Progress on three-dimensional cell culture technology and their application / 生物医学工程学杂志

Three-dimensional (3D) cell culture model is a system that co-culture carriers with 3D structural materials and different types of cells in vitro to simulate the microenvironment in vivo. This novel cell culture model has been proved to be close to the natural system in vivo. In the process of cell attachment, migration, mitosis and apoptosis, it could produce biological reactions different from that of monolayer cell culture. Therefore, it can be used as an ideal model to evaluate the dynamic pharmacological effects of active substances and the metastasis process of cancer cells. This paper compared and analyzed the different characteristics of cell growth and development under two-dimensional (2D) and 3D model culture and introduced the establishment method of 3D cell model. The application progress of 3D cell culture technology in tumor model and intestinal absorption model was summarized. Finally, the application prospect of 3D cell model in the evaluation and screening of active substance was revealed. This review is expected to provide reference for the development and application of new 3D cell culture models.

Survey on health literacy and influencing factor of family caregivers of chronic disease patients in Beijing / 中华全科医师杂志

Objective:To survey the health literacy and related factors of family caregivers of patients with chronic diseases in Beijing.Methods:A survey was conducted from September to November 2018, among 1 350 family caregivers of patients with chronic diseases selected by stratified random sampling from 6 districts of Beijing. A self-filling questionnaire was used for the survey, which consisted of the basic information and health literacy of family caregivers. Health literacy included three parts: daily living habits, basic knowledge (knowledge of prevention and management of behavioral risk factors, knowledge related to chronic diseases and knowledge related to first aid) and chronic disease-related skills.Results:A total of 1 268 valid questionnaires were collected with a recovery rate of questionnaires was 93.9%. The median age of 1 268 family caregivers was 62 years (23-86) and 75.7% (960/1 268) were females. In terms of daily habits, smokers and drinkers accounted for 11.3% (143/1 268) and 21.5% (272/1 268) respectively; 82.7% (1 049/1 268) caregivers exercised regularly accounted, of whom 72.5% (761/1 049) exercised at least 4 times a week; 28.9% (366/1 268) caregivers had habit of light diet. In terms of basic knowledge of health literacy, 12.9% (163/1 268) of family caregivers mastered the basic knowledge (≥80% total score); family caregivers who were able to measure blood pressure, blood sugar, pulse, coping with hypoglycemia, cardiopulmonary resuscitation and dialing the emergency number correctly accounted for 27.4% (347/1 268), 18.1% (230/1 268), 15.1% (191/1 268), 15.7% (199/1 268), 6.0% (76/1 268) and 33.8% (429/1 268), respectively. For the six chronic disease-related skills, 23.7% (301/1 268) were able to call emergency number correctly and only 2.6% (33/1 268) were able to perform CPR. There were significant differences in the knowledge of behavioral risk factors ( χ 2=3.88, P=0.017), chronic disease related knowledge ( χ2=7.40, P=0.025), first-aid related knowledge ( χ2=12.04, P=0.002) and overall basic knowledge ( χ2=13.56, P=0.001) among family caregivers with different educational levels. There were significant differences in the knowledge of chronic diseases among family caregivers in different occupations ( χ2=8.78, P=0.012). Conclusion:The health literacy level of family caregivers of patients with chronic diseases in Beijing needs to be further improved, and there are differences in the health literacy of family caregivers with different educational qualifications and occupations.

Potential inappropriate medication and its influencing factors among elderly hypertensive patients in community general practice clinic / 中华全科医师杂志

