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 distribution of pathogenic of nosocomial infections in intensive care unit (ICU) and the tendencies of its drug-resistances.Methods All of 130 patients of nosocomial infection from March 2009 to March 2013.Results Of all the nosocomial infection pathogens,gram-negative(G-) bacteria was the main(53.76％).The first five pathogens were E.coli(13.9％),E.faecalis (11.3％),A.baumannii (10.3％),S.aureus (9.8％) and K.pneumoniae (8.3％).The lower resistant to pseudomonas aeruginosa were amikacin (5.3％).A.baumannii increases rapidly and its resistances was severe.Two trains of E.faecalis were resistant to vancomycin.Conclusion G-bacteria is the main pathogens in ICU,fungal has upward tendency.The multidrug resistances of A.baumannii and E.faecalis were severe; Target monitoring is an effective surveillance method to reduce the prevalence of the nosocomial infection in ICU.

Objective To observe the clinical efficacy of acupuncture in treating primary hypertension and the effect of twirling reinforcing-reducing manipulations on the treatment of primary hypertension. Methods Totally 126 patients with primary hypertension were randomized into treatment group 1 of 40 cases, treatment group 2 of 44 cases, and a control group of 42 cases. The treatment groups were both intervened by acupuncture at Quchi (LI 11), while twirling reinforcing-reducing manipulations (twirling towards left) were applied in treatment group 1, while the manipulations (twirling towards right) were applied in treatment group 2;the control group was intervened by medication. The change of blood pressure after 10 min treatment was observed, and the clinical efficacies were compared. Results The total effective rate was 85.0%in treatment group 1, versus 88.6%in treatment group 2 and 61.9% in the control group, and the total effective rates in the two treatment groups were significantly different from that in the control group (P<0.05). In the two treatment groups, the systolic pressure and diastolic pressure respectively after 10 min treatment and 30 min treatment were markedly different from those 10 min before treatment in the same group (P<0.05). In the two treatment groups, the systolic pressure and diastolic pressure after 30 min treatment were markedly different from those after 10 min treatment in the same group (P<0.05). In the control group, the systolic pressure and diastolic pressure were significantly different from those 10 min before treatment in the same group (P<0.05). There were no significant inter-group differences in comparing the systolic pressure and diastolic pressure after 30 min treatment (P>0.05). Conclusions Acupuncture at Quchi (LI 11) is an effective approach in treating primary hypertension, and the reinforcing manipulation and reducing manipulation are both effective.

Objective:To explore the clinical effect of mild hypothermia combined with puncture aspiration operation on the hypertensive intracerebral hemorrhage and its effect on the serum TNF-α,IL-6 and CRP levels.Methods:112 cases of patients with hypertensive intracerebral hemorrhage admitted in our hospital from February 2015 to August 2016 were selected as the research objectives and randomly divides into 2 groups with 56 cases in each group.Both groups were treated with minimally puncture aspiration,and mild hypothermia was performed in the observation group additionally,the clinical effect,complication,short-term prognosis,serum TNF-α,IL-6,CRP levels at different time points before and after operation were compared between two groups.Results:The overall effective rate of observation group was 92.86％,which was significantly higher than of the control group(76.79％.P＜0.05).The incidence of MODS and complications were 0％ and 26.79％ respectively,which were significantly lower than those of the control group(P＜0.05).The serum TNF-α,IL-6,CRP levels of observation group were significantly decreased on the 3rd and 7th day postoperation,which were significantly lower than those before operation (P＜0.01).The serum TNF-α,IL-6,CRP levels of control group on the 3rd day postoperation were similar to those before operation (P＞0.05),but the serum TNF-α,IL-6,CRP levels on the 7th day postoperation were significantly decreased (P＜0.01).The serum TNF-α,IL-6,CRP levels on the 3rd,7th day postoperation were significantly lower than those of the control group at same time points (P＜0.01).The favorable prognosis of observation group was 80.36％,which was significantly higher than that of the control group (62.50％,P＜0.05).Conclusion:Mild hypothermia combined with puncture aspiration operation could effectively reduce the neurological deficits,inhibit the inflammatory response and decrease the mortality.

