follicular thyroid imaging reporting and data system(F-TIRADS)for differentiating benign and malignant follicular thyroid lesions.Methods Totally 502 patients with follicular thyroid lesions were retrospectively enrolled,including 104 patients with single malignant lesion(malignant group,containing 77 follicular thyroid carcinomas[FTC]and 27 follicular variant of papillary thyroid carcinomas[FVPTC])and 398 patients with 416 benign lesions(benign group,containing 197 follicular thyroid adenomas[FTA]and 219 thyroid adenomatous hyperplasia).Ultrasonic features of lesions were recorded,and F-TIRADS scores were assigned by 1 junior and 1 senior ultrasound physicians.Taken histopathology results as gold standard,receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the efficacy for differentiating benign and malignant follicular thyroid lesions using F-TIRADS.Results Significant differences of composition,internal echo,boundary,calcification and trabecular structure of lesions were found between groups(all P＜0.001).Taken F-TIRADS score≥ 7 as the optimal cut-off value,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value for differentiating benign and malignant follicular thyroid lesions by the junior physician was 76.92％,77.40％,77.31％,93.06％and 45.98％,while by the senior physician was 78.84％,81.25％,80.76％,93.89％and 51.25％,respectively.The efficacy of the latter was higher than of the former(AUC was 0.827 and 0.859,respectively,P＜0.05).Conclusion F-TIRADS could effectively identifying benign and malignant follicular thyroid lesions.

Objective To explore the value of improved ResNet18 lightweight deep learning(DL)models for automatically detecting gouty arthritis(GA)based on ultrasonogram of the first metatarsophalangeal joint(MTP1).Methods A total of 2 401 ultrasonograms obtained from 260 patients with suspected gout who underwent MTP1 ultrasound examination were included and divided into training set(1 910 ultrasonograms from 209 cases)and test set(491 ultrasonograms from 51 cases)at the ratio of 4∶1.GA lesions on ultrasonograms were manually labeled.After preprocessing,ResNet18 lightweight network was used to construct DL models for identifying the ultrasonogram category was normal or abnormal(with any manifestation of GA).Five-fold cross-validation method was adopted to evaluate the efficacy of the DL models constructed with 2,3,4 or 6 residual blocks,i.e.model 1,2,3 and 4,respectively,and the computational cost and the amount of parameters of each model were recorded.The efficacy of the models were verified using test set,and the best DL model was screened.Results The computational cost of model 1,2,3 and 4 was 7 558.27,2 963.73,4 012.33 and 6 093.39 M,respectively,while the amount of parameters was 4.61,4.91,4.91 and 5.28 M,respectively.Model 2 had the least computational cost with parameters only slightly more than model 1.In test set,no significant difference of accuracy nor the area under the curve was found among 4 models(all P＞0.05).The sensitivity of model 2 was higher than that of model 3,while its specificity was lower only than that of model 3(both P＜0.05),hence model 2 was the best DL model.Conclusion Improved ResNet18 lightweight DL models could be used for automatically detecting GA based on ultrasonogram of MTP1,among which model 2 was the best one.

Objective To observe the value of follicular thyroid imaging reporting and data system(F-TIRADS)for differentiating benign and malignant follicular thyroid lesions.Methods Totally 502 patients with follicular thyroid lesions were retrospectively enrolled,including 104 patients with single malignant lesion(malignant group,containing 77 follicular thyroid carcinomas[FTC]and 27 follicular variant of papillary thyroid carcinomas[FVPTC])and 398 patients with 416 benign lesions(benign group,containing 197 follicular thyroid adenomas[FTA]and 219 thyroid adenomatous hyperplasia).Ultrasonic features of lesions were recorded,and F-TIRADS scores were assigned by 1 junior and 1 senior ultrasound physicians.Taken histopathology results as gold standard,receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the efficacy for differentiating benign and malignant follicular thyroid lesions using F-TIRADS.Results Significant differences of composition,internal echo,boundary,calcification and trabecular structure of lesions were found between groups(all P＜0.001).Taken F-TIRADS score≥ 7 as the optimal cut-off value,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value for differentiating benign and malignant follicular thyroid lesions by the junior physician was 76.92％,77.40％,77.31％,93.06％and 45.98％,while by the senior physician was 78.84％,81.25％,80.76％,93.89％and 51.25％,respectively.The efficacy of the latter was higher than of the former(AUC was 0.827 and 0.859,respectively,P＜0.05).Conclusion F-TIRADS could effectively identifying benign and malignant follicular thyroid lesions.

