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.

In this work, starting from 4-hydroxycoumarin, three series of 22 coumarin derivatives, among which 8 have not been reported in the literature, were synthesized and their in vitro anti-inflammatory activities and mechanisms of action were preliminarily investigated using mouse macrophage model. The results showed that most of the derivatives could significantly inhibit the production of pro-inflammatory factor NO, with compounds 2e, 2f, 2g, 2h, 2i, 2j, 4e, and 4f showing better anti-inflammatory activity than the positive control drug dexamethasone. Further experiments showed that compounds 2h and 4f significantly inhibited the production of pro-inflammatory factors IL-6, TNF-α and IL-1β in RAW264.7 macrophages, and could, therefore, be used as lead compounds for further studies.

Objective : To explore the role and mechanism of 25-hydroxycholesterol (25-HC) in inflammatory bow- el disease (IBD) in mice． Methods : All mice were divided into three groups : the control group was fed normally ; the DSS model group was fed with 2. 5% dextran sulfate sodium (DSS) solution ; the DSS + 25-HC experimental group was fed with 2. 5% DSS solution and he mice in the experimental group were intraperitoneally injected with 25-HC．The symptom changes of the mice were evaluated by assessing the disease activity index(DAI) ，and the tis- sue changes were judged by histological scoring．The expression of interleukin-17 and its signaling pathways in the mice were detected by Western blot，qRT-PCR, immunohistochemistry /fluorescence，and flow cytometry．Combined with the detection of tight junction proteins in the intestinal epithelium of the mice，the mechanism by which 25-HC affects IBD in mice was explored． Results : In comparison to the DSS control group，The DSS + 25-HC experimen- tal group mice exhibited a reduction in body weight ( F = 30. 1，P ＜0. 000 1) ，a shortened colon ( F = 63. 8，P < 0. 05) ，and elevated DAI(F = 774. 5，P＜0. 000 1) and histopathological scores(F = 141. 5，P＜0. 05) ．Addition- ally，the expression of tight junction-associated proteins(ZO-2，Occludin，JAM and Claudin-4) was found to be sig- nificantly reduced．The level of IL-17 significantly decreased，and its expression level was positively correlated with tight junction proteins． Conclusion 25-HC inhibited IL-17 production by colonic γδ T cells through the RORγt pathway，aggravated mucosal injury，and promoted the development of DSS-induced acute colitis in mice．

This case report presents a 16-year-old male patient with deficiency of adenosine deaminase 2(DADA2). The patient had a history of Raynaud′s phenomenon with digital ulcers since childhood. As the disease progressed, the patient developed retinal vasculitis, intracranial hemorrhage, skin necrosis, severe malnutrition, refractory hypertension, and gastrointestinal bleeding. Genetic testing revealed compound heterozygous mutations in the ADA2 gene (paternal c.1072G > A pathogenic mutation + maternal c.1065C > A variant of unknown clinical significance). ADA2 enzyme activity was significantly reduced (0.1 U/L). A multidisciplinary treatment team developed an individualized plan to address key issues, including nutritional support, blood pressure control, rehabilitation, pain management, and balancing anticoagulation/bleeding risks. After systematic intervention, the patient′s condition showed partial improvement. This case reveals clinical challenges such as anticoagulation decisions and nutritional support of DADA2. It also emphasizes the importance of early molecular diagnosis, tumor necrosis factor-α inhibitor targeted therapy, and multidisciplinary collaboration in management, underlining the core value of precision medicine in rare disease management.

