Objective To investigate the clinical effect of combined therapy of left and right amlodipine in the treatment of hypertension complicated with perimenopausal syndrome. Methods 50 patients with hypertension associated with peri menopausal syndrome in our hospital from January 2015 to January 2016 were selected,and according to the different treatment and nursing intervention divided into observation group and control group,25 cases in each groups. The control group with routine nursing intervention and benazepril treatment, observation group with amlodipine and comprehensive psychological nursing intervention treatment before and after treatment in two; blood pressure, luteinizing hormone (LH), serum follicle stimulating hormone (FSH), estrogen (E2) level and the changes of anxiety and depression (SAS) (SDS) were recorded in detail, and the relevant data for comparative analysis. Results Amlodipine+comprehensive psychological nursing intervention (observation group) of peri menopausal comprehensive clinical effect is better than that of benazepril+routine nursing intervention patients with hypertension treatment (control group) clinical efficacy, clinical symptoms improved better than the control group, the difference was statistically significant (P<0.05). Conclusion Hypertension patients with perimenopausal syndrome patients choose amlodipine + comprehensive psychological nursing intervention treatment effect significantly, can effectively improve the clinical symptoms and psychological state, and is worthy of clinical application.

Objective To investigate and analyze the clinical efficacy of high dose hCG combined with psychological intervention in threatened abortion. Methods 50 patients with threatened abortion in our hospital from February 2015 to October 2016 were selected,and divided into study group and control group,25 cases in each groups. The study group for the first time the dosage of 10000U, after the dose to 5000U, use drug 2 times every week, and at the same time, the implementation of the corresponding psychological nursing intervention; patients in the control group for the first time the dosage was 2000U, after every day of medication 1 time, each time the dosage is still 2000U, to observe and compare the therapeutic effect. Results The patients in the study group, the success rate of pregnancy was significantly higher than the control group, while the patients in the study group, β -hCG and progesterone levels were significantly higher than those in the control group, while the study group after the nursing care of patients with anxiety and depression scores were significantly lower than the control group, the differences between the groups was obvious (P<0.05). Conclusion High dose hCG combined with psychological intervention in threatened abortion is more effective and effective in treatment of threatened abortion.

Objective To investigate the effect of magnifying endoscopy with narrow-band imaging (ME-NBI) in diagnosis of early gastric neoplastic lesion. Methods 151 patients with suspected gastric cancer underwent endoscopic examination in digestive endoscopy center from January 2013 to June 2016 were enrolled the study. They firstly received conventional white light endoscopy (WLE), then ME-NBI (including intervening part) and targeted biopsy. And all patients were divided into early cancer group (high grade intraepithelial neoplasia, intramucosal carcinoma and submucosal carcinoma, n = 72) and non-early cancer group (low grade intraepithelial neoplasia, n = 79). The area under receiver-operating characteristic curve (AUC) was performed to evaluate prognostic value of each index in early cancer. Results The incidences of the demarcation line, irregular microvascular pattern, irregular microsurface pattern and increasing intervening part in early cancer group were significantly higher than that in the non-early cancer group (P < 0.05). The AUC of ME-NBI for early gastric cancer was 0.947 and higher than 0.832 of WLE. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Youden index were 97.2%, 84.8%, 85.4%, 97.1% and 0.820, respectively. The AUC of intervening part for early gastric cancer was 0.907 and higher than 0.889 of the traditional VS classification, and AUC, sensitivity, specificity, PPV, NPV and Youden index of VS type combined with intervening part were 0.933, 95.8%, 83.5%, 84.1%, 95.7% and 0.794, respectively. Conclusions ME-NBI is an important method for diagnosis of early gastric cancer, and intervening part has the advantages of strong objectivity, simple and easy to operate, good repeatability, and it could be used to assist traditional VS classification in judging the nature of lesions.

2 years;appearedrigh quadrent abdominal signs,thickness of gallbladder wall≥3 mm;and hydrops of gallbladder.Conclusions The risk factors for conversion of LC to OC were attacks of acute cholecystitis,the length of disease,tenderness of upper abdomen,thickening of gallbladder wall and hydrops of gallbladder.A detailed history,clinical examination with suitable imaging test,proper selection of patients and improving the skill of operators,may decrease the occurrence of the LC conversion rate and the complicationafter operation.OC should be selected for the patients with the above risk factors.

Objective: To study the preparation and quality control methods of Yuanhu Zhitong HBS Tablet. Methods: the suitable excipients and formulation process of Yuanhu Zhitong HBS Tablet is sieved by means of testing quantity of tetrahydropalmatine through TLC UV. Results: the beginning floating time of HBS Tablet is 3min; relative dissolution of main component tetrahydropalmatine is 32% within 3hr, 86% within 9 hr. Conclusions: the study is found to be effective in the process of Yuanhu Zhitong HBS Tablet.

Objective:To determine the correlation of BCG concentration in Freund complete adjuvant ( FCA) and severity of arthritis during arthritis establishment in DBA 1/j male mice induced by bovine type Ⅱcollagen.Methods:CIA was induced by the im-munization of DBA1/j mice with bovine type Ⅱcollagen and BCG of various concentrations dissolved in FCA.To ascertain the effects administering the collagen booster,CIA-related features(including body weight,clinical scoring of arthritis),TNF-αin serum and the histopathological changes in the spleen and the joints regions were measured.Results:4 mg/ml BCG induced more serious arthritis than 1 mg/ml in DBA1/j mice after collagen exposure.Conclusion:There is a positive correlation of arthritis severity with BCG.Which indicates that selection of adjuvant with suitable BCG concentration could determine pathological outcome in CIA mouse model .

