Objective:To explore the construction of clinical competence index system for general practitioners based on CIPP(context evaluation, input evaluation, process evaluation, product evaluation) evaluation model.Methods:Based on the CIPP evaluation model, a research team was established to conduct a literature review. Research articles were retrieved, screened, and analyzed to formulate the primary clinical competence index system for general practitioners based on CIPP evaluation model and the expert consultation questionnaire. The Delphi method was employed to finalize the clinical competence index system for general practitioners based on CIPP evaluation model.Results:A total of 24 experts from grade A tertiary hospitals in several provinces and cities in China participated in two rounds of consultation. The effective recovery rate for both rounds was 100.00%. The authority coefficients were 0.905 and 0.912, respectively. After the consultations, the coefficients of variation of indexes at all levels were <0.25. The Kendall's W of all indexes ranged between 0.769 and 0.814 in the first round and between 0.867 and 0.905 in the second round of expert consultation ( P<0.001). The final clinical competence index system for general practitioners based on CIPP evaluation model included 4 first-level indexes, 12 second-level indexes, and 42 third-level indicators. Conclusions:The clinical competence index system for general practitioners based on CIPP evaluation model established in this study has reference significance for further research on the training assessment and evaluation index system of clinical competence for general practitioners in China, and has important practical significance for the evaluation tool of clinical work performance of general practitioners.

Objective To investigate the relationship between a body shape index(ABSI),bone mineral density(BMD),osteopo-rosis,and fracture risk,and to evaluate its potential value as a predictive marker for skeletal health risks in middle-aged and elderly in-dividuals.This study aims to provide scientific evidence for the early screening and intervention of osteoporosis and fracture risks.Meth-ods Using data from the National Health and Nutrition Examination Survey(NHANES)2017-2020,individuals aged ≥50 years were selected as the study population.ABSI was calculated and categorized into quartiles.The relationship between ABSI and fracture risk was analyzed using logistic regression models while adjusting for demographic characteristics,lifestyle factors,and clinical variables.A re-stricted cubic spline(RCS)model was employed to explore the dose-response relationship between ABSI and fracture risk.Subgroup an-alyses were conducted to identify potential effect modifiers.Results BMD decreased,and the risks of osteoporosis and fractures signifi-cantly increased with higher ABSI quartiles(trend P＜0.05).Compared to the lowest ABSI quartile,individuals in the highest quartile had a significantly increased fracture risk(adjusted OR=1.33,95％CI:1.04-1.70).RCS analysis demonstrated a linear positive cor-relation between ABSI and fracture risk(overall P＜0.001),with fracture risk progressively increasing with higher ABSI levels.Sub-group analyses revealed consistent associations across different age groups,sexes,and BMI categories.Conclusion ABSI is independ-ently associated with lower BMD,higher osteoporosis risk,and increased fracture risk.These findings suggest that ABSI is a simple and effective tool for identifying individuals at high skeletal health risk,providing scientific evidence for the early prevention and intervention of osteoporosis and fractures.

Objective To investigate the relationship between a body shape index(ABSI),bone mineral density(BMD),osteopo-rosis,and fracture risk,and to evaluate its potential value as a predictive marker for skeletal health risks in middle-aged and elderly in-dividuals.This study aims to provide scientific evidence for the early screening and intervention of osteoporosis and fracture risks.Meth-ods Using data from the National Health and Nutrition Examination Survey(NHANES)2017-2020,individuals aged ≥50 years were selected as the study population.ABSI was calculated and categorized into quartiles.The relationship between ABSI and fracture risk was analyzed using logistic regression models while adjusting for demographic characteristics,lifestyle factors,and clinical variables.A re-stricted cubic spline(RCS)model was employed to explore the dose-response relationship between ABSI and fracture risk.Subgroup an-alyses were conducted to identify potential effect modifiers.Results BMD decreased,and the risks of osteoporosis and fractures signifi-cantly increased with higher ABSI quartiles(trend P＜0.05).Compared to the lowest ABSI quartile,individuals in the highest quartile had a significantly increased fracture risk(adjusted OR=1.33,95％CI:1.04-1.70).RCS analysis demonstrated a linear positive cor-relation between ABSI and fracture risk(overall P＜0.001),with fracture risk progressively increasing with higher ABSI levels.Sub-group analyses revealed consistent associations across different age groups,sexes,and BMI categories.Conclusion ABSI is independ-ently associated with lower BMD,higher osteoporosis risk,and increased fracture risk.These findings suggest that ABSI is a simple and effective tool for identifying individuals at high skeletal health risk,providing scientific evidence for the early prevention and intervention of osteoporosis and fractures.

