Comprehensive occupational hazard risk assessment in employers is a core component of the pilot program for occupational health classification supervision and law enforcement. The quality and effectiveness of classification-based supervision are directly affected by both the assessment process and its outcomes. However, several issues have emerged since the implementation of the pilot program on the comprehensive risk assessment, including an excessive number of self-assessment items, lack of implementation basis for certain self-assessment items, misinterpretation for certain self-assessment items, inconsistencies between evaluation criteria and existing standards, incomplete implementation of some items, omission of comprehensive risk assessment elements, unclear definitions of key industries and key occupational hazards, and inconvenient assessment procedures on comprehensive risk assessment. To enhance the applicability, accuracy, and objectivity of the comprehensive risk assessments conducted by employers, it is recommended to optimize self-assessment items, standardize risk assessment content, tailor comprehensive risk assessments to actual workplace conditions, refine the identification of key industries and key occupational hazards, improve comprehensive risk assessment methodologies, and establish clear grading rules for the comprehensive risk assessment.

Objective: To analyze the association of participation in non-sports extracurricular tutoring classes with the prevalence of screening myopia, axial length (AL) and axial length to corneal radius ratio (AL/CR) among primary school students, so as to provide evidences for formulating myopia prevention and control policies. Methods: In December 2024, combination of convenience and cluster sampling method was used to select 2 273 students from two primary schools in Hefei City, Anhui Province. Ophthalmic examinations and questionnaire surveys were conducted to obtain information on myopia, AL, AL/CR and participation in various types of extracurricular tutoring. A binary Logistic regression model was used to analyze the association between non-sports tutoring and screening myopia, and multiple linear regression models were used to examine the associations between non-sports tutoring and AL and AL/CR. Results: Among the surveyed students, the participation rate in non-sports extracurricular tutoring classes was 64.9% , and the overall prevalence of screening myopia was 39.1%. The average AL and AL/CR were (23.60± 1.01 ) mm and (3.00±0.12), respectively. Univariate analysis showed that students who attended non-sports, music, or academic tutoring classes for ≥2 h per week had higher risks of screening myopia and greater AL/CR values than non-participants (screening myopia: OR =1.38, 1.82, 1.55; AL/CR: β =0.01, 0.03, 0.03; all P <0.05). After adjusting for sex, grade, and participation in sports tutoring, multivariate analysis indicated that participation in non-sports and musical instrument tutoring classes for ≥2 h per week remained significantly associated with higher risks of screening myopia ( OR =1.26, 1.49, both P <0.05). Multiple linear regression showed that participation in musical instrument tutoring for ≥2 h per week was positively correlated with AL ( β=0.14, P < 0.05). Conclusions Participation in non-sports extracurricular tutoring is common among primary school students. Attending non-sports tutoring classes for ≥2 h per week increases the risk of screening myopia.

Objective To evaluate the clinical efficacy of fluoroscopy-guided posterior medial branch release of lumbar spinal nerves in the treatment of facet articular low back pain in the elderly patients.Methods A total of 102 elderly patients with facet articular low back pain,who were admitted to the Department of Pain,Wuhan Municipal First Hospital of China from January 2017 to December 2018,were randomly divided into release group and conservative group.The patients of release group was treated with fluoroscopy-guided posterior medial branch release of lumbar spinal nerves,and the patients of conservative group was treated with analgesic drugs combined with physiotherapy.The preoperative and the postoperative one-week,one-month,3-month,6-month,12-month,24-month low back pain scores as well as the improvement of lumbar spine function were compared between the two groups.Results In the release group,the postoperative one-week,one-month,3-month,6-month,12-month,24-month visual analogue scores(VAS)were significantly decreased,and the differences were statistically significant(all P＜0.05),which were significantly lower than those in the conservative group,and the differences were statistically significant(all P＜0.05).In the release group,the postoperative one-week,one-month,3-month,6-month,12-month,24-month RM Q scores and Oswestry dysfunction indexes were strikingly decreased,and the differences were statistically significant(P＜0.05),which were significantly lower than those in the conservative group(P＜0.05).No procedure-related complications occurred in both groups.Conclusion For the treatment of facet articular low back pain in the elderly patients,fluoroscopy-guided posterior medial branch release of lumbar spinal nerves is clinically safe and feasible with excellent short-term and medium-long-term effect.

