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Objective:To survey the satisfaction and employment intention of general practice residents (GPRs) in Shanxi Province.Methods:A cross-sectional questionnaire survey was conducted in May 2021 among GPRs in Shanxi Province through the residency training information management platform. The questionnaire included general demographic information, clinical competency and independent practice ability, the status of the training base, their satisfaction with the training, career prospects and employment intention. The survey results were analyzed.Results:A total of 452 questionnaires were distributed, and 434 valid ones were recovered with an effective recovery rate of 96.02%. The age of respondents was (27.4±4.6) years, there were 155 GPRs (35.71%) enrolled in 2018, 131 GPRs (30.18%) in 2019, and 148 GPRs (34.10%) in 2020. A total of 286 GPRs (65.9%) thought that they were able to independently complete some procedures such as abdominal puncture, lumbar puncture, chest puncture, and bone puncture, and the proportion of GPRs who were able to complete the above procedures increased with the training time (49.3%(73/148), 70.2%(92/131), and 78.1%(121/155) in 2020, 2019, and 2018 batches, respectively, χ2=29.39, P<0.001); 372 respondents (85.7%) thought that they were able to independently receive patients with common diseases and make preliminary diagnosis and treatment, while there was no significant difference in the proportion of GPRs enrolled in 2020, 2019, and 2018 ( χ2=3.35, P=0.188); 425 GPRs (97.9%) expressed that the base arranged rotation according to the training syllabus; 390 GPRs (89.9%) thought that the proportion of knowledge and skill assessment in the final examination was appropriate. The survey showed that 70 GPRs (16.1%) thought that the number of cases and types of diseases in the teaching base fully met the requirements of the training program, 144 GPRs (33.2%) thought that mostly met the requirements, 197 GPRs (45.4%) thought that basically met the requirements, 22 GPRs (5.1%) thought that most of them did not meet the requirements, and 1 GPR (0.2%) thought that completely did not meet the requirements. Most of the respondents (368 (84.8%)) reported that they received guidance from clinical instructors for medical record writing; 174 (40.1%) and 172 (39.6%) GPRs were very satisfied or satisfied with general practice teachers and teaching base instructors; 207 GPRs (47.7%) were satisfied with accommodation (or subsidies), while 38 GPRs (8.3%) were very dissatisfied; 203 GPRs (46.8%) were satisfied with basic salary and benefit, while 35 GPRs (8.1%) were very dissatisfied. For general practice as the career, 88 GPRs (20.3%) liked it very much, 255 GPRs (58.8%) liked it, 67 GPRs (15.4%) did not like it very much, and 24 GPRs (5.5%) disliked it. For the prospects of general practice, 108 GPRs (24.9%) considered it very optimistic, 219 GPRs (50.5%) considered it relatively optimistic, 92 GPRs (21.2%) considered it not very optimistic, and 15 GPRs (3.5%) considered it very pessimistic. Regarding employment intentions, 174 GPRs (40.1%) intended to choose municipal hospitals, 170 GPRs (39.2%) to choose county level hospitals, only 9 GPRs (2.1%) to choose village clinics. Conclusions:The survey indicates that for GPRs the most dissatisfied aspects are the salary and benefit, as well as the living conditions during their training; after completing the contract, most GPRs hope to work in hospitals at county and above levels.
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Venous thrombosis is the second key factor causing death in cancer patients after the cancer itself. Even with anticoagulation interventions in clinic, it can be observed that cancer patients have multiple venous thrombosis. This paper reviews how to intervene and to prevent venous thrombosis in cancer patients through the exploration on the predictors and risk factors of recurrent venous thrombosis.
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A Survey on the current general practice residency training was carried out in January 2018 among 1 114 general practitioners (GPs) who attended the standardized residency training program during 2014-2017. Basic information was obtained from the management department, other information was obtained from questionnaire. Total 1089 valid questionnaires were received with a retrieval rate of 97.8%. The survey showed that the ratios of male trainees, trainees aged 20-30 years and with bachelor degree were increasing during 2014-2017. The participants were more satisfied with the teaching quality in general hospital bases than that in community practice bases. Participants suggested to improve teaching quality, add teaching contents of humanity courses and TCM knowledge. Only14.4%(157/1 089) participants choose GPs as their career because liked this specialty. And 77.7%(846/1 089) GPs understood the main work of GP. There were 81.4%(887/1 089) participants wanted to work in; 77.7%(846/1 089) participants thought that the prospect of general practice would be excellent or good. Increasing income, professional promotion and a sense of social recognition were their wishes. Standardized residency training is crucial for general practitioners to upgrade their quality and competence, to improve training quality and to develop incentive policies are necessary.
