Background The prevalence of chronic diseases among the Chinese occupational population is rising steadily, with hypertension and diabetes becoming important health concerns. Occupational health examinations (OHE) provide stable population coverage, standardized protocols, and fixed follow-up intervals, offering a robust data foundation for risk assessment. However, most existing hypertension prediction studies rely on cross-sectional data and mainly focus on clinic onset, failing to capture the dynamic progression and cumulation of individual risk. Objective To construct a machine learning-based risk prediction model for blood pressure abnormality in occupational populations, providing a reference for health risk stratification and targeted health interventions. Methods Longitudinal data from 2020 to 2023 were extracted from the occupational health examination database of an institution in Shanghai. After excluding individuals with hypertension in any of the first three years, 3710 workers who participated 4 consecutive years of OHE were included. Six categories of blood pressure-related indicators from 2020 to 2022 were selected, including basic information, lifestyles, occupational exposures, cardiovascular indicators, routine blood tests, and biochemical markers, comprising 30 variables in total. For feature engineering, continuous variables were processed to reflect three-year dynamic characteristics: level (mean), variability (variance), and temporal trend (slope). Categorical variables were incorporated using 2022 values. Least absolute shrinkage and selection operator regression was applied to identify variables for inclusion in the machine learning models. Five models (decision tree, logistic regression, random forest, support vector machine, and XGBoost) were employed to predict blood pressure abnormality risk in 2023. And then sensitive analysis was conducted. The optimal model was selected based on the area under the curve (AUC) of receiver operating characteristic. Feature importance and SHAP analyses were applied to interpret the final model. Results Feature engineering transformed 17 continuous variables into 51 secondary variables, combined with 13 baseline variables, resulted in 24 variables screened out by LASSO regression. The logistic regression model achieved the best performance. Feature importance analysis indicated that the dynamic trajectory of blood pressure played a central role in the model, complemented by other biochemical and lifestyle indicators. SHAP analysis further showed that the model’s ability to not only identify risks of high-normal blood pressure and hypertension but also quantify the specific contribution of individual examination indicators to predicted risk, supporting risk-stratified population management in occupational health management. Conclusion Based on an existing occupational health examination database and routinely collected data, this study has developed a risk prediction model for blood pressure abnormalities in occupational populations. By incorporating dynamic change characteristics from longitudinal examinations, the study demonstrates the feasibility of using routine health data for early risk identification and stratified management. However, its applicability is limited by the availability of repeated examination data and the focus on specific occupational groups, requiring further validation across broader populations and diverse clinic scenarios.

As a primary approach to safeguarding workers' occupational health in China, the work-related injury insurance still has insufficient preventive measures for occupational groups. By reviewing the preventive measures embedded in Germany’s statutory accident insurance (Gesetzliche Unfallversicherung) and Japan’s workers’ accident compensation insurance, this study summarized their best practices and then proposed the following policy directions based on China’s specific context: strengthening the prevention-oriented institutional framework, increasing financial investment in occupational injury prevention, improving the incentive mechanisms of floating premium rate, and promoting data integration and intelligent applications in occupational health management. These measures are expected to shift China’s work-related injury insurance system from a compensation-oriented model to one that emphasizes comprehensive prevention and health promotion, thereby providing useful insights for better safeguarding the health of Chinese workers.

