Chinese Physicians Research Articles

Mechanism of Bile‐Processed Coptidis Rhizoma to Treat Nonalcoholic Fatty Liver Disease in Type 2 Diabetes Mellitus Based on UPLC‐Q‐TOF/MS and Network Pharmacology

AbstractBile‐processed Coptidis Rhizoma (DL) is a unique processed product of Coptidis Rhizoma in traditional Chinese medicines, it's commonly used in the treatment of type 2 diabetes (T2DM) or non‐alcoholic fatty liver disease (NAFLD) by folk Chinese physicians, but information about its active components and mechanism of action are still lacking. Network pharmacology combined with a molecular docking approach was used to screen for possible mechanisms to predict DL for treating NAFLD in T2DM. Validation of the effects of DL on key protein‐related effects such as anti‐inflammatory, antioxidant and insulin resistance inhibition through pharmacological assays. 32 components in DL were identified and 558 target targets were obtained. A total of 6165 targets related to T2DM, 5306 targets related to NAFLD were intersected with the component targets to obtain 329 common targets. PPI network analysis showed that 55 targets may be key targets for DL treatment of NAFLD inT2DM. Molecular docking showed that the components were well bound to the protein. The therapeutic effects of DL through anti‐oxidation, anti‐inflammation and alleviation of insulin resistance were validated based on animal studies. This study provides a solid basis and scientific rationale for the mechanism of DL and its application in the treatment of NAFLD in T2DM and other related diseases.

Factors affecting physicians’ attitudes towards patient-centred care: a cross-sectional survey in Beijing

ObjectivesPatient-centred care has been raised as an important component in providing high-quality healthcare services. This research aims to measure physicians’ attitudes towards patient-centred care in Chinese healthcare settings and to...

Decent Work and Workplace Deviance Among Chinese Physicians: A Relative Deprivation Perspective.

Managing workplace deviance has long been a hot topic in the organizational research. However, the mechanisms through which decent work affects workplace deviance have yet to be fully understood. Drawing upon relative deprivation theory, this study examines the relationship between decent work and workplace deviance by focusing on the mediating role of relative deprivation and the moderating role of career calling. Two waves of data from 307 doctors and 61 supervisors of public hospitals in central China were examined using a the moderated mediation model. Decent work is negatively associated with workplace deviance via the mediation of relative deprivation, and the negative relationship between decent work and relative deprivation is negatively moderated by career calling. The mediating role of relative deprivation is moderated by career calling, and the indirect effect is stronger when career calling is high than when it is low. By focusing on the mediating role of relative deprivation and the moderating role of career calling, this study contributes to the literature by addressing the previously unexamined relationship between decent work and workplace deviance. Moreover, this study responds to calls for research on decent work from the perspective of relative deprivation.

Work-family conflict and its related factors among emergency department physicians in China: A national cross-sectional study.

Work-family conflict is common among emergency department physicians. Identifying the factors associated with work-family conflict is key to reducing its negative impact on mental health and work attitudes. However, the work-family conflict of Chinese emergency department physicians and the related factors have been scarcely studied. This study aimed to investigate the current status and related factors of work-family conflict among Chinese emergency department physicians. A national cross-sectional study was conducted among emergency department physicians in China from June 2018 to August 2018. A standard questionnaire was used to investigate the demographic characteristics, work-related factors, and work-family conflict of emergency department physicians. The generalized linear regression analysis was used to identify the related factors of work-family conflict. A total of 10,457 licensed emergency department physicians participated in the study. The average score of work-family conflict among the enrolled emergency department physicians was 19.27 ± 3.94, and the prevalence of high levels of work-family conflict was 69.19%. The multivariable regression analysis showed that emergency physicians who were female (linear regression coefficient, -0.25; SE, 0.08; P = 0.002), older than 40 years (linear regression coefficient,-0.53; SE, 0.14; P < 0.001), and earning more than 4,000 CNY per month (e.g., 4,001~6,000 vs. ≤4,000 CNY: linear regression coefficient, -0.17; SE, 0.09; P = 0.04) had lower work-family conflicts. However, emergency department physicians who were married (linear regression coefficient, 0.37; SE, 0.11; P < 0.001), highly educated (linear regression coefficient, 0.46; SE, 0.10; P < 0.001), had a high technical title (e.g., intermediate vs. junior technical title: linear regression coefficient, 0.61; SE, 0.09; P < 0.001), worked in a high-grade hospital (e.g., tertiary hospital vs. emergency center: linear regression coefficient, 0.38; SE, 0.11; P < 0.001), had a higher frequency of night shifts (e.g., 6~10 night shifts per month vs. 0~5 night shifts per month: linear regression coefficient, 0.43; SE, 0.10; P < 0.001), self-perceived shortage of physicians in the department (linear regression coefficient, 2.22; SE, 0.08; P < 0.001), and experienced verbal abuse (linear regression coefficient, 1.48; SE, 0.10; P < 0.001) and physical violence (linear regression coefficient, 0.84; SE, 0.08; P < 0.001) in the workplace had higher work-family conflict scores. Most emergency department physicians in China experience a high-level work-family conflict. Hospital administrations are recommended to develop family-friendly workplace policies, establish a scientific shift system, and keep the number of emergency department physicians to meet the demand to reduce work-family conflict.