Objective To investigate the expression of interleukin 6 (IL-6) in tumor microenvironment of natural killer/T cell lymphoma (NKTCL) and its relationship with clinical characteristics and prognosis. Methods From January 2005 to December 2012, 93 patients with NKTCL and available paraffin-embedded tissue in Sun Yat-sen University Cancer Center were included. The expression or IL-6 in tumor microenvironment was investigated by immunohistochemistry. The positive IL-6 expression was identified as≥10 cells/HP. The enumeration data and measurement data were compared by t test andχ2 test, respectively. Overall survival (OS) and progression free survival (PFS) were estimated with the Kaplan-Meier method. Survival rates were compared by the Log-rank test. Statistical significance was determined at a level of P<0.05. Results The median count of IL-6 positive cell number was 21 cells/HPF (range, 0-150 cells/HP), and 61.29%(57/93) patients were positive. Positive IL-6 expression was mostly associated with fever and high Korean prognostic index (KPI) score (both P< 0.05). The serum c-reactive protein (CRP) level was (29.28 ± 2.62) mg/L in IL-6 positive patients and (11.14±2.77) mg/L in IL-6 negative patients (t= -2.276, P= 0.025). Patients with negative IL-6 expression had better survival, with 52.7 % of 5-year PFS rate,and 60.0 % of 5-year OS rate; the 5-year PFS and OS rates in those with IL-6 positive were 23.6 % and 27.1 %, respectively (both P= 0.001). Conclusion The high expression of IL-6 in patients with NKTCL might be associated with adverse clinical feature and poor survival.

Background and purpose:Promoter methylation ofPCDH10, a gene encoding protocadherin 10, has been found to be correlated to poor prognosis in gastric cancer (GC) patients. However, the relationship between the expression of PCDH10 and prognosis in GC remained unknown. This study aimed to explore the relationship be-tween the expression of PCDH10 and clinicopathological features and prognosis of GC, and to identify biomarker for predictions of recurrence and survival of GC.Methods:mRNA expressions of PCDH10 in 115 pairs of GC tissues and adjacent normal tissues were detected by real-time lfuorescence quantitative polymerase chain reaction (RTFQ-PCR). The correlation between PCDH10 expression level and clinicopathological features and prognosis of GC was analyzed. Prediction models for 5-year recurrence and 5-year survival were established using logistic regression method.Results:Progression-free survival (PFS) and overall survival (OS) were signiifcantly prolonged in patients with PCDH10 low expression compared to patients without PCDH10 low expression (P=0.046 andP=0.033 respectively). PCDH10 low expression signiifcantly correlated with less lymph node metastasis (P=0.001) and earlier TNM staging (P=0.001), and was more common in female than in male (P=0.040). The mRNA expression of PCDH10 did not correlate with age, Lauren classiifcation, T stage, neural invasion or vascular invasion. Univariate Cox analysis showed Lauren classiifca-tion, T stage, N stage, M stage and PCDH10 expression signiifcantly correlated with PFS and OS. Logistic regression models for the prediction of 5-year recurrence or 5-year survival based on clinicopathological features included Lauren classiifcation, T stage, N stage and M stage as variables. Logistic regression models for the prediction of 5-year recur-rence or 5-year survival based on PCDH10 expression included Lauren classiifcation, T stage, M stage and PCDH10 expression level but not N stage as variables. The models based on PCDH10 expression had the same effciencies as models based on clinical parameters in predicting 5-year recurrence or 5-year survival for GC patients.Conclusion:PCDH10 low expression correlated with better prognosis, less lymph node metastasis and earlier TNM stage in GC patients. Low expression of PCDH10 may be a biomarker of better survival for GC patients. Logistic regression model based on PCDH10 mRNA expression may serve as a prediction model when patients have unknown lymph node metas-tasis status.

Objective To evaluate the efficacy and toxicity of SMILE regimen for NK/T-cell lymphoma. Methods From November 2006 to February 2008, 5 patients with relapsed and 5 with first treatment NK/T-cell lymphoma were involved in this study. These patients were treated with SMILE regimen including methotrexate, isofosfamide, L-asparaginase and etoposide.1 patient were treated with autolognus hematopoietic stem cell transplantation (AHSCT), and 2 patients received local regional radiation following SMILE. Results Among 10 patients, 8 were eligible to response evaluation. The overall response rate for whole group was 50 %(4/8) without complete remission. The overall response rate for both previously untreated and relapsed patients were 50 %(2/4). Major toxicity were bone marrow supression and transient transaminase elevation, the incidence of grade Ⅲ -Ⅳ neutroponia was 65 %, and febrile neutropenia was 25 %, Grade Ⅲ transaminase elevation was 10 %. Other toxicities were mild, no treatment-related mortality occurred. 26.1% cycles discontinued due to severe side effect. Conclusion SMILE may be an effective regimen for relapsed or refractory NK/T-cell lymphoma while significant toxicities were observed. Further investigation is requried before SMILE become a standard combination for relapsed or refractory NK/T-cell lymphoma.

