As a major category of occupational hazards in China, physical factors are widely distributed in various industries and affect a large number of workers. The list and diagnostic criteria of occupational diseases caused by physical factors are important basis for occupational disease diagnosis and protection of occupational health rights and interests for occupational populations. This article compares the differences in the list of occupational diseases caused by physical factors at home and abroad, analyzes the problems in the current list of occupational diseases caused by physical factors and related diagnostic standards in China, and puts forward relevant suggestions for further adjusting the list of occupational diseases caused by physical factors, formulating and revising relevant diagnostic standards for occupational diseases, providing reference for improving the classification and catalogue of occupational diseases in China in the future.

Exosomes, as crucial mediators of intercellular communication, exhibit a wide range of biological functions in the onset and treatment of atherosclerosis (AS). Recent studies have indicated that exosomes can carry various active substances, including miRNA, lncRNA, proteins, and lipids. By regulating inflammatory responses, lipid metabolism, vascular endothelial function, and the immune microenvironment, they mediate the formation, progression, and reversal of AS at multiple levels. Specifically, miRNAs within exosomes can target and regulate the expression of inflammatory factors, inhibiting macrophage activation and foam cell formation. Meanwhile, exosomes derived from endothelial cells (EC) or stem cells can enhance vascular endothelial integrity and suppress endothelial dysfunction (ED). Furthermore, exosomes have been extensively explored as natural carriers for delivering drugs and nucleic acid molecules. Their membrane structure possesses excellent biocompatibility and targeting capabilities, showcasing significant potential as a novel therapeutic tool. Starting from basic mechanistic studies, this article summarizes the molecular pathways and key biological effects of exosomes in AS intervention, and further explores their current clinical application and multiple challenges they face, aiming to provide theoretical support and research directions for novel cardiovascular disease intervention strategies.

As a major category of occupational hazards in China, physical factors are widely distributed in various industries and affect a large number of workers. The list and diagnostic criteria of occupational diseases caused by physical factors are important basis for occupational disease diagnosis and protection of occupational health rights and interests for occupational populations. This article compares the differences in the list of occupational diseases caused by physical factors at home and abroad, analyzes the problems in the current list of occupational diseases caused by physical factors and related diagnostic standards in China, and puts forward relevant suggestions for further adjusting the list of occupational diseases caused by physical factors, formulating and revising relevant diagnostic standards for occupational diseases, providing reference for improving the classification and catalogue of occupational diseases in China in the future.

The quality management system of occupational diseases diagnosis is belonged to one part of the hospital quality management system. It must be adhered to the quality management concept of comprehensive, full staff and whole process. To establish and improve the quality management system should be included: (1) Formulated a quality management manual for occupational disease diagnosis, including organization construction, rules and regulations, responsibilities, work flow, operating procedures and clinical pathways, standard instrument, etc. (2) Managed the document of occupational diseases diagnosis. (3) The continuous improvement of quality management. The quality management of occupational diseases diagnosis focuses on the mastery and implementation of the manual by employees, which is reflected in the continuous improvement of daily work, internal assessment and external assessment.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder, which is manifested by symptoms such as difficulties in social interaction and communication, stereotypical repetitive behaviors, and narrow areas of interests.At present, the intervention methods for ASD mainly include behavioral intervention, pharmacological intervention, physical intervention, exercise intervention, complementary and alternative medicine intervention.With the progress of science and technology and in-depth research, the intervention methods of ASD will develop in the direction of personalized intervention, deep learning technology, gene therapy and neurofeedback technology.These new intervention methods would hopefully improve the treatment effect and the quality of life of patients.

The quality management system of occupational diseases diagnosis is belonged to one part of the hospital quality management system. It must be adhered to the quality management concept of comprehensive, full staff and whole process. To establish and improve the quality management system should be included: (1) Formulated a quality management manual for occupational disease diagnosis, including organization construction, rules and regulations, responsibilities, work flow, operating procedures and clinical pathways, standard instrument, etc. (2) Managed the document of occupational diseases diagnosis. (3) The continuous improvement of quality management. The quality management of occupational diseases diagnosis focuses on the mastery and implementation of the manual by employees, which is reflected in the continuous improvement of daily work, internal assessment and external assessment.

