Objective:To analyze the current employment status and the reasons for not engaging in general practice among general practice residents who completed training during 2018-2020.Methods:This study was a cross-sectional study. A questionnaire survey on the current employment was conducted among general practice residents who completed redidency training from 2018 to 2020, participants were selected by stratified random sampling in 57 training centers from each 5 provinces(municipalities) of the eastern, middle and western regions in China. The reasons for not engaging in general practice were investigated through telephone contact.Results:Of the 1 037 general practice residents who responded to the questionnaire, 677 residents(65.3%, 677/1 037) were engaged in general practice after training, while 360 residents(34.7%, 360/1 037) left general practice career or were awaiting employment. The three provinces with the highest proportion of residents leaving general practice career were Hubei(76.5%, 26/360), Sichuan(74.4%, 29/360) and Shandong provinces(59.6%, 28/360). There were significant differences in proportion of residents leaving general practice career after completing the training among eastern, middle and western regions(χ 2=42.911, P<0.001). A total of 261 participants(25.2%, 261/1 037) were engaged in non-general practice clinical career like internal medicine, surgery, gynecology, pediatrics or medical imaging; and the proportion in the eastern(27.3%, 67/245) and middle(33.3%, 106/318) regions was significantly higher thant that in the western region(18.6%, 88/474)(χ 2=6.855, P<0.05; χ 2=21.651, P<0.05). Among 259(71.9%, 259/360) participants who left general practice career, the main reasons were personal choice(63.3%, 164/259) or employers′ arrangement(22.4%, 58/259); the three provinces with the highest percentage of personal choice were Hubei(92.0%, 23/25), Sichuan(85.2%, 23/27) and Henan provinces(80.0%, 20/25). The proportion of personal choice in the middle region(82.4%, 84/102) was significantly higher than that in the eastern(52.1%, 37/71) and western(50.0%, 43/86) regions(χ 2=16.799, P<0.05; χ 2=20.830, P<0.05). The three provinces with the highest proportion of employers′ arrangement were Xinjiang Uygur Autonomous Region(66.7%, 22/33), Zhejiang province(9/13), and Inner Mongolia Autonomous Region(38.5%, 10/26). The proportion of employers′ arrangement in the western region(41.9%,36/86) was significantly higher than that in the eastern(18.3%, 13/71) and middle(8.8%, 9/102) regions(χ 2=8.980, P<0.05; χ 2=26.186, P<0.05). Conclusions:The majority of general practice residents are engaged in general practice after training. The proportion of residents who left the general practice career and the related reasons in different regions are not the same.

Innate lymphoid cells are an important part of innate mucosal immunity and participate in immune response by secreting effector cytokines and regulating the functions of other immune cells.They are similar to T helper cells in transcription factors and secretory cytokines,but they also have some unique functions.Different innate lymphocyte subsets play different roles in chronic obstructive pulmonary disease(COPD)according to their respective characteristics.Compared with adaptive lymphocyte,innate lymphocyte is relatively less in lymphoid tissue,accounting for only a small part of lung immune cells,but these lymphocyte cells play a crucial role in the development and progression of COPD.In this paper,the role of innate lymphoid cells in COPD and the related research progress were reviewed.

Objective:To survey the post competency of general practitioners who had completed residency training in China.Methods:This study was a cross-sectional survey. An online questionnaire survey was conducted among general practitioners, institution leaders and patients from January to February 2021. The participants were selected from 45 general practice residential training bases in the eastern, central and western regions of China by a combination of stratified sampling and proportional random sampling methods. The post competency self-assessment questionnaire was used for the general practitioners, and the competency evaluation questionnaire was used for institution leaders and the patients.Results:A total of 677 valid self-assessment questionnaires were returned from general practitioners, 600 from institution leaders, and 2 579 from patients. The professionalism and humanistic literacy of the self-assessment questionnaire had the highest score (4.41±0.60),and the teaching, learning and research abilities had the lowest score(3.57±0.84). There was no significant difference in the post competency score of general practitioners among different regions ( P>0.05). The highest score of general practitioners′ post competency evaluated by leaders was the professionalism and humanistic literacy (4.64±0.57), and the lowest one was the basic public health service ability (4.31±0.95). The score of professionalism and humanistic ability in the eastern region was significantly higher than that in the central and western regions ( P<0.05). The highest score of general practitioners′ post competency evaluated by patients was the professionalism and humanistic literacy (4.73±0.55), and the lowest score was the basic medical service ability (4.11±1.35). There were significant differences in scores of the ability for basic medical service, ability for basic public health service, ability for interpersonal communication and ability for professionalism and humanistic literacy among different regions ( P<0.05). For institution leaders, 68.2% (409/600) believed that the general practitioners were fully competent for their current jobs, 28.7% (172/600) believed that the general practitioners were basically competent for their current jobs. For patients, 70.5% (1 817/2 579) were very satisfied with the general practitioners′ service, and 27.1% (700/2 579) were basically satisfied with the general practitioners′ service. Conclusions:The competency of general practitioners who had received training in some provinces is basically up to standard, but the basic public health service ability and teaching, learning and research ability need to be improved.

