Background The quality of occupational health technical services is directly linked to the protection of workers' health rights and the efficacy of occupational disease prevention and control. However, the industry still faces critical challenges: sporadic instances of institutional non-compliance and persistent irregularities in professional practice continue to undermine overall service performance. Objective To assess the current quality status of occupational health technical services in Zhejiang Province and propose countermeasures for quality improvement, providing a scientific basis for policy optimization and service delivery quality enhancement. Methods A total of 69 occupational health technical service institutions in Zhejiang Province that obtained formal accreditation as of April 30, 2024, were sampled, including 3 public institutions and 66 private institutions (comprising 3 formerly Class-A, 28 formerly Class-B, 11 formerly Class-C, and 24 newly certified institutions). Following the Technical Protocol for Quality Monitoring of Occupational Health Technical Service in Zhejiang Province and the Technical Protocol for Proficiency Testing of Occupational Health Detection in Zhejiang Province, a quality assessment task force comprising national and provincial experts was established. Evaluation was conducted across four dimensions: qualification maintenance and compliance, standardization of technical services, authenticity of technical services, and proficiency testing, utilizing a combination of document review, on-site inspections, and technical skill assessments. Results The occupational health technical service institutions in Zhejiang Province were predominantly private entities (82.5%), with significant disparities in overall service quality. The pass rates for qualification maintenance and compliance, technical service standardization, technical service authenticity, and the excellence rate for laboratory proficiency testing were 81.5%, 80.7%, 97.3%, and 90.4%, respectively. Regarding qualification maintenance, the pass rates for "environmental conditions" (49.8%, 56.7%) and "instrumentation and equipment" (58.2%、65.6%) were significantly lower for formerly Class-C and newly certified institutions compared to other categories. In terms of technical standardization, "standardized on-site inspections" recorded the lowest pass rate (67.4%), with newly certified institutions at only 48.0%. Regarding technical service authenticity, formerly Class-C institutions exhibited issues such as missing raw chromatograms for blank samples (85.7% pass rate). In laboratory proficiency testing, public and formerly Class-A institutions achieved 100% excellence rates, but the performance of formerly Class-C and newly certified institutions was comparatively weak; specifically, the failure rate for organic analysis in formerly Class-C institutions reached 20%; the failure rate for dust testing items in newly certified institutions was 10.3%. Conclusion The overall quality of occupational health technical services in Zhejiang Province still requires significant improvement, particularly in basic institutional conditions, the standardization of on-site inspections, and laboratory proficiency in organic and dust analysis. Formerly Class-C and newly certified institutions should be the primary focus of quality management efforts. Differentiated regulatory strategies are recommended, alongside strengthening interim and ex-post supervision to gradually enhance the quality of occupational health technical services across all institutions.

This article reports the diagnosis and treatment of one patient with fascioliasis of the common bile duct, aiming to provide reference for the clinical diagnosis and treatment of this disease. The patient sought medical attention due to long-term symptoms such as abdominal pain, abdominal distension, nausea, and vomiting. Imaging examinations displayed dilatation of the common bile duct and intrahepatic bile ducts, and the patient was admitted to the hospital with a diagnosis of “common bile duct stone”. Through endoscopic retrograde cholangiopancreatography and choledochoscopy, two worms were collected from the common bile duct, which were identified as Fasciola hepatica by high-throughput sequencing.

Objective To investigate the predictive value of uric acid for cardiovascular events in the elderly patients with ACS.Methods An observational follow-up study was conducted on 3440 ACS inpatients and outpatients admitted in the Heart Center of Beijing Chaoyang Hospital and the First Medical Center of Chinese PLA General Hospital from June 2017 to October 2022.According to the occurrence of cardiovascular events,they were divided into a cardiovascular event group(529 patients)and a non-cardiovascular event group(2911 patients).Their clinical data were collected for Cox risk proportional regression analysis.Results The cardiovascular event group had significantly uric acid when compared with the non-cardiovascular event group(P＜0.01).Af-ter adjusting the traditional risk factors and plasma biomarkers,uric acid was still a significant predictor for clinical endpoints(HR=2.634,95％CI:1.870-3.744,P＜0.01)and for cardiovascu-lar events(HR=1.508,95％CI:1.357-1.660,P＜0.01).Furthermore,uric acid was significantly correlated with acute heart failure,cardiovascular death and all-cause death(P＜0.01).Conclusion Uric acid is a risk predictor for cardiovascular events in elderly ACS patients,and can provide ear-ly warning information and diagnostic value for acute cardiovascular events.

