Survey on the awareness of diabetic foot screening among community medical personnel / 中华全科医师杂志

From July to August 2018, a survey on the awareness of diabetic foot screening was conducted using the online questionnaires posted on the WeChat group. From 107 trainees in General Practitioner Teacher Training Program of Beijing Xicheng District and 50 general practitioners working in Chinese Academy of Sciences, 145 valid questionnaires were received. All 145 participants worked in community health care settings, including 105 general practitioners, 76 had 10 to 20 years of service, and 98 had undergraduate degree. The survey showed that 75.9% (110/145) heard the diabetic foot screening and knew that screening should be done for all diabetic patients; 98.6% (142/145) knew that the screening should include medical history, foot skin, neuropathy, vascular status, and 73.1% (106/145) also knew that screening should include the foot bone, joint deformities and footwear selection; 21.4% (31/145) had participated in training related to diabetic foot screening. It is suggested that the awareness and knowledge of diabetic foot screening among Beijing community medical personnelare not sufficient, and more training opportunity is necessary for them.

Infectious disease rotation for general practice residency training / 中华全科医师杂志

The ability of prevention, treatment and management of infectious diseases is a basic requirement for general practitioners. This article introduces our experience in the infectious disease rotation for general practice residency training, focusing on the rotation management at different stages of training to explore how to improve teaching quality and the ability of trainers in a short period of the rotation.

Survey on the awareness of diabetic foot screening among community medical personnel / 中华全科医师杂志

From July to August 2018, a survey on the awareness of diabetic foot screening was conducted using the online questionnaires posted on the WeChat group. From 107 trainees in General Practitioner Teacher Training Program of Beijing Xicheng District and 50 general practitioners working in Chinese Academy of Sciences, 145 valid questionnaires were received. All 145 participants worked in community health care settings, including 105 general practitioners, 76 had 10 to 20 years of service, and 98 had undergraduate degree. The survey showed that 75.9% (110/145) heard the diabetic foot screening and knew that screening should be done for all diabetic patients; 98.6% (142/145) knew that the screening should include medical history, foot skin, neuropathy, vascular status, and 73.1% (106/145) also knew that screening should include the foot bone, joint deformities and footwear selection; 21.4% (31/145) had participated in training related to diabetic foot screening. It is suggested that the awareness and knowledge of diabetic foot screening among Beijing community medical personnelare not sufficient, and more training opportunity is necessary for them.

Infectious disease rotation for general practice residency training / 中华全科医师杂志

The ability of prevention, treatment and management of infectious diseases is a basic requirement for general practitioners. This article introduces our experience in the infectious disease rotation for general practice residency training, focusing on the rotation management at different stages of training to explore how to improve teaching quality and the ability of trainers in a short period of the rotation.

Reflection and suggestions on teaching and assessment model for standardized residency training of general practitioners / 中华全科医师杂志

A well - established residency standardized training system is crucial for cultivating qualified general practitioners(GPs). The syllabus has regulated the goals, objectives, contents and forms of training, but not proposed the concrete and effective teaching and assessment models. This article reflects the existing problems in GP training regarding teaching faculty,rotation plan, outpatient teaching, feedback and evaluation mechanisms as well as the assessment methods and contents,the article also gives specific suggestions for future improvement in order to train competent GPs.

Case-based learning: individualized treatment and comprehensive management for early diabetic kidney disease / 中华全科医师杂志

Diabetic kidney disease (DKD) is a common microvasscular complication in diabetic patients.It is necessary for general practitioner to recognize the early DKD,and give individualized treatment and comprehensive management.This article presents a patient with diabetic kidney disease,to whom individualized treatment and comprehensive management were given.Hopefully the case-based learning would help general practitioners to early recognize DKD and to give timely treatment and effective control of diabetic nephropathy.

Case analysis of a male patient with uncomplicated urinary tract infection in general practice clinic / 中华全科医师杂志

Urinary tract infection(UTI)is a common disease of the urinary system. Based on a case of male outpatient with primary acute uncomplicated pyelonephritis and the relevant guidelines, this article analyzes the identification, diagnosis and differential diagnosis as well as comprehensive management of uncomplicated upper urinary tract infection, in order to provide information and clinical thinking for general practitioners.

