Diabetic kidney disease (DKD) is a common microvasscular complication in diabetic patients.It is necessary for general practitioner to recognize the early DKD,and give individualized treatment and comprehensive management.This article presents a patient with diabetic kidney disease,to whom individualized treatment and comprehensive management were given.Hopefully the case-based learning would help general practitioners to early recognize DKD and to give timely treatment and effective control of diabetic nephropathy.

Common cold is the most common upper respiratory tract infection.No antibiotic use for common cold has been international consensus,while the irrational antibiotic use and subsequent antibiotic resistance become an important issue of public health security.This article reviews the current status of antibiotic use for common cold and its related factors.

This research summarized the exploration of English salon teaching on students in Department of General Practice,Peking University Health Science Center,illustrating thatthis teaching method was helpful to improve the students' English proficiency and theory of medicine,to promote communication and cohesion of the department,and to enhance the GP concept and competency.Based on the existing problems of English salon teaching,this research put forward the corresponding countermeasures so as to provide optimizing reference for teaching of GP,which included:(1)To encourage students to be active to participate inEnglish salon,correct the students' learning attitude and improve their learning methods,pay attention toteaching skills and take advantage of situational dialogue training methods;(2)To cultivate students' clinical thinking of diagnosis and treatment,urge the students to refer toliterature in time,takenotes and solve problemsas appropriate,as well as to promote supervisors' participation;(3)To recommend English salon teaching as an extension for thedelayed case-sharing.

A well - established residency standardized training system is crucial for cultivating qualified general practitioners(GPs). The syllabus has regulated the goals, objectives, contents and forms of training, but not proposed the concrete and effective teaching and assessment models. This article reflects the existing problems in GP training regarding teaching faculty,rotation plan, outpatient teaching, feedback and evaluation mechanisms as well as the assessment methods and contents,the article also gives specific suggestions for future improvement in order to train competent GPs.

As a powerful reserve force for primary care institutions, general practitioners (GPs) undergoing standardized training will be essential to solve the pediatric problems of first visit to primary medical institutions and coordinated care delivery system in the future, which puts forward new require-ments for the training of post competencies of GPs.However,the training and evaluating systems for GPs in Pediatric Department still need further exploration. This article tried to summarize the two-month rotating arrangement and its advantages for GPs in Pediatric Department of a general hospital.Based on the forgotten theoretical knowledge,superficial understanding of the diseases and individual teachers' poor teaching moti-vation, this article suggested reinforcing the theoretical basis of GPs through exploring multiple learning channels and increasing self-learning enthusiasm,strengthening the training and rewarding system of teachers to promote the specialist-GPs teaching, as well as promoting the set-up of Department of General Practice and taking the advantage of key disciplines in teaching hospitals to develop characteristic teaching model of general practice.

Purpose: To analyze the gene mutation, immune infiltration and tumor growth of primary tumor and distant tumor under different treatment modes. Materials and Methods: Twenty B16 murine melanoma cells were injected subcutaneously into the of both sides of the thigh, simulating a primary tumor and a secondary tumor impacted by the abscopal effect, respectively. They were divided into blank control group, immunotherapy group, radiotherapy group, and radiotherapy combined immunotherapy group. During this period, tumor volume was measured, and RNA sequencing was performed on tumor samples after the test. R software was used to analyze differentially expressed genes, functional enrichment, and immune infiltration. Results: We found that any treatment mode could cause changes in differentially expressed genes, especially the combination treatment. The different therapeutic effects might be caused by gene expression. In addition, the proportions of infiltrating immune cells in the irradiated and abscopal tumors were different. In the combination treatment group, T-cell infiltration in the irradiated site was the most obvious. In the immunotherapy group, CD8+ T-cell infiltration in the abscopal tumor site was obvious, but immunotherapy alone might have a poor prognosis. Whether the irradiated or abscopal tumor was evaluated, radiotherapy combined with anti-programmed cell death protein 1 (anti-PD-1) therapy produced the most obvious tumor control and might have a positive impact on prognosis. Conclusion Combination therapy not only improves the immune microenvironment but may also have a positive impact on prognosis.

