The Guidelines for Occupational Hazard Assessment and Control of Active Pharmaceutical Ingredient in the Pharmaceutical Industry (T/WSJD 60—2024) is the first guiding standard in the field of health in China that focuses on occupational health protection for active pharmaceutical ingredient (API). It covers the general principles, work procedures, assessment methods, and control strategies for API occupational hazard assessment, providing practical guidance and recommendations for pharmaceutical enterprises to eliminate or reduce occupational health risks associated with API, improve working environment, and enhance refined management practices. This article interpreted and analyzed the background of standard establishment, formulation process, fundamental basis, and main content, to provide scientific and comprehensive technical support for occupational health managers in the pharmaceutical industry to better apply this standard.

Objective: To explore the correlation between traditional Chinese medicine (TCM) constitution and depressive symptom among school aged children and adolescents, so as to provide evidences for informing constitution based regulation and prevention of depressive symptom. Methods: From June to December 2024, a total of 4 729 students aged 6-14 were recruited by cluster random sampling from 10 primary schools in Baoding (Hebei Province), Heze and Liaocheng (Shandong Province). General information, TCM constitution and depressive symptom were collected. Restricted cubic spline (RCS) models were used to analyze related factors and threshold effects of depressive symptom. Binary Logistic regression was applied to examine the association between depressive symptom and TCM constitution, with subgroup analyses conducted. Results: The detection rate of depressive symptom among the included children and adolescents was 25.82%. RCS analyses indicated non linear associations between depressive symptom and age (inflection point at 10 years old), bedtime (inflection point at 22:00), and wake up time (inflection point at 6:30 ) (all P non linearity <0.01). Linear associations were observed with body mass index (BMI) and sleep duration (all P non linearity > 0.05 ). After adjusting for covariates such as age, BMI and sleep status, binary Logistic regression analyses showed that Yin deficient constitution ( OR =1.26, 95% CI =1.09-1.45) and Phlegm-dampness constitution ( OR =1.42, 95% CI =1.11-1.82) were significantly associated with depressive symptom among children and adolescents (all P <0.05). Conclusions Depressive symptom among school aged children and adolescents is primarily associated with Yin deficiency and Phlegm dampness constitutions in TCM constitution. Active attention should be paid to susceptible TCM constitution among children and adolescents. Targeted health guidance and interventions should be implemented to improve TCM constitution health status for preventing the occurrence of depressive symptom.

ObjectiveTo investigate the trend and influencing factors of newly reported human immunodeficiency virus (HIV) positivity rate among men who had sex with men (MSM) in Shanghai from 2021 to 2024, and to provide evidence for formulating scientific prevention and control measures of AIDS. MethodsMultiple rounds of cross-sectional questionnaire surveys were conducted among MSM by Shanghai Qing’ai Health Promotion Center. Pearson and Cochran-Armitage trend χ² tests were used to analyze the differences and changes in population characteristics and newly reported HIV positivity rates. A logistic regression model was applied for multivariate analyses of factors associated with newly reported HIV positivity. ResultsA total of 1 653 MSM who had not been previously diagnosed with HIV infection were surveyed. The newly reported HIV positivity rates in 2021, 2023, and 2024 were 7.87%, 3.91%, and 3.06%, respectively, showing a decreasing trend (χ²_trend=13.460, P_trend<0.001). Multivariate analyses revealed that MSM aged 18‒<25 years, residing locally for <1 year, identifying as bisexual, lacking HIV knowledge, and having ≥10 same-sex partners in the past 6 months exhibited higher newly reported HIV positivity rates. Conversely, MSM knowledgeable about HIV prevention, residing locally for 1‒5 years, and engaging in oral sex with male partners in the past 6 months demonstrated lower HIV positivity rates. Annual analyses revealed that MSM with HIV knowledge had lower newly reported HIV positivity rates in 2023 and 2024 (aOR=0.300, 95%CI: 0.811‒0.111; aOR=0.202, 95%CI: 0.085‒0.483). ConclusionThe newly reported HIV positivity rate among MSM in Shanghai from 2021 to 2024 showed a decline. Future interventions should focus on young and mobile MSM, strengthen HIV knowledge education through platforms such as the internet, promote safe sexual behaviors and regular testing, and further expand the coverage of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) to control HIV transmission within this population.