Purpose To design PCR combined probes u-sing TaqMan technology to detect the expression of major driver genes in a variety of soft tissue sarcomas at one time,and to dis-cuss whether the combined probes can better assist clinicopatho-logical diagnosis based on histological features and FISH results.Methods Our research group designed 32 pairs of fusion gene probes related to soft tissue sarcoma based on TaqMan tech-nique,involving 10 types of sarcoma.The histopathological specimens of 70 patients with common fusion gene soft tissue sarcoma in our hospital were examined by fusion gene combina-tion,and the histopathological specimens of 30 patients with oth-er soft tissue sarcoma without fusion gene were set as controls.Individual common sarcoma types were analyzed with FISH probe detection.At the same time,the detection performance of the combined probe was evaluated by various methods.Results The soft tissue sarcoma-related fusion gene probe designed by our research group was used to detect the confirmed soft tissue sarcomas,and the results showed that the highest sensitivity was 100％.Among the three types of tumors,protuberant dermatofi-brosarcoma,synovial sarcoma and mucinous liposarcoma were verified by FISH,and the coincidence rate of the two methods was high,with no statistical significance(P＞0.05).The re-sults of interlot and intralot reproducibility of protuberous derma-tofibrosarcoma,mucinous liposarcoma and synovial sarcoma were consistent.Three different concentration limits were used to de-tect the positive plasmid of all the fused gene RNA,and 25 cop-ies/μL was the lowest concentration limit.Conclusion Com-bined with the pathological diagnosis results,TaqMan technology can be used to design PCR combined probes for soft tissue sarco-ma,which have high sensitivity and high specificity and good methodological performance,and meet the needs of primary medical institutions for one-time and rapid auxiliary pathological diagnosis of common soft tissue sarcoma.It provides a rapid and reliable method for the detection of multiple fusion genes in clin-ical soft tissue sarcoma.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective: To determine the association between anthropometric parameters and 20 meter shuttle run test (20 m SRT) score among children and adolescents. Methods: The convenient sampling method was conducted to select 3 192 primary and secondary school students in Baoan District, Shenzhen, based on the street school types school from April to May 2019. Height, weight, 20 m SRT score and general demographic indicators were assessed and collected. Individuals were divided into two groups based on the dose response correlation between different anthropometric parameters (the Z score of height, weight and BMI) and 20 m SRT score analyzed with the restricted cubic spline. The association between the Z score of height and 20 m SRT score was further analyzed using the Spearman correlation analysis. Logistic regression analysis was used to analyze separately the relationship different anthropometric parameters and 20 m SRT score. Results: The Z value of weight and 20 m SRT score showed a non linear dose response association ( P <0.01), the significant but weak linear correlation between the Z value of height and 20 m SRT score ( r=0.06, P <0.05). The prevalence rate on the low level of the Z value of 20 m SRT score in 3 192 children and adolescents was 44.7%, and the gender ( χ 2=14.02, P <0.01) and grade difference ( χ 2=93.28, P <0.01) were both statistically significant. There was no significant relationship between the Z value of height and 20 m SRT score grade among total population, different genders and different grades ( P > 0.05). Compared with the reference group on the Z value of weight ≤-0.23, individuals with the Z value of weight >-0.23 had the low level of 20 m SRT score ( OR =0.61, P <0.05). Compared with the reference group on the Z value of BMI ≤ 0.25, individuals with the Z value of weight >0.25 had the low level of 20 m SRT score ( OR =0.45, P <0.05). Stratified for gender and grade, the above significant relationship on the Z value of weight, Z value of BMI and 20 m SRT score were still observed ( P <0.01). Conclusions The higher height Z value shows on correlations with 20 m SRT score, but the positive association is found between weight and BMI Z value and the 20 m SRT score. The cardiopulmonary fitness improvement may be more effective among children and adolescents when tuking weight and BMI Z scores into consideration.

Objective: To develop the Assessment of Smartphone Multitasking for Adolescents (ASMA) and evaluate its reliability and construct validity, so that to provide an evaluation tool for relevant epidemiological studies. Methods: Based on literature review, expert based judgement, and group discussion, the self administered ASMA identified 3 dimensions named smartphone activities and non-media activities multitasking, smartphone activities and other media activities multitasking, and smartphone functional use multitasking, which initially included 27 items. From October to December 2021, 5 566 college students were selected from 7 regions, including Liaoning, Shanxi, Henan, Shanghai, Chongqing, Shenzhen, and Yunnan by multi stage cluster sampling method, and item analysis, factor analysis, and reliability evaluation were used to screen items and evaluate reliability and validity. Results: The final version of AMSA contained 3 dimensions covering 26 items. The variance cumulative contribution rate was 59.63 %. The internal consistency test showed that Cronbach s alpha coefficient for the questionnaire was 0.944, and ranged from 0.838 to 0.928 for each dimension. The split half coefficient of the questionnaire was 0.849 and ranging from 0.781 to 0.874 for each dimension. The results of confirmatory factor analysis showed that the root mean square error of approximation (RMSEA), comparative fit index (CFI), and Tucker Lewis index (TLI) of the questionnaire were 0.068, 0.901, and 0.891, respectively, which had which had a good fitting degree. The results of Pearson correlation analysis showed that the criterion validity of the questionnaire was good ( r=0.206-0.351, P <0.01). Conclusion The ASMA is consistent with the evaluation standard of psychometrics and can be used as an assessment tool to evaluate smartphone multitasking behaviors in adolescents.

