Objective To analyze the sonographic characteristics of endometrial lesions to increase the diagnostic accuracy of the sonography. Methods 69 patients diagnosed as endometrial lesions by transvaginal color Doppler sonography(TVCDS) were retrospectively analyzed. The findings of TVGDS were compared with pathological diagnosis. Results The total diagnostic accordance rate of TVCDS was 91. 3% for endometrial lesions, including 93. 0% for endometrial polyps,91. 3% for endometrial hyperplasia,84. 2% for endometrial cancer, and 95. 0% for submucosal uterine fibroids respectively. In addition,the blood flow image rate and arterial resistance index(RI) had significant difference (P＜0.05) between endometrial cancer and other benign lesions of endometrial, and all of these have obvious correlation with pathological findings. Conclusion TVCDS was an effective screening method for the diagnosis and differential diagnosis of endometrial lesions.

Objective:To survey the knowledge levels of sudden cardiac death (SCD) prevention among general practitioners (GPs) in Henan province.Methods:From October to November 2019, a questionnaire survey on the knowledge of SCD prevention and treatment was conducted among GP residents participating in the standardized training and assistant GPs taking final examination after training in Henan province. The questionnaire included three dimensions of SCD knowledge: prevention, early diagnosis and first aid. The factors influencing the knowledge levels on SCD prevention were analyzed.Results:A total of 546 questionnaires were distributed and 519 responders (95.1%) completed the questionnaire, including 176 GP residencies and 343 assistant GPs. The age of the respondents was 22-44 (27.91±2.84) years, 234 (45.1%) were males and 285 were females. The overall correct rate of SCD prevention and treatment was (61.46±12.39) %, and the correct rates of prevention, early diagnosis and first aid knowledge were (65.22±17.88)%, (56.58±20.20)% and (62.57±14.60)%, respectively. The overall correct rate and the correct rates of SCD prevention and treatment knowledge among GP residents were higher than those among assistant GPs ( t=10.55, 9.20, 8.62, 3.42, P<0.001); the overall correct rates and the correct rates of SCD first aid knowledge of female GPs were higher than those of males ( t=2.26, 2.13, P=0.025, 0.033); the overall correct rate and the correct rates of each dimensions in age group ≥28 years were higher than those in age group <28 years ( t=4.21, 3.37, 3.20, 2.00, P<0.05). The multivariate logistic regression analysis showed that compared to GP residents,the assistant GPs was the factor influencing the lower levels of the overall knowledge ( OR=0.24, 95 %CI:0.16-0.38, P<0.001), knowledge of prevention ( OR=0.19, 95 %CI:0.10-0.32, P<0.001) and knowledge of early diagnosis ( OR=0.35, 95 %CI: 0.23-0.52, P<0.001);compared to male responders,the females had significantly higher pass rate in SCD first aid knowledge ( OR=1.56, 95 %CI:1.07-2.28, P=0.020). Conclusions:The SCD knowledge levels of the prevention, early diagnosis, and emergency treatment are less satisfactory among GPs in Henan province; it is necessity for targeted training on the weak points of SCD knowledge for GPs.

Objective:To survey on the knowledge, attitude and prescribing of benzodiazepines (BZDs) among general practitioners.Methods:A questionnaire survey was conducted in November 2018 among 396 clinicians who participated in the general practice training in Henan Province, including 131 general practitioners (GP group) and 265 non-GPs (non-GP group). The questionnaire included basic information of clinicians, BZDs prescription and training, subjective attitude and knowledge of BZDs.Results:The results of 396 valid questionnaires showed that 55 (13.9%) clinicians had participated in BZDs related training, and 331 (83.6%) clinicians had prescribed BZDs. There was no significant difference in the duration of BZDs continuous use between the GP group and the non-GP group (χ 2= 8.37, P>0.05). The overall score of subjective attitude towards BZDs was low [4(2,6) - 5(3,9)], and the score of BZDs training needs was high [10(8,10)]. Compared to non-GP group, the GP group had lower confidence in BZDs indication [4(2,6) vs. 5(3,6), Z=-2.66, P<0.05 ], the lower ability of judging BZDs addiction [5(2,6) vs. 5(3,7), Z=-2.52, P<0.05], and less understanding of BZDs use guidelines [4(1,5) vs. 4(3,6), Z=-3.05, P<0.05]. In terms of prescription tendency, the GP group was less inclined to prescribe BZDs according to experience [5(2,7) vs. 6(4,8), Z=-3.50, P<0.05]. In the knowledge of BZDs, the total score of GP group was lower than that of non-GP group, the [11(8,12) vs. 11(9,13), Z=-2.06, P<0.05]. The proportion of GPs with drug addiction recognition[66.4%(87/131) vs.77.7%(206/265),χ 2=5.84] and pharmacology knowledge [59.5%(78/131) vs.72.1%(191/265),χ 2=6.32] were all lower than that of non-GPs( P<0.05). Conclusions:General practitioners are lack of knowledge about BZDs and confidence in prescribing BZDs. It is necessary to carry out training on BZDs, especially for addiction and drug effects.