Objective:To investigate the status quo of potentially inappropriate medication (PIM) among elderly hypertensive patients in community general practice clinic and related influencing factors.Methods:A total of 767 prescriptions for elderly hypertensive patients in a community health service center in Beijing from October 2020 to August 2021 were reviewed. The prevalence of PIM was assessed based on the criteria of potentially inappropriate medications for older adults in China(2017). Logistic regression analysis was employed to analyze the influencing factors for PIM. Results:The survey showed that 198 elderly patients had PIM with 244 person-doses. The top three drugs with high rate of PIM were benzodiazepine-estazolam (64 person-doses), clopidogrel (53 person-doses) and insulin (35 person-doses). Univariate analysis showed that PIM was significantly associated with types of medication;and underlying diseases hypertension with hyperlipidemia, coronary heart disease, type 2 diabetes, osteoarthritis, upper respiratory tract infection and insomnia (χ 2=82.58, 13.65, 17.74, 7.52, 10.34, 68.19,respectively,all P<0.05). Multivariate logistic regression analysis showed that the types of medication, hypertension complicated with upper respiratory tract infection, and insomnia were independent influencing factors for PIM ( OR=1.55, 2.47, 9.05; P<0.05). Conclusion:The study shows that PIM is more common in elderly hypertensive patients in community general practice clinics,which is associated with types of medication, hypertension complicated with upper respiratory tract infection and insomnia. It is suggested that general practitioner working in community clinics should be aware of PIM, minimize the number of prescription drugs, and choose new drugs or non-drug treatments to reduce the occurrence of PIM.

Survey on the training needs of chronic diseases among family health care workers in Beijing / 中华全科医师杂志

Objective:To survey the training needs for chronic diseases among family health care workers in Beijing.Methods:A questionnaire survey on training needs for chronic disease was conducted from September to November 2018 among 820 family health care workers from 15 community health service centers in Beijing selected by stratified random sampling. The questionnaire consisted of demographic information and training needs related to chronic diseases. The training needs included: the knowledge and skills related to chronic diseases: the types of chronic diseases expected to learn, the basic knowledge of chronic diseases (7 items), preventive health care knowledge (7 items), nursing and rehabilitation skills (9 items); the duration, frequency, method, time and location of training arrangement.Results:The survey showed that chronic disease that family health care workers most wanted to learn was hypertension (90.3%, 717/794); among the basic knowledge of chronic diseases, the highest need was disease risk factor (65.5%, 520/794); among the knowledge of preventive health care, the highest need was home safety protection (87.3%, 693/794); among nursing and rehabilitation skills, the highest need was blood glucose measurement (83.1%, 660/794). The female respondents had higher training need for basic knowledge of chronic diseases than males ( Z=2.51, P=0.012). There were significant differences in the needs for preventive health care knowledge among respondents of different gender ( Z=2.72, P=0.007), occupation ( H=15.02, P=0.001) and educational level ( H=12.01, P=0.002). Respondents with different age ( H=6.49, P=0.039), occupation ( H=52.93, P<0.001) and educational level ( H=9.56, P=0.008)) had different needs for nursing and rehabilitation skills. Among the respondents, 58.2% (462/794) indicated that duration of each course should be 30-59 min, 34.0% (270/794) wanted to participate in the training once a month, 53.1% (422/794) wanted to participate in the training in the form of large class, 39.2% (311/794) were willing to participate in the training on working days and 48.7% (387/794) wanted to be trained in community health service institutions. Conclusions:There are diverse training needs of family health care workers. Attention should be paid to the implementation of need-oriented training. It is crucial to promote the motivation of family health care workers to participate in the training, which can improve the training effect and facilitate their role in family health management.

Research progress on assessment tools of patient safety culture in primary care institutions / 中华全科医师杂志

Patient safety culture is an important aspect of ensuring patient safety in primary care institutions. The evaluation of patient safety culture helps researchers and managers to understand its essence and to develop more targeted and effective strategies for its promotion. In this article we review the current progress of the assessment tools for patient safety culture in primary care, to provide reference for their development and application in China.

