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.

ObjectiveTo investigate the mechanism of action of remifentanil （RMZL） in alleviating lung ischemia-reperfusion injury （LIRI） in rats by inhibiting pyroptosis through modulating hypoxia inducible factor-1α （HIF-1α）/NOD-like receptor thermal protein domain associated protein 3 （NLRP3） pathway. MethodsRats were stochastically assigned into Control group， LIRI group， RMZL low-dose group， RMZL medium-dose group， RMZL high-dose group， and RMZL high-dose+HIF-1α activator dimethyloxallyl glycine （DMOG） group， with 18 rats in each group. Rats in Control group only had their left pulmonary hilum free and did not undergo ischemia-reperfusion treatment. Except for the Control group， LIRI models were constructed in all other groups. Rats in LIRI group were intraperitoneally injected with an equal amount of physiological saline 15 minutes before constructing LIRI model； rats in Control group were intraperitoneally injected with an equal amount of physiological saline 15 minutes before freeing left pulmonary hilum； rats in other groups were intraperitoneally injected with corresponding dose of drug 15 minutes before constructing LIRI model. The wet/dry weight ratio of lungs was calculated. HE staining was used to study lung tissue pathology. Immunofluorescence staining was used to detect the relative fluorescence intensity of gasdermin D （GSDMD） and NLRP3 double positive cells in lung tissue. ELISA was used to detect interleukin-1β and IL-18 in lung tissue. Western blot was used to detect HIF-1α， NLRP3， cysteine-aspartic protease-1 （Cleaved caspase-1）， and gasdermin D-N （GSDMD-N） proteins in lung tissue. ResultsCompared to the Control group， the LIRI group showed disordered alveolar structure， thickened alveolar septa， and abundant inflammatory cell infiltration in rats. The lung wet/dry weight ratio， relative fluorescence intensity of GSDMD and NLRP3 double positive cells in lung tissue， IL-1β， IL-18 levels， and HIF-1α， NLRP3， Cleaved caspase-1， and GSDMD-N proteins increased （P0.05）. For the LIRI group， rats in the RMZL low， medium， and high-dose groups displayed attenuated alveolar septal thickening and reduced inflammatory cell infiltration. The lung wet/dry weight ratio， relative fluorescence intensity of GSDMD and NLRP3 double positive cells in lung tissue， IL-1β， IL-18 levels， and HIF-1α， NLRP3， Cleaved caspase-1， and GSDMD-N proteins declined， and the RMZL high-dose group showed the most prominent trend （P0.05）. Compared with the RMZL high-dose group， rats in the RMZL high-dose+DMOG group exhibited thickened alveolar septa and more inflammatory cell infiltration， along with increased lung wet/dry weight ratio， relative fluorescence intensity of GSDMD and NLRP3 double positive cells in lung tissue， levels of IL-1β and IL-18， and protein expression of HIF-1α， NLRP3， Cleaved caspase-1， and GSDMD-N （P0.05）. ConclusionRMZL may inhibit pyroptosis in LIRI rats by suppressing HIF-1α/NLRP3 pathway.

Objective This study aims to explore the impact of changes in psychological status on non-suicidal self-inju-ry(NSSI)among junior high school students,in order to provide a theoretical basis for promoting their mental health development and to formulate more effective prevention and intervention measures.Methods A longitudinal study design was employed.Baseline data were collected in 2021(T1)from 652 first-year junior high school students selected through stratified cluster ran-dom sampling from two middle schools in a city.In 2023(T2),585 valid follow-up cases were obtained(effective response rate:89.72％).Chi-square tests,binary logistic regression,and ROC curve analysis were used to examine the effects of dynamic changes in psychological stress,internet addiction,depression,anxiety,and insomnia on NSSI(significance level α=0.05).Results ① Univariate analysis showed that the detection rate of NSSI significantly decreased from 22.05％(129/585)at T1 to 8.55％(50/585)at T2(x2=41.164,P＜0.001),with an average annual decline of 6.75％.Gender differences:the detec-tion rate decreased from 14.68％(43/293)to 5.80％(17/293)in boys(x2=18.577,P＜0.001),and from 29.45％(86/292)to 11.30％(33/292)in girls(x2=5.658,P=0.017),with a narrowing gender gap(T1:14.77％→ T2:5.70％).The NSSI detection rates between boys and girls were statistically significant at both time points(x2=18.577,5.658).② Com-parison between the persistent group and the NSSI-remission group showed that both decreased insomnia severity(OR=3.525,95％CI:1.230-10.105)and increased insomnia severity(OR=5.431,95％CI:1.895-15.570)were associated with an in-creased risk of NSSI persistence or onset(P＜0.01).③ Predictive efficacy:When scores of GAD-7+PHQ-9+ISI all in-creased by≥2 points,AUC=0.709,with a sensitivity of 44.0％-67.7％for predicting NSSI.When PHQ-9+ISI scores both increased by≥2 points,AUC=0.705,with a sensitivity of 50.2％-67.8％.Conclusion This study reveals a high natural re-mission rate of NSSI(82.17％,106/129 in the remission group)during junior high school,but also identifies gender heteroge-neity and persistent risks.Accumulated psychological stress,aggravated internet addiction,and worsened emotional disorders(anxiety/depression)are factors associated with NSSI persistence or onset.Clinical interventions should focus on monitoring dy-namic psychological indicators and early threshold identification.Although these results provide valuable insights,future research is needed to further explore the interaction mechanisms among these factors and how to effectively translate these findings into practical prevention and intervention measures.

