Objective To study the impact of head nurses'support on the creation of encouraging management atmosphere.Methods We randomly selected 120 clinical nurses from the Sir Run Run Shaw hospital.Then we adopted head nurses'support questionnaires,nurses'stressor questionnaires and career satisfaction questionnaires and drew argumentation of our hypothesis by introducing double-factor theory.Results The management atmosphere was only inferior to the workload among all of the stressor resources.The supportive behaviors of head nurses were positively related to the career satisfaction of nurses and the encouraging management atmosphere.Conclusion Head nurses'could relieve nurses'working pressure and unsatisfactory attitude toward work by using supportive management style.In this way they could increase encouraging factors in the management and facilitated the creation of encouraging management atmosphere and improvement of effective management.

In this study ,the objective is to establish a nested‐PCR assay for the detection of H .bilis with high sensitivity and specificity .The nested primers were designed based on sequences of 16S rRNA gene of seventeen subtypes of H .bilis .Af‐ter optimizing reaction condition ,the sensitivity and specificity of the assay were examined via the detection of feces simulated samples ,mice infection model samples and clinic patients’ samples .The detection sensitivity of H .bilis strain for feces simu‐lated samples was 10 CFU/100 μL .H .bilis was successfully detected in the liver ,caecum and feces of experimentally infected mice .Moreover ,H .bilis was successfully detected in the bile ,cholecyst mucous membrane and feces samples from two of ten patients with cholelithiasis .Due to the PCR assay’s high sensitivity and specificity ,the method may be used to detect the infec‐tion of H .bilis .

Objective: To study the protective effect of melatonin (MT) against lead-induced neurotoxicity. Methods: PC12 cells were divided in four groups (control, 25 μmol/L PbAc, 50 μmol/L MT and 25 μmol/L PbAc+50 μmol/L MT) . After treatment, cell viability was detected by cell counting kit-8 (CCK-8) assay and cytotoxicity LDH assay were used to evaluate cell damage rate. The expression of Cleaved-Caspase-3 and cytochrome C (cyto C) was detected by immunofluorescence (IF) . ROS levels were measured by DCFH method. GSH contents and SOD activities were detected after whole cell protein was extracted. Results: Compared with control group, 25 μmol/L PbAc caused significantly decreased cell viability, GSH contents and SOD activities, while increased cell damage rate and ROS level significantly (P<0.05) . 25 μmol/L PbAc could also increase the protein level of cleaved-caspase-3 and cyto C in cytoplasm. Compared with 25 μmol/L PbAc group, 50 μmol/L MT+25 μmol/L PbAc caused significantly increased cell viability, GSH contents and SOD activities, while decreased cell damage rate and ROS level significantly (P<0.05) . Compared with 25 μmol/L PbAc group, 50 μmol/L MT+25 μmol/L PbAc decreased the protein level of cleaved-caspase-3 and cyto C. Conclusion Melatonin could attenuate PbAc-induced oxidative stress and cell death and promote cell survival.

Objective To explore the change and significance of blood lipid and oxidative stress in subchnical hypothyroidism during pregnancy.Methods 100 pregnant women with subclinical hypothyroidism during pregnancy were chosen and set as the disease group,while 100 healthy pregnant women were chosen and set as the control group.Thyroid function index:free three iodine thyroid original glycine (FT3),free thyroid hormones (FT4),thyroid stimulating hormone (TSH),blood lipids index:triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),and oxidative stress indicators:superoxide dismutase (SOD),malondialdehyde (MDA),type oxidized low density hpoprotein (ox-LDL) in the two groups were detected and analyzed.Results FT3 and FT4 between the two groups had no statistical significance (P＞0.05).TSH in the disease group was (4.63±1.09) mIU/L,significantly higher than that of the control group(P＜0.05).The comparison of TG,HDL-C between the two groups had no statistical significance(P＞0.05).TC and LDLC in the disease group were significantly higher than those of the control group (P＜0.05).MDA and ox-LDL in the disease group were significantly higher than those of the control group,while SOD was significanTLy lower than that of the control group(P＜0.05).Conclusion Subclinical hypothyroidism during pregnancy can cause metabolic disorder of blood lipid and reduce oxidative stress ability.Monitoring and intervention of blood lipid and oxidative stress status is necessary.

Objective To summarize the clinical characteristics of patients with occupational melanosis. Methods Diagnostic data of 69 patients with occupational melanosis was analyzed using retrospective analysis. Results The main occupational hazards for the 69 patients with occupational melanosis were coal tar, petroleum and its fractionated products, pigments and dyes and their intermediates, rubber additives and rubber products. The median length of occupational exposure and disease latency were 8.0 and 6.0 years, respectively, with a highly positive correlation between them (Spearman correlation coefficients=0.962, P<0.01). Skin lesions were mainly found on exposed areas such as the face-to-neck and limbs, prevalence of 94.2% and 75.4% respectively. And 78.3% of patients had skin lesion on more than two sites. The lesions were mostly in the form of irregular flakes (59.4%), with a gray-black color (44.9%). About 43.5% of patients experienced skin itching. Complete blood count, liver function, and kidney function were all within normal ranges. Skin biopsy results showed that epidermal hyperkeratosis, thinning of the spinous layer, liquefaction degeneration of basal cells, increased superficial dermal melanocytes, and infiltration of lymphocytes, histiocytes, and melanocytes around the blood vessels. Reflectance confocal microscopy (RCM) detection showed focal liquefaction degeneration of basal cells in the lesions, with a significant infiltration of melanocytes and inflammatory cells in the dermal papillae and superficial layers. Conclusion The primary target organ of occupational melanocytes is the skin, and no damage to other organs was identified thus far. Results from skin biopsies and RCM examinations can be used for differential diagnosis.

ObjectiveTo analyze the effect of frailty status on the risk of mortality in a community-based population aged 45 years and above in Shanghai with different characteristics， and to provide further basis for population-based interventions for frailty and prevention of adverse outcomes. MethodsData were derived from baseline data from the Shanghai prospective study on AGEing and adult health （2009-2010） and cohort follow-up of causes of death up to October 30， 2021. Frailty index （FI） scores were constructed from 40 variables. Those with frailty index FI≥0.2 were judged to be in a frail state， and a multifactorial Cox regression model was used to calculate the hazard ratio （HR） to evaluate the effect of frailty status on the risk of death in different age groups by gender. Socioeconomic characteristics （age， residence， marital status， education and family economic level， etc.） and health-related behaviors （smoking， alcohol consumption， fruit and vegetable intake， social participation， etc.） were included as control variables. ResultsThe study included 7 978 subjects， 777 （9.7%） of whom were in a frail state. After （11.3±1.8） years of follow-up， 1 043 （13.1%） individuals were dead， including 214 （27.5%） who were frail. The results of the multifactorial Cox regression analysis showed that the effect of frailty on the risk of death in each subgroup was in descending order of men in the middle-aged group （45‒ years） （HR=2.92， 95%CI： 1.38-6.19）， women in the low-aged elderly group （60‒ years） （HR=1.68， 95% CI： 1.08-2.60）， and women in the old-aged elderly group （≥75 years and older） （HR=1.59， 95%CI： 1.22‒2.06）. ConclusionFrailty is associated with the risk of death， and we should focus on the frailty status of men aged 45~59 years and women aged 60 years and above. Early screening and assessment of frailty status and taking appropriate preventive interventions may reduce the occurrence of adverse outcomes and premature death.