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Objective To evaluate the outcomes of the standardized general practice training program in Shanghai Zhongshan Hospital,Fudan University.MethodsTotal 183 graduates of 11cohorts completed general practice standardized training in Shanghai Zhongshan Hospital,Fudan University since 2000.A questionnaire survey on the career status was conducted and 173 graduates were responded successfully with a respond rate of 95％.ResultsAmong 173 responded graduates,55 were males and 118 females with an average age of 33.8 y.One hundred and sixty nine graduates (98％) were still engaged in general practice,including 148 working in Shanghai and 21working in other cities.For professional ranks,3 of them were chief physicians,17 vice-chief physicians,81attending physicians and 72 residents (34 of them would be soon promoted to attending physician).Among the 173 graduates,39 were heads of GP teams and 49 held administrative positions.Up to February 2011,81graduates had published 184 papers as firstauthor,32 were successful in grant application and 33 research grants were awarded with a total fund of 2.487 million Yuan.Thirteen graduates obtained the chance for further study of general practice in Hong Kong,Taiwan or abroad.ConclusionThe follow-up study shows that the outcomes of general practice standardized training program in Shanghai Zhongshan Hospital are satisfactory.

To introduce the achievements and experiences made by the Training Center of GP teachers.since its establishment,in training hospital-based GP teachers and community-based GP teachers,and to discuss problems occurred in the course of teacher training and resolutions for them.It suggests establishing encouragement mechanism for GP teaching and authentication system of GP teachers and enhancing the teaching capability of GP teachers.

Objective To evaluate the standardized general practice training program.Methods A questionnaire survey was conducted among general practitioners who completed the standardized residency training program in Zhongshan Hospital,Fudan University from January 2000 to June 2011.Results During this period 183 residents received general practice training,15 were excluded the survey due to loss of follow-up or other reasons,168 questionnaires were distributed and 165 valid questionnaires were returned with a recovery rate of 98％.The main findings:2/3 of surveyed GPs were sent by their affiliated institutions; 85％ evaluated the program as highly or very highly; 56％ thought that their expectations were completely or mostly fulfilled; 68％ thought that the program enhanced their clinical capability and theoretical levels; over half thought that the clinical rotation and strict teaching management were the advantages of the program; 84％ thought that they improved their skills,knowledge and ideas; 74％ thought that the training program was very good or fairly good; 48％ thought that the preceptors in communities were comparatively weak and some theoretical lessons were not relevant to the context of the community.The surveyed GPs required improving of practice components,shortening the total length of training and increasing the teaching contents on scientific research.Conclusion The surveyed general practitioners give credit to the GP residency training in Zhongshan Hospital and put forward some proposals for further improvement.

Objective To assess training programs from trainees of Shanghai General Practice Teacher Training Center for further improvement.Methods Total 171 trainees attending the GP teacher training program in April,2012 were selected for survey.A self-designed questionnaires were adopted in the survey.The rationality of the curriculum and training contents in the program were analyzed.Results Among 170 trainees who answered the questionnaires,86 of them (51％) considered the training curriculum as very appropriate,76 of them (9％) considered as appropriate; 97 of them (57％) thought the training forms as very vivid,65 of them (38％) thought as vivid.The overall evaluation score for teachers was 4.64.Ninety three of the 170 trainees (55％) expressed a great willingness for training,70 (41％) expressed as willingness.Among 170 trainees 156 (92％) preferred to learn new advances in medicine,111 (65％) preferred to learn teaching skills and theories in general practice.Thirty two trainees (19％) considered that the contents of training met the trainees' needs completely,129 (76％)considered that most contents of training met the trainees' needs.Eighty two (48％) considered that they gained a lot after the training,80 (47％) considered that they gained fairly.The survey showed that 147 (86％) believed the training had broadened their minds,104 (61％) believed the training had increased their capabilities of clinical diagnosis and treatment; 53 (31％) thought the training helped raise their theoretical level.Eighty seven (51％) were very satisfied and 75 (44％) were comparatively satisfied with the training in overall evaluation.Conclusion The training program provided by Shanghai General Practice Teacher Training Center is basically satisfactory and trainees are benefited from the training considerably.

A total of 135 patients diagnosed with Budd-Chiari syndrome(BCS)during August 2004 and February 2007 were reviewed and analyzed retrospectively.The results showed that 105 subiects (77.8%)caused by malignances,while 29 participants(21.5%)had no definite pathogens.The most commonly seen symptom included jaundiee(69.6%),followed by ascites(48.2%),abdominal distention (40.7%)and lower extremity edema(37.0%).Hisher levels of STB,PT and γ-GT were determined.Color Dopple ultrasound,CT and MRI could be helpful in diagnosing BCS;angiography remained the most accurate measurement.Main treatment strategies were stent implantation and/or balloon dilation.BCS is a clinical syndrome with no typical symptoms.which makes its management very difficult.A complete understanding of the condition will help reduce misdiagnosis.Angiography and stent implantation are primary ways to diagnose or treat BCS.

