Objective To assess the quality of gross α and β radioactivity measurements conducted by radiological health service institutions and disease prevention and control centers in Gansu Province, China, and regulate their measurement methods. Methods The samples were distributed by Gansu Provincial Center for Disease Control and Prevention as the organizer of the inter-comparison through mail. The institutions participated in the inter-comparison carried out the measurements in accordance with national standards, and submitted the inter-comparison reports in the form required by the inter-comparison scheme. Results A total of 13 institutions participated in the 2023 inter-comparison of gross α and β radioactivity measurement capabilities, and all measurement results met the required standards. The absolute Z-scores for gross α inter-comparison ranged from 0 to 1.21, and the absolute Z-scores for gross β inter-comparison ranged from 0.08 to 1.85. The comprehensive scores ranged from 74.5 to 93.0. Conclusion The measurement capacities of the institutions participated in the 2023 inter-comparison showed improvement compared with the previous year. However, 12 institutions participated in the inter-comparison showed issues in data processing, report formatting, and laboratory quality control. It is necessary to strengthen technical training, standardize the measurement procedures, and improve the measurement capabilities and skills to ensure the quality of services.

In environmental epidemiological research, extensive non-random environmental exposures and complex confounding biases pose significant challenges when attempting causal inference. In recent years, the introduction of causal inference methods into observational studies has provided a broader range of statistical tools for causal inference research in environmental epidemiology. The instrumental variable (IV) approach, as a causal inference technique for effectively controlling unmeasured confounding factors, has gradually found application in the field of environmental epidemiological research. This article reviewed the basic principles of IV and summarized the current research progress and limitations of applying IV for causal inference in environmental epidemiology. IV application in the field of environmental epidemiology is still in the initial stage. Rational use of IV and effective integration with other causal inference methods will become the focus of the development of causal inference in environmental epidemiology. The aim of this paper is to provide a methodological reference and basis for future studies involving causal inference to target population health effects of environmental exposures in China.

Objective To investigate the effects of occupational exposure to ionizing radiation on blood indicators of radiation workers, and to provide evidence for occupational health monitoring. Methods This study included 3853 radiation workers who participated in occupational health examination in Gansu Provincial Center for Disease Control and Prevention from January 1, 2021 to December 31, 2022. The results of fasting blood glucose, renal function, liver function, white blood cell count, platelet count, and lymphocyte micronucleus were analyzed. Results The detection rates of abnormal fasting blood glucose and liver function were significantly higher in males than in females (P < 0.05), and the detection rates of abnormal renal function, white blood cell count, platelet count, and lymphocyte micronucleus were significantly lower in males than in females (P < 0.05). The detection rates of abnormal fasting blood glucose, liver function, and lymphocyte micronucleus were significantly higher in radiation workers with ≥ 21 years of working experience than those with ≤ 10 years of working experience (P < 0.05). The detection rate of abnormal fasting blood glucose was significantly higher in the non-medical group than in the diagnostic radiology, radiation therapy, and interventional radiology groups (P < 0.05). The detection rate of abnormal fasting blood glucose was significantly higher in the primary medical institution group than in the tertiary medical institution group (P < 0.05). The detection rate of abnormal liver function was significantly higher in the primary medical institution group than in the secondary and tertiary medical institution groups (P < 0.05). Conclusion Long-term occupational exposure to ionizing radiation may cause radiation damage to the human body. Health education should be strengthened for non-medical and male radiation workers to prevent the occurrence of chronic metabolic diseases.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective To investigate the effects of occupational exposure to ionizing radiation on blood indicators of radiation workers, and to provide evidence for occupational health monitoring. Methods This study included 3853 radiation workers who participated in occupational health examination in Gansu Provincial Center for Disease Control and Prevention from January 1, 2021 to December 31, 2022. The results of fasting blood glucose, renal function, liver function, white blood cell count, platelet count, and lymphocyte micronucleus were analyzed. Results The detection rates of abnormal fasting blood glucose and liver function were significantly higher in males than in females (P < 0.05), and the detection rates of abnormal renal function, white blood cell count, platelet count, and lymphocyte micronucleus were significantly lower in males than in females (P < 0.05). The detection rates of abnormal fasting blood glucose, liver function, and lymphocyte micronucleus were significantly higher in radiation workers with ≥ 21 years of working experience than those with ≤ 10 years of working experience (P < 0.05). The detection rate of abnormal fasting blood glucose was significantly higher in the non-medical group than in the diagnostic radiology, radiation therapy, and interventional radiology groups (P < 0.05). The detection rate of abnormal fasting blood glucose was significantly higher in the primary medical institution group than in the tertiary medical institution group (P < 0.05). The detection rate of abnormal liver function was significantly higher in the primary medical institution group than in the secondary and tertiary medical institution groups (P < 0.05). Conclusion Long-term occupational exposure to ionizing radiation may cause radiation damage to the human body. Health education should be strengthened for non-medical and male radiation workers to prevent the occurrence of chronic metabolic diseases.