Social support system for family caregivers of schizophrenic patients in the communities of Beijing / 中华全科医师杂志

Objective To develop the social support system for family caregivers of schizophrenic patients in community. Methods Based on the previous field investigation and the principle of comprehensiveness,feasibility,pertinence,suitability,generality and classification,the social support service item pool was established. Fifteen experts with intermediate or higher professional titles and working in the mental health fields were selected from government departments,specialized hospitals and community health service centers. The experts were consulted by Delphi and the results were analyzed. Results The average age of the consultation specialists was (40.7 ± 8.0) years, and the duration of working in mental illness rehabilitation was (14.9±7.6) years. The positive coefficients of the two rounds of consultation were 100％,the authoritative coefficients of experts were 0.795,and the coordination coefficients of opinions were from 0.252 to 0.344, respectively. The 67 items of social support service for family caregivers of schizophrenic patients in Beijing were obtained after two rounds of expert consultation, but fewer of the services were for schizophrenic caregivers only. Conclusion The authority and society should take measures to establish a social support system for family caregivers of patients with schizophrenia, in order to reduce their family burden and improve the quality of rehabilitation for mental patients in the community.

Survey on consultation length and waiting time of community general practice clinics / 中华全科医师杂志

Objective To survey the consultation length and waiting time of general practice clinics in community health service centers(CHSC).Methods Three CHSCs were selected from urban areas,urban-rural junction and rural areas Beijing Chaoyang District.The length of consultation,waiting time and the satisfaction of patients were surveyed by self-designed questionnaires among 373 patients visiting these three CHSCs between July to August 2018.Results In 364 patients who completed the questionnaire 69.0％(251/364) had a consultation length between 5 to 10 min,and the proportion of consultation length＜ 5 min was the highest (27.9％) in urban-rural junction.The waiting time was＜5 min in 43.7％ patients (159/364),only 9.3％ of patients waited for＞30 min.The proportion of patients with waiting＜5 min was the lowest (20.7％) in urban area.The distribution of consultion length was different among groups of the reason of consultion,frequently seen doctor and the familarity with the doctor(P＜0.05).Most patients were satisfied with the length of consultation (85.4％) and waiting time (74.5％).The satisfaction of patients in urban areas with the consultation length (75.2％) and waiting time (49.6％) was lower than that in urban-rural junction and rural areas.Conclusion The consultation length in general practice clinics of CHSC is relatively short,but patients are basically satisfied with the current status of consultation length and waiting time.However,consultation length and wating time should be regularly monitared,to promote the quality of care in general practice clinics.

Simultaneous use of budesonide and formoterol in asthma control and relieving therapy:a Meta analysis / 重庆医学

Objective To systematically assess the effectiveness and safety of simultaneously using budesonide(BUD) and formoterol(FORM) in asthma control and relieving therapy.Methods The databases including PubMed,Cochrane Library,EM-base,VIP,CNKI,CBM,Wanfang Data Knowledge Service Platform Database were retrieved by computer.The randomized controlled trials(RCTs) about BUD and FORM simultaneous use in asthma control and relieving therapy(observation group),BUD and FORM use in asthma control and terbutaline(TER) use in relieving therapy were collected in the various databases from their establishment to May 2017.The meta analysis was conducted by adopting the RevMan 5.3 software.Results A total of 5 RCTs(6 control groups) involving 10158 patients were included.The observation group was lower than the control group in the aspects of asthma aggravation admission or emergency person-times(OR=0.70,95％CI:0.59-0.85,P＜0.01),occurrence rate of serious adverse events(OR=0.66,95％CI:0.52-0.82,P＜0.01),occurrence rate of experiment termination by various causes[OR=0.84,95％CI:0.73-0.96,P=0.01);compared with the observation group,the improvement of night PEF value and FEV1 value after treatment in the control group was more significant (MD=4.05,95 ％ CI:0.18-7.93,P =0.04;MD =0.04,95 ％ CI:0.03-0.05,P＜0.01);the number of nocturnal awakening decrease times and occurrence rate of fatal adverse events had no statistically significant difference between the two groups[OR=1.25,95％CI:1.00-1.56,P=0.05;OR=1.01,95％CI:0.23-4.45,P=0.99).Conclusion BUD and FORM simultaneous use in asthma control and relieving therapy has an advantage in the aspects of reducing asthma acute attack and safety;BUD and FORM is used in asthma control,while TER is used in relieving therapy and has better effect for improving the lung function.