Objective To investigate current status of general practice service teams in urban Shanghai to provide practical evidence and lay theoretical basis for sustainable development of general practice service teams in the future. Methods A cross-sectional study was carried out for 40 staff members of eight general practice service teams in eight urban districts of Shanghai, as well as 110 local residents, by observation, interview and questionnaire methods during March to April 2008. Results Among 21 general practitioners, 86 percent of them ( 18/21 ) were graduated from medical colleges or universities with three-year curriculum or at levels above it and 52 percent ( 11/21 ) had intermediate professional titles or above.Among the eight general practice service teams, five had full coverage of supervision and management for tuberculosis therapy, six had full coverage of management for tumor patients, four had full coverage of management for cardiovascular and cerebrovascular diseases and four had full coverage of management for patients with mental disorders. In all staff members of eight general practice service teams, 38 percent of them (15/40) were satisfactory with their working environment, 40 percent (16/40) with their work activities, five percent (2/40) with their incomes, and 28 percent (11/40) with their professional future.In 110 local residents, 77 percent (85/110) were satisfactory with service environment, 85 percent (93/110) with quality of health-care service and 89 percent (98/110) with the attitude of service teams.Conclusions Implementation of management for chronic diseases and two-way referral, as well as satisfaction of staff members in general practice service teams should be improved further.

Objective To survey the training needs for key general practice (GP) trainers.Methods The survey was conducted among participants of the first training course for national key GP trainers hold on March 2014 in Shanghai.The contents of questionnaire used for the survey included training needs of GP relevant knowledge,teaching ability and modes of assessment.The differences in training needs between GP trainers from community teaching bases and hospital teaching bases were analyzed.Results Total 151 key trainers completed the questionnaire (male/female:48/103) with average age of (38 ± 6)years.Among them 67.5％ (102/151) were from community teaching bases and 29.8％ (45/151) from hospital teaching bases;60.9％ (92/151) participated in the General Practitioner Structured Vocational Training Program (GPSVTP).According to the survey,general practice clinical kills (72.2％,106/151) and general practice clinical thinking (70.2 ％,106/151) were most required relevant knowledge;while general practice basic concept was least required (25.8％,39/151).The rate with need of policy system related GP training in hospital trainers was higher than that in community teaching base trainers(66.7％ vs.44.1％,P ＜ 0.05).For teaching ability needs,85.4％ (129/151) selected teaching methods,75.5％ (114/151) chose teaching assessment and evaluation methods.The participants showed more interesting in new-type teaching and evaluation methods,such as PBL,OSCE,mini-CEX and DOPS,and would use them in future teaching work (P ＜ 0.01).Workshop (58.3％,88/151),demonstration(57.0％,86/151) and experience exchange (50.3％,76/151) were three most interested modes in current training;meanwhile theoretic teaching was lease interested (38.4％,58/151).Study tour was most interested training models for the future (71.5％,108/151),followed by short-term courses (49.0％,74/151),overseas study (39.1％,59/151) and distance learning (27.8％,42/151).Conclusion There are different needs for GP trainers from hospital and community teaching bases.To meet the different requirements,the focused training course and training method should be adapted.

The objective structured teaching evaluation (OSTE) is a new method for training and objective assessment of the teaching ability of clinical faculty by using standardized students and teaching scenario.It is mainly used to evaluate training programs,train teaching skills and assess teaching ability of clinical faculty.The differences and association between teaching ability,teaching skills and teaching scenario should be clarified before designing OSTE.Although there are some differences in various studies,OSTE can be summarized into two aspects:teaching administration knowledge and special teaching skills.Given the great potential of OSTE in training and assessing faculty,medical educators in general should actively explore its concept and application.

Objective To investigate the methods and results of lengthened proximal femoral nail antirotation (PFNA) in the treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures. Methods Of the 21 patients with femoral shaft combined with ipsilateral femoral neck fractures treated by lengthened PFNA from 2006 to 2009,16 patients with complete follow-up were retrospectively studied.There were 15 males and 1 female,at mean age of 35 years (range,21-51 years).Injury causes were all high-energy trauma including traffic injuries in 11 patients and fall injuries in five.According to Garden classification,there were seven patients with type Ⅰ femoral neck fractures,six with type Ⅱ and three with type Ⅲ.Femoral shift fractures contained six superior part fractures and nine medial part fractures and one inferior part fracture.According to Winquist classification,there were two patients with type Ⅰ femoral shaft fractures,four with type Ⅱ,six with type Ⅲ and four with type Ⅳ.Two patients had open fractures belonging to type Ⅰ Gustilo-Anderson.Harris hip score was used to evaluate functional outcomes at the last follow-up postoperatively. Result The mean follow-up time was 2.4years (range,1-4 years ).The mean period for healing of femoral neck and shaft fractures was 4.2months ( range,3-6 months) and 5.1 months ( range,3-8 months) respectively.Four patients showed delayed diagnoses of femoral neck fractures ; two patients had delayed union of femoral shaft fractures ; one suffered from avascular necrosis of the femoral head ; one patient presented 3 cm of extension of the affected limb and was accompanied by active pain of the knee joint for over four months.According to Harris score,function of hip joints was excellent in seven patients,good in six and fair in three,with excellence rate of 82％. Conclusions It is relatively few that the femoral shaft fracture is combined with ipsilateral femoral neck fracture.The rate of missed diagnosis of femoral neck fractures is high and the patients with high energy trauma hould be highly paid attention to.Lengthened PFNA conforms to characteristics of biomechanical fixation and presents short operation time and solid fixation. Lengthened PFNA achieves affirmatory effects for treatment of femoral shaft fractures combined with ipsilateral femoral neck fractures.