This paper analyzes current issues in general practitioners (GP) education (e.g., inadequate systems, faculty shortages, misaligned training with community needs, low workforce attractiveness) and proposes strategies for reform in the new development era. Key recommendations include: strengthening academic discipline building in general practice within medical universities; innovating curricula to integrate prevention with treatment and emphasize practical skills; leveraging institutional resources to foster clinician-educator-researcher roles; tailoring training pathways to regional contexts; deepening collaboration between medical education and healthcare delivery systems; and building a robust lifelong learning framework for GPs. Furthermore, the paper details the comprehensive reform initiatives undertaken by Guangzhou Medical University (GMU). These include establishing integrated education platforms spanning university, hospital, and community settings. GMU′s experience offers valuable insights for enhancing GP training quality and scalability in China.

Objective:To identify the risk factors of venous thromboembolism (VTE) in postoperative renal transplantation recipients by Meta-analysis, and to provide evidence-based reference for clinical staff to develop early VTE prevention strategies.Methods:PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, VIP database, Wanfang database and Chinese Biomedical Literature Database were searched to collect the studies on the risk factors of postoperative VTE in kidney transplant recipients. The search period was from the establishment of the database to March 10, 2024. After literature screening, data extraction and quality evaluation were conducted independently by two researchers, Meta-analysis was performed using RevMan 5.3 software.Results:A total of 15 literatures with 20 influencing factors were included. Meta-analysis showed that age ( MD = 6.36, 95% CI 2.56-10.17, P<0.05), body mass index ( MD = 1.83, 95% CI 0.15-3.50, P<0.05), VTE history ( OR = 2.04, 95% CI 1.08-3.86, P<0.05), blood transfusion history ( OR = 3.77, 95% CI 2.43-5.83, P<0.05), glomerular filtration rate ( MD = -5.54, 95% CI -9.93 - -0.91, P<0.05), donor age ( MD = 3.18, 95% CI 1.10-5.25, P<0.05), combination of malignant tumor ( OR = 2.87, 95% CI 1.45-5.68, P<0.05), end-stage renal disease as polycystic kidney disease ( OR = 1.76, 95% CI 1.39-2.22, P<0.05), and interstitial nephritis ( OR = 1.60, 95% CI 1.06-2.40, P<0.05) were the influencing factors for postoperative VTE in renal transplant recipients. Conclusions:Clinical medical staff should actively identify high-risk groups for VTE after kidney transplantation by considering the 8 influencing factors determined by this study, and take targeted measures early to reduce the risk of postoperative VTE.

This paper analyzes current issues in general practitioners (GP) education (e.g., inadequate systems, faculty shortages, misaligned training with community needs, low workforce attractiveness) and proposes strategies for reform in the new development era. Key recommendations include: strengthening academic discipline building in general practice within medical universities; innovating curricula to integrate prevention with treatment and emphasize practical skills; leveraging institutional resources to foster clinician-educator-researcher roles; tailoring training pathways to regional contexts; deepening collaboration between medical education and healthcare delivery systems; and building a robust lifelong learning framework for GPs. Furthermore, the paper details the comprehensive reform initiatives undertaken by Guangzhou Medical University (GMU). These include establishing integrated education platforms spanning university, hospital, and community settings. GMU′s experience offers valuable insights for enhancing GP training quality and scalability in China.

