Objective To develop a suitable instrument for measuring health beliefs related to reproductive tract infections (RTIs) and testing its reliability and validity. Methods Within the framework of the Health Belief Model, 500 questionnaires of health beliefs related to RTIs were collected, its reliability and validity was analyzed. Results The instrument contained two subscales, all content validity index(CVI)were 1.0. RTIs-related health belief subscale extracted four factors, the cumulative variance was 75.91%;RTIs-related self-efficacy subscale extracted four factors,the cumulative variance was 68.19%. Scale statistics consisted with the structure and design structure. The dimensions Cronbach's α coefficient, test-retest reliability, split half reliability were greater than 0.70. Conclusions This scale has good reliability and validity and can be used for measuring health beliefs related to reproductive tract infections in women of childbearing age.

The reform of performance appraisal and salary system is key to public hospitals reform.This paper introduced practices of the factor performance and salary system reform based on the Balance Scorecard in hospitals.It established a four-dimension performance appraisal structure,a motive salary allocation model covering all members of a hospital.This would help build the performance appraisal and salary allocation system meeting present needs of public hospitals in China.

Objective To investigate the change of serum alkaline phosphatase (ALP) level in patients with acute cerebral infarction (ACI) and its clinical significance.Methods A total of 400 patients with ACI (ACI group) and 240 gender-and age-matched healthy controls during the same period were enrolled in this study.Serum ALP,total protein,alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and other indicators of liver function,serum creatinine (Cr),blood urea nitrogen (BUN) and other indexes of renal function were determined.ACI patients were divided into three subgroups according to the largest diameter of infarction slice on the diffusion weighted imaging (DWI):small area group (＜1.5cm),middle area group (1.5-4.0cm) and large area group (＞4.0cm).The degree of neurologic impairment at admission and the degree of nerve function recovery at discharge were assessed by National Institute of Health stroke scale (NHISS) and modified-Rankin Scale (mRS) in all patients.The relationship of serum ALP level with infarction area,NHISS score and mRS was analyzed.Results Serum ALP level was higher in ACI group than in control group [(80.1±24.4)U/L vs.(75.5±21.5)U/L,t=-2.471,P=0.014].Serum ALP level was elevated along with the increase of infarction areas in ACI group [(78.0 ± 23.3)U/L,(79.4±24.9) U/L vs.(87.7±26.0) U/L,F=4.374,P=0.013].The correlation analysis showed that serum ALP level was positively correlated with infarction area (r=0.118,P=0.019) and NHISS score (r=0.114,P=0.023),but no significant relationship was found with mRS (r=0.071,P=0.08).Multivariate regression analysis revealed that patients with high serum ALP level (＞86 U/L) had 1.691-fold higher risk for cerebral infarction than did those with low serum ALP level(＜67 U/L) (OR=1.691,95％CI:1.103～2.594) after adjusting for confounding variables including age,gender,hypertension,diabetic mellitus,heart disease (coronary heart disease and atrial fibrillation),et al.Receiver operating curves (ROC) analysis revealed that the area under the curve of serum ALP level for predicting ACI was 0.557 (95％CI:0.512～0.602,P=0.016),and its sensitivity and specificity were 43.1％ and 67.6 ％ respectively when serum ALP level was 81.5 U/L.Conclusions Serum ALP level is increased in ACI patients,which has positive correlations with cerebral infarction areas and NHISS scores.In the future,maybe,we could assess ACI by monitoring serum ALP levels or improve the prognosis of ACI patients by decreasing serum ALP levels in the future.

Objective In order to choose a suitable method in detecting MRS,the detection rate,sensitivity and specificity of Vitek-32 auto microbacteria indentity system,oxacillin agar dilution test,cefoxitin disk diffusion test and PCR for mecA gene are evaluated.Methods MRSA and MRCNS are detected by the four methods metioned above in 175 staphylococci,then comparing the postive detection rate by Chi-square test and calculating sensitivity and specificity of the other three methods based on PCR for meeA gene as a gold standard.Results The detection rate of four methods have no difference in detecting MRSA,but the detection rate of Vitek-32 auto microbacteria indentity system and oxacillin agar dilution test is better than that of PCR for mecA gene in detecting MRCNS.Sensitivity and specificity of Vitek-32 auto microbacteria indentity system,oxacillin agar dilution test and cefoxitin disk diffusion test in detecting MRSA are 100%、96.3%、96.3% and 88.2%、100%、100% respectively,the sensitivity of detecting MRCNS are all 100%,the specificity of detecting MRCNS are 50%、46.1% and 65.4% respectively.Conclusions Both mecA gene and the determination for MIC of Oxacillin should be considered in final decision for MRS,Furthermore.the MRS mediated by mecA gene and the MRS mediated by non-mecA gene should be treated differentially.

