Occupational disease diagnostician (ODD) is the core technology professional who is responsible for occupational disease diagnosis and identification and the main inspection work for occupational medical examination. The implementation of regular assessment management for ODDs is a key component of standardized workforce management, which facilitates dynamic evaluation of professional competence, regulation of medical practice, and assurance of medical safety. Since January 2025, Guangdong Province has implemented regular assessment management for ODDs within its administrative region. The assessment adopts an integrated model consisting of three components including professional competency evaluation, performance appraisal, and professional ethics evaluation, with each assessment cycle lasting three years. ODDs who passed all three components are classified as qualified ODD, whereas those who failed to pass any one of the three components result in an unqualified assessment outcome. In the implementation of ODD regular assessment management, Guangdong Province has emphasized integrating assessment with quality evaluation, strengthening full-cycle supervision of ODDs′ professional conduct, optimizing assessment strategies for special groups of ODDs, and reinforcing the primary management responsibility of medical institutions. Meanwhile, ODDs′ professional competence, service quality, and professional integrity have been continuously promoted by adopting human-computer interactive assessments, information-based assessment management, and "elimination" mechanism.

Objectives:To systematically evaluate the effectiveness and safety of sacubitril valsartan in the treatment of heart failure with mildly reduced ejection fraction(HFmrEF).Methods:Computer searches were conducted on PubMed,Embase,China National Knowledge Infrastructure(CNKI),VIP,and Wanfang Data,all from the time of database establishment until December 31,2023.Randomized controlled trials(RCT)of sacubitril valsartan(experimental group)compared to conventional drugs such as renin angiotensin converting enzyme inhibitors/angiotensin Ⅱ receptor antagonists(control group)for the treatment of HFmrEF were collected.After screening literature and extracting data,meta-analysis was conducted using Stata 15.0 and Rev Man 5.3 software,and bias and sensitivity analyses were published in parallel.Results:A total of 13 RCTs were included,with a total of 1 150 patients.The meta-analysis results showed that all-cause mortality risk of patients(RR=0.63,95%CI:0.45-0.86,P=0.004),and the risk of elevated blood creatinine(RR=0.65,95%CI:0.50-0.84,P=0.001)in the experimental group were significantly lower than those in the control group.The level of six-minute walk test post therapy was significantly higher in the experimental group patients than that in the control group(weighted mean differences[WMD]=66.33 m,95%CI:11.77-120.90,P=0.02).There was no statistically significant difference in the comparison on the readmission rate of heart failure(RR=0.87,95%CI:0.61-1.24,P=0.43),NT-proBNP levels(WMD=319.67 pg/ml,95%CI:-823.36 to 1 462.70,P=0.58),soluble suppression of tumorigenicity 2(sST2)levels(WMD=4.48 μg/L,95%CI:-0.58 to 9.54,P=0.08),incidence of hypotension(RR=1.03,95%CI:0.61-1.76,P=0.90),and incidence of hyperkalemia(RR=0.95,95%CI:0.67-1.33,P=0.75)between the two groups of patients after treatment.The results of publication bias and sensitivity analysis both indicated a high possibility of publication bias,and some indicators had unstable results.Conclusions:Sacubitril valsartan may effectively reduce all-cause mortality,and the risk of elevated blood creatinine in HFmrEF patients,improving their long-term prognosis.However,the incidence of hypotension and hyperkalemia remains unclear.

Objectives:To systematically evaluate the effectiveness and safety of sacubitril valsartan in the treatment of heart failure with mildly reduced ejection fraction(HFmrEF).Methods:Computer searches were conducted on PubMed,Embase,China National Knowledge Infrastructure(CNKI),VIP,and Wanfang Data,all from the time of database establishment until December 31,2023.Randomized controlled trials(RCT)of sacubitril valsartan(experimental group)compared to conventional drugs such as renin angiotensin converting enzyme inhibitors/angiotensin Ⅱ receptor antagonists(control group)for the treatment of HFmrEF were collected.After screening literature and extracting data,meta-analysis was conducted using Stata 15.0 and Rev Man 5.3 software,and bias and sensitivity analyses were published in parallel.Results:A total of 13 RCTs were included,with a total of 1 150 patients.The meta-analysis results showed that all-cause mortality risk of patients(RR=0.63,95%CI:0.45-0.86,P=0.004),and the risk of elevated blood creatinine(RR=0.65,95%CI:0.50-0.84,P=0.001)in the experimental group were significantly lower than those in the control group.The level of six-minute walk test post therapy was significantly higher in the experimental group patients than that in the control group(weighted mean differences[WMD]=66.33 m,95%CI:11.77-120.90,P=0.02).There was no statistically significant difference in the comparison on the readmission rate of heart failure(RR=0.87,95%CI:0.61-1.24,P=0.43),NT-proBNP levels(WMD=319.67 pg/ml,95%CI:-823.36 to 1 462.70,P=0.58),soluble suppression of tumorigenicity 2(sST2)levels(WMD=4.48 μg/L,95%CI:-0.58 to 9.54,P=0.08),incidence of hypotension(RR=1.03,95%CI:0.61-1.76,P=0.90),and incidence of hyperkalemia(RR=0.95,95%CI:0.67-1.33,P=0.75)between the two groups of patients after treatment.The results of publication bias and sensitivity analysis both indicated a high possibility of publication bias,and some indicators had unstable results.Conclusions:Sacubitril valsartan may effectively reduce all-cause mortality,and the risk of elevated blood creatinine in HFmrEF patients,improving their long-term prognosis.However,the incidence of hypotension and hyperkalemia remains unclear.

