Objective To explore the diagnostic value of serum carcinoembryonic antigen (CEA), carbohydrate antigen 724 (CA724) combined with long non-coding RNA MALAT1 in gastric cancer. Methods A total of 100 patients with gastric cancer diagnosed in Changzhou Cancer Hospital, Soochow University from March 2013 to February 2018 were collected as the case group, and 100 healthy people during the same period in our hospital were collected as the control group. The levels of serum CEA, CA724 were detected by using chemiluminesent immunoassay assay, and the relative expression of MALAT1 was detected by using real-time fluorescence quantification polymerase chain reaction (PCR). The relationships between CEA, CA724, MALAT1 and the clinicopathological features of gastric cancer were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of CEA, CA724 and MALAT1 in patients with gastric cancer. The odds ratio (OR) and 95％ confidence interval (CI) were calculated by using logistic regression. Results The levels of serum CEA, CA724 and MALAT1 in the case group were higher than those in the control group [(3.08 ±0.21) ng/ml vs. (0.74 ±0.11) ng/ml, t= 3.814, P= 0.002; (4.28 ±0.17) U/ml vs. (0.51± 0.07) U/ml, t=4.703, P<0.01; (113.9±3.9) vs. (36.1±1.2), t=7.160, P<0.01 respectively], and the three indexes were related to the pathological types and TNM staging of gastric cancer (all P< 0.05), and the most significant increase was seen in tubular adenocarcinoma patients and stage Ⅲ-Ⅳ patients. ROC curve analysis showed that the area under curve (AUC) of serum CEA, CA724 and MALAT1 in the differential diagnosis between the gastric cancer and the healthy people were 0.675 (95％CI 0.578-0.755, P= 0.001), 0.865 (95％CI 0.800-0.922, P< 0.01) and 0.847 (95％CI 0.771-0.911, P< 0.01), and the sensitivity was 69.1％, 80.2％, 85.8％, and specificity was 63.5％, 77.4％, 74.5％, respectively. AUC of combination of the three indicators for diagnosis of gastric cancer was 0.887 (95％CI 0.821-0.949, P<0.001), and the sensitivity was 84.3％ and the specificity was 91.9％. Logistic regression results showed that high levels of serum CEA, CA724 and MALAT1 were risk factors for gastric cancer. After adjusting for age, sex, smoking history and drinking history, high levels of serum CEA, CA724 and MALAT1 remained the independent risk factors for gastric cancer. Conclusion The combined detection of serum CEA, CA724 and MALAT1 can be used to predict the risk of gastric cancer, and the three have a value for the diagnosis of gastric cancer, which is worthy of clinical application.

Teaching clinics represent a unique form of outpatient training of resident physicians and serve as a crucial instrument and core component of standardized training of general practice residents. This article reviews the common model and innovations of teaching clinics of general practice in China, and analyzes their reported effectiveness in enhancing the capabilities of consultation of resident physicians, the teaching capabilities of general practice trainers, as well as satisfaction levels of involved participants. It outlines the challenges encountered in implementing teaching clinics, including inadequate teaching facilities and equipment, incomplete incentive system for teaching, difficulties in patient recruitment, and weaknesses in the teaching capabilities of trainers. To address these challenges, this article proposes corresponding strategies based on realistic needs, including the improvement of facilities and equipment in teaching clinics, the establishment of incentive systems for teaching clinics, the expansion of patient recruitment channels for teaching clinics, and the enhancement of training for trainers' teaching capabilities. This is envisaged to provide both theoretical bases and practical guidance for the effective execution and standardized development of teaching clinics in general practice residency training bases.