A Review of the History of Ancient China

Handwritten prescriptions are based on the thorough understanding of diseases and accurate diagnosis of patients by ancient Chinese physicians. This article discusses the particularities of TCM handwritten prescriptions in different historical periods in China, which are crucial to the study of contemporary medicine and calligraphy and the treatment of TCM diseases with their unique writing styles. We aim at study and summarize the evolution of ancient Chinese manuscripts from a historical perspective. As the only way to record the experience of disease diagnosis and treatment, in-depth research on handwritten prescriptions can open up new fields of scientific research in traditional Chinese medicine, promote the wide application and dissemination of ancient Chinese calligraphy works around the world, and provide more opportunities for future generations of medical references. This paper mainly adopts the survey method, literature review method, data analysis method, comparative analysis method and inductive summary method to conduct research, and strive to make the research convincing. Traditional Chinese medicine formulas are the empirical data of generations of doctors in meticulous diagnosis, investigation, prescription, dialectical treatment, and are a precious medical case. TCM has a long history in China, and it is an important foundation for TCM to treat diseases because of its good medicinal calligraphy styles. In-depth research has the potential to open up new areas of scientific research in Chinese medicine and encourage the widespread adaptation and dissemination of ancient Chinese calligraphy works worldwide. Its widespread use increases the number of references available for future medicine.

Prevalence and predictors of workplace violence against emergency physicians in China: a cross-sectional study

BackgroundWorkplace violence (WPV) is considered a global problem, particularly in the health sector; however, no studies have assessed the national prevalence of WPV against emergency physicians and the associated factors in China.MethodsA national cross-sectional survey was conducted in 31 provinces/autonomous regions/municipalities across China between July 2019 and September 2019. A total of 15 455 emergency physicians were selected using a multistage stratified random sampling method. A structured self-administered questionnaire was used to collect information on WPV and potential associated factors among emergency physicians. Descriptive and multivariable logistic regression analyses were used to identify the predictors of WPV.ResultsA total of 14 848 emergency physicians responded effectively (effective response rate: 96.07%). Of the respondents, 90.40%, 51.45%, and 90.00% reported exposure to any type of WPV, physical or nonphysical violence in the preceding year, respectively. Verbal aggression (87.25%) was the most common form of violence, followed by threat (71.09%), physical assault (48.24%), verbal sexual harassment (38.13%), and sexual assault (19.37%). Patients’ families were the main perpetrators of these incidents. Unmet patient needs, taking drugs or drinking, and long waiting times were the main contributors to WPV. Physicians who were from low-developed regions, female, and without shift work were less likely to have experienced any type of WPV. Chinese emergency physicians who were from medium-developed regions, had a bachelor’s degree, worked in a higher level hospital, had a higher professional title, with lower incomes, had a history of hypertension or coronary heart disease, were smokers or drinkers, and worked in hospitals without preventive measures or training for WPV and not encouraging to report WPV were more likely to have experienced any type of WPV. The predictors of WPV varied in different types of WPV.ConclusionsThis study shows that the prevalence of WPV against emergency physicians is high in China. Measures should be taken at the physicians, patients, hospital, and national levels to protect GPs from WPV; for example, improving physicians’ level of service and hospital’ reporting procedures. Creating a prevention strategy and providing a safer workplace environment for emergency physicians should be prioritized.

