Diet and lifestyle behaviours simultaneously act on frailty: it is time to move the threshold of frailty prevention and control forward.

BACKGROUND: To analyse the association among the simultaneous effects of dietary intake, daily life behavioural factors, and frailty outcomes in older Chinese women, we predicted the probability of maintaining physical robustness under a combination of different variables. METHODS: The Fried frailty criterion was used to determine the three groups of "frailty", "pre-frailty", and "robust", and a national epidemiological survey was performed. The three-classification decision tree model was fitted, and the comprehensive performance of the model was evaluated to predict the probability of occurrence of different outcomes. RESULTS: Among the 1,044 participants, 15.9% were frailty and 50.29% were pre-frailty; the overall prevalence first increased and then decreased with age, reaching a peak at 70-74 years of age. Through univariate analysis, filtering, and embedded screening, eight significant variables were identified: staple food, spices, exercise (frequency, intensity, and time), work frequency, self-feeling, and family emotions. In the three-classification decision tree, the values of each evaluation index of Model 3 were relatively average; the accuracy, recall, specificity, precision, and F1 score range were between 75% and 84%, and the AUC was also greater than 0.800, indicating excellent performance and the best interpretability of the results. Model 3 takes exercise time as the root node and contains 6 variables and 10 types, suggesting the impact of the comprehensive effect of these variables on robust and non-robust populations (the predicted probability range is 6.67-93.33%). CONCLUSION: The combined effect of these factors (no exercise or less than 0.5 h of exercise per day, occasional exercise, exercise at low intensity, feeling more tired at work, and eating too many staple foods (> 450 g per day) are more detrimental to maintaining robustness.

Palladium-Catalyzed Direct Carbonylation of Bromoacetonitrile to Synthesize 2-Cyano-N-acetamide and 2-Cyanoacetate Compounds.

Nitrile compounds containing ester and amide groups are important functionalized chemicals in synthetic and medicinal chemistry. In this article, an efficient and convenient palladium-catalyzed carbonylative procedure toward 2-cyano-N-acetamide and 2-cyanoacetate compounds has been developed. The reaction proceeds under mild conditions via radical intermediate which is suitable for late-stage functionalization. Gram-scale experiment was performed successfully under low catalyst loading and gave the target product in excellent yield. Additionally, this transformation can be performed under atmospheric pressure and provide alternative routes to 7 drug precursors.

[Therapeutic efficacy of volume-guaranteed high frequency oscillation ventilation on respiratory failure in preterm infants with a gestational age of 28-34 weeks: a prospective randomized controlled study]. / 容量保证的高频振荡通气模式对胎龄28~34å‘¨æ—©äº§å„¿å‘¼å¸è¡°ç«­ç–—æ•ˆçš„å‰çž»æ€§éšæœºå¯¹ç §ç ”ç©¶.

OBJECTIVES: To investigate the therapeutic efficacy of volume-guaranteed high frequency oscillation ventilation (HFOV-VG) versus conventional mechanical ventilation (CMV) in the treatment of preterm infants with respiratory failure. METHODS: A prospective study was conducted on 112 preterm infants with respiratory failure (a gestational age of 28-34 weeks) who were admitted to the Department of Neonatology, Jiangyin Hospital Affiliated to Medical School of Southeast University, from October 2018 to December 2022. The infants were randomly divided into an HFOV-VG group (44 infants) and a CMV group (68 infants) using the coin tossing method based on the mode of mechanical ventilation. The therapeutic efficacy was compared between the two groups. RESULTS: After 24 hours of treatment, both the HFOV-VG and CMV groups showed significant improvements in arterial blood pH, partial pressure of oxygen, partial pressure of carbon dioxide, and partial pressure of oxygen/fractional concentration of inspired oxygen ratio (P<0.05), and the HFOV-VG group had better improvements than the CMV group (P<0.05). There were no significant differences between the two groups in the incidence rate of complications, 28-day mortality rate, and length of hospital stay (P>0.05), but the HFOV-VG group had a significantly shorter duration of invasive mechanical ventilation than the CMV group (P<0.05). The follow-up at the corrected age of 6 months showed that there were no significant differences between the two groups in the scores of developmental quotient, gross motor function, fine motor function, adaptive ability, language, and social behavior in the Pediatric Neuropsychological Development Scale (P>0.05). CONCLUSIONS: Compared with CMV mode, HFOV-VG mode improves partial pressure of oxygen and promotes carbon dioxide elimination, thereby enhancing oxygenation and shortening the duration of mechanical ventilation in preterm infants with respiratory failure, while it has no significant impact on short-term neurobehavioral development in these infants.