Objective To analyze the difference of rotator cuff muscle group fat content by MR proton density fat fraction(PDFF)tech-nology,and to explore the correlation between these variations and the severity grading of supraspinatus tendon injury.Methods Ninety-three patients with supraspinatus tendon injury were retrospectively selected and divided into the tendinitis group(grade Ⅰ),the partial tear group(grade Ⅱ),and the complete tear group(grade Ⅲ).The fat fraction(FF)values of the three groups of rotator cuff mus-cle group were measured using the PDFF technology,and the differences in FF values among the rotator cuff muscle group in the three groups were compared.The risk factors of the grading of supraspinatus tendon injury and the correlation between FF values and the severity grading of supraspinatus tendon injury were analyzed.Results The differences in the FF values of the supraspinatus and infraspinatus muscles among the three groups were statistically significant(P＜0.01).The FF values of both the supraspinatus and infraspinatus muscles were identified as significant factors associated with the severity grading of supraspinatus tendon injury.Further-more,the FF values of the supraspinatus and infraspinatus muscles were positively correlated with the severity grading of supraspina-tus tendon injury(r=0.576,P＜0.01;r=0.510,P＜0.01).Conclusion MR PDFF technology can effectively evaluate the extent of fat infiltration in the rotator cuff muscle group after supraspinatus tendon injury.Specifically,the FF values of the supraspinatus and infraspinatus muscles serve as reliable quantitative indicators for classifying supraspinatus tendon injury.

Objective:To explore the clinical efficacy of pelvic floor biofeedback combined with electroacupuncture therapy in the treatment of chronic pelvic floor pain syndrome (CPPS).Methods:Ninety CPPS patients admitted to the Dongguan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine from August 2022 to July 2023 were selected prospectively, and they were divided into two groups by random number table method, each group with 45 cases. The control group received pelvic floor biofeedback treatment alone, while the observation group received pelvic floor biofeedback combined with electroacupuncture treatment. The two groups were treated once a day, 10 times as a course of treatment. After two courses of treatment, the clinical efficacy, pain degree before and after treatment, inflammatory factor levels, SF-36 health questionnaire (SF-36) scores, pelvic floor surface myoelectric parameters, and incidence of adverse reactions were compared between the two groups.Results:The total effective rate in the observation group after treatment was higher than that in the control group: 95.56% (43/45) vs. 75.56% (34/45), there was statistical difference ( χ2 = 7.28, P<0.05). After treatment, the visual analogue scale (VAS) scores, levels of procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP) in the two groups were decreased, and SF-36 scores were increased, there were statistical differences ( P<0.05); the VAS scores, PCT, IL-6 and CRP levels in the observation group were lower than those in the control group, and SF-36 scores was higher than that in the control group: (2.11 ± 0.24) scores vs. (2.87 ± 0.34) scores, (0.92 ± 0.08) ng/L vs. (1.26 ± 0.09) ng/L, (24.08 ± 2.52) μg/L vs. (28.49 ± 3.10) μg/L, (4.55 ± 0.51) mg/L vs. (6.06 ± 0.63) mg/L, (74.55 ± 7.29) scores vs. (70.18 ± 7.80) scores, there were statistical differences ( P<0.05). After treatment, the surface muscle potential of pelvic floor muscle were increased in the front resting stage, rapid contraction stage, tension contraction stage, endurance contraction stage and post-resting stage, and the above parameters in the observation group were higher than those in the control group: (3.56 ± 0.34)μV vs.(3.20 ± 0.37) μV, (35.26 ± 3.05) μV vs. (31.47 ± 3.08) μV, (34.22 ± 3.25) μV vs. (31.15 ± 3.01)μV, (29.77 ± 3.17) μV vs. (27.04 ± 2.68) μV, (3.21 ± 0.27) μV vs. (3.00 ± 0.34) μV, there were statistical differences ( P<0.05). The incidence rate of adverse reactions in the two groups had no statistical difference ( P>0.05). Conclusions:Pelvic floor biofeedback combined with electroacupuncture in the treatment of CPPS has good clinical effect, and can relief pain response, regulate the inflammatory response and pelvic floor function, and have high safety.

