Objective To develop cadres' stress scale for the Chinese people' s armed police forces.Methods Based on the stress theory and principles of the psychometrics,combined with characteristics of armed police forces. The cadres' stress scale was developed by ourselves. 802 cadres were evaluated as samples and statistic the data by item analysis ,factor analysis, reliability and valid analysis. Results The scale included four dimensions: task stress, economy stress, interpersonal stress and development stress. The internal consistency reliability was 0.893 ,the split-half reliability coefficient was 0.812. Retest reliability coefficient was 0.813. The criterion related validity to the stress scale and SCL-90 was good and the correlation coefficient with somatization, anxiety,depression, interpersonal sensitivity was 0. 376,0. 383,0. 396,0. 387 individually (P ＜ 0.05 ). Conclusion Cadres stress scale for cadres of Chinese people's armed police forces has good reliability and validity.

Objective To study the practical value of 3 dimensional computed tomography on diagnosis of bladder tumor. Methods Fifteen patients with bladder masses were examined by thin layer computed tomography.The results of 3 dimensional reconstructed images were compared with the final diagnosis and the pathological stages. Results According to 3 dimensional reconstructed images,among the 15 cases,12 cases of bladder cancer were diagnosed,and the pathological types were transitional carcinoma.Two cases were diagnosed as benign tumor (leiomyoma),and the other one was colon cancer,which invaded bladder.The accuracy was 100%.The clinical stages were determined.Of the 12 bladder carcinomas,5 was in stage T 1,3 in T 2,3 in T 3 and 1 in T 4.The accuracy of staging was up to 83%(10/12) compared with pathological stages. Conclusions The 3 dimensional reconstructed technology may improve the accuracy of staging of bladder carcinoma,and to provide important evidence for surgery options.

An analysis of the time pattern of outpatients visits to our hospital from 1997 to 2000 led to the discovery of the variation pattern of each outpatient departments workload. This discovery has enabled the managers of the hospital to rationally deploy the manpower and material resources of various departments, make full use of limited resources, readjust the working hours and shifts of different kinds of staff, and work out a flexible system of working hours which is more scientific and more convenient to patients. Implementation of such a system has ensured that prompt delivery of medical service is accessible to patients even at the peak of visiting hours. Hence the reduction of patients time of waiting and the provision of a scientific guarantee for establishing a quality, efficient, low consumption and fast outpatient service system, meeting the medical needs of patients to the maximum and enhancing work efficiency.

Objective To explore whether PPARαtransgenic mice are more sensitive animal models in the evalua-tion of toxicity of PPARαagonists.Methods Twenty-eight 8-week old PPARαtransgenic mice (Tg) and 28 C57BL/6J mice (WT) with half males and half females were randomly divided into high dose group (400 mg/kg of clofibrate), low dose group (30 mg/kg of clofibrate) and solvent control group (10%sodium carboxymethyl cellulose ).The time of gavage administration lasted 28 days.The blood biochemistry , organ coefficient and pathological changes of the heart , liver, kid-neyweretestedafterthedrugadministration.Thegrowthofmicewasalsorecorded.Results ①Bloodbiochemistry:Com-pared with the WT male administration group , in the Tg male administration group , the levels of blood creatinine ( CREA) and aspartate aminotransferase (AST) were markedly increased (P<0.01, P<0.05).② Organ coefficient: Compared with the Tg control group, the kidney coefficients of Tg administration group were significantly increased (P<0.01,P<0.05).③Histopathology:Compared with the WT administration group , the pathological damages of liver and kidney were more serious in the Tg administration group .Conclusions Compared with C57BL/6J mouse, PPARαtransgenic mice are more sensitive in evaluation of hepatotoxicity and nephrotoxicity of PPARαagonists .It is a new animal model .