Objective To develop an index system for evaluation index system for community general practice teaching base.Methods A draft of evaluation index system for community general practice teaching base was preliminarily developed on the basis of literature research.Two rounds Delphi consultations with 32 experts of general practice were conducted between July 2014 and May 2015.The results of consultation were analyzed and the evaluation index system for community teaching base was established.Results In two rounds of Delphi consultation,the positive coefficients were both 100％,the authority coefficient of experts were 0.879 and 0.897,respectively,and the coordination coefficient were 0.165 and 0.204 (P ＜0.01).The established evaluation index system consisted of 4 first-class indexes,8 second-class indexes and 27 third-class indexes.Four first-class indexes were basic conditions,teaching conditions,teaching staff and teaching practice.Conclusion The established evaluation index system may be used to accredit community general practice teaching base and to improve the quality of general practitioner training.

Objective To survey the current situation of teaching for general practitioners (GPs) in community health centers of Shanghai.Methods A questionnaire survey on the teaching situation was conducted among 742 GP mentors who attended a municipal training workshop during July to October 2012 in Shanghai.The items of the survey included general background,previous teaching experience and self-evaluation on teaching ability.Results Among 742 GP mentors receiving the survey,the average age was (37 ± 6) years old.49.8％ (366/734) of mentors expressed their willingness of teaching,and the main reason was that it may upgrade themselves,while learning from teaching (58.6％,419/715).Heavy work load,lack of teaching time (31.8％,378/1 187) and teaching experience (30.7％,364/1 187) were the main obstacles for teaching.Among 106 GP mentors who had teaching experience in community health center previously,79.2％ (80/101) made teaching plans,but only 8.9％ (9/102) often prepared syllabus.Teaching plans were made mainly according to the work needs in community health care (54.2％,52/96),the situation and demands students (29.1％,28/96) or requirement of syllabus (17.7％,17/96).The problems included lack of teaching experience (50.5 ％,50/99) and time (42.4％,42/99),monotonous instructional modality (24.1％,25/104),and weak operability of the syllabus (21.2％).The self-reported results showed that 14.4％ were not able to develop a teaching program and to execute,18.3％ were not able to use a variety of teaching methods,31.2％ were not able to engage in teaching for 1.5 days per week.Logistic regression analysis showed that mentors with higher education background (OR =2.027,P ＜ 0.05),community teaching experience (OR =3.069,P ＜ 0.05),higher self assessment of general personal quality and communication ability (OR =2.488,P ＜ 0.05),higher teaching ability (OR =2.399,P ＜ 0.05) and strong training wishes (OR =11.382,P ＜ 0.05) were more willing to engage in the teaching work.Conclusions Heavy work load,insufficiency of teaching capacity and experience are main problems for GP mentors in Shanghai community health centers.Educational theory and methods should be focus on teacher training so as to improve teaching abilities.

Objective To explore the role of CD4+CD25+CD127low/-regulatory T cells (Tregs) in the pathogenesis of psoriasis vulgaris(PV). Methods Flow cytometry analysis was used to detect the amount of Tregs in peripheral blood and ELISA to test the levels of IL-10 and TGF-β1 in blood serum; the suppressive function of Tregs on autologous CD4+CD25-T cells was determined by MTT method. Results No significant difference was found in the proportion of Tregs in PV patients and healthy controls(P>0.05). There was a diminished suppression of Tregs from patients on autologous CD4+CD25- responder T cell proliferation in PV patients when compared with that in controls (P < 0.01). The serum level of IL-10 in patients was lower than that in controls (P < 0.01) while that of TGF-β1 in PV patients was significantly higher than that in controls(P < 0.01). Conclusion Abnormal function of Tregs and low secretion of IL-10 in PV patients might be related to the pathogenesis of psoriasis.

Objective To investigate the capacity and training needs of the community general practice mentors in different areas of Shanghai.Methods General practice mentors from community health centers,who attended a municipal training program in Shanghai during July 2012 to October 2012,were participated in the survey with a self-designed questionnaire.The general condition,basic ability (clinical skill,teaching ability and professional development),motivation and needs of training were investigated.The factors affecting the willingness of training were analyzed.Results Among 742 mentors receiving the survey,259 were from the urban area,174 from rural-urban continuum and 309 from rural area.The academic degree in urban group was relatively higher:17 out of 257 (6.6％) holding master degree.The ratio of participants who had received standardized training in urban,rural-urban and rural areas was 33.2％,25.3％,37.4％,respectively.The personal quality and communication skills in urban group were significantly higher than those in rural-urban continuum and rural group (18.58 ± 2.49,17.89 ± 2.69,17.85 ±2.34,P ＜0.05).The clinical skill (12.31 ± 1.98,11.95 ±2.02,11.52 ± 1.81),teaching ability (11.99 ± 2.62,11.63 ± 2.86,11.12 ± 2.77) and professional development (6.42 ± 1.61,6.36 ± 1.55,5.61 ± 1.38) in urban group were all significantly poorer than those in other two groups.The main purpose of participation in training was to improve medical knowledge and clinical skills in three groups (70.8％,74.0％,80.4％,respectively),followed by the need for community teaching.The rural group has higher training requirements in improving clinical diagnosis and treatment ability (75.3％,80.1％,85.5％,respectively in three groups),doctor-patient communication ability (38.0％,44.0％,50.7％,respectively) and community preventive care ability (29.4％,30.7％,42.8％,respectively).The urban group had much more requirements in scientific research training (38.8％,34.9％,14.1％,respectively).Logistic regression analysis showed that doctors with supports from the leadership (OR =2.688,P ＜ 0.05) and with less working stress (OR =2.241,P ＜ 0.05) were more willing to participate in mentor training.Conclusion There are discrepancies in basic ability and training needs of community general practice mentors in different areas of Shanghai,so we should develop specific or targeted training program in the future.