Chinese recommendations for the management of fibromyalgia syndrome

Fibromyalgia syndrome (FMS) is a common clinical syndrome. At present, the lack of epidemiological data from large-sample studies in our country persists, and there are many difficulties in diagnosis and treatment. It is imperative to formulate diagnosis and treatment guidelines for FMS in our country. As such, a project was jointly initiated by the China Association of Chinese Medicine Rheumatology Society, the Fibromyalgia Research Group of Traditional Chinese and Western Medicine in Rheumatology and Immunology, and the Capital Institute of Rheumatology and Immunology of Integrated Chinese and Western Medicine, which adopted the Grading of Recommendations Assessment, Development, and Evaluation grading system and the Reporting Items for Practice Guidelines in Health Care for guideline development. Detailed evidence-based recommendations on 11 clinical problems of FMS that concern Chinese first-line physicians are given in the guideline, aiming to encourage the departments of rheumatology, psychology, pain, and other related departments to attach great importance to the comprehensive management, early identification and intervention, and assessment of FMS to improve the quality of life of patients with FMS.

Using less keystrokes to achieve high top-1 accuracy in Chinese clinical text entry.

As a routine task, physicians spend substantial time and keystrokes on text entry. Documentation burden is increasingly associated with physician burnout. Predicting at top-1 with less keystrokes (TLKs) is a hot topic for smart text entry. In Western countries, contextual autocomplete is deployed to alleviate the burden. Chinese text entry is intercepted by input method engines (IMEs), which cut off suggestions from electronic health records (EHRs). To explore a user-friendly approach to make text entry easier and faster for Chinese physicians. Physicians were shadowed to uncover the real-word input behaviors. System logs were collected for behavior validation and then used for context-based learning. An in-line web-based popup layer was proposed to hold the best suggestion from EHRs. Keystrokes per character and TLK rate were evaluated quantitatively. Questionnaires were used for qualitative assessment. Nine hundred fifty-two physicians were enrolled in a field testing. 14 facilitators and 17 barriers related to IMEs were identified after shadowing. With system logs, physicians tended to split long words into short units, which were 1-4 in length. 81.7% of these units were disyllables. Compared to the control group, the intervention group improved TLK rate by 40.3% (p < .0001), and reduced keystrokes per character by 48.3% (p < .0001). Survey results also promised positive feedback from physicians. Keystroke burden and frequent choice reaction time challenge Chinese physicians for text entry. The proposed system demonstrates an approach to alleviate the burden. Contextual information is easily retrieved and it further helps improve the top-1 accuracy, with a smaller number of keystrokes. While positive feedback is received, it promises a benefit to protect patient privacy.

Pain Physicians' Attitudes and Experiences Regarding Clinical Pharmacy Services in China: A National Cross-Sectional Survey.

Pharmacists are key members of the pain management interdisciplinary team in many developed countries. However, the implementation of clinical pharmacy services in pain management is impeded by the imbalance between the pain physicians and clinical pharmacists specializing in pain management in China. The purpose of this study was to elucidate the perceptions, expectations and current experience of Chinese pain physicians regarding clinical pharmacy services. An anonymous, self-administered questionnaire was designed according to previously published studies with minor modifications and distributed online to 1100 pain physicians selected randomly in hospitals across all 31 provinces of mainland China in 2021. Data were analyzed using descriptive and inferential statistics. A total of 1071 valid questionnaires were included for analysis. The pain physicians were from all 31 provinces of mainland China and most of them were from tertiary hospitals holding an undergraduate degree. Among listed kinds of clinical pharmacy services, pain physicians were less comfortable with pharmacists treating minor illnesses (p < 0.001). Pain physicians' experiences with clinical pharmacy services were far less than their expectations (p < 0.001), which is in line with the results that most of pain physicians (65.9%) interacted with pharmacists at a frequency of less than once a week. Significant differences in the experiences were found among ages (p < 0.01) and among years of work experience (p < 0.05) of pain physicians. Pain physicians' expectations of pharmacists were positively correlated with their experiences with clinical pharmacy services (p < 0.001). Pain physicians in China had positive perceptions and high expectations, but relatively low experiences regarding clinical pharmacy services. Expanding clinical pharmacist pain management credentialing and increasing pain physicians' exposure to clinical pharmacy services are favourable to support the interdisciplinary collaboration in pain management in China.

