By questionnaire we conducted a cluster sampling survey on 150 general practice meutors in Zhejiang province who completed training program during November 2011 to May 2013.By using Kirkpatrick's four level evaluation methods,we evaluated the training program based on the response level,learning level and behavior level.A total of 141 valid questionnaires were collected.The results showed that 92.2％ of participants (130/141) were satisfied with the training contents,94.3％ (133/141) were satisfied with the teachers,87.9％ (124/141) were satisfied with the training environment,83.7％ (118/141) thought the training contents useful,and 89.4％ (126/141) were satisfied with the training organization.Only 31.2％ (44/141) of participants mastered the knowledge and skills of general practice before training,and the figure increased to 87.2％ (123/141) after training.The results also showed that 67.3％ (95/141) of participants were able to use the knowledge acquired in the training,and 81.6％ (115/141) of them were able to apply the concept of general practice in their teaching practice.These results indicate that general practice mentors are satisfied with the training in the aspects of response,learning and behavior,aud the training program would play a positive role in promoting their performance in teaching practice.

Objective To investigate the clinical effect and survival quality of raltitrexed and radiotherapy in treatment of esophagus cancer. Methods 100 cases with esophagus cancer were selected. There were 50 cases using raltitrexed combined with concurrent radiotherapy as observation group. Others were treated with 5-Fu combined with concurrent radiotherapy as control group. The clinical therapeutic effect and survival situation of two groups were evaluated. Results After treatment, the total response rate of observation group (86.0%) was higher than control group (58.0%), the differences between the two groups was statistical difference(P<0.05).The one- and two-year survival rates in observation group were higher than control group (χ2 = 4.32, 7.954, P=0.038, 0.005<0.05).There was no significant difference between the two groups in incidence rate of acute esophagitis, acute bone marrow suppression and acute skin reaction. Conclusion The clinical therapy of raltitrexed plus radiotherapy in treatment of esophagus cancer is distinct, and improve the survival time and the quality of life of patients.

Objective To characterize rpoB gene mutations in rifampin-resistant Mycobacterium tuberculosis (M.tuberculosis) in Zhejiang Province.Methods A total of 188 clinical isolates of M.tuberculosis from 188 patients with pulmonary tuberculosis in Tongde Hospital of Zhejiang Province and Integrated Chinese and Western Medicine Hospital of Zhejiang Province were collected.Conventional drug resistance analysis was performed and the mutation of rpoB gene was detected by PCR-based DNA sequencing.The association between gene mutations in rifampin-resistance determining region of M.tuberculosis and clinical resistance was analyzed.Results Fifty-seven out of 188 isolates (30.3％) were drug-resistant strains,including 18 isolates (9.6％) with single-resistance to rifampin,28 isolates (14.9％) with single-resistance to other anti-tuberculosis drugs (10 to isoniazid,12 to streptomycin and 6 to ethambutol),and 11 isolates (5.9％) with multi-drug-resistance (rifampin plus one or more drugs of isoniazid,streptomycin and ethambutol).Among 29 rifampin-resistant strains,rpoB gene mutation existed in 27 strains (93.1％),and the most frequently mutated sites were codons 526 (55.6％,16/27),513 (22.2％,5/27),531 (14.8 ％,4/27)) and 529 (7.4％,2/27).Among 28 strains which were resistant to other anti-tuberculosis drugs,rpoB mutations existed in 4 strains (14.3％),and the mutated sites were codons 526 (2 strains) and 513 (2 strains).All 13 sensitive isolates had no mutation in rpoB gene.Conclusion Rifampin resistance in M.tuberculosis is closely correlated with rpoB gene mutations in Zhejiang province,and the most frequent sites of mutation are at codons 526 and 513.

Objective:To evaluate in vitro antifungal activities of zhexinmycin against dermatophytes. Methods: The minimum in-hibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of zhexinmycin against 7 strains of dermatophytes were determined by using broth microdilution method according to CLSI M-38A. Results:The MIC of zhexinmycin against dermatophytes was within the range of 0. 125-2. 000μg·ml-1 . The MFC was within the range of 0. 250-4. 000μg·ml-1 . Conclusion:Zhexinmycin shows strong in vitro antifungal effect on multiple fungi such as Epidermophyton floccosum, Trichophyton rubrum, Trichophyton violaceum, Mi-crosporum canis, Trichophyton mentagrophytes, Trichophyton tonsurans and Microsporum gypseum.