Objective To evaluate the efficacy,safety and patient compliance of a quadruple therapy containing minocycline compared with the traditional quadruple therapy in the treatment of Helicobacter(H.)pylori.Methods This study included 200 H.pylori positive patients,with 100 assigned to the minocycline-containing bismuth quadruple therapy group(LBMC group)and the other 100 to the amoxicillin-containing bismuth quadruple therapy group(LBAC group).After matching the two groups of patients using the propensity score matching(PSM)method,there were 86 cases in each group.Telephone follow-up was conducted on the 14th day after the start of treatment to record patient medication compliance and adverse drug reactions.A 13C urea breath test was performed for re-examination at least one month after completing the treatment plan and discontinuing medication.The intention-to-treat(ITT)and per-protocol(PP)analyses were used to compare the H.pylori eradication rates between the two groups,and Chi-square test and t-test were used for intergroup comparison.Results In the ITT analysis,the eradication rates of the LBMC group and the LBAC group were 89.5%(77/86,95%CI:82.9%～96.1%)and 82.6%(71/86,95%CI:74.4%～90.7%),respectively.In the PP analysis,the eradication rates were 92.6%(75/81,95%CI:86.8%～98.4%)and 88.8%(71/80,95%CI:81.7%～95.8%),respectively.The adverse reaction rate of the LBMC group was 27.9%(24/86),and that of the LBAC group 31.4%(27/86),showing no statistically significant difference(P>0.05).In terms of compliance,the LBMC group was 94.2%(81/86),and the LBAC group 93.0%(80/86),revealing no statistically significant difference(P>0.05).Conclusion As a first-line treatment for eradicating H.pylori,regimens containing minocycline demonstrate equivalent eradication rates to those containing amoxicillin,with similar safety and compliance.They can be used as an alternative treatment for patients allergic to penicillin.

Objective To compare the diagnostic performance of two syphilis reverse testing protocols recommended by the U.S.Centers for Disease Control and Prevention(USCDC)and the European Centre for Disease Prevention and Control(ECDC)within maternal and child populations,and to explore the factors contributing to false-positive results in chemiluminescent immunoassays(CLIA).Methods A retrospective analysis was performed on serological test results from 109,003 patients collected between 2021 and 2023.All participants were initially screened for specific syphilis antibodies using CLIA,and those with positive results underwent confirmatory testing with both the toluidine red unheated serum test(TRUST)and the Treponema pallidum particle agglutination assay(TPPA).The kappa statistic was employed to assess the diagnostic agreement between the USCDC and ECDC protocols,while also analyzing the distribution patterns of CLIA false-positive results across varying S/CO value ranges and demographic groups.Results Both protocols achieved a syphilis positivity rate of 0.34%.The hospital's high-prevalence syphilis screening program identified no cases with CLIA-positive or TRUST-positive but TPPA-negative results,suggesting high specificity in this population.The two protocols demonstrated perfect agreement with a Kappa value of 1.0,indicating no significant difference in diagnostic performance between maternal and child populations.CLIA exhibited a true positive rate of 71.04%,which was positively correlated with S/CO values:21.88%when 1.010.The highest false positive rate for CLIA(38.75%)was observed among young adults,while the largest proportion of false positives-reaching 40.00%—was associated with pregnancy and abortion status.Conclusions The two reverse detection methods for syphilis exhibit comparable diagnostic efficacy in women and children from populations with low syphilis prevalence.CLIA demonstrates high sensitivity;however,when the S/CO ratio is less than 10,particularly in adult women of childbearing age,clinicians should remain vigilant for potential false-positive results to prevent misdiagnosis and unnecessary medical interventions.