Progress on targets and therapeutic drugs for pancreatic cancer / 药学学报

Pancreatic cancer is a highly malignant tumor with a poor prognosis. It is very hard to treat pancreatic cancers for their high heterogeneity, complex tumor microenvironment, and drug resistance. Currently, gemcitabine plus nab-paclitaxel, capecitabine and FOLFIRINOX are standard chemotherapy for resectable or advanced metastatic pancreatic cancer. Considering the limited efficacy and toxic side effects of chemotherapy, targeted and immune drugs have gradually attracted attention and made some progress. In this article, we systematically reviewed the chemotherapeutic drugs, targets and related targeted drugs, and immunotherapy drugs for pancreatic cancer.

Research progress in drugs targeting tumor associated macrophage / 药学学报

Tumor brings great threat to human public health. In recent years, incidence rate and mortality of tumor were rapidly increased in the world. Anti-tumor therapies have undergone the development of cytotoxic therapy, targeted therapy, and immunotherapy. Among them, tumor immunotherapy is rapidly developed and becomes an important anti-tumor therapy in recent years, although it also brings some related side effects. Tumor microenvironment (TME) is composed of immune cells, vascular vessels, fibroblasts, the extracellular matrix, etc. TME significantly affects the efficacy of immunotherapy. Macrophages in the TME are named as tumor associated macrophages (TAMs). Recently, increasing studies have shown that TAMs play an important role in the regulation of tumor immunity, especially in tumor immune surveillance and immune escape. Currently, more and more anti-tumor immunotherapy strategies targeting TAMs are at the development stage. Based on the important role of TAMs in the TME and their potential as therapeutic targets in tumor immunotherapy, we first reviewed the subtypes and functions of TAMs, as well as the roles of TAMs in tumors. Furthermore, we summarized the research progress on anti-tumor strategies targeting TAMs and the current status of drug targeting TAMs. The current review will provide new ideas and novel insights for tumor immunotherapy.

On the post competency evaluation system of general practitioners based on Delphi method / 中华医学教育探索杂志

Objective:To build a system for evaluation on post competency of general practitioners.Methods:From April to October 2020, the Delphi method was used to consult on the importance of 4 first-level indicators and 48 second-level indicators for evaluation on post competency of general practitioners. Excel 2016 and SPSS 22.0 was used for data entry and statistical analysis.Results:There were 16 consulting experts, and the positive coefficients of the two rounds were 100% and 75%, respectively. The overall authority coefficient Cr of experts was 0.85. For the first-level indicators, the mean values of the importance of the two rounds were 8.07-9.00 and 8.67-9.00, and the coefficient of variation were 0-0.16 and 0-0.09, respectively. For the second-level indicators, the mean values of the importance of the two rounds were 6.79-9.00 and 8.17-9.00, and the coefficient of variation were 0-0.38 and 0-0.16, respectively. All the coordination coefficient tests were statistically significant ( P<0.001). Finally, the evaluation system was established including 4 first-level indicators and 32 second-level indicators. Conclusion:The constructed post competency evaluation system for general practitioners has a relatively high coordination and credibility, which can provide a reference for the post competency evaluation of general practitioners.

Application of Delphi method in constructing the cultivation system of professional postgraduate medical students / 中华医学教育探索杂志

Objective:To construct a training system of the professional postgraduate degree of general practice using the Delphi method.Methods:On the basis of consulting relevant policies and literature, and drawing lessons from foreign general practice training systems, the index system of training professional postgraduate medical students of general practice was preliminarily developed. After two rounds of Delphi expert consultation, using the threshold method to select evaluation indexes, the training system was finally established. Excel 2010 and SPSS 19.0 were used to make data entry and statistical analysis.Results:The active coefficients of experts in the two rounds of Delphi consultation were 75.0% (12/16) and 91.7% (11/12) respectively, both the two rounds of the degree of specialist authority were 0.87, and the final coordination coefficient of the specialists' opinion was 0.452. The index system was composed of 5 first-level indexes including training objectives, theoretical curriculum setting, clinical practice setting, teaching staff and graduation requirements and 31 second-level indexes.Conclusion:The experts have great initiative and authority on research subjects. The opinions of all experts tend to be uniform after two rounds of consultation, and the results are reliable. A relatively complete and credible training index system of professional postgraduate degree of general medicine has been built.

