Transformation of the education of health professionals in China: progress and challenges.

In this Review we examine the progress and challenges of China's ambitious 1998 reform of the world's largest health professional educational system. The reforms merged training institutions into universities and greatly expanded enrolment of health professionals. Positive achievements include an increase in the number of graduates to address human resources shortages, acceleration of production of diploma nurses to correct skill-mix imbalance, and priority for general practitioner training, especially of rural primary care workers. These developments have been accompanied by concerns: rapid expansion of the number of students without commensurate faculty strengthening, worries about dilution effect on quality, outdated curricular content, and ethical professionalism challenged by narrow technical training and growing admissions of students who did not express medicine as their first career choice. In this Review we underscore the importance of rebalance of the roles of health sciences institutions and government in educational policies and implementation. The imperative for reform is shown by a looming crisis of violence against health workers hypothesised as a result of many factors including deficient educational preparation and harmful profit-driven clinical practices.

Evaluation of a medical education policy with compulsory rural service in China.

Background: Since 2010, China has implemented a national programme to train general practitioners for rural areas. The programme enrolled medical students with a rural background who signed a contract for 6 years' compulsory rural service after graduation. China is transitioning its national COVID-19 strategies in view of the features of coronavirus Omicron variant, the vaccination coverage, and the need for socioeconomic development. Strengthening primary health care, especially the health workforce in rural areas, should be an important consideration during the policy transition. This study aims to evaluate the implementation process of enrolling medical students in the programme, their willingness to work in the rural settings and their actual job choice after graduation. Methods: The study chose four medical universities in central and western China. A total of 2,041 medical graduates who have signed a contract for compulsory rural service and 1,576 medical graduates enrolled "as usual" (no compulsory rural service) were recruited in five campaigns-every June from 2015 to 2019. A survey was conducted 1 week before their graduation ceremony. Results: The top three reasons for choosing this programme were: a recommendation of a family member or teacher, a guaranteed job after graduation and the waiver of the tuition fee. 23.0-29.7% of the study participants were not familiar with the policy details. 39.1% of the medical students signed a contract with a county other than that of their hometown. Medical graduates on the compulsory rural service programme had very low willingness (1.9%) to work in rural areas but 86.1% of them actually worked at township health centers. In contrast, the willingness to work at township health centers was 0.2% for the comparison group (medical graduates without the contract), and their actual job choice at township health centers was 0%. Conclusions: Although the well-trained medical graduates on the compulsory rural service programme have low willingness to work in the township health centers, 86.1% of them choose to do so following their contract. This programme will strengthen the primary health workforce to deal with the increasing disease burden as China is transitioning its national COVID-19 strategies.

Superhydrophobic and superaerophilic hierarchical Pt@MIL-101/PVDF composite for hydrogen water isotope exchange reactions.

A hierarchical porous composite of Pt@MIL-101/ployvinylidene fluoride (Pt@MIL-101/PVDF) was successfully prepared through a solution-processed method. This composite possesses advanced superhydrophobic and superaerophilic performance which makes it a promising catalyst facilitating liquid phase catalytic exchange techniques (LPCE) in hydrogen-water isotope exchange process. Its superhydrophobic property results in the repellence of water drops from flooding the catalytic surface with a relatively large contact angle in the exchange reaction, and its superaerophilic surface broke hydrogen bubbles into thin film so as to reach higher catalytic reactive efficiency. High reactivity and long-term stability in the reaction process can also be achieved by the configuration of mesoporous cages of MIL-101 confining Pt nanoparticles and preventing them from sintering.

[Analysis of hydrogen isotopes by gas chromatography using a MnCl2 coated γ-Al2O3 capillary packed column].

The conventional packed column gas chromatographic analysis of hydrogen isotopes has low column efficiency, broad peak and long retention time. In this work, a γ-Al2O3 with MnCl2 coated capillary packed column was tested at cryogenic temperature. The systematic column efficiency analysis and the hydrogen isotopes analytical technique research had been carried out. The results showed that, the γ-Al2O3 with MnCl2 coating could greatly improve the surface degree of order, pore structure and adsorption properties. Also the o-H2 peak and p-H2 peak were eluted in a single area. The γ-Al2O3 with MnCl2 coating was packed into a 0.53 mm inner diameter and 1.0 m long fused silica capillary column. It had a good linear relationship used this column with thermal conductivity detector (TCD) to detect the volume concentrations of hydrogen isotopes from 1 to 10 mL/L, and the relative error was less than 5% for low concentration sample testing. For H2, HD and D2, the retention times can be shortened to 39, 46 and 60 s, respectively. The limits of detection were reduced to 0.046, 0.067 and 0.072 mL/L, respectively. Compared with conventional packed column, capillary packed column had sharper peak form, higher separation degree of adjacent components, shorter retention time and lower detection limits. The above results indicate that the capillary packed column with TCD detector can be used for fast detection of low concentration of hydrogen isotopes and their online analysis.

Honeycomb-patterned fluorescent films fabricated by self-assembly of surfactant-assisted porphyrin/polymer composites.

A novel honeycomb-patterned fluorescent film was fabricated by self-assembly of polystyrene (PS)/poly(ethylene glycol) (PEG)/meso-tetra (N-methy-4-pyridyl) porphinetetratosylate (TMPyP) blend system, at the assistance of diisooctyl sodium sulfosuccinate (AOT). Ordered microporous PS/PEG/TMPyP/AOT blend films were prepared by the breath figure method. The condensed water droplets acted as the sacrificial templates, which were stabilized by strong hygroscopic PEG and amphiphilic surfactant AOT. Relative humidity and evaporation conditions considered as critical factors were investigated to control the morphologies of the films. The introduction of surfactant AOT greatly promoted the dissolution of the TMPyP in PS/PEG polymer solution according to the UV-vis spectra data, which led to the fluorescence enhancement of ordered porous blend films. The unique "internal ring" structures were formed during phase separation and confirmed by scanning electron microscopy images and fluorescence micrographs.