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 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 analyze the clinical and epidemiological characteristics of adult carotid body tumors (CBTs) in Northwest China to provide references for early diagnosis and treatment of CBTs.Methods:A multicenter, retrospective, non-intervention epidemiological investigation was conducted on adult CBTs patients who were hospitalized from January 1, 2011 to June 30, 2023 in 7 Class A tertiary hospitals in Northwest China (Departments of Neurosurgery, First Affiliated Hospital of Air Force Medical University, Second Affiliated Hospital of Lanzhou University, People's Hospital of Gansu Province, 940 th Hospital of PLA Joint Logistic Support Force, People's Hospital of Qinghai Province, General Hospital of Ningxia Medical University, People's Hospital of Ningxia Hui Autonomous Region). Medical records were collected in these patients, and they were divided into 2 groups according to their average altitude residence: high altitude group (≥1 500 m) and low altitude group (<1 500 m); meanwhile, these patients were divided into Shamblin type I, type II and type III groups according to Shamblin classification criteria; differences in general data and clinical features among patients from different altitude groups or Shamblin subgroups were compared. Independent influencing factors for Shamblin type III CBTs were analyzed by multivariate ordered Logistic regression. Results:(1) A total of 359 patients were enrolled in the study, including 276 females and 83 males, aged (48.80±12.07) years; 211 patients were into the high altitude group and 148 into the low altitude group; 165 patients were into Shamblin type I group, 146 into Shamblin type II group, and 48 into Shamblin type III group. (2) Compared with those in the low altitude group, patients in the high altitude group had higher proportion of females, older age, lower proportion of Han nationality, higher proportion of Shamblin type I, smaller tumor volume, lower platelet count, higher red blood cell count, hematocrit, hemoglobin level, platelet distribution width and mean platelet volume, and higher large platelet percentage, with significant differences ( P<0.05). (3) Compared with those in the Shamblin type I group, patients in the Shamblin type III group had younger age, lower resident altitude, larger tumor volume, longer time interval from onset to diagnosis, higher proportion of unintentional tumor discovery, larger volume of intraoperative blood loss, lower hemoglobin level, hematocrit, mean erythrocyte volume, and mean hemoglobin concentration, decreased erythrocyte distribution width variable coefficient, and increased platelet count, with significant differences ( P<0.05). Compared with those in the Shamblin type II group, patients in Shamblin type III group had younger age, larger tumor volume, longer time interval from onset to diagnosis, larger volume of intraoperative blood loss, lower hemoglobin, hematocrit and mean erythrocyte volume, higher erythrocyte distribution width variable coefficient and platelet count, with significant differences ( P<0.05). (4) Age ( OR=0.960, 95% CI: 0.942-0.977, P<0.001), residence altitude ( OR=0.992, 95% CI: 0.990-0.999, P=0.020) and time interval from onset to diagnosis ( OR=1.009, 95% CI: 1.005-1.014, P<0.001) were independent influencing factors for Shamblin type III CBTs. Conclusions:More females than males are noted in patients with adult CBTs in Northwest China, and more CBTs patients live at high altitude, with Shamblin type I enjoying the highest proportion. More female and old patients lived at high altitude is noted than those lived at low altitude; patients with Shamblin type III have the youngest age, lowest altitude, and longest time interval from onset to diagnosis. CBTs patients with young age, low residence altitude, and long time interval from onset to diagnosis are more likely to develop Shamblin type III.

OBJECTIVETo investigate the effect of kirenol on bovine type II collagen (CII)-specific lymphocytes in vivo and in vitro, and explore the mechanism of kirenol-induced immunosuppression in antigen-specific lymphocytes.

METHODSTwenty-four Wistar rats were randomized into control group, collagen-induced arthritis (CIA) model group, kirenol group (2 mg/kg), and prednisolone group (2 mg/kg). After CII injection, the rats in the latter two groups received intragastric administration of kirenol and prednisolone for 30 days, and the spleens and draining lymph nodes of the rats were harvested to prepare single cell suspensions for measurement of the cytokine levels using ELISA. In the in vitro experiment, the lymphocytes from the control rats, with or without 20 µg/ml CII treatment in the presence of 0-80 µg/ml kirenol, were evaluated for cell proliferation and apoptosis using [(3)H]-thymidine incorporation and flow cytometry, respectively.

RESULTSCompared with those in CIA group, IFN-γ and TNF-α production was significantly reduced in splenocyte culture supernatant of kirenol group (P<0.05 and P<0.01, respectively), and the level of IL-10 and IL-4 was up-regulated (P<0.05 and P<0.01, respectively); IFN-γ and TNF-α secretion by the cultured lymph node cells (LNCs) significantly decreased (P<0.05 and P<0.001, respectively) and IL-10 and IL-4 production increased (P<0.05, P<0.001) in kirenol group. In the in vitro experiment, kirenol treatment caused obvious suppression of CII-induced LNC proliferation and dose-dependently induced antigen-specific apoptosis of the splenocytes and LNCs.

CONCLUSIONKirenol treatment reduces pro-inflammatory cytokine secretion, increases anti-inflammatory cytokine production, inhibits cell proliferation and induces apoptosis of CII-specific lymphocytes in vitro, suggesting the potential of kirenol as an immunosuppressant.

Animals ; Anti-Inflammatory Agents ; pharmacology ; therapeutic use ; Apoptosis ; drug effects ; Arthritis, Rheumatoid ; chemically induced ; drug therapy ; immunology ; Cattle ; Cell Proliferation ; Cells, Cultured ; Collagen Type II ; immunology ; Cytokines ; immunology ; Diterpenes ; pharmacology ; therapeutic use ; Female ; Immunosuppressive Agents ; pharmacology ; therapeutic use ; Lymphocytes ; cytology ; drug effects ; immunology ; Rats ; Rats, Wistar