Background Long-term occupational health surveillance facilitates the identification of chronic health risks arising from occupational hazard exposures. However, under low-level exposure conditions in chemical enterprises, traditional workplace-centered risk assessment models are insufficient to fully explain the observed health effects among workers, highlighting the need for individual-focused health management strategies that focus on the worker. Objective To characterize long-term health trends among workers in a chemical enterprise and examine the limitations of workplace hazard monitoring and health surveillance under low-level multiple exposure scenarios, thereby providing a scientific basis for more comprehensive worker health protection measures. Methods We analyzed 972 occupational health examination records collected over a 15-year period (2010–2024) from a chemical enterprise, integrating these with enterprise hazard monitoring reports and workshop air monitoring of volatile organic compounds (VOCs). The annual counts and prevalences of abnormalities in liver function tests, metabolic syndrome-related indicators, and liver imaging were summarized. Temporal trends were evaluated using the Cochran-Armitage trend test. Time-related changes in abnormal health indicators among active workers were evaluated by generalized linear mixed-effects models (GLMMs), adjusting for age and sex. Individual longitudinal profiles were described for nine workers with continuous 15-year records. In addition, paired comparisons of health outcomes were conducted for 81 workers with both pre-employment and periodic examinations. Results Workplace hazard monitoring indicated that airborne concentrations of major occupational contaminants including VOCs, acids and bases, dust, and physical factors were below national occupational exposure limits. However, 62 VOC species—including chlorobenzene, chloromethane, and cyclohexane—were detected in workshop air, suggesting complex mixed organic solvent exposure. From 2010 to 2015, occupational health examination records were primarily based on physicians’ qualitative assessment, yielding generally low abnormality detection rates. During 2016–2024, data collection was complete, and the prevalences of abnormalities in liver function, metabolic syndrome-related indicators, and liver imaging among active workers remained relatively high. Trend analysis indicated that only the abnormality rates of total bilirubin (TBIL) and hypertension showed statistically significant temporal trends; other indicators exhibited no significant linear changes despite high prevalences. After adjusting for age and sex, the GLMMs showed that the abnormality rates of aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), TBIL, and hypertension decreased over time, whereas those of total cholesterol, triglycerides, and fatty liver increased. In a subgroup of 9 workers with continuous 15-year follow-up data, the cumulative number of abnormal health indicators increased in several individuals after 2016. Among the 81 workers with both pre-employment and periodic records, abnormalities in total cholesterol, triglycerides, body mass index, and fatty liver were significantly more prevalent after employment over time, whereas changes in liver function enzymes were not statistically significant. Conclusion With increasing age, workers exhibit a gradual deterioration in liver function and metabolic-related health indicators, reaching abnormality rates comparable to those reported in the general population. These findings suggest that both workplace-related and non-occupational factors jointly contribute to the observed health changes. Consequently, occupational health management should shift towards an "individual-centered" approach. Enhancing workers' health literacy, strengthening workplace health promotion, and extending occupational health services beyond the workplace are essential to comprehensively protect workers' health.

Objective To analyze the coverage of chronic disease-related indicators and the distribution of positive detection rates in occupational medical examinations (OME). Methods A total of 872 862 currently employed workers who underwent OME from 2015 to 2023 were selected as the study participants using a convenience sampling method. According to the year of OME, the study period was divided into three periods: 2015-2017, 2018-2020, and 2021-2023. The examination rates and positive detection rates of five chronic disease-related indicators, including obesity, high blood pressure, hyperglycemia, dyslipidemia, and hyperuricemia, were analyzed. Results Regarding the routine medical examination indicators in OME, the examination rates for systolic and diastolic blood pressure were both 97.4%, while those for body height and weight were both 6.8%. Among the mandatory or optional examination items for specific occupational groups in OMEs, the examination rates of fasting blood glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were 35.2%, 18.5%, 18.5%, 7.8%, and 7.9%, respectively. Regarding items not included in OMEs, the examination rates of glycated hemoglobin and uric acid were 0.2% and 19.2%, respectively. The examination rates for systolic and diastolic blood pressure consistently exceeded 95.0%, the examination rates for fasting blood glucose, triglycerides, and uric acid ranged from 32.9% to 37.0%, 16.8% to 21.4%, and 16.9% to 24.1%, respectively, while the rates for body height and weight remained below 10.0% across these three periods. Among workers who completed corresponding OME items, dyslipidemia and hyperuricemia showed relatively higher positive detection rates, with rates of 23.2% and 23.0%, respectively. The positive detection rates of obesity, high blood pressure, and hyperglycemia were relatively lower, at 9.6%, 3.5%, and 1.4%, respectively. Across the three periods, the positive detection rates of dyslipidemia, hyperuricemia, obesity, high blood pressure, and hyperglycemia ranged from 18.0% to 33.7%, 7.0% to 28.5%, 7.8% to 10.9%, 3.3% to 3.9%, and 1.4% to 1.5%, respectively, all showing increasing trends with advancing OME periods (all P<0.01). Conclusion Current OME practices show a mismatch between the coverage of chronic disease-related indicators and the actual health risks among occupational worker populations. Although blood pressure monitoring is well implemented, basic physical indicators (body height and body weight) and key metabolic indicators (blood glucose, blood lipids, and uric acid) are insufficiently covered, limiting comprehensive assessment of occupational health risks. Optimization of monitoring strategies is urgently needed to improve data completeness.

The Pharmacopeia of the People’s Republic of China 2025 Edition (referred to as the Chinese Pharmacopoeia 2025 Edition, ChP 2025) will be promulgated and implemented. This article introduces the process of development of ChP 2025 Edition (Volume Ⅱ), including the selection, the revision of general notices,the addition and revision of drug monographs, etc., and provides some analysis and examples to illustrate,which can facilitate the readers to understand and implement the ChP 2025 Edition (Volume Ⅱ).

