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.

AIM: To explore the impact of myopia severity in adolescents on the vascular density in the optic disc area and macular thickness, as well as their correlationship.METHODS: Cross-sectional study. A total of 106 cases(176 eyes)of adolescent myopia patients who chose Shanghai Zhongye Hospital for treatment were selected as the research subjects. They were divided into three groups according to the spherical equivalent(SE): low myopia, moderate myopia and high myopia. The vascular density in the optic disc area, macular thickness and microperimetry-related indicators of the three groups were compared. The correlation of the vascular density in the optic disc area with macular thickness was analyzed, as well as the mediating role of the two in SE with the average macular light sensitivity(MLS)of the retina.RESULTS: The baseline characteristics of the three groups of patients were comparable. With the increase of myopia degree, SE, the vessel density in all directions and the average vascular density of the optic disc area, the thickness of all regions of the macular area except the fovea, and the related indicators of microperimetry all decreased significantly, while the axial length and the thickness of the macular fovea increased significantly(all P<0.05). The generalized additive model showed that the vascular density in all directions and the average vascular density of the optic disc area, and the thickness of all regions of the macular area except the fovea had a negative impact on the degree of myopia, while the thickness of the macular fovea had a positive impact(all P<0.05). Pearson correlation analysis indicated that the vascular density of the optic disc area negatively correlated with the thickness of the macular fovea, and positively correlated with the thickness of other regions of the macula(all P<0.05). The mediation effect analysis showed that the thickness of all regions of the macula and the vascular density of some areas of the optic disc area had a significant mediating regulatory effect between SE and the overall MLS(all P<0.001).CONCLUSION: With the increase of myopia degree, the vascular density in the optic disc area and the thickness of all regions of the macula except the fovea decrease, while the thickness of the macular fovea increases; the vascular density in the optic disc area negatively correlated with the thickness of the macular fovea, and positively correlated with the thickness of other regions; the thickness of the macula and the vascular density in the optic disc area play a significant mediating role between SE and MLS.

Objective To analyze the characteristic influencing factors for enlarged perivascular spaces(EPVS)in different regions of acute ischemic stroke(AIS)patients and explore their un-derlying pathogenesis.Methods A total of 172 AIS patients admitted to our department from September 2020 to September 2023 were consecutively enrolled.According to the distribution of EPVS,they were divided into basal ganglia EPVS group(n=103)and non-basal ganglia EPVS group(n=69),as well as centrum semiovale EPVS group(n=77)and non-centrum semiovale EPVS group(n=95).General information,NIHSS score at onset,TOAST classification,fasting blood glucose,liver function,coagulation function,and homocysteine(Hcy)level were collected in all the patients.Multivariate logistic regression analysis was used to identify independent influen-cing factors for EPVS in different regions.Results The basal ganglia EPVS group had significant-ly advanced age and larger proportion of hypertension than the non-basal ganglia EPVS group,while the centrum semiovale EPVS group had smaller proportion of hyperhomocysteinemia,and larger ratios of smoking and alcohol consumption,higher alanine aminotransferase(ALT)level,and longer thrombin time than the non-centrum semiovale EPVS group(P＜0.05,P＜0.01).Mul-tivariate logistic regression analysis showed that hypertension(OR=2.093,95％CI:1.045-4.192,P=0.037)and age(OR=1.071,95％CI:1.016-1.130,P=0.011)were independent influ-encing factors for basal ganglia EPVS,while alcohol consumption(OR=2.418,95％CI:1.097-5.330,P=0.029)and thrombin time(OR=1.593,95％CI:1.129-2.249,P=0.008)were inde-pendent influencing factors for centrum semiovale EPVS.Conclusion EPVS in different regions of AIS patients are associated with distinct risk factors.Age and hypertension are primary influen-cing factors for basal ganglia EPVS,while alcohol consumption and prolonged thrombin time are significant factors for centrum semiovale EPVS.

