A controlled clinical study of a two-trocar mini-laparoscopic technique versus the standard laparoscopic technique in treatment of adult renal cysts.

INTRODUCTION: Laparoscopic renal cyst decortication is currently the best choice for the treatment of simple renal cysts and is widely used in clinical practice. AIM: To investigate the safety and clinical efficacy of two-trocar mini-laparoscopic decortication of adult renal cysts. MATERIAL AND METHODS: A total of 90 patients were enrolled in the study and randomly divided into two groups: a two-trocar mini-laparoscopic treatment group (M group) and a three-trocar standard laparoscopic treatment group (S group), with 45 patients in each group. RESULTS: The average length of hospital stay was shorter, and the demand for postoperative analgesics was less in the M group than in the S group (p < 0.05). The proportion of "very satisfied" patients in the patient physical recovery satisfaction survey was significantly higher in the M group than in the S group (p < 0.05). Of the 45 patients in the M group, 40 successfully underwent surgery. In 3 patients, the two-trocar procedure was converted to a three-trocar procedure due to difficulty in separating perirenal adhesion for visualization. Mini-laparoscopic surgery was converted to classic laparoscopic surgery in 2 patients. In the S group, 44 patients successfully underwent the renal cyst decortication procedure. One patient underwent partial renal resection due to an intraoperative diagnosis of multilocular cystic renal cell carcinoma. Postoperative urine leakage was reported in 3 patients in the M group and two in the S group. CONCLUSIONS: Two-trocar mini-laparoscopic treatment of renal cysts is as safe and effective as traditional laparoscopy but is associated with less cosmetic damage, leading to a better physical appearance.

Resolving the Dilemma of Fe-N-C Catalysts by the Selective Synthesis of Tetrapyrrolic Active Sites via an Imprinting Strategy.

Combining the abundance and inexpensiveness of their constituent elements with their atomic dispersion, atomically dispersed Fe-N-C catalysts represent the most promising alternative to precious-metal-based materials in proton exchange membrane (PEM) fuel cells. Due to the high temperatures involved in their synthesis and the sensitivity of Fe ions toward carbothermal reduction, current synthetic methods are intrinsically limited in type and amount of the desired, catalytically active Fe-N4 sites, and high active site densities have been out of reach (dilemma of Fe-N-C catalysts). We herein identify a paradigm change in the synthesis of Fe-N-C catalysts arising from the developments of other M-N-C single-atom catalysts. Supported by DFT calculations we propose fundamental principles for the synthesis of M-N-C materials. We further exploit the proposed principles in a novel synthetic strategy to surpass the dilemma of Fe-N-C catalysts. The selective formation of tetrapyrrolic Zn-N4 sites in a tailor-made Zn-N-C material is utilized as an active-site imprint for the preparation of a corresponding Fe-N-C catalyst. By successive low- and high-temperature ion exchange reactions, we obtain a phase-pure Fe-N-C catalyst, with a high loading of atomically dispersed Fe (>3 wt %). Moreover, the catalyst is entirely composed of tetrapyrrolic Fe-N4 sites. The density of tetrapyrrolic Fe-N4 sites is more than six times as high as for previously reported tetrapyrrolic single-site Fe-N-C fuel cell catalysts.

Laparoscopic Orthotopic Kidney Transplantation in Swine: A Novel Vascular Prop Device for Venous Anastomoses.

Objective: To investigate the safety and efficacy of a vascular prop device for laparoscopic orthotopic kidney transplantation (LOKT) in swine. Material and Methods: Twenty swine were randomly divided into two groups. A vascular prop device was used in the observation (VP) group, and the vein beltization technique was used in the control (VB) group. The right kidney, as a donor graft, was laparoscopically transplanted to the location of the left kidney after a left nephrectomy. Data on the operative time, venous anastomotic time, vein stenosis, etc., and the survival of the swine in the two groups were recorded. Results: The mean transplant operative time, the mean cold ischemia time, and the venous anastomotic times in the VP group were significantly shorter than those in the VB group. Seven swine in the VP group and three swine in the VB group survived for 7 days. Autopsy results showed the occurrence of one artery stenosis and one vein stenosis in the VP group and one artery stenosis and five vein stenoses in the VB group. The median survival time was 6.25 days for the swine in the VP group and 4.40 days for those in the VB group. Conclusions: The vascular prop device is safe and feasible for LOKT in swine and may accelerate venous anastomosis and ensure the quality of venous anastomotic stoma.