Objective:To explore the correlation of different HBV DNA loads with peripheral blood lymphocyte subsets and interleukin-6 (IL-6) in patients with chronic hepatitis B.Methods:A cross-sectional study was conducted. A total of 519 patients with chronic hepatitis B admitted to the Fifth Medical Center of the General Hospital of the People′s Liberation Army from April 2019 to June 2024 were included. The patients were divided into high, medium, and low viral load groups and a negative group based on HBV DNA load. Another 100 healthy individuals who underwent physical examinations during the same period were recruited as the control group. The quantities of peripheral blood lymphocyte subsets and IL-6 levels were compared among the groups. Meanwhile, alanine aminotransferase (ALT) levels were recorded and compared among the groups. The correlation of HBV DNA levels with lymphocyte subsets and IL-6 was analyzed using Pearson correlation analysis.Results:HBV DNA loads were negatively correlated with the counts of CD3 +, CD4 +, CD8 +, CD19 +, and CD56 + lymphocyte subsets (correlation coefficients r were -0.483, -0.508, -0.524, -0.573, and -0.561, respectively; all P<0.001) and positively correlated with IL-6 levels ( r=0.862, P<0.05). Compared with the control group, the counts of each lymphocyte subset were higher in the high, medium, and low viral load groups ( P<0.05). In the HBV DNA-negative chronic hepatitis B group, the counts of CD8 + and CD19 + lymphocyte subsets were significantly higher [712.32(526.00,898.64) and 495.62(345.74,645.50) cells/μl] than those in the control group [612.10(479.89,744.31) and 470.32 (396.00,544.64) cells/μl] ( P<0.05). Conclusion:The degree of HBV replication activity in patients with chronic hepatitis B is associated with the immune status of the body, and negatively correlated with the quantities of lymphocyte subsets and positively correlated with IL-6 levels.

Objective To analyze the impact of the National Centralized Drug Procurement Policy(hereinafter referred to as the"centralized procurement policy")on the utilization of breast cancer treatment drugs in a specialized cancer hospital.Methods The defined daily dose(DDD)method was used to compare the daily drug cost(DDC),drug utilization frequency(DDDs),and affordability of letrozole,anastrozole,and capecitabine before and after the implementation of the centralized pro-curement policy in a tertiary specialized cancer hospital in Guangzhou.Results and Conclusion After the policy implementa-tion,the DDC of all three drugs decreased.The out-of-pocket DDC for the selected drugs remained stable or decreased,while the out-of-pocket DDC for both originator drugs and generic drugs increased,with a more pronounced increase for originator drugs.The proportion of DDDs for the selected drugs increased post-policy.The centralized procurement policy not only reduced the prices of selected drugs but also drove down the prices of generic and originator drugs.It is recommended to further expand the scope of centralized procurement for anticancer drugs and the types of cancers covered,as well as to establish a transitional mech-anism for medical insurance payment standards.

Men who have sex with men (MSM) represent a high-risk group for human papillomavirus (HPV) infection and transmission. HPV vaccination for MSM has been extensively explored in clinical trials and real-world settings in foreign countries, but it has not been widely promoted for MSM in the Chinese mainland. This article provides a comprehensive review of the HPV vaccination status among MSM, as well as the effectiveness, immunogenicity, safety, and cost-effectiveness of HPV vaccines, aiming to provide reference for the implementation and promotion of HPV vaccination among MSM in the Chinese mainland.

Objective:To explore the effectiveness of digital health management in the management of community patients with essential hypertension comorbid with somatization symptom disorder.Methods:This was an intervention-controlled study. Patients with essential hypertension comorbid with somatization symptom disorder who visited the outpatient clinic of Jiangwan Town Community Health Service Center in Hongkou District, Shanghai from January to December 2022 were enrolled. Based on the time of initial diagnosis, patients were divided into a digital health management group (initial diagnosis from January to June 2022) and a control group (initial diagnosis from July to December 2022). Baseline clinical data were collected. The control group received conventional interventions, while the digital health management group utilized the Health Cloud APP 5.3.11 platform for online digital health management without altering the original medication regimen. The intervention lasted for 24 weeks. Before and after the intervention, the Somatization Symptom Scale (SSS), 9-item Patient Health Questionnaire (PHQ-9), and 7-item Generalized Anxiety Disorder Scale (GAD-7) were used to assess somatization symptoms, depression, and anxiety, respectively. The reduction rate in SSS scores was calculated, and blood pressure and heart rate were measured. The evaluation criteria for somatization symptom intervention effectiveness were as follows: at the endpoint of the intervention, SSS ≤29 or a reduction rate of SSS ≥ 75% was considered "cured"; a reduction rate of 50% to <75% was considered "markedly effective"; a reduction rate of 25% to <50% was considered "effective"; and a reduction rate of <25% was considered "ineffective".The overall effectiveness rate=(number of cured patients + number of markedly effective patients + number of effective patients)/total number of patients × 100%.Results:A total of 62 patients in the digital health management group and 65 patients in the control group were included in the final analysis. The mean age of the digital health management group was (50.5±3.5) years, with 30 males (48.4%), while the mean age of the control group was (50.2±3.2) years, with 31 males (47.7%). There were no statistically significant differences in the age or gender distribution between the two groups (both P>0.05). Before the intervention, there were no significant differences between the two groups in SSS sub-item scores, total SSS scores, PHQ-9 scores, GAD-7 scores, blood pressure, or heart rate (all P>0.05). After 24 weeks of intervention, all scores decreased in both groups, and did blood pressure and heart rate (all P<0.05). The differences in SSS sub-item scores, total SSS scores, PHQ-9 scores, GAD-7 scores, blood pressure, and heart rate before and after the intervention were greater in the digital health management group than in the control group (all P<0.05). The proportion of patients with effective intervention for somatization symptom was higher in the digital health management group than in the control group (57 cases (91.9%) vs. 38 cases (58.5%), P<0.001). Conclusion:Digital health management can improve somatization symptom disorder, blood pressure, and heart rate in patients with hypertension.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