ObjectiveTo investigate the mechanisms by which the combination of berberine （BBR） and baicalin （BAI） ameliorates type 2 diabetes mellitus （T2DM） due to internal accumulation of dampness-heat from the perspectives of gut microbiota and metabolomics. MethodsAntibiotics were used to induce pseudo-sterile mice. Thirty pseudo-sterile mice were randomized into a normal fecal microbiota transplantation group （n=10） and a T2DM （syndrome of internal accumulation of dampness-heat） fecal microbiota transplantation group （n=20）. The mice were then administrated with suspensions of fecal microbiota from healthy volunteers and a patient with T2DM due to internal accumulation of dampness-heat by gavage， respectively. Each mouse received 200 µL suspension every other day for a total of 15 times to reshape the gut microbiota. The T2DM model mice were then assigned into a model group （n=8） and a BBR-BAI group （n=11）. BBR was administrated at a dose of 200 mg·kg^-1， and BAI was administrated in a ratio of BBR-BAI 10∶1 based on preliminary research findings. The administration lasted for 8 consecutive weeks. Fasting blood glucose （FBG）， glycated hemoglobin （HbA1c）， insulin （INS）， triglycerides （TG）， total cholesterol （CHOL）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， aspartate aminotransferase （AST）， and alanine aminotransferase （ALT） levels were measured to evaluate the effects of the BBR-BAI combination on glucose and lipid metabolism and liver function in T2DM mice. Hematoxylin-eosin staining was employed to observe pathological changes in the colon tissue. The expression of claudin-1， zonula occludens-1 （ZO-1）， and occludin in the colon tissue was determined by Western blot. Real-time quantitative polymerase chain reaction（Real-time PCR） was employed to assess the levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） in the colon tissue. The fecal microbiota composition and differential metabolites were analyzed by 16S rRNA sequencing and ultra-high performance liquid chromatography-quadrupole-time of flight tandem mass spectrometry （UPLC-Q-TOF-MS）， respectively. ResultsThe BBR-BAI combination lowered the FBG， HbA1c， and INS levels （P<0.05， P<0.01） and alleviated insulin resistance （P<0.01） in T2DM mice. Additionally， BBR-BAI elevated the levels of ZO-1， occludin， and claudin-1 （P<0.05， P<0.01） and down-regulated the expression levels of TNF-α， IL-1β， and IL-6 in the colon （P<0.05， P<0.01）. The results of 16S rRNA sequencing showed that BBR-BAI increased the relative abundance of Ligilactobacillus， Phascolarctobacterium， and Akkermansia （P<0.05）， while significantly decreasing the relative abundance of Alistipes， Odoribacter， and Colidextribacter （P<0.05）. UPLC-Q-TOF-MS identified 28 differential metabolites， which were primarily involved in arachidonic acid metabolism and α-linolenic acid metabolism. ConclusionBBR-BAI can ameliorate T2DM due to internal accumulation of dampness-heat by modulating the relative abundance of various bacterial genera in the gut microbiota and the expression of fecal metabolites.

OBJECTIVE To understand the drug resistance genes,virulence genes and molecular epidemiological characteristics of extensively drug-resistant hypervirulent Klebsiella pneumoniae(XDR-hvKP)strains causing hospital-associated infection.METHODS The clinical isolates of XDR-hvKP were collected from Tongling People's Hospital from Jul.2020 to Dec.2022.The strains were identified by matrix-assisted laser desorption ionization-time-of-flight(MALDI-TOF)mass spectrometry,the common drug resistance genes and virulence genes were an-alyzed by Sanger sequencing,the capsular serotypes were determined by wzi gene sequencing;the drug resistance genes,virulence genes and ST subtypes were observed by means of whole-genome sequencing(WGS)technique.RESULTS Totally 18 strains of XDR-hvKP were collected,55.56％(10/18)of which were isolated from blood specimens,and 61.11％(11/18)were isolated from critical care medicine department.Sanger sequen-cing analysis showed that all of the strains carried blaKPC-2 drug resistance gene;rmpA2(100.00％)and rmpA,i-roN,iutA(94.44％,17/18)were the major virulence genes carried by the strains.WGS analysis indicated that all of the 18 XDR-hvKP isolates carried multiple drug resistance genes such as blaKPC-2 carbapenemase and the viru-lence genes like capsule(rmpA/rmpA2),aerobacterin(iucABCD-iutA),Salmonella(iroN)and yersinin(ybt).All of the ST subtypes were ST 11,and all of the capsular serotypes were KL 64.CONCLUSIONS The ST11-KL64 type XDR-hvKP strains carry blaKPC-2;rmpA,rmpA2,iroN and iutA are the major virulence genes.It is necessary to strengthen the monitoring of key population of the key departments and make joint efforts of multiple departments to contain the transmission of the strains.