Clinical Observation of UreTron Single-Probe Ultrasonic Intracorporeal Lithotripter for Ureteral Calculi.

OBJECTIVE: The present study aimed to observe and discuss the effectiveness and safety of the UreTron single-probe ultrasonic intracorporeal lithotripter in ureteroscopic lithotripsy. METHODS: The clinical data of patients with unilateral solitary ureteral calculi treated with ureteroscopic lithotripsy who were hospitalized at the Department of Urology (West District) of Beijing Chaoyang Hospital between March 2016 and August 2020 were selected for retrospective analysis. The patients were divided into the UreTron group (group U) and holmium laser group (group H) according to the lithotripsy method adopted. The operation duration, length of hospital stay, stone clearance rate, proportion of patients requiring flexible ureteroscopy-assisted lithotripsy, and complications were compared between the groups. RESULTS: There was no statistical difference between the groups in terms of the general characteristics, operation duration, or length of hospital stay (P > 0.05). Regarding the stone clearance rate (group U=93.5%; group H=75%), proportion of patients requiring flexible ureteroscopy-assisted lithotripsy (group U=6.5%; group H=27.8%), and incidence of surgical complications (group U=1 case; group H=9 cases), group U was superior to group H, and the differences between the groups were statistically significant (P < 0.05). However, the differences in other complications (cardiocerebral complications and lower extremity thrombosis) were not statistically significant between the groups (P > 0.05). CONCLUSION: The UreTron system is a new lithotripsy apparatus that is safe and effective for ureteroscopic lithotripsy and has certain advantages in terms of the stone clearance rate, proportion of patients requiring flexible ureteroscopy-assisted lithotripsy, and surgical complications, making it worthy of clinical application.

Comparison of 18 F-FDG PET/CT and 68 Ga-DOTATATE PET/CT in the Targeted Imaging of Culprit Tumors Causing Osteomalacia.

OBJECTIVE: To assess and compare the performance of fluorine-18-labeled fluorodeoxyglucose positron emission tomography (18 F-FDG-PET/ CT) and gallium-68-labeled tetraazacyclododecanetetraacetic acid-DPhe1-Tyr3-octreotate (68 Ga- DOTATATE) PET/CT in the targeted imaging of culprit tumors causing osteomalacia. METHODS: This was a clinical retrospective analysis. We analyzed 13 patients (five men, eight women; mean age, 49 years; range, 19-55 years) with suspicion of tumor-induced osteomalacia (TIO) between March 2017 and October 2019. All patients underwent two functional imaging methods to locate the culprittumors. Studies were performed on a PET/CT scanner. The injection doses of 18 F- FDG and 68 Ga-DOTATATE were 0.5mCi/kg and approximately 5.0mCi, respectively. In the two scans, the whole body was captured from head to toe 45 to 60 min after intravenous tracer injection. 68 Ga-DOTATATE PET/CT and 18 F-FDG PET/CT imaging results locate culprit tumors according to the following criteria: (i) abnormal foci uptake concentration was observed locally, and the uptake level was higher than the background level of the right lobe of the liver; (ii) combined CT showed or did not have obvious abnormal density changes; and (iii) non-specific ingestion lesions due to fracture, arthritis, necrosis of femoral head are excluded. Compared with the results of pathological examination and clinical follow-up, the sensitivity, specificity and accuracy of 68 Ga-DOTATATE PET/CT imaging and 18 F-FDG PET/CT imaging for TIO were analyzed. RESULTS: All patients had symptoms of osteomalacia and hypophosphatemia. The lag time (symptoms to PET diagnosis) ranged from 2 to 12 years. There were eight cases of TIO patients and five cases of non-TIO patients confirmed by surgery, pathology and follow-up. Among the eight TIO patients, there were six cases (75.0%) of PMTs, one case (12.5%) of giant cell tumor, one case (12.5%) of hemangiopericutoma. Most (n = 6, 75.0%) of the confirmed tumors in our patient population were in the lower extremities, followed by craniofacial regions (n = 1, 12.5%), and torso (n = 1, 12.5%), respectively. Among the five non-TIO patients, there were two cases of Fanconi syndrome, one case of rickets, and two cases of sporadic osteomalacia hypophosphorus. The culprit tumors could be located either in the bone (n = 5, 62.5%) or the soft tissue (n = 3, 37.5%). 18 F-FDG PET/CT was able to localize the tumor in six (6/13, 46.1%) patients. 68 Ga-DOTATATE PET/CT detected tumor in 8 (83.3%) of 13 patients. The sensitivity of 68 Ga-DOTATATE PET/CT imaging and 18 F-FDG PET/CT imaging in the evaluation of TIO in our patient population were 100% (8/8) vs 75% (6/8). The specificity of the two different methods was 80% (4/5). The overall accuracy was 92.3% (12/13) vs 76.9% (10/13). CONCLUSIONS: 68 Ga-DOTATATE PET/CT is very effective in assessing hypophosphatemia patients with TIO typical symptoms compared with 18 F-FDG. Therefore, in clinically suspected cases of hypophosphatemic osteomalacia, 68 Ga-DOTATATE PET/CT should be preferred as an imaging modality investigation to avoid delay in the treatment of this disease.

