Association between iron intake from different sources and risk of gestational diabetes mellitus： a retrospective cohort study / 上海预防医学

ObjectiveTo explore the association between total iron， iron supplements， dietary total iron， heme iron intake and the risk of gestational diabetes mellitus（GDM）. MethodsA total of 668 pregnant women who gave birth in one hospital in Shanghai during January 2020 to July 2021 were included in a retrospective cohort study. Baseline characteristics and data of iron supplements in second trimester were collected through a questionnaire. A simplified dietary frequency questionnaire was used to quantify the food intake in second trimester. Total iron， iron supplements， dietary total iron， and heme iron intake was classified into groups by quintile and median. The association between iron intake from different sources and risk of GDM was determined using logistic regression analysis. ResultsAfter correction for age， family history of diabetes， overweight / obesity before pregnancy， hemoglobin（Hb）in first trimester， energy， carbohydrate energy， protein， and free sugar， it showed no association between total iron intake and risk of GDM （P>0.05）， while elevated risk of GDM among women with high iron supplements intake （OR=1.65； 95%CI： 1.14‒2.39）， and decreased risk of GDM among those with high dietary total iron intake （OR=0.53； 95%CI： 0.35‒0.81）. However， no association was found between heme iron intake and risk of GDM （P>0.05）. ConclusionHigh dietary total iron intake may be a protective factor， while high iron supplements may be a risk factor for GDM. It suggests that pregnant women should carefully choose high-dose iron-containing supplements in the absence of iron deficiency， as dietary iron intake should be the priority.

A Study on the Tendency of Medical Students’ Choice of Moral Dilemma / 中国医学伦理学

【Objective:】 Using classic moral dilemma cases, this paper investigates the choice tendency of medical students when facing the moral dilemma, and analyzes their cognitive status and characteristics when facing the "moral dilemma", in order to provide effective enlightenment for optimizing the teaching cases of medical ethics. 【 Method:】 771 medical students in Shanghai Jiao Tong University School of Medicine were investigated by electronic questionnaire and SPSS 20.0 for statistical description and statistical analysis. 【Result:】 In the emergency room doctors and transition scenes, medical students tend to the principle of maximum happiness, and in the ring track scene and pedestrian overpass scene, they tend to the principle of deontology; In the loop track scene and pedestrian overpass scene, boys are more inclined to deontological principles than girls, and undergraduates are more inclined to deontological principles than postgraduates, and the difference is statistically significant (P<0.05). 【Conclusion:】 Although medical students have different moral tendencies in different scenes, they generally do not agree with the practice of sacrificing one person to save five people. Especially when more rigorous sacrifice conditions cause greater moral pressure, the vast majority of medical students will tend to the latter between utilitarianism and deontological principles.

Effects of strict control of tobacco advertisement after implementation of the Advertising Law / 上海交通大学学报（医学版）

Objective · To compare the prevalence of tobacco advertisement before and after implementation of the new edition of Advertising Law of the People's Republic of China and evaluate the effects of implementation of the new Advertising Law. Methods · Tobacco sales places, public places, and streets in Shanghai were randomly selected to observe tobacco advertisement and complete the survey. The survey was carried out in 10 districts of Shanghai in June 2015 with 10 tobacco sales places selected in each district, and in 4 districts of Shanghai in June 2016 with 25 tobacco sales places selected in each district. Sales places included convenient stores, tobacco stores, supermarkets, and kiosks. In addition, public transport waiting points, public transport vehicles, hospitals, shopping centers, restaurants, bars, and Internet cafes were selected into survey in 2016. Results · In 2016, the proportion of tobacco sales places having tobacco advertisement was lower than that in 2015, but the proportion of tobacco promotion behaviors was higher. In 2016, 128 public places and streets were investigated and only 1 had outdoor tobacco advertisement. Conclusion · The new edition of Advertising Law has significant effect on controlling tobacco advertisement, but tobacco sales places still have tobacco advertisement with various disguised promotion forms. Tobacco sales places have diversified business styles and minors often enter these places. It is recommended that a clear definition of disguised forms of tobacco advertisement should be made, tobacco advertisement at tobacco sales places needs to be supervised, the release of tobacco advertisement should be strictly reviewed, and existing tobacco advertisement should be severely punished, so as to prevent minors from exposing to tobacco advertisement and information luring smoking.

