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.

OBJECTIVE This study aims to investigate the epidemiological characteristics and influencing factors of skin diseases among soldiers performing duties and working in tunnel environments,and to propose targeted pre-ventive and therapeutic measures.METHODS A cross-sectional survey was conducted on 537 soldiers from multi-ple sites within a military unit from Nov.2022 to Oct.2023.The survey collected data on general information,liv-ing habits,and details of current skin diseases,including types,symptoms,duration and treatment status.Logis-tic regression analysis was applied to identify risk factors for the skin diseases observed.RESULTS A total of 21 types of skin diseases were identified,with dermatophyte infections being the most prevalent(59.96％,322/537),followed by acne(26.82％,144/537).Further analysis revealed that the incidence of dermatophyte infec-tions was closely associated with the region where the soldiers were stationed[OR(95％CI)=1.694(1.062,2.693),P=0.032]and the frequency of sock washing[OR(95％CI)=1.734(1.023,2.988),P=0.043],but no significant correlation was found between the prevalence of dermatophyte infections and the frequency of washing feet[OR(95％CI)=1.520(0.836,2.824),P=0.175].CONCLUSIONS This study highlights the epidemiological char-acteristics and key risk factors for skin diseases among soldiers in tunnel environments.Targeted prevention strategies are proposed,providing valuable scientific evidence for the prevention and control of skin diseases in similar environments.

Objective:To explore the efficacy and safety of B-Raf proto-oncogene, serine/threonine kinase (BRAF) inhibitor and epidermal growth factor receptor (EGFR) inhibitor combined with immune checkpoint inhibitor in microsatellite stable (MSS) BRAF V600E metastatic colorectal cancer (mCRC) patients.Methods:The data and outcomes of mCRC patients with MSS BRAF V600E who received BRAF inhibitor, EGFR inhibitor combined with immune checkpoint inhibitor in Tianjin Medical University Cancer Hospital from May 2022 to April 2024 were retrospectively collected.Results:A total of 12 mCRC patients were included in this study, the objective response rate was 50.0%, the disease control rate was 66.7%, and the median disease control time of patients who achieved objective response was 8.0 months. The median progression-free survival was 6.8 months and the median overall survival was 8.4 months. Overall adverse reactions were controllable, the most common treatment-related adverse events were fatigue (8 cases), fever (5 cases), and rash (4 cases). There were no grade 4 adverse event, serious adverse event, and treatment-related death.Conclusion:BRAF inhibitor and EGFR inhibitor combined with immune checkpoint inhibitor show good efficacy and controllable safety in BRAF V600E mCRC patients.

Objective:To explore the effect of hospital-community continuous management based on mobile health and dyadic coping intervention in ileostomy patients and their spouses.Methods:This was a randomized controlled trial. Patients with rectal cancer who underwent ileostomy at Taizhou People′s Hospital between August 2018 and August 2023, along with their spouses, were enrolled. Patient-spouse dyads were randomly assigned to either the intervention group or the control group using a random number table method. Baseline demographic data were collected from both groups. The control group received routine care, whereas the intervention group was given a hospital-community transitional care program based on mHealth (mobile health) and a dyadic coping model. Stoma adaptation, family functioning, and dyadic coping capacity were evaluated at 1 week, 1 month, and 3 months postoperatively. Sedentary behavior time and exercise compliance were also assessed at 1 month and 3 months after surgery.Results:A total of 47 patient-spouse dyads were included in the control group and 48 dyads in the intervention group. There were no statistically significant differences in baseline characteristics between the two groups (all P>0.05). Similarly, no significant differences were found in the age, sex or education level of the spouses (all P>0.05). At 1 week postoperatively, there were no significant differences in family cohesion and adaptability scores between the two groups (all P>0.05). However, at 1 and 3 months postoperatively, the intervention group had significantly higher family cohesion and adaptability scores than the control group (all P<0.05). With regard to dyadic coping capacity, no significant differences were observed in any of the subscale scores of the dyadic coping questionnaire at 1 week postoperatively (all P>0.05). At 1 and 3 months postoperatively, the intervention group scored significantly higher than the control group on stress communication, supportive coping, delegated coping, and joint coping ( P<0.05), but lower on negative coping ( P<0.05). In terms of stoma adaptation, no significant difference was found between the two groups at 1 week postoperatively ( P>0.05). At 1 and 3 months postoperatively, the intervention group showed significantly higher stoma adaptation and exercise compliance scores, as well as shorter sedentary behavior time, compared to the control group (all P<0.05). Conclusions:The hospital-community transitional care program developed by the research team effectively improves family functioning, dyadic coping capacity in ileostomy patient-spouse dyads, and postoperative stoma adaptation and rehabilitation outcomes.