[PM2.5 Inversion Using Remote Sensing Data in Eastern China Based on Deep Learning].

PM2.5, which is a major source of air pollution, has a considerable impact on human health. In this study, a multi-element joint PM2.5 inversion method based on a deep learning model is proposed. With PM2.5 concentration as the ground truth, 10 elements including the Himawari-AOD daily data products, temperature, relative humidity, and pressure, were introduced as inversion elements. To verify the effectiveness of the method, the experiment was carried out by season using remote sensing data in Eastern China during 2016-2018. The results demonstrate that PM2.5 concentrations were positively correlated with AOD, precipitation, wind speed, and high vegetation cover index and negatively correlated with dwarf vegetation cover index. The correlation with temperature, humidity, pressure, and DEM changed with seasons. Comparative experiments indicated that the accuracy of PM2.5 inversion based on the deep neural network is higher than that of traditional linear and nonlinear models. R2 was above 0.5, and the error was small in each season. The R2 value for autumn, which showed the best inversion, was 0.86, that for summer was 0.75, that for winter was 0.613, and that for spring was 0.566. The visualization of the model illustrates that the inversion result of the DNN model is closer to the PM2.5 concentration distribution interpolated by the ground monitoring station, and the resolution is higher and more accurate.

EGFR/EGFRvIII remodels the cytoskeleton via epigenetic silencing of AJAP1 in glioma cells.

EGFR amplification and mutations are the most common oncogenic events in GBM. EGFR overexpression correlates with GBM invasion, but the underlying mechanisms are poorly understood. In a previous study, we showed that AJAP1 is involved in regulating F-actin to inhibit the invasive ability of GBM. In addition, in a GBM cell line, the AJAP1 promoter was highly bound by H3K27me3 and, through bioinformatics analysis, we found that AJAP1 expression was negatively correlated with EGFR. In this study, we found that the pathway downstream of EGFR had a higher activation level in GBM cell lines, which led to excessive tumor suppressor silencing. Therefore, we deduced that in glioma cells, the pathway downstream of EGFR remodels the cytoskeleton via AJAP1 epigenetic silencing to enhance invasion. Furthermore, MK2206 reversed AJAP1 downregulation by inhibiting the EGFR pathway. In vivo, MK2206 also inhibited the proliferation and local invasion of 87-EGFRvIII. These data suggest that activation of the EGFR signal transduction pathway genetically silences anti-oncogenes to enhance GBM malignancy. MK2206 might be a promising therapeutic for EGFR/EGFRvIII-positive GBMs.

A high sensitivity field effect transistor biosensor for methylene blue detection utilize graphene oxide nanoribbon.

In this work, we developed a field effect transistor (FET) biosensor utilizing solution-processed graphene oxide nanoribbon (GONR) for methylene blue (MB) sensing. MB is a unique material; one of its crucial applications is as a marker in the detection of biomaterials. Therefore, a highly sensitive biosensor with a low detection limit that can be fabricated simply in a noncomplex detection scheme is desirable. GONR is made by unzipping multiwall carbon nanotubes, which can be mass-produced at low temperature. The GONR-FET biosensor demonstrated a sensitivity of 12.5µA/mM (determined according to the drain current difference caused by the MB concentration change). The Raman spectra indicate that the materials quality of the GONR and the domain size for the C=C sp2 bonding were both improved after MB detection. X-ray photoelectron spectroscopy revealed that the hydroxyl groups on the GONR were removed by the reductive MB. According to XPS and Raman, the positive charge is proposed to transfer from MB to GONR during sensing. This transfer causes charge in-neutrality in the GONR which is compensated by releasing •OH functional groups. With high sensitivity, a low detection limit, and a simple device structure, the GONR-FET sensor is suitable for sensing biomaterials.

