A survey on teaching ability of general practitioners in community health centers of Shanghai and its influencing factors / 中华全科医师杂志

Objective:To survey the teaching ability of general practitioners(GPs) in community health centers of Shanghai, and its influencing factors.Methods:A questionnaire survey on the teaching ability of general practice trainers was conducted from January to February 2017. The participants of the survey were GPs with teaching experiences from community health centers in Shanghai selected by a stratified and proportional cluster sampling method. The questionnaire included two aspects: the general information and teaching ability of the participants. The influencing factors of teaching ability were analyzed by univariate and multivariate regression analysis.Results:A total of 1 138 GPs from 116 selected community health centers participated in the questionnaire survey, among whom 63.6% (724/1 138) worked in community teaching bases and 78.5% (893/1 138) had received training for trainers. The total score of teaching ability was 38.00 (30.00, 40.00). The score of the item"interesting in teaching"was (3.46±0.80), 75%—80% of the other questions answered "yes". The score of"application of multi-teaching methods"was (3.78±0.72). Multivariate analyses showed that working for 5—9 and 10—19 years [ OR=7.14 (2.47—11.81), P=0.003; OR=5.32 (1.30—9.33), P=0.009], working in community teaching bases [ OR=13.23 (9.88—16.57), P<0.001] and receiving training for trainers [ OR=17.76 (13.80—21.71), P<0.001] were influencing factors of teaching ability. Conclusion:The main problems related to teaching ability in community GPs are lack of teaching interest and the poor application of multi-teaching methods, the relevant training is necessary for them in the future.

Investigation on status quo and needs of pharmaceutical training among general practice faculty / 中华全科医师杂志

Objective:To investigate the current situation and needs of pharmaceutical training for general practice faculty.Methods:A self-designed questionnaire survey was conducted in April 2019. The participants were general practice faculty attending the national training course in Zhongshan Hospital and selected by convenience sampling method.Results:A total of 219 general practice teachers participated in the survey, 51.14% (112/219) of the participants thought that the current pharmaceutical knowledge did not meet the needs of pharmaceutical services in daily work, and 67.58% (148/219) attended pharmacy related training every year, and the frequency was mainly 1—2 times per year (56.62%, 124/219). The main reasons for attending the training were working needs (68.24%, 101/148) and willingness (55.41%, 82/148); 63.51% (94/148) of the participants thought that the training was moderate or less effective, mainly because of the weak strength of trainers (40.54%, 60/148), insufficient attention paid by trainers (37.16%, 55/148) and lack of depth (37.16%, 55/148). The survey showed that 76.26% (167/219) of general practice teachers had pharmaceutical training needs; and gender, working years and working experience in secondary and/or tertiary hospitals were influencing factors for pharmaceutical training needs. And female faculty, those working less than 10 years and with working experience in secondary hospitals had higher demand for pharmaceutical training. The expected pharmaceutical training focused primarily on the selection and optimization of medication schemes (72.60%, 159/219), interaction/incompatibility between medicines (62.10%, 136/219) and pharmaceutical care in medical treatment (57.08%, 125/219). The expected training methods were mainly interactive case analysis and discussion (69.41%, 152/219) through the internet or APP (such as WeChat) (54.34%, 119/219); the expected training frequency was no more than once in two months (36.07%, 79/219), better in working time (48.86%, 107/219) and each session was 30—45 minutes (38.36%, 84/219).Conclusion:General practice faculty has a high demand for pharmaceutical training. Targeted, individualized and systematic pharmaceutical training courses should be developed according to the pharmaceutical training needs of participants.