Abstract A105: Participants with lower socioeconomic status or lacking access to health care benefited more from a decision support navigation trial to increase colorectal cancer screening: Study of Chinese and Korean American primary care patients

Abstract Background: Although colorectal cancer (CRC) is the second most common cancer among Asian Americans, cancer screening rates among Chinese- and Korean Americans are lower than in other racial/ethnic groups in the United States. To address this disparity, we designed, implemented, and evaluated the effectiveness of a culturally adapted decision support navigation trial. Methods: Twenty-four Chinese and Korean primary care physicians (PCPs) from Maryland and northern Virginia were recruited to the STOP CRC (Screening TO Prevent CRC) program, a cluster randomized controlled trial. The PCPs’ clinics were randomized into intervention or control group. Then, 400 Chinese and Korean Americans were recruited through the PCPs’ clinics. Participants randomized to a decision support navigation intervention group (n=200) received an informational booklet, instructions to access colonoscopy screening, and a free fecal immunochemical test (FIT) kit at baseline. A bilingual patient navigator also guided them through an exercise to facilitate screening test choices. Six months after enrollment, participants randomized to the control group (n=200) received the informational booklet, colonoscopy instructions, and a FIT kit. Participants were offered a choice to select between the FIT or colonoscopy. Screening (completion of FIT or colonoscopy) was measured at 6 and 12 months after enrollment by medical record review and self-report. Generalized estimating equations (GEE) models with an exchangeable working correlation matrix to account for clustering effects at the PCP level were employed to examine intervention effects on CRC screening outcomes. Results: Intervention and control participants were comparable in their socio-demographic background and access to healthcare at baseline. At 12 months, screening adherence in the intervention group was (93%) substantially higher than in the control group (63%) (Prevalence Ratio: 1.51, 95% confidence interval: 1.37-1.66). Interestingly, the effect of the intervention on CRC screening was significantly higher among those with less than or equal to high school education (PR=1.95; 95% CI: 1.89-2.02) compared to those with higher than high school education (PR=1.37; 95% CI: 1.37; 95% CI: 1.22-1.54). Moreover, the impact of the intervention on CRC screening was higher among participants with lower income (&amp;lt;$100,000: PR=1.60; 95% CI: 1.56-1.65) than the participants with higher income (≥$100,000: PR=1.18; 96% CI: 0.85-1.64). The same impact was higher among those without health insurance (PR=1.70; 95% CI: 1.28-2.25) and those with Medicare/Medicaid (PR=1.80, 95% CI: 1.29-2.52) compared to those who have private health insurance (PR=1.35, 95% CI: 1.19-1.53). Conclusions: The STOP CRC program, a culturally and linguistically adapted decision support navigation intervention, is effective in increasing CRC screening among Chinese and Korean American primary care patients who are not up-to-date with the screening. This impact is more pronounced among participants with lower socioeconomic status or lacking access to health care. Citation Format: Sunmin Lee, Soomin Ryu, Carissa Kwan, Ronald E. Myers, Yuxi Shi, Luohua Jiang, Brittany N. Morey. Participants with lower socioeconomic status or lacking access to health care benefited more from a decision support navigation trial to increase colorectal cancer screening: Study of Chinese and Korean American primary care patients [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A105.

Utilization of complementary and alternative medicine by perimenopausal women in China: a cross-sectional study.

To investigate the utilization of complementary and alternative medicine (CAM) by perimenopausal women and explore factors associated with their preference. A cross-sectional study was conducted involving 558 perimenopausal women in Wuhan, China. Online questionnaires were available from December 2021 to April 2022. Instruments used were the International Complementary and Alternative Medicine Questionnaire and the Greene Climacteric Scale. The association between scores and participants' sociodemographic characteristics and perimenopausal symptoms was analyzed using multiple linear regression. The overall utilization of CAM by perimenopausal women was 50.4% (281/558). Perimenopausal symptoms affecting the frequency of CAM usage included anxiety (adjusted β = 0.18), somatic (adjusted β = 0.07), and vasomotor symptoms (adjusted β = 0.76), P < 0.05. The most commonly used CAM were massage (37.7%), herbal therapies (19.9%), and dietary supplements (18.2%). Walking (58.6%) was the most popular self-practice therapy. Perimenopausal women consulted Western (38.4%) and Chinese medicine physicians (34.8%) and dentists (36.0%) most frequently. Perimenopausal women experience discomforts during this age-related stage, and their use of CAM to manage symptoms is common. The usage and preferences of these management strategies are worthy of further exploration. There is a need to understand cost-effective and appropriate management interventions to improve the quality of life of perimenopausal women.

An Insight into the Elusive Healer Plant “Luffa echinata Roxb.”