Objective To explore the value of improved ResNet18 lightweight deep learning(DL)models for automatically detecting gouty arthritis(GA)based on ultrasonogram of the first metatarsophalangeal joint(MTP1).Methods A total of 2 401 ultrasonograms obtained from 260 patients with suspected gout who underwent MTP1 ultrasound examination were included and divided into training set(1 910 ultrasonograms from 209 cases)and test set(491 ultrasonograms from 51 cases)at the ratio of 4∶1.GA lesions on ultrasonograms were manually labeled.After preprocessing,ResNet18 lightweight network was used to construct DL models for identifying the ultrasonogram category was normal or abnormal(with any manifestation of GA).Five-fold cross-validation method was adopted to evaluate the efficacy of the DL models constructed with 2,3,4 or 6 residual blocks,i.e.model 1,2,3 and 4,respectively,and the computational cost and the amount of parameters of each model were recorded.The efficacy of the models were verified using test set,and the best DL model was screened.Results The computational cost of model 1,2,3 and 4 was 7 558.27,2 963.73,4 012.33 and 6 093.39 M,respectively,while the amount of parameters was 4.61,4.91,4.91 and 5.28 M,respectively.Model 2 had the least computational cost with parameters only slightly more than model 1.In test set,no significant difference of accuracy nor the area under the curve was found among 4 models(all P＞0.05).The sensitivity of model 2 was higher than that of model 3,while its specificity was lower only than that of model 3(both P＜0.05),hence model 2 was the best DL model.Conclusion Improved ResNet18 lightweight DL models could be used for automatically detecting GA based on ultrasonogram of MTP1,among which model 2 was the best one.

Objective:To investigate the relationship between the expression of microtubule-associated protein light chain 3B (LC3B), Beclin-1, and p62 in serum CD 4+ T lymphocytes of patients infected with varicella-zoster virus (VZV) and viral replication. Methods:This study used a cross-sectional design. A total of 106 patients with VZV who received treatment at The First People's Hospital of Huzhou between October 2018 and October 2019 were included in the study group. Additionally, 50 healthy individuals who underwent health examinations during the same period were included in the control group. The expression levels of LC3B, Beclin-1, and p62 in serum CD 4+ T lymphocytes among patients with different VZV DNA copy numbers were compared. The effects of different levels of LC3B, Beclin-1, and p62 on disease severity were evaluated. Spearman correlation analysis was performed to investigate the relationship between the expression of LC3B, Beclin-1, and p62 in the peripheral blood CD 4+ T lymphocytes of VZV-infected patients, viral replication, and disease duration. Results:The relative expression levels of LC3B and Beclin-1 in peripheral blood CD 4+ T lymphocytes of the study group were (60.19 ± 7.59)% and (34.99 ± 4.34)%, respectively, which were significantly higher than those in the control group [(37.71 ± 4.33)%, (16.18 ± 1.92)%, t = 19.48, 29.29, both P < 0.001]. The relative expression level of p62 in the study group was significantly lower than that in the control group [(5.81 ± 0.58)% vs. (10.11 ± 1.24)%, t = -29.57, P < 0.001]. The peripheral blood VZV DNA copy number in the study group was (4.28 ± 0.47). In patients with a VZV DNA copy number ≥ 4.28, the expression levels of LC3B [(72.22 ± 8.83)%] and Beclin-1 [(40.09 ± 5.56)%] were significantly higher than those in patients with a VZV DNA copy number < 4.28 [LC3B: (51.23 ± 6.88)%, Beclin-1: (29.67 ± 3.12)%, t = 13.57, 11.77, both P < 0.001]. The expression level of p62 in patients with a VZV DNA copy number ≥ 4.28 [(4.77 ± 0.36)%] was significantly lower than that in patients with a VZV DNA copy number < 4.28 [(6.98 ± 0.79) %, t = -18.76, P < 0.001]. The expression levels of LC3B and Beclin-1 in patients at moderate or advanced stages were significantly higher than those in patients with early-stage VZV ( P < 0.05), while the expression levels of p62 in patients with moderate- or advanced-stage VZV were significantly lower than those in patients with early-stage VZV (both P < 0.05). Additionally, the expression levels of LC3B and Beclin-1 were positively correlated with viral replication ( r = 0.817, 0.839) and disease duration ( r = 0.849, 0.822, all P < 0.001). The expression level of p62 was negatively correlated with viral replication and disease duration ( r = -0.850, -0.822, both P < 0.001). Conclusions:In patients infected with VZV, the autophagy levels in peripheral blood CD 4+ T lymphocytes were significantly upregulated, as evidenced by increased expression of LC3B and Beclin-1 and decreased expression of p62. Autophagy positively influences viral replication, with elevated autophagy levels promoting viral replication.