Research advances on the correlation between gut microbiota and depression / 中华全科医师杂志

Major depressive disorder (MDD) is a type of mood disorder characterized by a significant and persistent group of depressive symptoms. Gut microbiota may play a critical role in the pathogenesis of MDD. It has been found that the gut microbiota composition of MDD patients is significantly different from that of healthy controls, and depression phenotype can be transferred to rodents by fecal microbiota transplantation. Nevertheless, the mechanism of gut microbiota dysbiosis contributing to depression is complicated, and it is currently accepted that the microbiota-gut-brain axis is a crucial part. A set of probiotics and prebiotics have been found to have antidepressant properties, and related microbial therapies are expected to become an important method for treating depression and other mental diseases in the future.

Prevalence and influencing factors of generalized anxiety disorder among disabled people in Shanghai Jing'an district / 中华全科医师杂志

Objective To survey the status of generalized anxiety disorder (GAD) among disabled people in Shanghai Jing'an district and to investigate the influencing factors.Methods A cross-sectional study was conducted in January to March 2016 among the disabled residents in Shanghai Jing'an district.The general information was collected with questionnaire;the GAD status was rated with the Chinese version of 7-item Generalized Anxiety Disorder Scale;the influencing factors related to GAD was examined with Logistic regression analysis.Results Among 1 417 participants there were 713 males (50.3％) and 704 females (49.7％).The highest proportion of disability was disabled limb (n=742,52.4％).The grade 4 disability (mild) accounted for 45.9％ (650/1 417),and the grade 1 and 2 disability (severe) accounted for 13.6％ (190/1 417) and 15.2％ (212/1 417),respectively.There were 347 participants positive for GAD screening (GAD≥5) with a positive rate of 24.5％:24.3％ for males and 24.1％ for females (x2=0.007,P=0.960).The rates of mild,moderate and severe GAD were 19.1％,3.5％ and 1.1％,respectively.Multi-factor analysis showed that subjects with severe disability (vs.mild disability,/β=0.575,P=0.003),those unable activities of daily living (ADL) (vs.normal ADL,β=0.034,P=0.000)were nore likely to lead to GAD.There was a lower risk of GAD for people with high school or junior college education than those with bachelor degree or above (P＜0.05).The frequency of GAD in the disables aged 18-40 years was lower (P＜0.05).Conclusion The GAD positive rate of disabled people in Shanghai Jing'an district is relatively high.Severe disability,ADL disorder,educational level and age are the factors affecting the prevalence of GAD.

Application of GAD-7 in population screening for generalized anxiety disorder / 中华全科医师杂志

Generalized anxiety disorder (GAD) is one of the most common anxiety disorders.However,the diagnosis of GAD is difficult,GAD has the lowest diagnostic reliability among anxiety disorders and is often neglected.This article reviews the application of the General Anxiety Disorder-7 (GAD-7) in population screening for GAD,focusing on its history of development and the scope of unilization.

Application of e-health among patients visiting community healthcare centers in Shanghai / 中华全科医师杂志

Objective@#To exmine the status and perspectives of e-health among patients in Shanghai community health center.@*Methods@#In November 2014, a semi-open and in-depth qualitative interview was conducted among 40 patients from two community health service centers in Shanghai. According to the results of the interview, a self-made questionnaire was designed and a cross-sectional survey was carried out from March 2015 to May 2015. Eight districts or counties of Shanghai were randomly selected, and one community health service center was randomly selected from each district or county. Total 480 patients who visited the selected center participated in the survey. The main contents of the interviews and questionnaires included: the current status of communication using information and communication technologies (ICT) in patient daily life; the status of the communication with medical personnel by using ICT; the attitudes and perspectives of patients in applying ICT for medical service; and views on e-health development.@*Results@#Among the participants, 25.0%(10/40) of the interviewees and 16.7%(62/371)of the quesitionnaire surveyees had experience of using e-health. Among the questionaired patients, telephone-call was the most common method for communication with doctors (90.3%, 335/371), followed by short message (16.1%, 60/371) and wechat (12.9%, 48/371). Illness consulting is the most common perpurse for communication(64.5%, 40/62), followed by medicine advice(40.3%, 25/62) and sudden physical help(24.2%, 15/62). Among the participants, 56.3%(209/371)of whom thought that e-health should be promoted in the community, 69.4% (145/209) of whom thought that it could save time and effort; among the patients not using or considering unnecessary to use e-health, 87.6% (142/162) of whom thought they lived closer to the hospital and easy to access.@*Conclusion@#At present, less patients have the experience of using e-health, but more than half of them believe that it is necessary to use e-health and it should be promoted in the community healthcare.