Pharmacognosy Research,2023,15,1,26-41.DOI:10.5530/097484900254Published:December 2022Type:Review ArticleAuthors:Sumanta Mondal, Kausik Bhar, Renu Kumari, Prasenjit Mondal, Subhadip Chakraborty, and Nooka Yaswanth Teja Author(s) affiliations:Sumanta Mondal1,*, Kausik Bhar1, Renu Kumari1, Prasenjit Mondal2, Subhadip Chakraborty1, Nooka Yaswanth Teja1 1Department of Pharmaceutical Chemistry, GITAM School of Pharmacy, GITAM (Deemed to be University), Visakhapatnam, Andhra Pradesh, INDIA. 2Department of Pharmaceutical Technology, Brainware University, Ramkrisnapur Road, Kolkata, West Bengal, INDIA. Abstract:Recent years have seen a global rise in the use of herbal medicine. Many naturally occurring bioactive substances, especially those derived from plants, have been studied as potential cures for various diseases. Luffa echinata Roxb., a mysterious medicinal plant from the Cucurbitaceae family, has recently gained recognition as one of the most important medicinal herbs among them. Many phytochemicals found in this plant have been found to have therapeutic potential, including xanthones, alkaloids, phytosterols, flavonoids/isoflavonoids, chalcone, glycosides, terpenoids, saponins, carbohydrates, proteins, reducing sugars, fatty acids, tannins, and phenolic compounds. Other potent phytoconstituents of this plant include saponins, hentriacontane, gypsogenin, sapogenin, cucurbitacin (A, B, C, D, E, K, S, and I), β-sitosterol, echinatol (A and B), oleanolic acid, isoquercetin, quercimeritrin, and sitosterol glycoside. Cucurbitacin, a prominent class of triterpenoids found in L. echinata, has been proven effective in numerous reports. Recent research has shown that cucurbitacins can decapitate or inhibit the proliferation of cancer cells. Luffa echinacea's fruit and leaves have long been used as purgatives and to cure liver disease, hemorrhoids, jaundice, migraines, emesis, and other conditions by Indian and Chinese physicians. Ulcers and sores have also been expelled using them. During the field study, it was found that the tribal community (Tharus) of Khatima utilized extremely bitter, squeezed fruit stuff given to sufferers of dog bites in the morning on an empty stomach, and more than 500 people have been adequately treated thus far. The therapeutic potential and phytoconstituents of Luffa echinata have been clarified by pharmacological and phytochemical studies; further study is required to investigate these phytoconstituents and their structures. Keywords:Cucurbitaceae, Cucurbitacin, Ethnobotanical, Luffa echinata Roxb., Pharmacobotanical, Pharmacological Testimony, PhytomoleculesView:PDF (1.66 MB)

Expert consensus on the diagnosis and treatment of allergic bronchopulmonary aspergillosis(2022 update)

As an allergic lung disease caused by Aspergillus species, allergic bronchopulmonary aspergillosis(ABPA) is manifested by asthma and recurrent lung infiltrates, often with signs of bronchiectasis. ABPA is not uncommon, but under-diagnosis/misdiagnosis and inappropriate management are common in clinical practice, due to the varied manifestations, inconsistent diagnostic criteria, and the need of complicated laboratory studies. To improve the diagnosis and treatment of ABPA, experts of the Asthma Group of Chinese Thoracic Society proposed an expert consensus on the diagnosis and treatment of ABPA in 2017 (1 st Edition). Its publication has been well received by the Chinese physicians, and promoted the appropriate management of the disease. In the past 5 years, advances have been made in the investigation into the mechanisms, and in the diagnosis and therapy of ABPA, including novel insight into the pathogenesis, more studies of the diagnostic criteria, and more evidence on the efficacy of glucocorticoid, antifungal and/or biologic therapies. Based on new evidence and the clinical practice in China, experts of the Asthma Group of Chinese Thoracic Society updated the consensus.

In vivo anti-tumor activity of Lignosus rhinocerus TM02® using a MCF7-xenograft NCr nude mice model