Objective: To analyze the association between eye use behavior and self reported myopia in middle and high school students, and provide the scientific basis for the prevention and control of myopia. Methods: A total of 14 872 middle and high school students was selected from four provinces and cities from December 2015 to March 2016, including Jiangxi(Nanchang,Yintan,Dexing), Liaoning(Shenyang), Guangdong(Shenzhen), Henan(Zhengzhou) provinces. A self administrated questionnaire was used to collect the basic information, self reported myopia and eye use behaviors among middle and high school students. The Chi square tests were applied to compare the differences in self reported myopia among middle and high school students with different characteristics. Multivariate binary Logistic regression models were used to analyze the association between eye use behavior and self reported myopia in middle and high school students. Results: The self reported myopia rate of middle and high school students was 68.5%, with 59.7% and 78.6% for junior high school students and senior high school students, respectively. After adjusting for the potential confounders, the Logistic regression models showed that middle and high school students who read and write with their heads down ( OR =1.94, 2.32),middle and high school students who lie down or lie on stomach when using their eyes ( OR =1.27, 1.28) had a higher risk of self reported myopia ( P <0.01). There was a negative correlation between eye use distance (reading and writing distance, distance from eyes to TV, mobile phone, or tablet) and self reported myopia ( OR =0.73, 0.70, 0.81; 0.61, 0.66 , 0.76) in middle and high school students ( P <0.01). In addition, the risk of self reported myopia was lower in middle school students with longer eye to computer distance ( OR=0.77, P <0.01). Conclusion There is a significant association between eye use postures, eye use distance and self reported myopia in middle and high school students. Health education for the risk and behavior factors of myopia should be actively promoted to ensure the visual health of children and adolescents.

ObjectiveTo investigate the dietary preference and nutritional knowledge needs of the elderly people who dined at meal service sites. MethodsUsing the form of stratified and convenience sampling method with self-designed questionnaire was used， in November 2021， to select 700 elderly people who dine at meal service sites in 7 jurisdictions in Shanghai were selected， and a self-designed questionnaire was used to investigate the basic information. Results91.64% of the elderly surveyed would eat at relatively fixed meal service sites， and the total Dietary Diversity Score （DDS9） was 3.56±1.46. 41.45% of the elderly with diseases preferred unhealthy cooking methods. Only 8.03% of the surveyed seniors said they were unwilling to accept targeted and personalized nutrition tips and reminders. Multivariate logistic regression analysis showed that the probability reaching the “understanding” level of “Food Guide Pagoda for Chinese Residents” and “Four Principles Recommended by the Core Dietary Guidelines for the Elderly” was different in the elderly with different education levels. The willingness of the elderly to expect to receive different nutrition tips and reminders was related to whether they cared about the corresponding contents. There was a statistically significant difference （P<0.05） among the elderly who were concerned about different health problems in terms of the willingness to receive different nutritional tips. There were significant differences in the proportion of elderly people with different health status for intervention （χ²=5.402， P<0.05）. ConclusionThe elderly who dine at meal service sites are highly dependent on the sites， have a low level of dietary diversification， and do not have a high degree of understanding of nutrition-related knowledge， and have a high demand for targeted nutritional interventions. Nutritional interventions for the sick elderly should be piloted through multiple channels.

Objective: To assess screening method for myopia among Chinese school age children and adolescents, and to provide scientific evidence for an appropriate protocol for vision screening. Methods: According to technical protocols of 2014 Chinese National Survey on Students Constitution and Health, a total of 1 725 primary and middle school girls aged 9 to 13 years old from Suzhou, Hefei and Chizhou of Anhui Province were selected. Basic information and menarche were collected by questionnaires. Distance visual acuity and subjective refraction were used for screening myopia. And multivariate Logistic regression analysis was used to analyze the relationship between menarche and screening myopia. Results: The detection rate of screening positive myopia of girls aged 9-13 years in Anhui province was 62.5%(1 078). The ratio of screening myopia was significantly higher in urban girls (71.0%) compared with suburban girls(54.6%), and higher in girls with homework time >2 h compared (70.8%) with homework time 1-2 h and <1 h (68.4%, 54.9%) groups ( χ 2=49.50, 37.88, P <0.01). The detection rate of screening myopia between different menarche groups was only statistically significant among girls aged 9 and 13 years ( χ 2=4.75, 11.22, P <0.05). Multivariate Logistic regression analysis showed that menarche was significantly associated with screening myopia ( OR =2.06, 95% CI =1.68- 2.52 ). After controlling age and BMI, the association remained ( P <0.05). After further controlling family residence background and homework time, the association diminished ( P >0.05). Conclusion Menarche is closely associated with screening myopia among girls in selected age groups, future cohort studies are needed to focus on prevention and control of myopia during pubertal development.