An analysis of the present development of general practitioners in China,probed into the bottlenecks found.The paper proposed to set forth from the training,use and incentives of GPs to promote the systematic design of China's GP system.These measures center on the regulation of GPs development,while building a multi-channel and multi-level GP development system.Other recommendations include raising the professional standing and attractiveness of GPs as a discipline,and enhancing GPs capacity building to promote general practitioners development.

ObjectiveTo study the effect of early rehabilitation on disability of motion and cognition.Methods107 patients were randomly divided into two groups,rehabilitation group (51 cases) and control group (56 cases).Patients in rehabilitation group were given regular early rehabilitation,while all patients in both groups were given usual clinical treatment. The Barthel Index (BI), Fugl-Meyer Assessment (FMA), Mini-mental Status Examination (MMSE) were used to evaluate these two groups before and 3 months after treatment. ResultsAfter treatment, the scores of BI, FMA and MMSE were improved significantly(P<0.05) in rehabilitation group compared with that before treatment, so did that of BI, FMA in control group(P<0.05).The scores of BI、FMMS、MMSE in rehabilitation group improved significantly compared with that in control group(P<0.05).ConclusionEarly rehabilitation may obviously improve the motive and cognitive function and increase the quality of living of hemiplegia after stroke.

Objective:To study the role of FDCs-miR-548m-CDK6 axis on clonogenicity in mantle cell lymphoma. Methods:RT-qPCR and Western blot were used respectively to test the expression of miR-548m and CDK6. Bioinformatics assay was applied to predict the targets of miR-548m, and Western Blot was used to test the expression level of CDK6 after miR-548m overexpression or in-hibition. Luciferase report assay was performed to test whether CDK6 was a direct target of miR-548m. Colony forming assay was used to test the colony forming activity in MCL after overexpression of miR-548m or knockdown of CDK6. Results:Cell adhesion to FDCs induced downregulation of miR-548m and CDK6 expression in MCL. Bioinformatics assay revealed that miR-548m could target the 3'-UTR of CDK6 and that a negative correlation exists between the level of miR-548m and the CDK6 expression. Luciferase report as-say confirmed that miR-548m directly targeted 3'-UTR of CDK6. Colony forming assay showed that overexpression of miR-548m or knockdown of CDK6 significantly suppressed MCL colony formation. Conclusion:This study reveals that FDC-enhanced mantle cell lymphoma clonogenicity is mediated by the miR-548m/CDK6 axis.

Objective To observe the effect of finger-pressing combined with conventional rehabilitation therapy on the recovery of upper limb function after stroke.Methods A total of 60 cerebral stroke patients were randomly divided into an experimental group (n =30) and a control group (n =30).All patients were treated with conventional anti-symptomatic drugs but no anti-spasticity ones.The experimental group was given conventional rehabilitation and finger-pressing therapy,while the control group was given conventional rehabilitation only.Both groups were measured the motor function,using the upper-extremity portion of the Fugl-Meyer Scale,and the mean integrated electromyography (iEMG) output of biceps and flexor carpi radialis after the first finger-pressing treatment and 1 month later,so as to observe the immediate and continuous effects of finger-pressing therapy respectively.Results After the first session of finger-pressing therapy,the average Fugl-Meyer score(FMA) (12.63 ± 4.64) of the experimental group was significantly higher than in a pretest (12.13 ± 4.88) (P ＜ 0.05),while the iEMG of biceps (41.64 ± 9.22) and flexor carpi radialis (37.06 ± 7.02) were lower than before (P ＜ 0.01).One month after the treatment,compared with the control group,the average FMA (25.17 ± 5.93) and iEMG of biceps(34.42 ± 7.55) and flexor carpi radialis sEMG(30.63 ± 5.54) in the experimental group were significantly improved (P ＜ 0.01).Conclusions Finger-pressing therapy has significant and immediate effects in improving the upper extremity spasticity of stroke survivors.Combined with conventional rehabilitation therapy it can effectively reduce the upper extremity spasticity in stroke patients and significantly improve the upper extremity function.The combination is superior to conventional rehabilitation alone.

Objective:This study aims to investigate the correlation and significance between the expression of P53 and epitheli-al-mesenchymal transition (EMT) in breast cancer. Methods:The expression patterns of P53, Twist, Snail, E-cadherin, N-cadherin, Vi-mentin, and Fibronectin protein were detected via immunohistochemistry in 63 cases with breast carcinoma. The correlation of P53 pro-tein with clinicopathologic features and survival of breast carcinoma, as well as the relationship between the expression of P53 and EMT, was analyzed. Results:The expression rates of P53, Twist, Snail, and EMT are 44.4%(28/63), 54.0%(34/63), 68.3%(43/63), and 41.3%(26/63), respectively. The P53 protein expression is correlated with tumor grade (P<0.05) but not with other clinicopatholog-ic features (P>0.05). The expression of P53 is also correlated with the expression of Twist and Snail, which are associated with EMT (P<0.05). Multivariate survival analysis reveals that lymph node metastasis, P53, and EMT are independent prognostic factors. Conclu-sion:The expression of P53 is correlated with tumor grade and EMT in breast cancer, which can be used as an independent prognostic factor. Therefore, P53 may be an effective target for breast cancer therapy.