Objective:To assess the consistency of ultrasound and dual-energy computed tomography (DECT) in the diagnosis of gouty arthritis(GA), reasons of the differences were further analyzed.Methods:The ultrasound and DECT images of 150 knee joints from 147 patients diagnosed with gout at the Gout Specialty Clinic of Qingdao University Affiliated Hospital from February 2022 to October 2023 were retrospectively analyzed. According to anatomy, the knee joint was anatomically segmented into five regions: intra-articular, anterior, posterior, medial, and lateral.Location of monosodium urate (MSU) deposition was meticulously recorded. The Kappa consistency test was employed to assess the consistency of the two examination results in different regions of the knee joint. The McNemar chi-square test was utilized to conduct a differential analysis between DECT and ultrasound results.Results:Double contour sign(DCS) (81.2%, 92/112) was the most common intra-articular ultrasound sign in knee joints with GA. In the extra-articular region, MSU was commonly deposited in and around the popliteal tendon (ultrasound: 51.6%, 66/128; DECT: 54.7%, 70/128). Corresponding MSU deposits on DECT were found in 9 of 92 joints with DCS and in 9 of 49 joints with aggregates detected on ultrasound.In the assessment of MSU deposits, ultrasound showed an overall higher positive rate than DECT (87.3% vs. 72.3%, P=0.001), with poor consistency between the two examinations (Kappa=0.153). In distinct anatomical regions, ultrasound and DECT showed high consistency in the medial (Kappa=0.697) and lateral (Kappa=0.718) sides and the difference was not statistically significant ( P>0.05). Intra-articular (Kappa=0.289) and anterior (Kappa=0.303) regions exhibited only fair consistency, with statistically significant diagnostic differences ( P<0.05). When exclusively assessing cases with tophus, ultrasound and DECT demonstrated high consistency in the medial and lateral aspects(Kappa=0.685, 0.748) without statistical difference ( P>0.05). In the anterior region, the consistency between the two examinations was moderate (Kappa=0.256), while in the intra-articular region, the consistency of the two methods was lower (Kappa=0.147), and the differences was statistically significant ( P<0.001). Conclusions:Both ultrasound and DECT exhibit good diagnostic capabilities for gouty knee arthritis.However, the consistency between the two techniques varies in different anatomical locations. Clinical assessment should be tailored based on the specific anatomical position. DECT has an advantage in evaluating intra-articular MSU deposits, while ultrasound is more sensitive to detect early and scattered MSU deposits.