Dietary risk factors for inflammatory bowel disease in Shanghai: A case-control study.

BACKGROUND AND OBJECTIVES: Inflammatory bowel disease (IBD) is a multifactorial condition involving the complex interplay of genomics, microbiota, immunology, environment, and personal behaviors, particularly diet. METHODS AND STUDY DESIGN: A case-control study in a tertiary referral hospital. Fifty patients with IBD and 50 controls without gastrointestinal diseases were enrolled consecutively from October 1, 2016, to December 31, 2017. Sociodemographic and Food Frequency Questionnaires (FFQs) were completed, and dietary risk factors for IBD were identified. RESULTS: Six major foods were associated with the recurrent incidence of IBD (p<0.05): chili, fish, milk, nuts, eggs, and fruit. Logistic regression analysis revealed that eating chili and drinking milk more than three times weekly increased the risk of relapse, as did eating fish and nuts one or two times weekly. Eating fruit more than once weekly reduced the risk of IBD. Fish, seafood, vegetables, nuts, beef, and fruit, along with a history of food allergy, were associated with a high risk of clinically recurrent IBD. Dietary patterns featuring seafood and nuts also increased the risk of relapse. CONCLUSIONS: The consumption of chili, milk, fish, and nuts beyond moderate weekly frequencies increased the risk of IBD, whereas fruit consumption was consistently protective against IBD development. Relapse susceptibility was also associated with a history of food allergy. Thus, IBD risk management can involve more personalized and less restrictive dietary patterns, as well as the enforcement of weekly dose thresholds. Uncertainty remains regarding association differentials between ulcerative colitis (UC) and Crohn's disease (CD).

Clinical effect of different maintenance doses of caffeine citrate in the treatment of preterm infants requiring assisted ventilation: a pilot multicenter study. / ä¸åŒç»´æŒå‰‚é‡æž¸æ©¼é ¸å’–å•¡å› å¯¹è¾ åŠ©é€šæ°”æ—©äº§å„¿çš„ç–—æ•ˆè¯„ä¼°ï¼šä¸€é¡¹åˆæ­¥å¤šä¸­å¿ƒç ”ç©¶.

OBJECTIVES: To explore the optimal maintenance dose of caffeine citrate for preterm infants requiring assisted ventilation and caffeine citrate treatment. METHODS: A retrospective analysis was performed on the medical data of 566 preterm infants (gestational age ≤34 weeks) who were treated and required assisted ventilation and caffeine citrate treatment in the neonatal intensive care unit of 30 tertiary hospitals in Jiangsu Province of China between January 1 and December 31, 2019. The 405 preterm infants receiving high-dose (10 mg/kg per day) caffeine citrate after a loading dose of 20 mg/kg within 24 hours after birth were enrolled as the high-dose group. The 161 preterm infants receiving low-dose (5 mg/kg per day) caffeine citrate were enrolled as the low-dose group. RESULTS: Compared with the low-dose group, the high-dose group had significant reductions in the need for high-concentration oxygen during assisted ventilation (P=0.044), the duration of oxygen inhalation after weaning from noninvasive ventilation (P<0.01), total oxygen inhalation time during hospitalization (P<0.01), the proportion of preterm infants requiring noninvasive ventilation again (P<0.01), the rate of use of pulmonary surfactant and budesonide (P<0.05), and the incidence rates of apnea and bronchopulmonary dysplasia (P<0.01), but the high-dose group had a significantly increased incidence rate of feeding intolerance (P=0.032). There were no significant differences between the two groups in the body weight change, the incidence rates of retinopathy of prematurity, intraventricular hemorrhage or necrotizing enterocolitis, the mortality rate, and the duration of caffeine use (P>0.05). CONCLUSIONS: This pilot multicenter study shows that the high maintenance dose (10 mg/kg per day) is generally beneficial to preterm infants in China and does not increase the incidence rate of common adverse reactions. For the risk of feeding intolerance, further research is needed to eliminate the interference of confounding factors as far as possible.

Charge transport spectra in superconductor-InAs/GaSb-superconductor heterostructures.