Exploration of English salon teaching on general practice / 中华医学教育探索杂志

This research summarized the exploration of English salon teaching on students in Department of General Practice,Peking University Health Science Center,illustrating thatthis teaching method was helpful to improve the students' English proficiency and theory of medicine,to promote communication and cohesion of the department,and to enhance the GP concept and competency.Based on the existing problems of English salon teaching,this research put forward the corresponding countermeasures so as to provide optimizing reference for teaching of GP,which included:(1)To encourage students to be active to participate inEnglish salon,correct the students' learning attitude and improve their learning methods,pay attention toteaching skills and take advantage of situational dialogue training methods;(2)To cultivate students' clinical thinking of diagnosis and treatment,urge the students to refer toliterature in time,takenotes and solve problemsas appropriate,as well as to promote supervisors' participation;(3)To recommend English salon teaching as an extension for thedelayed case-sharing.

Current status of antibiotic use for common cold and related factors / 中华全科医师杂志

Common cold is the most common upper respiratory tract infection.No antibiotic use for common cold has been international consensus,while the irrational antibiotic use and subsequent antibiotic resistance become an important issue of public health security.This article reviews the current status of antibiotic use for common cold and its related factors.

Summary and optimization for standardized training of general practitioners in the pediatric department / 中华医学教育探索杂志

As a powerful reserve force for primary care institutions, general practitioners (GPs) undergoing standardized training will be essential to solve the pediatric problems of first visit to primary medical institutions and coordinated care delivery system in the future, which puts forward new require-ments for the training of post competencies of GPs.However,the training and evaluating systems for GPs in Pediatric Department still need further exploration. This article tried to summarize the two-month rotating arrangement and its advantages for GPs in Pediatric Department of a general hospital.Based on the forgotten theoretical knowledge,superficial understanding of the diseases and individual teachers' poor teaching moti-vation, this article suggested reinforcing the theoretical basis of GPs through exploring multiple learning channels and increasing self-learning enthusiasm,strengthening the training and rewarding system of teachers to promote the specialist-GPs teaching, as well as promoting the set-up of Department of General Practice and taking the advantage of key disciplines in teaching hospitals to develop characteristic teaching model of general practice.

Determination of Levofloxacin Hydrochloride Ophthalmic in situ Gel by HPLC / 中国药师

Objective:To establish an HPLC method for the determination of levofloxacin in levofloxacin hydrochloride ophthalmic in situ gel. Methods:The chromatographic column was Agilent Zorbax C18(150 mm ×4.6 mm,5μm). The mobile phase consisted of hexane sulfonic acid sodium solution-methanol(72∶28). The flow rate was 1. 0 ml·min-1. The detection wavelength was 293 nm. The chromatographic column temperature was 40℃. The injection volume was 10 μl. Results:The calibration curve was linear within the range of 0. 040 3-0. 403 0 mg·ml-1(r=1. 000 0) for levofloxacin. The average recovery was 99. 8% (RSD=1. 08%,n=9). Conclusion:The method is accurate, simple and rapid, and suitable for the content determination of levofloxacin in levofloxacin hydro-chloride ophthalmic in situ gel.

Common variants in PERK, JNK, BIP and XBP1 genes are associated with the risk of prediabetes or diabetes-related phenotypes in a Chinese population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Prediabetes is an early stage of β-cell dysfunction presenting as insulin resistance. Evidences suggest that endoplasmic reticulum (ER) stress is involved in the pathogenesis of type 2 diabetes mellitus and prediabetes. In a Chinese population with prediabetes, we investigated single nucleotide polymorphisms (SNPs) in the genes of PERK, JNK, XBP1, BIP and CHOP which encode molecular proteins involved in ER stress pathways.</p><p><b>METHODS</b>Nine SNPs at the PERK, JNK, XBP1, BIP and CHOP loci were genotyped by mass spectrometry in 1 448 unrelated individuals. By using a 75 g oral glucose tolerance test (OGTT), 828 subjects were diagnosed as prediabetes and 620 subjects aged 55 years and over as normal controls based on WHO diagnostic criteria (1999) for diabetes mellitus.</p><p><b>RESULTS</b>The allele C of SNP rs867529 at PERK locus was a risk factor for prediabetes, with the carriers of C allele genotype at a higher risk of prediabetes compared to non-carriers (OR = 1.279, 95% CI: 1.013-1.614, P = 0.039, after adjustment for age, sex and body mass index (BMI). The SNPs rs6750998 at PERK locus was associated with homeostasis model assessments of insulin resistance (HOMA-IR) (P = 0.019), and rs17037621 with BMI (P = 0.044). The allele G of SNP rs10986663 in BIP gene was associated with a decreased risk of prediabetes (OR = 0.699, 95% CI: 0.539-0.907, P = 0.007). The SNP rs2076431 in JNK gene was associated with fasting plasma glucose levels (P = 0.006) and waist-hip ratios (P = 0.019). The SNP rs2239815 in XBP1 gene was associated with 2-hour plasma glucose levels after 75 g oral glucose load (P = 0.048) in the observed population.</p><p><b>CONCLUSION</b>Common variants at PERK and BIP loci contributed to the risk of prediabetes, and the genetic variations in JNK and XBP1 genes are associated with diabetes-related clinical parameters in this Chinese population.</p>