Objective:To observe any impact of supplementing conventional rehabilitation training with electrothermal acupuncture on the upper limb motor functioning of hemiplegic stroke survivors.Methods:Thirty-six hemiplegic persons who had recently survived a stroke were divided at random into an electrothermal acupuncture group ( n=18) and a control group ( n=18). Both groups received conventional rehabilitation training, while the electrothermal acupuncture group was additionally provided with daily 30-minute sessions of electrothermal acupuncture, 6 days per week for 3 weeks. Before and after the treatment everyone′s upper limb motor functioning was quantified using the Fugl-Meyer assessment (FMA-UE), and their ability in the activities of daily living (ADL) was assessed using the modified Barthel index (MBI). The Hong Kong version of the functional test for the hemiplegic upper extremity (FTHUE-HK) was also administered. Surface electromyography (sEMG) was employed to compute the co-contraction ratios (CRs) of the agonist to antagonist muscles during elbow flexion and extension. Results:After the treatment, both groups exhibited significant improvements in their average FMA-UE, FTHUE-HK and MBI results, but with significantly greater improvement in the electrothermal acupuncture group. The root mean square values of the wrist flexor and extensor and elbow flexor muscles during flexion showed significant improvement in both groups, with the average values in the electrothermal acupuncture group significantly better than those of the control group. The CR values during elbow extension in the electrothermal acupuncture group demonstrated significant improvement compared to before the treatment.Conclusions:Supplementing conventional rehabilitation measures with electrothermal acupuncture can better increase the strength of the elbow and wrist extensor muscles in the early days after a stroke. It promotes the recruitment of muscle fibers in the extensor muscle group, reduces abnormal coordination patterns in the elbow joint, and improves upper limb motor function, the practicality of hand function, and ability in the activities of daily living.

[Objective]To investigate the potential value of thyroid hormones in cerebrospinal fluid in predicting autism-like behaviors induced by hypothyroidism in pregnant rats.[Methods]Twelve pregnant Wistar rats were randomly divided into a control group and a hypothyroidism group(hypothyroidism model group).Offspring from both groups had serum and cerebrospinal fluid levels of thyroid-stimulating hormone(TSH),total triiodothyronine(TT3),total thyroxine(TT4),free triiodothyronine(FT3),and free thyroxine(FT4)levels in serum and cerebrospinal fluid.Ultrasonic vocalization tests were conducted on postnatal day 2(P2),day 7(P7),and day 14(P14),while behavioral tests using the three-box social interaction test were performed on day 21(P21).[Results]Compared with the control group,free T4(FT4)levels in the cerebrospinal fluid of the hypothyroidism group were significantly reduced during the developmental period(P0-P21;P2:P<0.05;P7:P<0.05;P14:P<0.01;P21:P<0.01),with no statistical difference between the two groups only at P0(P>0.05).In the ultrasonic vocalization(USV)tests,the number and duration of USVs in offsprings from the hypothyroidism group were significantly reduced compared with those of the control group on P2,P7 and P14:for USV counts(P2:P<0.05;P7:P<0.001;P14:P<0.01);for USV duration(P2:P<0.05;P7:P<0.001;P14:P<0.001).In the three-box social tests,offsprings of the hypothyroidism group showed significantly reduced sniffing time with unfamiliar rats at P21 compared to the control group(all P<0.001).The FT4 levels in cerebrospinal fluid had a significantly positive correlation with USV counts(P7:r=0.883,P<0.05;P14:r=0.902,P<0.05)and sniffing time with unfamiliar rats(r=0.814,P<0.01).[Conclusion]Measuring free T4 in cerebrospinal fluid can predict autism-like behaviors in offsprings of rats induced by hypothyroidism during pregnancy.

