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Objective:To survey the knowledge levels about diagnosis and management of asthma among general practitioners in community health centers in Shanghai and to analyze influencing factors.Methods:A questionnaire survey was conducted from May to June 2022 among general practitioners from 80 community health care centers in Shanghai. The questionnaire contained the basic information of the responders; knowledge about the diagnosis of asthma (symptoms, diagnostic methods, interpretation of bronchodilation and fractional exhaled nitric oxide, FeNO tests); and treatment of asthma (choosing and usage of therapeutic drugs). Logistic regression was used to analyze.Results:A total 324 general practitioners completed the questionnaire survey. Among them 221 (68.21%) had bachelor degree; 200 (61.73%) were attending doctors; the median working duration was 11 years; 174 (53.70%) had training on asthma knowledge in last 3 years. The survey results showed that 55 (16.98%) responders misinterpreted results of bronchodilation test, and 90(5.86%)misinterpreted results of FeNO test for diagnosis of asthma; 244 responders (75.31%) suspected implication of long-term cough for diagnosis of asthma; 277(85.49%)would order bronchodilation text to suspected patients; 273(84.26%)prescribed inhaled corticosteroid plus long-acting beta-2 agonist to asthma patients. For mild asthma patients, 144 responders(44.44%)suggested to use budesonide formoterol as needed; for moderate to severe asthma, 174(53.70%)suggested to use budesonide formoterol regularly and as needed, 100(30.86%)suggested to use salmeterol fluticasone regularly and salbutamol as needed. Logistic analysis showed that longer working duration was correlated with higher misinterpretation rate of bronchodilation and FeNO tests( OR=0.798,95% CI:0.694-0.918, P=0.002; OR=0.859,95% CI:0.739-0.998, P=0.047). The accuracy rate of all the questions was significantly higher in general practitioners who had training on asthma knowledge than those who didn′t receive training in last 3 years(all P<0.05). Conclusions:Most general practitioners in community health service centers in Shanghai have relatively high levels of knowledge about diagnosis and treatment of asthma. Years of work experience and training experience can affect the levels of asthma knowledge among community general practitioners.
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Objective To explore the effect and significance of clinical pathway guided teaching in the residency standard training program of respiratory medicine. Methods Total 47 resident physicians were selected and divided into clinical pathway group and control group from March 2014 to November 2014. The pathway group (n=24) was introduced into the teaching guided by clinical pathway management. The control group (n=23) was taught by traditional teaching method. All physicians were tested for the basic theory and the ability of case analysis after 4 weeks training. The ability of chemotherapy strategy ordered by residents independently and correctly was assessed each week during training. A satisfaction questionnaire survey was conducted to evaluate the effectiveness and satisfaction of teaching guided by clinical pathway. GraphPad Prism 5.0 was used and T test was done for comparison of data between groups. Results The medical records about basic theory and case analysis in the pathway group was higher than those in the control group with significant statistical difference (P<0.05). The records of resident physicians who could issue orders for chemotherapy independently and correctly were (70.75±2.79), (81.43±1.91), (85.23±1.3), (90.62±2.34) in the pathway group and (69.65±2.06), (77.11±2.21), (80.3±1.96), (87.78±2.21) in the control group at each week time point. There was statistical increase of the records in the pathway group than in the control group since the second week time point (P<0.05) The overall satisfaction of the pathway group was 95.84%(23/24), and the teaching satisfaction was higher than that of the control group(91.29%, 21/23). Pathway group doctors believe that the relevant teaching effectively improve the level of their knowledge , experience and ability. Conclusions The teaching method guided by clinical pathway is help-ful to standardize the teaching behavior, develop the standardized medical behavior of resident physicians, improve their clinical working ability efficiently, promote the relationship between teaching and studying, which is worth application in the residency standard training program of respiratory medicine.
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Along with prolongation of overall survival and increasing of therapeutic methods in advanced non-small cell lung cancer, whole-process management has become more and more important. We reviewed the whole-process management strategy according to difference of mutation state of epidermal growth factor receptor (EGFR) gene.
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<p><b>OBJECTIVE</b>To synthesize a novel nano-antibacterial inorganic filler and provide a new way to give dental composite resin antibacterial property.</p><p><b>METHODS</b>Quaternary ammonium iodide N,N,N-trimethyl-3-(trimethoxysilyl) propan-1-aminium iodide were organically synthesized firstly and then the N,N,N-trimethyl-3-(trimethoxysilyl) propan-1-aminium iodide was grafted to the nano-silica particle to synthesize the antihacterial inorganic fillers nano-silica particle grafted with quaternary ammonium salt. All the products were analyzed and identified by infrared spectrum analysis. Then Streptococcus mutans were chosen as experimental object to analysis the antibacterial property of nanoantibacterial inorganic filler.</p><p><b>RESULTS</b>Quaternary ammonium salt was grafted to the surface of nano-silica particles successfully by infrared spectrum analysis. Compared with the control group, the nano-silica particle grafted with quaternary ammonium salt had a strong bactericidal effect on Streptococcus mutons (P < 0.01).</p><p><b>CONCLUSION</b>The nano-silica particle grafted with quaternary ammonium salt has a strong antibacterial property and could be used to improve dental composite resin antibacterial property.</p>
Subject(s)
Acrylic Resins , Ammonium Compounds , Anti-Bacterial Agents , Composite Resins , Polyurethanes , Quaternary Ammonium Compounds , Silicon Dioxide , Streptococcus mutansABSTRACT
Objective:To investigate the effects of N-acetylcysteine(NAC)on the number of Clara cells and secretion of Clara cell16000(CC16)protein in murine asthmatic model.Methods:The murine asthmatic model was established by sensitiz-ing and challenging BALB/c mice with ovalbumin(OVA).Thirty mice were divided into control,asthmatic and NAC groups (n=10). The number of Clara cells and synthesis of CC16were determined by immunohistochemistry.The CC16level in bronchoalveolar lavage fluid(BALF)was determined by Western blot.Results:The proportions of Clara cells in terminal and respiratory bronchioles were(58.05?3.75)%and(63.70?1.79)%in the asthmatic group,(74.54?5.81)%and (78.46?1.68)% in the control(P
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The fibroblasts have long been considered as structural elements and playing a main role in wound healing. Recent studies indicated that fibroblasts are heterogenic cells and function as resident sentinel cells in inflammatory reaction. When activated by substances released during tissue injury or derived from infectious microorganisms or by proinflammatory cytokines, tissuespecific fibroblasts can transiently produce certain chemokines and initiate a cascade of inflammatory reaction. In addition fibroblasts can produce prostanoids that participate in inflammatory and immune responses. In this review, the new role of fibroblasts in regulation of inflammation and immune reactions and possible molecular mechanism will be discuss.