Objective To research the position transition training effect of general practitioner of northeast district of Chongqing,and find out the problems and their reasons.Methods 326 students and 150 unit leaders were chosen to make a questionnaire survey(recycled 307,150).The Kirkpatrick model was also used for data analysis from 4 levels.The result was described in percentage.Results Reaction Level:42.02％(129/307) of the trainees were not satisfied with the time arrangement of clinical medicine training; Study Level:3 courses were at high failure rate 19.54％(60/307),22.8％(70/307),17.92％(55/307); Behavior Level:81.43％(250/307)of the trainees considered the training effective; Result Level:94.00％(141/150)unit leaders considered the training had a positive impact.Conclusion The time arrangement of clinical medicine training is mostly unsatisfied and the ability of instrument using and result interpretation is weak.Most people consider the position transition training is effective.

Objective To evaluate HSP90 levels in the diagnosis and staging of gastrointestinal tumors.Method Patients with gastrointestinal tumors hospitalized from 2014 January to 2015 April were enrolled in this study.Serum level of HSP90 was detected.Results The serum HSP90 level of cancer group(112 ± 74)was significantly higher than the control groups,the area under the ROC curve of HSP90's was 0.875 and the cut-off point was 63.63 with sensitivity of 76.1％ and specificity of 92.6％.The HSP90 level in gastric cancer group(135 ±73)ng/ml was the highest,in colon cancer group was (105 ± 60) ng/ml and in rectum cancer group was(79 ± 42)ng/ml (all P ＜ 0.05).Serum HSP90 levels in moderate and low differentiated adenocarcinoma were higher than well differentiated adenocarcinoma group (P ＜ 0.05).Serum HSP90 level was higher in tumors with submucosa and serosa infiltration (P ＜ 0.05).Those with lymphatic metastasis tend to have a higher serum HSP90 level than those without.Conclusion Serum HSP90 level has a good predictive value on gastrointestinal tumor diagnosis,and it is correlated with tumor staging and infiltration status.

Objective To research expression changes of COX-2 gene in Barrett′s esophageal mucosa before and after argon plasma coagulation (APC)operation and to explore it′s clinical curative effect and possible mechanism .Methods 66 barrett′s e-sophageal diagnosed with gastroscope and pathology were randomly divided into normal esophageal group (the negative control group ,group A) ,the APC with acid suppression therapy group(group B) ,Acid antimicrobial drug treatment group(group C) .Ob-serve symptom relief condition ,barrett esophagus epithelium ablation under gastroscope before and after treatment ,esophageal mu-cosa tissue samples was detected by real-time fluorescent quantitative PCR technique .Expression of COX-2 gene in barrett′s esoph-ageal mucosa were compared among groups .Results Compared with group A ,both Group B and group C could effectively relieve symptoms (P<0 .05) .Symptom remission rate had no no statistically significant difference in Group B and group C .Barrett esopha-gus epithelium was not significantly narrowed under gastroscope follow-up Group A and group C ,while Barrett esophageal mucosal occurred ablation with pink mucous covered in Group B .The expression of Cox-2 mRNA in group B decreased ,which was similar to group A .The expression of Cox-2 mRNA in group C also decrease ,but there was no significant differences before and after treat-ment .Conclusion APC with acid suppression therapy could effectively relieve symptoms ,melting Barrett esophagus epithelium ,and is of a safe and effective treatment on Barrett′s esophagus .