Charge transport physics in InAs/GaSb bi-layer systems has recently attracted attention for the experimental search for two-dimensional topological superconducting states in solids. Here we report measurement of charge transport spectra of nano devices consisting of an InAs/GaSb quantum well sandwiched by tantalum superconductors. We explore the current-voltage relation as a function of the charge-carrier density in the quantum well controlled by a gate voltage and an external magnetic field. We observe three types of differential resistance peaks, all of which can be effectively tuned by the external magnetic field, and, however, two of which appear at electric currents independent of the gate voltage, indicating a dominant mechanism from the superconductor and the system geometry. By analyzing the spectroscopic features, we find that the three types of peaks identify Andreev reflections, quasi-particle interference, and superconducting transitions in the device, respectively. Our results provide a basis for further exploration of possible topological superconducting state in the InAs/GaSb system.

Multiple factors influence bacterial community diversity and composition in soils with rare earth element and heavy metal co-contamination.

The effects of long-term rare earth element (REE) and heavy metal (HM) contamination on soil bacterial communities remains poorly understood. In this study, soil samples co-contaminated with REEs and HMs were collected from a rare-earth tailing dam. The bacterial community composition and diversity were analyzed through Illumina high-throughput sequencing with 16S rRNA gene amplicons. Bacterial community richness and diversity were lower in the co-contaminated soils than in the uncontaminated soils, with clearly different bacterial community compositions. The results showed that total organic carbon and available potassium were the most important factors affecting bacterial community richness and diversity, followed by the REE and HM contents. Although the canonical correspondence analysis results showed that an REE alone had no obvious effects on bacterial community structures, we found that the combined effects of soil physicochemical properties and REE and HM contents regulated bacterial community structure and composition. The effects of REEs and HMs on bacterial communities were similar, whereas their combined contributions were greater than the individual effects of REEs or HMs. Some bacterial taxa were worth noting. These specifically included the plant growth-promoting bacteria Exiguobacterium (sensitive to REEs and HMs) and oligotrophic microorganisms with metal tolerance (prevalent in contaminated soil); moreover, relative abundance of JTB255-Marine Benthic Group, Rhodobacteraceae, Erythrobacter, and Truepera may be correlated with REEs. This study was the first to investigate the responses of bacterial communities to REE and HM co-contamination. The current results have major implications for the ecological risk assessment of environments co-contaminated with REEs and HMs.

[Textual research on classical prescriptions in Mongolian medicine].

Mongolians have a long history of using prescriptions, which can be classified into four stages as follows: the germination and experience accumulation stage before the 13 th century, the theoretical formation stage from the 13 th to 16 th century, the rapid development stage from the 17 th to 20 th century, and the leaping development stage from the mid-20 th century to the present. The prescriptions from the ancient classical or representative medical books have always been used by Mongolian physicians for generations, and they are still in use due to the definite curative effects. In 2008, the Notice on Issuing the Supplementary Provisions to the Registration and Management of Traditional Chinese Medicine(TCM) described that China has attached more importance to the excavation and development of classical prescriptions. As stipulated in the Law of the People's Republic of China on Traditional Chinese Medicine, the classical prescriptions should be those available in ancient TCM classics and still in wide use, with exact curative effects, distinct features, and obvious advantages. This paper expounded the historical formation and development of classical prescriptions in Mongo-lian medicine, introduced the five most influential ancient medical books revealing the formation and development of these classic prescriptions, and traced the origin of such classical prescriptions as Wenguanmu Siwei Decoction, Shouzhangshen Bawei Decoction, Jianghuang Siwei Decoction and summarized the origin, development history and characteristics of classical prescriptions in Mongolian medicine, aiming to provide a reference for their further research and development.

A Note on the Hierarchy of Quantum Measurement Incompatibilities.

The quantum measurement incompatibility is a distinctive feature of quantum mechanics. We investigate the incompatibility of a set of general measurements and classify the incompatibility by the hierarchy of compatibilities of its subsets. By using the approach of adding noises to measurement operators, we present a complete classification of the incompatibility of a given measurement assemblage with n members. Detailed examples are given for the incompatibility of unbiased qubit measurements based on a semidefinite program.

Early Change in Global Longitudinal Strain is an Independent Predictor of Left Ventricular Adverse Remodelling in Patients With Right Ventricular Apical Pacing.