Objective:To analyze the current employment status and the reasons for not engaging in general practice among general practice residents who completed training during 2018-2020.Methods:This study was a cross-sectional study. A questionnaire survey on the current employment was conducted among general practice residents who completed redidency training from 2018 to 2020, participants were selected by stratified random sampling in 57 training centers from each 5 provinces(municipalities) of the eastern, middle and western regions in China. The reasons for not engaging in general practice were investigated through telephone contact.Results:Of the 1 037 general practice residents who responded to the questionnaire, 677 residents(65.3%, 677/1 037) were engaged in general practice after training, while 360 residents(34.7%, 360/1 037) left general practice career or were awaiting employment. The three provinces with the highest proportion of residents leaving general practice career were Hubei(76.5%, 26/360), Sichuan(74.4%, 29/360) and Shandong provinces(59.6%, 28/360). There were significant differences in proportion of residents leaving general practice career after completing the training among eastern, middle and western regions(χ 2=42.911, P<0.001). A total of 261 participants(25.2%, 261/1 037) were engaged in non-general practice clinical career like internal medicine, surgery, gynecology, pediatrics or medical imaging; and the proportion in the eastern(27.3%, 67/245) and middle(33.3%, 106/318) regions was significantly higher thant that in the western region(18.6%, 88/474)(χ 2=6.855, P<0.05; χ 2=21.651, P<0.05). Among 259(71.9%, 259/360) participants who left general practice career, the main reasons were personal choice(63.3%, 164/259) or employers′ arrangement(22.4%, 58/259); the three provinces with the highest percentage of personal choice were Hubei(92.0%, 23/25), Sichuan(85.2%, 23/27) and Henan provinces(80.0%, 20/25). The proportion of personal choice in the middle region(82.4%, 84/102) was significantly higher than that in the eastern(52.1%, 37/71) and western(50.0%, 43/86) regions(χ 2=16.799, P<0.05; χ 2=20.830, P<0.05). The three provinces with the highest proportion of employers′ arrangement were Xinjiang Uygur Autonomous Region(66.7%, 22/33), Zhejiang province(9/13), and Inner Mongolia Autonomous Region(38.5%, 10/26). The proportion of employers′ arrangement in the western region(41.9%,36/86) was significantly higher than that in the eastern(18.3%, 13/71) and middle(8.8%, 9/102) regions(χ 2=8.980, P<0.05; χ 2=26.186, P<0.05). Conclusions:The majority of general practice residents are engaged in general practice after training. The proportion of residents who left the general practice career and the related reasons in different regions are not the same.

Objective:To survey the post competency of general practitioners who had completed residency training in China.Methods:This study was a cross-sectional survey. An online questionnaire survey was conducted among general practitioners, institution leaders and patients from January to February 2021. The participants were selected from 45 general practice residential training bases in the eastern, central and western regions of China by a combination of stratified sampling and proportional random sampling methods. The post competency self-assessment questionnaire was used for the general practitioners, and the competency evaluation questionnaire was used for institution leaders and the patients.Results:A total of 677 valid self-assessment questionnaires were returned from general practitioners, 600 from institution leaders, and 2 579 from patients. The professionalism and humanistic literacy of the self-assessment questionnaire had the highest score (4.41±0.60),and the teaching, learning and research abilities had the lowest score(3.57±0.84). There was no significant difference in the post competency score of general practitioners among different regions ( P>0.05). The highest score of general practitioners′ post competency evaluated by leaders was the professionalism and humanistic literacy (4.64±0.57), and the lowest one was the basic public health service ability (4.31±0.95). The score of professionalism and humanistic ability in the eastern region was significantly higher than that in the central and western regions ( P<0.05). The highest score of general practitioners′ post competency evaluated by patients was the professionalism and humanistic literacy (4.73±0.55), and the lowest score was the basic medical service ability (4.11±1.35). There were significant differences in scores of the ability for basic medical service, ability for basic public health service, ability for interpersonal communication and ability for professionalism and humanistic literacy among different regions ( P<0.05). For institution leaders, 68.2% (409/600) believed that the general practitioners were fully competent for their current jobs, 28.7% (172/600) believed that the general practitioners were basically competent for their current jobs. For patients, 70.5% (1 817/2 579) were very satisfied with the general practitioners′ service, and 27.1% (700/2 579) were basically satisfied with the general practitioners′ service. Conclusions:The competency of general practitioners who had received training in some provinces is basically up to standard, but the basic public health service ability and teaching, learning and research ability need to be improved.

Objective: To explore the relationship between premenarchal dietary carbohydrate and dietary fiber intakes and age at menarche in Chinese girls. Methods: Based on dietary and menarcheal information on 750 girls from the Chinese Health and Nutrition Survey, multivariate linear regression models and logistic models were used to analyze the influence of dietary carbohydrate and dietary fiber intakes before menarche onset and age at menarche. Carbohydrate intake was replaced by engergg ratio carbohydrate for a sensitivity analysis. Results: Adjusting for residence, per capita household income, body mass index standard deviation score, and energy intake, higher intake and higher energy ratio of carbohydrate were associated with later age at menarche(P<0.01). Compared to girls at the lowest tertile of carbohydrate intake level, those at the highest tertile had a 0.35 years(2.8%) delay in age at menarche, while 55% decreased[OR(95%CI)=0.45(0.30-0.69)]. Dietary fiber intake was not associated with age at menarche in any model(P>0.2). Conclusion Girls with higher premenarcheal carbohydrate intake experienced menarche later, while dietary fiber intake was not associated with age at menarche.

