Objective To investigate the serum adiponectin levels and TNF-? levels in women with gestational diabetes and to study their clinical significance.Methods Plasma concentration of adiponectin,tumor necrosis factor alpha and correlate parameters were measured in 50 patients with gestational diabetes(GDM)and 36 pregnant women with normal glucose tolerance(NGT).Radio immunoassay was used to measure the adiponectin,TNF-? level was measured by ELISA.Serum insulin level was measured by Electrochemiluminescent immunoassays fasting glucose levels by glucose oxidase method.Results GDM patients had significantly lower concentrations of adiponectin(10.3?(2.4) mg/L) and elevated levels of TNF-?(4.6?(1.5)?g/L) in comparison to NGT women.In GDM group TNF-? level was correlated positively with serum insulin level,glucose level.Concentration of adiponectin was negatively correlated with corresponding parameters.Conclusion Elevated level of TNF-? and decreased adiponectin concentration may not simply reflect maternal adiposity and insulin resistant state,but may contribute to the impaired glucose metabolism during pregnancy and forecast the risk of metabolism syndrome.

Objective To investigate Shanghai rehabilitation resources and services, define the status and problems and provide suggestions for making Shanghai rehabilitation health care system planning. Methods Based on the "Structure-Process-Result" theoretical framework, the questionnaire survey and field investigation were conducted on medical institutions in term of the rehabilitation departments setting, manpower, beds, equipment, housing, income and expenditure, and referral services. Results There were 321 rehabilitation doctors, 860 rehabilitation therapists and 666 rehabilitation nurses, 2199 preparation beds and 2573 real beds in all kinds of rehabilitation medical institutions. The rates of carrying out rehabilitation services were 94.79% in general hospitals, 100.00% in rehabilitation hospitals, 75.56% in community health service centers, rehabilitation equipment rates were 50.79%, 71.15%, 17.77%, and 27.73 %, 30.00%, 13.21% of them provided outpatient rehabilitation services. Conclusion Shanghai tertiary rehabilitation medical services architecture has initially formed, however, there are still many problems in the rehabilitation function. The rehabilitation health care system planning should focus on rehabilitation services capacity, rehabilitation staff team, rehabilitation resources and services referrals.

Objective To investigate the status of rehabilitation personnel in Shanghai. Methods Shanghai medical institutions were investigated through self-questionnaire including rehabilitation personnel quantity, basic characteristics of sociology and training from 2011 to 2013. Results There are 2262 rehabilitation personnel on duty in the medical institutions, with 321 rehabilitation doctors, 860 rehabilitation therapists and 666 rehabilitation nurses, 415 people without identity; female rehabilitation doctors, female rehabilitation therapists and female rehabilitation nurses account for 48.91%, 54.77%, 98.80% respectively; 25-34 years old group accounts for 44.24%, 38.84% and 39.79% respectively; working less than 5 years accounts for 30.84%, 65.00% and 60.81% respectively. Rehabilitation doctors with bachelor degree and clinical profession account for 56.70% and 75.07% respectively; rehabilitation therapists with college degree and rehabilitation profession account for 48.37% and 89.19% respectively; rehabilitation nurses with college degree and nursing profession account for 52.25% and 99.55% respectively; rehabilitation physicians, therapists and rehabilitation nurses who didn't accept the professional training of rehabilitation account for 4.36%, 4.07% and 28.68% respectively. Conclusion Shanghai rehabilitation personnel are deficient and some staff has not yet been identified, rehabilitation personnel structure and functional reeducation also need to be reinforced.