CYP2E1 enzyme encoded by cyp2e1 gene plays an important role in metabolism of heterogeneous organics in mammalian liver cells. The transgenic plant with cyp2e1 can metabolize various low molecular weight organic pollutants. However, it is unclear the mechanism of expression control of cyp2e1 in transgenic plant. In this study, plasmid pSLD50-6 with cyp2e1 and pKH200 with gus as control were transformed into Agrobacterium tumefaciens GV3101 separately. Then, the cyp2e1 or gus genes were transferred into tobacco (Nicotiana tabacum) and the transgenic plants were regenerated via Agrobacterium tumefaciens method. Real-time quantitative PCR (qRT-PCR) was used to analyze the cyp2e1 gene expression. The expression of cyp2e1 in transgenic tobacco with cyp2e1 decreased obviously treated by ethyl alcohol and reduced slightly by benzene and toluene, while it enhanced by acetone, formaldehyde and oxygen deficit in different levels. In addition, the gene expression of NADPH-P450 oxidoreductase and cytochrome b5 enzyme in the transgenic tobacco with cyp2e1 were increased significantly treated by benzene, which showed that NADPH-P450 oxidoreductase and cytochrome b5 enzyme in transgenic tobacco have relation with CYP2E1 detoxication process. It suggested that the NADPH-P450 oxidoreductase and cytochrome b5 enzyme in transgenic plant formed the requirement in mammalian and participated in the electron transport chain of CYP2E1 enzyme catalytic process.
Agrobacterium tumefaciens ; genetics ; Animals ; Cytochrome P-450 CYP2E1 ; biosynthesis ; genetics ; Gene Expression Regulation, Enzymologic ; genetics ; Gene Transfer Techniques ; Genetic Vectors ; genetics ; Plants, Genetically Modified ; genetics ; Soil Pollutants ; isolation & purification ; Tobacco ; enzymology ; genetics ; Transfection

Objective: This study aimed to evaluate the validity and predictive value of different methods for myopia screening, and to provide the most effective method of myopia screening. Methods: A total of 7 441 students of grade 1-12 selected from 36 primary and middle schools in 12 counties in Jiangsu Province were enrolled in this study for ophthalmological examination, and uncorrected visual acuity (UCVA, Plan A), noncycloplegic autorefraction (NCAR, Plan B) and combination of UCVA and NCAR (Plan C) were included in the examination. Receiver operating characteristics (ROC) curve was performed to determine the cut-off values (The gold standard is cycloplegic refraction: SE≤0.5 D), and positive predictive value, sensitivities, specificities and other indicators of three screening tests were compared and calculated. Results: The AUC of the combination test for uncorrected visual acuity(UCVA) and noncycloplegic autorefraction (NCAR) was nearly 1(0.91, 95%CI=0.90-0.92), and the sensitivity, specificity, Yoden index, diagnostic coincidence rate, positive predictive value and negative predictive value were 92.4%，89.5%，0.82，91.1%，91.3%，90.8%, respectively, but the index of the younger pupils in primary schools was relatively low. The result of screening plan A for students of middle and high school students was the closest to that of myopia diagnosis. Conclusion Combination test, which was recommended by China National Health Commission, can be a practical solution for school students for myopic screening. Under the condition of no mydriatic refraction, Plan A could be considered for myopia screening especially for middle and high school students. For the younger pupils, it is suggested to use the internationally recommended myopia screening strategy, that is, SE ≤ 0.50D after mydriasis.

Objective: To explore the influencing factors of exposure to campus bullying among junior and senior school students, and to establish a column line diagram model for risk prediction, while providing a theoretical basis for campus bullying prevention and control in secondary schools. Methods: A total of 22 034 junior and senior school students were selected via direct sampling technique from September to November 2021 in 13 cities in Jiangsu Province, China, and questionnaires were administered using the Student Health Behavior Questionnaire. The Chi squared test and multifactor Logistic regression analysis were used to derive the influencing factors of exposure to campus bullying, and a column line graph prediction model was drawn. Results: A total of 540 students reported that they had experienced campus bullying, with a prevalence rate of 2.45%. Being in a non conventional family ( OR =1.30,95% CI =1.02-1.65), overweight/obesity ( OR =1.35,95% CI =1.09-1.67), scolding by parents in the past 30 days ( OR =2.27,95% CI =1.82-2.84), cigarette smoking in the past 30 days ( OR =1.54,95% CI =1.11-2.15), Internet addiction ( OR =2.03，95% CI =1.34-3.08), and depressive symptoms( OR =5.24，95% CI =4.16-6.61), all of which were positively correlated with exposure to campus bullying among junior and senior school students ( P <0.05). Furthermore, the following factors were negatively associated with junior and senior school students protection from campus bullying in female students ( OR = 0.58 , 95% CI =0.46-0.72)，senior school students ( OR =0.68，95% CI =0.54-0.83), eating breakfast sometimes ( OR =0.37，95% CI = 0.22 -0.62), and eating breakfast everyday ( OR =0.28，95% CI =0.17-0.49) ( P <0.05). The column line graph established based on the above influencing factors had an area under the curve of 0.792 (95% CI =0.769-0.815), and the calibration curve showed that the predicted value was basically the same as the measured value. Conclusions Non conventional families, overweight/obesity, male students, junior school students, scolding by parents, cigarette smoking, Internet addiction, and depressive symptoms are correlated with school bullying among middle school students. The predictive model constructed in the study can provide an effective basis to predict the risk of school bullying and facilitate the implementation of proactive interventions for junior and senior school students.

