Objective:To investigate the efficacy of clinical pathway teaching method in standardized training of general practitioners in gastroenterology.Methods:From 2018 to 2019, 40 residents who participated in the standardized training of general practitioners in the Department of Gastroenterology, Zhongshan Hospital Qingpu Branch, Fudan University Medical College were randomized into the experimental group and the control group. The residents of the experimental group were trained by clinical pathway teaching method, while the control group were trained by traditional methods. After 6 weeks' teaching, theoretical examination, operation skills and case analysis test were assessed and satisfaction surveys were conducted.Results:The operation skills and case analysis scores of the experimental group were significantly better than those of the control group [operation test (91.50±2.77) vs. (89.80±3.74), P<0.01; case analysis (92.10±1.98) vs. (86.40±2.87), P<0.01]. The teaching satisfaction of the experimental group was significantly higher than that of the control group, and the difference was statistically significant ( P<0.01). Conclusion:The teaching model of clinical pathway can improve the teaching quality of the residents in the department of gastroenterology, improve the satisfaction of the doctors in the training, and broaden clinical thinking, which is worthy of promotion in clinical teaching.

Objective To study the mechanism of differentiation of high glucose induced M2 macrophages used by high glucose medium stimulation. Methods Raw264.7 (murine macrophage cell line)was cultured and stimulated by 4. 25% glucose medium, and mannitol medium was used as osmotic pressure control. Cells were harvested at 0h,4h,8h and 12h to examine the expression of CD206 and Arg-1 and the activation of PI3K/Akt signaling pathway. After blocking the PI3K/Akt signaling pathway by LY294002(the specific inhibitor of PI3K),the expression of Arg-1 was examined by western blot. Results The expression of Arg-1 was increased from 8h while CD206 reached the peak at 12h induced by high glucose which indicated the activation of M2 in a time-dependent manner. Akt was phosphorylated at 8h stimulated by high glucose medium. The specific inhibitor of PI3K reduced the expression of Arg-1 by blocking the phosphorylation of Akt. Conclusion High glucose, rather than high osmotic pressure,induced macrophages polarized into M2 via activation of PI3K/Akt signaling pathway.