Guidelines for Ideological and Political Teaching of the Doctor-patient Communication Courses / 中国医学伦理学

To promote the ideological and political construction of the doctor-patient communication course, the research group discussed the subject characteristics and proposed the goals, principles, elements, and paths of the ideological and political construction of the doctor-patient communication course combined with practical teaching and relevant policy documents. Besides, this paper put forward the top-level framework design for the implementation, curriculum assessment, and evaluation indicators of the ideological and political construction, and developed the Guidelines for Ideological and Political Teaching of the Doctor-patient Communication Course and related teaching evaluation indicators, with a view to providing reference evaluation standards for the ideological and political construction of the doctor-patient communication course in China.

Cognitive Analysis and Countermeasures of Medical Humanistic Service Ability Based on the Perspective of Medical Staff in Public Hospitals / 中国医学伦理学

【Objective:】 To explore the cognition of medical staff in public hospitals regarding the medical humanistic service ability, and to discuss, analyze, and put forward targeted suggestions based on statistical data. 【Methods:】 A self-designed questionnaire survey was conducted among 825 medical staff randomly selected from public medical institutions in Nanjing, Central, Northern and Southern Jiangsu Province. SPSS21.0 was used to analyze the data. 【Results:】 The average score of medical staff’s familiarity with medical humanities was 3.64 points. In the cognition of the components of medical humanistic service ability, the doctor-patient communication ability accounted for the highest proportion (90.82%). There were differences in the cognition of medical staff with different demographic characteristics on the dimensions of appearance and behavior ability, doctor-patient communication ability, and patient care ability (P<0.05). The surgeon’s cognition of the importance of medical humanities was lower than that of the other four departments (P<0.05). 【Conclusion:】 Medical staff needed to improve their medical humanistic service abilities, and the cognition of humanistic differences among different categories of personnel needed to be adjusted. Public hospitals were suggested to clarify the evaluation elements and standards of medical humanistic services, and focus on solving cognitive differences to improve medical humanistic service abilities, speeding up the construction of humanistic hospitals, promoting medical humanistic service abilities. In addition, it was also necessary to improve the quality of medical humanistic education in colleges and universities through ideological and political courses.

Discussion on the Discipline Structure of Chinese Medical Humanities Based on the Views of Chinese Scholars / 中国医学伦理学

Discipline structure, as the core of discipline construction, plays an important role in promoting the prosperity of medical humanities. By sorting out the Chinese scholars’ division of the structure of medical humanities in China, this paper preliminarily discussed the existence of the subordinate discipline of medical humanities in China, and preliminarily verified the rationality and feasibility the viewpoint of "building a first-class discipline of medical humanities under the medical category, and forming a subordinate discipline of medical humanities based on horizontal association". At the same time, this paper put forward the view that the structure of medical humanities in China should be determined according to the needs of the current social development in China, and the concepts and criteria contained in the division of the Chinese discipline catalogue, so as to pave the way for the follow-up research.

Dynamic competition between SARS-CoV-2 NSP1 and mRNA on the human ribosome inhibits translation initiation

SARS-CoV-2 recently emerged as a human pathogen and is the causative agent of the COVID-19 pandemic. A molecular framework of how the virus manipulates host cellular machinery to facilitate infection remains unclear. Here, we focus on SARS-CoV-2 NSP1, which is proposed to be a virulence factor that inhibits protein synthesis by directly binding the human ribosome. Using extract-based and reconstitution experiments, we demonstrate that NSP1 inhibits translation initiation on model human and SARS-CoV-2 mRNAs. NSP1 also specifically binds to the small (40S) ribosomal subunit, which is required for translation inhibition. Using single-molecule fluorescence assays to monitor NSP1-40S subunit binding in real time, we demonstrate that eukaryotic translation initiation factors (eIFs) modulate the interaction: NSP1 rapidly and stably associates with most ribosomal pre-initiation complexes in the absence of mRNA, with particular enhancement and inhibition by eIF1 and eIF3j, respectively. Using model mRNAs and an inter-ribosomal-subunit FRET signal, we elucidate that NSP1 competes with RNA segments downstream of the start codon to bind the 40S subunit and that the protein is unable to associate rapidly with 80S ribosomes assembled on an mRNA. Collectively, our findings support a model where NSP1 associates with the open head conformation of the 40S subunit to inhibit an early step of translation, by preventing accommodation of mRNA within the entry channel. SIGNIFICANCE STATEMENTSARS-CoV-2 is the causative agent of the COVID-19 pandemic. A molecular framework for how SARS-CoV-2 manipulates host cellular machinery to facilitate infection is needed. Here, we integrate biochemical and single-molecule strategies to reveal molecular insight into how NSP1 from SARS-CoV-2 inhibits translation initiation. NSP1 directly binds to the small (40S) subunit of the human ribosome, which is modulated by human initiation factors. Further, NSP1 and mRNA compete with each other to bind the ribosome. Our findings suggest that the presence of NSP1 on the small ribosomal subunit prevents proper accommodation of the mRNA. How this competition disrupts the many steps of translation initiation is an important target for future studies.

Analysis and effect evaluation of the intervention using GLTC doctor-patient communication program for inpatients / 中华医院管理杂志

Objective:To explore the value of a holistic communication program for inpatients developed based on the medical humanistic GLTC communication model, designed to improve patient satisfaction and medical quality, and effectively enhance doctors′ communication and clinical work capabilities.Methods:A GLTC Doctor-Inpatient Communication Program and an Inpatient Satisfaction Questionnaire for Doctor-patient Communication were customized.From August 2018 to February 2019, the communication program was used to train doctors from different departments of five tertiary public hospitals in Jiangsu province. The questionnaire was used to survey both doctors and their inpatients. 250 questionnaires were distributed each time, to compare the doctor-patient satisfaction before and after the training and influencing factors. Data so acquired were subject to descriptive analysis, t-tests and multiple linear regression analysis. Results:Since application of the program, patient satisfaction scoring was higher than that before in general( P<0.05), while the patient satisfaction for medical expenses and disease explanation communication related programs was low. The difference of both doctors and patients satisfaction scoring for doctor-patient communication was statistically significant( P<0.05). Oncologists presented a higher evaluation on the applicability of the program than those from other departments( P<0.05). Conclusions:Application of the GLTC doctor-patient communication program can effectively improve the satisfaction of inpatients. It is recommended that this communication program be integrated into the entire medical treatment of inpatients, and the implementation plan should be differentiated according to the differences of inpatients. It is necessary to strengthen the communication of medical expenses and explain medical knowledge to inpatients, while doctors′ mindset of consultation should be adapted, with the program constantly improved for higher clinical applicability.

Reflection on enhancing medical humanitarian activities in clinical teaching / 中华医学教育探索杂志

Enhancing medical humanitarian activities in clinical teaching is demanded by modern medicine and education.It contains the modern values of constructing a harmonious doctor-patientrelationship and adjusting to medical education and modern medical model development.We put forward several countermeasures such as establishing concept of respect for people,improving teachers'humanistic caring ability,strengthening management to enhance students' sense of responsibility,enhancing students' doctor-patient communication skills,and abiding by relevant laws and regulations in the current situation which lacks humanistic care,doctor-patient communication and legal concept.