Objective:To explore the construction of clinical competence index system for general practitioners based on CIPP(context evaluation, input evaluation, process evaluation, product evaluation) evaluation model.Methods:Based on the CIPP evaluation model, a research team was established to conduct a literature review. Research articles were retrieved, screened, and analyzed to formulate the primary clinical competence index system for general practitioners based on CIPP evaluation model and the expert consultation questionnaire. The Delphi method was employed to finalize the clinical competence index system for general practitioners based on CIPP evaluation model.Results:A total of 24 experts from grade A tertiary hospitals in several provinces and cities in China participated in two rounds of consultation. The effective recovery rate for both rounds was 100.00%. The authority coefficients were 0.905 and 0.912, respectively. After the consultations, the coefficients of variation of indexes at all levels were <0.25. The Kendall's W of all indexes ranged between 0.769 and 0.814 in the first round and between 0.867 and 0.905 in the second round of expert consultation ( P<0.001). The final clinical competence index system for general practitioners based on CIPP evaluation model included 4 first-level indexes, 12 second-level indexes, and 42 third-level indicators. Conclusions:The clinical competence index system for general practitioners based on CIPP evaluation model established in this study has reference significance for further research on the training assessment and evaluation index system of clinical competence for general practitioners in China, and has important practical significance for the evaluation tool of clinical work performance of general practitioners.

OBJECTIVE：To provide reference for the R&D of TCM patents for treating gastric cancer and layout. METHODS：TCM patents for treating gastric cancer collected by the State Intellectual Property Office and the European Patent Office Espacenet were retrieved from the inception to Dec. 31st， 2019. After the initial examination ，a second search was conducted based on the keywords such as “Stomachache”“Fuliang” “Accumulation”“Cancer of stomach ”“Gastric”and their synonyms. Each literature was read one by one and screened manually. Excel 2007 software was used to input general information of included patents. SPSS modeler 15.0 software and SPSS 22.0 software were used for association rule analysis and hierarchical cluster analysis of TCM used more than 30 times and top 30 frequently used. Based on patent analysis ，internal strength （S），weakness（W），external opportunity （O）and threat （T）of TCM for treating gastric cancer were analyzed ；based on this ，four different types of combination strategies were formulated. RESULTS & CONCLUSIONS ：Finally，385 patents were obtained ，including 379 domestic patents （98.44％） and 6 foreign patents （1.56％）. The number of patent applications and applicants of TCM for treating gastric cancer in China was on the rise during 1994-2016. The commonly used TCM for treating gastric cancer were mainly tonifying deficiency drugs and heat clearing drugs ， and the meridian tropism were mostly the stomach meridian and spleen meridian. According to the efficacy ，the commonly used drug combinations include the combination of tonifying spleen and Qi ，the combination of anti-cancer and detoxification ，and the combination of drying dampness and resolving phlegm. The results of hierarchical cluster analysis showed that Poria cocos ， Atractylodes macrocephala ，Astragalus membranaceus ，Scutellaria barbata ，Hedyotis diffusa and Glycyrrhiza uralensis were clustered into one category and the common combination for treating gastric cancer. The remaining cluster distributions are also in line with the characteristics of TCM syndrome differentiation and treatment. Strength of domestic TCM patents for treating gastric cancer were that the number of patents in China was taking a leading position in the world ，the patent system of key applicants was mature，the combination of compound patents embodied the characteristics of disease and dialectical theory. Weakness included low patent authorization rate ，to-be-improved effectiveness and safety studies of TCM patents ，weak development of TCM extract patents，low degree of patent internationalization and hanging same-family patents. Opportunities were that the demand for drugs for gastric cancer was increasing with each passing day ，and natione actively support the development of the TCM industry. Threats were that competitors in the international market had the potential to seize the market. The development of TCM for treating gastric cancer in China should take market demand and national policy support as an opportunity ，learn from TCM patent characteristic system of key applicants ，continue to give full play to the advantages of TCM in prevention and syndrome differentiation of disease，pay more efforts to the development of weak links such as TCM extracts ，safety and effectiveness ，improve the international competitiveness in the field of patents ，while establish a warning and navigation analysis system for patents to effectively reduce the intellectual property threats and risks of invention patents of China in the international environment.

Objective To investigate the anticancer effect of oxymatrine on cervical cancer cell line (HeLa). Methods MTT assay was used to detect the anti-proliferative effect of oxymatrine.Transwell chamber was used to detect the anti-metastatic effect of oxymatrine.Real-time PCR was used to detect the mRNA levels of MMP-2 and MMP-9.Western blot was used to detect the protein levels of MMP-2,MMP-9,AKT,p-AKT and GADPH. Results We found that application of oxymatrine significantly inhibited the growth of HeLa cells at the concentration above 0.8 mg/mL.We also found that oxymatrine (0.1,0.2 and 0.4 mg/mL)inhibited the invasion of HeLa cells under cytotoxic dose,which was (77.07±20.43)%,(53.95±18.17)% and (20.35±11.20)% of cells that migrated through the matrigel when compared with those of non-oxymatrine treatment group (P<0 .0 5 ). Further research found that oxymatrine (0.1,0.2 and 0.4 mg/mL)could reduce the expression of MMP-2 at the mRNA level,i.e.(82.76±8.71)%,(39.51±12.79)% and (21.53±5.38)% of the expression level when compared with that of non-oxymatrine treatment group (P<0 .0 5 ).The protein expression level of MMP-2 in 0 .4 mg/mL group was (64.69 ±16.52)% of non-oxymatrine treatment group (P<0.05).The phosphorylation level of AKT in 0.4 mg/mL group was (41.27±7.13)% of non-oxymatrine treatment group (P<0.05).Conclusion Oxymatrine can inhibit the invasion of HeLa cells by reducing the expression of MMP-2 via inhibiting the activity of AKT signal pathway.All together,our findings bring new insights into the mechanism of the anticancer effects induced by oxymatrine treatment.