" Mutual recognition and sharing of medical examination and test results in Zhejiang Province" (MRZJ) holds significant value in rationally utilizing healthcare resources, reducing patient costs, streamlining treatment procedures, and enhancing patient satisfaction. This study reviewed the development of medical test result mutual recognition in China and summarized the implementation of MRZJ at Zhejiang Provincial People′s Hospital. Since its launched in October 2021, the hospital had achieved interoperability through enhanced organizational leadership, standardized coding, process optimization, capacity building, quality control reinforcement, and public awareness campaigns. By March 2024, MRZJ covered all outpatient departments of the pilot hospital, with 936 items recognized daily, improving healthcare efficiency and generating notable social and economic benefits. These outcomes provided references for advancing nationwide medical test mutual recognition. Future efforts should focused on strengthening standardized training, refining performance evaluation mechanisms, developing MRZJ early warning functions, and safeguarding patients′ informed consent and choice rights.

" Mutual recognition and sharing of medical examination and test results in Zhejiang Province" (MRZJ) holds significant value in rationally utilizing healthcare resources, reducing patient costs, streamlining treatment procedures, and enhancing patient satisfaction. This study reviewed the development of medical test result mutual recognition in China and summarized the implementation of MRZJ at Zhejiang Provincial People′s Hospital. Since its launched in October 2021, the hospital had achieved interoperability through enhanced organizational leadership, standardized coding, process optimization, capacity building, quality control reinforcement, and public awareness campaigns. By March 2024, MRZJ covered all outpatient departments of the pilot hospital, with 936 items recognized daily, improving healthcare efficiency and generating notable social and economic benefits. These outcomes provided references for advancing nationwide medical test mutual recognition. Future efforts should focused on strengthening standardized training, refining performance evaluation mechanisms, developing MRZJ early warning functions, and safeguarding patients′ informed consent and choice rights.

Objective:To evaluate the risk of major chemical exposure positions in copper and nickel smelting enterprises, and provide a basis for risk assessment and prevention control measures.Methods:From September to October 2023, two copper nickel ore smelting enterprises in Xinjiang Uygur Autonomous Region were selected as the research objects. Relevant information on chemicals was collected through occupational hazard field investigations. Qualitative analysis and exposure index methods were used in GBZ/T 298-2017 "Technical Guidelines for Occupational Health Risk Assessment of Chemical Hazardous Factors in the Workplace" to conduct risk assessments on the main chemical exposure positions. The qualitative risk assessment results were checked for consistency using the Weighted Kappa coefficient.Results:The positions with high risk of exposure to hazardous chemicals in copper nickel smelting enterprises are saponification positions exposed to hydrochloric acid in refining processes, black nickel positions exposed to sodium hydroxide, and tail suction positions. The consistency between the two occupational health risk assessment results is poor (Kappa=0.14) .Conclusion:The amount of major hazardous chemicals in copper-nickel smelting enterprises is large, and the occupational health risks caused by exposure are complex and diverse, so the effects of chronic occupational health should be strengthened.

Objective:To evaluate the risk of major chemical exposure positions in copper and nickel smelting enterprises, and provide a basis for risk assessment and prevention control measures.Methods:From September to October 2023, two copper nickel ore smelting enterprises in Xinjiang Uygur Autonomous Region were selected as the research objects. Relevant information on chemicals was collected through occupational hazard field investigations. Qualitative analysis and exposure index methods were used in GBZ/T 298-2017 "Technical Guidelines for Occupational Health Risk Assessment of Chemical Hazardous Factors in the Workplace" to conduct risk assessments on the main chemical exposure positions. The qualitative risk assessment results were checked for consistency using the Weighted Kappa coefficient.Results:The positions with high risk of exposure to hazardous chemicals in copper nickel smelting enterprises are saponification positions exposed to hydrochloric acid in refining processes, black nickel positions exposed to sodium hydroxide, and tail suction positions. The consistency between the two occupational health risk assessment results is poor (Kappa=0.14) .Conclusion:The amount of major hazardous chemicals in copper-nickel smelting enterprises is large, and the occupational health risks caused by exposure are complex and diverse, so the effects of chronic occupational health should be strengthened.

