China launched the nationwide resident standardized training (residential training) project since 2013 and has trained a large number of general practitioners. The primary health care institutions and general practitioners have played an important role during the prevention and control of COVID-19 epidemic, which not only presented the remarkable effect of residential training project, but provided new ideas for the further training program of general practitioners. It is proposed in this paper that we should adjust the training and assessment priorities in the following aspects: highlight the characteristics of general practice in the future training, so as to train general practitioners with more comprehensive ability, such as strengthening the ability to deal with public health emergencies, strengthening the consciousness and capability of scientific research, and increasing the proportion of humanistic quality training; At the same time, we should enhance career attractiveness of general practitioners to keep the excellent general residents stay for their career;All mentioned above will further improve the overall quality of general practitioners, and enable them to better deal with public health emergencies.

One hundred and thirty general practitioners ( GP ) who received standard training ( training group ) and 189 GPs who did not receive standard training ( non-training group ) were selected with cluster random sampling method from five districts in Beijing.A questionnaire survey was conducted from April to May 2013, including basic information , working condition , professional competency and continuing education of the interviewees.The survey showed that 72.3%(94/130) in training group had physician titles;89.3%(116/130 )had work experience <10 y;97.0%(126/130)of them had bachelor degree or above;82.3%(107/130) expressed their interest in scientific research , but the 95.4% of them had no research projects;and 96% had no teaching appointment.GPs in non-training group were in a favorite position of education level and professional competency over those in training groups ; however , the latter were highly enthusiastic in further training and scientific research , and had strong potential for career development.

Objective To compare the effectiveness of CO2 laser treatment and routine scalpel procedure for facial sebaceous cyst (SC),and to compare cosmetic effect of laser welding and routine suture skin incision.Methods Two hundred patients with SC were randomly divided into two groups:CO2 laser operative treatment group (laser group),and routine scalpel operative treatment control group (control group),with 100 patients in each group.For the laser group,skins of SC were incised and cyst were extirpated using CO2 laser beam (power 20 W,diameter of light spot 0.2 cm and power density 637 W/cm2).If cyst wall was broken,then CO2 laser was used to gasify the residual.After cleaning skin incision,both border of incision with anastomat of laser welding skin was performed,next to welding skin incision with CO2 laser (power 1 W,diameter of light spot 0.2 cm and power density 32 W/cm2) scanning radiating 2 mm/s.For the control group,skins of SC were incised and cyst or residual wall were extirpated with single-use scalpel,and skin incisions were sutured with 1-0 silk thread by whole layer interrupted suture.Results For the laser group,97 cases (97 ％) were cured,3 cases (3 ％) improved.For the control group,87 cases (87 ％) were cured,9 cases (9 ％)improved and 2 cases (2 ％) had no improvement.Cure rate of laser group was obviously higher than that of the control group (P＜0.05).The cosmetic effect of the laser group was also better than that of the control group (P＜0.01).For the laser group,successful rate of welding skin incision was 100 ％.Conclusions Surgical removal of SC on face and welding skin incision with CO2 laser is very effective.The chances of recurrence and cicatrisation are greatly reduced.In particular,laser welding skin incision establishes a new non-suture reparable method of skin incision,which has important value for the cosmetic and plastic surgery.

Objective To observe the effect of treatment and cosmetology in cbildren patients with strawberry hemangioma (SH) on face by three kind of infrared wavelength lasers.Methods In 300 children patients aged from 5 to 12 years with SH on face were randomly divided into a semi con ductor laser group (100 cases),a Nd ∶ YAG laser group (100 cases) and a CO2 laser group (100 cases).The parameters of laser were the same in the three groups,such as 10 W,light spot 0.2 cm in diameter and 318 W/cm2.According to size of area in the semiconductor laser and Nd ∶ YAG laser groups SH were coagulated by semiconductor laser and Nd ∶ YAG laser,and in the CO2 laser group it were gasified by CO2 laser,respectively.Children patients with SH were followed up for observation of cicatrzation and evaluation of the effect of therapeutics and cosmetology at six months after laser treatment.Results The cure rates were 89 ％ in the semiconductor laser group,83 ％ in the Nd ∶ YAG laser group and 69 ％ in the CO2 laser group (P＜0.05).The excellent and faworahle rates of cosmetic effect were 87.0 ％ in the CO2 laser group,86.5 ％ in the semiconductor laser group and 57.8 ％ in the Nd ∶ YAG laser group (P＜0.01).The analysis also showed that average therapeutic time,operative time and quantity of bleeding in the semiconductor laser group were less than that of in the Nd ∶ YAG laser and CO2 laser groups (P＜0.01).Conclusions The semiconductor laser (wave length 830 nm and power 318 W/cm2) for the treatmet of children patients with SH on face has many advantages,such as higher cure rate,shorter operative time,less bleeding in operation and better cos metic effects.It might become a first selective therapy for children patients with SH on face.