Deep microbleeds and periventricular white matter disintegrity are independent predictors of attention/executive dysfunction in non-dementia patients with small vessel disease.

BACKGROUND: Cerebral small vessel disease (SVD) is the common cause of cognitive decline in the old population. MRI can be used to clarify its mechanisms. However, the surrogate markers of MRI for early cognitive impairment in SVD remain uncertain to date. We investigated the cognitive impacts of cerebral microbleeds (CMBs), diffusion tensor imaging (DTI), and brain volumetric measurements in a cohort of post-stroke non-dementia SVD patients. METHODS: Fifty five non-dementia SVD patients were consecutively recruited and categorized into two groups as no cognitive impairment (NCI) (n = 23) or vascular mild cognitive impairment (VaMCI) (n = 32). Detailed neuropsychological assessment and multimodal MRI were completed. RESULTS: The two groups differed significantly on Z scores of all cognitive domains (all p < 0.01) except for the language. There were more patients with hypertension (p = 0.038) or depression (p = 0.019) in the VaMCI than those in the NCI group. Multiple regression analysis of cognition showed periventricular mean diffusivity (MD) (ß = -0.457, p < 0.01) and deep CMBs numbers (ß = -0.352, p < 0.01) as the predictors of attention/executive function, which explained 45.2% of the total variance. Periventricular MD was the independent predictor for either memory (ß = -0.314, p < 0.05) or visuo-spatial function (ß = -0.375, p < 0.01); however, only small proportion of variance could be accounted for (9.8% and 12.4%, respectively). Language was not found to be correlated with any of the MRI parameters. No correlation was found between brain atrophic indices and any of the cognitive measures. CONCLUSION: Arteriosclerotic CMBs and periventricular white matter disintegrity seem to be independent MRI surrogated markers in the early stage of cognitive impairment in SVD.

The CRISPR/Cas9 system targeting EGFR exon 17 abrogates NF-κB activation via epigenetic modulation of UBXN1 in EGFRwt/vIII glioma cells.

Worldwide, glioblastoma (GBM) is the most lethal and frequent intracranial tumor. Despite decades of study, the overall survival of GBM patients remains unchanged. epidermal growth factor receptor (EGFR) amplification and gene mutation are thought to be negatively correlated with prognosis. In this study, we used proteomics to determine that UBXN1 is a negative downstream regulator of the EGFR mutation vIII (EGFRvIII). Via bioinformatics analysis, we found that UBXN1 is a factor that can improve glioma patients' overall survival time. We also determined that the down-regulation of UBXN1 is mediated by the upregulation of H3K27me3 in the presence of EGFRvIII. Because NF-κB can be negatively regulated by UBXN1, we believe that EGFRwt/vIII activates NF-κB by suppressing UBXN1 expression. Importantly, we used the latest genomic editing tool, CRISPR/Cas9, to knockout EGFRwt/vIII on exon 17 and further proved that UBXN1 is negatively regulated by EGFRwt/vIII. Furthermore, knockout of EGFR/EGFRvIII could benefit GBM in vitro and in vivo, indicating that CRISPR/Cas9 is a promising therapeutic strategy for both EGFR amplification and EGFR mutation-bearing patients.

Intercalation-assisted longitudinal unzipping of carbon nanotubes for green and scalable synthesis of graphene nanoribbons.

We have demonstrated an effective intercalation of multi-walled carbon nanotubes (MWCNTs) for the green and scalable synthesis of graphene nanoribbons (GNRs) using an intercalation-assisted longitudinal unzipping of MWCNTs. The key step is to introduce an intercalation treatment of raw MWCNTs with KNO3 and H2SO4, making it promising to decrease the strong van der Waals attractions in the MWCNTs bundles and between the coaxial graphene walls of CNTs. Systematic micro Raman, X-ray photoelectron spectroscopy (XPS), and X-ray diffraction (XRD) characterizations suggest that potassium, nitrate, and sulfate ions play an important role in the CNT intertube and intratube intercalations during the pretreatment. Detailed scanning electron microscopy (SEM), transmission electron microscopy, XRD, and micro Raman characterizations indicate that the developed methodology possesses the ability to synthesis GNRs effectively with an improved CNT concentration in H2SO4 of 10 mg/ml at 70 °C, which is amenable to industrial-scale production because of the decreased amount of strong acid. Our work provides a scientific understanding how to enhance the GNR formation by accelerating the CNT longitudinal unzipping via suitable molecular intercalation.