BACKGROUND: Right ventricular apical (RVA) pacing is related to adverse left ventricular (LV) remodelling. This study assessed changes in global longitudinal strain (GLS) after permanent RVA pacing, and investigated whether GLS at one month can predict later LV ejection fraction (LVEF) decline. METHODS: The study enrolled 68 patients with normal LVEF (≥50%) who underwent dual chamber pacemaker implantation for third-degree atrioventricular block. Global strains and LVEF were assessed using three-dimensional (3D) speckle tracking strain echocardiography (STE). RESULTS: At one month, GLS was significantly lower in those patients who developed pacing-induced LV dysfunction (PIVD), which was defined as a reduction in LVEF ≥5 percentage points at 12 months, than those who did not (-14.9±1.8 vs -16.1±1.7, p=0.014), although GLS was similar at baseline. In patients who developed PIVD, only GLS was significantly reduced at one month compared to baseline (-14.9±1.8 vs -16.6±1.2, p=0.022) whereas LVEF was not. Global longitudinal strain at one month was the only independent predictor for PIVD at 12 months on multivariate analysis (OR, 1.623; 95% CI, 0.986-2.210; p=0.009). Receiver operating characteristic (ROC) analysis showed that GLS at one month had a high predictive accuracy for the development of PIVD at 12 months, with an area under curve (AUC) of 0.88, 94% sensitivity, and 70% specificity. CONCLUSIONS: Global longitudinal strain at one month after pacemaker implantation had high predictive accuracy for identifying subsequent development of PIVD. Global longitudinal strain may be an invaluable parameter to predict LV adverse remodelling following permanent RVA pacing.

π and 4π Josephson Effects Mediated by a Dirac Semimetal.

Cd_{3}As_{2} is a three-dimensional topological Dirac semimetal with connected Fermi-arc surface states. It has been suggested that topological superconductivity can be achieved in the nontrivial surface states of topological materials by utilizing the superconductor proximity effect. Here we report observations of both π and 4π periodic supercurrents in aluminum-Cd_{3}As_{2}-aluminum Josephson junctions. The π period is manifested by both the magnetic-field dependence of the critical supercurrent and the appearance of half-integer Shapiro steps in the ac Josephson effect. Our macroscopic theory suggests that the π period arises from interference between the induced bulk superconductivity and the induced Fermi-arc surface superconductivity. The 4π period is manifested by the missing first Shapiro steps and is expected for topological superconductivity.

Neptunicoccus sediminis gen. nov., sp. nov., a member of the family Rhodobacteraceae isolated from the Yellow Sea.

A novel Gram-stain-negative bacterium, designated strain CY02T, was isolated from sediment of the Yellow Sea. Cells of CY02T were aerobic, coccus or short rods. Growth occurred at 5-42 °C (optimum, 35 °C), pH 6-10 (optimum, 8.0) and 0.5-9.0 % NaCl (optimum, 1.5-3.0 %). Phylogenetic analysis of 16S rRNA gene sequences revealed that CY02T was a member of the family Rhodobacteraceae and exhibited less than 95 % sequence similarities with the closely related type strains of the family Rhodobacteraceae. The genomic DNA G+C content of CY02T was 57.5 mol%. The major respiratory quinone was ubiquinone-10 (Q-10). The polar lipids consisted of phosphatidylcholine, phosphatidylglycerol, phosphatidylethanolamine, diphosphatidylglycerol, three unidentified lipids, one unidentified phospholipid and one unidentified aminolipid. The predominant cellular fatty acids were C18 : 1ω7c (57.6 %), 11-methyl C18 : 1ω7c (22.8 %) and C16 : 0 (10.6 %). Based on the results of morphological, physiological, biochemical, chemotaxonomic, genotypic and phylogenetic analyses, strain CY02T represents a novel species of a novel genus of the family Rhodobacteraceae, for which the name Neptunicoccus sediminis gen. nov., sp. nov. is proposed. The type strain of Neptunicoccus sediminis is CY02T (=CCTCC AB 2015430T=KCTC 42985T=NBRC 111872T=MCCC 1K03518).

Topological Majorana Two-Channel Kondo Effect.

A one-dimensional time-reversal-invariant topological superconductor hosts a Majorana Kramers pair at each end, where time-reversal symmetry acts as a supersymmetry that flips local fermion parity. We examine the transport anomaly of such a superconductor, floating and tunnel-coupled to normal leads at its two ends. We demonstrate the realization of a topologically protected, channel-symmetric, two-channel Kondo effect without fine-tuning. Whereas the nonlocal teleportation vanishes, a lead present at one end telecontrols the universal transport through the other end.