McCune-Albright syndrome(MAS) is a postzygotic somatic mutation disorder caused by activating mutations in the GNAS gene, which encodes the α subunit of the stimulatory G protein. Its clinical features typically include polyostotic fibrous dysplasia, cafe-au-lait skin pigmentation, and endocrine hyperactivity, such as Cushing′s syndrome, hyperthyroidism, and growth hormone excess. Here, we report two rare cases of MAS complicated with adrenocorticotropic hormone(ACTH)-independent Cushing syndrome, and provide a review and analysis of previously reported MAS cases associated with Cushing′s syndrome.

This study investigated the effect of Wuling San on transforming growth factor-β1(TGF-β1)-induced fibrosis, inflammation, and oxidative stress in human renal tubular epithelial cells(HK-2) and its mechanism of antioxidant stress injury. HK-2 cells were cultured in vitro and divided into a control group, a TGF-β1 model group, and three treatment groups receiving Wuling San-containing serum at low(2.5%), medium(5.0%), and high(10.0%) doses. TGF-β1 was used to establish the model in all groups except the control group. CCK-8 was used to analyze the effect of different concentrations of Wuling San on the activity of HK-2 cells with or without TGF-β1 stimulation. The expression of key fibrosis molecules, including actin alpha 2(Acta2), collagen type Ⅰ alpha 1 chain(Col1α1), collagen type Ⅲ alpha 1 chain(Col3α1), TIMP metallopeptidase inhibitor 1(Timp1), and fibronectin 1(Fn1), was detected using qPCR. The expression levels of inflammatory cytokines, including tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6(IL-6), interleukin-8(IL-8), and interleukin-4(IL-4), were measured using ELISA kits. Glutathione peroxidase(GSH-Px), malondialdehyde(MDA), catalase(CAT), and superoxide dismutase(SOD) biochemical kits were used to analyze the effect of Wuling San on TGF-β1-induced oxidative stress injury in HK-2 cells, and the expression of nuclear factor E2-related factor 2(Nrf2), heme oxygenase 1(HO-1), and NAD(P)H quinone oxidoreductase 1(NQO1) was analyzed by qPCR and immunofluorescence. The CCK-8 results indicated that the optimal administration concentrations of Wuling San were 2.5%, 5.0%, and 10.0%. Compared with the control group, the TGF-β1 model group showed significantly increased levels of key fibrosis molecules(Acta2, Col1α1, Col3α1, Timp1, and Fn1) and inflammatory cytokines(TNF-α, IL-1β, IL-6, IL-8, and IL-4). In contrast, the Wuling San administration groups were able to dose-dependently inhibit the expression levels of key fibrosis molecules and inflammatory cytokines compared with the TGF-β1 model group. Wuling San significantly increased the activities of GSH-Px, CAT, and SOD enzymes in TGF-β1-stimulated HK-2 cells and significantly inhibited the level of MDA. Furthermore, compared with the control group, the TGF-β1 model group exhibited a significant reduction in the expression of Nrf2, HO-1, and NQO1 genes and proteins. After Wuling San intervention, the expression of Nrf2, HO-1, and NQO1 genes and proteins was significantly increased. Correlation analysis showed that antioxidant stress enzymes(GSH-Px, CAT, and SOD) and Nrf2 signaling were significantly negatively correlated with key fibrosis molecules and inflammatory cytokines in the TGF-β1-stimulated HK-2 cell model. In conclusion, Wuling San can inhibit TGF-β1-induced fibrosis in HK-2 cells by activating the Nrf2 signaling pathway, improving oxidative stress injury, and reducing inflammation.
Humans ; Oxidative Stress/drug effects* ; Transforming Growth Factor beta1/metabolism* ; Fibrosis/genetics* ; Cell Line ; Drugs, Chinese Herbal/pharmacology* ; Epithelial Cells/immunology* ; Inflammation/metabolism*