Chronic obstructive pulmonary disease(COPD),as a global health challenge,brings heavy economic and psychological burdens to patients and their families.Accurately identifying the risk factors for COPD and excluding false associations are crucial for understanding its pathogenesis and formulating prevention strategies.Mendelian randomization(MR),as a supplementary method,has shown great potential in reducing the interference of confounding factors,lowering the cost of experimental research,and avoiding experimental ethical issues.This article focuses on MR and its main derivative methods,discusses their basic principles and applicable conditions,and analyzes their application effects and limitations in COPD research in combination with specific cases,enabling MR to be more widely applied in the study of influencing factors of COPD.

Objective To evaluate the application of ELISA randomized quality control,and continuously improve the laboratory testing capacity and quality assurance,in order to gradually improve the application of randomized quality control to the daily testing of ELISA.Methods Collected the quality control data of KEHUA HBsAg,compared the difference between randomized quality control data and immobilized quality control data.Group comparison of randomization quality control between rows and columns.The randomized quality control data were analyzed retrospectively and the quality control chart was established by using the randomized quality control data.Analyzed and compared the lost-control situation of randomized quality control and immobilized quality control.Results Randomized quality control S/CO value(2.831±0.343)and immobilized quality control S/CO value(2.651±0.260)in the same microplate,the difference between two was statistically significant(t=5.970,P＜0.05).The differences between randomized quality control and immobilized quality control in columns 2 to 8 were statistically significant(t=2.285～5.536,all P<0.05).There were no statistically significant differences between randomized quality control and immobilized quality control in column 9 to 12(t=0.031～1.605,all P>0.05).There was no statistically significant difference in randomization quality control among all lines(F=0.858,P＞0.05).The randomized quality control data was used to establish a quality control chart.Within the time range of the collected data,the randomized quality control was out of control for 6 times,all were greater than+3s,and the loss of control rate was 4.72%(6/127).Fixed position quality control lost control 9 times during the same period,all of which were greater than+3s,with a loss of control rate of 0.61%(9/1 481).Conclusion The randomized quality control has a greater possibility to reflect the factors affecting all the samples on the microporous plate.Random quality control can be used to find possible systematic errors in testing.Randomized quality control can gradually be fully applied to daily indoor quality control,but the loss of control rate and coefficient of variation may increase.

OBJECTIVE To understand the drug resistance genes,virulence genes and molecular epidemiological characteristics of extensively drug-resistant hypervirulent Klebsiella pneumoniae(XDR-hvKP)strains causing hospital-associated infection.METHODS The clinical isolates of XDR-hvKP were collected from Tongling People's Hospital from Jul.2020 to Dec.2022.The strains were identified by matrix-assisted laser desorption ionization-time-of-flight(MALDI-TOF)mass spectrometry,the common drug resistance genes and virulence genes were an-alyzed by Sanger sequencing,the capsular serotypes were determined by wzi gene sequencing;the drug resistance genes,virulence genes and ST subtypes were observed by means of whole-genome sequencing(WGS)technique.RESULTS Totally 18 strains of XDR-hvKP were collected,55.56％(10/18)of which were isolated from blood specimens,and 61.11％(11/18)were isolated from critical care medicine department.Sanger sequen-cing analysis showed that all of the strains carried blaKPC-2 drug resistance gene;rmpA2(100.00％)and rmpA,i-roN,iutA(94.44％,17/18)were the major virulence genes carried by the strains.WGS analysis indicated that all of the 18 XDR-hvKP isolates carried multiple drug resistance genes such as blaKPC-2 carbapenemase and the viru-lence genes like capsule(rmpA/rmpA2),aerobacterin(iucABCD-iutA),Salmonella(iroN)and yersinin(ybt).All of the ST subtypes were ST 11,and all of the capsular serotypes were KL 64.CONCLUSIONS The ST11-KL64 type XDR-hvKP strains carry blaKPC-2;rmpA,rmpA2,iroN and iutA are the major virulence genes.It is necessary to strengthen the monitoring of key population of the key departments and make joint efforts of multiple departments to contain the transmission of the strains.