Study of the correlation between different upper limb abduction angles and the occurrence of malposition of PICC into internal jugular vein / 中华护理杂志

Objective To investigate the effects of different upper limb abduction angles on the occurrence of malposition of PICC into internal jugular vein. Methods Totally 210 cases of patients treated with PICCs for unilateral breast cancer of our hospital from August,2015 to January,2017 were randomly assigned to three groups with 70 cases in each group. The abduction angle of the upper limb for placement was set at 45° ,90° and 160° , respectively. We chose the basilic vein of the uninfected arm using modified Seldinger technique under the guidance of ultrasound for PICC,and malposition was confirmed by detecting the tip of PICC in internal jugular vein. Results The incidence rate of internal jugular venous dislocation in 45° group was 7.14%(5 cases) and 8.57% in 90° group (6 cases),and no internal jugular venous dislocation in 160° group. There was no statistically significant difference among 45°,90° and 160° groups(χ2=5.95,P>0.05). Significant differences of group comparisons for 45° v.s. 160° and 160° v.s. 90° were found (P0.05). Conclusion Abduction angles of 45° ,90° and 160° can all be used for PICC placement. The abduction angle can be selected according to specific situation of patients instead of being limited to the standard abduction angle of 90°.

Quality of life and its influencing factors in elderly patients with advanced cancer / 中华全科医师杂志

Objective To assess the quality of life and its influencing factors in ellerly patients with advanced cancer.Methods The quality of life was evaluated with EORTC QLQ-C30 scale Chinese version in 103 elderly patients with advanced cancer in a hospital outpatient clinic of Beijing from July 2013 to July 2014.The overall health,physical function,role function,cognitive function,emotional function,social function and individual symptoms score were assessed.The general information and clinical data of patients were analyzed.Results The general score of quality of life in elderly advanced cancer patients was (35.77 ± 21.98).In the domain of function the role functional score was the lowest (36.60 ± 27.97);in the domain of symptoms the tired score was the highest(50.82 ± 30.16),the score of appetite loss was the highest in individual symptoms (39.78 ± 24.32).Educational level,marital status,living condition,medical insurance and the number of comorbidities were correlated with overall health in elderly patients with advanced cancer (P ＜ 0.05).Multiple linear regression analysis showed that the educational level (t =2.447,P ＜ 0.05),marital status (t =2.118,P ＜ 0.05),medical insurance (t =3.770,P ＜ 0.05) and overall health status were positively correlated with the quality of life scores;and number of eomorbidities (t =-7.157,P ＜ 0.05) was negatively associated with the overall quality of life.Conclusion The quality of life was generally poor in elderly patients with advanced cancer;and educational level,marital status,medical insurance,comorbidities are important influencing factors.

Survey on Acinetobacter Baumannii Infection and Analysis of Drug Susceptibility in ICU / 现代检验医学杂志

Objective To investigate the current situation on the infection of Acinetobacter baumannii in ICU and evaluate the efficiency of resistance control project which was performed in Xiaolan hospital,so as to provide scientific basis for clinical rational use of antibiotics.Methods Used VITEK-2 microbiology analysis system for the pathogen identification and drug sensitivity.Compared drug resistance of Acinetobacter baumannii isolated from the samples of ICU patients in 2012 (before the project executed)with that in 2013 (after the project executed).Results 71 strains and 57strains Acinetobacter bauman-nii were isolated from the ICU in 2012 (before the project executed)and in 2013 (after the project executed)respectively, which majorly isolated from the samples of respiratory system,and occupied 94.4% and 84.2% respectively.The infection rate of multi-resistant Acinetobacter baumannii was decreased from 77.5% to 66.7%,and the resistance rate of Acinetobact-er baumannii to cefepime,ceftazidime,cefatriaxone,tobramycin and cotrimoxazole decreased distinctly after the implementa-tion of drug resistance control management (χ2 > 3.84,P <0.05).Conclusion The drug resistance rates of Acinetobacter baumannii to 14 kinds of routine antibacterial drugs in 2013 were lower than that in 2012 in ICU.Among them,the drug re-sistance rates of Acinetobacter baumannii to 5 kinds of antibacterial drugs decreased distinctly.

