Résumé
Objective: To analyze the status of occupational medical examination (OME) institutions in Guangdong Province and the critical control points affecting their future development. Methods: A total of 211 OME institutions registered in Guangdong Province were selected as the research subjects. Their current statue was investigated, and the risk assessment of their future development was carried out based on hazard analysis and critical control point theory. Results: The OME institutions were mainly concentrated in the Pearl River Delta, accounting for 72.0%. The public and private medical and health institutions accounted for 70.6% and 29.4% respectively. The filing rates of different OME categories from high to low in the order were physical factors, chemical factors, dust, other, radiation factors, biological factors (P<0.01), and the filing rates were 89.6%, 88.6%, 84.8%, 63.0%, 7.1% and 1.0%, respectively. The rates of excellence in the field assessment from high to low in the order were hearing atlas analysis personnel, lung function examination operators, chest film reading personnel, chief examination physician, technical director, quality director (P<0.01), and the rates of excellence were 49.4%, 26.2%, 20.6%, 10.8%, 8.2% and 4.6%, respectively. A total of 37 institutions did not submit OME information, of which 23 institutions did not carry out OME work after filing. The required diagnosis rate and confirmed diagnosis rate of suspected occupational diseases in 2020 were 34.3% and 55.3%, respectively. In 2021, the detection rate of suspected occupational diseases was only 1.1‰. Among the institutions with biological monitoring records, 64.1% did not participate in external quality assessment program in laboratory, and the unqualified rate of 38 participating institutions was 55.3%. The risk assessment results show that the future development of OME institutions needs to focus on private institutions, institutions that have not reported OME information, institutions that have missed diagnosis and missed reporting of suspected occupational diseases, institutions that have not participated in external quality assessment program in laboratory and core personnel such as quality managers, technical leaders, and main inspection physicians. Conclusion: OME institutions in Guangdong Province show the characteristics of centralized filing category, centralized filing region and centralized filing institution nature. Combined with the potential risks of OME institutional capacity building, it is necessary to implement classified management, strengthen information construction, supervision and management, implement post responsibilities, and promote the high-quality development of OME institutions.
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The Prevention and Control of Occupational Diseases Law revised in 2017 abolished the qualification test and approval for occupational health examination institutions, and replaced it with record management. The record does not belong to any type of administrative permit and does not require the premise of “general prohibition”. Its core idea is that “the public law actively acts as an obligation”, which does not prohibit administrative counterpart from carrying out specific tasks, mainly information collection, supervision and management of follow-ups, and emphasizes on simplifying procedures, improving working efficiency and stimulating market vitality. It is a strategic measure of the government's reform on “release, control and service”. It has the functional significance of alleviating information asymmetry, cultivating market credit mechanism and reflecting the government's flexible supervision and management mechanisms. However, China has not yet unified legislation on record management, and individuals on the theoretical and practical circles have different understandings on the concept, operation principle, and management effectiveness of the record management. There are practical dilemmas in the record management of occupational health examination institutions, such as alienation of record management into licensing, insufficient regulation of record management procedures, and weak in-process and post-process supervision and management capabilities. It is suggested to clarify the legal nature of record management, unify and improve the record management procedures, and improve in-process and post-process supervision and management capabilities. By building a legal, scientific and systematic regulation for the record management of occupational health examination institutions, adhering to the unity of “discharge” and “control”, it could effectively safeguard the legitimate rights and interests of occupational health examination institutions, workers and employers.
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OBJECTIVE: To explore the correlation between the cognition on hearing protection and mental health status of noise-exposed workers. METHODS: A total of 499 noise-exposed workers from 3 enterprises of coal mine, steel and textile in Xinjiang region were selected as study subjects by stratified cluster random sampling method. The cognitive status of hearing protection and mental health status of each group were investigated by the Workplace Health Promotion Pilot Project Questionnaire. RESULTS: A total of 235 workers had abnormal mental health status.The abnormal rate of mental health status was 47.1%(235/499). The results of logistic regression analysis showed that female, age ≤40.0 years, unable to bear current noise hazards, worried about noise-induced-deafness and noise-induced discomfort were the risk factors of abnormality of mental health status(odds ratio values were 1.62, 1.87, 2.42, 2.20, 2.14, P<0.05). Using hearing protectors for ≥3.0 years was the protective factor of abnormality of mental health status(odds ratio value was 0.47, P<0.05). CONCLUSION: The subjective cognition on hearing protection has an impact on the mental health of noise-exposed workers.
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Based on reviewing briefly the development of the general education both in China and United States,selecting respectively a university as the example,the article has analyzed comparatively curriculum programs of general education between the two schools.Aimed at existing problem,from curriculum content carding,structure optimizing,teaching operating and evaluation of the effect,the article has proposed new thinking of reform on the general education of higher institutions.
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Objective To explore the relationship between CRP and glucose metabolism in advanced solid tumor patients. Methods 32 advanced stage malignant tumor patients with mild pain took celecoxib 200mg/qd orally, the plasma level of CRP, FBS, FINS, IR were measured before taking drug and 5 days later. Results CRP is well related with FINS, IR, P level, CRP[(8.17?1.76) mg/L vs (4.37?0.65) mg/L], P(876?123)pmol/L vs (621?145) pmol/L], FINS[(14.23?7.21) ?U/L vs (9.83?3.37) ?U/L] and IR [(3.2?1.01) vs (1.9?0.78)] all were improved significantly after taking celecoxib. Conclusion CRP has some relationship with abnormal glucose metabolism in advanced stage malignant tumor patients, taking celecoxib may improve this abnormal glucose metabolism.
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As an important force in the process of China’s public medical education, private higher medical education is faced with severe challenges at the same time the development is made. On the basis of analyzing the development situation of private higher medical colleges and the deep space of development, the article promotes suggestions of the healthy development of private medical colleges, by macro-coordination from the government, private schools running orderly, improving the quality of education, and social support.
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By analysing the new requirements of higher medical education curriculum in the new era,making curriculum changes of Nanjing Medical University as an analysed object,the arti-cle analyses the existing problems and shortcomings of China's current medical education course system,puts forward optimizing the course system further by running clear thinking,construction of composite course system,innovating teaching methods,strengthening the building of teaching mate-rials,the establishment of curriculum assessment mechanisms.