Objective:To identify the risk factors of venous thromboembolism (VTE) in postoperative renal transplantation recipients by Meta-analysis, and to provide evidence-based reference for clinical staff to develop early VTE prevention strategies.Methods:PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, VIP database, Wanfang database and Chinese Biomedical Literature Database were searched to collect the studies on the risk factors of postoperative VTE in kidney transplant recipients. The search period was from the establishment of the database to March 10, 2024. After literature screening, data extraction and quality evaluation were conducted independently by two researchers, Meta-analysis was performed using RevMan 5.3 software.Results:A total of 15 literatures with 20 influencing factors were included. Meta-analysis showed that age ( MD = 6.36, 95% CI 2.56-10.17, P<0.05), body mass index ( MD = 1.83, 95% CI 0.15-3.50, P<0.05), VTE history ( OR = 2.04, 95% CI 1.08-3.86, P<0.05), blood transfusion history ( OR = 3.77, 95% CI 2.43-5.83, P<0.05), glomerular filtration rate ( MD = -5.54, 95% CI -9.93 - -0.91, P<0.05), donor age ( MD = 3.18, 95% CI 1.10-5.25, P<0.05), combination of malignant tumor ( OR = 2.87, 95% CI 1.45-5.68, P<0.05), end-stage renal disease as polycystic kidney disease ( OR = 1.76, 95% CI 1.39-2.22, P<0.05), and interstitial nephritis ( OR = 1.60, 95% CI 1.06-2.40, P<0.05) were the influencing factors for postoperative VTE in renal transplant recipients. Conclusions:Clinical medical staff should actively identify high-risk groups for VTE after kidney transplantation by considering the 8 influencing factors determined by this study, and take targeted measures early to reduce the risk of postoperative VTE.

Objective:To translate the Cumulated Ambulation Score (CAS) into Chinese and test its reliability and validity in elderly inpatients, to provide a basis for assessing elderly inpatients′ basic mobility during hospitalization.Methods:This was a cross-sectional study. After obtaining the authorization of the original author, the Chinese version of CAS was formed by WHO′s cross-cultural translation process. A total of 414 hospitalized elderly inpatients from Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, and Shanghai Yangpu District Kongjiang Hospital were selected between March and September 2021. Cronbach′s α coefficient was used to test internal consistency, linear weighted Kappa was employed to assess inter-rater reliability, and concurrent validity was examined using items related to mobility of Barthel Index scores as a reference standard.Results:Of the 414 patients, 221 were males and 193 were females, and the patients aged (76.67 ± 9.98) years old; 122 cases (29.5%) had a perfect score of 6 with normal basic mobility, 89 cases (21.5%) had a score of 0 with complete loss of mobility, and the remaining 203 patients had a score of 1-5 with varying degrees of reduced mobility. The Chinese version of CAS demonstrated good assessment performance for basic mobility in elderly inpatients with a Cronbach′s α coefficient of 0.952. Weighted Kappa values for individual items and total scores showed excellent agreement among raters (>0.85), while concurrent validity yielded a value of 0.935 ( P<0.01) when compared with Barthel Index scores.Total score of CAS was significantly correlated with item scores and total score of Barthel index ( r values were 0.423 to 0.944, all P<0.01). Conclusions:The Chinese version of CAS has good reliability and validity. The items are concise, clear and easy to understand. It is suitable as a preliminary screening tool for clinical departments to evaluate the basic mobility of elderly inpatients.

Objective:To evaluate the knowledge of autism among child health care professionals in primary health care institutions.Methods:The study was a cross-sectional survey. An online questionnaire survey was conducted from February to March 2023 in primary health care institutions in Guangzhou to investigate the knowledge on autism among medical staff engaged in children′s health services and the influencing factors.Results:A total of 341 questionnaires were returned and 312 questionnaires were valid with a recovery rate of 91.5%. The age of 312 respondents was (35.9±7.9) years, of which 303 (97.1%) were female. One hundred and fifty-two (48.7%) child health care professionals in primary health care institutions had received specialist training in assessing the psychological and behavioral development of children, and only 139 (44.6%) reported that they were aware of the"five no"principle for early identification of autism. The questionnaire scores were 88.1% pass (275/312) and 53.2% excellent (166/312). The three questions with low accuracy were: autism can be cured with drugs, autism has a genetic basis and rehabilitation training has no effect, and the accuracy for these questions was 42.6% (133/312), 52.2% (163/312) and 70.2% (219/312), respectively. The passing of autism-related knowledge was positively associated with receiving relevant training ( OR=2.585, 95% CI:1.200-5.569), and the excellence was positively associated with the highest education ( OR=1.939, 95% CI:1.220-3.083) and receiving relevant training ( OR=2.016, 95% CI:1.247-3.260). Conclusions:There is a need for more professional training in autism knowledge among child health care professionals in primary health care institutions.