Objective:To investigate the expression of osteoprotegerin (OPG) and receptor activator of nuclear factor-κB ligand (RANKL) in type 2 diabetic rats with periodontitis.Methods:46 male Wistar rats were randomly divided into the healthy group(n =10),the periodontitis group(n =12),the type 2 diabetes mellitus group(n =12) and the type 2 diabetic periodontitis group(n =12).Animal models were prepared respectively.The expression of OPG and RANKL protein in alveolar bone was detected by immunohistochemistry(IHC).Results:Compared with the healthy group,the expression of OPG in the type 2 diabetes mellitus group,the periodontitis group,the type 2 diabetes mellitus with periodontitis group decreased in turn,however the expression of RANKL increased in turn.The expression of OPG and RANKL had no significant difference between periodontitis group and type 2 diabetes periodontitis group,while there was statistically significant difference among the other groups (P ＜ 0.05).Conclusion:Inflammation may lcad to upregulation of RANKL in osteoclasts and immune cells,and downregulation of OPG in osteoblasts.

Objective: To assess the effectiveness of online and offline myopia prevention and control health education interventions using wearable behavior monitoring tools for non myopic elementary school students,so as to provide evidence based medical support for public health practices. Methods: From May to June in 2021, two schools were selected within the same county in Jiangsu Province. School 1 conducted online and offline parental health education ( n =111), while school 2 exclusively conducted offline health education activities, representing the traditional intervention group ( n =122). Students from both schools underwent monitoring through wearable behavior tracking tools, with feedback reports provided (eye distance, eye duration, ambient light, and outdoor exposure time). Both schools relied on activities to carry out health education interventions, and organized the distribution of promotional materials and display boards. The intervention group also established WeChat groups to conduct online "Healthy Parents Action" (answering and providing feedback on health knowledge related to myopia prevention and control, myopia prevention and control, science popularization, etc. raised by parents). Evaluation criteria included myopia rates, post dilation refractive error, and axial length, with a tracking period of two years (from 2021 to 2023). Additionally, the study collected refractive parameters from non myopic students who did not participate in wearable tool monitoring in the 12 classes across the two schools. Results: The baseline results indicated that there were no significant differences between the two groups in terms of refractive parameters and wearable tool monitoring results (including screen time, viewing distance, outdoor exposure time, and homework light exposure)( t/Z/χ 2=1.94,1.17,0.58,0.40,0.80,0.69,0.32, P >0.05). After a two-year follow up, in the first and second year, the myopia rate of the online Healthy Parents Action group (11.4%, 29.7%) were lower than that of the traditional group (26.2%, 50.9%), and the degree of refractive change in the intervention group [0.63(0.38,1.19)D] was lower than that of the traditional group [0.91(0.40,1.50)D], and all the differences were statistically significant( χ 2/ Z =4.93，10.37，2.29， P <0.05). However, there were no significant differences ( P >0.05) in axial length changes between the two groups over the twoyear intervention period. Nevertheless, in the second year, the axial length change in the traditional group [0.35(0.20,0.65)mm] was lower than that in the natural observation group [0.55(0.30,0.75)mm], and this difference was statistically significant ( Z =1.92, P <0.05). Conclusions Online and offline myopia prevention and control health education can effectively reduce myopia rates. The intervention mode combining wearable behavior monitoring tools with online health education may have better effects, but further large sample and multi center studies are needed to provide additional evidence and confirmation.