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 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.

To study the characteristics of pharmacological effects of property combinations of traditional Chinese medicines (TCMs) distributing in the stomach meridian based on medicinal property combination, in order to further define the association relationship between properties of TCMs and their pharmacological effects, and build a bridge for the interpenetration and combination between the medicinal property theory of TCMs and their pharmacological effects. On the basis of the studies on the medicinal property theory of TCMs distributing along the kidney meridian and their pharmacological effects, efforts were made to collect relevant data for medicinal properties and pharmacological effects and mine the characteristics of pharmacological effects that were corresponding to relevant medicinal property combination by processing materials related to medicinal properties and pharmacological effects with the association rules method. According to the analysis, TCMs distributing along the kidney meridian with different medicinal property combinations were significantly differentiated in the pharmacological effects, but shared identical pharmacological effects, such as immunological enhancement. In this study, TCMs distributing along the kidney meridian with different medicinal property combinations were taken as the carriers to closely integrate the traditional Chinese medicine theory with the modem study achievements, lay a solid foundation for further developing and enriching the traditional Chinese medical property theory, while providing a new perspective on the development of modem medicine.
Databases, Factual ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Humans ; Kidney ; drug effects ; Kidney Diseases ; drug therapy ; Meridians

Objective To investigate the in vitro effects of human bone marrow derived mesenchymal stem cells (hBMSC) on Th17 cells of the human peripheral blood.Methods The density gradient centrifugation combined with lymphocyte separation medium was used to isolate hBMSC,which were then cultured.Cytokine IL-17 in the peripheral blood from a healthy person was measured by enzyme-linked immunosorbent assay (ELISA).Proportion of Th17 cells was evaluated by flow cytometry.Results The expression level of IL-17 in spent culture supernatant of the healthy person PBMC and AML hBMSC was (292.32±37.25) pg/ml,and was significantly higher than that of the healthy person PBMC and healthy hBMSC [(169.64±17.47) pg/ml,P ＜ 0.01].There was no significant difference between the expression level of IL-17 in spent culture supernatant of the healthy person PBMC and ALL hBMSC [(159.89±23.71) pg/ml] and the level of the healthy person PBMC and hBMSC.The percentages of Th17 cells of co-culture systems from hBMSC,ALL-hBMSC,and AML-hBMSC and PBMC were (10.13±2.19) ％,(13.77±4.04) ％ and (21.53±5.05) ％,respectively,with the result between AML patients and healthy people being statistically different (P ＜ 0.01).ALL patients and healthy people showed no difference (P ＞ 0.05).Conclusion AML-hBMSC promotes the CD~ T cells to generate Th17 cells,which suggests that the MSC from AML marrow may play a role in the regulation of immune suppression.

Objective To develop the Chinese version of Attribution Questionnaire-27 and examine its replicability,reliability and validity.Methods The questionnaire was translated using the standard translation/back-translation method and examine its replicability,reliability and validity in 230 medical students who were selected by convenient method.Results The Cronbach α coefficient for Attribution Questionnaire-27 was 0.82 and ranging between 0.55 and 0.84 for the subscales.The test-retest reliabilities of the total scale was 0.77 and the subscales was between 0.61 to 0.81 after one week.Confirmatory factor analysis confirmed the hypothesized six factors attribution of responsibility model (x2/df=3,GFI=0.925,NFI=0.880,CFI=0.856,IFI=0.761,RMSEA=0.094) and three factors dangerous model (x2/df=1.773,GFI=0.959,NFI=0.941,CFI=0.973,IFI=0.973,RMSEA=0.058).The path analysis results support the existing theoretical assumptions.Condusions The Chinese version of Attribution Questionnaire-27 has good reliability and validity and can be used in medical student.

Objective To investigate the status of nurses' resilience and to explore the related factors.Methods 1356 nurses from 11 level Ⅱ and level Ⅲ hospitals of Guangzhou were assessed by using the general information questionnaire and the Chinese version of Conner-Davidson resilience scale.Results The score of nurses' resilience was(59.99±13.59)points and it was significantly lower than that of the domestic norm.There was statistical difference of the score of nurses' resilience on different genders,educational background,professional titles,hospital level and night shifts.There was a positive correlation among educational background,night shifts and nurses' resilience,and a negative correlation between hospital level and nurses' resilience.The hospital level,night shifts and educational background were the influencing factors of nurses' resilience.Conclusions The level of nurses' resilience is low.The higher hospital level and educational background,and the less night shift,the higher of nurses' resilience.