Objective: This study aims to investigate the correlation between the expression of FoxP3, TGF-β1, and epitheli-al-mesenchymal transition (EMT) in breast cancer and to determine the clinical significance of FoxP3. Methods: The expression of FoxP3, TGF-β1, E-Cadherin, N-Cadherin, Vimentin, and Fibronectin protein were detected in the cancer cells of 74 cases with breast carcinoma via immunohistochemistry. The correlation of FoxP3 protein with clinico-pathologic features of breast carcinoma and the re-lationships among the expressions of FoxP3, TGF-β1, and epithelial-mesenchymal transition (EMT) were analyzed. Results:The ex-pression rates of FoxP3, TGF-β1, and EMT are 36.5%(27/74), 39.2%(29/74), and 40.5%(30/74), respectively. The FoxP3 protein ex-pression in breast cancer is correlated with lymph node metastasis (P<0.05) but not with other clinico-pathological features (P>0.05). The expression of FoxP3 is also correlated with the expression of TGF-β1. Furthermore, TGF-β1 can induce EMT (P<0.05). Conclu-sion:The expression of FoxP3 is correlated with lymph node metastasis and EMT in breast cancer. Therefore, FoxP3 may be a marker for predicting metastasis.

Objective To investigate the effect of siRNA targeted against Bcl-xl on cell proliferation of rheumatoid arthritis (RA) and the effect on expres-ion of apoptosis relevant factors Bcl-xl,Bax,Caspase-3.Methods Human RA synovial cells were cultured and passed by tissue block collagenase digestion method.The siRNA plasmid targeting Bcl-xl gene was constructed by Bcl-xl cDNA sequence provided by gene banks,while single missense sequences were used as negative controls.LipofectamineTM 2000 was used to transfect synovial cells.The effect of Bcl-xl silencing on proliferation of synovial cells was evaluated by MTT at 24,48,72 hours after transfection.The expressions of Bcl-xl,Bax,Caspase-3 protein,synovial apoptosisrelated factors were determined by Western blotting after transfected at different time points.The average of multiple-sample average was analyzed by single-factor x2 test or LSD-t and Tamhane's T2 test was used for twotwo comparison.Results MTT result s showed that RNA interference that specifically silent Bcl-xl could obviously suppress the proliferation of sliding film cells,which was most eveident at 48 hours.This inhibition was gradually weakened with prolonged time,but when compared was the control group,differences was significant (P＜0.05).Western blotting results displayed that when compared to the control group,Bcl-xl protein expression obviously declined after transfection P＜0.01,which was the least at 48 h time point.Bax,Caspase3 protein expression were obviously increased when compared to the coutrol group.Conclusion The expression of Bcl-xl,a RA synovial cell anti-apoptotic factor,is significantly reduced by specific RNA interference silencing Bcl-xl,which may play an important role in inhibiting the excessive proliferation of synovial cells.

One hundred and sixteen patients with lower limb fracture were screened by Doppler ultrasound for deep vein thrombosis(DVT) of bilateral lower extremities within the first 72 h, d7 and d21 after fracture. Results showed that DVT was detected in 31 (26. 7% ) out of 116 cases within 72 h; at d7 and d21 DVT was detected in 3 and 1 patient respectively with a cumulated DVT rate of 30. 2% in 3 weeks.Serial Doppler ultrasonography is of value in screening for DVT of the lower extremities in patients with lower limb fracture at early stage.

Objective To evaluate the clinical efficacy of percutaneous transhepatic biliary drainage (PTBD) and pcrcutaneous transhcpatic insertion of biliary stent (PTIBS) for malignant biliary obstruction.Methods PTBD or PTIBS were performed in 56 patients with malignant biliary obstruction, which were aused by hepatic carcinoma (n = 14), biliary duct carcinoma (n = 11), gallbladder carcinoma (n = 5),stomach carcinoma accompanied with metastasis of lymph node (n = 14), carcinoma of ampulla (n = 1 ) or carcinoma of pancreatic head (n = 11 ). The diagnosis was confirmed by ultrasonography, CT or MRI in all patients. The obstructed site was well identified, including high obstruction in 19 patients and lower obstruction in 37 patients. Based on the imaging findings, suitable interventional procedure was employed.Results PTBD or PTIBS were performed successfully in all 56 patients, of them PTBD was adopted in 11,PTIBS in 40 and both PTBD and PTIBS in 5. The serum total bilirubin decreased from (295.65±152.86)μmol/L before the procedure to (151.05 ± 107.36) μmol/L after the procedure, (P < 0.01 ). Postoperative infection could affect the fading of jaundice (P < 0.01 ), but the location of the obstruction carried no relationship with the fading of jaundice (P = 0.063). Conclusion Both PTBD and PTIBS are safe and effective palliative therapies for malignant biliary obstruction, which can markedly relieve patient of jaundice,improve the quality of life and elongate the survival period.

Acute Disease ; Adult ; Benzene ; poisoning ; Female ; Humans ; Leukemia ; chemically induced ; Occupational Exposure ; adverse effects