Objective To analyze the characteristic influencing factors for enlarged perivascular spaces(EPVS)in different regions of acute ischemic stroke(AIS)patients and explore their un-derlying pathogenesis.Methods A total of 172 AIS patients admitted to our department from September 2020 to September 2023 were consecutively enrolled.According to the distribution of EPVS,they were divided into basal ganglia EPVS group(n=103)and non-basal ganglia EPVS group(n=69),as well as centrum semiovale EPVS group(n=77)and non-centrum semiovale EPVS group(n=95).General information,NIHSS score at onset,TOAST classification,fasting blood glucose,liver function,coagulation function,and homocysteine(Hcy)level were collected in all the patients.Multivariate logistic regression analysis was used to identify independent influen-cing factors for EPVS in different regions.Results The basal ganglia EPVS group had significant-ly advanced age and larger proportion of hypertension than the non-basal ganglia EPVS group,while the centrum semiovale EPVS group had smaller proportion of hyperhomocysteinemia,and larger ratios of smoking and alcohol consumption,higher alanine aminotransferase(ALT)level,and longer thrombin time than the non-centrum semiovale EPVS group(P＜0.05,P＜0.01).Mul-tivariate logistic regression analysis showed that hypertension(OR=2.093,95％CI:1.045-4.192,P=0.037)and age(OR=1.071,95％CI:1.016-1.130,P=0.011)were independent influ-encing factors for basal ganglia EPVS,while alcohol consumption(OR=2.418,95％CI:1.097-5.330,P=0.029)and thrombin time(OR=1.593,95％CI:1.129-2.249,P=0.008)were inde-pendent influencing factors for centrum semiovale EPVS.Conclusion EPVS in different regions of AIS patients are associated with distinct risk factors.Age and hypertension are primary influen-cing factors for basal ganglia EPVS,while alcohol consumption and prolonged thrombin time are significant factors for centrum semiovale EPVS.

AIM: To explore a more convenient and accurate method for evaluating the anterior chamber angle width based on the Van Herick method.METHODS:A total of 58 patients(69 eyes)with age-related cataract who visited our hospital between January and December 2021 were included. They were divided into the chamber angle width ≥1/2 corneal thickness(CT)group(44 eyes of 37 cases)and <1/2CT group(25 eyes of 21 cases)according to the Van Herick method. The central anterior chamber depths and the peripheral anterior chamber angle degrees were measured by ultrasound biomicroscopy.RESULTS: There were statistically significant differences in central anterior chamber depth between the two groups(2.64±0.27 mm vs. 2.23±0.29 mm, P<0.01), and the differences of chamber angle degrees of quadrants of superior, temporal, inferior and nasal compared between two groups were all statistically significant(P<0.01). The difference of chamber angle degrees of quadrants of superior and inferior in chamber angle width ≥1/2CT group was not statistically significant(P>0.05), while the differences of chamber angle degrees of other quadrants were all statistically significant(P<0.05). The differences of chamber angle degrees of quadrants of superior and nasal, temporal and the chamber angle degrees of quadrants of inferior and temporal were all statistically significant in chamber angle width <1/2CT group(P<0.05).CONCLUSION: In the overall evaluation of the anterior chamber angle, it would be more simple, fast and accurate when evaluating the temporal chamber angle width and inferior quadrant of chamber angle width by using the Van Herick method under silt lamp.

Objective: Investigation on the quality control method of bacterial endotoxin in betahistine hydrochloride injection.
Methods: The method of bacterial endotoxin gel test of 23 batches of betahistine hydrochloride injection from 5 manufacturers was studied.
Results: The limit value of endotoxin in this product was 3 EU·mg^-1, which was suitable for the bacterial endotoxin test of China Pharmacopoeia 2020.
Conclusion: The quality of betahistine hydrochloride injection can be controlled by bacterial endotoxin test, and the limit of bacterial endotoxin can be set as follows: the content of endotoxin in every 1mg of betahistine hydrochloride should not exceed 3 EU.