[Preparation of Rubber Accelerator 3-Methylthiazolidine-2-Thione and Its Spectral Analysis].

In the study, rubber accelerator 3-methylthiazolidine-2-thione (MTT) was synthesized by one-step method firstly. MTT was detected and characterized by XRD, FTIR, TG-DSC. The micro-structure and intrinsic regularity were revealed. Chemical bond types into MTT molecule were revealed by FTIR. MTT phase composition and structure were given by crystallographic data from XRD detecting such as cell parameters, crystal face index. The phase composition and qualitative identification of MTT structure were completed. Two kinds of information were detected by TG-DSC as quality change and thermal effect. MTT phase transition and decomposition temperature were 76.3 and 306.9 ℃ respectively. The decomposition temperature of MTT was very high. It could provided reference with research on rubber vulcanizing properties by MTT on rubber vulcanizing machine. This study can provide the basis experimental data on the enterprises to designate the working standard tracing detection of MTT industrialized production. Performance index of MTT was judged.

[Preparation of Rubber Accelerator 3-Methylthiazolidine-2-Thione and Its Spectral Analysis].

In the study, rubber accelerator 3-methylthiazolidine-2-thione (MTT) was synthesized by one-step method firstly. MTT was detected and characterized by XRD, FTIR, TG-DSC. The micro-structure and intrinsic regularity were revealed. Chemical bond types into MTT molecule were revealed by FTIR. MTT phase composition and structure were given by crystallographic data from XRD detecting such as cell parameters, crystal face index. The phase composition and qualitative identification of MTT structure were completed. Two kinds of information were detected by TG-DSC as quality change and thermal effect. MTT phase transition and decomposition temperature were 76.3 and 306.9 ℃ respectively. The decomposition temperature of MTT was very high. It could provided reference with research on rubber vulcanizing properties by MTT on rubber vulcanizing machine. This study can provide the basis experimental data on the enterprises to designate the working standard tracing detection of MTT industrialized production. Performance index of MTT was judged.

Controllable Tailoring Graphene Nanoribbons with Tunable Surface Functionalities: An Effective Strategy toward High-Performance Lithium-Ion Batteries.

An effective, large-scale synthesis strategy for producing graphene nanoribbons (GNRs) with a nearly 100% yield has been proposed using a stepwise, solution-based, lengthwise unzipping carbon nanotube (CNT) method. Detailed Raman and X-ray photoelectron spectroscopy (XPS) analysis suggest that GNRs with tunable density of oxygen-containing functional groups on the GNR surfaces can be synthesized by adjusting the oxidant concentration during the CNT unzipping. The electrochemical characterization reveals that the as-produced GNRs with 42.91 atomic percent (atom %) oxygen-containing functional groups deliver a capacity of 437 mAh g(-1) after 100 cycles at 0.33C, while the as-produced GNRs with higher oxygen-containing functional groups only present a capacity of 225 mAh g(-1). On the basis of the electrochemical assessment and XPS analysis, the funtionals groups (epoxy-, carbonyl-, and carboxyl groups) in GNRs could be the effective contributor for the high-performance Li-ion batteries with appropriate adjustment.

[Dynamic studies on photosynthetic and growth characteristics of Angecila dahurcia].

Photosynthetic and growth characteristics of Angelica dahurica were studied in order to clarity the relations of photosynthesis, growth and root dry weight, and provide a theoretical basis for its cultivation. Photosynthesis and growth indexes were meas- ured every 25 days. The contents of chlorophyll a, b, a + b, soluble protein and the activities of Hill reaction, Ca(2+)-ATPase, Mg(2+)-ATPase had an increasing trend; They had the highest value in leaf high-speed growth period. Then, they were decreased in root high- speed growth period. The root dry weight showed negative corelation with photosynthetic characteristics indexes except stomatal con- ductance, however, the negative corelation only from net photosynthetic rate and Ca(2+)-ATPase were significant. The vegetative growth period of spring sowing A. dahuricia was divided into three phases: seedling period, leaf high-speed growth period and root high-speed growth period. The root dry weight showed a significantly positive corelation with the root diameter, leaf dry weight, shoot dry weight, aboveground dry weight. There was the competitive relation between aboveground and underground, so underground growth could be es- timated from leaf area and shoot dimeter.

Brief screening for mild cognitive impairment in subcortical ischemic vascular disease: a comparison study of the Montreal Cognitive Assessment with the Mini-Mental State Examination.