Objective: To analyze the trends in new diagnosis rates of HIV/AIDS cases in Huzhou City, Zhejiang Province from 2009 to 2023, so as to provide the basis for improving HIV/AIDS prevention and control strategies. Methods: Data of newly reported HIV/AIDS cases in Huzhou City from 2009 to 2023 were collected through the Chinese Disease Prevention and Control Information System. The new diagnosis rate was calculated as the ratio of newly reported HIV/AIDS cases within one year to the permanent resident population during the same period. The gender, age, and regional distribution characteristics of new diagnosis rates of HIV/AIDS cases were described. The trends were analyzed using average annual percent change (AAPC) and annual percent change (APC). Results: A total of 2 088 new HIV/AIDS cases were reported in Huzhou City from 2009 to 2023, with an average annual new diagnosis rate of 4.53/105. The new diagnosis rates showed an overall increasing trend from 2009 to 2023 (AAPC=12.745%, P<0.05), with rapid growth during 2009 to 2015 (APC=32.734%, P<0.05) but no significant trend during 2015 to 2023 (P>0.05). The average annual new diagnosis rate was significantly higher in males than in females (7.54/100 000 vs. 1.40/100 000, P<0.05). Male new diagnosis rate trend closely mirrored the overall population pattern, while females showed a continuous upward trend without clear inflection point (AAPC=12.575%, P<0.05). Age-specific analysis revealed average annual new diagnosis rates of 2.75/100 000, 6.16/100 000 and 3.83/100 000 for AIDS/HIV cases aged <25, 25-<50 and ≥50 years, respectively. The cases aged <25 years showed no significant trend (P>0.05), while the cases aged 25-<50 and ≥50 years followed patterns similar to the overall population. The average annual new diagnosis rates of HIV/AIDS cases in Wuxing District, Nanxun District, Deqing County, Changxing County and Anji County were 6.54/100 000, 3.43/100 000, 3.45/100 000, 3.56/100 000 and 4.94/100 000, respectively, showing overall upward trends (AAPC=9.672%, 27.599%, 11.800%, 18.896% and 10.254%, all P<0.05). Conclusions The new diagnosis rate of HIV/AIDS cases showed an overall upward trend in Huzhou City from 2009 to 2023. Cases are mainly concentrated among males, people aged 25-<50 years and Wuxing District, making them key targets for HIV/AIDS prevention and control.

Objective To compare the short-term outcomes and postoperative complications of endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)in the treatment of early colorectal cancer.Methods A total of 110 patients with early colorectal cancer who were admitted to Suining Central Hospital from June 2020 to June 2022 were prospectively enrolled and randomly assigned to two groups by random number table.Of them,58 patients underwent ESD and 52 patients underwent EMR.Operation related indexes,inflammatory factors(interleukin-6[IL-6],tumor necrosis factor-α[TNF-α],and C-reactive protein[CRP])before operation and 3 days after operation,and postoperative quality of life index(QL-Index)were compared between the two groups.The complications of the two groups were observed.Results The operation time,hospital stay,postoperative exhaust time,defecation time,and intraoperative blood loss in ESD group were lower than those in EMR group,and the rates of complete resection and en bloc resection in ESD group were higher than those in EMR group(P<0.05).The levels of IL-6,TNF-α and CRP were increased 3 d after operation in both groups,but the levels of IL-6,TNF-α and CRP in ESD group were lower than those in EMR group(P<0.05).The total score of QL-Index and the scores of activity,daily activities,health,and overall situation in ESD group were significantly higher than those in EMR group(P<0.05).The incidence of complications in ESD group was higher than that in EMR group,without significant difference(P>0.05).Conclusion The pocket ESD can effectively promote postoperative rehabilitation,increase resection rate,reduce postoperative inflammation,and improve the quality of life of patients with early colorectal cancer,and there is no obvious complication.

Objective To observe the effects of acupuncture at acupoints along the meridians on the expression of frontal lobe associated protein kinase in pchlorophenylalanine(PCPA)induced insomnia rats;To explore the mechanism of acupuncture in improving insomnia.Methods Totally 60 rats were randomly divided into blank group,model group,sham acupuncture group,acupuncture group and Western medicine group,with 12 rats in each group.An insomnia model rat was induced by intraperitoneal injection of PCPA.The acupuncture group received acupuncture at"Baihui","Shenmen"(bilateral),and"Sanyinjiao"(bilateral),while the sham acupuncture group only fixed the needle at the corresponding acupoints but did not penetrate the skin,while the model group was only fixed for 30 minutes,the Western medicine group was given a solution of estazolam by gavage for 7 consecutive days,the blank group was not treated.The pentobarbital sodium reversal experiment was used to detect the sleep latency and sleep time of rats,ELISA was used to detect the content of melatonin(MT)in plasma,RT-PCR was used to detect the mRNA expressions of calmodulin dependent protein kinase(CaMK)Ⅱ,protein kinase C(PKC)and p38 mitogen activated protein kinase(MAPK)in frontal lobe tissue,and Western blot was used to detect the protein expressions of CaMKⅡ,PKC and p38MAPK in frontal lobe tissue.Results Compared with the blank group,the sleep latency of the model group rats were significantly prolonged and the sleep time were significantly shortened(P<0.01),the content of MT in plasma was significantly reduced(P<0.01),and the mRNA and protein expressions of CaMKⅡ and PKC in frontal lobe tissue were significantly decreased(P<0.01),the mRNA and protein expressions of p38MAPK were significantly increased(P<0.01).Compared with the model group,the sleep latency were significantly shortened and the sleep time were significantly prolonged in the acupuncture group and the Western medicine group(P<0.01),the plasma MT content significantly increased(P<0.01),the mRNA and protein expressions of CaMKⅡ and PKC in frontal lobe tissue significantly increased(P<0.05),and the mRNA and protein expression of p38MAPK significantly decreased(P<0.01).Compared with the sham acupuncture group,the sleep latency shortened and sleep time were significantly prolonged in the acupuncture group and the Western medicine group(P<0.01),plasma MT content significantly increased(P<0.01),PKC mRNA expression in frontal lobe tissue significantly increased(P<0.01),and p38MAPK mRNA expression significantly decreased(P<0.01).There was no statistically difference in various indicators between the acupuncture group and the Western medicine group(P>0.05).Conclusion Acupuncture at acupoints along the meridians can shorten the sleep latency and prolong sleep time,improve sleep status by regulating the expression of associated protein kinase in frontal lobe of insomnia rats.

