The application of continuous quality improvement program in standardized residency training examination in the central Hospital of Shanghai Jiading was introduced to inquire into the way to improve the quality of standardized training of resident doctors. Through the steps of FOCUS-PDCA, we continuously improved the examination content and quality compliance training personnel, and developed the examination process including test, training, supervision, learning and using. After the implementation of the project, the percentage of the departments that meet the residency training examination requirements has been increased from 33.3%to 100%in our hospital. The percentage of the students that passed the licensed medical skills examination was 96.6%in that year. 100%of the students passed the graduation comprehen-sive examination. Year-end evaluation showed that the students' satisfaction degree to the teachers increased from 94.5%to 98.2%. Thus, through the implementation of CQI project, we achieved the goal of promoting teaching and promoting learning.

OBJECTIVE:To study the influence of calcineurin gene polymorphism on the efficacy of cyclosporine A (CsA). METHODS:The blood samples of patients treated with CsA were collected. The trough blood concentration of CsA was detected by EMIT. The genotype of PPP3CA and PPP3CB was assayed by RFLP-PCR method. The expression of NFAT-regulated gene IL-2, IFN-γand GM-CSF were measured by RT-qPCR,which were used to define the index of indirect efficacy of CsA. The relationship of gene polymorphism with CsA efficacy was study by relationship analysis and multiple factor regression method,etc. RESULTS:A to-tal of 100 blood samples were collected. There was no significant correlation between the expression of CsA efficacy-related NFAT-reg-ulated gene GM-CSF and trough concentration of CsA(rGM-CSF=-0.04,P=0.238);the expression of IL-2 and IFN-γ were negatively correlated with trough concentration of CsA significantly(rIL-2=-0.384 3,P<0.001;rIFN-γ=-0.335 4,P<0.001). Using the average value of mRNA expression of IL-2 and IFN-γas indirect efficacy index,the polymorphism of PPP3CB rs3763679 site significantly in-fluenced the efficacy of CsA(P<0.05),but PPP3CA rs3804358 had no any effect on it(P>0.05). Stratified analysis showed that among patients with immune disease underwent renal transplantation,efficacy of patients with PPP3CB rs3763679 genovariation(TC+TT) were better than those with wild-type gene (CC)(P<0.05). After the efficacy was normalized by CsA trough concentration, multivariate analysis showed that normalized efficacy of CsA was negatively correlated with gender,PPP3CB rs3763679,lactate dehy-drogenase and creatinine significantly,but positively correlated with PPP3CA rs3804358,leucocyte count,usea nitrogen,glycerin trilaurate,etc. CONCLUSIONS:PPP3CB rs3763679 gene polymorphism influence the efficacy of CsA;among patients with immune disease underwent renal transplantation,efficacy of patients with PPP3CB rs3763679 TT+TC is better than that of CC type. At the same time,gender,PPP3CA rs3804358,leucocyte count,usea nitrogen,glycerin trilaurate and other factors all can influence the nor-malized efficacy of CsA to different extent. Multiple factors should be considered when using CsA.

Commonly, the interbacterial transfer of circular plasmids is initiated by nicking at an internal sequence, oriT, followed by transferring one strand as single-stranded DNA through a type Ⅳ secretion channel on cell membrane. In contrast, Streptomyces conjugative linear plasmids, containing a free 3'-end but a protein-capped 5'-end, can potentially undergo cell-to-cell transfer by transfer of non-nicked DNA. It was reported that circular derivatives of the Streptomyces lividans linear plasmid SLP2, as well as the parental linear plasmid itself can transfer efficiently. And the genetic requirements for such transfer was described. Efficient transfer of plasmid requires six co-transcribed SLP2 genes, encoding a Tra-like DNA translocase, cell wall hydrolase, two cell membrane proteins that interact with an ATP binding protein, and a protein of unknown function. Reduced transfer efficiency of plasmid from SalⅠ R-/M-to Sal Ⅰ R/M hosts argues that transfer of both the circular and linear forms of the plasmid involves double-stranded DNA. These results suggest that conjugal transfer occurs by a similar mechanism for SLP2-derived linear and circular plasmids, and cellular membrane/wall functions in the transfer process.