Objective: To study the pollution status of polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCB), polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in cord blood of newborns in an e-waste dismantling area of Guangdong Province. Methods: We recruited 20 eligible mothers and newborns who could meet the inclusion criteria in local hospitals of Guiyu in 2007. The inclusion criteria included directly engaged in dismantling e-waste during pregnancy and within 1 year before pregnancy; living in the e-waste dismantling workshops or the distance between living place and the e-waste dismantling areas was ≤200 m; the father of newborn was directly engaged in electronic waste dismantling for more than 1 year; the frequency of visiting the e-waste dismantling workshop during pregnancy was ≥3 times in a week. Questionnaires and physical examinations were performed on maternal and neonatal, and cord blood was collected from newborns to detect PCDD/Fs, PCB and PBDE. The concentration level of organic pollutants was corrected by the blood lipid content, and the total toxicity equivalent was calculated. The correlation between three compounds was analyzed by Spearman correlation. Results: The mothers of the 20 newborns were (23.45±3.27) years old and lived for more than 5 years. The number of one parent engaged in e-waste dismantling, the mother or father smoking, and parent engaged in e-waste dismantling work were 3, 13, 15 and 19, respectively. The weight of newborns ranged from 2.5 to 3.6 kilogram and the Apgar score was 10 points. No adverse birth outcomes such as preterm birth, malformation or stillbirth were found. The median (maximum, minimum) concentration of PCBs, PCDD/Fs and PBDEs in cord blood were 263.22 (328.29, 244.19), 38.42 (147.49, 12.68), 39.33 (265.11, 14.81) pg/g lipid, respectively. The median (maximum, minimum) of toxic equivalence concentrations of PCDD/Fs and PCB were 3.94 (9.24, 2.69) and 15.95 (26.64, 9.28) pg TEQ/g lipid. PBDE, the proportion of PBDE, PCB and PCDD/Fs in cord blood was 50.41%, 49.25% and 0.34%, respectively. PCBs and PBDEs were positively correlated (r=0.733, P=0.039). Conclusion The high concentrations of PCDD/Fs, PCB, and PBDE were detected in the e-waste dismantling area. It is recommended that the risk of such substances on the health of local people should be assessed in a timely manner.

Increasing e-waste has become a major problem for global environment and public health. In the process of dismantling and recycling of disordered electronic waste, heavy metals such as lead and brominated flame retardants and organic substances are released into environmental media such as air, soil, dust and water, which is harmful to the health of local residents. Taking an e-waste dismantling area in Guangdong Province as an example, this paper reviews exposure levels of heavy metals and organic matters in e-waste recycling areas in China, as well as the health effects of local residents. Previous studies have found that e-waste recycling activities led to serious environmental pollution and high exposure levels of heavy metals and organic matters in local residents, which has a certain impact on the physiological functions of various human systems. The establishment of a centralized dismantling zone can effectively reduce the load level of various pollutants.