Community Health Committee (CHC), an innovative public participation mechanism of grassroots health service management, established a bottom-up communication channel between the public and government to communicate health related problems and opinions, and set up a grassroots community health services supervision system. The rural residents were endowed with opportunities to take part in grassroots health care decision making and management by CHC. CHC changed the top-down model of traditional health management, improved the grassroots medical services, and increased governance capability of local government We introduced the CHC practice in Zhejiang project counties, exhibited the primary effects and experience of this pilot program, and explored new mechanism and model for rural community residents to participate in grassroots health service management

Objective To investigate the expression of actin-associated protein Transgelin in pancreatic cancer with or without diabetes and its effects on migration and invasion in SW1990 cell line. Methods The expression of Transgelin in 92 pancreatic cancer tissue specimens (45 cases accompanied with diabetes) and adjacent tumor-free tissue specimens (over 5cm from the edge of the tumor) was detected by immunohistochemistry, and their association with clinical pathological characteristics were also analyzed. Transgelin siRNA was designed and transfected into pancreatic cancer cell line SW1990. The changes of migration and invasion before and after transfection were observed through Transwell test.Results The positive percentage of Transgelin expression in pancreatic cancer was 68.5 ％ (63/92), which was significantly higher than that of adjacent tumor-free tissues[33.7％ ( 31/92), P＜ 0.05]. The positive percentage of Transgelin expression in pancreatic cancer accompanied with diabetes was 84.4％ (38/45), which was significantly higher than that without diabetes[53.2％ (25/47), P＜0.05]. The expression of Transgelin in pancreatic cancer tissues was associated with lymph nodes metastasis and TNM staging (both P＜0.05), but not related with gender, age, site, differentiation and portal vein or nerve invasion (P＞0.05). After Transgelin was interfered for 48 hours, the migration ability was significantly lower (migration cell number 49.2 ±9.5 cells) than negative control group (61.9±7.5 cells) and blank group (65.3±10.6 cells) (both P＜0.05), and the invasion of SW 1990 cells (48.0 ± 8.6 cells) also significantly lower than negative control group (63.5±11.4 cells) and blank group (67.5±9.6 cells) (both P＜0. 05). Conclusion Transgelin may involve in the metastasis of pancreatic cancer accompanied with diabetes through promoting pancreatic cancer cell migration and invasion.

Objective To evaluate the effect of tirofiban injection in coronary artery occlusion by suction catheter on the opening time of the coronary artery occlusion , the improvement of the blood flow and the incidence of adverse events in 30 days. Methods A total of 97 patients with acute myocardial infarction in recent 4 years were included , whose culprit vessels were subtotal occlusion or total occlusion by angiography and were randomly divided into thrombus aspiration group (group A) and tirofiban injection in occlusion and thrombus aspiration group (group B). The opening time of the coronary artery, the improvement of the blood flow and the incidence of adverse events in 30 days were compared between two groups. Results The opening time of the coronary artery occlusion in group A was shortened when compared with group B but the blood flow arriving TIMI III grade in group B was shorter (P < 0.05). No-reflow incidence in group B was lower while the proportion of blood flow arriving TIMI III grade was higher than that in group A in early phase (P < 0.05). The incidence of adverse events in 30 days was decreased in group B when compared with group A ,but the difference wasn't statistically significant (P > 0.05). Conclusion Direct tirofiban injection in coronary artery occlusion could effectively shorten the opening time of the coronary artery occlusion reduce no-reflow incidence , and improve coronary perfusion but could not decrease the incidence of adverse cardiovascular events in 30 days.