Objective:To explore the effect of blood flow restriction training on the quadriceps femoris and on knee stability after anterior cruciate ligament reconstruction.Methods:Forty patients recovering from anterior cruciate ligament reconstruction were randomly divided into an experimental group and a control group, each of 20. In addition to routine rehabilitation training, the control group was given routine knee flexion and extension strength training, while the experimental group trained for an additional 20 minutes doing knee flexion and extension resistance training with the blood pressure in their groins at 70% of their individual arterial occlusive pressure. (The mean pressure was (123±11.23)mmHg). The training lasted 8 weeks, three times a week. Knee function and hamstring and quadriceps peak torque were assessed before and after the intervention using a Lysholm scale and Humac Norm isokinetic muscle strength tests.Results:There were no significant differences between the two groups in any of the measurements before the training. After the intervention, all of the measurements had improved significantly in both groups, with the average Lysholm score, H/Q% and peak torque of the experimental group significantly better than the control group′s averages.Conclusions:Blood flow restriction training can improve the effectiveness of quadriceps femoris strength, knee stability and knee function training after anterior cruciate ligament reconstruction.

Objective To explore the predictive value of coagulation indexes on the risk of venous thrombosis in perioperative period of hip fracture.Methods Totally 160 patients with hip fracture admitted to our hospital from February 2020 to December 2022 were retrospectively included.They were randomly divided into training set(n=112 cases)and verification set(n=48 cases).Further,according to whether deep vein thrombosis(DVT)occurred in the perioperative period,the patients in the training group were further divided into the occurrence group and the non-occurrence group.Use the least absolute shrinkage and selection operator(LASSO)to select variables to form a LASSO regression model.Draw receiver operating characteristic(ROC)curve to analyze the prediction efficiency of the model;The prediction efficiency of the verification model is realized through the verification set data.Results There was no statistically significant difference in gender,age,and other general and clinical data between the training set and the validation set(P>0.05).There were significant differences in sex,age,time from fracture to admission,body mass index,D-dimer,fibrinogen,total protein,albumin,prealbumin,globulin,hemoglobin,serum calcium,red blood cell volume,white blood cell count,red blood cell volume distribution width,activated partial thromboplastin time,prothrombin time and lymphocyte ratio between the patients in the training set(P<0.05).Six optimal variables with non-zero coefficients were selected by intraclass correlation coefficient(ICC)and LASSO,namely age,body mass index,D-dimer,fibrinogen,prothrombin time and activated partial thromboplastin time.The non-zero coefficients were 9.104,1.792,1.270,2.447,3.037 and-1.561 respectively.Conclusion The LASSO regression model formed by the combination of age,body mass index,D-dimer,fibrinogen,prothrombin time and activated partial thromboplastin time variables can serve as an auxiliary tool for predicting the risk of perioperative DVT formation in patients with hip fractures.

Objective:To explore any effect of training assisted by a pelvic rehabilitation robot on trunk control and walking after cerebral infarction.Methods:Forty cerebral infarction survivors with hemiplegia were randomly divided into an experimental group and a control group, each of 20. Both groups were given routine neurological medication and rehabilitation training, while the experimental group was additionally provided with 20 minutes of robot-assisted gait training daily, five times a week, for 4 weeks. Before and after the intervention, the motor function, walking function, trunk control and pelvic movement were assessed using a simplified version of the Fugl-Meyer assessment (FMA-LL), functional ambulation categories (FAC) and the trunk control test (TCT).Results:After the treatment, significant improvement was observed in all of the above measurements in both groups. The average FMA-LL, FAC and TCT results of the experimental group as well as their average pelvic lateral displacement, height displacement, rotation angle and roll angle were all significantly superior to the control group′s averages.Conclusions:Robot-assisted training can effectively improve lower limb motor functioning, trunk control, walking and pelvic motion after cerebral infarction, with better curative effect than routine rehabilitation training alone.