Odd-Integer Quantum Hall States and Giant Spin Susceptibility in p-Type Few-Layer WSe_{2}.

We fabricate high-mobility p-type few-layer WSe_{2} field-effect transistors and surprisingly observe a series of quantum Hall (QH) states following an unconventional sequence predominated by odd-integer states under a moderate strength magnetic field. By tilting the magnetic field, we discover Landau level crossing effects at ultralow coincident angles, revealing that the Zeeman energy is about 3 times as large as the cyclotron energy near the valence band top at the Γ valley. This result implies the significant roles played by the exchange interactions in p-type few-layer WSe_{2}, in which itinerant or QH ferromagnetism likely occurs. Evidently, the Γ valley of few-layer WSe_{2} offers a unique platform with unusually heavy hole carriers and a substantially enhanced g factor for exploring strongly correlated phenomena.

Large-Scale, Facile Transfer of Oleic Acid-Stabilized Iron Oxide Nanoparticles to the Aqueous Phase for Biological Applications.

Fe3O4 nanoparticles synthesized via thermal decomposition in the organic phase have attracted tremendous research interest because of their unique morphology, size dispersion, and crystallinity. However, their poor water dispersibility strongly limited their development in biomedical applications. Therefore, a phase-transfer strategy through which hydrophobic nanoparticles with good performance in the aqueous phase can be obtained is an extremely critical issue. Herein, we present a large-scale, facile, highly efficient strategy for the phase transfer of oleic acid-coated Fe3O4 nanoparticles via a reverse-micelle-based oxidative reaction. The reverse micelle system improves the efficiency of the interface oxidative reaction and prevents the aggregation of nanoparticles during the reaction, facilitating the transfer of Fe3O4 nanoparticles from the organic phase to the aqueous phase. The transferred Fe3O4 nanoparticles are used as a T2 contrast agent to perform magnetic resonance imaging of CNE2 cells (nasopharyngeal carcinoma cell line). In addition, the free carboxyl groups on the surface of transferred nanoparticles can also be programmed to permit the conjugation of other molecules, in turn allowing nanoparticles to be extended in biological targeting or biological recognition applications. Therefore, this strategy offers a promising platform for the large-scale, highly efficient phase transfer of oleic acid-capped nanoparticles and may become a new paradigm to promote the development of diverse nanoparticles for widespread biomedical applications.

Long-Term Outcomes and Predictors of Sustained Response in Patients with Intestinal Behcet's Disease Treated with Infliximab.

BACKGROUND: Intestinal Behcet's disease (BD) is a specific subtype of BD. Effective drug therapy for intestinal BD remains elusive. AIMS: To investigate long-term outcomes and identify predictors of sustained response in intestinal BD patients receiving infliximab (IFX) treatment. METHODS: The medical records were reviewed of patients received IFX from September 2012 to March 2016. The cumulative probabilities of sustained response were calculated using the Kaplan-Meier. Predictor factors for sustained response were accessed by receiver operating characteristic curve. RESULTS: Totally, 27 active intestinal BD patients were enrolled. Sustained responses were observed in 17 patients, after a median follow-up duration 24 months (interquartile range 9-37). The proportion of clinical remission at week 14, 30, and 52 had occurred in 84.6, 70, and 70%, respectively, with the proportion of clinical remission of 69.2, 40, and 55%. The mucosal healing (MH) rate at week 14 was 72%. Kaplan-Meier estimated patients with achievement of clinical and biological responses at week 14 or MH was likely to remain sustained clinical response. ROC curve analysis revealed CRP level (of 6.85 mg/L) at week 14 is a potential predictor for discriminating patients with sustained response from relapse, with an area under the curve values of 0.837. CONCLUSIONS: IFX is effective and safe for induction and maintenance therapy in Chinese patients with moderate-to-severe active intestinal BD. Early achievement of clinical response and mucosal healing might associate long-term response. A lower CRP level seems to be associated with a more benign clinical course.

Effects of degree of hydrolysis (DH) on the functional properties of egg yolk hydrolysate with alcalase.