BACKGROUND AND PURPOSE: To assess the validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in the detection of vascular mild cognitive impairment (VaMCI) in patients with subcortical ischemic vascular disease (SIVD). METHODS: Among 102 SIVD patients, both cutoff scores of the MMSE and MoCA for differentiating VaMCI from no cognitive impairment (NCI) or differentiating VaMCI from vascular dementia (VaD) were determined by the receiver operator characteristic (ROC) analysis. Optimal sensitivity with specificity of cutoff scores was obtained after the raw scores were adjusted for education. RESULTS: After adjusting for education, the MoCA cutoff score for differentiating VaMCI from NCI was at 24/25 and that for differentiating VaMCI from VaD was at 18/19. After applying the adjusted MoCA scores from 19 to 24 to identify VaMCI in all SIVD patients, sensitivity was at 76.7% and specificity was at 81.4% (κ = 0.579). The adjusted cutoff score of the MMSE for differentiating VaMCI from NCI was at 28/29 and that for differentiating VaMCI from VaD was at 25/26. The sensitivity and specificity of the adjusted MMSE was at 58.1 and 71.2%, respectively, when using the score from 26 to 28 to identify VaMCI in SIVD patients (κ = 0.294). CONCLUSIONS: The MoCA detected subcortical VaMCI better than the MMSE.

[Effects of shade and competition of Chenopodium album on photosynthesis, fluorescence and growth characteristics of Flaveria bidentis].

It is necessary to elucidate its growth mechanism in order to prevent and control the further spread of Flaveria bidentis, an invasive plant in China. The effects of shading (shading rate of 0, 50% and 80%, respectively) and planting pattern (single cropping of F. bidentis, single cropping of Chenopodium album and their intercropping) on germination rate, fluorescence characteristics and growth characteristics of the two plants were investigated. The results showed that moderate shading contributed to emergence rate, but emergence rate of F. bidentis was not uniform, which was one of important factors as a stronger invader. With the increasing light intensity, net photosynthetic rate (Pn), photochemical quenching (qP), electron transport rate of PS II (ETR), quantum yield of PS II (Y), non-photochemical quenching (qN), water use efficiency (WUE), shoot bio-mass rate (SMR), crown width (CW) and dry biomass (DM) increased, specific leaf area (SLA) decreased, LMR of F. bidentis significantly increased, LMR of C. album changed insignificantly, and the increment of DM of F. bidentis was higher than that of C. album. In 80% shade treatment, Pn and DM of F. bidentis were lower than those of C. album. In natural light treatment, Pn, qN, WUE and relative competitive index (RCI) were the highest, CW and DM of intercropped F. bidentis and Pn, Y of C. album were significantly lower than that of the respective single treatment. F. bidentis had higher light saturation point (LSP) and light compensation point (LCP). In conclusion, the shade-tolerant ability of F. bidentis was weaker than that of C. album, but it was reversed in natural light treatment. The two plants adapted to the weak light in 80% shade treatment by increasing SLA and decreasing LMR. F. bidentis improved competition under natural light by increasing SMR and decreasing CW.

[A survey on the attitudes and confidence of general practitioners in handling dementia and its related problems].

OBJECTIVE: To investigate general practitioners (GPs)' attitudes and confidence in handling dementia and its related problems. METHOD: A questionnaire survey was conducted in GPs from Shanghai on 25th Sep, 2012. The questionnaire included the basic information of the GPs and their attitudes toward and confidence in handling dementia and its related problems. RESULTS: A total of 287 GPs from 73 hospitals participated in the survey.78.4% of them responded that they met fewer demented patients during their clinical practice and only 24.7% of them had attended some kinds of dementia-related knowledge training courses.Senior GPs were less enthusiastic than junior GPs in handling dementia and its related problems as they were more likely to think that dementia should be diagnosed by specialist (87.1% vs. 74.8%, OR = 2.28, 95%CI:1.14~4.57, P = 0.02), less likely to actively referral patients (22.0% vs. 10.1%, OR = 2.52, 95%CI:1.24~5.14, P = 0.01), and more likely to think about that GPs have very limited role in care of demented patients (9.7% vs. 0.7%, OR = 15.59, 95%CI:1.96~123.81, P = 0.00). CONCLUSION: The GPs in Shanghai are lack of trainings about the dementia and its' related knowledge and their attitudes toward the care of dementia are pessimistic. Thus, it is necessary to train the GPs more to enhance their confidence and enthusiasm in care of dementia.