Objective To survey the current situation of teaching for general practitioners (GPs) in community health centers of Shanghai.Methods A questionnaire survey on the teaching situation was conducted among 742 GP mentors who attended a municipal training workshop during July to October 2012 in Shanghai.The items of the survey included general background,previous teaching experience and self-evaluation on teaching ability.Results Among 742 GP mentors receiving the survey,the average age was (37 ± 6) years old.49.8％ (366/734) of mentors expressed their willingness of teaching,and the main reason was that it may upgrade themselves,while learning from teaching (58.6％,419/715).Heavy work load,lack of teaching time (31.8％,378/1 187) and teaching experience (30.7％,364/1 187) were the main obstacles for teaching.Among 106 GP mentors who had teaching experience in community health center previously,79.2％ (80/101) made teaching plans,but only 8.9％ (9/102) often prepared syllabus.Teaching plans were made mainly according to the work needs in community health care (54.2％,52/96),the situation and demands students (29.1％,28/96) or requirement of syllabus (17.7％,17/96).The problems included lack of teaching experience (50.5 ％,50/99) and time (42.4％,42/99),monotonous instructional modality (24.1％,25/104),and weak operability of the syllabus (21.2％).The self-reported results showed that 14.4％ were not able to develop a teaching program and to execute,18.3％ were not able to use a variety of teaching methods,31.2％ were not able to engage in teaching for 1.5 days per week.Logistic regression analysis showed that mentors with higher education background (OR =2.027,P ＜ 0.05),community teaching experience (OR =3.069,P ＜ 0.05),higher self assessment of general personal quality and communication ability (OR =2.488,P ＜ 0.05),higher teaching ability (OR =2.399,P ＜ 0.05) and strong training wishes (OR =11.382,P ＜ 0.05) were more willing to engage in the teaching work.Conclusions Heavy work load,insufficiency of teaching capacity and experience are main problems for GP mentors in Shanghai community health centers.Educational theory and methods should be focus on teacher training so as to improve teaching abilities.

Objective To analyze the correlation of nonalcoholic fatty liver disease (NAFLD) with waist,hip circumference and body mass index in order to explore the prevention countermeasures.Methods The datum of routine physical examination and questionnaire survey among 2 503 employees of 12 enterprises in November 2013 were collected.The indexes of height,weight,waist circumference,hip circumference,blood pressure,blood lipid and blood glucose of the subjects were measured.The grouping was according to whether the subjects suffering from NAFLID.The correlation and epidemiological characteristics between each group and the risk factors of body weight,waist,hip circumference and body mass index were analyzed.Results 2 503 subjects were collected including 490 NAFLID patients (19.57％).The body weight and body mass index of NAFLID patients were significantly lower than those of the control group.The result of BMI classification showed that the subjects of the control group were overweight while the subjects with NAFLID were obesity.The waist circumference and hip circumference of NAFLID patients were significantly larger than that of the control group.Conclusions Larger waist and hip circumference and overweight are risk factors of NAFLID.Effective intervention measures,scientific control of body weight,rational diet,the strengthening of physical exercises should be taken in order to prevent and control the development of fatty liver.

As the change of medicine mode,measuring approaches of patient satisfaction have been widely focused on and become an important tool to improve the quality of medical service.This paper is aimed to analyze the latest development of patient satisfaction questionnaires including relevant content and methods by literature review.

Objective To develop an index system for evaluation index system for community general practice teaching base.Methods A draft of evaluation index system for community general practice teaching base was preliminarily developed on the basis of literature research.Two rounds Delphi consultations with 32 experts of general practice were conducted between July 2014 and May 2015.The results of consultation were analyzed and the evaluation index system for community teaching base was established.Results In two rounds of Delphi consultation,the positive coefficients were both 100％,the authority coefficient of experts were 0.879 and 0.897,respectively,and the coordination coefficient were 0.165 and 0.204 (P ＜0.01).The established evaluation index system consisted of 4 first-class indexes,8 second-class indexes and 27 third-class indexes.Four first-class indexes were basic conditions,teaching conditions,teaching staff and teaching practice.Conclusion The established evaluation index system may be used to accredit community general practice teaching base and to improve the quality of general practitioner training.

Objective To investigate the capacity and training needs of the community general practice mentors in different areas of Shanghai.Methods General practice mentors from community health centers,who attended a municipal training program in Shanghai during July 2012 to October 2012,were participated in the survey with a self-designed questionnaire.The general condition,basic ability (clinical skill,teaching ability and professional development),motivation and needs of training were investigated.The factors affecting the willingness of training were analyzed.Results Among 742 mentors receiving the survey,259 were from the urban area,174 from rural-urban continuum and 309 from rural area.The academic degree in urban group was relatively higher:17 out of 257 (6.6％) holding master degree.The ratio of participants who had received standardized training in urban,rural-urban and rural areas was 33.2％,25.3％,37.4％,respectively.The personal quality and communication skills in urban group were significantly higher than those in rural-urban continuum and rural group (18.58 ± 2.49,17.89 ± 2.69,17.85 ±2.34,P ＜0.05).The clinical skill (12.31 ± 1.98,11.95 ±2.02,11.52 ± 1.81),teaching ability (11.99 ± 2.62,11.63 ± 2.86,11.12 ± 2.77) and professional development (6.42 ± 1.61,6.36 ± 1.55,5.61 ± 1.38) in urban group were all significantly poorer than those in other two groups.The main purpose of participation in training was to improve medical knowledge and clinical skills in three groups (70.8％,74.0％,80.4％,respectively),followed by the need for community teaching.The rural group has higher training requirements in improving clinical diagnosis and treatment ability (75.3％,80.1％,85.5％,respectively in three groups),doctor-patient communication ability (38.0％,44.0％,50.7％,respectively) and community preventive care ability (29.4％,30.7％,42.8％,respectively).The urban group had much more requirements in scientific research training (38.8％,34.9％,14.1％,respectively).Logistic regression analysis showed that doctors with supports from the leadership (OR =2.688,P ＜ 0.05) and with less working stress (OR =2.241,P ＜ 0.05) were more willing to participate in mentor training.Conclusion There are discrepancies in basic ability and training needs of community general practice mentors in different areas of Shanghai,so we should develop specific or targeted training program in the future.