OBJECTIVE:To investigate the application effect of PDCA circulation method in clinical pharmaceutical care. METHODS:According to the method of PDCA cycle,clinical pharmaceutical care quality and satisfaction degree of physicians, nurses and patients in 2013 were investigated to find out the problems;the reasons were analyzed and countermeasures were made out,checked and implemented. Finally,the quality of clinical pharmaceutical care,the medical staff and patient's satisfaction with clinical pharmaceutical care were compared before and after the implementation of PDCA circulation. RESULTS:Due to the poor quality of clinical pharmaceutical care and low satisfactory degree of our hospital,we formulated related countermeasures,such as enhancing the medication service skill of clinical pharmacists in obstetrics and gynecology department,extending the coverage of pharmaceutical ward round,developing the pharmaceutical care for patients with high risk pregnancy or underwent assisted repro-duction,strengthening communication and propaganda of medical staff and patients. After the implementation of countermeasures, the quality indicators of clinical pharmaceutical care were improved in 2014,compared to 2013,such as the number of patients in-cluded in pharmaceutical ward round increased from 445 to 1 780;total number of reasonable medication intervention suggestion in-creased from 14 to 29;that of pharmaceutical consultation increased from 8 to 23;the satisfaction degree of medical staff and pa-tients improved from 55.93% and 45.95% to 100% and 92.10%,respectively. CONCLUSIONS:PDCA circulation can significant-ly improve the quality of clinical pharmaceutical care and satisfactory degree of our hospital,and promote pharmaceutical care of our hospital.

Objective:To detect the methylation level and mRNA expression level of peroxisome proliferator activated receptory-coactivator-1α (PGC-1α) gene in placental tissue of pregnant women with gestational diabetes (GDM) and to explore the relationship between them and fetal distress.Methods:A total of 174 pregnant women with GDM admitted to in our hospital from Jul. 2018 to Dec. 2019 were selected as the study objects, among which 78 pregnant women with fetal distress were selected as the fetal distress group; and 96 pregnant women with normal delivery and without fetal distress were the control group; during the same period, 82 normal pregnant women without GDM were selected as the healthy group. The methylation level of PGC-1α gene in placenta was detected by direct sequencing after DNA was treated with sodium bisulfite; the expression of PGC-1α mRNA in placenta was detected by real-time fluorescence quantitative PCR (qRT-PCR) ; the levels of triglyceride (TG) , total cholesterol (TC) , low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were measured by automatic biochemical analyzer; the relationship between methylation frequency of PGC-1α gene and the expression level of PGC-1α mRNA was analyzed; and the influencing factors of fetal distress were analyzed.Results:PGC-1α gene methylation frequency and TG level were higher in the fetal distress group [ (25.42±7.31) %, (4.72±0.68) mmol/L] than in the control group [ (9.26±2.67) %, (4.31±0.64) mmol/L] and the healthy group [ (3.24±1.07) %, (4.33±0.72) mmol/L]. PGC-1α gene methylation frequency was higher in the control group than in the healthy group, and the differences were statistically significant ( P<0.05) ; PGC-1α mRNA expression level in fetal distress group (0.67±0.16) is lower than that in the control group (0.74±0.14) and healthy group (1.00±0.27) . PGC-1α mRNA expression level in control group was lower than that in healthy group, and the difference was statistically significant ( P<0.05) ; the methylation frequency of PGC-1α gene was negatively correlated with the expression level of PGC-1α mRNA in pregnant women with fetal distress ( r=-0.515, P<0.05) ; the methylation of PGC-1α gene was an independent risk factor for fetal distress ( P<0.05) , and the high expression of PGC-1α mRNA was the protective factor of fetal distress ( P<0.05) . Conclusion:DNA methylation level of PGC-1α gene in pregnant women with GDM is related to fetal distress, which may be the target of gene modification for fetal distress.

Objective:Objective To explore the special role of nutrition specialists in the one-day-care clinic of gestational diabetes mellitus (GDM), and provide a basis for strengthening the standardized construction of one-day-care clinic.Methods:It was a retrospective observation study that the pregnant women who participated in the one-day-care clinic of GDM in our hospital without nutrition specialists in November and December 2017 were divided into control group (177 cases), and who participated in the one-day-care clinic of GDM in our hospital with nutrition specialists in January and February 2018 were divided into observation group (307 cases). The differences of pregnancy outcomes between the two groups were compared after the propensity score matching.Results:176 pairs of patients were successfully matched with a 1:1 propensity score. The incidence of macrosomia in pregnant women with GDM in the observation group (2.8%) was significantly lower than that in the control group (8.5%) ( P=0.036). There were no significant differences in the weight gain during pregnancy, the gestational week of delivery and the incidences of insulin use, hypertension during pregnancy, preeclampsia, cesarean section, premature infants, premature rupture of membranes, umbilical cord around the neck, and fetal distress between the two groups ( P>0.05). Conclusion:Nutrition specialists are indispensable in the multidisciplinary cooperation of one-day-care clinic of GDM, and they play a key role in considerably lowering the prevalence of macrosomia in GDM pregnant women.