Passive smoking status and its influencing factors among pregnant women in Shanghai / 上海交通大学学报（医学版）

Objective · To investigate the prevalence of passive smoking among pregnant women in Shanghai and to analyze its influencing factors and to provide the basis and suggestion for making related intervention measures to reduce the harm of secondhand smoke on the health of pregnant women. Methods · From July to October 2014, pregnant women and their spouses were recruited for a questionnaire investigation at the antenatal care clinics of 3 maternity hospitals and 3 community hospitals in Shanghai. The questionnaire included demographic information, family basic situation and cognitive status of passive smoking. Results · The passive smoking rate before pregnancy in the 2831 pregnant women, who were involved in the investigation, was 17.1%. The passive rate during pregnancy was 7.8%. The difference between these two rates was statistically significant (P<0.05). 71.0% of the pregnant women have passive smoking for 15~59 min each day. Relative to home and work place, the passive smoking rate of pregnant women in public place was the highest (P<0.05). The passive smoking rate of pregnant women was significantly associated with the educational level of smoking spouses and the attitude of pregnant women when they faced the smokers. Conclusion · The passive smoking rate of pregnant women is influenced by the educational level of their spouses and the pregnant women's feedback to the smokers face to face. Public places are the most important exposure places to secondhand smoke for pregnant women. In order to reduce the harm from passive smoking to pregnant women and their fetuses, the related measures of smoking control at home education and smoking ban in public place should be made.

Intention of quitting smoking and influencing factors among the husbands in gestational households in Shanghai / 上海交通大学学报（医学版）

Objective · To investigate the intention of quitting smoking and influencing factors among husbands in gestational households in Shanghai and provide a scientific basis for establishing smoking cessation strategies. Methods · Pregnant women and their spouses who received antenatal examination in 5 hospitals in Shanghai were asked to finish two versions of questionnaires respectively. Basic demographic information, smoking history, history of smoking cessation and intention of quitting smoking were investigated. The database was set up by EpiData 3.1, and data were analyzed by SPSS 22.0, such as descriptive analysis, χ2 test (univariate), and Logistic regression analysis (multivariate). Results · A total of 282 questionnaires were sent to smoking husbands and 266 effective questionnaires got back with the effective rate of 94.3%. Among them 34.2% smoking husbands had intention of quitting smoking, 18.4% were trying to quit, and 22.9% had tried to quit before. Single-factor analysis showed that influencing factors for intention of quitting smoking among smoking husbands in gestational households included the daily cigarette consumption, overall opinion for smoking, the knowledge about the harm of passive smoking to pregnant women and fetuses, having smoking cessation experience or not, how many people smoking among five intimate friends except family members (P<0.05). Multivariate Logistic regression analysis showed that intention of quitting smoking had relationship with the daily cigarette consumption (OR = 0.456, 95% CI: 0.245 ~ 0.852), overall opinion for smoking(OR=2.443, 95% CI: 1.008 ~ 5.921), having smoking cessation experience or not (OR =0.316, 95% CI: 0.162 ~ 0.616). Conclusion · Intention of quitting smoking is relatively strong in gestational households. It is recommended to strengthen the education of tobacco control for smoking husband in gestational households, and encourage smokers who had smoking cessation experience before to quit smoking again.

Investigation on smoking status of hypertensive elderly in Waigang Town of Shanghai: a cross-sectional study / 上海交通大学学报（医学版）

Objective · To investigate the smoking hypertensive elderly, find out the status of smoking in this population, and explore effective system intervention. Methods · The smoking hypertensive elderly in Waigang Town of Shanghai who received free antihypertensive drugs were recruited to investigate and descriptively analyze the smoking status of them with questionnaires. Results · There were 77.6% of the smoking hypertensive elderly who began to smoke in the age of 13 to 25, and nearly 70% smoking for more than 40 years. There were 59.5% of these people smoking 11 to 29 cigarettes daily in recent 3 years, and 41.6% spending 200-299 yuan on smoking monthly. Conclusion · Currently almost 70% of the smoking hypertensive elderly, who receives free antihypertensive drugs, have been smoking for more than 40 years, and the average number of cigarettes smoked daily is big. It is clear that the health education attached to the policy of providing free antihypertensive drugs has not changed the behavior. Therefore, medical personnel still needs to contact the illness and smoking hazards to help the elderly reduce smoking. Besides, it proves that tobacco control should be implemented in the young population to control epidemic at the early stage.