Publications of general practice education in China mainland 1993-2012: a bibliographic review / 中华全科医师杂志

Objective To review the publication of general practice education in China mainland in 20 years from 1993 to 2012.Methods The research articles of general practice education published between January 1,1993 and December 31,2012 were searched from CNKI and Wanfang databases, and analyzed with bibliometric and literature management software NoteExpress 2, Epidata 3.1 and SPSS 13.0.Results Total 4 281 articles were retrieved and 241 education relevant articles were selected.29.9％ (72/241) of the 241 articles were on on-campus education, 67.6％ (163/241) were on continuing medical education and 4.5％ (11/241) were on post-graduation education.As to the published institutions, 58.5％ (141/241) were from the medical colleges and research institutions, 25.7％ (62/241 were from the tertiary hospitals, 3.7％ (9/241) were from primary care institutions, 1.7％ (4/241 were from the secondary hospitals and 5.8％ (14/241) were from the government departments.The general practice education grants increased from 1 in 2001 to 46 in 2012;20 of which were supported by provincial and ministerial level funds.Conclusion The contents of general medical education literature in China is mainly on on-campus education and continuing medical education;most of which were from the tertiary hospitals and the medical colleges and research institutions.The amount of research grants of general practice education were increasing year by year during 1993-2012, indicating that more attention had been paid to general practice education in mainland China in the last two decades.

Distribution and drug resistance of Gram positive bacteria of ten hospitals in Chongqing / 重庆医学

Objective To investigate the distribution and drug resistance of the gram positive bacteria isolates from hospital in Chongqing during 2006-2011 .Methods Non-repetitive gram positive bacterias were collected retrospectively from ten hospitals in Chongqing .Antimicrobial susceptibility testing of all clinical isolates were carried out using Kirby-Bauer(KB) .Results 14 473 strains were isolated .There were 4 840 strains of Staphylococcus aureus (33 .4% ) ,2 566 strains of Staphylococcus epidermidis (17 .7% ) ,1 822 strains of Staphylococcus haemolyticus (12 .6% ) ,1 325 strains of Enterococcus (E .faecalis/E .faecium )(9 .2% ) . Staphylococcus was highly sensitive to nitrofurantoin ,rifampicin ,piperacillin/tazobactam ,linezolid ,teicoplanin and vancomycin ,but their resistance rate to ampicillin/sulbactam ,oxacillin ,penicillin and clarithromycin was high .The resistance rate of E .faecium to the majority of antimicrobial agents was obviously higher than that of E .faecalis ,excluding imipenem ,chloramphenicol and tetracy-cline .Vancomycin and linezolid still remain the strongest antibacterial activity to Enterococcus .Conclusion The distribution and drug resistance of pathogenic bacteria in Chongqing present regional particularity ,and antibiotic resistance is severe .It is significant to strengthen the epidemiology study of pathogenic bacteria and to develop policies to intervene in the use of antimicrobial agents .

Study on relationship between sperm morphology with seminal plasma zinc and sperm acrosin activity in male infertile patients / 国际检验医学杂志

Objective To investigate the relationship of sperm morphology with seminal plasma zinc and sperm acrosin activity in male infertile patients.Methods 455 patients with male infertility were divided into 5 groups and 8 groups according to age and sperm morphology respectively.The sperm morphology,seminal plasma zinc and sperm acrosin activity were detected by the Diff-Quik stain,modified 5-Br-PAPS and modified Kennedy methods respectively.Results The percentages of morphologically normal sperm and seminal plasma zinc concentration in the infertile men groups were not different in various age groups(P >0.05 ).The sperm acrosin activity in the age group of 36-50 years was remarkably decreased (P 0.05).Seminal plasma zinc concentration in the infertile men groups were not different in the 8 groups (P >0.05 ).Sperm acrosin activity was decreased with the percentage decrease of morphologically normal sperm (r =0.93,P <0.01).Conclusion The percentage of morphologically normal sperm is not affectd by the age and the seminal plasma zinc,which is positively correlated with the sperm acrosin activity.

