Objective To better promote the health education and health promotion among patients with chronic disease, general practitioners (GPs) in the community should master the knowledge of non-communicable diseases (NCDs). This paper aimed to describe the current situation of GPs' knowledge about prevention and treatment of NCDs. Methods Self-designed questionnaires were issued to 1 077 GPs in community health service centers, and all GPs finished the questionnaire without assistance. The content of questionnaire includes the general information of GPs and six questions focusing on NCDs. Results Overall, 1 076 GPs completed the questionnaire, and the response rate was 99.9% (1 076/1 077). With regard to the six questions about NCDs, 90.4% (973/1 076) of GPs were well aware of the diagnosis of hypertension. Apart from that, the knowledge of diabetes mellitus (60.9%, 655/1 076), factors related to NCDs (70.2%, 755/1 076), the concepts of mental illness (52.0%, 560/1 076) and the clinical significance of tumor markers (87.9%, 946/1 076) among GPs were adequate, while more than half of the GPs did not know a lot about home oxygen therapy. Conclusion The mastering level of knowledge about prevention and treatment of NCDs among GPs varies that they need further improvement.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Child ; Cytarabine ; administration & dosage ; Daunorubicin ; administration & dosage ; adverse effects ; Female ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Middle Aged ; Mitoxantrone ; administration & dosage ; adverse effects ; Young Adult

Objective To investigate the effects of dexmedetomidine on sedation and inflammatory response in patients undergoing brachial plexus anesthesia, to provide a reference for the selection of sedative drugs in forearm traumatic patients undergoing brachial plexus block anesthesia .Methods 80 forearm traumatic patients underwent trauma surgery with brachial plexus nerve block from July 2015 to June 2016 were selected and randomly divided into two groups of dexmedetomidine group (dexmedetomidine group, D group) and normal saline group (control group, C group), each group of 40 cases.The mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO2) were recorded before operation (T0), incision (T1), 15 min (T2), 30 min (T3).Interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) were measured at different time points. At the same time, the Ramsay sedation score and the degree of amnesia after operation were measured.Results There were no significant differences in MAP, HR and SpO2 before anesthesia between the two groups.In group D, MAP and HR were significantly lower than those in group C at T1, T2, T3 and T4, the difference was statistically significant (P<0.05).There was no statistical difference in SpO2 between the two groups.The Ramsay sedation score of group D at T1 to T4 was significantly higher than that of group C, the difference was statistically significant (P<0.05).The levels of IL-1β, IL-6 and TNF-αin group D were significantly lower than those in group C at T1 to T4, the difference was statistically significant (P<0.05).Conclusion Dexmedetomidine has good curative effect on forearm traumatic patients with brachial plexus block and less hemodynamics changes , which is beneficial to patients'forgotten of operation and inhibition of inflammatory reaction in forearm traumatic patients.

In recent ten years, general practitioner (GP) training and practice develops rapidly in China. It has established a relatively complete GP training system, including medical college education and standardized residency training. However, the path of continuing professional development and clinical skills improvement for GP after standardized residency training is still unclear. The concept of GP with special interest (GPSI) has been proposed these days, and it has put forward a new development direction for the career path of GP. In this article, on the basis of understanding the current status of GPSI in China, we try to discuss its advantages and problems, and then propose our suggestions for its future development.