The syndrome of inappropriate antidiuretic hormone secretion: the level on its diagnosis and treatment should be improved / 中华内分泌代谢杂志

The syndrome of inappropriate antidiuretic hormone secretion ( SIADH ),characterized with dilutional hyponatremia,is the most frequent pathophysiology of euvolemic hyponatremia in hospital inpatients.Conventional therapies for SIADH include fluid resriction,saline infusion,and some pharmacologic adjustments of fluid balance.For various reasons,conventional therapies show poor efficiency.Vasopressin receptor antagonist,a new class of pharmacologic agent,can directly block vasopressin-mediated receptor activation and target underlying pathophysiology of SIADH.

Linkage Analysis of Chromosome 7p22 Region in a Chinese Pedigree with Familial Hyperaldosteronism Type Ⅱ / 中华高血压杂志

Background Familial hyperaldosteronism type Ⅱ(FH-Ⅱ) is characterized by autosomal dominant inheritance and hyperaldosteronism.Linkage analysis demonstrated chromosome 7q22 most likely harbor the genetic defect.Objective To identify the disease locus in a Chinese pedigree with FH-Ⅱ using genetic linkage analysis.Methods Haplotypes of the FH-Ⅱ pedigree were analyzed using four microsatellite markers(D7S531,D7S2521,D7S511,D7S481) at 7p22 to determine the critical region,and multipoint logarithm of odds(LOD) scores were calculated to assess linkage with FH-Ⅱ.Results Several members(affected members) in the family had hypertension,hypokalemia,hyperaldosteronism,low renin activity.Hypertension and hypokalemia was improved by spironolactone test.Dexamethasone suppression test was performed but without clinical or hyperaldosteronism improvement in three affected members,confirmed FH-Ⅱ family pedigree.The same haplotypes D7S531(ac,n=24)-D7S2521(ac,n=11)-D7S511(ca,n=21)-D7S481(ac,n=16) were shared by all known affected members and one suspicious member,but also by one unaffected member of the family,making it unlikely that this region contains the causative gene mutation.In this FH-Ⅱ family,the LOD scores of the four markers were

Inhibitory effect of metformin on TNF-? expression in hepatic tissue of OLETF rats / 基础医学与临床

Objective To investigate the TNF-? expression in hepatic tissue of Otsuka Long-Evans Tokushima Fatty(OLETF) rats(an insulin resistance model) with abnormalities of glucose-lipid metabolism and effect of metformin on TNF-? expression.Methods OLETF rats were randomly assigned to two groups(OLETF and OLETF/M).The OLETF/M group was treated with metformin [100 mg/(kg?d)],the OLETF group and age-matched LETO(nondiabetic Long-Evans Tokushima Otsuka rats) group were fed with placebo.Twenty-two weeks after treatment,we analyzed hepatic triglyceride level and measured expression of TNF-? by western-blot(protein) and quantitative RT-PCR(mRNA).Results Twenty-two weeks after treatment,the level of fasting glucose,insulin,triglyceride,free fatty acids(FFA) and hepatic triglyceride increased significantly in OLETF group as compared with LETO group.Western-blot method showed upregulated expression of TNF-? protein in OLETF group(1.57-fold vs LETO group,P

Spontaneous pregnancy in a patient with lymphocytic hypophysitis / 北京大学学报(医学版)

Lymphocytic hypophysitis(LH) is a rare but increasingly recognized autoimmune endocrine condition that causes partial or total hypopituitarism and is often associated with peripartum young women.We here report a 28-year-old patient who had a spontaneous and uneventful pregnancy following LH that had been treated with transspenoidal surgery and followed by anti-inflammatory agent.The woman failed to lactate and developed frontal headaches 3 months after normal delivery of her first child 3 years ago.Lab test showed the reduced concentrations of thyroxine,estradial and cortisol,suggesting hypopituitarism.Magnetic resonance imaging of the brain with contrast was performed and showed a uniformly enhancing pituitary mass with elevated optic chiasm.She underwent transsphenoidal surgery and histological examination of the resected specimen was consistent with lymphocytic hypophysitis.Anti-inflamation was started with prednisolone 40 mg per day because of a recurrence of headache that had completely recovered after surgery and regularly withdrawn to a long term maintenance dose of 10 mg per day.Physiological thyroxine replacement therapy was maintained.Her menstruation was restored without sex hormone replacement after 3 months.Three years after surgery,she got pregnant spontaneously and had normal breastfeeding after delivery.LH did not recur during this peripartum.

