A qualitative study on the career development path of general practitioners in the community / 中华全科医师杂志

Objective:To analyze the career development path and related problems of general practitioners (GPs)in the community.Methods:In October 2019, general practitioners with different positions working in Malu Town Community Health Service Center of Shanghai Jiading district were selected by typical sampling to participate in a focus group interview. Based on the saturation principle, 5 general practitioners were invited for in-depth interviews on their career development and related issues. The original data were analyzed with Colaizzi′s seven-step analysis method.Results:The career development of the general practitioners working in the community was divided into three stages: start stage, experience-accumulation stage and career-differentiation stage. In the start stage (the first 0-24 months), the GPs mainly got familiar with the community health service center through community rotation. In the experience-accumulation stage (1-5 years after entering the community health service center), GPs accumulated clinical experience from outpatient clinic, ward, and being family doctor, etc; at the same time, they accumulated management experience through part-time public health management, research and education management, secondment in district health committee. In the professional differentiation stage (5 years or more after entering the community health service center), GPs may take a position of full-time management, or department head. The three respondents had confusion in certain career development stages, including confusion in clinical skills upgrading and balance between clinical and management duties.Conclusions:The study suggests that general practitioners in the entry stage need to be given timely clinical rotation as well as research and teaching training; in the career differentiation stage, it is necessary to incorporate upgrading clinical service and management capability with policy development directions and institutional development needs to promote the successful career differentiation of general practitioners.

Infection of Oligochaetes, Limnodrilus hoffmeisteri (Annelida: Oligochaeta), in the Nasal Cavity of a Chinese Man

The infection by Limnodrilus hoffmeisteri Claparède, 1862 (Oligochaeta: Tubificinae) in humans is relatively uncommon. The present report is to describe an incidental human infection with oligochaetes in the nasal cavity of a Chinese man, a 25-year-old man residing in Zhangjiakou city, Hebei province, China presenting with nose bleed, severe itching, continuous sneezing, and rhinorrhea. A lot of oligochaete worms were found in the nasal discharge of the patient. The detected worms were identified as Limnodrilus hoffmeisteri (Annelida: Oligochaeta) based on morphological and molecular characteristics. This incidental L. hoffmeisteri nasal infection is the first case in China and indicates that oligochaete worms can be encountered in humans.

Regulation of tumor cell migration by protein tyrosine phosphatase (PTP)-proline-, glutamate-, serine-,and threonine-rich sequence (PEST) / 癌症

Protein tyrosine phosphatase (PTP)-proline-, glutamate-, serine-, and threonine-rich sequence (PEST) is ubiquitously expressed and is a critical regulator of cell adhesion and migration. PTP-PEST activity can be regulated transcriptionally via gene deletion or mutation in several types of human cancers or via post-translational modifications, including phosphorylation, oxidation, and caspase-dependent cleavage. PTP-PEST interacts with and dephosphorylates cytoskeletal and focal adhesion-associated proteins. Dephosphorylation of PTP-PEST substrates regulates their enzymatic activities and/or their interaction with other proteins and plays an essential role in the tumor cell migration process.

Nonmetabolic functions of pyruvate kinase isoform M2 in controlling cell cycle progression and tumorigenesis / 癌症

Pyruvate kinase catalyzes the rate-limiting final step of glycolysis, generating adenosine triphosphate (ATP) and pyruvate. The M2 tumor-specific isoform of pyruvate kinase (PKM2) promotes glucose uptake and lactate production in the presence of oxygen, known as aerobic glycolysis or the Warburg effect. As recently reported in Nature, PKM2, besides its metabolic function, has a nonmetabolic function in the direct control of cell cycle progression by activating β-catenin and inducing expression of the β-catenin downstream gene CCND1(encoding for cyclin D1). This nonmetabolic function of PKM2 is essential for epidermal growth factor receptor (EGFR) activation-induced tumorigenesis.