OBJECTIVE:To optimize the stir-bake with saltwater processing technology for Fujian Alismatis rhizoma,and es-tablish its HPLC fingerprint. METHODS:Using 23-acetyl alisol B,total triterpenoids contents and appearance as comprehensive in-dexes,single factor experiment and orthogonal test were employed,3 factors'levels including the quantity of salt,processing tem-perature and time were optimized. HPLC was used to develop fingerprints of 10 batches of Fujian Alismatis rhizoma at wavelength of 208,245 nm;the similarity between fingerprints and control profile was compared by using software. RESULTS:The optimal technology was as follow as 2 kg salt dissolved with 10 kg water for each 100 kg Fujian Alismatis rhizoma,moistening for 1 h, stir-frying for 8 minutes under 100 ℃. In verification test,the appearance of 3 batches of processed products were all in line with requirements,average comprehensive score was 93.94 (RSD=6.63%,n=3);23-acetyl alisol B and total triterpenoids contents were stable(RSD=7.41%,7.39%,n=3),respectively. Totally 17 and 10 common peaks were marked in 208 nm and 245 nm re-spectively;similarities of 10 batches of samples'fingerprints were higher than 0.9. CONCLUSIONS:Optimized stir-bake with salt-water technology is reasonable,feasible,and reproducible;the stability of common peaks of established fingerprints can conduct ef-fective quality evaluation for Fujian Alismatis rhizoma processed by saltwater.

Objective To investigate the diagnostic value of sonographic changes of adipose tissue in benign and malignant breast lesions.Methods The sonographic characteristics of subcutaneous adipose tissue were retrospectively analyzed in 92 patients with 114 breast lesions,all lesions were confirmed by postoperative pathology.Receive operating characteristic (ROC) curve was drew with the pathological results as standard,the diagnostic value of subcutaneous adipose tissue changes in benign and malignant breast lesions was evaluated.Results The area under the ROC curve that derived from all of the lesions (61 benign and 53 malignant) was 0.862 (P =0.000).The ultrasonographic findings which showed subcutaneous adipose tissue changes at grade Ⅲ or higher suggested that the tumors were more likely malignant lesions.When adipose tissue changes at grade Ⅲ was taken as the diagnostic indicator for the presence of malignant breast lesions,the diagnostic sensitivity reached 73.6％ while specificity reached 93.4％.At ultrasound imaging scan,the adipose tissue in malignant lesions had the following manifestations:increased fibrosis,increased echogenicity,the sonographic images were turbidity or blurred,presence of ground-glass-like opacity.There were significant differences (P =0.000) between the benign and the malignant lesions in the range of adipose tissue changes.Conclusions The ultrasonographic changes were helpful to the differential diagnosis between the benign and the malignant breast lesions.

Objective To explore effect of endogeneous gangliosides(Gls) and integrin ?2?1 on protein phosphotyrosine expression of pp125 focal adhesion kinase (pp125FAK) after adhesion of SK-N-SH neuroblastoma cells to collagen(Col).Methods SK-N-SH cell line with high expression of integrin ?2?1 was cultured in presence of D-threo-1-phenyl-2-decanolamino-3-morphinoline-1-propanol(D-PDMP).Effect of endogeneous Gls,anti-?2 and anti-?1 monoclonal antibody on protein phosphotyrosine expression of pp125FAK during adhesion of SK-N-SH cells to Col were determined by immunoprecipitate and Western blotting.Results After 6 days,endogenous Gls in cells were almost depleted.Gls-depletion,anti?2 and anti-?1 monoclonal antibody were able to decrease pp125FAK expression of SK-N-SH cells adherent to Col respectively.GD2,the major component of neuroblastoma cell Gls could reco-ver pp125FAK expression to a certain degree.Conclusions Endogenous tumor Gls regulate protein phosphotyrosine expression of pp125FAK during adhesion of neuroblastoma cells to Col.It is suggested that tumor Gls may increase signal transduction of tumor cell integrin ?2?1 by increasing tyrosine phosphorylation of pp125FAK.