Objective To compare the effect of treating chronic colonitis diarrhea (CCD) using He-Ne laser irradiation of acupoints with routine drug treatment. Methods Two hundred patients with CCD were randomly divided into a laser irradiation group (laser group) and a routine drug treatment group (control group) with 100 patients in each group. The laser group patients were treated with a He-Ne laser ( power density 478 mW/cm2 )through coupling fiberoptic cable radiating onto the Shenque (REN8) , bilateral Tianshu (ST25) and Dachangshu (BL25) acupoints, each for 10 min daily for 10 days. Control group patients were treated with routine drugs such as antibiotics, astringents, antidiarrheals, antispasmodic analgesics, vitamins and Chinese herbal enemas. Three months after treatment the patients were examined by fibercoloscope to evaluate the therapeutic efficacy in the two groups. Results In the laser group 66 cases (66%) experienced a short-term cure, 27 cases (27%) improved and7 cases (7%) showed no effect. In the control group 33 cases (33%) were short-term cures, 43 cases (43%) improved and 24 cases (24%) had no effect. These differences were statistically significant. In both groups the effects for patients with short histories was better than for those with longer histories. In the laser group the pathological changes in the distal colon were significantly better than in the proximal colon, but this difference wasn't significant in the control group. The average days of total treatment to achieve short-term cure and improvement in the laser group were significantly less than in the control group. In the laser group the average days to the disappearance of abdominal pain and diarrhea in the short-term cure patients of was significantly fewer than in the control group. Conclusions Laser irradiation was more effective than routine drug treatment, especially for stopping diarrhea, spasmolysis and analgia.

The current status of primary health institutions and personnels in China were analyzed based on the data from China Health and Family Planning Statistics Yearbook 2016 and China Health Statistics Summary 2018. By the end of 2017, there were 253 000 general practitioners in China, accounting for 7.46% of all practicing physicians or assistant physicians in the country(339 000). In 2017, the number of general practice residents was 8 517, accounting for 11.92% of all residents(71 430), which was 1.70% lower than that in 2016 (8 664) . The registered nurses in primary health care institutions were not sufficient, even the proportion of nursing to medical staff did not reach 1 ∶ 1 in primary settings. The distribution of primary health care institutions was not balanced. In the township hospitals and village clinics the number of practicing physicians or assistant physicians was far from meeting the requirement of the service. In view of the current problems, the social resources would be applied to promote the development of primary health care institutions and to improve the primary medical services in multiple ways such as personnel training, hardware construction, network construction and financial support, etc.

Patients aged ≥65 years with dementia diagnosed by neurological specialists were selected in Yuetan community from March 2016 to December 2016.The basic information of patients was collected from the health and medical records;the needs for community care were obtained through a questionnaire survey.Total 91 elderly patients with dementia was included in the study,among whom 15 (16.5％) were found by community institutions,18 (19.9％) patients got medication from the community health institutions.The survey showed that the numbers of participants who agreed that the community health service could provide treatment,drug prescription,referral service,condition assessment,regular follow-up,professional guidance for caregivers,door-to-door service and counseling services for patients and their relatives were 29 (31.8％),18 (19.9％),33 (36.3％),19 (20.9％),23 (25.3％),24 (26.4％),49 (53.8％) and 29 (31.9％),respectively.Results showed that 53.8％ (49/91) dementia patients or their family members wanted to receive instruction of drug use in community health service,17.6％ (16/91) wanted to know about the professional care skill as caregivers.Currently the services for dementia patients in health service centers and stations of Yuetan community are less sufficient,which cannot meet the needs of dementia patients and their family members.

Objective:To investigate the mental health status and psychological intervention needs in community health service staff during the outbreak of COVID-19.Methods:From February 28 to March 2, 2020, a total of 554 questionnaires on the mental health status and psychological intervention needs were collected from community health service staff in Beijing, Zhejiang, Hebei and Shanghai. The mental health was assessed by physical symptoms and GAD-7. The status and effectiveness of psychological intervention was analyzed.Results:The survey found that 19.7% (109/554) of community health service staff needed psychological support. Most psychological supports were received from colleagues′ encouragement (59.6%, 330/554) and internet mental health knowledge (41.2%, 228/554); in contrast, less from group intervention (5.8%, 32/554) and one-on-one counseling (5.6%, 31/554). Higher proportion of staff with anxiety symptoms and physical symptoms needed psychological support than that without symptoms (χ 2=53.41, 71.47), and a higher proportion of responders thought that the existing psychological intervention was not helpful (χ 2=26.89, 17.79), the difference is statistically significant ( P<0.05). Conclusion:It is necessary to strengthen the mental health assessment of community health service staff and give effective psychological intervention according to their needs during the outbreak of COVID-19.