Objective To study the calculational method for the radiotherapy facilities of the medical linear accelerator' s useful beam towars its maze.Methods The shielding calculation was made under the relevant national standards for a radiotherapy treatment room and compared with the test results.Results The dose rates at the maze entrance as calculated and measured were 89 and 86 μSv/h inside the maze door,as well as 5.7 and 6.2 μSv/h outside the maze door,respectively.The calculated results were consistent with measured results.Conclusions By comparison of calculated results with measured results,the accuracy of the theoretical calculation method could be verified.

Objective: To observe the therapeutic effect of Jingyuankang capsule on peripheral leukopenia in patients with HIV/AIDS.Methods: The methods of randomized,double blind,double analogue clinical trials were used for two groups: 58 cases treated with Jingyuankang capsule,Likejun tablet analogue and HAART therapy;58 cases treated with Likejun tablets,Jingyuankang capsule analogue and HAART therapy.Both groups had systematic administration of 6 weeks.The peripheral blood cells were examined to observe the therapeutic effect of Jingyuankang capsule on peripheral leukopenia.Results: Jingyuankang capsule had a good therapeutic effect in treating peripheral leukopenia.It signifi cantly increased the numbers of leukocytes and granulocytes.As the time of administration,it could promote the growth of leukocyte more obviously.It was clinical safe and effective.No toxic and side effect was found in the process of treatment and later follow-up visit.Conclusion: Jingyuankang capsule can effectively treat peripheral leukopenia in patients with HIV/AIDS.

A"3+2"standardized training program of assistant general practitioner was launched in Shanghai Jiading District in 2012 in order to train new medical talent in suburb area.The program was developed through the jointed efforts among the government,medical school and train bases.The model was designed as training assistant general practitioners with distinctive sequential education process in different levels and stages.After five years of practice,the"3+2"standardized training program of assistant general practitioner has accomplished its goal,which provides a reference for training assistant general practitioners in Shanghai Municipality.

BACKGROUND: Atopic dermatitis (AD) affects approximately 10% of adults worldwide. CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling. This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD. METHODS: This multicenter, randomized, double-blind, placebo-controlled, phase 2b trial was conducted in 21 medical institutions in China from February to November 2021. Totally 120 eligible patients were enrolled and randomized (1:1:1) to receive subcutaneous injections of 300 mg CM310, 150 mg CM310, or placebo every 2 weeks for 16 weeks, followed by an 8-week follow-up period. The primary endpoint was the proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (EASI-75) score from baseline at week 16. Safety and pharmacodynamics were also studied. RESULTS: At week 16, the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups (70% [28/40] for high-dose and 65% [26/40] for low-dose) than that in the placebo group (20%[8/40]). The differences in EASI-75 response rate were 50% (high vs . placebo, 95% CI 31%-69%) and 45% (low vs . placebo, 95% CI 26%-64%), with both P values <0.0001. CM310 at both doses also significantly improved the EASI score, Investigator's Global Assessment score, daily peak pruritus Numerical Rating Scale, AD-affected body surface area, and Dermatology Life Quality Index compared with placebo. CM310 treatment reduced levels of thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase, and blood eosinophils. The incidence of treatment-emergent adverse events (TEAEs) was similar among all three groups, with the most common TEAEs reported being upper respiratory tract infection, atopic dermatitis, hyperlipidemia, and hyperuricemia. No severe adverse events were deemed to be attributed to CM310. CONCLUSION CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.
Adult ; Humans ; Dermatitis, Atopic/drug therapy* ; Treatment Outcome ; Severity of Illness Index ; Antibodies, Monoclonal, Humanized/therapeutic use* ; Injections, Subcutaneous ; Double-Blind Method