Preliminary construction of health literacy monitoring questionnaire for general practitioners / 中华全科医师杂志

Objective:To develop a monitoring tool for evaluating health literacy level of general practitioners.Methods:The health literacy monitoring questionnaire for general practitioners was preliminarily developed by referring to the National Residents′ Health Literacy Monitoring Questionnaire. The Delphi method was used to conduct two rounds of consultation among 15 experts to improve the questionnaire.Results:The effective response rates of the two rounds of expert consultation were 100.0%, the expert authority coefficients of the two rounds of consultation were 0.87 and 0.86, the mean scores of the two rounds of expert questions were 3.93 -5.00 and 4.47-5.00. The variance coefficients of the two rounds of expert scores were 0-0.32 and 0-0.20, and the Kendall harmony coefficients of the two rounds of expert scores were 0.167 and 0.102, respectively (all P<0.05). Finally, the basic theory literacy dimension (including 8 chronic disease prevention items, 5 maternal and child health items and 5 infectious disease prevention items), and the basic skill literacy dimension (including 6 safety and first aid items, 8 health information items), and the healthy lifestyle and behavior dimension (7 items, including regular physical examination, exercise, diet and so on) were established. A total of 39 items and 3 dimensions were used to monitor the health literacy level of general practitioners. Conclusion:The monitoring tool of health literacy level for general practitioners based on Delphi method has been preliminarily constructed, which can be used to evaluate the health literacy level of general practitioners.

Current status and development of the training of general practitioners with special interest (GPSI) in China / 中华医学教育探索杂志

In recent ten years, general practitioner (GP) training and practice develops rapidly in China. It has established a relatively complete GP training system, including medical college education and standardized residency training. However, the path of continuing professional development and clinical skills improvement for GP after standardized residency training is still unclear. The concept of GP with special interest (GPSI) has been proposed these days, and it has put forward a new development direction for the career path of GP. In this article, on the basis of understanding the current status of GPSI in China, we try to discuss its advantages and problems, and then propose our suggestions for its future development.

Effect of Modified Shenfuwan on Lumbar Disc Herniation Due to Kidney Deficiency and Cold Coagulation / 中国实验方剂学杂志

Objective:To observe short-term and long-term effect of modified Shenfuwan on lumbar disc herniation due to kidney deficiency and cold coagulation. Method:100 cases were randomly divided into the control group and observation group，50 cases each. The control group were taken meloxicam tablets，7.5 mg each time，once a day and the observation group were given modified Shenfuwan，300 mL each time，twice a day. The treatment course was 3 months. The short form McGill pain questionnaire（SF-MPQ），oswestry disability index（ODI），and lumbar intervertebral disc herniation due to kidney deficiency and cold coagulation by traditional Chinese medicine （TCM ） syndrome were observed before and after treatment. Whole blood viscosity （high，medium，low），serum inflammatory factors ［tumor necrosis factor-alpha（TNF-<italic>α</italic>），interleukin-1<italic>β</italic>（IL-1<italic>β</italic>），interleukin-6（IL-6），pain mediators［endothelin-1（ET-1），prostaglandin E₂（PGE₂），cyclooxygenase-2（COX-2）］ were detected. The clinical efficacyand，recurrence rate followed up for 12 and 24 months was was observed. The type and time of adverse reactions were recorded during the study. Result:After treatment，the total effective rate in the observation group was 98.0%（49/50） higher than that 82.0%（41/50） in the control group（<italic>P</italic><0.05）. After 12 months of follow-up，the recurrence rate in the observation group was 23.9%（11/46） lower than that 52.5%（21/40） in the control group （<italic>χ</italic>²＝5.193，<italic>P</italic><0.05）. After 24 months of follow-up，the recurrence rate in the observation group was 43.9%（18/41） lower than that that 80.6%（29/36） in the control group（<italic>P</italic><0.05）. Compared with the control group after treatment，SF-MPQ，ODI，TCM symptoms，whole blood viscosity，TNF-<italic>α</italic>，IL-1<italic>β</italic>，IL-6，ET-1，PGE₂ and COX-2 were significantly reduced in the observation group（<italic>P</italic><0.05）. The incidence of adverse reactions in the observation group was 2.0%（1/50） lower than that 52.0%（26/50） in the control group（<italic>χ</italic>²＝6.264，<italic>P</italic><0.05）. Conclusion:Modified Shenfuwan can significantly improve the short-term and long-term clinical efficacy of patients with lumbar disc herniation due to kidney deficiency and cold coagulation syndrome，and the incidence of adverse reactions is low.