The scrota and testes of the rabbits were exposed to 2450 mHz microwave field and the temperature of scrotal skin was raised to 41-42℃ for 20 minutes. Ultrastructural observations on the peritubular tissue of ductus epididymides were studied at different intervals from 30 minutes to 4 months after the treatment, and alkaline phosphatase cytochemical changes were observed at intervals from 12 hours to 30 days. Pronounced morphological alterations of the smooth muscle cells and endothelial cells of capillaries were detected within 30 minutes to I hour following exposure. After 24 hours to 3 days, the thickening of the peritubular tissue were noted. The thickening and infolding of the proper lamina were also prominent. The degenerative smooth muscle cells generally returned to normal appearance after 3-4 months, but the thickening of the peritubular tissue and infolding of the proper lamina still appeared. Alkaline phosphatase was localized in the basal lamina, proper lamina, the innermost smooth muscle cells cytoplasm and surface vesicles. There were no obvious alterations of alkaline phosphatase activity after 12 hours. After 15 days, the alkaline phosphatase prominently decreased, while after 30 days the alkaline phosphatase increased nearly to normal.

OBJECTIVE To determine distribution of pathogens and resistance characteristic in urinary infection and to provide basis for clinicians to select antibiotics correctly.METHODS A total of 272 strains of pathogens were identified and ESBLs-producing G-bacilli were detected.RESULTS Among 272 strains,68.4% of G-bacilli,19.1% of G+cocci,12.5% of fungi,41.1% of Escherichia coli and 18.2% of Klebsiella pneumoniae strains produced ESBLs.CONCLUSIONS G-bacilli are major pathogens of urinary infection and their resistance is raised.Much attention should be paid to resistance detection.It is important to control nosocomial infection and select antibiotics correctly.

Objective To investigate the radiosensitization effect of antihelminthic niclosamide on human triple-negative breast cancer MDA-MB-231 cells and the potential mechanism related to Wnt/β-catenin signaling pathway.Methods Four methyl thiazolyl tetrazolium(MTT) assay was used to measure the effect of niclosamide on cell viability at different concentrations and 50％ inhibitory concentration(IC50)value was calculated.MDA-MB-231 cells were divided into 4 groups:untreated control,niclosamide treatment alone group,radiation alone group and niclosamide plus radiation treatment group.The cells with or without 1.0 and 1.5 μmol/L niclosamide pre-treatment were irradiated with 137Cs γ-rays at doses of 0,2,4 and 6 Gy.Cell survival was assayed with the colony formation method,radiation-induced γH2AX foci was analyzed with immunofluorescence,cell cycle progression was assayed with flow cytometry,and the changes of phospho-and non-phospho-β-catenin and Cyclin D1 protein expressions were measured with Western blot.Results Niclosamde obviously inhibited the viability of MDA-MB-231 cells in a dosedependent manner with a IC50 value of 13.63 μmol/L.Pretreatment of cells with 1.0 and 1.5 μmol/L niclosamide evidently enhanced the radiosensitivity of MDA-MB-231 cells to γ-rays,and the values of SER were 1.37 and 1.62,respectively.Niclosamide pretreatment significantly increased radiation-induced γH2AX foci formation(t =3.91,P ＜0.05),diminished the radiation-induced G2/M arrest(t =8.05,P ＜0.01),and inhibited radiation-induced expressions of phospho-β-catenin (S675),non-phospho-β-catenin and Cyclin D1 proteins in MDA-MB-231 cells.Conclusions Niclosamide significantly can enhance the sensitivity of MDA-MB-231 cells to γ-ray irradiation through inhibiting Wnt/β-catenin signaling pathway,which results in the inhibition of DNA DSBs repair and the reduction of radiation-induced G2/M arrest.Wnt/β-catenin signaling pathway may serve as an ideal molecular target for radiosensitization of triplenegative breast cancer.

