Analysis on self-evaluation of Chinese physicians′ competency and its influencing factors / 中华医院管理杂志

Objective:To understand the current situation of physicians′ competency in China and statistically analyze its influencing factors, hence providing referential evidences for promoting their competency.Methods:The evaluation scale for Chinese physicians′ competency was developed by referring to sophisticated overseas evaluation frameworks. Based on the electronic platform of the medical alliance, stratified sampling was conducted at 39 hospitals in 13 provinces, from which 2 156 physicians were surveyed, and statistical analysis was made on the current situation and influential factor of their competency in 6 dimensions(medical knowledge, diagnosis and treatment, scientific research and teaching, interpersonal communication, spirit of professionalism, population health)Results:The score range in multiple dimensions of physicians′ competency was between 2.85 and 3.89(5 in total), among which spirit of professionalism dimension scores the highest, and teaching and research dimension scores the lowest. Logistic regression analysis shows that their competency level in 6 dimensions is correlated to a range of factors, including gender, degree, title, supervisor qualifications, standardized training program of specialist physicians, and affiliation or not to teaching hospitals( P<0.05). Conclusions:Their overall competency is expected to be elevated. To name a few, they are lack of teaching and research abilities, and need to conduct clinical-oriented scientific research; they are expected to enrich knowledge structure, and need to embrace a wider concept of health; they need to improve their non-technical service abilities, and should further emphasize their humanistic quality; physicians′ practice competency depends upon their extent of medical education, and ensuring the quality of standardized training becomes the key measure.

Analysis on the status quo and influencing factors of physician title promotion satisfaction in public hospitals / 中华医院管理杂志

Objective:To investigate the current physician title promotion satisfaction in public hospitals, and analyze the main influence factors, for references in improving their satisfaction.Methods:June to December 2018, 2 156 in-job physicians of 39 hospitals in China were surveyed with questionnaires via the medical alliances platform, in order to learn their title promotion satisfaction. General information was subject to descriptive analysis, while the main influencing factors for their satisfaction were evaluated with univariate analysis.Results:Among the 2 156 samples, the overall satisfaction scored (3.17±0.84), at a satisfaction rate of 32.88%(709/2 156), the lowest satisfaction scoring was found in the promotion ratio(2.90±1.03). The univariate analysis results indicated that such factors as teaching titles, hospital grading and their location influenced their satisfaction on title promotion with a significant difference( P<0.05), while those with medium titles presented the lowest scoring in their satisfaction. Conclusions:As the overall satisfaction rate for their professional title promotion was not high, it is necessary to take the following measures. They refer to reasonable adjustment of the proportion ratio, dynamic coordination, and proactive exploration to establish different promotion series and launch differentiated appraisal, focusing on building a scientific and reasonable promotion criteria by levels and by categories for the purpose of enhancing teambuilding of physicians.

HR characteristics of physicians at public hospitals in China and an international comparison / 中华医院管理杂志

Public hospitals in China are categorized as level II public benefit Institutions, in which the permanent employment has become the icon of the physicians. The authors systematically analyzed the HR characteristics of physicians of public hospitals, problems in physicians′ HR system and the relevant reform practices in China. They also draw on the physician practice administrative systems and experiences from the U. S., the U. K., Germany and Japan, providing insight and suggestions for the reform of physician HR system reform in China.

Introduction to the clinical learning environment review program of the American physician training site and its enlightenment to China / 中华医院管理杂志

This paper systematically introduced the clinical learning environment review ( CLER) from the U.S.in the aspects of background, initiation, progression, priority and procedure of evaluation as well as the status quo of its implementation.Therefore, reference and theoretical evidence will be provided for development of residential training system and fellowship training system as well as improvement for the training site review system in China.

PEST analysis and strategy on development of respiratory medicine in China / 中华医院管理杂志

There are many types of respiratory diseases, affecting a large population, and their incidence, prevalence, disability rate and mortality are high as well, posing severe harms to the health of the Chinese people. The PEST analysis as used in the study, explored the present status and difficulties of respiratory medicine in terms of the political, economic, social and technological dimensions, and put forward strategies, and theoretical references as well.

Overview on the studies of overseas physician′s competency assessment / 中华医院管理杂志

This research introduced four models of overseas physician competency assessment , and their methodology ,and hotspot′Milestone′project in the USA. The authors propose to provide a national assessment benchmark in favor of industry consensus. In terms of physician assessment methods ,they recommended to test the validity and reliability of these tools ,rather than merely focusing on the development of new assessment tools. Regarding physician assessment phasing ,the paper proposed to build a dynamic and process-based assessment system .

Study of teleconsultation pricing formulation for public hospitals in China / 中华医院管理杂志

The teleconsultation model of the National Telemedicine and Connected Health Center is cited as an example, to study the pricing formulation of video teleconsultation. This refers to the pricing composed of such four parties as the inviter′s hospital, invitee′s hospital, technical support, and business operation. Based on such pricing standard, teleconsultation charges can be collected. From 2015 to 2017, the annual applications of teleconsultation is on the rise year by year. Such pricing has been accepted by patients at large, as it embodies the value of each party, and ensures the long-term running of telemedicine system. Therefore, this pricing formulation could be a referable model for the localities to formulate their teleconsultation pricing.