Objective: To investigate the prospective effects of the consumption of protein and animal foods before menarche on the age at menarche among Chinese girls. Methods: This paper was based on the data collected in the China Health and Nutrition Survey(CHNS) from 1997 to 2015. A total of 683 girls aged 6 and over who had completed information on age at menarche, height, weight, per capita annual household income, maternal education level and participated in at least one complete dietary survey within 1 to 4 years before menarche were included. Urban-rural stratified multivariable linear regression model was used to examine the effects of protein and animal foods intake before menarche on Chinese girls age at menarche in urban and rural areas. Results: After adjusted for total energy intake, body mass index standard deviation score and per capita annual household income, the consumption of meat before menarche was negatively associated with the age at menarche among rural Chinese girls(B=-0.003, P=0.00), but not among urban Chinese girls(B=0.002, P>0.05). Total protein, dairy, eggs and aquatic products intake before menarche were not associated with Chinese girls age at menarche in urban and rural areas(B=0.002, -0.001, 0.003, 0.000; 0.001, 0.001, -0.001, -0.003, P>0.05). Conclusion Higher intake of meat before menarche might lead to earlier menarche onset in rural Chinese girls. The consumption of total protein, dairy, eggs, and aquatic products before menarche did not affect the age at menarche in Chinese girls.

Objective:To establish the norm of the Chinese version of Karitane Parenting Confidence Scale (KPCS) in urban areas of China.Methods:From August to December 2017, the parents of 2 216 children (<36 months old) were selected from 15 cities (Beijing, Lianyungang, Hangzhou, Chengdu, Xi′an, Guangzhou, Changsha, Jinan, Guiyang, Ningbo, Dalian, Qinhuangdao, Maanshan, Chongqing and Wuhan) in 14 provinces by stratified random sampling. The general demographic characteristics and parents′ parenting confidence were collected by a self-made questionnaire and KPCS Chinese version. The percentile norm was established. P 3, P10 and P 25 were used as the criteria to define the degree of lack of parenting confidence. Results:The age of mothers was (30.67±4.29). The age of the father was (32.50±4.99) years old. There were 726 (32.76%), 759 (34.25%) and 731 (32.99%) infants in 6-12, 12-23 and 24-35 months old groups. The total scores of P 50, P 25, P 10 and P 3 of KPCS (Chinese version) of infant parents in urban areas in China were 41, 38, 33, and 29 respectively. When the scores of parents were 34-37, 30-33, and ≤ 29, they were judged as mild, moderate, and severe lack of parenting confidence. There was no significant difference in the Chinese version of KPCS between parents of different age groups and parents of different gender (χ2=3.53, P=0.171; χ2=1.41, P=0.236). Each factor score≤ P 3 is defined as the boundary score, and the corresponding boundary scores of "parenting" "support" and "competence" were 13, 9, and 5 respectively. Conclusion:The Chinese version of KPCS can be used to assess the parenting confidence of infants in urban areas of China. It can used as one of the bases for scientific and objective evaluation of the parenting status of families.

Based on the data from China Health and Nutrition Survey (CHNS), 840 girls aged 6-15 years who had information about menarche and participated in dietary survey at least once within 1-5 years before onset of menarche between 1989 and 2015 were included in the study. The median age at baseline of the 840 participants was 10 (9, 11) years. The median age at menarche of the participants was 13 (12, 14) years. After adjusting for the age of birth, place of residence, body mass index Z-score, physical activity level and annual household income per capita, the average age of menarche was advanced by 0.036 (95% CI: -0.068, -0.004) years for every 10 g increase in daily fat intake before menarche. The average age at menarche was 0.008 (95% CI: -0.014, -0.001) years earlier for every 1% increase in the daily energy supply ratio of fat before menarche.

Objective:To investigate the efficacy and safety of polatuzumab vedotin (pola) in treatment of patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 1 DLBCL patient receiving multiple treatments in Jiangsu Cancer Hospital in May 2016 were retrospectively analyzed, and the related literature was reviewed.Results:The patient, a 57-year-old male, was diagnosed with DLBCL in May 2016. Since June 2016, he had received treatments with four lines including anti-CD20 monoclonal antibody combined with chemotherapy, chemotherapy only and chimeric antigen receptor T cell (CAR-T). However, the disease relapsed or progressed after all treatments. Therefore, the patient had received 6 cycles of pola combined with rituximab since December 2019. Unexpected adverse events were not found during the treatment. The evaluation of clinical efficacy was complete remission after the end of treatment. The progression-free survival time was more than 13 months with follow-up until January 2021.Conclusion:Pola initially shows good efficacy and safety in treatment of patients with relapsed/refractory DLBCL.