Objective To evaluate the clinical capability of young general practitioners (GPs) in communities in Shanghai.Methods A cross-sectional survey on clinical ability of young GPs was adopted from October to December 2014.Total 211 GPs aged (31 ± 2) years (25-35) from 17 districts of Shanghai participated in the study.Written examination and objective structured clinical examination (OSCE) was applied in the evaluation.Results All 211 GPs (63 male and 148 females) completed the assessment.The overall score of the assessment was (602 ± 83) and the pass rate was 62.6％ (132/211).In written examination the average score was (64 ±7) and the pass rate was 72.1％ (152/211).In OSCE,the highest score (80 ± 15) and pass rate (92.9％,196/211) was in CPR skill,followed by communication skill [average score:(76 ± 15) and pass rate:85.8％ (181/211)].The lowest average score was physical examination (47 ± 15) with a pass rate of 26.1％ (55/211),followed by electrocardiogram reading [average score:(84 ±31) and pass rate:39.8％ (84/211)].In basic operation station,the lowest score was using funduscope and gynecologial examination (29.8％ and 45.4％,respectively).Conclusion Young GPs in Shanghai communities basically master clinical skills,but also have some deficiencies,the training in certain skills need to be strengthened.

Objective To assess community health service ability of general practitioners (GPs) with the Standardized General Practitioner Training(SGPT) in Shanghai.Methods One hundred and four GPs receiving SGPT and matched 102 GPs without SGPT were enrolled in this retrospective cohort study from September to November in 2014.Community health service ability,including abilities in basic medical service and public health service were assessed and compared between two groups.Written examination was applied in the public health services ability assessment.Objective structured clinical examination (OSCE) was applied for evaluation of basic medical service abilities.Results The scores of written examination in GPs with SGPT were higher than those without SGPT[(66 ±4) vs.(62 ±7),P ＜0.01].The OSCE scores in GP with SGPT were higher than those without SGPT [(494 ± 78) vs.(448 ± 80),P ＜ 0.01].GPs with SGPT also abtained the higher scores in consultation competence and clinical skills assessment [(245 ± 44) vs.(225 ±40),P＜0.01;(252 ±59) vs.(225 ±61),P ＜0.01].In OSCE,GPs with SGPT got higher score than those without SGPT in 5 stations (medical history collection,doctor-patient communication,basic operation,ECG interpretation,and CPR) (all P ＜ 0.01);however,no significant differences were observed in 3 stations (physical examination,case analysis and X-ray interpretation) between two groups (all P ＞ 0.05).Conclusions GPs with SGPT have better basic medical service and public health service ability.But some aspects of basic medical service ability need to be strengthened in the training and practice.

Objective To investigate the clinical effect of selective bronchial artery infusion chemotherapy for central squamous cell carcinoma of the lung.Methods 93 cases of central lung squamous cell carcinoma patients who were treated in our hospital from February 2015 to February 2017 were enrolled in the study.They were divided into the observation group (n =45) and the control group (n =48) according to the patients'final treatment.The observation group was treated with bronchial artery perfusion chemotherapy,and the control group was treated with systemic venous chemotherapy.The short-term effect and the improvement of lung function in the two groups were observed,and the prognosis of the patients was followed up.Results The short-term effect of the observation group was better than that of the control group (P ＜0.05),and the total effective rate of the observation group was 95.56％;The forced vital capacity (FVC)and forced expiratory volume in the first second (FEV,) of the observation group were (75.39 ± 6.88)％and (78.19 ± 7.79)％,respectively,which were significantly higher than those in the control group (P ＜0.05).The reoperation ratio of the observation group was 44.44％ after chemotherapy,which was significantly higher than that of the control group,with statistically significant difference (P ＜ 0.05).The median total survival time of the observation group was 17 months,which was significantly higher than that of the control group,with statistically significant difference (P ＜ 0.05).The incidence of adverse reaction in the observation group was 6.67％,which was significantly lower than that in the control group,with statistically significant difference (P ＜ 0.05).Conclusions Selective bronchial artery infusion chemotherapy for central lung cancer is effective and worthy of clinical application.

Objective To analyze peripheral blood hemogram, lymphocyte micronucleus and chromosomal aberrations of radiologists, so as to provide basis for occupational protection and health monitoring of radiologists. Methods Lymphocyte micronucleus, chromosome and blood hemogram analysis were performed on 127 radiologists who received health examinations in 2015, 2017 and 2019, and they were assigned to the radiation group. In addition, 133 medical staff with no history of radiation exposure were selected as the control group. Results The micronucleus rate and chromosome aberration rate of the radiation group were higher than those of the control group, and the white blood cell and platelet counts were lower than those of the control group, both of which were statistically significant (P < 0.05). The total number of white blood cells in peripheral blood of 127 radiologists decreased gradually with the increase of exposure time to ionizing radiation, and the chromosome aberration rate increased gradually, all of which had statistical significance (P < 0.05). The rate of chromosomal aberration was higher in radiologists with damage work age of more than 20 years than in the low-work age group, and there was no statistical significance between different damage work age (P > 0.05). The chromosome aberration rate of nuclear medicine and interventional therapy was higher than that of other types, with statistical significance (P < 0.05). Conclusion Long-term exposure to low-dose ionizing radiation can reduce the total number of white blood cells and increase the chromosome aberration rate of radiologists. It is necessary to strengthen the protective measures for radiologists to reduce the degree of ionizing radiation damage, especially to strengthen the occupational protection for radiologists in nuclear medicine and interventional therapy.