OBJECTIVE This study aims to investigate the epidemiological characteristics and influencing factors of skin diseases among soldiers performing duties and working in tunnel environments,and to propose targeted pre-ventive and therapeutic measures.METHODS A cross-sectional survey was conducted on 537 soldiers from multi-ple sites within a military unit from Nov.2022 to Oct.2023.The survey collected data on general information,liv-ing habits,and details of current skin diseases,including types,symptoms,duration and treatment status.Logis-tic regression analysis was applied to identify risk factors for the skin diseases observed.RESULTS A total of 21 types of skin diseases were identified,with dermatophyte infections being the most prevalent(59.96％,322/537),followed by acne(26.82％,144/537).Further analysis revealed that the incidence of dermatophyte infec-tions was closely associated with the region where the soldiers were stationed[OR(95％CI)=1.694(1.062,2.693),P=0.032]and the frequency of sock washing[OR(95％CI)=1.734(1.023,2.988),P=0.043],but no significant correlation was found between the prevalence of dermatophyte infections and the frequency of washing feet[OR(95％CI)=1.520(0.836,2.824),P=0.175].CONCLUSIONS This study highlights the epidemiological char-acteristics and key risk factors for skin diseases among soldiers in tunnel environments.Targeted prevention strategies are proposed,providing valuable scientific evidence for the prevention and control of skin diseases in similar environments.

Objective:To explore the efficacy and safety of B-Raf proto-oncogene, serine/threonine kinase (BRAF) inhibitor and epidermal growth factor receptor (EGFR) inhibitor combined with immune checkpoint inhibitor in microsatellite stable (MSS) BRAF V600E metastatic colorectal cancer (mCRC) patients.Methods:The data and outcomes of mCRC patients with MSS BRAF V600E who received BRAF inhibitor, EGFR inhibitor combined with immune checkpoint inhibitor in Tianjin Medical University Cancer Hospital from May 2022 to April 2024 were retrospectively collected.Results:A total of 12 mCRC patients were included in this study, the objective response rate was 50.0%, the disease control rate was 66.7%, and the median disease control time of patients who achieved objective response was 8.0 months. The median progression-free survival was 6.8 months and the median overall survival was 8.4 months. Overall adverse reactions were controllable, the most common treatment-related adverse events were fatigue (8 cases), fever (5 cases), and rash (4 cases). There were no grade 4 adverse event, serious adverse event, and treatment-related death.Conclusion:BRAF inhibitor and EGFR inhibitor combined with immune checkpoint inhibitor show good efficacy and controllable safety in BRAF V600E mCRC patients.

Objective:To explore the effect of hospital-community continuous management based on mobile health and dyadic coping intervention in ileostomy patients and their spouses.Methods:This was a randomized controlled trial. Patients with rectal cancer who underwent ileostomy at Taizhou People′s Hospital between August 2018 and August 2023, along with their spouses, were enrolled. Patient-spouse dyads were randomly assigned to either the intervention group or the control group using a random number table method. Baseline demographic data were collected from both groups. The control group received routine care, whereas the intervention group was given a hospital-community transitional care program based on mHealth (mobile health) and a dyadic coping model. Stoma adaptation, family functioning, and dyadic coping capacity were evaluated at 1 week, 1 month, and 3 months postoperatively. Sedentary behavior time and exercise compliance were also assessed at 1 month and 3 months after surgery.Results:A total of 47 patient-spouse dyads were included in the control group and 48 dyads in the intervention group. There were no statistically significant differences in baseline characteristics between the two groups (all P>0.05). Similarly, no significant differences were found in the age, sex or education level of the spouses (all P>0.05). At 1 week postoperatively, there were no significant differences in family cohesion and adaptability scores between the two groups (all P>0.05). However, at 1 and 3 months postoperatively, the intervention group had significantly higher family cohesion and adaptability scores than the control group (all P<0.05). With regard to dyadic coping capacity, no significant differences were observed in any of the subscale scores of the dyadic coping questionnaire at 1 week postoperatively (all P>0.05). At 1 and 3 months postoperatively, the intervention group scored significantly higher than the control group on stress communication, supportive coping, delegated coping, and joint coping ( P<0.05), but lower on negative coping ( P<0.05). In terms of stoma adaptation, no significant difference was found between the two groups at 1 week postoperatively ( P>0.05). At 1 and 3 months postoperatively, the intervention group showed significantly higher stoma adaptation and exercise compliance scores, as well as shorter sedentary behavior time, compared to the control group (all P<0.05). Conclusions:The hospital-community transitional care program developed by the research team effectively improves family functioning, dyadic coping capacity in ileostomy patient-spouse dyads, and postoperative stoma adaptation and rehabilitation outcomes.

