Objective:To survey the awareness of common primary care clinical guidelines among primary care providers in Qingdao city.Methods:A questionnaire survey on the awareness of common clinical guidelines in primary care was conducted in August 2020 among 659 providers (293 males and 366 females) from 81 primary medical institutions in Qingdao city. The contents of the questionnaire included the general information of primary physicians, the frequency of using the guidelines, the level of understanding of the guidelines, the effect of guidelines in clinical work, the attitudes towards promoting the guidelines, and the interest in learning the guidelines and the way of learning.Results:A total of 659 valid questionnaires were recovered with a recovery rate of 100.0%. The results showed that 14.7% (97/659) practitioners applied the guidelines in most cases, and 31.6% (208/659) frequently used. There were significant differences in use frequency among providers with different practice types, professional titles, education background, practice locations and institutions ( P<0.01). Among participants, 15.2% (100/659) did not know about primary care guidelines, 63.3% (417/659) knew but did not learned guidelines, 21.5% (142/659) knew and studied guidelines carefully. The top five of the learned guidelines (114, 80.3%) were bronchial asthma (113, 79.6%), type 2 diabetes (108, 76.1%), chronic obstructive pulmonary disease (101, 71.1%), and chronic cor pulmonale (83, 58.5%). Most participants who learnt the guidelines viewed the guidelines as quite helpful or very helpful, the score of usefulness for professional knowledge was the highest (4.44±0.60). Most of participants (94.2%, 621/659) thought it was necessary to develop primary care guidelines; and the major factors affecting the promotion were lack of training (79.8%, 526/659), difficulties in access (46.7%, 308/659) and ignorance or neglect (23.2%, 153/659).Most practitioners (93.8%, 618/659) were interested in learning primary care clinical guidelines, and the expected ways of training were online teaching (70.0%, 420/618), training courses(58.3%, 360/618) and special lectures (55.2%, 341/618). Conclusion:The current situation of learning clinical guidelines among primary care providers in Qingdao is not satisfactory, but they are willing to learn the guidelines for improving clinical practice. We should strengthen the training and promotion of primary care guidelines among primary care providers in the future.

Objective To investigate the protective effect of Klotho on renal ischema-reperfusion injury (IRI).Methods Plasmid expression vector of secreting type Klotho (pV5-sKlotho) was injected through the tail vein 24 h before operation.The renal ischemia-reperfusion model was established and the experiment was divided into 6 groups:sham group of young mice,sham group of aged mice,control group of young mice,control group of aged mice group,Klotho transfected group of young mice and Klotho transfected group of aged mice.The serum creatinine (Cr) and blood urea nitrogen (BUN) levels were determined at 1st,3rd,7th,and 14th after reperfusion.The mRNA expression of Klotho and P53 in the renal tissue,concentration of the malondialdehyde (MDA),superoxide dismutase (SOD) and pathological changes in the renal tissue were examined.Results As compared with young mice group,the Cr and BUN levels were significantly increased after reperfusion (P<0.05),the expression of Klotho mRNA was significantly decreased (P<0.05) and the expression of P53 mRNA was significantly increased (P<0.05),the MDA level in the renal kidney tissue was significantly increased and SOD level was significantly decreased (P<0.05) in aged mice.Vacuolar degeneration and necrosis in tubules were major pathological changes 24 h after operation in aged mice,and at 14th day after IRI renal tubular atrophy,fibrosis and inflammatory cell infiltration were seen in aged mice.After transfection with pV5-sKlotho,as compared with control group of aged mice,the kidney function was significantly improved in Klotho transfected group of aged mice (P<0.05),and the up-regulated expression of Klotho and down-regulated expression of P53 were detected in Klotho transfected group of aged mice (P<0.05),also the MDA level in the renal tissue was obviously reduced and SOD level was obviously increased (P<0.05).Vacuolar degeneration and necrosis in tubules at 24th h after IRI and tubular atrophy,fibrosis and inflammatory cell infiltration at 14th day after IRI were significantly improved in Klotho transfected group of aged mice.Conclusion Transfection with Klotho can protect the acute kidney injury and chronic kidney disease induced by IRI in aged mice.

Objective To explore the effect of back Tuina on motor behavior,oxidative stress and in-flammation in rats with chronic fatigue syndrome(CFS).Methods Twenty-four Sprague-Dawley rats were randomly divided into a blank group,a model group and a Tuina group,each of 8,according to a random number table.The CFS rat model was prepared by means of forced weight-bearing swimming combined with chronic stress stimulation in 21 days.After modeling,the Tuina group was given daily 20-minute Tuina for 14 days.The general condition semi-quantitative score,exhaustion swimming time and open field experiment(OFE)distance of all groups were recorded.After the experiment,sam-ples were collected,and the histopathological changes of the vertical spine muscles were observed by hematoxylin and eosin(HE)staining.The cross-sectional area and diameter of muscle fibers were calcu-lated using Image Pro Plus software,and the frequency distribution diagram of cross-sectional area of muscle fibers was processed by using the Origin software.The contents of superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)and peroxisome proliferator-activated receptor γ-coactivator 1α(PGC-1α)and tumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-6 in the serum of rats were mea-sured.Results After the intervention,the general condition semi-quantitative score of the Tuina group was significantly lower than the model group(P<0.01),while the exhaustion swimming time and OFE distance were significantly higher than the latter group(P<0.05,P<0.01).(2)HE staining showed that the significant atrophy of erector spinal muscle cells in the model group,was significantly relieved in the Tuina group.(3)Compared with the blank group,the contents of SOD,GSH-Px and PGC-1α in erectus muscles decreased significantly(P<0.01),while those of TNF-α,IL-1β and IL-6 in the se-rum of the model group increased significantly(P<0.01).However,compared with model group,the contents of SOD,GSH-Px and PGC-1α in erectus muscle increased significantly(P<0.05,P<0.01),while those of TNF-α,IL-1β and IL-6 of the Tuina group decreased significantly(P<0.05,P<0.01).Conclusion Tuina in the back can regulate the oxidative stress response,reliever the inflammatory re-sponse and improve the motor behavior of CFS rats.

Objective: To detect the hemodynamic mechanism of the novel endovascular stent on complicated abdominal aortic aneurysms by Computational Fluid Dynamics(CFD) firstly, and then compare the effect of the novel endovascular stent and the streamliner multilayer flow modulator(SMFM) stent. Methods: All medical images were obtained by computed tomography. A semiautomatic segmentation protocol within Mimics(v17.0; Materialise, Leuven, Belgium) was used to extract the threedimensional aortic aneurysms. The stents was generated numerically and fitted along the aortic aneurysms. The lumen volume represented the fluid domain that was discretised in smaller volumes, which defined a mesh within the ICEM software(Ansys ICEM CFD v15.0). Hemodynamic analysis was performed with software Fluent 16.0. Results: Both kinds of stents can change the pattern of flow distribution. Compared with SMFM, the novel endovascular stent can significantly reduce the flow velocity in aneurysms, the shear force and the pressure on the aneurysms wall.What’s more, the flow velocity of the branch artery was accelerated by the novel endovascular stent. Conclusion The novel endovascular stent can significantly reduce the flow velocity in aneurysms, the shear force and the pressure on the aneurysms wall, and acceleratethe the flow velocity of the branch artery.