Nesidioblastosis in an adult with type 2 diabetes mellitus:A case report / 北京大学学报(医学版)

Adults-onset nesidioblastosis,as a differential diagnosis of organic hyperinsulinemic hypoglycemia,is very rare and has been recognised as "noninsulinoma pancreatogenous hypoglycaemia syndrome(NIPHS)".Here we described an extremely rare case of NIPHS in an eldly type 2 diabetes mellitus with insulin therapy.A 84-year old male was diagnosed as type 2 diabetes six years ago and switched from an oral hypoglycemic drug to pro-mixed insulin treatment 3 years ago.According to medical records,he had good-glucose control over few hypoglycemia.He was admitted to hospital due to frequent fasting hypoglycaemic episodes and comas despite withdrawal of any anti-diabetes drugs and continous infusion of homogenate meal at night.Lab test showed low fasting glucose level and inappropriate high insulin/C-peptide level,and anti-insulin antibody was negative.A characteristic of hyperinsulinemic hypoglycemia with high C-peptide level was consistent with the possible diagnosis of insulinoma,but localizing studies including computed tomography of the abdomen and somatostatin receptor scintigraphy were negative.Surgical exploration by the palpation and intraoperative ultrasonography failed to detect any mass in the pancreas and 70% distal pancreatectomy was performed.Histological examination of the resected pancrease revealed an increased number and size of islets consistent with nesidioblastosis.After transient decline,his serum insulin travelled back to the level before pancreaectomy,but recurrent fasting hypoglycemia was mild and controlled by regular night eating postpancreaectomy.Abstract:SUMM ARY Adults-onset nesid ioblastosis,as a d ifferential d iagnosis of organic hyperinsulinem ic hypo-glycem ia,is very rare and has been recognised as"noninsulinoma pancreatogenous hypoglycaem ia syn-drome(NIPHS)".Here we described an extremely rare case ofNIPHS in an eldly type 2 d iabetesmelli-tus with insulin therapy.A 84-year old male was d iagnosed as type 2 d iabetes six years ago and switched from an oral hypoglycem ic drug to pro-m ixed insulin treatment 3 years ago.Accord ing tomed ical records,he had good-glucose control over few hypoglycem ia.He was adm itted to hospital due to frequent fasting hypoglycaem ic episodes and comas despite withdrawal of any anti-d iabetes drugs and continous infusion of homogenate meal at night.Lab test showed low fasting glucose level and inappropriate high insulin /C-peptide level,and anti-insulin antibody was negative.A characteristic of hyperinsulinem ic hypoglycem ia with high C-peptide level was consistentwith the possible d iagnosis of insulinoma,but localizing stud ies includ ing computed tomography of the abdomen and somatostatin receptor scintigraphy were negative.Surgical exploration by the palpation and intraoperative ultrasonography failed to detect any mass in the pancreas and 70% d istal pancreatectomy was performed.H istological exam ination of the resected pancre-ase revealed an increased number and size of islets consistent with nesid ioblastosis.After transient de-cline,his serum insulin travelled back to the level before pancreaectomy,but recurrent fasting hypoglyce-m ia was m ild and controlled by regular night eating postpancreaectomy.

Reninoma / 中国实用内科杂志

A reninoma is a renal juxtaglomerular cell apparatus tumor that produces excessive amounts of renin,resulting in secondary hyperaldosteronism,and associated hypertension and hypokalemia.It is a rare form of secondary hypertension and occurs mainly in young adult females.Common symptoms include headache,nocturia,polyuria,polydipsia,and fatigue.Imaging examination and selective renal vein sampling has been the traditional method of localizing the tumour.The diagnosis should be considered in all patients with hypertension and hypokalemia and no evidence of primary hyperaldosteronism and renal artery stenosis.Reninoma represents a surgically correctable cause of hypertension.

Research on amnesia improving effect of alcohol extract of Rhoponticum uniflorum / 中成药

Objective: To study the effects of the alcohol extract of Loulu (AEL) on the ability of learning and memory in mice and on the activity of cholinesterase in brain and whole blood.Methods: In order to establish the effect of the alcohol ectract of Loulu on the ability of learning and membory in mice, the methods of one trial passive avoidance response(step down test) were used. Results: The AEL could antagonize the acquisition impairment of memory induced by scopolamine (SCPL) and the consolidation disruption of memory elicited by cycloheximide (CYC), inhibit the activity of cholinesterase in brain and whole blood. Conclusion: The improving effect of the AEL on the ability of learning and memory might be related with its effect of improving function of the central cholinesterase system.