Lactic acidosis is a hallmark of the tumor microenvironment (TME) and a critical impediment to the efficacy of transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC). Incomplete embolization preserves viable tumor cells that amplify hypoxia-driven glycolysis, generating a lactic acid-rich milieu that drives treatment resistance, skews immune populations toward immunosuppressive phenotypes, and impairs cytotoxic T lymphocyte function. In this review, we elucidate the pathways through which lactic acidosis compromises TACE efficacy and propose novel strategies for its mitigation. We examine emerging approaches, including systemic or intra-arterial alkalization, targeted inhibition of lactate production and export, and calcium carbonate nanoparticles, and evaluate their respective merits and limitations. Finally, we propose a combination regimen of calcium carbonate nanoparticles, lactate-targeting agents, and TACE to achieve precise drug delivery, synergistic lactic acid depletion, and enhanced antitumor immunity. These integrated strategies have the potential to convert immunologically “cold” HCC lesions into “hot” ones, thereby improving TACE outcomes and disease control.

Objective:To explore and analyze the characteristics and influencing factors of language development in children with attention deficit hyperactivity disorder (ADHD).Methods:A case-control study was used, from May 2021 to August 2023, patients diagnosed with attention deficit hyperactivity disorder (ADHD) were enrolled in the mental health clinic of the Children′s Hospital Affiliated to the Capital Institute of Pediatrics. The language ability of 272 children with ADHD and 117 healthy children who underwent physical examination in children′s health center during the same period were tested by Diagnostic Receptive and Expressive Assessment of Mandarin-Comprehensive (DREAM-C), and the development levels of total language, receptive, expressive, semantics and syntax of the two groups were compared by independent sample t-test. The influential factors of language lag in children with ADHD were analyzed by univariate χ2 analysis and multiple logistic regression. Results:There were 272 children with ADHD, including 206 males and 66 females, with an age range of 6-8 (7.29±1.17) years. While in the control group, there were 117 healthy children, including 91 males and 26 females, with an age range of 6-8 (7.02±0.82) years. The average scores of total language, expressive and syntax of ADHD children were lower than those of healthy children [(92.73±12.47/96.36±11.04), t=-2.857, P<0.05; (84.49±13.24/87.78±15.25), t=-2.029, P<0.05; (87.93±10.26/90.27±11.05), t=2.022, P<0.05]. Univariate χ2 analysis showed that disharmonious family relationship ( χ2=4.183, P<0.05), the main caregivers were non-parents ( χ2=9.121, P<0.05), early screen exposure ( χ2=3.889, P<0.05), ADHD family history ( χ2=5.423, P<0.05) were influential factors of language development lag in ADHD children. The results of multivariate logistic regression model analysis showed that cesarean section ( OR=2.137, 95% CI: 1.078-4.379, P=0.030), disharmonious family relationship ( OR=2.659, 95% CI: 1.178-5.999, P=0.019), early screen exposure ( OR=3.556, 95% CI: 1.127-11.213, P=0.030), ADHD family history ( OR=1.959, 95% CI: 1.058-3.630, P=0.033) were risk factors for comorbidities of language development in children with ADHD. Conclusion:The total language ability, expressive and syntax scores of ADHD children lag behind those of healthy children. The delayed language development of ADHD children is related to delivery mode, family relationship, the main caregivers, early screen exposure, family history of ADHD.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.