Objective:To estimate tissue/organ doses and effective dose to operators in the overexposure incident during an interventional procedure using Monte Carlo method.Methods:The phantoms were constructed for both the operators and the patient based on the adult mesh-type reference computational phantoms (MRCPs) recommended by the International Commission on Radiological Protection (ICRP) Publication 145 and phantom deformation technology. Models of exposure scenario were constructed based on the on-site equipment and the irradiation conditions. The Monte Carlod simulation method was used to evaluate the absorbed dose to critical tissues and organs, such as the operator′s eye lens and thyroid, as well as the effective dose.Results:In the particular exposure conditions, the maximum absorbed doses in the primary organs of the two operators were in the left eye lens, with doses of 1.216 and 0.223 mGy, respectively. The thyroid absorbed doses were 0.074 and 0.019 mGy, while the effective doses to the two operators were 0.088 and 0.021 mSv, respectively. The reduction rates of effective dose for the two operators when wearing lead aprons and lead thyroid collars were 67.16% and 78.79%, respectively.Conclusions:The combination of Monte Carlo method and MRCPs can be used to restore a specific irradiation scenario to a high degree and to estimate the physical dose of to the irradiated persons.

Objective To study the effects and mechanism of norcantharidin(NCTD)on proliferation and apoptosis of NB4 and K562 human leukemic cells by regulating phosphoprotein phosphatase 5 catalytic(PPP5C).Methods PC3.1 and PPP5C-PC3.1 plasmids were electroporated into NB4 and K562 cells.Stable NB4 and K562 cell lines were selected with geneticin(G418).Protein and mRNA expression levels of PPP5C were measured by Western blot and RT-qPCR,respectively.Proliferation,migration,and apoptosis of NB4 and K562 cells were determined by a CCK-8 assay,transwell assay,and Live & Dead? animal cell viability/toxicity detection kit,respectively.NB4 and K562 cells were divided into 0 μg/mL NCTD group and various NCTD dose groups,and cultured in RPMI 1640 medium containing 0,8,16,or 32 μg/ml NCTD.The Live & Dead? animal cell viability/toxicity detection kit measured the numbers of dead and live cells,and cell morphology was observed under a microscope.Western blot was used to measure protein expression levels of caspase 3,Cleaved caspase 3,JNK,p-JNK,p38,p-p38,and α-Tubulin.Results Proliferation,migration,and apoptosis of NB4 and K562 cells were enhanced by overexpression of PPP5C.Compared with 0 μg/mL NCTD group,NCTD promoted apoptosis in a dose-dependent manner.PPP5C overexpression antagonized the killing effect of NCTD on leukemic cells.Mechanistic investigations showed that PPP5C reduced the protein level of p-JNK by dephosphorylating and regulating the expression of apoptosis-related protein Cleaved caspase 3.Conclusions NCTD promotes apoptosis of NB4 and K562 cells and inhibits their proliferation by inhibiting PPP5C.

Triple-negative breast cancer (TNBC) is a nasty disease with extremely high malignancy and poor prognosis. Annexin A3 (ANXA3) is a potential prognosis biomarker, displaying an excellent correlation of ANXA3 overexpression with patients' poor prognosis. Silencing the expression of ANXA3 effectively inhibits the proliferation and metastasis of TNBC, suggesting that ANXA3 can be a promising therapeutic target to treat TNBC. Herein, we report a first-in-class ANXA3-targeted small molecule (R)-SL18, which demonstrated excellent anti-proliferative and anti-invasive activities to TNBC cells. (R)-SL18 directly bound to ANXA3 and increased its ubiquitination, thereby inducing ANXA3 degradation with moderate family selectivity. Importantly, (R)-SL18 showed a safe and effective therapeutic potency in a high ANXA3-expressing TNBC patient-derived xenograft model. Furthermore, (R)-SL18 could reduce the β-catenin level, and accordingly inhibit the Wnt/β-catenin signaling pathway in TNBC cells. Collectively, our data suggested that targeting degradation of ANXA3 by (R)-SL18 possesses the potential to treat TNBC.

Stigma is common in patients with head and neck cancer, which greatly affects their physical and mental health and the quality of life. This article summarizes the research progress of stigma in patients with head and neck cancer from the aspects of research status, measurement tools, influencing factors and intervention strategies, in order to provide a reference for carrying out the research on stigma in patients with head and neck cancer in China.