Objective:To assess the discriminatory value of the Thyroid Follicular Tumor Ultrasound Risk Stratification System (F-TIRADS) in differentiating follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA), and to compare its performance with other risk stratification systems(RSS).Methods:A retrospective analysis was conducted on 325 patients (327 thyroid nodules) diagnosed postoperatively as FTC or FTA at Affiliated Hospital of Qingdao University from January 2016 to December 2023. The cases were divided into FTC group (81 nodules) and FTA group (246 nodules). The nodules were classified based on F-TIRADS, the 2020 Chinese Thyroid Imaging Reporting and Data System (C-TIRADS), the 2015 American Thyroid Association guidelines (ATA guidelines), and the 2017 European Thyroid Association Thyroid Imaging Reporting and Data System (EU-TIRADS) by two ultrasound physicians. Multivariate Logistic regression analysis was used to identify independent predictors associated with FTC. Diagnostic performance of the 4 RSS was compared using postoperative pathological results as the gold standard.Results:Multivariate Logistic regression analysis showed maximum diameter, solid composition, hypoechogenicity, unclear or angular margins, marginal or ring calcifications, trabecular structure, and central blood flow were independent predictors of FTC( OR=1.914, 3.427, 9.926, 9.163, 45.918, 3.191, 8.936, respectively; all P<0.05). Within each RSS, the actual malignancy rate increased with higher risk categories, aligning closely with the recommended malignancy rates (except for ATA guidelines). The optimal cut-off values for distinguishing FTC from FTA were FTC risk 50%-90% in F-TIRADS, C-TIRADS 4B, moderately suspicious nodules in ATA guidelines, and EU-TIRADS 4, with areas under the curve of 0.916, 0.808, 0.827, and 0.836, respectively. F-TIRADS demonstrated the best overall performance (sensitivity: 82.72%, specificity: 82.93%), with significant differences compared with C-TIRADS, ATA guidelines, and EU-TIRADS (all P<0.05). Conclusions:F-TIRADS is highly effective in distinguishing FTA from FTC, outperforming C-TIRADS, ATA Guidelines, and EU-TIRADS. Clinicians should pay close attention to solid hypoechoic nodules with unclear or angular margins, marginal or ring calcifications, central blood flow, or a trabecular structure.

Objective To investigate the relationship between hemoglobin glycation index(HGI)and metabolic syndrome(MS)and its components.Methods A cross-sectional study was conducted to randomly select 823 patients from the First People's Hospital of Huzhou from September 2022 to September 2023.HGI is calculated based on fasting blood glucose(FPG)and glycosylated hemoglobin(HbA1c)values.The patients were divided into low HGI group(HGI<-0.250%,274 cases),medium HGI group(-0.250%≤HGI≤0.214%,275 cases)and high HGI group(HGI>0.214%,274 cases)by HGI quantile method.The general data and metabolic indexes of each group were compared,and the correlation between HGI and MS and its components was analyzed by multiple Logistic regression.Results With the increase of HGI level,the prevalence rate of MS showed an upward trend(P<0.05).The prevalence rate of MS in low,medium and high HGI groups was 24.8%,42.5%and 55.5%,respectively.Multiple Logistic regression analysis showed that elevated HGI level was risk factor for MS,central obesity,hypertension,hyperglycemia,hypertriglyceridemia and low high-density lipoprotein hyperlipidemia(P<0.05).The risk of MS,central obesity,hypertension,hyperglycemia,hypertriglyceridemia and low high-density lipoprotein hyperlipidemia in high HGI group was 4.005 times(95%CI:2.763-5.808),3.765 times(95%CI:2.604-5.443),1.596 times(95%CI:1.089-2.337),2.655 times(95%CI:1.809-3.895),2.024 times(95%CI:1.404-2.918)and 2.247 times(95%CI:1.537-3.284)of that in low HGI group,respectively.Conclusion HGI is related to MS and its components,and HGI may be a new indicator to prevent and monitor MS.