Objective To explore the value of post processing technique of dual source CT in diagnosing peripheral PE.Methods One hundred and fifty patients with suspected PE were underwent dual source CT scan,and 20 of the all patients met the criterion. The raw CT data were reconstructed by the pulmonary embolism detection (PED)software,double energy perfusion imaging (DEPI)and CT pulmonary artery angiography (CTPA).The PED,DEPI and CTPA map were analyzed by 2 senior doctors in cardiovascular diagnosis profession.According to the diagnosis standard of PE,the location,number of the emboli in segmental and sub-segmental pulmonary arteries were respectively recorded on the PED and DEPI map.We calculated the detection rate,evaluated the significant difference and evaluated the diagnosis consistency between the DEPI and CTPA map.Results Emboli were found in 30 segmental and 40 sub-segmental arteries on the CTPA map with the detection rate of 7.50% and 5.00%,respectively.Emboli were found in 48 segmental and 62 sub-segmental arteries on PED map with the detection rate of 12.00% and 7.75%,respectively.There was significant difference between the CTPA and PED map (χ2 =4.60,5.06,P<0.05).The DEPI and PED map had higher consistency in diagnosing PE.The Kappa coefficient was 0.94 if the PED map was regarded as the reference standard,Among 48 cases with segmental PE detected by the PED map,there were 13 cases of complete filling defects and 35 cases of partial filling defects.Among 13 cases of complete filling defects,there were perfusion defect in 10, and perfusion thin in 3 on the DEPI map.Among 35 cases of partial filling defects,there were perfusion defect in 2,perfusion thin in 29,and perfusion normal in 4 on the DEPI map.Conclusion The PED map combined the DEPI map of dual source CT can significantly improve the diagnosis rate of peripheral PE and has a high clinical value.

Objective To explore the effect of α-phenyl-N-tert-butylinitrone (PBN) on expression of nerve growth factor (NGF) in serum and spinal cord tissue in rats after spinal cord injury (SCI). Methods 174 female Sprague-Dawley rats were randomly assigned to following groups: normal control group (n=54), normal saline control group (NS group, n=60, intrathecally injected normal saline 15 μl), and PBN group (n=60, intrathecally injected PBN, 3 mg, 15 μl). The model was established with New York University blow device (150 kDyne, 1 s dwell time). PBN was intrathecally injected into the damaged areas 30 min after operation, then once a day for 7 days. The Basso-Beattie-Bresnahan (BBB) Locomotor Rating Scale was used to assess the rats 3 days and 1 day before, and 1 day, 5 days, 10 days, 15 days, 20 days,25 days, 30 days and 35 days after SCI. NGF in the injured spinal cord tissue and serum was measured 1 h, 12 h, 24 h, 48 h, 3 days, 7 days,14 days and 21 days after SCI. Results NGF increased in serum but not in spinal cord. The ratio of NGF/total protein in serum rose and peaked 48 h after SCI, and the ratio was higher in NS group (0.92%±0.02%) than in PBN group (0.77%±0.05%) (P=0.021). BBB scores increased from the 9th day, and PBN group improved better than NS group (P<0.01). Conclusion PBN could reduce the expression of NGF in the SCI rats, and promote the recovery of neurol function.

The lipase labeled with the fluorescein isothiocyanat (FITC) was immobilized on the derivatives of the polyethylene glycol. The article discussed the effect of factors on the characters of lipase and analyzed the relationships among the activity of lipase, conformation, and fluorescence spectrum while the activity and the fluorescence spectrum of immobilized lipase were determined. The results demonstrated that polyethylene glycol 400-diacrylate could form appropriate network to improve the activity of enzyme. Adding ligand induced the lipase's catalytic conformation to increase the activity twice more than before. The active centre of lipase could be released by the extraction of ligand thus increasing the activity. After immobilization, the stability of labeled lipase improved greatly: immobilized lipases retained more than 70% and 60% of initial activity under conditions of 90 degrees C and strong acid or alkali, respectively. After immersing immobilized lipases into guanidine hydrochloride or urea for 15 days, the lipases retained upwards of 70% activity. The fluorescence spectrum could obviously reflect the changes of the activity and conformation of lipase. The fluorescence intensity was the minimum in the optimal pH and temperature. In the denaturing agent it declined as time passed. These results indicated that the unfolded processes of immobilized lipases are different under different conditions.
Dextrans ; chemistry ; Enzyme Stability ; Enzymes, Immobilized ; chemistry ; metabolism ; Fluorescein-5-isothiocyanate ; analogs & derivatives ; chemistry ; Fluorescent Dyes ; chemistry ; Lipase ; chemistry ; metabolism ; Polyethylene Glycols ; chemistry ; Protein Unfolding ; drug effects

Present studies have proved that tumor in-situ is infiltrated with plenty of macrophages (M?), M? may contribute up to or more than half of a tumor’s mass. It’s frustrated that as the main component of immune system, M? promote the tumor growth, and create a suitable microcircumstance to promote the progression of tumor as well. The furtherknowledge of the mechanism mentioned focusing on finding the new way to anti-tumor clinical research were reviewed.

Tissue plasminogen activator(tPA) had been used clinically as a choice drug for the therapy of ischemic shock.Evidence in animal experiments suggests that tPA may play a neurotoxic role in central nervous system(CNS) via the induction of microglial activation,degradation of laminin matrix and enhancement of the N-methyl-D-aspartate(NMDA) receptor-mediated signaling in neurons,other reports imply tPA could protect rat neuronal cells from zinc-induced toxicity.