Objective:To investigate the role of lateral spread response (LSR) of the facial nerves in distinguishing primary hemifacial spasm (HFS), HFS caused by facial palsy and Meige syndrome, and explore the relationship between LSR presence or absence before microvascular decompression (MVD) and MVD efficacy in patients with primary HFS.Methods:A retrospective analysis was performed; 127 patients with HFS, including primary HFS ( n=86), HFS caused by facial palsy ( n=27) and Meige syndrome ( n=14), were enrolled in Department of Neurology, Zhongshan Hospital, Fudan University from November 2021 to July 2023. All patients underwent needle electrode electromyography in the lateral facial muscles, and tests of motor branch conduction of facial nerves, blinking reflex and LSR; the general data, myokymia incidence, latency of facial nerves, abnormal rate and R1 amplitude of blinking reflex, and LSR detection rate and latency were compared among the 3 groups. Spearman correlation was used to analyze the correlation between course of primary HFS and LSR presence or absence. For patients with primary HFS accepted MVD, MVD efficacy was evaluated according to Shorr efficacy evaluation criteria 1 month after procedure, and efficacy differences between patients with LSR presence and LSR absence were compared. Results:(1) Compared with the Meige syndrome group, the group of HFS caused by facial palsy had significantly younger age, and the group of HFS caused by facial palsy and primary HFS group had statistically higher incidence of left side lesions ( P<0.05). The latency of facial nerves in group of HFS caused by facial palsy ([2.97±0.63] ms) was significantly longer than that in the primary HFS group ([2.46±0.59] ms) and Meige syndrome group ([2.53±0.62] ms, P<0.05). The abnormal rate of blinking reflex in group of HFS caused by facial palsy (59.26%) was significantly higher than that in primary HFS group (23.26%) and Meige syndrome group (21.43%, P<0.05). The LSR detection rate in primary HSF group (48.84%) was statistically higher than that in group of HFS caused by facial palsy (37.04%) and Meige syndrome group (7.14%, P<0.05). The LSR latency in group of HFS caused by facial palsy (12.30[12.30, 13.80] ms) was significantly longer than that in the primary HFS group (11.20[9.73, 11.20] ms, P<0.05). (2) No significant correlation was noted between course of primary HFS and LSR presence or absence ( rs=0.051, P=0.640). (3) In 33 patients with primary HFS accepted MVD, no significant difference in MVD efficacy was noted between patients with LSR presence ( n=22) and those with LSR absence ( n=11, P>0.05). Conclusion:In patients with LSR presence and long latency of facial nerves and LSR, HFS caused by facial palsy should be considered; preoperative LSR can not predict the MVD efficacy in patients with primary HFS.

Objective:To explore the efficacy of magnetic resonance imaging (MRI) and X-ray computed tomography (CT) examinations based on blood perfusion and metabolic status in the assessment of cerebrovascular disease of the elderly. Methods:A total of 92 elderly patients with suspected cerebrovascular disease admitted to Shandong Electric Power Center Hospital from March 2021 to March 2023 were selected. All patients were examined by using MRI and CT based on blood flow perfusion and metabolic status in order to detect cerebral blood flow (CBF),cerebral blood volume (CBV),time to peak (TTP),mean transit time (MTT),as well as glucose metabolism rate (CMRGluc),cerebral oxygen metabolism rate (CMRO2),and oxygen extraction fraction (OEF). Using a four grid table to analyze the efficacy of two examination methods in diagnosing cerebrovascular disease of elderly. Results:Both the perfusion CT and MRI images of cerebral blood flow on axial direction showed reduction,however,the CT showed a greater reduction in CBF and CBV on the affected side,and a greater increase in TTP and MTT on the affected side,and the differences of these indicators on the affected side between CT and MRI were significant (t=26.485,15.404,1.599,3.341,P<0.05),respectively. Both CT and MRI showed cerebral metabolic rate parameters on the affected side decreased,however,CT showed a greater decrease in CMRGluc,CMRO2 and OEF on the affected side,and the differences were statistically significant (t=3.390,2.710,2.996,P<0.05),respectively. The numbers of cases with true positive of CT and MRI were respectively 88 cases and 80 cases in diagnosing cerebrovascular disease of elderly,and the numbers of cases with true negative of them were respectively 2 cases and 1 case. The numbers of cases with false positive of them were respectively 1 case and 4 cases,and the numbers of cases with false negative were respectively 1 case and 5 cases. There was no significant difference in the diagnostic accuracy between CT examination and MRI examination (P>0.05). Conclusion:MRI has a higher sensitivity in detecting the subtle structure and function of brain,but the visualization of MRI on blood vessels is less clear than that of CT. The cerebrovascular disease of elderly patients still need CT and MRI results to make a more accurate diagnosis.