Objective This study aims to explore the impact of changes in psychological status on non-suicidal self-inju-ry(NSSI)among junior high school students,in order to provide a theoretical basis for promoting their mental health development and to formulate more effective prevention and intervention measures.Methods A longitudinal study design was employed.Baseline data were collected in 2021(T1)from 652 first-year junior high school students selected through stratified cluster ran-dom sampling from two middle schools in a city.In 2023(T2),585 valid follow-up cases were obtained(effective response rate:89.72％).Chi-square tests,binary logistic regression,and ROC curve analysis were used to examine the effects of dynamic changes in psychological stress,internet addiction,depression,anxiety,and insomnia on NSSI(significance level α=0.05).Results ① Univariate analysis showed that the detection rate of NSSI significantly decreased from 22.05％(129/585)at T1 to 8.55％(50/585)at T2(x2=41.164,P＜0.001),with an average annual decline of 6.75％.Gender differences:the detec-tion rate decreased from 14.68％(43/293)to 5.80％(17/293)in boys(x2=18.577,P＜0.001),and from 29.45％(86/292)to 11.30％(33/292)in girls(x2=5.658,P=0.017),with a narrowing gender gap(T1:14.77％→ T2:5.70％).The NSSI detection rates between boys and girls were statistically significant at both time points(x2=18.577,5.658).② Com-parison between the persistent group and the NSSI-remission group showed that both decreased insomnia severity(OR=3.525,95％CI:1.230-10.105)and increased insomnia severity(OR=5.431,95％CI:1.895-15.570)were associated with an in-creased risk of NSSI persistence or onset(P＜0.01).③ Predictive efficacy:When scores of GAD-7+PHQ-9+ISI all in-creased by≥2 points,AUC=0.709,with a sensitivity of 44.0％-67.7％for predicting NSSI.When PHQ-9+ISI scores both increased by≥2 points,AUC=0.705,with a sensitivity of 50.2％-67.8％.Conclusion This study reveals a high natural re-mission rate of NSSI(82.17％,106/129 in the remission group)during junior high school,but also identifies gender heteroge-neity and persistent risks.Accumulated psychological stress,aggravated internet addiction,and worsened emotional disorders(anxiety/depression)are factors associated with NSSI persistence or onset.Clinical interventions should focus on monitoring dy-namic psychological indicators and early threshold identification.Although these results provide valuable insights,future research is needed to further explore the interaction mechanisms among these factors and how to effectively translate these findings into practical prevention and intervention measures.

Objective:To observe any impact of supplementing conventional rehabilitation training with electrothermal acupuncture on the upper limb motor functioning of hemiplegic stroke survivors.Methods:Thirty-six hemiplegic persons who had recently survived a stroke were divided at random into an electrothermal acupuncture group ( n=18) and a control group ( n=18). Both groups received conventional rehabilitation training, while the electrothermal acupuncture group was additionally provided with daily 30-minute sessions of electrothermal acupuncture, 6 days per week for 3 weeks. Before and after the treatment everyone′s upper limb motor functioning was quantified using the Fugl-Meyer assessment (FMA-UE), and their ability in the activities of daily living (ADL) was assessed using the modified Barthel index (MBI). The Hong Kong version of the functional test for the hemiplegic upper extremity (FTHUE-HK) was also administered. Surface electromyography (sEMG) was employed to compute the co-contraction ratios (CRs) of the agonist to antagonist muscles during elbow flexion and extension. Results:After the treatment, both groups exhibited significant improvements in their average FMA-UE, FTHUE-HK and MBI results, but with significantly greater improvement in the electrothermal acupuncture group. The root mean square values of the wrist flexor and extensor and elbow flexor muscles during flexion showed significant improvement in both groups, with the average values in the electrothermal acupuncture group significantly better than those of the control group. The CR values during elbow extension in the electrothermal acupuncture group demonstrated significant improvement compared to before the treatment.Conclusions:Supplementing conventional rehabilitation measures with electrothermal acupuncture can better increase the strength of the elbow and wrist extensor muscles in the early days after a stroke. It promotes the recruitment of muscle fibers in the extensor muscle group, reduces abnormal coordination patterns in the elbow joint, and improves upper limb motor function, the practicality of hand function, and ability in the activities of daily living.

Immunogenic cell death(ICD)is a form of cell death that can activate the immune system,especially in the treatment of cancer.ICD can enhance the recognition of tumors by the immune system and the release of damage associated molecular patterns(DAMPs),to achieve tumor cell death.Oncolytic viruses(OVs)can selectively infect and kill tumor cells without damaging normal cells.OVs are type Ⅱ ICD inducers that induce ICD in tumor cells by targeting the endoplasmic reticulum.Here,we review the characteristics of ICD and the mechanism of ICD induction by OVs.We also review the latest clinical progress involving ICD and discuss future treatment strategies for tumors.