Objective To determine the contents of free ferulic acid and total ferulic acid in different processed products of Rhizoma Chuanxiong.Methods With methanol-formic acid(95∶5) as the extraction solvent for free ferulic acid and with methanol-2% NaHCO3 water solution(95∶5) as the extraction solvent for total ferulic acid,ultrasonic method was used for the extraction.The contents of free ferulic acid and total ferulic acid were determined by HPLC,and the chromatographic conditions were as follows: C18 column(250mm?4.6mm,5?m),the mobile phase consisting of acetonitrile-1%acetic acid solution(20∶80),the detecting wavelength at 320nm,flow rate being 1.0 mL/min and detection at room temperature.Results The average contents of free ferulic acid and total ferulic acid in Rhizoma Chuanxiong roasted by wine were higher than those in raw and other processed Rhizoma Chuanxiong,and free ferulic acid content in raw and different processed Rhizoma Chuanxiong was lower than the total ferulic acid content.Conclusion The method is simple,accurate and can be used for the quality control standard for Rhizoma Chuanxiong,and the chemical assay of total ferulic acid content would be a better choice of assessing the herbal quality of Rhizoma Chuanxiong.

China ; Humans ; Logistic Models ; Non-alcoholic Fatty Liver Disease ; Risk Factors

Objective To evaluate the effect of clinical competence training for general practitioners in Shanghai.Methods Total 759 general practitioners participated in clinical competence training from July 2011 to October 2012 in Shanghai.The theoretical and practical operation scores of all the 759 trainees were compared before and after the training and the influencing factors of training effect were analyzed.Results The trainees,including 260 (34.26％) males and 499 (65.74％) females,had average working experiences (13.6±7.1) years.The average total scores before and after training were(67.40 ±8.57)and (73.61 ±7.20) (t =17.96,P ＜ 0.01).The practical operation scores were improved more significantly,the average scores of physical examination before and after training were (12.90 ± 3.76) and (14.00 ±3.51),scores of clinical skill before and after training were (9.41 ±4.80) and (13.40 ±4.02) (t =6.31 and 19.01,P ＜ 0.01).Among seven items of physical examination test,scores of four items (cardiopulmonary examination,abdominal examination,neurological examination and thyroid examination) were significantly higher than those before training (P ＜ 0.05 or ＜ 0.01).Scores of all 7 items of clinical skill test were higher than those before training (P ＜ 0.01).The main factors influencing the effect of training were gender,educational background,score before training and type of practice (P ＜ 0.01 or ＜0.05).Conclusions The clinical competence of general practitioners can be improved after the training.The training contents should be optimized in consistent with conditions of community health and general practitioners in the future.

The non-neuronal cholinergic system, widely exists in prokaryotic, eukarytic, and even plant cells, however, it has not been investigated in preadipocytes and adipocytes. To search for evidence its existence in preadipocytes and adipocytes, the nicotinic acetylcholine receptor (nAChR) α7 subunit, acetyicholinesterase (ACHE) and choline acetyltransferase (CHAT) in 3T3-L1 cells were examined using immunohistochemical staining and Western blotting. The choline-regulated visfatin expression in 3T3-L1 preadipocytes was also tested by reverse transcriptase-PCR. Incubation with methyilycaconitine (10-6 to 10-4mol/L) for 12, 24 and 36 hours dose-dependently increased visfatin expression from 1.3- to 1.55-folds (P <0.01) with maximal induction at 24 hours with 10-4mol/L methyllycaconitine. Nicotine treatments (10-6 to 10-4 mol/L) for 12, 24 and 36 hours decreased visfatin expression; choline chloride (10-4 mol/L))suppressed visfatin expression in 3T3-L1 preadipocytes at 36 hours by 1.64 to 2.03 fold (P < 0.05) which was more effective as compared with nicotine. It was concluded that α7 nAChR was expressed in 3T3-L1 preadipocytes and involved in visfatin expression.

Objective To evaluate the clinical competence training model for community general practitioners (GPs).Methods Total 759 Gps participated in clinical ability training course (training group) between July 2011 and October 2012.The course included lectures,group discussion,role play,simulation for theoretical teaching;and video demonstration,scene teaching and medical simulator for physical examination and surgical skill training.Other 703 Gps without participating in training course were selected as control group.The examination consisting of theoretical and clinical skill tests were carried out and the results were compared between two groups.Results The participants included 260 males (34.2％) and 499 females (65.8％) were with an average service year of 13.9 ± 7.0 and 72.8％ of them hold bachelor degree.There were no significant differences in gender composition,work seniority and educational level between the two groups (P ＞ 0.05).Before and after training the total scores of the training group were (67.39 8.57) and (73.62 ± 7.19) respectively,(68.67 8.31) and (65.73 ±9.02) respectively for the control group.Before training,the total score and theoretical results of control group were significantly higher than those of training group (all P ＜ 0.01),and there was no significant difference between the two groups in physical examination and operation skill.After training,the total scores and the individual scores (written examination,physical examination and operation skill) of training group were significantly increased,compared with those before training (all P ＜ 0.01),and those of control group (all P ＜ 0.01).Conclusions The clinical competences training model can improve the theoretical knowledge and clinical ability of community general practitioners.