Establishment of transgenic mouse models expressing human HSP22 protein / 中华老年医学杂志

Objective To establish transgenic mouse models expressing human HSP22 protein.Methods pCAGGS-HA-Wt HSP22 transgenic expressing vector carrying human HSP22 gene was constructed by gene recombination technology.The linearized DNA was got by SalI、Hind Ⅲ and BsaⅪ digestion of PCAGGS-HA-Wt HSP22,purified and microinjected into fertilized eggs from C57BL mice.The tail DNA of pups was tested by PCR and DNA sequencing.Expression of human HSP22 protein was detected by western blot with anti-HA tag monoclonal antibody.Results 4 transgenic founder mice (Tg646,Tg648,Tg649,Tg661) carrying human HSP22 gene were identified by PCR and DNA sequencing.The human HSP22 protein was expressed in the lines Tg646,Tg648 and Tg649 founder mice,but was not expressed in the line Tg661 founder mouse.Conclusions The mouse models expressing human HSP22 protein are established successfully and provide the foundation for HSP22 gene research in vivo.

Application and evaluation of general practice assessment questionnaire Chinese version for patients' satisfaction in community health-care service / 中华全科医师杂志

Objective To study application of Chinese general practice assessment questionnaire (GPAQ)consultation version 2.0 in evaluating patients' satisfaction with community health-care service (CHS).Methods First,origihal GPAQ consultation version 2.0 in English was translated into Chinese language by three experts in general practice/family medicine field,then translated it back into English,finally a Chinese version of GPAQ was formed.Ten medical doctors who were on duty on 25 April,2008 at each out-patient clinic from CHS of Daxing,Nancaiyuan,Yongning and Hancunhe were selected randomly as targets for evaluation of service satisfaction.A sample of the first 30 patients(1200 in total)aged more than 16 years who visited the clinic on that day were selected to fill out the Chinese GPAQ consultation version 2.0 to express their satisfaction with the medical doctors they visited,and reliability and validity of the questionnaire was then evaluated.Results Cronbach's alpha ranged 0.734 to 0.813 for each domain of the Chinese version of GPAQ2.0.and cumulated contribution of three common factors with the eigen-value more than one reached 58.722%.Scores of patients' satisfaction withreceptionists,access,continuity,doctor's communication skills andpatient enablement were significantly lower,as compared to those of national bench-mark in the United Kingdom,with t-values of -6.397,-11.729,-6.328,-59.871 and -2.210,and all P＜0.05.respectively.Conclusions The Chinese version of GPAO 2.0 achieves good reliability and modcrate validity,and can be used as an instrument for evaluating patient's satisfaction with quality of CHS in China as further revision in the future studies.

The relationship between gastric intestinal metaplasia and helicobacter pylori infection in the elderly / 中华老年医学杂志

Objective To evaluate the relationship between intestinal metaplasia (IM) and helicobacter pylori infection in elderly patients with chronic gastritis. Methods The patients over 60 years old and diagnosed as chronic gastritis by endoscopy from January 2008 to December 2009 were divided into two groups by pathological appearance. One group was chronic gastritis with IM (IM group), the other was chronic gastritis without IM (NIM group). The infection of helicobacter pylori, activity of inflammation, atrophy of gland, and folliculus lymphaticus in gastric mucosa were observed. Results The infection of helicobacter pylori, infiltration of neutrophil and atrophy ratio of gland were significantly higher in IM group than in NIM group (52.7% vs. 37.3%, 35.5% vs.24.0 %, 36.6 % vs. 3.5%, x2 = 10. 677, 7.641, 95. 606; P = 0. 001, 0. 006, 0. 000, respectively).There was no statistical difference in presentation of folliculus lymphaticus between IM group and NIM group (x2 = 0.003, P=0. 957). The infiltration of neutrophil and presentation of folliculus lymphaticus were significantly higher in helicobacter pylori positive patients than in helicobacter pylori negative patients (45.8% vs. 14.8%, 42.6% vs. 4.2%, both P=0.000). Conclusions The appearance of IM seems to be related with helicobacter pylori infection, activity inflammation and atrophy of gland. The presentation of folliculus lymphaticus seems to be closely related with helicobacter pylori infection. The eradication treatment of helicobacter pylori infection in the elderly chronic gastritis patients should be strengthened.