Ethnopharmacological relevanceLignosus rhinocerus (Cooke) Ryvarden (also known as Tiger Milk mushroom, TMM), is a basidiomycete belonging to the Polyporaceae family. It has been documented to be used by traditional Chinese physicians and indigenous people in Southeast Asia to treat a variety of illnesses, such as gastritis, arthritis, and respiratory conditions, as well as to restore patients' physical well-being. TMM has also been used in folk medicine to treat cancer. For example, people from the indigenous Kensiu tribe of northeast Kedah (Malaysia) apply shredded TMM sclerotium mixed with water directly onto breast skin to treat breast cancer, while Chinese practitioners from Hong Kong, China prescribe TMM sclerotium as a treatment for liver cancer. L. rhinocerus has previously been demonstrated to possess selective anti-proliferative properties in vitro, however pre-clinical in vivo research has not yet been conducted. Aim of studyThis study aimed to examine the anti-tumor activities of L. rhinocerus TM02®, using two different sample preparations [cold water extract (CWE) and fraction] via various routes of administration (oral and intraperitoneal) on an MCF7-xenograft nude mouse model. This study also investigated the inhibitory effect of TM02® CWE and its fractions against COX-2 in vitro using LPS-induced RAW264.7 macrophages, on the basis of the relationship between COX-2 and metastasis, apoptosis resistance, as well as the proliferation of cancer cells. Materials and methodsThe first preparation, L. rhinocerus TM02® sclerotium powder (TSP) was dissolved in cold water to obtain the cold water extract (CWE). It was further fractionated based on its molecular weight to obtain the high (HMW), medium (MMW) and low (LMW) molecular weight fractions. The second preparation, known as the TM02® rhinoprolycan fraction (TRF), was obtained by combining the HMW and MMW fractions. TSP was given orally to mimic the daily consumption of a supplement; TRF was administered intraperitoneally to mimic typical tumorous cancer treatment with a rapid and more thorough absorption through the peritoneal cavity. Another experiment was conducted to examine changes in COX-2 activity in LPS-induced RAW264.7 macrophages after a 1-h pre-treatment with CWE, HMW, and MMW. ResultsOur results revealed that intraperitoneal TRF-injection (90 μg/g BW) for 20 days reduced initial tumor volume by ∼64.3% (n = 5). The percentage of apoptotic cells was marginally higher in TRF-treated mice vs. control, suggesting that induction of apoptosis as one of the factors that led to tumor shrinkage. TSP (500 μg/g BW) oral treatment (n = 5) for 63 days (inclusive of pre-treatment prior to tumor inoculation) effectively inhibited tumor growth. Four of the five tumors totally regressed, demonstrating the effectiveness of TSP ingestion in suppressing tumor growth. Although no significant changes were found in mouse serum cytokines (TNF-α, IL-5, IL-6 and CCL2), some increasing and decreasing trends were observed. This may suggest the immunomodulatory potential of these treatments that can directly or indirectly affect tumor growth. Pre-treatment with CWE, HMW and MMW significantly reduced COX-2 activity in RAW264.7 macrophages upon 24 h LPS-stimulation, suggesting the potential of L. rhinocerus TM02® extract and fractions in regulating M1/M2 polarization. ConclusionBased on the findings of our investigation, both the rhinoprolycan fraction and crude sclerotial powder from L. rhinocerus TM02® demonstrated tumor suppressive effects, indicating that they contain substances with strong anticancer potential. The antitumor effects of L. rhinocerus TM02® in our study highlights the potential for further explorations into its mechanism of action and future development as a prophylactic or adjunct therapeutic against tumorous cancer.

Effects of psychological capital and social support availability on anxiety and depression among Chinese emergency physicians: Testing moderated mediation model.

Anxiety often precedes depression, and the pathway from anxiety to depression may be affected by multiple exposures. Our research aims to explore the mediating effect of the social support availability (SSA) between anxiety and depression and how it is moderated by psychological capital. A cross-sectional study was conducted among Chinese emergency physicians at the top-level general hospitals in eastern China. Data were collected via the questionnaire including anxiety and depression subscales of Symptom Checklist-90, Psychological Capital Questionnaire as well as Social Support Rating Scale. The PROCESS v3.4 macro was employed to assess the mediating role of SSA and a moderating role of psychological capital. A total of 536 valid samples were filtered. Anxiety, depression, SSA, and psychological capital were significant correlated. Anxiety was positively associated with depression (β = 0.82, p < 0.001), and the SSA mediated the relationship between anxiety and depression (indirect effect = 0.013, 95%BootCI [0.005, 0.023]). Psychological capital (specifically, self-efficacy, hope and resilience) further played a moderating role in the relationship between SSA and depression (β = 0.06, p < 0.01). The mental health of emergency physicians should be concerned. In order to decrease anxiety and depression, SSA and psychological capital should be increased as the interventions for emergency physicians.

Relationship between psychological capital and depression in Chinese physicians: The mediating role of organizational commitment and coping style.