Overview on the studies of overseas physician's competency assessment / 中华医院管理杂志

This research introduced four models of overseas physician competency assessment, and their methodology, and hotspot "Milestone"project in the USA.The authors propose to build a national assessment benchmark framework in favor of industry consensus.In terms of physician assessment methods, they recommended to test the validity and reliability of these existing tools,rather than merely focusing on the development of new assessment tools.Regarding physician assessment phasing,the paper proposed to build a dynamic and process-based assessment system.

Survey of current respiratory departments setup in China / 中华医院管理杂志

Objective To learn the present setup of respiratory departments as well as development of diagnosis and treatment in China, for reference and policy making of the respiratory specialty development. Methods In May and June 2016,3 202 hospitals were surveyed, to learn their respiratory department development,development of sub-specialty,naming of departments,staffing ratio of the medical staff to bed,basic indicators for medical services,medical techniques and disease types treated. Results 77.8% of the tertiary hospitals and 38.8% of the secondary hospitals have independent respiratory departments. Among such tertiary hospitals,54.4% of them have respiratory intensive care units,21.8% have respiratory & sleep disorder clinics, and 13.1% have smoking cessation clinic. The physician-nurse ratio of respiratory department of such hospitals amounted to 1:1.66, while that of secondary hospitals to 1:1.61. 99.8% of the tertiary hospitals and about 95.0% of the secondary hospitals are competent of invasive positive pressure ventilation,noninvasive mechanical ventilation,and pulmonary function test among others. Conclusions Rooms of improvement are found in the following areas. Poor respiratory specialty and sub-specialty construction at such hospitals; insufficient nursing staff; tertiary hospitals have not formed unique advantages in diagnosis and treatment techniques and types of diseases; hierarchical medical system is to be further established.

Research on scientific research integrity behavior and knowledge of medical postgraduates / 中华医学科研管理杂志

Objective To understand the current situation of scientific research integrity level of medical graduate students,the development of integrity education in their universities,to put forward corresponding suggestions for improvement.Methods From December 2015 to March 2016,128 postgraduates are selected as the participants of the survey by randomized method (123 responded).We conducted a questionnaire survey in four famous medical universities in Beijing,descriptive analytical method was adopted to analyze survey findings.The contents of survey included the status of academic integrity of the current medical students,education of academic integrity in Medical Universities,awareness of scientific integrity and acquisition channel of relevant knowledge.Results According to the survey,the awareness rate of research integrity is not high,scientific misconduct has occurred consciously or unconsciously.By analyzing the access and demands to knowledge of research integrity,we find that related seminars or lecture is the best channel to acquire academic research integrity knowledge,accounting for 61.48％.Followed by the curriculum of academic ethics and compliance aspects was the network information or communication with classmates,which accounts for 39.34％.The data also show that 95.90％ of respondents thought it is necessary for medical graduate students to accept academic ethics and norms of education,68.03％ of the respondents realized that cultivating students' awareness of scientific integrity in the process of scientific research gradually has great guiding significance for mentors and counselors.Conclusions The survey suggests that the education of scientific integrity in our country is very inadequate,the knowledge on good scientific integrity was fragmented.At present,most of the medical universities have not yet set up scientific integrity course,and access to the knowledge of integrity is limited for students.The scientific integrity education has become an extremely urgent issue for cultivating the sense of integrity in scientific research for researchers as soon as possible.

miR-200b suppresses proliferation and induces apoptosis in non-small cell lung cancer cells by targeting DNMT3A / 天津医药

Objective To investigate whether miR-200b suppresses proliferation and induces apoptosis of non-small cell lung cancer cells by targeting DNMT3A. Methods A qRT-PCR was employed for detecting the expression of miR-200b in different non-small cell lung cancer cells and human bronchial epithelial cells. A549 cells were transfected with miR-200b mimics, scramble, DNMT3A-siRNA and control-siRNA, respectively. The scramble and control-siRNA were served the negative control of miR-200b mimics and DNMT3A-siRNA, respectively. Western blot assay was conducted to detect the expression of DNMT3A protein in A549 cells. MTT and Annexin V/propidium iodide staining were employed to detect the proliferation ability and apoptosis rate of A549 cells. The effects of miR-200b mimics and DNMT3A-siRNA on the proliferation and apoptosis rate of A549 cells were compared between groups. Results Results of qRT-PCR showed that the expression of miR-200b was significantly down-regulated in A549, H1299, L78 and H460 cells than that of 16HBE cells. Among them, the most obviously reduction was found in A549 cells (P<0.05). Western blot assay showed that the level of DNMT3A protein was inhibited by restored miR-200b or knock-down DNMT3A in A549 cells. After transfection of miR-200b mimics or knock-down DNMT3A for 48 h, 72 h and 96 h, MTT showed that the OD values, which reflected the optical density of cell proliferation were significantly lower than those in the control group (P<0.05). Annexin V/propidium iodide staining showed that apoptosis rates of A549 cells after transfection of miR-200b mimics or knock-down DNMT3A were (23.33%±0.90%and 20.41%±0.70%), compared with the control group (5.28%± 0.55%and 5.68%±0.47%, P<0.01). Conclusion miR-200b suppresses cell proliferation and induces apoptosis by targeting DNMT3A in non-small cell lung cancer.