Objective To investigate the alternation of right ventricular volume and systolic function in patients with severe pulmonary regurgitation under percutaneous pulmonary valve implantation(PPVI) by real-time three-dimensional echocardiography(RT-3DE).Methods Ten patients with severe pulmonary regurgitation were enrolled.The 2D echocardiography images and real-time 3D full volume images on apical four-chamber view on a Philips IE33 system were acquired before PPVI and at 3 days,1 month,3months and 6 months after PPVI.Right ventricular end diastolic volume (EDV),end systolic volume(ESV),stroke volume (SV),ejection fraction(EF),fractional area change(FAC),tricuspid annular plane systolic excursion (TAPSE),right ventricular longitudinal strain-free wall(RVLSf) and right ventricular longitudinal strainseptum(RVLSs) were analysed using off-line TomTec software,the differences among the five groups were compared,and correlation analysis was made between the CMR and RT-3DE measurements.Results The level of pulmonary regurgitation had decreased or disappeared after PPVI.Compared with the preoperation,EDV,ESV at 3 days,1 month,3months and 6 months after operation had decreased significantly.EF,FAC,TAPSE,RVLS had increased significantly(all P ＜0.05).There were close correlation in EDV,ESV,EF between RT-3DE and CMR(pre-operation r =0.811,0.817,0.807,post-operation r =0.735,0.834,0.800,all P ＜0.055).Conclusions RV volume notably decreases while RV systolic function remarkably improves.The RT-3DE is a helpful technology in the evaluation of right ventricular volume and systolic function in patients after PPVI.

Objective To investigate the association of the expressions of glomerular nephrin, vascular endothelial growth factor (VEGF) and its receptor (VEGFR) with proteinuria in preeclampsia rats. Methods A rat model of preeclampsia was developed by inhibitor of nitric oxide synthase (L-NAME). The systolic blood pressure (SBP) and 24 h urine protein were compared among the normal female group (n=6), the normal pregnant group (n=8), nonpregnant control group (n=6) and preeclampsia group(n=8). The kidney biopsies of each group were observed by light and electron microscopy. The glomerular nephrin was detected by Western blotting and real-time PCR. Immunofluorescence was used to detect the expression of WT1. The level of glomerular VEGF and VEGFR (Flt-1 and Flk-1) were evaluated by Western blotting. Results The level of glomerular nephrin protein in the rats with preeclampsia (0.0726±0.0074) was significantly lower compared with normal female group (0.3795±0.0509), normal pregnant group (0.2361±0.0437) and nonpregnant control group (0.7265±0.0503) (P＜0.01, respectively), while the levels of nephrin mRNA were not significantly different among 4 groups. The expression of WT1 was not significantly different among 4 groups as well. The level of glomerular VEGF in preeclampsia group (1.5429±0.0898) was significantly higher compared with normal female group (1.1870±0.1160), normal pregnant group (1.3741 ±0.1165) and nonpregnant control group (1.0155±0.0742)(P＜0.01,respectively). VEGFR (Flt-1 and Flk-1) was also significantly higher in preeclampsia rats compared with other control groups (P＜0.05, respectively). Conclusions In preeclampsia rats, nephrin is decreased significantly and the glomerular VEGF-VEGFR is increased significantly compared with the other control groups. The abnormal expression of nephrin and VEGF-VEGFR may be involved in the preeclampsia proteinuria. The underlying mechanism of this phenomenon needs further research.

Objective:To explore the effects of teamwork strategy in cardiac rehabilitation exercise therapy for elderly patients with myocardial infarction.Methods:From November 2017 to May 2019, we selected elderly patients with myocardial infarction at Shulan (Hangzhou) Hospital as the study objects by convenience sampling. All patients were divided into control group ( n=58) and observation group ( n=60) . Control group implemented the routine nursing. On the basis of routine nursing, observation group carried out the cardiac rehabilitation exercise therapy by applying the teamwork strategy. We compared the exercise compliance and activities of daily living (ADL) of patients between two groups. Results:The exercise compliance of patients in observation group was higher than that in control group with a statistical difference ( P<0.01) . At discharge, the score of Barthel index of patients in observation group was higher than that in control group also with a statistical difference ( P<0.01) . Conclusions:Teamwork strategy helps to improve the exercise compliance and ADL in elderly patients with myocardial infarction.