Attributes of community medical service products and their development / 中华全科医师杂志

As a new service form,community medical service provides primary health care for residents and it is operated with reasonable medical expenses.The function and service range of community medical service have reached consensus in medical industry,but the key issues of how to gain the market by competitive products and reasonable price have not been solved.This article analyzes the position of community medical service in healthcare system to clarify its unique attributes.The article further discusses the contents and pricing characteristics of community medical service,and the main influencing factors.The article introduces the issues dealing with community medical service product development,including the procedure of development,key points at different stages of development and the related research methods for the development of new service products.

Survey on the current situation of professional knowledge and protection consciousness in CSSD practitioners in Shanghai / 上海交通大学学报（医学版）

Objective · To conduct a survey on the current status of professionalism and personal protection in Central Sterile Supply Department (CSSD) practitioners in Shanghai, analyze the existing problems and provide suggestions, in order to improve work quality and management level of CCSD. Methods · Cluster sampling was used to extract 23 different level hospitals with CSSDs among 4 districts in Shanghai including Jing'an, Jinshan,Qingpu and Jiading. A total of 147 participants consisted of 104 employees and 43 heads of CSSDs. Field investigation and questionnaire survey were applied into CSSD practitioners for investigating their essential information, professionalism and personal protection status. Results · Practitioners in different hospitals showed different professional knowledge, especially practitioners in private hospital performed worse than those in secondary and tertiary-level hospitals in this survey of professionalism. Daily protection measures were defective due to lacking of consciousness of personal protection.Conclusion · There was problem of personal professionalism and protection consciousness in CSSD practitioners. It is important to optimize the allocation of CSSD human resource, reinforce skill training and improve quality management.

Study on the competency of community health administrators / 中华医院管理杂志

Objective To explore the competency of community health administrators in a survey of such administrators at large in Shanghai. Methods McClelland's Competency Dictionary was used to set two benchmark positions, while the behavioral event interviewing and questionnaires were made to survey 19 community health service centers in Shanghai. Results The competency model benchmarking on the head of a medical branch consists of 6 character clusters, 11 characteristic items, 27 evaluation dimensions and 27 typical behavior descriptions. The model benchmarking on the community team leader consists of 5 character clusters, 8 characteristic items, 21 evaluation dimensions and 21 typical behavior descriptions. Conclusion Findings of the survey provide objective criteria for competence appraisal of community health administrators, and serve as reference for formulating their development plans as well.

Exploration of research and development in biomedical industry by reference of kanban management concept / 中华医学科研管理杂志

This paper summarized the theory and characteristics of Kanban management,analyzed characteristics of the biomedical industry,research and development.The Kanban management put forward some ideas for the managemerit of biomedical research and development,also the task decomposition,team communication and the compression cycle were proposed respectively in it.The industry case would corroborate the Kanban management for the management of the biomedical research and development to be able to use as a reference to management innovation.

Advanced Contract Research Organization-Based Innovated Pattern of Biopharmaceutical Industry / 中国药房

OBJECTIVE:To explore the innovation pattern of biopharmaceutical industry in China.METHODS:Three major problems encountered by the research and development (R&D) of new drug,the core of Chinese biopharmaceutical industry,including the weak construction of operation base for R&D of new drug,insufficient fund,difficulty in the transformation of achievements were analyzed.An innovation pattern of biopharmaceutical industry was founded based on the "Contract Research Organization(CRO)".RESULTS:An innovation industry pattern consisting of multiple-concurrent CRO R&D mode,venture capital and patent/new drug certificate tie-in financing form and new drug certificate oriented R&D process management has been put forward,which was integrated into an "advanced CRO"(CRO+) mode.CONCLUSION:The CRO+ mode is an open and integrative service system which can help shorten the R&D cycle,lower the cost and risk of R&D and promote the development of biopharmaceutical industry in China.