It is well known that the medical profession is a high-risk practice, with intense work and complex situations. The physicians are prone to suffer from depression due to occupational stress under high workloads for long periods of time. Depression not only impairs physicians' mental health, but also affects the quality of health services, so it is important to explore the factors and mechanisms affecting depression among physicians. In this cross-sectional study, 1,139 physicians from Heilongjiang Province were surveyed by cluster sampling procedures. The questionnaires included Psychological Capital Questionnaire, Chinese Employee Organizational Commitment Questionnaire, Trait Coping Style Questionnaire and Self-rating Depression Scale. Pearson correlation analysis and Bootstrap were used for statistical analysis. This study found that 41.6% of physicians suffering from depression. Among them, 17.0% of physicians showed moderate depression, and 2.6% of physicians exhibited severe depression. The serial-multiple mediation of organizational commitment and positive coping styles in the relationship between psychological capital and depression was significant. The results showed that the psychological capital was sequentially associated with increased organizational commitment, and then increased positive coping styles, which resulted in reduced depression among physicians.

Communication Skills (CS) training of physicians in China and its role in actual challenges of patient-physician relationship: a cross-sectional survey

BackgroundThe Chinese healthcare system is affected by frequent disputes between physicians and patients. Although recent reforms have contributed towards improving the patient-physician relationship, distrust in physicians is still high. Communication skills (CS) training of physicians holds the key to improving patient confidence and diffusing stressful situations. This survey reports on the status of CS training in medical education in China, and the experiences and attitudes of physicians towards CS training.MethodsA cross-sectional survey was conducted at medical institutions across China. A questionnaire developed for this study included the status of CS training, current aspects of patient-physician relationships, perceived own CS and patient-centeredness with Likert-scaled items from 1 (most negative) to 6 (most positive). Physicians’ attitude towards CS training was measured with the Communication Skills Attitude Scale (CSAS) and its subscales PAS (Positive Attitude Scale) and NAS (Negative Attitude Scale). Data were analyzed descriptively and for group differences between the hospital level and operating vs. non-operating physicians. Binary logistic regression analysis was done to find associations explaining the occurrence of verbal and physical attacks and the role of CS attitudes.ResultsOut of 1080 questionnaires, 772 physicians met inclusion criteria. A total of 466/772 participants (60.4%) had received at least one CS training during their career. The participants rated the current situation related to patient-physician relationship in China as highly stressful (mean = 4.52, SD = 1.26, 95% CI: 4.43–4.60), experiencing verbal attacks in the past three years once a year in 372/772 cases (48.2%) and physical attacks 111/772 times (14.4%). The mean PAS was 62.96 (SD = 7.63, 95% CI: 62.41–63.47). Being female was associated with increased risk of verbal attacks (OR = 1.51, 95% CI: 1.01–2.25) while working in a tertiary hospital and showing high levels of PAS decreased this risk (OR = 0.62, 95% CI: 0.43–0.89, and OR = 0.95, 95% CI: 0.93–0.98). Having received a previous CS training decreased the odds of physical attacks (OR = 0.54, 95% CI: 0.35–0.83).ConclusionsA majority of Chinese physicians showed a high positive attitude towards CS training, were trained in CS and would value further training. Our results highlight that CS training is likely to promote patient-centered communication and reduce attacks against physicians. Both of these effects are to improve the patient-physician-relationship in the long run. More CS training should be offered to Chinese physicians, especially at secondary- and primary-care hospitals, where such practices remain infrequent.

Prevalence and determinants of smoking behavior among physicians in emergency department: A national cross-sectional study in China.

To understand the current status of smoking behavior among emergency physicians in China and to explore its determinants. The emergency department is considered a more appropriate setting for tobacco interventions. However, the smoking behavior of emergency physicians can reduce the effectiveness of interventions for patient smoking behavior. From July to August 2018, we conducted a structured online questionnaire among Chinese emergency medicine physicians. We used descriptive analysis with binary logistic regression to analyze the current smoking status of Chinese emergency physicians and its determinants. A total of 10,457 emergency physicians were included in this study. The prevalence of smoking among physicians was 25.35% (with 34.15 and 1.59% among male and female physicians, respectively). Results of logistic regression showed that postgraduate education (OR = 0.52, 95% CI: 0.41-0.66), chief-level title (OR = 0.79, 95% CI: 0.65-0.97), and regular exercise habits (OR = 0.83, 95% CI: 0.76-0.92) were associated with a lower risk of smoking behavior. However, being over 50 years old (OR = 1.71, 95% CI: 1.29-2.27), being fixed-term (OR = 1.25, 95% CI: 1.10-1.42), and having depressive symptoms (OR = 1.43, 95% CI: 1.28-1.61) were associated with a higher risk of smoking. The prevalence of smoking behavior among emergency physicians in China is high. Hospital management could reduce the incidence of smoking behavior among emergency physicians by strengthening smoking cessation training, paying attention to physicians' psychological health, reducing pressure on physicians in fixed-term positions, and encouraging physicians to develop regular exercise habits.