Objective:To analyze and compare the clinical indicators and the liver failure-related prognostic score of patients with amanita phalloides poisoning with different prognoses, and to explore potential prognostic indicators.Methods:A retrospective case-control study was conducted. The clinical data of 52 patients with amanita phalloides poisoning admitted to the department of emergency of Xijing Hospital Affiliated to Air Force Medical University from September 2016 to September 2021 were collected, including general information (gender, age), clinical indicators at admission [mean arterial pressure (MAP), total bilirubin (TBil), aspartate transaminase (AST), alanine transaminase (ALT), albumin (ALB), serum creatinine (SCr), blood urea nitrogen (BUN), creatine kinase (CK), D-dimer, fibrinogen degradation product (FDP), prothrombin time (PT), activated partial thromboplastin time (APTT), prothrombin activity (PTA), international normalized ratio (INR), white blood cell count (WBC), platelet count (PLT)], liver failure-related prognostic score [sequential organ failure assessment (SOFA), chronic liver failure (CLIF)-SOFA score, European Foundation for the Study of Chronic Liver Failure-organ failure (CLIF-C OF)], and 28-day outcome. The clinical indicators and liver failure-related prognostic scores of the patients with different prognoses were compared. Receiver operator characteristic curve (ROC curve) was used to determine the prognostic value of statistically significant indicators between different prognosis of patients with amanita poisoning.Results:A total of 45 patients were enrolled, of which 38 survived and 7 died within 28 days. The coagulation indicators including PT, APTT, INR, and liver failure-related prognostic scores including SOFA score, CLIF-SOFA score, and CLIF-C OF score in the patients of death group were significantly higher than those in the survival group [PT (s): 69.59±15.94 vs. 25.99±4.64, APTT (s): 83.44±17.82 vs. 42.64±3.79, INR: 6.13±1.47 vs. 2.07±0.33, SOFA score: 11.57±1.38 vs. 6.03±0.77, CLIF-SOFA score: 9.86±2.17 vs. 5.55±0.67, CLIF-C OF score: 11.71±0.97 vs. 8.37±0.35], and PLT was significantly lowered (×10 9/L: 80.57±29.65 vs. 169.60±11.80, all P < 0.05). ROC curves showed that coagulation indicators including PT, APTT, INR, PLT, and liver failure-related prognostic scores including SOFA score and CLIF-C OF score were associated with the prognosis of patients with amanita phalloides poisoning, with the area under the ROC curve (AUC) of > 0.75. The sensitivity of the clinical indicators was above 85%, and the AUC and specificity of INR were the highest, which were 0.88 [95% confidence interval (95% CI) was 0.74-1.00] and 83.0%, respectively; meanwhile, the sensitivity of the liver failure-related prognostic scores was 100%, and the AUC and specificity of the CLIF-C OF score were the highest, which were 0.86 (95% CI was 0.74-0.99) and 66.0%, respectively. Conclusion:INR and CLIF-C OF score can be used to evaluate the poor prognosis of patients with amanita phalloides poisoning.

Sudden cardiac death (SCD) is one of the most common causes of death for patients with cardiovascular diseases. General practitioners are the providers of primary medical and health service, it its worthwhile to discuss their role positioning in the prevention and control system of SCD. In this study, SWOT analysis was used to explore the strength, weakness, opportunity and threats of the involvement of general practitioners in SCD prevention and control system, to clarify the roles of general practitioners and to provide suggestions for the improvement and development of SCD prevention and control system in China.