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A Survey on the current general practice residency training was carried out in January 2018 among 1 114 general practitioners (GPs) who attended the standardized residency training program during 2014-2017.Basic information was obtained from the management department,other information was obtained from questionnaire.Total 1089 valid questionnaires were received with a retrieval rate of 97.8％.The survey showed that the ratios of male trainees,trainees aged 20-30 years and with bachelor degree were increasing during 2014-2017.The participants were more satisfied with the teaching quality in general hospital bases than that in community practice bases.Participants suggested to improve teaching quality,add teaching contents of humanity courses and TCM knowledge.Only14.4％(157/1 089) participants choose GPs as their career because liked this specialty.And 77.7％(846/1 089) GPs understood the main work of GP.There were 81.4％(887/1 089) participants wanted to work in;77.7％(846/1 089) participants thought that the prospect of general practice would be excellent or good.Increasing income,professional promotion and a sense of social recognition were their wishes.Standardized residency training is crucial for general practitioners to upgrade their quality and competence,to improve training quality and to develop incentive policies are necessary.
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Objective To investigate the risk factors and prognosis of the patients with malignant solid tumors complicated with the disseminated intravascular coagulation (DIC). Methods The clinical data of 54 malignant solid tumors patients complicated with DIC in Shanxi Provincial People's Hospital from January 2004 to December 2014 were analyzed retrospectively, which were compared with the malignant tumor patients without DIC. Multivariate logistic regression analysis was used to explore the risk factors of solid tumor complicated with DIC, and the effect of concurrent DIC on the prognosis of patients was analyzed. Results Multiple factor analysis showed that advanced tumor (OR = 0.252, P = 0.019), concurrent hypoproteinemia(OR=0.119,P=0.005),concurrent infection(OR=0.122,P=0.003)were the independent risk factors of the malignant solid tumor patients complicated with DIC. The case fatality rate of the patients with DIC was 85.2 % (46/54), which was higher than that of the control group (7.4 %, 4/54), and the difference was statistically significant(χ2=65.69,P <0.001).Conclusion Early detection of malignant solid tumors, positive correction of hypoproteinemia, and the effective control of infection as soon as possible can help to prevent the occurrence of DIC and reduce the death caused by DIC.
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The expression of tissue factor (TF) on the surface can be called TF positive MP, which participate not only in thrombosis, but also in the invasion and metastasis of tumors. Therefore, this article will review the role of TF positive MP in patients with malignant tumors.
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In hospitals,the construction and development of key academic disciplines is the fundamental driving force for the ongoing improvement of healthcare competence and scientific research capacity.This paper draw on the experience of a recent 3-year disciplinary development program of a comprehensive hospital in Shanxi province,discussed measures that has been proven effective and set up guide line for future advancement of disciplinary development.
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Medical research is the core-competitiveness of hospitals.Research management in hospitals with weak scientific research capacity is different from others and has its own demands.People of the management neet to develop themselves to meet the special demands,and can then help develop the hospital.
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Objective To explore the expression of glial cell line-derived neurotrophic factor (GDNF) in rats with spinal cord injury (SCI) after epidermal neural crest stem cells (EPI-NCSCs) transplantation.Method EPI-NCSCs were isolated from GFP transgenic rats for transplantation.The rat SCI model was made by NYU-II impactor (10 g 25 mm) at T10 level.Then 30 SD rats were randomly divided into blank injury group (group A),DMEM transplantation group (group B),and experimental group (group C).The EPI-NCSCs were transplanted into the injured region one week after SCI.In DMEM group,the DMEM/F12 was used to substitute for the EPI-NCSCs.No treatment was done in blank injury group.The locomotor function was appraised by BBB score every week after transplantation.At sixth week after transplantation,GDNF mRNA and protein expression was detected.Result The BBB score in experimental group was significantly higher than the other two groups from two weeks after transplantation (P＜0.05).The expression of GDNF mRNA and protein in experimental group was significantly higher than the other two groups (P＜0.05).There was no significant difference between blank injury group and DMEM transplantation group (P ＞ 0.05).Conclusion The expression of GDNF can be up-regulated by EPI-NCSCs transplantation,which may be one of the mechanisms for EPI-NCSCs repairing SCI.