Current Status of Intergroup Threats Perceived by Chinese Physicians and Its Association with Organizational Psychology, Behavior, and Well-Being during the COVID-19 Pandemic: A Cross-Sectional Survey.

(1) Background: Chinese physicians have encountered serious physical and verbal attacks in recent decades due to poor patient–physician relationships, leading to a broad spectrum of negative consequences. This study aims to assess the status of intergroup threats perceived by physicians and explore its association with organizational psychology, behavior, and well-being during the COVID-19 pandemic. (2) Methods: We conducted a cross-sectional online survey with physicians from November to December 2020 in three provinces: Heilongjiang Province, Henan Province, and Zhejiang Province, in China. A total of 604 physicians were recruited to complete an anonymous questionnaire. There were 423 valid questionnaires. (3) Results: We developed a 25-item intergroup threat scale with four dimensions: interest damage, performance impairment, value derogation, and unjust sentiment. Internal consistency reliability analyses showed that the four dimensions and overall scale exhibited high internal consistency (0.756–0.947). Additionally, the average scores for physicians’ perceived overall intergroup threat, interest damage, performance impairment, value derogation, and unjust sentiment were 4.35 ± 0.51, 4.24 ± 0.73, 4.33 ± 0.58, 4.22 ± 0.65, and 4.53 ± 0.55, respectively. Moreover, this study shows that the intergroup threats perceived positively by physicians were associated with psychological stress (β = 0.270, p < 0.01), emotional exhaustion (β = 0.351, p < 0.01), turnover intention (β = 0.268, p < 0.01), and defensive medical behavior (β = 0.224, p < 0.01), and were negatively associated with job satisfaction (β = −0.194, p < 0.01) and subjective well-being (β = −0.245, p < 0.01). (4) Conclusions: The newly developed scale in this study is a reliable tool for measuring intergroup threats perceived by Chinese physicians. Physicians in China were suffering high-level intergroup threats during the anti-COVID-19 pandemic, which has a significant impact on damage to organizational psychology, behavior, and well-being. Intergroup threats perceived by physicians not only enlarged the risk of emotional exhaustion and psychological stress but also threatened organizational well-being. Moreover, greater intergroup threats were associated with a lower job satisfaction, more frequent defensive medical behavior, and a higher turnover intention for physicians. The results of this study suggest that essential intervention and governance measures should be considered to protect physicians’ well-being and benefits in China, which are urgently needed.

A new approach for optimizing empirical prescriptions of famous physicians based on network target: taking Qingluo Decoction as an example

Based on the network target approach and technology, this study proposed for the first time a novel optimization method for Chinese medicine formulae. Moreover, with Qingluo Decoction as an example, a method for the research and development of Chinese medicine, which combines scientific methodology and experience of famous doctors, was developed. Specifically, based on the composition of Qingluo Decoction, this study used the using network target for intelligent and quantitative analysis on drug actions(UNIQ) to predict the medicinals that targeted the key pathways of rheumatoid arthritis(RA) such as angiogenesis. Then, combining the experience of the first national Chinese medical master LI Ji-ren and Aihui famous Chinese medicine doctor LI Yan and Chinese medicine theory, this study developed a novel angiogenesis-targeted prescription modified Qingluo Decoction(MQLD). Afterward, the clinical efficacy and mechanism of MQLD were verified. The results showed that 27 medicinals with significant regulatory effect on angiogenesis-related key signaling pathways were identified by UNIQ, among which 6 were selected by the Chinese medicine physicians to develop the MQLD. Clinical trials demonstrated that the clinical efficacy of MQLD, in terms of either American College of Rheumatology 20% improvement and 50% improvement criteria(ACR20, ACR50) or TCM syndrome evaluation, was better than that of Qingluo Decoction. Experimental study revealed that MQLD can inhibit RA angiogenesis by acting on the vascular endothelial growth factor(VEGF) pathway, nuclear factor κB(NF-κB) pathway, inflammatory cytokine release, and immune cell regulation. Taken together, this study developed a new formula MQLD with improved clinical efficacy, precise applicable clinical settings, and authorized patent through the network target technology, thus providing a new way for the precise development of Chinese medicine and preservation of the experience of famous physicians.