Effect of Modified Anshentang on Serum Inflammatory Factors, Immune Function, Bone Metabolism on Treatment of Patients with Ankylosing Spondylitis in Early and Middle Stages / 中国实验方剂学杂志

Objective:This study aims to investigate the clinical efficacy of modified Anshentang on the treatment of ankylosing spondylitis in early and middle stages with kidney deficiency and cold-governing syndrome and its effect on serum inflammatory factors， immune function， and bone metabolism indexes of patients. Method:In this study， 120 patients were randomly divided into control group and observation group， 60 cases in each group. On the basis of ethotrexate treatment， patients in control group took Bushen Shuji granule orally， while patients in observation group took modified Anshentang orally for 8 weeks. Before and after treatment， patients in two groups were observed for clinical symptoms ［ bath ankylosing spondylitis patient global score （BAS-G）， bath ankylosing spondylitis disease activity index （BASDAI）， spondyloarthritis research consortium of Canada （SPARCC）， traditional Chinese medicine symptoms （TCM symptoms）<italic> </italic>］， serum inflammatory factors ［ tumor necrosis factor-<italic>α </italic>（TNF-<italic>α</italic>）， macrophage migration inhibitory factor （MIF）， interleukin-23 （IL-23）］， immune function ［ immunoglobulin A（IgA）， immunoglobulin G（IgG）， immunoglobulin M（IgM）］， bone metabolic indicators ［osteocalcin （BGP）， bone morphogenetic protein-2 （BMP-2）， bonespecific alkaline phosphatase （BALP）］. The clinical efficacy， adverse reactions and recurrence rates of 12 months in two groups were observed. Result:During the study， 4 cases dropped out from control group and 2 cases from observation group. The total effective rate of 96.55% （56/58） in observation group was higher than 80.36% （45/56） in control group （<italic>χ</italic>²=4.827，<italic>P</italic><0.05）. The recurrence rate of 5.17% （3/58） in observation group was lower than 19.64% （11/56） in control group （<italic>χ</italic>²=5.187， <italic>P</italic><0.05）. Compare with control group after treatment， BAS-G，BASDAI， SPARCC， TCM symptoms， TNF-<italic>α</italic>， MIF and IL-23 in observation group were significantly decreased （<italic>P</italic><0.05）， while BGP， BMP-2， BALP， IgA， IgG and IgM were significantly increased （<italic>P</italic><0.05）. The incidence of adverse reactions was 12.07%（7/58） in observation group， which was lower than 32.14%（18/56） in control group （<italic>χ</italic>²=4.826，<italic>P</italic><0.05）. Conclusion:Modified Anshentang is effective in the treatment of ankylosing spondylitis in early and middle stages with kidney deficiency and cold-governing syndrome， and the incidence of adverse reactions is low.

