Objective: To investigate the relationship between occupational stress and working ability of workers in a petroleum processing enterprise in a high altitude area. Methods: A total of 728 workers in a petroleum processing enterprise at an altitude of 2850 m were subjected to a survey using Occupational Stress Inventory (OSI) , Work Ability Index (WAI) Scale, Occupational Role Questionnaire (ORQ) , Personal Strain Questionnaire (PSQ) , and Personal Resource Questionnaire (PRQ) from May 2014 to August 2016. Results: Of the 728 workers, 55 (7.6%) had a poor working ability, moderate in 262 (35.9%) , and good in 411 (56.5%). There were significant differences in WAI between the workers with different types of work, sexes, ages, and working years (P<0.05). There was a significant difference in WAI between different occupational stress groups (P<0.05). WAI was negatively correlated with ORQ score and PSQ score (r_s=-0.387, P<0.05; r_s=-0.467, P<0.05) and positively correlated with PRQ score (r_s=0.343, P<0.05). The multiple linear regression analysis showed that high ORQ score and PSQ score were the inhibitory factors for high WAI (B=-0.058; B=-0.082) and high PRQ score was a contributing factor for high WAI (B=0.029) . Conclusion Occupational stress is an influencing factor for the working ability of workers in the petroleum processing enterprise in the high altitude area. Hypoxia in high altitude area may further reduce the working ability. In order to reduce occupational stress and improve work ability, it should be considered to strengthen skills training, improve the working environment, and pay attention to mental health.

Abstract: In order to ensure the safety and efficacy of generic drugs for the substitution of narrow therapeutic index (NTI) drugs, and to improve and optimize China's generic drug substitution policy, we searched foreign literature databases and government websites to collect and sort out the typical measures taken by some foreign countries to ensure the safety and efficacy of generic drugs for the substitution of NTI drugs, including R&D registration, generic drug substitution and post-market surveillance. On the basis of comparative analysis, this paper summarizes the practices China can learn from. It can be seen that there are problems and challenges in China's generic drug substitution for NTI drugs, such as unclear targets for bioequivalence studies of NTI drugs, insufficient rational decision-making basis for generic substitution of NTI drugs, and imperfect post-market surveillance system, etc. It is recommended that we should formulate a list of NTI drugs, play the roles of physicians and pharmacists in generic drug substitution, adjust the generic drug substitution for NTI drugs according to the level of risk of drug use, and improve the reporting system for adverse reactions due to generic drug substitution.

OBJECTIVE To provide reference for the construction of remote inspection mode of pharmaceutical production in China. METHODS By combing the guidance documents of remote inspection and related pilots issued abroad， the experience of constructing remote inspection mode of pharmaceutical production was summarized. RESULTS & CONCLUSIONS Typical foreign countries and regions have carried out remote inspection pilots all over the world， and clearly defined the application situation， implementation process， inspection techniques and related points for attention of remote inspection of pharmaceutical production. In terms of application， the European Union pointed out four specific applicable situations， including travel restrictions， while the United States stipulated that remote inspection was applicable to pre-approved inspection and so on. In terms of the implementation process， the United States developed a four-step method of remote inspection， while the European Union has defined the specific implementation process of remote inspection in more detail. In comparison， Japan paid more attention to the remote inspection process of production documents. In terms of inspection techniques， the European Union used 360° cameras， Matterport 3D technology and document review software to realize the remote inspection of production sites and production documents. In terms of attention points for remote inspection， the United States required that access rights should be set for information sharing to avoid information disclosure. Both the European Union and the United States required inspectors to be trained and equipment inspected before remote inspection. It is suggested that China should formulate unified guidelines for remote inspection of pharmaceutical production， clarify the applicable situations， and formulate the implementation process of remote inspection of pharmaceutical production with reference to the opinions of drug manufacturers. In addition， intelligent remote inspection technology can be used in combination with the information construction level of drug manufacturers， and remote inspection training program can be formulated to cultivate professional remote inspection team.

OBJECTIVE: To explore the relationship between metabolic syndrome( MS) and occupational stress among workers in high altitude area. METHODS: A cross-sectional study was conducted in 940 workers as research subjects who were engaged in petroleum smelting,thermal power generation and financial management et al. in high altitude area. A questionnaire survey was conducted using the Occupational Stress Inventory-Revised for occupational stress, The occupational health examination was performed to measure waist circumference,blood pressure,blood sugar and blood lipids. RESULTS: The abnormal rates in obesity,triglycerides,high-density lipoprotein,blood pressure and fasting blood glucose were 28. 3%,16. 3%,14. 3%,13. 3% and 6. 5%, respectively. The detection rate of MS was 5. 0%( 47/940). The multivariate logistic regression analysis showed that the risk of elevated MS decreased with the increased of occupational stress level( P < 0. 05),and the risk of elevated MS increased with the increased of occupational stress reaction severity( P < 0. 05),after adjusting the confounding factors of gender and labor nature. CONCLUSION: The higher occupational stress reaction of the workers in high altitude area,the higher the risk of MS.

OBJECTIVE: To comprehend the status of knowledge-attitude-practice( KAP) and its effect on blood lead in workers exposed to lead.METHODS: Three hundred and fifty-one first-line lead exposed workers in the smelting industry were chosen as study subjects by cluster sampling method.Blood lead levels in peripheral venous blood were detected.Questionnaire survey was conducted by self-compiled Questionnaire of Knowledge-attitude-practice on Occupational Health in Lead Workers.RESULTS: Among the study subjects,145 workers had abnormal blood lead level( ≥600 μg/L),the abnormal rate was 41.3%.The correct scoring rate in occupational knowledge,attitude,and practice were 25.1%,45.3% and 15.7%,respectively.Multivariate logistic regression analysis results showed that the four risk factors of high blood lead level were wearing no personal protective equipment,not bathing and changing clothes before returning home,not gargling and washing hands before meals,smoking and eating in workplace.CONCLUSION: Poor occupational behaviors can increase the risk of high blood lead level in lead exposed workers.

To meet the requirement of pathological practice and development, we systematically analyzed the situation of pathological residents training and the importance of initiating the clinical scientific research training. Additionally, we proposed the principle and implementation strategy for clinical scientific research training. According to features of pathological practice, we employed the modularized teaching to divide the training courses into several modules: discussion module for clinical pathology, lecture module for advanced research, and training modules for basic scientific theory, technology and writing skill. With these approaches, the systematic and structured system of standardized residents training is implemented to improve the clinical research ability of pathological residents.