Objective To investigate the characteristics of repair of DNA double strand breaks (DSB) induced by high-LET α-particle irradiation and their relationship with chromatin structure in the G0 lymphocytes of human peripheral blood,in order to provide the experimental basis for the judgement and dose evaluation of internal α-particle radiation.Methods Peripheral whole blood were collected from four healthy adults and lymphocytes were separated.A monocellular layer of human lymphocytes attached in Mylar film were irradiated with 0 and 0.5 Gy of α-particles and the lymphocytes suspensions were irradiated with 0 and 0.5 Gy of γ-rays.The formations of γH2AX foci as a surrogate marker of DSB and Rad51 foci as a marker of homologous recombination (HR) repair and their spatial localization in chromatin structure were measured by immunofluorescence staining technique at 10 min-48 h post-irradiation.Results Linear-γH2AX foci tracks were observe at 10 min-2 h post-irradiation in lymphocytes exposed to α-particle irradiation(t =11.12,14.40,16.56,P ＜ 0.05),and almost completely disppeared at 6 h postirradiation.The frequencies of γH2AX foci peaked at 30 min after α-particle irradiation (t =51.72,P ＜0.05) and then decreased rapidly during 6 h post-irradiation (t =29.83,P ＜ 0.05).The average number of foci remained only about 16％ at 24-48 h post-irradiation.Moreover,27％ of γH2AX foci located at DAPI-bright heterochromatin region at 10 min after α-particle radiation,suggesting that the efficacy of DSB repair may be decreased.In contrast,at 10 min-48 h after γ-ray irradiation,no linear γH2AX foci track was observed and the γH2AX foci diffused randomly in nucleus and predominantly located in DAPI-weak euchromatin region.The numbers of formative and residual γH2AX foci after γ-ray irradiation were significantly less than those after α-particle radiation.During 30 min-2 h after α-particle and γ-ray irradiation,the frequencies of Rad51 foci slightly but not significantly increased in comparison with background level,and the frequencies of co-localization of Rad51 foci and γH2AX foci were only 3％-8％.Conclusions The formation of linear γH2AX foci tracks induced by high-LET α-particle irradiation in Go human lymphocyte could be used as biological indicator to estimate whether a person has been exposed to internal α-particle radiation.Prolonged persistence of residual γH2AX foci may be applicable for biological dosimetry.

OBJECTIVETo investigate the prediction effect of the self-reported periodontal health on moderate and severe chronic periodontitis and its feasibility.

METHODSA total of 330 subjects from five districts of Shenyang city attended the survey.Each subject answered questions about self-reported periodontal health and risk factors of periodontitis and was given a periodontal examination. The predictiveness was assessed by logistic regression modeling measuring receiver operator characteristic (ROC) curve and area under curve (AUC), sensitivity and specificity.

RESULTSSelf-reported periodontal health for the prediction of moderate and severe chronic periodontitis was moderately effective, with AUC of 0.837, sensitivity of 74.8%, specificity of 71.3%.Self-reported periodontal health combined with risk factors of periodontitis was highly effective in prediction of moderate and severe chronic periodontitis, with AUC of 0.912, sensitivity of 82.1%, specificity of 85.4%.

CONCLUSIONSSelf-reported periodontal health can be used for epidemiological investigation of moderate and severe chronic periodontitis.Self-reported periodontal health combined with risk factors of periodontitis can improve the accuracy of the results of the survey.

Chronic Periodontitis ; Data Collection ; Humans ; Logistic Models ; Periodontitis ; epidemiology ; ROC Curve ; Risk Factors ; Self Report ; Sensitivity and Specificity ; Smoking

Background: In China, secondary cytoreductive surgery (SCR) has been widely used in ovarian cancer (OC) over the past two decades. Although Gynecologic Oncology Group-0213 trial did not show its overall survival benefit in first relapsed patients, the questions on patient selection and effect of subsequent targeting therapy are still open. The preliminary data from our pre-SOC1 phase II study showed that selected patients with second relapse who never received SCR at recurrence may still benefit from surgery. Moreover, poly(ADP-ribose) polymerase inhibitors (PARPi) maintenance now has been a standard care for platinum sensitive relapsed OC. To our knowledge, no published or ongoing trial is trying to answer the question if patient can benefit from a potentially complete resection combined with PARPi maintenance in OC patients with secondary recurrence. Methods SOC-3 is a multi-center, open, randomized, controlled, phase II trial of SCR followed by chemotherapy and niraparib maintenance vs chemotherapy and niraparib maintenance in patients with platinum-sensitive second relapsed OC who never received SCR at recurrence. To guarantee surgical quality, if the sites had no experience of participating in any OC-related surgical trials, the number of recurrent lesions evaluated by central-reviewed positron emission tomography–computed tomography image shouldn't be more than 3. Eligible patients are randomly assigned in a 1:1 ratio to receive either SCR followed by 6 cyclesof platinum-based chemotherapy and niraparib maintenance or 6 cycles of platinum-based chemotherapy and niraparib maintenance alone. Patients who undergo at least 4 cycles of chemotherapy and must be, in the opinion of the investigator, without disease progression, will be assigned niraparib maintenance. Major inclusion criteria are secondary relapsed OC with a platinum-free interval of no less than 6 months and a possibly complete resection. Major exclusion criteria are borderline tumors and non-epithelial ovarian malignancies, received debulking surgery at recurrence and impossible to complete resection. The sample size is 96 patients. Primary endpoint is 12-month non-progression rate.