Effect of KIF22 on promoting proliferation and migration of gastric cancer cells via MAPK-ERK pathways / 中华医学杂志(英文版)

BACKGROUND@#Gastric cancer (GC) is one of the most globally prevalent cancers in the world. The pathogenesis of GC has not been fully elucidated, and there still lacks effective targeted therapeutics. The influence of altered kinesin superfamily protein 22 (KIF22) expression in GC progression is still unclearly. The aim of this study was to investigate the KIF22 effects on GC and related mechanisms.@*METHODS@#Gastric carcinoma tissues and matching non-cancerous tissues were collected from patients with GC who have accepted a radical gastrectomy in Lanzhou University Second Hospital from May 2013 to December 2014. The expression of KIF22 was examined in GC of 67 patients and 20 para-carcinoma tissues by immunochemical staining. The relationship between the expression of KIF22 and clinicopathologic characteristics was next investigated in the remaining 52 patients except for 15 patients who did not complete follow-up for 5 years. Cell viability was performed via 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) test and colony formation assay in the MGC-803 and BGC-823 GC cells. Cell scratch and trans-well invasion assay was performed to assess migration ability in the MGC-803 and BGC-823 GC cells. Gene set enrichment analysis (GSEA) pathway enrichment analysis was performed to explore the potential functions. Cell cycle was detected by flow cytometry. In addition, the two GC cell lines were used to elucidate the underlying mechanism of KIF22 in GC in vitro via assessing the effects on mitogen-activated protein kinase and extracellular regulated protein kinases (MAPK/ERK) signal transduction pathway-related expressions by Western blotting assays. The differences were compared by t tests, one-way analysis of variance, and Chi-squared tests.@*RESULTS@#The study showed that KIF22 was up-regulated in GC, and KIF22 high expression was significantly related to differentiation degree (χ = 12.842, P = 0.002) and poorly overall survivals. GSEA pathway enrichment analysis showed that KIF22 was correlated with the cell cycle. Silence of KIF22 decreased the ability of the proliferation and migration in gastric cells, induced G1/S phase cell cycle arrest via regulating the MAPK-ERK pathways.@*CONCLUSIONS@#KIF22 protein level was negatively correlated with prognosis. KIF22 knockdown might inhibit proliferation and metastasis of GC cells via the MAPK-ERK signaling pathway.

The implementation status of the long-term prescription / 中华全科医师杂志

In order to alleviate the "difficulty and annoyance in dispensing medicine" of patients with chronic diseases and promote hierarchical healthcare system, the policy of long-term prescription for chronic diseases has been implemented in the country. This article summarizes the current status and effectiveness of implementation of the long-term prescription, and explores the existing problems. The improvement of prescription formulation, review, deployment, distribution of drugs, health education and other issues to ensure the safety of treatment are discussed. Meanwhile, we suggest that the relevant supporting policies of medical insurance should be improved to further promote the long-term prescription.

The implementation status of the long-term prescription / 中华全科医师杂志

In order to alleviate the "difficulty and annoyance in dispensing medicine" of patients with chronic diseases and promote hierarchical healthcare system, the policy of long-term prescription for chronic diseases has been implemented in the country. This article summarizes the current status and effectiveness of implementation of the long-term prescription, and explores the existing problems. The improvement of prescription formulation, review, deployment, distribution of drugs, health education and other issues to ensure the safety of treatment are discussed. Meanwhile, we suggest that the relevant supporting policies of medical insurance should be improved to further promote the long-term prescription.

Prognosis value of cardiac magnetic resonance cardiac function index in patients with pulmonary hypertension / 第二军医大学学报