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Objective To investigate the distribution of-6411A/G (rs208679) polymorphism in the 5' region of catalase (CAT) gene among Han population in Chongqing and its correlation with noiseinduced hearing loss (NIHL).Methods A total of 225 healthy volunteers (normal control group) and 237 noise exposure cases (noise exposure group) were collected from the unrelated Han people in Chongqing.The noise exposure group were further divided into non-deaf group (n =170) and deaf group (n =67) according the presence or absence of NIHL.rs208679 polymorphism in the 5' region of CAT gene was identified using the improved multiplex ligation detection reaction (iMLDR) technique.Genotypes,allelic frequencies and clinical deaf incidence were compared among groups.Results Three genotypes (AA,AG,and GG) were detected in the rs208679 locus.Frequencies of A and G alleles in normal control group and noise exposure group were 0.76 and 0.24 respectively.Genotype distribution in normal control group and noise exposure group showed no deviation from the Hardy-Weinberg equilibrium (P ＞0.05).There were no significant differences in gene polymorphism (AA,AG,and GG) and allelic frequencies (A and G) between normal control group and noise exposure group and between deaf group and non-deaf group (P ＞ 0.05).However,significant difference was observed between deaf group and non-deaf group in recessive analysis (GG vs AG + AA,P ＜ 0.05).Conclusion rs208679 is the predisposing gene to NIHL and can be used as the biomarker for NIHL susceptibility.
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Objective To detect the myelinating role of olfactory ensheathing cells (OECs in the contused spinal cord and their impact on remyelination.Methods The rats were subjected to spinal cord injury at T10(10 g ×25 mm) using a NYU-Ⅱ impactor.One week later,the rats were transplanted with green fluorescence protein (GFP)-OECs (OECs group) or an equal volume of Dulbecco' s modification of Eagle's medium (DMEM) (control group) at epicenter of the injury as well as its rostral and caudal sites.Six weeks after transplantation,the spinal cords were removed for frozen section.Myelin basic protein (MBP),protein zero (P0),and S100 protein (S100) were determined with qualitative and semi-quantitative immunocytochemical assay.Moreover,plastic embedded semithin and ultrathin sections were prepared for qualitative and semi-quantitative examination under light microscopy and electroscopic study of myelin sheath ultrastructure.Results In OECs group,the nerve fibers labeled with S100,MBP,and PO were extended from the normal tissues to the injured region and even grew through the region with space consuming of 12.3％,11.6％,and 9.3％ respectively.Moreover,there were no statistical differences regarding the number of fibers labeled by the three proteins,but all were significantly larger than that in control group (2.89％,P ＜ 0.01).Number of myelinated nerve fibers in injured regions on hemithin sections was increased significantly to 354.67 ± 59.00 in OECs group,with significant difference compared with 167.33 ± 42.16 in control group (P ＜ 0.01).The regenerated myelin sheaths in OECs group were smaller and thicker than those in control group.Conclusions OECs can accelerate regeneration of myelinated nerve fibers.Additionally,some OECs form myelin sheaths themselves,but the sheath structures are relatively thinner.
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Less consciousness for science research,lower level of research work,shortage of research team,lack of research institution and so on are the mean problems in clinical hospitals.In recent years,we take the measures of carrying out research training,perfecting research equipment,strengthening the research team,establishing encourage and punish rules.these measures promote the research work of our hospital,change the research sense of hospital staff therefor we get notable progress in research work.
