This paper reviews the development of physician professionalism and its research at home and abroad in recent decades.Content,evaluation,the problems and challenges,and the affecting factors of physician professionalism are analyzed.With regard to the status quo of physician professionalism in China,some ideas to improve and build physician professionalism in China are proposed.

Objective To investigate the clinical effect of low molecular heparin combined with mesalazine in patients with active ulcerative colitis(UC).Methods 90 cases of patients with UC were randomly divided into three groups:A group,B group and C group,with 30 cases in each group.A group was given oral treatment with sulfasalazine enteric-coated tablets,B group was given oral treatment with mesalazine and C group was given low molecular heparin calcium combined with mesalazine (4100 iu,1 /d).The three groups were treated for 2 weeks. Coagulant function index such as activated partial prothrombin time (APTT),fibrinogen(FIB),platelet count(PLT), platelet maximum aggregation rate(PAG(Max)),D-dimer(D-D),C-reactive protein(CRP)were detected in the two groups before and after treatment of 7 and 14d.Mayo disease activity index score was also recorded before and after treatment of 7 and 14d.And the differences among three groups were compared.Results There were significant differences in APTT,FIB,PLT and PAG(Max)after 7d,14d treatment among A,B and C groups(7d:F value were 17.652,12.427,42.873,14.318 respectively;14d:F value were 43.804,139.172,51.932,79.440 respectively,all P value <0.05).APTT of C group after 7d,14d[(36.32 ±3.56)μg/mL,(40.15 ±4.24)μg/mL]were higher than B group[(32.14 ±2.86)μg/mL,(33.04 ±3.32)μg/mL]and A group [(31.82 ±3.36 )μg/mL,(32.15 ± 3.24)μg/mL];FIB of C group after 7d,14d[(4.07 ±0.41 )g/L,(3.14 ±0.28)g/L]were lower than B group [(4.47 ±0.40)g/L,(4.06 ±0.33)g/L]and A group[(4.58 ±0.44)g/L,(4.23 ±0.37)g/L];PLT of C group af-ter 7d,14d[(262.22 ±60.61)×109 /L,(201.38 ±49.42)×109 /L]were lower than B group[(296.34 ±63.51)× 109 /L,(253.25 ±55.47)×109 /L]and A group[(301.71 ±70.62)×109 /L,(262.05 ±64.11)×109 /L];PAG (Max)of C group after 7d,14d[(0.46 ±0.08),(0.30 ±0.05)]were lower than B group[(0.57 ±0.10),(0.46 ± 0.06)]and A group[(0.59 ±0.12),(0.51 ±0.08)].There were significant differences in CRP,D-D after 14d treatment among A,B and C groups(F value were 91.967,139.172 respectively,all P value <0.05).CRP of C group after 14d[(7.50 ±1.35)mg/L]were lower than B group[(10.80 ±1.37)mg/L]and A group[(12.12 ±1.64)mg/L];D-D of C group after 14d[(0.26 ±0.02)mg/L]were lower than B group[(0.47 ±0.03)mg/L]and A group[(0.51 ± 0.04)mg/L].There were significant differences in Mayo index score,△Mayo index score after 14d treatment among A,B and C groups (F value were 182.170,89.802 respectively,all P value <0.05).Mayo index score of C group after 14d(1.51 ±0.33)were lower than B group(2.93 ±0.46)and A group(3.42 ±0.63);.△Mayo index score of C group after 14d(5.67 ±1.60)were lower than B group(4.25 ±1.32)and A group(3.79 ±1.21);Pearson corre-lation analysis showed that △Mayo Mayo index score were positively correlated with PAG(Max)reduction△PAG (Max),△D-D,△CRP,△PTL(r value were 0.616,0.702,0.734,0.569,respectively,all P <0.05).Multiple step-wise linear regression analysis showed that △PAG(Max),△D-D,△CRP,△PTL were closely related to △Mayo Mayo index score(partial regression coefficient were 4.209,2.451,0.801 respectively;t value were 7.890,4.787, 2.201,respectively,all P <0.05).Conclusion The clinical effect of low molecular heparin combined with mesala-zine in patients with active ulcerative colitis is effective,and the method can significantly improve the inflammation in patients with UC and high coagulation state,improving the clinical symptoms is better than the single drug,and worth clinical recommendations.

The pathogenesis of malignant lymphoma has been an important topic in tumor research ,but it is still unclear.Recent clinical studies showed that the expression level of Toll -like receptor 4(TLR4)was signif-icantly high in mantle cell lymphoma tissue and a variety of lymphoma cell lines .At the same time,the TLR4 ex-pression level was correlated with prognosis .The Role of TLR4 in malignant lymphoma for occurrence and devel-opment is reviewed in this article ,which may elucidate the pathogenesis and provide a new basis for the therapy of lymphoma.

[Objective] The artical summarizes in diagnosis and treatment of postnatal lack of lactation academic thoughts and characteristics of drug use,and own thoughts. [Method] Summary by reading text and access to my perception ,combined with the actual clinical,summarized his main syndrome differentiation and treatment of postnatal lack of lactation thought,medication,and explain orally .[Results] FU Qingzhu according to the cause of postnatal lack of lactation divided into two types, deficiency of Qi and blood,blockage of liver. Pointed out that the error appeared in the dialectical and put forward the correct opinions;and that the disease is mainly related to the lack of blood and liver qi stagnation; the main therapy is tonifying qi and blood, smoothing liver qi, dredging collateral for promoting lactation;the corresponding therapeutic prescriptions were given and analyzed;clinical application of good results.[Conclusion] FU Qingzhu 's idea put forward the original opinion and treatment of medicine, in order to inherit traditional Chinese medicine academic, improve the curative effect of postpartum hypogalactia,and give my opinion, may be the hope of the authority.