Objective To explore the effect of cardiac magnetic resonance (CMR) imaging parameters on prognosis of the patients with pulmonary hypertension (PH). Methods Ninety PH patients, who were diagnosed by right heart catheterization and received CMR examination in our hospital, were enrolled for this study. The cardiac functional parameters, including end-diastolic volume index (EDVI), end-systolic volume index (ESVI), stroke volume index (SVI) and ejection fraction (EF) of the right ventricle and left ventricle, and tricuspid annular plane systolic excursion (TAPSE), were analyzed. The study end-point was major adverse cardiovascular event (MACE). Two independent sample t test was used to analyze the differences of CMR parameters between MACE group and non-MACE group. Cox proportional hazards regression model was used to determine the independent predictors of end-point events. Kaplan-Meier survival curve was drawn based on the optimal cut-off value of receiver operating characteristic (ROC) curve. Results Compared with the non-MACE group, the right ventricular EF, left ventricular SVI and TAPSE were decreased in the MACE group ([27.00±9.92]% vs [32.68±11.34]%, [29.14±8.73] mL/m2 vs [35.41±11.59] mL/m2 and [12.51±4.17] mm vs [16.04±7.37] mm), while the right ventricular EDVI and ESVI were increased ([139.72±48.70] mL/m2 vs [116.07± 44.79] mL/m2 and [104.26±42.88] mL/m2 vs [79.37±35.67] mL/m2), and the differences were significant (t=-2.065, -2.286, -2.089, 2.076 and 2.668, all P<0.05). Multivariate analysis showed that left ventricular SVI and TAPSE were independent predictors of MACE in the PH patients (hazard ratio [HR]=0.942 and 0.904, P=0.039 and 0.022). The optimal cut-off values of left ventricular SVI and TAPSE determined by ROC curve were 30.27 mL/m2 and 15.65 mm, respectively. Kaplan-Meier survival analysis showed that the incidence of MACE was significantly increased when left ventricular SVI≤30.27 mL/m2 or TAPSE≤15.65 mm (P=0.001 and 0.019). Conclusion The left and right heart functions of PH patients with MACE are poor. TAPSE and left ventricular SVI are the independent predictors of MACE in the PH patients.

Survey on perception of general practice and career intention among undergraduates in Harbin Medical University / 中华全科医师杂志

A questionnaire survey on the perception of general practice and career intention was conducted among 365 undergraduates in Harbin Medical University in May 2018. Among all participants 71 (19.45%) had studied the course of Introduction to General Medicine, and 289 did not (79.18%). Twenty one students well knew general practice (5.78%), 189 knew (51.78%) and 155 students did not know (42.47%); 164 (44.93%) would pursue a master degree study in general practice after graduation, 216 people (59.18%) were willing to attend standardized residency training after graduation, and 147 (40.27%) choose to be a general practitioner after graduation. The proportion of students willing to pursue a master degree study in general medicine and to receive standardized resident training of general practice in students who had studied "Introduction to General/Family Medicine" was lower than that in hose did not studied (χ2=7.46, 7.14, both P<0.05). The top three reasons for becoming a general practitioner were more chance for career development (70.15%, 109/147), loving the subject (52.38%, 77/147), and difficulty to be employed for other specialties (27.21%, 40/147). The first three reasons for not being a general practitioner were less chance for career development (52.17%, 133/138), less interesting specialty (47.10%, 65/138), unfamiliar with grassroots work (39.86%, 55/138). The survey indicates that medical colleges should continue to strengthen the education of general practice, and constantly improve its curriculum system to attract more medical students to join the team of general practitioners after their graduation.

Research progress of tumor immune and tumor metabolic drug targets / 药学学报

The occurrence and development of tumors are closely related to the tumor microenvironment. Among them, tumor immune microenvironment and tumor metabolic microenvironment play important roles in tumor. Tumor immunotherapy is a way to kill tumor cells by activating the body's immune system. Tumor immunotherapy has shown good therapeutic effects in a variety of solid tumors. In recent years, significant progress has been made in tumor immunotherapy. The Warburg effect indicates that tumor cells use aerobic glycolysis to acquire energy. In the tumor, the energy metabolism pathway is abnormal, and the tumor microenvironment can induce the reprogramming of tumor cell metabolism. Therefore, targeting tumor metabolism is also of great significance for tumor treatment. In this paper, we reviewed the research progress of drug targets related to tumor immunology and tumor metabolism in recent years, as well as the progress of drug development.

Research advances in endogenous neural stem cells promoting neural repair after ischemic stroke / 生理学报

Neural stem cell therapy, as a new therapeutic method for neural diseases, has aroused a wide concern for over 20 years since neural stem cells were first found in 1992. Ischemic stroke is highly concerned because of its high incidence, mortality and disability rates. Because the brain has a limited ability to repair itself, to improve neural function and promote neural regeneration may help to prevent occurrence and development of neurological diseases. It is noteworthy that some stroke patients showed an ability to repair brain several months after the stroke happened, suggesting an existence of endogenous nerve repair in these patients. The research advances in functions of endogenous neural stem cells in neural regeneration and the related regulators after ischemic stroke are summarized in this review to provide new views of the mechanism of neural functional recovery after ischemic stroke.