Development of referral indications for low back pain with RAND-UCLA consensus panel method / 中华全科医师杂志

Objective To study the validity of RAND-UCLA (Rand Corporation and University of California at Los Angeles) consensus panel method in developing guidelines of referral indications for low back pain (LBP).Methods Evidence-based clinical guidelines for LBP management at community level and its referral guidelines published since 2001 and other tools were retrieved with varied tools.All clinical guidelines met inclusion criteria were evaluated with clinical studies and evaluation tools (AGREE).An pool of indication items was established based on evidence for developing referral indications for LBP, which were added by RAND-UCLA consensus panel method, and alternative referral indications were selected and clinical guidelines for LBP referral were established.Results A total of 15 copies of clinical guidelines from nine countries or regions were included in it after critical appraisal.Four copies of referral guidelines from two countries were included.Referral indications for LBP were derived directly from the RAND-UCLA consensus panel process, consisting of 44 referral indications for three groups (immediate, urgent and routine referral).Conclusions The RAND-UCLA consensus panel method is a more useful and practical tool in developing clinical guidelines, referral guidelines, which is worthwhile being recommended and spread.

Establishment of an index system to evaluate the demonstration community teaching base for general practice / 中华医院管理杂志

Objective Developing an index system to evaluate the community teaching bases of general practice, for the purpose of identifying and completing at least one demonstration teaching base for general practice in each city in 2010. Methods Initial building of the index system by means of Delphi method and experts interview, followed by selection of experts for consultation, statistical analysis on the results of letter inquiries, and rounded up by the establishment of the index system for evaluation in the end. Results The recovery rates of a two-round Delphi questionnaire response are 94.12% and 100.00%respectively. Expert's authority degrees of five indexes are all over 0.8, which suggests high expert's authority. The average coordination coefficient of two-round Delphi experts consultation is 0.262and 0.534 respectively, showing good experts coordination. In the end, the study established four first-class indexes, ten second-class indexes, 41 third-class indexes and five additional indexes. Conclusions The index system is established in view of the current development of community teaching bases. It focuses on evaluating teachers, the teaching process and base's function. The evaluation system provides reference for selecting demonstration community teaching bases of general practice.

The expression of XIAP, Smac, HtrA2 and XAF1 in the rat hippocampus following status epilepticus / 中华神经科杂志

Objective To investigate the expression of XIAP, Smac, HtrA2 and XAF1 in the hippocampus following SE in rats and to explore the pathophysiological mechanisms of expression of XIAP and its negative regulators after SE. Methods The lithium-pilocapine model of status epilepticus was established in SD rat. XIAP, Smac, HtrA2, XAF1 and activated caspase-3 protein were examined using immunohistochemistry. Western blot was used to detect the protein levels of XIAP, Smac, HtrA2 and activated easpase-3. Results XIAP immunoreactivity diffusely distributed within the neuron after SE. Compared with the control group, the expression of CA3 XIAP protein in the SE group was increased gradually since 2 hours (0.5503±0.0172 vs 0.1507±0.0165, t=115.87, P<0.01), peaking at 8 hours (0.6221±0.0238 vs 0.1507±0.0165, t=136.69, P<0.01). The expression of CA3 Smac, HtrA2, XAF1 and activated caspase-3 protein were increased generally following SE. Western blot analysis showed a significant increase in Stoat, HtrA2, activated caspase-3 protein levels from 2 to 72 hours following SE, but no significant differences were seen in XIAP protein levels between the control group and the SE group. Conclusions The XIAP, Smac, HtrA2 and XAF1 are involved in the regulation of neuronal apoptosis and implicated in pathophysiological mechanisms of neuronal damage after SE.