Objective:To explore the efficacy of magnetic resonance imaging (MRI) and X-ray computed tomography (CT) examinations based on blood perfusion and metabolic status in the assessment of cerebrovascular disease of the elderly. Methods:A total of 92 elderly patients with suspected cerebrovascular disease admitted to Shandong Electric Power Center Hospital from March 2021 to March 2023 were selected. All patients were examined by using MRI and CT based on blood flow perfusion and metabolic status in order to detect cerebral blood flow (CBF),cerebral blood volume (CBV),time to peak (TTP),mean transit time (MTT),as well as glucose metabolism rate (CMRGluc),cerebral oxygen metabolism rate (CMRO2),and oxygen extraction fraction (OEF). Using a four grid table to analyze the efficacy of two examination methods in diagnosing cerebrovascular disease of elderly. Results:Both the perfusion CT and MRI images of cerebral blood flow on axial direction showed reduction,however,the CT showed a greater reduction in CBF and CBV on the affected side,and a greater increase in TTP and MTT on the affected side,and the differences of these indicators on the affected side between CT and MRI were significant (t=26.485,15.404,1.599,3.341,P<0.05),respectively. Both CT and MRI showed cerebral metabolic rate parameters on the affected side decreased,however,CT showed a greater decrease in CMRGluc,CMRO2 and OEF on the affected side,and the differences were statistically significant (t=3.390,2.710,2.996,P<0.05),respectively. The numbers of cases with true positive of CT and MRI were respectively 88 cases and 80 cases in diagnosing cerebrovascular disease of elderly,and the numbers of cases with true negative of them were respectively 2 cases and 1 case. The numbers of cases with false positive of them were respectively 1 case and 4 cases,and the numbers of cases with false negative were respectively 1 case and 5 cases. There was no significant difference in the diagnostic accuracy between CT examination and MRI examination (P>0.05). Conclusion:MRI has a higher sensitivity in detecting the subtle structure and function of brain,but the visualization of MRI on blood vessels is less clear than that of CT. The cerebrovascular disease of elderly patients still need CT and MRI results to make a more accurate diagnosis.

Objective:To investigate the role of lateral spread response (LSR) of the facial nerves in distinguishing primary hemifacial spasm (HFS), HFS caused by facial palsy and Meige syndrome, and explore the relationship between LSR presence or absence before microvascular decompression (MVD) and MVD efficacy in patients with primary HFS.Methods:A retrospective analysis was performed; 127 patients with HFS, including primary HFS ( n=86), HFS caused by facial palsy ( n=27) and Meige syndrome ( n=14), were enrolled in Department of Neurology, Zhongshan Hospital, Fudan University from November 2021 to July 2023. All patients underwent needle electrode electromyography in the lateral facial muscles, and tests of motor branch conduction of facial nerves, blinking reflex and LSR; the general data, myokymia incidence, latency of facial nerves, abnormal rate and R1 amplitude of blinking reflex, and LSR detection rate and latency were compared among the 3 groups. Spearman correlation was used to analyze the correlation between course of primary HFS and LSR presence or absence. For patients with primary HFS accepted MVD, MVD efficacy was evaluated according to Shorr efficacy evaluation criteria 1 month after procedure, and efficacy differences between patients with LSR presence and LSR absence were compared. Results:(1) Compared with the Meige syndrome group, the group of HFS caused by facial palsy had significantly younger age, and the group of HFS caused by facial palsy and primary HFS group had statistically higher incidence of left side lesions ( P<0.05). The latency of facial nerves in group of HFS caused by facial palsy ([2.97±0.63] ms) was significantly longer than that in the primary HFS group ([2.46±0.59] ms) and Meige syndrome group ([2.53±0.62] ms, P<0.05). The abnormal rate of blinking reflex in group of HFS caused by facial palsy (59.26%) was significantly higher than that in primary HFS group (23.26%) and Meige syndrome group (21.43%, P<0.05). The LSR detection rate in primary HSF group (48.84%) was statistically higher than that in group of HFS caused by facial palsy (37.04%) and Meige syndrome group (7.14%, P<0.05). The LSR latency in group of HFS caused by facial palsy (12.30[12.30, 13.80] ms) was significantly longer than that in the primary HFS group (11.20[9.73, 11.20] ms, P<0.05). (2) No significant correlation was noted between course of primary HFS and LSR presence or absence ( rs=0.051, P=0.640). (3) In 33 patients with primary HFS accepted MVD, no significant difference in MVD efficacy was noted between patients with LSR presence ( n=22) and those with LSR absence ( n=11, P>0.05). Conclusion:In patients with LSR presence and long latency of facial nerves and LSR, HFS caused by facial palsy should be considered; preoperative LSR can not predict the MVD efficacy in patients with primary HFS.