Oxaliplatin-loaded nanostuctured lipid carriers (OP-NLC) were prepared by ultrasonic emulsification method. And its optimal prescription was selected by orthogonal design. The laser light scattering technique, zeta potential analyzer, TEM, DSC, XRD and HPLC were employed to study the physicochemical parameters of OP-NLC, which displayed in terms of particle size, zeta potential, crystalline, drug loading and encapsulation efficiency. The results showed that OP-NLC had an average diameter of (111 +/- 20) nm, zeta potential of (-27.4 +/- 13.1) mV, encapsulation efficiency of (77.4 +/- 2.5) % and drug content of (0.8 +/- 1.5) mg mL(-1). TEM, DSC and XRD indicated that OP-NLC was spherical and the drug was dispersed as nanoparticles by means of non-crystalline. The in vitro release test showed that the drug could be sustained-released from NLC in buffer solution (pH 4.5) after a burst release in initial phase.

AIM: To investigate the effects of low-dose paclitaxel on the morphology of bladder after partial bladder outlet obstruction ( BOO) in rats.METHODS:Healthy female Sprague-Dawley rats ( n=30) were randomly di-vided into sham operation group, BOO group and low-dose paclitaxel group.The rats in BOO group and low-dose paclitaxel group received operation to establish an obstruction model, while the rats in sham group underwent sham operation.After operation, the rats in low-dose paclitaxel group received intraperitoneal injection of paclitaxel at a dose of 0.3 mg/kg twice a week for 4 weeks.At the same time, the animals in sham group and BOO group received the same volume of saline by in-traperitoneal injection.Four weeks after operation, each rat was sedated and the bladder was weighted.Histological chan-ges of the bladder were observed by HE staining.Collagen deposition in the bladder tissue was observed by Masson stai-ning, and the fibrosis area was measured.The ultrastructure of the detrusor was studied by transmission electron microsco-py.RESULTS:Compared with sham operation group, a significant increase in bladder weight (0.376 g ±0.052 g vs 0.112 g ±0.014 g, P<0.05), the muscle hypertrophy, and a decrease in the percentage of collagen area [collagen/(col-lagen+muscle), 29.66%±2.69%vs 38.94%±3.67%, P<0.05] was observed in BOO group.Under electron micro-scope, intracellular connection had more gap junction and desmosomes than intermediate junction.The cell gap widened with a large amount of collagen fiber.Compared with BOO group, low-dose paclitaxel group decreased bladder weight (0.215 g ±0.025 g vs 0.376 g ±0.052 g, P<0.05) and improved the muscle hypertrophy.The percentage of the colla-gen area was also decreased (19.94%±1.90% vs 29.66%±2.69%, P<0.05).The detrusor microstructure showed that the intermediate junction was characterized by a predominance among the intracellular connections, and the intercellu-lar space contained less collagen fibers in low-dose paclitaxel group.CONCLUSION:Low-dose paclitaxel may ameliorate the morphological damage of the bladder and recover bladder function in the rats with BOO by slowing down the process of bladder fibrosis.

Objective To investigate the cardiovascular risk factors in perimenopausal women and evaluate the risk for cardiovascular disease. Methods A total of 692 perimenopausal women permanent residents in a community of Zhengzhou from September, 2014 to May, 2015 were selected using multi-stage random sampling. Their age, blood pressure, body weight, smoking history, history of diabetes and fast-ing blood glucose, blood lipid and other information were collected. They were assessed with The National 10-Year Risk Assessment for Ischemic Cardiovascular Disease (ICVD). Results Prevalence of the cardiovascular risk factors screened for were as follow:hypertension 14.3%, dyslipidemia 32.1%, overweight or obesity 59.2%, type 2 diabetes mellitus 7.9%, smoking 0.6%. The absolute risk for ICVD in the next 10 years averaged as (2.01 ± 3.04)%, and increased with age. The incidence of high blood pressure, high total cholesterol, smoking, as well as the level of risk for ICVD were different among various age groups. Conclusion The cardiovascular factors are not controlled ideal-ly in the perimenopausal women, and result in high risk of cardiovascular disease, which need a set of intervention as their risk stratification.