Detection of preoperative chemoradiotherapy sensitivity molecular characteristics of rectal cancer by transcriptome second generation sequencing / 北京大学学报(医学版)

OBJECTIVE@#To detect the preoperative chemoradiotherapy sensitivity molecular characteristics of rectal cancer by transcriptome second generation sequencing.@*METHODS@#The clinicopathological data of 30 patients with locally advanced rectal cancer were collected prospectively, including 9 indicators (general conditions, imaging data before radiotherapy and chemotherapy, pathological data of biopsy before radiotherapy and chemotherapy, and tumor differentiation degree, etc.), in order to analyze the correlation between them and tumor regression grading (TRG) after radiotherapy and chemotherapy for rectal cancer. At the same time, frozen specimens of colonoscopy biopsy before neoadjuvant therapy were collected from these 30 patients, and transcriptome second-generation sequencing was performed for bioinformatics analysis to screen out the genes that might drive the radio chemotherapy sensitivity of rectal cancer.@*RESULTS@#Among the 30 patients with rectal cancer, 9 had complete pathological remission, 12 had partial remission, and 9 had poor remission. The degree of pathological TRG remission after radiotherapy and chemotherapy for rectal cancer was negatively correlated with the preoperative MRI T stage (P=0.046), and positively correlated with preoperative MRI rectal cancer extravascular invasion (EMVI) (P=0.003). Transcriptome second-generation sequencing of the obtained 217 transcripts (P<0.05) for signal pathway enrichment analysis, and multiple cell signal transduction pathways related to antigen presentation could be found. The high expression of HSPA1A, HSPA1B and EXOSC2 was positively correlated with postoperative pathological remission (P<0.05). The high expression of DNMBP, WASH8P, FAM57A, and SGSM2 was positively correlated with postoperative pathological remission (P<0.05).@*CONCLUSION@#Preoperative NMR detection of extra-tumoral vascular invasion (EMVI-positive) in patients with rectal cancer was significantly better than that of EMVI-negative patients after chemoradiotherapy. Patients with high expressions of HSPA1A, HSPA1B and EXOSC2 had poor postoperative pathological remission, while patients with high expressions of genes, such as DMNMB, WASH8P, FAM57A, and SGSM2 had good postoperative pathological remission. Based on the molecular characteristics of rectal cancer radiotherapy and chemotherapy, attempts to block or enhance the molecular pathways associated with chemosensitivity of rectal cancer, are to be made to further explore new candidate therapeutic targets that can increase the sensitivity of radiotherapy and chemotherapy for rectal cancer.

Study on relationship between IGFBP-5/p53 axis and anti-proliferation effect of tetrandrine in MCF-7 cells / 中国药理学通报

Aim To study the effect of tetrandrine ( Tet ) on proliferation of MCF-7 breast cancer cells and the possible mechanism underlying this biological process. Methods CCK-8, flow cytometric and Western blot were introduced to analyze the effect of Tet on proliferation and apoptosis in MCF-7 cells.Re-al-time PCR and/or Western blot assay were employed to detect the effect of Tet on expression of IGFBP-5 , p53 and MDM2.CCK-8 and recombinant adenovirus were utilized to determine the effect of IGFBP-5 on the proliferation inhibitory effect of Tet .Western blot assay was introduced to evaluate the effect of IGFBP-5 on p53 which was induced by Tet .Results Tet inhibited the proliferation , arrested cell cycle at G 1 phase and decreased the expression of PCNA concentration dependently in MCF-7 cells.Meanwhile, Tet increased the percentage of apoptotic cells , the level of Bad and reduced the level of Bcl-2.Tet increased the expres-sion of IGFBP-5 either mRNA or protein , over-expres-sion of IGFBP-5 enhanced the anti-proliferation activity of Tet in MCF-7 cells, but knockdown of IGFBP-5 at-tenuated this effect of Tet .Tet increased the level of p53 and decreased that of MDM2, and exogenous IG-FBP-5 enhanced the effect of Tet on p53 and MDM2, respectively .Conclusion Tet can inhibit the prolifer-ation of MCF-7 cells, and this activity is partly media-ted by increasing the function of p 53 signal , which may be triggered by the Tet-induced IGFBP-5.