Functionalized liposomes can improve the in vivo process of drugs to achieve high-efficiency delivery by enhancing drug absorption， changing drug distribution and reducing the elimination， which is one of the hotspots in nanomedicine research with broad application prospects. However， the drug information published by official websites of National Medical Products Administration （NMPA）， the United States Food and Drug Administration （FDA）， and the European Medicines Agency （EMA） shows that there are few liposomal products on the market， and the domestic varieties are mainly generic drugs. Excepting for polyethylene glycolized （PEGylated） liposomes， no other functionalized liposomes have been approved for marketing， which indicates that the clinical translation of functionalized liposomes remains at a low level. Therefore， the relevant reports of functionalized liposomes in recent years were reviewed in this paper， their application advantages and main challenges in preparation research and development were discussed based on the in vivo process， and their low clinical translation mainly because of the insufficient clinical thinking， safety and efficacy of functional materials， inaccurate in vitro and in vivo analysis methods and difficulty in scaling up production. Meanwhile， the possible strategies such as introducing the concept of clinical multi-function to improve clinical acuity， focusing on examining the modification density of functional materials and the interaction between the modified materials， evaluating the drug delivery performance of functionalized liposomes from multiple perspectives and scenarios， and conducting cost and convenience-oriented formulation composition and preparation process optimization were proposed in order to provide a reference for the development of functionalized liposomes and other carrier-based nanomedicines.

Background Healthcare workers suffer from great internal and external pressure and are prone to burnout. Existing studies have shown that depressive symptoms are important influencing factors of burnout, both of which are closely related to job stress. Objective To analyze overall prevalence of burnout among healthcare workers using a new survey tool developed by our team, and to reveal potential influencing factors related to burnout. Methods A cross-sectional multi-center study was conducted in August–October 2019 and June–September 2020, using multi-stage stratified cluster sampling. A total of 8738 healthcare workers from 22 hospitals in 5 provinces (Shandong, Hubei, Hunan, Guangdong, and Chongqing) of China were selected in this study. A set of survey questionnaires, including the general information questionnaire and the Chinese versions of General Burnout Scale, Core Occupational Stress Scale, Patient Health Questionnaire-9, and Self-administered Sleep Questionnaire were distributed. Independent samples t-test or one-way ANOVA were employed for inter-group comparison of burnout. Spearman correlation was used to evaluate correlations among burnout, depressive symptoms, and occupational stress. Stepwise linear regression was conducted to identify factors independently associated with burnout. Process plug-in was used to test potential mediating effect of depressive symptoms on occupational stress and burnout. Results Of the 8738 questionnaires distributed, 8456 valid questionnaires were collected, and the recovery rate was 96.77%. Among the 8456 healthcare workers, the prevalence of burnout was 58.0%, that of occupational stress was 31.8%, and that of depressive symptoms was 31.0%. Among those with depressive symptoms and occupational stress, the proportions of burnout were 86.7% and 83.7%, respectively. According to the stepwise linear regression analysis, depressive symptoms, occupational stress, work experience, drinking, and marital status were all independent influencing factors of burnout. Especially, depressive symptoms, social support, and organization and reward had significant influences on burnout (b'=0.455, −0.183, 0.220, P<0.001). Depressive symptoms showed mediating effects on occupational stress (and its subscales) and burnout, and the contribution rates of the mediating effects were 41.00%, 47.02%, 43.44%, 56.62%, and 59.45%, respectively. Conclusion Burnout is a prominent problem among healthcare workers in the 5 provinces, with the prevalence of 58.0%. And nearly 1/3 suffering from depressive symptoms and occupational stress, which has a great impact on burnout.

Objective:To investigate clinical and histopathological features and differential diagnostic considerations of mucoepidermoid carcinoma (MEC) .Methods:A retrospective study was carried out on clinical manifestations, histopathological and immunohistochemical features, treatment and prognosis of 8 patients with MEC, who were collected from Department of Pathology, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College during 2018 - 2021.Results:Among the 8 patients, 5 were males and 3 were females, and their age at onset ranged from 19 to 67 years. Skin lesions were located on the lip mucosa in 5 cases, on the cheek in 2 cases, and on the nose in 1 case. Tumors were all located in the dermis and subcutaneous tissue, parts of which were connected to the epidermis; different proportions of mucous cells, epidermoid cells and intermediate cells were arranged in nests or clumps, and formed solid or cystic structures accompanied by varying degrees of formation of ducts and mucus lakes; all epidermoid cells and intermediate cells expressed cytokeratins AE1/AE3, CK5/6, P63, carcinoembryonic antigen and epithelial membrane antigen. According to the current Chinese grading system, 1 of the 8 patients was diagnosed with intermediate-grade MEC, and others were diagnosed with low-grade MEC. No abnormalities were found by systemic examination. All patients received surgical resections. After the follow-up of 12 - 36 months, no recurrence or distant metastasis was observed.Conclusion:MEC presents no characteristic clinical manifestations, its diagnosis mainly depends on histopathological features, and mucus in the cytoplasm of mucous cells as shown by alcian blue staining is specific for MEC.

To project the basis of occupational health examination quality assessment, and put forward advices for cheking: the quality and safety of occupational health examination, assessment requirements, the key points on-site, utilization of the quality assessment results. Total quality control (TQC) contains basic quality, link quality, final quality and front, middle, back of the quality in occupational health examination.