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@#The Chinese Guidelines on Diagnosis and Management of Atrial Fibrillation, jointly formulated by the Chinese Society of Cardiology, Chinese Medical Association and the Heart Rhythm Committee of Chinese Society of Biomedical Engineering, was first released on June 15, 2023. The guidelines elaborate the various aspects of atrial fibrillation management, in which emergency management of atrial fibrillation is also an integral part. This article interpreted the emergency management part in the guidelines in detail by reviewing relevant literature.
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@#The World Health Organization (WHO) released the WHO 2020 guidelines on physical activity and sedentary behaviour in November 2020. Compared with the 2010 WHO guidelines, this guideline has incorporated more extensive medical evidence and made targeted recommendations for special populations. The main content includes physical activity and sedentary behaviour advice for children and adolescents, adults, older adults, pregnant and postpartum women, people with chronic conditions, and disability. This review will interpret the 2020 WHO guidelines in detail.
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In order to effectively manage the atrial fibrillation patients, West China Hospital has established an integrated general-specialty management model within medical consortium. This model takes the atrial fibrillation-stroke integrated management outpatient clinic as the platform, combines general practice and specialty to provide standardized care for atrial fibrillation patients. The model was characterized by primary diagnosis, two-way referral, up and down linkage, and differential management for acute and chronic conditions. This article, taking West China Hospital as an example, introduces the integrated team of cardiologists and general practitioners in the tertiary hospital with general practitioners in the community, and the preliminary accomplishment in the management of atrial fibrillation within the medical consortium. It would provide a reference for the long-range management of atrial fibrillation in other provinces and cities.
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At present, general practitioners in China lack both specialist knowledge and ability, which calls for close cooperation between general practitioners and specialists to better guarantee medical quality and patient safety. The authors reviewed the connotation, research status, development trend, problems and suggestions of general practitioners-specialists joint consultation service. Based on such, they pointed out that such a general practitioner-specialist joint clinic is quite new in the country, but numerous literature has confirmed that it can not only make up for services fragmentation, but also reduce referral rate.Furthermore, it can improve the quality of people′s lives, improve the general practitioner′s professional knowledge and skills, standardize general practitioner′s rational drug use. All these prove the reform an effective measure and deserves further promotion and greater supervision.
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The knowledge and clinical skill competition scores of 331 general practitioners (GPs),who attended the grassroots health posts training in Sichuan Province and Chengdu Municipality in 2016 and 2017,were documented.The factors influencing the competition results were analyzed.The mean knowledge test score of 331 participants were higher than the clinical skill score [(76.89±6.56) vs.(54.13±10.91),P＜0.01].The mean operational score in the clinical skill competition was higher than that of medical history collection,physical examination and clinical interview abilities [(32.31 ±3.28) vs.(21.82±5.09),P＜0.01].There were significant differences in knowledge and clinical skill scores among doctors from different regions or with different professional ranks (P＞0.05).The levels of clinical skills of general practitioners at the grass-roots level need to be further improved,according to relevant influencing factors.
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The present study is to explore the change process and distribution of phosphorylated DARPP-32 (p-DARPP-32) in rat brain including cortex, hippocampus and striatum and to further deduce whether p-DARPP-32 was possibly involved in epilepsy induced by repetitive low doses of pentylenetetrazol (PTZ). PTZ-induced epilepsy model in rat was established with 30 male SD rats randomly divided into 6 groups, control group and five trial groups [PTZ 1 h, PTZ 6 h, PTZ 24 h, PTZ 48 h and PTZ 72 h respectively, after onset of status epilepticus (SE)]. Immunohistochemistry and immunofluorescence double-labeling were used to detect the temporal time change and distribution of p-DARPP-32 expression and to analyze the coexpression of DARPP-32 and p-DARPP-32 in rat brain after the onset of PTZ-induced generalized SE. The results showed that there was a temporal time change of p-DARPP-32 expression in rat brain after the onset of SE. The number of p-DARPP-32-positive cells increased significantly and reached the peaks at the ends of 1 hour and 6 hours after the onset of SE, but decreased at the end of 24 hours. The moderate to strong p-DARPP-32-immunopositive neurons were observed in cortex, hippocampus and striatum, and located in cell cytoplasm and cell nucleus. Further immunofluorescence double-labeling revealed that denser colocalization of p-DARPP-32 and DARPP-32 in the neurons existed in the area mentioned above. Therefore, PTZ-induced SE may cause phosphorylation of DARPP-32 in rat brain. The temporal time change and distribution of p-DARPP-32 suggest that phosphorylation of DARPP-32 may be involved in PTZ-induced epilepsy in rat brain including cortex, hippocampus and striatum, and p-DARPP-32 may play a central role in the onset of SE.
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Animals , Male , Rats , Cerebral Cortex , Metabolism , Corpus Striatum , Metabolism , Dopamine and cAMP-Regulated Phosphoprotein 32 , Metabolism , Hippocampus , Metabolism , Neurons , Metabolism , Pentylenetetrazole , Rats, Sprague-Dawley , Status Epilepticus , MetabolismABSTRACT
Objective To determine the prevalence of diabetes mellitus and related risk factors among residents in the urban and rural area of Chengdu.Methods A cluster sampling was used to establish a study population of inhabitants aged 30 to 70.Totally,1 847 participants were enrolled in this study.Questionnaire including general information and dietary information in the past year was used to collect related data.Height,body weight and oral glucose tolerance test (OGTT) were measured.Factor analysis was used to analyze the dietary pattern while multivariate unconditional logistic regression used for risk factors in total population,urban and rural residents,respectively.Results The population standardized prevalence rates of diabetes in the overall,urban and rural residents were 20.2％,28.7％,11.1％,respectively.Among total population,middle-aged (OR=2.337,95％CI:1.305-4.185) and the elderly (OR=5.990,95％ CI:3.389-10.586) residents had higher diabetes risk than the younger ones.Administrators (OR=1.434,95％ CI:1.000-2.057) and ordinary clerks (OR=2.870,95％ CI:1.653-4.980) were more vulnerable to diabetes than peasants.Similarly,middle-aged (OR=2.973,95％ CI:1.101-8.031) and elderly (OR=5.972,95％ CI:2.267-15.730) turned out to be more predisposed than young people in the urban area.Compared with peasants,ordinary clerks (OR=2.196,95％CI:1.213-3.975) seemed to be more liable to diabetes.In the mral areas,dietary pattern with higher energy and protein (OR=1.404,95％ CI:1.113-1.772) could be subject to diabetes.Conclusion The prevalence of diabetes in Chengdu was relatively high.Age,career and dietary pattern are mainly risk factors.The factors in different districts are vaious.Intervention on nutrition should be different,area-wise.