Molecular mechanism of Andrographolide on MMP-9 expression in human lung cancer cells / 中国生化药物杂志

Objective To investigate the effect and molecular mechanism of Andrographolide (AD) on matrix metalloproteinase-9 (MMP-9) expression in human colon cancer H 3255 cells. Methods Human lung cancer H3255 cell line weve cultured in vitro, and treated with 1.0, 3.0, 5.0μmol/L AD for 24 h, untreated cells was used as blank control. Cell viability, cell migration and cell invasion were analyzed by MTT assay, scratch healing assay and transwell membrane assay, respectably. Expression of MMP-9 mRNA was analyzed by RT-PCR. Protein expression and phosphorylation of Akt were detected by Western blot. Activity of NF-κB and MMP-9 were analyzed by luciferase reporter assay. Results AD could significantly reduced H 3255 cells invasion and migration without affecting the viability of cells, as demonstrated by scratch healing and transwell membrane assay. Furthermore, Western blot and RT-PCR results showed that AD could markedly inhibited MMP-9 activity and its expression in both protein and mRNA levels. AD could attenuated Akt’s phosphorylation and the activity of NF-κB. Moreover, LY 294002, an inhibitor of PI3 K, could significantly inhibited NF-κB transcriptional activity and MMP-9 expression. In addition, different concentrations of AD could inhibit the promote activity of MMP-9. Conclusion AD was a potential anti-invasive agent by inhibiting MMP-9 involved in PI3 K/NF-κB pathways.

C-phycocyanin protects doxorubicin-induced myocardial cells injury by Nrf 2/heme oxygenase-1 pathway / 中国生化药物杂志

Objective To observe the role of heme oxygenase (HO)-1 on the protective effect of C-phycocyanin (CPC) on doxorubicin (DOX)-induced myocardial cells injury by Nvf2/HO-1 pathway. Methods 60 SD rats were randomly divided into control group, DOX group, CPC group and tin protoporphyrin IX (SnPP, an inhibitor of HO-1) group. The control group was injected with normal saline injection,while the DOX group was administrated with doxorubicin by intraperitoneal injection in a cumulative dose of 15 mg/kg for two weeks. For the CPC rats, 20, 40 and 60 mg/kg of CPC was administrated. The level of creatine kinase (CK) and lactate dehydrogenase (LDH) were detected, and the activity of HO-1 and caspase-3 were also examined. Expression of HO-1 and activation of Nrf 2 were detected by Western blot. Results Compared with control group, serum levels of CK, LDH and Caspase-3 activity in DOX group were significantly increased(P<0.05), but HO-1 in cardiac muscle was only increased slightly. upregulation. Treatment with CPC could significantly ameliorated the CK, LDH and Caspase-3 activity, and markedly induce HO-1 expression and its activity. The reduction of CK, LDH and Caspase-3 activity by CPC could be reversed by treatment of the HO-1 inhibitor, SnPP. Furthermore, CPC sould also induce Nrf 2 activation. Conclusion The protective effect of CPC on doxorubicin-induced myocardial cells in jury via Nrf 2 induced HO-1 HO-1 expression.

Protective effect and mechanism of Rosa laevigata Michx on adriamycin-induced cardiotoxicity / 中国生化药物杂志

Objective To study the protective effect mechanism of Rosa laevigata Michx (RLM) on cardiotoxicity induced by adriamycin in rats. Method 30 SD rats were randomly into control group, doxorubicin group and RLM groups. The control group was injected with normal saline injection, while the model group was injected with adriamycin intraperitoneally at the dosage of 15 mg/kg every other day. For the RLM groups,1~5 g/kg RLM were given after adriamycin injection. The survival rate, plasma BNP was observed. Apoptosis of cardiomyocyte was detected by instituted-labeled DNA (TUNEL). The activity of GSH-PX, CAT and total SOD in the myocardium tissue were also observed. The expression level of CuZn-SOD , bcl-2 and bax were detected by real-time PCR. Results The survival rate was significantly improved in SD rats treated with RLM compared with that in the adriamycin group (P<0.01). The BNP level was increased when treated by adriamycin (P<0.01), and decreased after RLM administration (P<0.01). RLM could also upregulate the expression of the CuZn-SOD mRNA level, and enhance the activity of GSH-PX, CAT and T-SOD compared with that in adriamycin group. Adriamycin could induce myocardial cells apoptosis, as demonstrated by TUNEL. RLM could inhibit adriamycin-induced apoptosis, bax mRNA expression, and increase bcl-2 expression and bcl-2/bax ratio. Conclusion RLM exhibit some antioxidant activity through many stages, and the anti-apoptosis activity may be related to affect the expression of bax and bcl-2 expression.