Objective:To optimize the extraction process of berberine hydrochloride from Sanhuang Diyu oil by Box-Benhnken re-sponse surface methodology. Methods:The extraction process was optimized with the size of each medicine ( X1 ) , the liquid-solid ra-tio ( X2 ) and the extraction time ( X3 ) as the independent variables and berberine hydrochloride extraction amount ( Y) as the depend-ent variable, and the effects of variables and their interactions on the extraction efficiency were studied. Results:The experiment results indicated that the optimal extraction conditions were as follows:the size of each medicine was 60 meshes, the liquid-solid ratio was 18, and the extraction time was 1. 5 h. Under the above conditions, 3 batches of berberine hydrochloride from Sanhuang Diyu oil were ex-tracted. The average extraction rate of berberine hydrochloride was (16.6 ±0.6) mg·g-1(n =3). Conclusion: The extraction process of Sanhuang Diyu oil optimized by Box-Behnken response surface methodology is simple, stable and predictable.

Pancreatic encephalopathy (PE)is a serious complication of pancreatitis,with difficulties in early diagnosis and poor prognosis. This article introduces the possible pathogenesis of PE involving pancreatin activation,cytokines,infection,water and electrolyte imbalance, and vitamin deficiency,summarizes the clinical manifestations and laboratory features of PE,and points out that the clinical manifestations of PE lack specificity and there are no reliable biochemical indices or diagnostic criteria.This article also elaborates on the diagnosis and treat-ment strategies for PE and points out that the key to PE treatment is active and effective treatment of the primary disease.Most PE patients are improved with the control of pancreatitis.

Objective To evaluate the risk factors for healthcare-associated infection (HAI)in patients in depart-ment of cardiology.Methods Clinical data of inpatients were performed retrospective case-control analysis,patients with HAI were as case group,while without HAI were as control group,factors for HAI between two groups were compared.Results 117 cases of HAI occurred among 2 308 patients,infection rate was 5.07%.The main infection site was respiratory tract (n=71 ,60.68%);a total of 90 pathogenic isolates were isolated,gram-negative bacteria, gram-positive bacteria,and fungi accounted for 72.22%(n=65),22.22%(n=20),and 5.56%(n=5)respective-ly.Univariate analysis revealed that 7 variables were risk factors for HAI,multivariate non-conditional logistic re-gression analysis revealed that independent risk factors for HAI were age,cardiac function classification,serum al-bumin level,and invasive operation.Conclusion HAI rate is higher among cardiology inpatients,which is related to many factors.Attention should be paid to the elderly,long term hospitalization,heart failure correcting,treatment for complications,reducing of invasive procedure,and strict sterile manipulation.

Epithelial-mesenchymal transition (EMT) is an important biological process in embryonic development and tumori-genesis. In this process, epithelial tumor cells can obtain mesenchymal phenotypes and promote tumor invasion and metastasis. EMT is controlled by multiple transcription factors, signal pathways, and microRNAs. EMT and cancer stem cells are closely related. EMT also promotes the self-renewal ability of tumor cells and the overexpression of EMT-related markers in tumor cells with stemness. Some mi-croRNAs can control EMT process and stemness. In this study, recent developments on EMT and cancer stem cells in tumor metastasis were summarized to provide new insights into target therapy of tumor metastasis and recurrence.

Objective To explore the social economic factors related to depressive in patients with long-term hemodialysis.Methods A total of 122 patients with hemodialysis for more than 3 months from December 1st 2008 to February 1st 2009 in Dongfang Hospital and Wangjin Hospital,were divided into a depression group (41 cases) and a non-depressed group (81 cases).Informations such as economic status,social interaction,education,hobbies,etc were collected by questionnaire and the relationship between these factors and depression was analyzed.Results There was significant difference between the two groups in the factors of economic status,social interaction,education,and hobbies (x2 values were 14.671 、6.256、6.744、6.390,P＜0.05).There was no significant difference in the factors of gender,drinking,relationship of family,profession,the condition of housing,social status,seasons of born,and careers,etc (x2 values were 3.651、0.765、2.034、3.093、0.772、5.956、2.687、5.138,P＞0.05).Conclusion Thepatientswithpooreconomic,lower education,less social communication,fewer hobbies,and no smoking habits are easy to be depressive.

[Summary] When accompanied with pulmonary disease ,the lung functions of diabetic patients usually represent decreases of diffusing capacity ,ventilation function ,bronchomotor tone and respiratory muscles. The mechanisms of lung damage may include non‐enzymatic glycosylation of proteins ,oxidative stress ,IR ,local defensive ability change ,and autonomic neuropathy. Diabetes mellitus is a risk factor for lung function damage ,and lung function damage is an independently predictive factor of diabetes mellitus. The change of lung function in diabetic patients is associated with age ,duration ,blood glucose level and complications.