Total 280 non-medical undergraduates (174 males and 106 females) were enrolled in the study from September 2015 to January 2016.Among all participants,132 received comprehensive cardio-pulmonary resuscitation (CPR) training,including knowledge teaching,video playing and simulation practice (study group),and 148 received knowledge teaching and simulation practice only (control group).Changes of CPR knowledge,skills and willingness were evaluated before and after training,and compared between two groups.The theory scores were increased after the training in both groups (study group: 87.7±5.6 vs.47.9±4.7,P<0.001;control group: 71.6±5.2 vs.48.4±4.9,P<0.001);there was no significantly difference between two groups before the training (P>0.05),however,there was significant difference after the training (P<0.001).The qualified rates of CPR skills were increased after the training in both groups (study group 81.8% vs.26.5%,P<0.001;control group: 68.2% vs.26.4%,P<0.001);there was no significant difference in qualified rates before the training between two groups (P>0.05),however,there was significant difference after the training (P<0.01).The willingness rates of performing CPR were increased after the training in both groups (study group: 64.4% vs.13.6%,P<0.001;control group: 46.6% vs.14.2%,P<0.001);there was no significant difference in willingness level before the training between two groups (P>0.05),however,there was significantly difference after the training (P<0.01).The study shows that comprehensive training can enhance CPR knowledge,skills and willingness for non-medical undergraduates,indicating that it may also be effective for other social groups.

Objective To assess the effect of meal replacements on body weight control and blood glucose and lipid profile by adjusting their nutrients intake with a meal replacement approach.Methods One hundred and thirty subjects were randomly divided into intervention group (100 subjects) and control group (30 subjects).Besides dietary consulting and health education,all subjects in intervention group received a dietary treatment with 2 meal replacements each day over a shot-term (3 months).All subjects were evaluated by recording the body measurements and laboratory data every 2 weeks.Results Compared with the baseline,mean percentages of BMI loss and decrease in waist circumference were 7.2 ％ and 6.5％ for intervention group(P＜0.01) by week 12.Meanwhile,systolic blood pressure,diastolic blood pressure,fasting plasma glucose,and triglyceride levels were significantly reduced (P＜0.01),showing significant difference compared with control group at the same period(all P＜0.01).Conclusion The meal replacement approach evaluated is an effective strategy to control body weight,and thus to achieve great improvement in the prevention of obesity-related diseases.

This paper described the measures taken by Sir Run Run Shaw Hospital of Zhejiang University School of Medicine in development of general medicine,and differential care of acute and chronic diseases. Rational allocation of medical resources and leveraging of tertiary hospital′s advantages in medicine and education effectively improved the utilization ratio of medical resources for better health of the people.

Objective To investigate the clinical application of the fine needle aspiration on spleen by ultrasonic guidance.Methods The fine needle aspiration by ultrasonic guidance was performed on 36 patients with spleen diseases.Among them,29 patients underwent diagnostic puncture,and the other 7 patients underwent remedial puncture.The definite diagnosis rate of the diagnostic puncture group was calculated by organism pathology and cytology result,as well as final diagnosis after the operation,while the curative effect of the remedial puncture group was appraised by re-examination after the operation.Results The definite diagnosis rate of the diagnostic puncture was higher,and the definite diagnosis rate of histology biopsy group(85.7%)was higher than that of cytology aspiration group(62.5%).All the patients who took remedial puncture were cured.Conclusion The fine needle aspiration on spleen by ultrasonic guidance has very important practical value in identifying the diagnosis of spleen disorders and treating fluidity processes of spleen.

Objective To evaluate the effectiveness of regional electrocardiographic consultation network for primary medical institutions.Methods A distance electrocardiographic ( ECG ) consultation center was established in Yuyao People′s Hospital in September 2012, which was connected to 56 regional primary medical through internet.The online consultation was provided by ECG specialists in the center for general practitioners in regional primary health care institutions.Additionally, the ECG training course was also conducted monthly for general practitioners.The 2-year data of ECG consultation were retrospectively reviewed and the effectiveness of the consultation network was evaluated.Results During the past two years, 86 593 electrocardiograms were uploaded by primary medical institutions, in which 3 976 were required for consultation. The monthly number of electrocardiograms sent by general practitioners was increased from 3 269 ±290 in the first year to 3 947 ±376 in the second year ( P<0.01 ) .However, the requirements of ECG consultation were not significantly different between two years.Compared to the first year, the rates of consultation requirements, misdiagnosis and missed diagnosis for ECGs of atrial and ventricular premature beats, atrial fibrillation, supraventricular tachycardia, left and right bundle branch blocks,ⅠandⅡdegree atrioventricular blocks and myocardial infarction were significantly decreased ( all P<0.05) in the second year;meanwhile there was a tendency towards the reduction for ECGs of atrial flutter and Ⅲ degree atrioventricular block in the second year.Conclusion The regional electrocardiographic consultation network is effective to improve the capability of primary medical institutions in electrocardiographic diagnosis.