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Objective To observe the expression of brain-derived neurotrophical factor (BDNF) in injury spinal cord after transplantation olfactory ensheathing cells (OECs), and to investigate the mechanism of OECs repairing spinal cord injury.Methods OECs from GFP transgenic rats were separated and cultured for transplantation. Spinal cord injury rats were separated two groups by random digits table. In experimental group, OECs suspension were transplanted into injured spinal cord following spinal cord injury. In control group, DMEM was transplanted into the injured spinal cord after spinal cord injury. Motor function was evaluated per week after transplantation. The expression levels of BDNF mRNA and protein were detected by using RT-PCR and immunohistochemistry respectively, and compared with those from normal SD rats.Results Motor function of two groups was improved gradually after transplantation. The motor function scores in experimental group was obviously higher than in control group at 21st day after transplantation (P<0.05). A lot of survival GFP OECs distributed around impaired myeloid tissue. At 21st day after transplantation, BDNF mRNA and protein expression in experimental group were strongest (P<0.05), and stronger in control group than in normal group (P<0.05).Conclusion The transplantation of OECs can repair the injured spinal cord by increasing the expression of BDNF mRNA and protein to improve local microenvironment.
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Objective To evaluate the effect of tissue factor (TF), tissue factor pathway inhibitor-1,2 (TFPI-1,2) on cancer metastases and thrombosis complicated with cancer. Methods Blood samples from 292 cancer patients were collected and were divided into different teams according to cancer types,complicated with or without thrombosis; TF, TFPI-1, TFPI-2, plasma concentrations were measured by ELISA;Tissue expression of TF, TFPI-1, TFPI-2 were observed by immunohistochemical method. Results Plasma concentrations of TF and TFPI-1 in all kinds of cancers were higher than the control and lung cancer was the highest; TFPI-2 plasma concentrations had no statistics differences among all these teams. Tissue expression of TF of all kinds of cancer were higher than the adjacent tissues, lung cancer was higher than the other types of cancer. There were no statistics differences for TFPI-1 and TFPI-2. Both TF and TFPI-1 plasma concentrations of cancer with-or without-thrombosis were higher than control. TF was even higher in cancer with thrombosis team, TFPI-1 had no statistic difference between these two teams. TFPI-2 concentrations had no differences among all these teams. Conclusion Many kinds of tumor have higher expression of TF, it is expressed with different intensity according to different types of cancer. TFPI-1 has no clear effect in cancer growing and metastases. Unbalance of TF and TFPI-1 in plasma may relate to high coagulation state of cancer and may accelerate the thrombosis formation in cancer.
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Objective To investigate changes in indicators related to inflammatory cytokines, coagulation and fibrinolysis system in patients with disseminated intravascular coagulation (DIC) and multiple organ dysfunction syndrome (MODS) resulted from sepsis. Methods In total, 97 patients diagnosed as sepsis were divided into different groups and their plasma concentrations of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), tissue factor (TF) and tissue factor pathway inhibitor (TFPI), tissue plasminogen activator (t-PA), and plasminogen activator inhibitor 1 (PAI-1) were measured by ELISA and plasma activity of protein C (PC:A) was measured by chromogenic substrate assay. Results Plasma concentrations of TNF-α and I L-6 were (38 ± 12) ng/L and (77 ± 9) ng/L, respectively, in patients of sepsis complicated with DIC, much higher than those without DIC [ ( 17±6) ng/L and (45 ± 6), respectively], P <0.05;and (63±25) ng/L and (103±28) ng/L, respectively, in those complicated with MODS, significantly higher than in those without MODS [ (29 ± 7 ) ng/L and (48±9)ng/L, respectively], P < 0/05 and those without DIC [( 17 ± 6) ng/L and (45 ± 6) ng/L, respectively], P <0. 05;as well as significantly higher in the dead than in survivors (P <0. 05). Plasma activity of protein C was (32 ± 10) percent in those with DIC and (24 ± 12) percent in those with MODS, both significantly lower than in those without DIC [ (57±28) percent] and without MODS [ (55 ± 17) percent], respectively, P <0. 05, as well as significantly lower in the dead than in survivors, P <0. 05. Plasma concentrations of t-PA and PAI-1 were significantly higher in sepsis patients with DIC [(48±17)μg/L] than that in those without DIC [(103 ± 38)μg/L], P < 0.05. Conclusions Inflammatory cytokines play important roles in development of DIC as well as MODS in patients with sepsis. Decreased activity of protein C and increased plasma level of PAI-1 can result in deposition of fibrin on the vessel wall and thrombosis, which can be used as indicators of poor prognosis for patients with DIC.