ObjectiveTo explore the potential value of diffusion weighted imaging(DWI) in the clinical diagnosis of soft-tissue tumors.MethodsDiffusion-weighted MRI was performed in 48 histologically proven soft-tissue tumor cases using diffusion-weighted spin-echo sequences.Of the 48 soft-tissue tumor cases,there were 28 cases of sarcoma and 20 cases of benign tumor.The apparent diffusion coefficient(ADC) values of a large region with no necrosis,scar tissue,hemorrhage or calcification representing the lesion were measured.ADC values of benign tumors,malignant tumors and normal muscles were compared.ResultsThe ADC value of the malignant tumors (0.95 ± 0.31 )× 10-3mm2/s was significantly lower than that of benign lesions( 1.87 ±0.66) × 10-3mm2/s and muscles( 1.62 ±0.50) × 10 -3mm2/s.There was no significant difference in ADC value between benign lesions and muscles.Sensitivity(75％ ) and specificity(89％ ) were obtained when the ADC value was 1.38 × 10-3mm2/s in the differentiation of benign and malignant tumors.ConclusionDiffusion-weighted MRI had potential value in differentiating benign softtissue tumors from malignant ones.

OBJECTIVETo discuss the rationality of the clinical replacement of traditional Chinese medicine (TCM) bear bile with bile acid constituents, and analyze the difference between these constituents and bear bile in drug properties.

METHODSummarizing the drug properties of bear bile by reference to medical literatures for drug properties of TCM bear bile and Science of Traditional Chinese Medicine (China Press of Traditional Chinese Medicine, 2007). Analyzing and summarizing the pharmacological effects of main bile acid constituents according to relevant literatures for studies on pharmacological effects of main bile acid constituents in CNKI database. Predicating the drug properties of these bile acid constituents by using the drug property predication model established by the study group according the pharmacological effects of main bile acid constituents in the paper, and compare the prediction results with the drug properties of bear bile.

RESULTBile acid constituents in bear bile were mostly cold in property, bitter in taste, and the combination of their drug properties could reflect the combined drug properties of bear bile.

CONCLUSIONAll of these bile acid constituents in bear bile could show part of effects of bear bile. Attention shall be given to regulate the medication scheme in clinical application according to actual conditions.

Animals ; Bile ; chemistry ; Bile Acids and Salts ; chemistry ; pharmacology ; Humans ; Medicine, Chinese Traditional ; Taste ; Ursidae

Aluminum ; toxicity ; Animals ; Animals, Newborn ; Calcium ; metabolism ; Cerebral Cortex ; drug effects ; metabolism ; Dose-Response Relationship, Drug ; Female ; Male ; Rats ; Rats, Wistar

OBJECTIVETo investigate the impact of 1, 25-(OH)2D3 on left ventricular hypertrophy (LVH) in type 2 diabetic rats.

METHODSType 2 diabetic mellitus (DM) model rats were established by intraperitoneally injecting with 30 mg/kg streptozotocin. After 8 weeks, 19 male rats were identified as diabetic with left ventricular hypertrophy (LVH) by ultrasound examination, and randomly assigned into three groups: untreated (DM-LVH, n=7), treated with insulin (DM-LVH+INS, n=6), and treated with 1, 25-(OH)2D3 (DM-LVH+VD, n=6). Healthy male rats were used as the controls group (n=6). The fasting blood glucose and the insulin level were determined weekly. The left ventricular mass index, myocardial collagen content, collagen volume fraction, and 1, 25-(OH)2D3-receptor level were determined by 4 weeks later.

RESULTSIn the DM-LVH model group, the insulin level was significantly decreased compared with the non-diabetic control group (P<0.05), whereas the blood glucose, left ventricular mass index, myocardial collagen content, collagen volume fraction, and 1, 25-(OH)2D3-receptor expression were significantly increased (all P<0.05). In the DM-LVH+INS and DM-LVH+VD groups, the insulin levels were significantly increased compared with the DM-LVH model group (P<0.05), whereas the other parameters were significantly decreased (all P<0.05).

CONCLUSION1, 25-(OH)2D3 could reverse LVH in diabetic rats and that the mechanism may involve stimulating insulin secretion and reducing blood glucose via direct up-regulation of 1, 25-(OH)2D3-receptor expression.

Animals ; Blood Glucose ; analysis ; Calcitriol ; therapeutic use ; Diabetes Mellitus, Experimental ; blood ; complications ; Diabetes Mellitus, Type 2 ; blood ; complications ; Hypertrophy, Left Ventricular ; prevention & control ; Insulin ; blood ; Male ; Rats ; Rats, Wistar ; Receptors, Calcitriol ; analysis ; Streptozocin