Objective: To explore the association between the accumulation of metabolic syndrome (MS) components and abnormal brachial ankle pulse wave velocity (baPWV), and to investigate the effect of accumulation of abnormal metabolic components on abnormal baPWV among adult individuals undergoing routine health examination. Methods: It's a cross-sectional study. Data from 9 201 stratified sampled subjects, aged between 25 to 75 years old, who took part in the annual health checkups in 11 cities of Zhejiang Province from January to December 2016, were analyzed. Blood pressure(BP), fasting plasma glucose(FPG), waist circumference(WC), triglyceride(TG), high-density lipoprotein cholesterols(HDL-C) were defined as MS components. The baPWV was measured by VP-1000 (BP-203RPE Ⅲ) and ΔbaPWV (measured baPWV-reference baPWV/reference baPWV) ×100 (%)> 10% was defined as abnormal. The relationship between MS components and ΔbaPWV was analyzed by linear regression, and impact of accumulation of MS components on ΔbaPWV was analyzed by logistic regression, and the ΔbaPWV in subjects with different levels of MS components were analyzed by analysis of variance. Results: (1) The linear regression analysis demonstrated a positive correlation between ΔbaPWV and MS components including systolic blood pressure, diastolic blood pressure, WC, FPG, TG, while ΔbaPWV was negatively correlated with HDL-C. The β values were 0.518, 0.616, 0.208, 2.778, 1.862, -1.339, respectively (all P<0.001), indicating a strong association between ΔbaPWV and systolic blood pressure, diastolic blood pressure, and FPG. (2) The logistic regression analysis showed that the proportion of abnormal ΔbaPWV was 2.595 times higher in MS individuals than in non-MS individuals (P<0.001). Abnormal ΔbaPWV increased in proportion with increase in numbers of the metabolic components (OR=1.913, 2.884, 3.833, 6.161, 11.176 in individuals with 1,2,3,4,5 metabolic components, respectively, all P<0.001). (3) The logistic analysis suggested that each component of MS could affect baPWV,and OR was 4.68, 2.45 for systolic blood pressure and/or diastolic blood pressure and FPG. All combinations of 2 components of MS also significantly affected baPWV,and OR value was the highest (5.104(95%CI 4.281-6.085), P<0.001) for FPG+BP. All combinations of 3 components of MS significantly affected baPWV,and OR value was the highest(5.385(95%CI 4.245-6.831), P<0.001) for BP+FPG+TG. All combinations of 4 components of MS affected baPWV,and OR value was the highest (6.519(95%CI 4.731-8.984), P<0.001) for BP+FPG+WC+TG. (4) Finally, every component of MS was divided into 3 levels, their impact on abnormal ΔbaPWV was analyzed. Prevalence of abnormal ΔbaPWV significantly increased with the increasing levels of the metabolic components expect for HDL-C, the F values were 1 224.66, 832.89, 192.72, 112.79 and 56.22, respectively (all P<0.001), indicating that higher levels of metabolic components significantly affected the ΔbaPWV. Conclusions MS and accumulation of abnormal MS components are closely related with abnormal ΔbaPWV, and the combination of BP and FPG have the greatest impact on the abnormal ΔbaPWV. Analysis on the accumulation of MS components might serve as an early indicator of arteriosclerosis.

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The study is designed to explore new methods of evaluation for teachers′ comprehensive ability in general medicine. In the whole education process of resident aiming at general practitioner (GP) residency post competency, the authors made comprehensive evaluation of GP faculty, and created a comprehensive GP faculty evaluation model of result orientation. The efforts aim at exploring and introducing faculty evaluation methods and promoting education quality, in order to develop outstanding GP residents of strong post competency.

Communication between doctors and patients is an important way to establish good doctorpatient relationship.It is crucial to master doctor-patient communication skills and arts for general practitioners who will extensively serve the people in community for life-long time after completion of residency training.To improve the communication skills and to enhance the clinical competency of general practitioners,we applied the Balint special group activities as core of doctor-patient communication course in residency training program.Through 3 years of practice,we found that the application of Balint group enriched the teaching contents and form of general practice residency training;improved doctor-patient communication skills,and enhanced the competency and professionalism of general practice trainees.