Analysis on the features of outpatients between online and offline general practice clinics / 中华医院管理杂志

Objective To identify the features of outpatients visiting the online GP clinics and compare the data with outpatients in offline clinic visits, for reference of outlining the service boundaries of online outpatient services. Methods Data were collected from the online outpatient clinic of the First Affiliated Hospital of Zhejiang University between February 2016 and February 2017. The data usage was descriptive statistical analysis of the basic information and disease information of the patients. Results An analysis of the 715 online general practice consultations found the following proportions: diseases of the digestive system(11.3%), that of urinary system(7.7%), that of endocrine system(7.1%), that of respiratory system(6.9% )and that of circulatory system(4.6% ). Among the 5 796 offline consultations, the proportions were as follows:diseases of the digestive system(27.4% ), that of endocrine system(15.5% ), that of respiratory system(10.2%), that of urinary system(5.8%) and that of musculoskeletal system (5.4% ). 563 online outpatients ( 78.7% ) and 4 716 offline outpatients ( 81.4% ) were diagnosed respectively, while 152 online and 1 080 offline outpatients were medically unexplained physical symptoms. The comparison of the two groups lacked significant differences. Conclusions Characteristics of online outpatients look similar to offline ones, while the former facilitates appointment-based laboratory and imaging examination, health consultation and follow-up of chronic diseases.

Characteristics of Ventricular Function in Pulmonary Hypertension Patients with Different Shape of Interventricular Septum: Preliminary Study with Cardiac Magnetic Resonance Imaging / 中国肺癌杂志

BACKGROUND@#To study the characteristics of ventricular function in Pulmonary Hypertension (PH) Patients with different shape of Interventricular Septum (IVS) by cardiac magnetic resonance (CMR).@*METHODS@#36 PH patients diagnosed by right heart catheterization accepted CMR. According to the morphology of IVS, the patients were divided into two groups: the non-deformation group (10 patients) and the deformation group (26 patients). The ventricular function parameters were as follows: RV and LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), stroke volume index (SVI), cardiac index (CI), ejection fraction (EF), and myocardial mass index (MMI).@*RESULTS@#ANOVA analysis showed that the differences of RVEDVI, RVESVI, RVSVI, RVCI, RVEF, RVMMI, LVEDVI, LVESVI, LVSVI and LVCI were significant among the three groups. Compared with control group, RVSVI (P=0.017), RVEF (P<0.001), LVEDVI (P=0.048) and LVSVI (P=0.015) decreased in IVS non-deformation group. Compared with IVS non-deformation group, RVEDVI (P<0.001), RVESVI (P<0.001), RVCI (P=0.002) and RVMMI (P=0.017) were increased in IVS deformation group; while RVEF (P=0.001), LVEDVI (P=0.003), LVSVI (P<0.001) and LVCI (P=0.029) were decreased. Compared with the control group, RVEDVI (P<0.001), RVESVI (P<0.001), RVCI (P=0.004) and RVMMI (P=0.003) were increased in the IVS deformation group, while RVEF (P<0.001), LVEDVI (P<0.001), LVESVI (P<0.001), LVSVI (P<0.001), LVCI (P<0.001) were decreased.@*CONCLUSIONS@#Ventricular function is different in PH Patients with different IVS shape. The IVS shape can represent the changes of ventricular function in PH patients.

Suggestions on community training for general practice residency / 中华全科医师杂志

Residency training is the main way to cultivate qualified general practitioners , while community training is an indispensable part of the training .However, currently the curricula and teaching plan of community training are various in terms of departments and time for residency rotation .It is important to formulate nationwide united standard and curricula of community training for cultivation of highly qualified general practitioners .