Objective:To analyze and summarize the key points of design and implementation of new drug clinical trials for ankylosing spondylitis.Methods:The platform for drug clinical trial registration and information published on the official website of center for drug review and evaluation of national medical products administration (CDE) was searched to obtain data and classified statistics was conducted then. The Mean±SD and M ( Q1, Q3) were used for quantitative data for statistical description, and the rate, composition or relative ratio of qualitative data were used for statistical description. Results:A total of 23 clinical trials meeting the requirements were screened, among which 19 were biological products included in nine phase Ⅲ clinical trials. Among the four chemical drugs, two were phase Ⅱ clinical trials. One of the clinical trials on AS adopted the 1966 New York classification criteria, accounting for 4%. Nineteen of the trials adopted the1984 New York classification criteria, accounting for 83%. Three other trials adopted unspecified classification criteria, accounting for 13%. In one of these clinical trials, the age of patients included was older than 16 years old, 9 trials were 18 to 65 years old, 6 were 18 years old but without upper limit. In the definition of active AS, 19 trials took BASDAI≥4 as the cut-off value for active disease, and BASDAI, total back pain, spinal pain and morning stiffness were regarded as active disease in 4.Conclusion:The number of dosestic AS clinical trial projects continnes to rise. The 1984 classification criteria is adopted as the classification criteria in clinical trials. The minimum age in the inclusion criteria is 18 years old, there is no upper limit in age for inclusion. Disease activity can be evaluated by BASDAI score, combined with comprehensive indicators such as night-time back pain, global spinal pain and morning stiffness.

Objective:To describe the prevalence of food allergy among children aged 0-5 years in China and to explore related influencing factors.Methods:Multistage stratified random sampling method was used to collect data from 275 surveillance sites of the China National Nutrition and Health Survey of Chinese children and lactating mothers programs in 31 provinces (autonomous regions and municipalities) of China in 2016-2017. A total of 70 107 participants aged 0-5 years were included in this study. The study collected information of participants' demographic characteristics and food allergies by face-to-face questionnaire. The prevalence of food allergy was analyzed, using the complex data weighting method. The logistic regression models were used to analyze the influencing factors related to food allergy.Results:The overall prevalence of self-reported food allergy among children aged 0-5 years was 4.81%. Prevalence rates in infants aged 0-5 months, and 6-23 months and preschool children aged 2-5 years were 0.81%, 4.68% and 5.26%, respectively. The results of logistic analysis showed that there was a significantly positive correlation between factors including children from 6 months to 5 years old, urban area, southwest area, first-born, mothers with college education or above, and the prevalence of food allergy in children. Shrimp, poultry eggs, crab shellfish, fruit, milk and fish appeared the common allergic foods in children aged 0-5 years, with prevalence rates of self-reported food allergy as 1.55%, 1.25%, 0.99%, 0.97%, 0.87% and 0.86%, respectively. The proportion of single food allergy in children with allergies was 69.85%.Conclusions:Among children aged 0-5 years, the prevalence of self-reported food allergy increases with age, in China. Foods that is prone to allergies include fish, shrimp, crab, shellfish, poultry eggs, milk and fruits, etc. Most allergies were only caused by single food in children, under observation.