Objective:To identify the feasibility of inferior vena cava variability (ΔDIVC) combined with rectus femoris atrophy fraction in predicting the outcome of weaning from invasive mechanical ventilation (IMV).Methods:From January to December 2021, the patients with the need for IMV admitted to the Affiliated Yixing Hospital of Jiangsu University were recruited into prospective case-control study. The patients who met the withdrawal criteria were treated with a 2-h spontaneous breathing trial (SBT) and then extubated immediately. Patients with stable spontaneous breathing after extubation for more than 48 h were classified as successful weaning group, and on the contrary, the other patients were classified as failed weaning group. The clinical data and withdrawal indexes of the two groups were evaluated. The correlation between ΔD IVC and rectus femoris atrophy fraction was assessed. The influencing factors of weaning outcome were observed. The diagnostic value of ΔD IVC, rectus femoris atrophy fraction and the combination of two indexes in predicting weaning success were calculated by a plotting receiver operating characteristic (ROC) curve. Results:Sixty IMV patients were included in this study, including 38 cases of successful weaning and 22 cases of failed weaning. The two groups were comparable with regard to clinical data (all P>0.05). The rectus femoris cross-sectional area in the two groups diminished gradually with the length of ICU stay ( F=3.266, 3.625, both P<0.05). The rectus femoris cross-sectional area at the first SBT was significantly lower than that on the first day of admission in both groups [the successful weaning group: (2.54±0.88) cm 2vs. (3.08±0.98) cm 2; the failed weaning group: (2.22±0.87) cm 2vs. (3.02±1.10) cm 2, both P<0.05], but there was no significant difference between the two groups (all P>0.05). Patients in the successful weaning group had higher ΔD IVC and higher rectus femoris atrophy fraction than those in the weaning failure group [ΔD IVC: (25.02±4.65)% vs. (20.30±3.16)%; rectus femoris atrophy fraction: (81.89±5.09)% vs. (72.68±8.98)%, both P<0.05]. There was a positive correlation between ΔD IVC and rectus femoris atrophy fraction ( r=0.346, P=0.007). Both ΔD IVC and rectus femoris atrophy fraction played an important role in affecting weaning success (all P<0.05). The area under the curve (AUC) of ΔD IVC combined with rectus femoris atrophy fraction for predicting the weaning success was 0.880, which was significantly higher than that of ΔD IVC (AUC=0.791) or rectus femoris atrophy fraction (AUC=0.826). Conclusions:The predictive value of ΔD IVC combined with rectus femoris atrophy fraction for successful weaning of patients undergoing IMV is relatively accurate, which can be used to guide weaning.

OBJECTIVEThe relationship between occlusion and temporomandibular disorders (TMD) remains disputed. The related epidemiological studies have been carried out focused on the occlusal characteristics in motion, for example in protrusion, retrusion or laterally extension and on some of malocclusion features. Very few studies were carried out on the intercuspal occlusion which is the most important occlusal relationship. Angle's classification of occlusion and the relationship of over-jet and over-bite are two prominent features now generally used in clinical practice for occlusal evaluation. In present study two kinds of features of occlusion were compared among TMD patients, malocclusion patients and university student volunteers, who of the laters represented nature population.

METHODS100 continued cases visiting our TMD Clinic during the year of 2 000 with complain of TMD problem, 100 malocclusion patients in continued orthodontic department records, and 268 university student volunteers were included. All subjects were with complete dentitions, except of age-related third or second molar tooth eruption difference. Study cast were obtained for all 468 subjects involved and following characters were studied. 1. Angle's classification; 2. Over-jet and over-bite relationship. Anteriorly it included cross-bite, cusp-to cusp bite, deep over-bite (without deep over-jet), deep over-jet (with or without deep-bite), open bite, and others. Posteriorly it included cross-bite, reverse cross-bite and others. 3. Abnormal occlusal index: For the purpose of quantitatively comparing the abnormal occlusal relationship of over-bite and over-jet, the occlusal index was introduced. The anterior continued abnormal was scored as 3 while posterior continued oclcusal abnormal scored as 5. The sum of the scores in the same subject was taken as his abnormal occlusion index.

RESULTS1. Ratio of Angle's I patients in malocclusion group was significantly lower than those in TMD group and US group (P < 0.05), while the later two groups had no difference (P > 0.05). 2. The ratios of anterior cross-bite and deep over-jet were higher in malocclusion group than those in other two groups. No significant difference for the other kinds of abnormal over-jet and over-bite relationship were found among the three groups. 3. The abnormal occlusion index of malocclusion group was higher than that of US group, but not than that of TMD group which had no difference with US group either.

CONCLUSIONS1. Aesthetic related anterior abnormal occlusion such as anterior cross-bite and deep-over-jet attract more attention of popular. But they had no relationship with TMD. 2. TMD patients had not significant occlusal features on Angle's classification and over-jet and over-bite relationship compared to malocclusion and nature population subjects.

Dental Occlusion ; Humans ; Malocclusion ; epidemiology ; Students ; Temporomandibular Joint Disorders ; Universities

砄bjectire: To investigate whether the disturbed occlusion can induce TMJ degeneration. Methods: 2 Rhesus female monkeys, 1 served as experimental animal and the other as the control, were included. Right mandibular first molar and left maxillary first molar of the experimental animal were extracted. Small strings were set at the missing space to pull the neighbor teeth inclined into the space and to occlude with opposite teeth in convex to convex relation. 8 months later condyles and discs of both animals were surgically obtained and prepared for scanning electron microscopy examination. Results: Gelatin like material was found over the condyle and disc surface of the control animal and obvious rigids were found on its articular surface. On the sagittal section of the condyle cells arranged in lines of each of the three layers of the soft tissue were observed. But on the top of the condyle surface of the experimental animal there was an area from media anterior to lateral posterior where the gelatin like material twisted or even disappeared here and there. There was an area where fibers were exposed. The soft tissue layers were thinner and the cellular layer was discontinued locally. The waves on the surface of middle and posterior part of the disc were disturbed and fossae like changes were found on the inferior surface. Conclusion: TMJ degeneration can be produced by gradually induced occlusal disturbance.