Objective To investigate the clinical states of enuresis children companied with spina bifida occulta(SBO)and study the efficient way of treatment.Methods The children with SBO were check out by X ray from a total of 121 children with bedwetting.Their parents were asked to complete the enuresis questionnaires.Urine routine test and B-ultrasound examination about kidney,bladder and ureter were also asked to be done.The clinic data of the 49 children were attained and analyzed.They were randomly divided into 2 groups,and given the controlled treatment.Group A[used 1-deamino-8-D-arginine vas-opressin(DDAVP)only] and group B(used DDAVP plus oxybutynin plus bladder training)treated for 12 weeks.Results There were totally 49 bedwetting children companied with SBO,and most of them(44 cases,89.8%)were severe type(bedwetting times≥7 times/week).Some of them coexisted with frequency,urgency,gentle urgency incontinence and microscopic hematuria(22 cases).Thirty cases were found the functional bladder capacity(FBC)decrease by B-ultrasound.The cure rates were 58.3%(group A)and 88.0%(group B)respectively.The relapse rates were 36.8%(group A)and 12.5%(group B)respectively after stopping treatment for 3 months.Conclusions SBO accounts for considerably higher rate in enuretic children.It might cause the disability of bladder function.The treatment plan with DDAVP plus oxybutynin plus bladder training can not only increase the cure rate but also lower the relapse rate.

AlM: To observe retinal hemodynamic influence of compound xueshuantong capsule on nonproliferative diabetic retinopathy ( NPDR) after laser photocoagulation.METHODS:A total of 41 patients (72 eyes) with NPDR after laser photocoagulation were enrolled in this study. They were all given compound xueshuantong capsule, and used color Doppler flow imaging for detection of retinal hemodynamics.
RESULTS: After treatment, patients with retinal blood perfusion significantly improved; central retinal arterial peak systolic velocity ( PSV ) , end - diastolic velocity (EDV) and medial velocity (Vm) were increased, while the resistance index ( Rl) decreased. The difference have statistical significance (P<0. 05). The visual acuity of 61 eyes improved, efficiency was 85%. Visual acuity was related with PSV, Vm and Rl.
CONCLUSlON: Compound xueshuantong capsule can improve retinal blood perfusion for nonproliferative diabetic retinopathy after laser photocoagulation, which is related to improvement of visual prognosis.

Background The neovascular form of the disease usually causes severe vision loss in a number of eye diseases.Special-domain optical coherence tomography (SD-OCT) provides high-quality in retinal imaging and the possibility of the measurement in vivo.Objective This study aimed to investigate the feasibility of SD-OCT dynamically measuring choroidal neovascularization (CNV).Methods CNV was induced in 30 left eyes of 30 clean Brown Norway(BN)rats by retinal photocoagulation with the laser parameter as follows: wavelength 532 nm,exciting power 200 mW,spot diameter 100 μm and irradiating time 50 ms.Bubble or less retinal bleeding was thought as Brunch membrane breakage and CNV model establishment.Fundus fluorescein angiography(FFA) was performed to determine the establishment of CNV model and scored based on the fluorescein leakage on 3,7,14,21 days after photocoagulation.Meanwhile,CNV memberane thickness (CMT) was dynamically measured in vivo as the maxiume value from retinal inner limiting membrane through choroidal vessel layer in various time points.Histopathologic examination was used in the 14th day to evaluate and verify the result of SD-OCT.The right eyes were as controls.Results FFA examination showed that disc-like leakage of fluorescein appeared in 7 days and extended in 14 days after photocoagulation with the scores of 1.6±0.4,2.5±0.6 and 2.4±0.5 in 7,14 and 21 days,showing a significant difference among them(F=13.11,P＜0.01).The fluorescein leakage score was significantly higher in 14 and 21 days than that of 7 days(both P＜0.05).CMT measured by SD-OCT was(76.33±10.09),(102.03±14.21)and(98.03±13.76) μm in 7,14 and 21 days after photocoagulation respectively,with a significant difference among 3 time points (F=23.25,P＜0.01),and that in 14 and 21 days was significantly declined in comparison with 7 days(both P＜0.05).The results of SD-OCT showed a consistent tendency with that of FFA.Histopathological examination showed CNV formation in 14 days after photocoagulation.Conclusions Experimental CNV model was successfully induced by laser photography.SD-OCT technology allows excellent visualization of CNV in vivo.