Expression of FcγRⅡb on peripheral B cells and its clinical significance in patients with primary Sj(o)gren's syndrome / 中华风湿病学杂志

Objective To investigate the expression of FcγRⅡb on peripheral B cells and its clinical significance in primary Sj(o)gren's syndrome (pSS).Methods FcγRⅡb expression on peripheral B cells from 19 pSS patients and 15 healthy controls was examined by flow cytometry.The levels of serum anti-SSA and SSB antibodies were determined using enzyme-linked immunosorbent assay (ELISA).Data were analyzed with t test,one-way ANOVA,SNK-q test and Pearson's correlation test.Results The percentage of memory CD19+CD27+ B cell subpopulation was significantly lower in pSS patients [ (20.8±2.7)％] when compared to normal controls [(37.8±2.2)％ ](t=-4.002,P＜0.01).The level of expression of FcγRⅡb in active pSS memory CD19+CD27+ B cells [ MFI(74±8)] was significantly reduced when compared to inactive [ MFI( 132±11)] and normal controls [ MFI (139±12)] (F=10.699,P＜0.01).The level of expression of FcγRⅡb on memory CD19+CD27+ B cells from pSS patients was inversely correlated with Sj(o)gren's syndrome disease activity index (SSDAI) (r=-0.744,P=0.0003 ).pSS patients with the serum anti-SSA/SSB antibodies positive group [ MFI(75+3),(48±7)] displayed a lower expression of FcγRⅡb on memory CD19+CD27+ B cell than in patients with the serum anti-SSA/SSB antibodies negative group [MFI( 122±11),(108±9)] (t=-4.336 and -3.776 respectively,the P value of both tests were less than 0.01).The level of expression of FcγRⅡb in the memory CD19+CD27+ B cells of patients with active pSS was inversely correlated with anti-SSA antibody titers (r=-0.685,P=0.014).Conclusion The expression of FcγRⅡb on peripheral memory B cells from active pSS patients is inversely correlated with SSDAI and is also inversely associated with anti-SSA antibody levels.Decreased expression of FcγRⅡb might play an important role in the pathogenesis of pSS.

Change and clinical significance of peripheral blood γδT cells in patients with systemic lupus erythematosus / 中华风湿病学杂志

ObjectiveTo investigate the number of γδT cells in the peripheral blood from patients with systemic lupus erythematosus(SLE) and their correlation to disease activity.MethodsγδT cells were detected in the peripheral blood from 42 SLE patients and 20 normal controls by flow cytometry.Anniex-V/Pl double-staining flow cytometry was employed to observe the proportion of the apoptotic γδ and CD3+ T cells in 6 SLE patients with active disease and 6 normal controls,respectively.The levels of plasma anti-nuclear antibody and anti-dsDNA antibody were determined by using enzyme-linked immunosorbent assay.Data were analyzed with t test and Pearson's correlation test.ResultsThe percentages of γδT cells were remarkably down-regulated in SLE patients [(3.0±1.8)％ ] with active disease compared with that of those patients with inactive[(5.3±3.0)％] disease and normal controls [(6.8±2.8)％](t=-3.071 and -5.913 respectively,both P＜0.01 ).The absolute number of γδT cells decreased significantly in SLE patients with active disease[ ( 1.7± 1.6)× 107/L ] than those with inactive SLE [ (5.3±3.6)× 107/L ] (t=-3.292,P＜0.01 ),and both were lower than the normal controls [ (10.1±5.0)×l 07/L] (t=-7.247 and -2.905 respectively,both P＜0.01 ).There was a negative correlation between systemic lupus erythematosus disease activity index (SLEDAI) andT cell counts in 30 SLE patients with active disease (r=-0.365,P=0.047).γδT cell percentage (r=-0.336,P=0.030) and counts (r=-0.410,P=0.007) were both inversely correlated with the erythrocyte sedimentation rate,but positive correlation were found between hemoglobulln and γδT cell counts (r=0.409,P=0.007).The apoptosis ofγδT cells in SLE patients was more common than in normal controls(t=2.886,P＜0.05 ).The number of apoptotic γδT cells was higher than that of CD3+ T cells in SLE patients (t=2.952,P＜0.05 ).Conclusion γδT cells of the peripheral blood of SLE patients are down-regulated partially due to excessive apoptosis,which may correlate with the disease activity.

The Experimental Study of Garlicin in Treating Pneumocystis carinii Pneumonia in Rats / 中国寄生虫学与寄生虫病杂志

Objective To assess the therapeutic effect of garlicin on Pneumocystis carinii pneumonia (PCP) of immuosuppressed rats. Methods The Wistar rats were injected intramuscularly continually with dexamethasone for eight weeks to establish the rat model of PCP. The rats were treated with garlicin, meanwhile control groups without treatment and with SMZ-TMP treatment were established respectively in PCP model. The efficacy was evaluated based on the lung weight, lung /body weight ratio and mean cyst number per 100 fields in lung print smear. Results The mean lung weight of the rats in garlicin is 1.73?0.17, lung/body weight ratio is 0.84?0.12, they are obvious lower than 2.31?0.35 and 1.25?0.35 of control (P