Objective: To observe the correlation between Nε-carboxymethyl-Lysine (CML), the main component of advanced glycation end products and the calcification of the anterior tibial artery plaque in patients with diabetic foot post foot amputation. Methods: Sixty patients hospitalized for foot amputation operation due to diabetic foot from June 2012 to June 2016 in the Department of Orthopedics, Affiliated Hospital of Jiangsu University were prospectively recruited.The patients were categorized into mild stenosis (0n=20), moderate stenosis (50%≤stenosis<70%, n=20) and severe stenosis (70%≤stenosis≤100%, n=20) based on the color Doppler ultrasound assessed severity of anterior tibial artery stenosis.The baseline clinical data of patients were collected and anterior tibial artery was isolated.Then, HE staining, O-Cresolphthalein Complexone method, enzymic method and ELASA analysis were then performed to detect the evolution of calcification, arterial calcium content, alkaline phosphatase activity and serum CML concentration, respectively. Results: The results from both color Doppler ultrasound scan before amputation and HE staining after amputation showed that echo intensity as well as spotty blue calcium particles of anterior tibial artery plaque increased significantly in proportion to degree of stenosis and destructed elastic plate of the arterial wall was evidenced in patients with severest stenosis.The content of calcium ((2.3±0.9), (3.9±1.3), (6.6±1.7) μmol/mg, respectively, P<0.001), ALP activity ((102.4±39.4), (202.3±73.4), (483.7±117.9) U/mg, respectively, P<0.001) and serum CML level ((28.9±4.4), (37.9±5.3), (57.3±7.1)μg/L, respectively, P<0.001) increased significantly in proportion to stenosis severity.Pearson correlation analysis showed that serum CML level was positively correlated with the content of calcium (r=0.749, P<0.001) and ALP activity (r=0.923, P<0.001), respectively. Conclusions Serum CML level is positively correlated with the calcification of anterior tibial arterial plaque in patients with diabetic foot and could be used to evaluate the calcification of anterior tibial arterial plaque and stenosis degree of anterior tibial arterial in these patients.

Objective:To observe any effect of intermittent theta burst stimulation (iTBS) of the cerebellum on swallowing dysfunction after cerebellar infarction, and to explore its mechanism.Methods:Sixty-two cerebellar stroke survivors with dysphagia were randomly divided into an observation group and a control group, each of 29. In addition to the routine swallowing rehabilitation training, the observation group was treated with iTBS, while the control group was given sham iTBS. The incubation and amplitude of the bilateral suprahyoid muscle motor evoked potential (MEP) were recorded before and after 4 weeks of treatment. The exponential approximate entropy (ApEn) of different brain regions was compared between the two groups during reflex and autonomous swallowing. Swallowing function was evaluated using the penetration-aspiration scale (PAS).Results:MEP incubation in the bilateral suprahyoid muscles had decreased significantly after 4 weeks of treatment in the observation group, and the MEP amplitude in the bilateral suprahyoid muscles of the two groups had increased significantly. The average improvement in the amplitude and incubation in the observation group was significantly greater than in the control group. The average ApEn at C3, C4, P3, P4, T5 and T6 had increased significantly in both groups during both reflex and spontaneous swallowing, with the improvement in the observation group significantly greater. Swallowing function had improved significantly in both groups, but the average PAS grade of the observation group was again significantly better.Conclusions:iTBS can improve the swallowing function of dysphagic cerebellar stroke survivors. This may be due to iTBS improving the excitability of the cerebral cortex and improving motor control of the swallowing muscles.

At present, discipline construction has gradually become the core theme of the development of clinical pharmacy in hospitals. As a key construction project unit of clinical pharmacy in Shanghai, from August 2017 to October 2019, the Obstetrics and Gynecology Hospital of Fudan University continued to promote the clinical pharmacy from four aspects: improving the practical ability of clinical pharmacists, building the information and automatic clinical pharmaceutical service mode, establishing the talent training echelon and promotion system, and strengthening the capacity of clinical transformation research and construction.