Effects of enzymatic hydrolysis on the physicochemical and functional properties of egg yolk were investigated in this study. Alcalase, neutrase and flavourzyme were used to hydrolyze egg yolk. Solubility, foaming properties, emulsifying and microstructure properties of egg yolk were determined after enzymatic hydrolysis. Results showed that alcalase had better efficiency of hydrolysis than neutrase and flavourzyme. Enzymatic hydrolysis caused a marked changes in protein solubility, surface hydrophobicity, molecular weight distributions, microstructure and other functional properties. It was observed that egg yolk and its hydrolysates exhibited a relatively smooth curve over the entire pH range; egg yolk hydrolysates with high DH had higher solubility than those having lower DH. Foam capacity and stability generally increased with increasing DH although foam stability showed a decrease at 15% DH. Hydrolysates of egg yolk showed scattered and fewer aggregated particles. This study demonstrated that egg yolk hydrolysates could be an excellent emulsifying agent for food and other applications.

Interband Absorption Enhanced Optical Activity in Discrete Au@Ag Core-Shell Nanocuboids: Probing Extended Helical Conformation of Chemisorbed Cysteine Molecules.

Detailed understanding of the interaction between a chiral molecule and a noble metal surface is essential to rationalize and advance interfacial self-assembly of amino acids and metal-mediated anchoring of proteins. Here we demonstrate that individual Au@Ag core-shell nanocuboids can serve as a plasmonic reporter of an extended helical network formed among chemisorbed cysteine molecules, through generating an interband absorption enhanced, Ag-surface-exclusive circular dichroism (CD) band in the UV region. The observed unusual, strong CD response in the hybrid Au@Ag-cysteine system can be used to probe in real time conformational evolution and structural rearrangement of biomolecules in general and also monitor the interfacial interaction between a metal surface and an adsorbed molecule, opening up the possibility of using Ag nanostructures as promising stereochemically attuned nanosensors.

Effectiveness of estrogen treatment before transcervical resection of adhesions on moderate and severe uterine adhesion patients.

Intrauterine adhesion (IUA), also known as Asherman's syndrome, is a common disease for among women. The extent of adhesion and pre-surgery hormone therapy greatly affects the function of uterine cavity. This current study investigates the association of different doses of estrogen before transcervical resection of adhesions (TCRA) surgery and clinical outcome in serious IUA. About 120 newly diagnostic serious IUA patients who underwent TCRA were randomly divided into three study groups: Estradiol valerate (progynova) 3 or 9 mg per diet before surgery and the control group. Follow-up hysteroscopy checkups were taken in 1- and 3-month post-operation. The effective power of 9 mg group was significantly higher than other groups. The 9 mg group achieved the best menstrual recovery rate in all study groups compared with the other two groups in 6 months post-operatively (p < 0.05). Our results confirmed estradiol valerateas an alternative effective drug for the prevention of IUAs before and after hysteroscopic surgery.

Identifying the competencies of doctors in China.

BACKGROUND: China adopted a Flexnerian model as its medical institutions developed over the recent past but the political, social, and economic environment has changed significantly since then. This has generated the need for educational reform, which in other countries, has largely been driven by competencies-oriented models such as those developed in Canada, and the United States. Our study sought to establish the competencies model, relevant to China, which will support educational reform efforts. METHODS: Data was collected using a cross-sectional survey of 1776 doctors from seven provinces in China. The surveys were translated and adapted from the Occupational Information Network General Work Activity questionnaire (O*NET-GWA) and Work Style questionnaire (O*NET-WS) developed under the auspices of the US Department of Labor. Exploratory factor analysis and confirmatory factor analysis ascertained the latent dimensions of the questionnaires, as well as the factor structures of the competencies model for the Chinese doctors. RESULTS: In exploratory factor analysis, the questionnaires were able to account for 64.25 % of total variance. All responses had high internal consistency and reliability. In confirmatory factor analysis, the loadings of six constructs were between 0.53 ~ 0.89 and were significant, Construct reliability (CR) were between 0.79 ~ 0.93 respectively. The results showed good convergent validity. The resultant models fit the data well (GFI was 0.92, RMSEA was 0.07) and the six-factor competencies framework for Chinese doctors emerged. CONCLUSIONS: The Chinese doctors' competencies framework includes six elements: (a) technical procedural skills; (b) diagnosis and management; (c) teamwork and administration; (d) communication; (e) professional behavior; and (f) professional values. These findings are relevant to China, consistent with its current situation, and similar to those developed in other countries.