Smoking status among people with disabilities in Shanghai Jing′an District / 中华全科医师杂志

Objective To survey on the smoking status among people with disabilities in Shanghai Jing′an District.Methods A cross-sectional questionnaire survey on smoking status among people with disabilities was conducted from July to December 2015 in 5 communities of Shanghai Jing′an District. Results Total 1 815 valid questionnaires were collected.Among all participants,278 were smokers with an overall smoking rate of 15.3%(278/1 815); the smoking rate in males was 28.1%(265/944)and in females was 1.5%(13/871).The disables people aged 45 -60 years had the highest smoking rate (23.4%,141/602).The nicotine dependence rate in regular smokers accounted for 74.6%(182/244). The nicotine dependence was mainly mild to moderate, and the average of Fagerstrom Test of Nicotine Dependence(FTND)score was 3.75 ±1.97.Most participants(90.8%,238/262)were aware of the harm of smoking to health,but the awareness rate of health hazards of second-hand smoke was only 59.5%(156/262).The awareness rates of tobacco-related diseases were all lower than 70%.The rate of quitting was 33.5%(93/278),but only 17.2%(16/93)succeeded;66.0%(173/262)of the smokers did not intend to quit,only 15.3%(40/262)started to quit or to reduce the smoking;and 83.6%(219/262)of current smokers thought that it was impossible to quit smoking.Conclusion The smoking rate in people with disabilities is lower than that in the general population,the awareness of the harm of second-hand smoke is low and there is lack of knowledge of tobacco related diseases;the intend of quitting is low but the success rate of smoking cessation is high among people with disabilities in Shanghai Jing ′an District.

Survey on the quality of life of disabled people in Shanghai Jing'an district and analysis of influencing factors / 中华全科医师杂志

Objective To survey the quality of life of disabled people in Shanghai Jing'an district and to analyze the influencing factors.Methods A face-to-face interview was conducted among 1 831 disabled people from 5 communities of Jing'an district between September 2015 and January 2016.The quality of life was evaluated with Modified Barthel Index (MBI),12-Item Short Form Health Survey (SF-12) and Patient Health Questionnaire (PHQ).Results There were 941 males and 870 females among 1 815 qualified participants.There were 433 cases of visual disability (23.86％),222 cases of hearing disability (12.23％),20 cases of language disability(1.10％),742 cases of limb disability (40.88％),169 cases of intelligent disability (9.31％),198 cases of mental disability (10.91％) and 31 cases (1.71％) of multiple disabilities.The SF-12 showed that the mean scores of both physical aspect and mental aspect were 50.0 ± 10.0.Multiple linear regression showed showed that the low self-care ability of daily life (β =0.24,P =0.00),depression (β =-9.65,P =0.00) and high serum lipids (β =-2.36,P =0.02) were associated with the quality of life.Conclusion The study indicates that the quality of life of the disabled people in Jing'an district is generally low,which is affected by various factors.

Insulin resistance and serum resistin levels in patients with systemic lupus erythematosus / 中华皮肤科杂志

bnormality in these parameters was improved.

Application of standardized patients in teaching of communication skills for medical students / 中华全科医师杂志

The case design,standardized patients(SPs)training and training communication skills for medical students with SPs were illustrated in this paper.And our experiences of SPs using Were summarized.

Internalization and down-regulation of the epidermal growth factor receptor in a human keratinocyte cell line HaCaT / 中华皮肤科杂志

Objective To understand the molecular mechanism underlying the epidermal growth factor receptors(EGFR)signal transduction and its feed-back regulation.Methods Two human keratinocyte cell lines,HaCaT and CHOwt,were cultured and treated with a certain concentration of different ligands,including epidermal growth factor(EGF),heparin-bounding(HB)-EGF,transforming growth factor α (TGFα)and heregulin(HER),for various durations(2,4,8,16,20 hours).After the treatment,cells were collected and protein was extracted.The amount of total and active EGFR was measured by immunoprecipitation and immunoblot assay.The internalization and down-regulation of EGFR were visualized with immunofluorescence and laser seanning confocal microscopy.Results As shown by immunoblot technique,EGF and HB-EGF continuously down-regulated the total amount of EGFRs,whereas TGFα and HER had no significant effect on the degradation of EGFRs.The activation of EGFRs was also attenuated to different extent after long-time treatment with EGF,HB-EGF and TGFα.As indirect immunofluorescenee revealed,in untreated HaCaT and CHOwt cells,EGFRs were essentially located at the plasma membrane,with a little cytosolic distribution;after ten-minute treatment with EGF,EGFRs clustered into patch-like structures which were particularly obvious in HaCaT cells,and translocated into cytoplasmic vesicles resembling endosomes (relatively apparent in CHOwt cells),while the total amount of EGFRs remained constant in these cells.The fluorescence signal from the total EGFRs decreased evidently after four-hour treatment with EGF,indicating a strong reduction in the receptors.Conclusions EGF and HB-EGF,but not TGFα or Heregulin,could down-regulate the amount of total and active EGFRs.There might be different mechanisms for the signal transduction related to EGFRs intemalization and down-regulation between HaCaT and CHOwt cells.

1,25-Dihydroxyvitamin D3 and Its Analogues Modulate the Expression and Secretion of IL-10 by Human Monocyte-derived Dendritic Cells / 中华皮肤科杂志

Objective To elucidate the therapeutic mechanism of 1,25-dihydroxyvitamin D3 and its analogues in psoriasis. Methods The modulating role of calcitriol, calcipotriol and tacalcitol on the expression and secretion of IL-10 in monocyte-derived dendritic cells (MDDCs) was investigated. Human monocytes were differentiated into MDDCs in vitro in the presence of GM-CSF and IL-4. Semi-quantitative RT-PCR and ELISA were used to analyze the mRNA expression and protein production of IL-10 in MDDCs. In each experi-ment, 24,25-dihydroxyvitamin D3 (a vitamin D3 metabolite with a low affinity to the vitamin D receptor) was used as a control. Results The mRNA expression and protein secretion of IL-10 in MDDCs was up-regulated by calcitriol, calcipotriol or tacalcitol with a similar potency, but not by 24,25-dihydroxyvitamin D3. The up-regulatory role of calcitriol on IL-10 protein secretion was dose dependent. Conclusion The therapeutic effect of calcitriol and its analogues in the treatment of psoriasis may be related to the induction of IL-10 production.

Expression of CD25and CD69on T Cells of Patients With Psoriasis Vulgaris / 中华皮肤科杂志

0.05).Expression of CD25and CD69on CD8 + T cells was significantly higher in patients(16.30%?5.97%and32.61%?6.36%)than that in control group(9.21%?2.14%and10.03%?2.35%)(P

Differentiation of Monocyte derived Dendritic Cells in Patients with Psoriasis / 中华皮肤科杂志

Objective To investigate the differentiation of dendritic cells from monocytes of the peripheral blood in patients with psoriasis. Methods Flow cytometry was used to analyze the phenotype of monocyte derived dendritic cells (MoDC). The capacity of MoDC to stimulate the proliferation of T lymphocytes was evaluated by allogeneic mixed lymphocyte reaction. Results Monocytes in the peripheral blood of patients with psoriasis could differentiate into dendritic cells. Expression of CD40, CD80, CD86 and HLA-DR by MoDC was significantly increased in patients with psoriasis compared with that in normal controls (P