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.

In Western countries, the mutation status of the BRCA1 and BRCA2 genes is commonly determined for genetic counseling among members of families with a history of breast or ovarian cancer, especially for women of the Ashkenazi Jewish ethnicity. Recent studies in the Cancer Genome Atlas project have demonstrated that BRCA2 mutation carriers are more responsive to platinum-based chemotherapy among high-grade serous ovarian cancer patients. Thus, in Western countries, the mutation status of BRCA1 and BRCA2 is recognized to have an important value with which to assess cancer risk and therapeutic response. However, very limited studies of BRCA1 and BRCA2 mutations and their implications for counseling and therapeutic prediction have been conducted in China. Therefore, a potentially important genetic test that is technically simple has not benefited Chinese women with an increased risk of breast or ovarian cancer. This article summarizes the current progress in the study of BRCA1/2 mutation in China and recommends an increased effort in applying advances in genetic testing to the clinical management of Chinese patients with ovarian cancer.
Age Factors ; Asian Continental Ancestry Group ; genetics ; Disease-Free Survival ; Female ; Genes, BRCA1 ; Genes, BRCA2 ; Genetic Predisposition to Disease ; ethnology ; Genetic Testing ; Humans ; Mutation ; Ovarian Neoplasms ; drug therapy ; ethnology ; genetics ; surgery ; Platinum ; therapeutic use ; Remission Induction ; Risk ; Survival Rate

Objective　To explore the prophylactic effect of T cell vaccination (TCV) on type 1 diabetes. Methods　6-week-old nondiabetic femele NOD mice were vaccinated intraperitoneally with the attenuated, activated T lymphocytes isolated from the spleen of 4-week-old nondiabetic NOD mice, 18-week-old newly diabetic NOD mice and 32-week-old long-term diabetic NOD mice. The incidence of cyclophosphamide-treated diabetes, inflammatory score of insulitis in NOD mice as well as T lymphocyte subset changes in spleen and thymus were determined after TCV. Results　TCV was able to reduce the incidence of cyclophosphamide-treated diabetes, to alleviate insulitis, to increase the percentage of CD8+ T lymphocyte subset in spleen and CD4- CD8+ simple-positive T lymphocyte in thymus, and to decrease the percentage of IL-2R+ T lymphocyte and CD4+/CD8+ rate in spleen. Conclusion　TCV may decrease host autoimmunity, which seems related to the changes of T lymphocyte subsets in spleen and thymus and prophylactic effect on diabetes.

The aim of the study is to investigate the effects of concentration, intestinal segments, pH, inhibitors of proteins (P-gp), Na(+)-dependent glucose transporter (SGLT1) on the intestinal absorption of berberine, and to compare intestinal absorption of berberine in combinations. With phenol red as the indicator, in situ single pass intestinal perfusion (SPIP) model was used and intestinal absorption of pure berberine at concentrations of 36.70, 46.17 and 92.33 microg x mL(-1), simulated system of HLJDT (mixture of berberine, baicalin and geniposide), HLJDT with the concentration of berberine 92.33 microg x mL(-1) in perfusion solution of different intestinal segments (duodenum, jejunum, ileum, and colon) were determined by HPLC in combination with diode array detection (DAD). The results indicated that Ka values ofberberine at different concentrations had little significant difference among that obtained after perfusing via duodenum, jejunum, ileum and colon indicating that the absorption of berberine was mainly the passive diffusion. It was also suggested that SGLT1 and P-gp might exert some effects on the absorption of berberine. Ka and Peff values of berberine in a mixture of pure compounds and HLJDT for different intestine segments of rat showed an increasing tendency and was significantly different (P < 0.05) indicating that berberine in a mixture of pure compounds and HLJDT was assimilated better in small intestine. These results indicate that the intestinal absorption of berberine may be affected by compatibility of compounds. Additionally, berberine has wide absorption window and better absorption in colon.

Objective To construct a luciferase gene expression vector containing full-length 3' untranslated region(3'UTR)of mouse vascular endothelial growth factor-C(VEGF-C)gene,and to observe the effects of VEGF-C 3'UTR on luciferase gene expression by a double-fluorescence report system.Methods Polymerase chain reaction(PCR)was used to amplify VEGF-C 3'UTR and a 312bp VEGF-C coding region(CR)fragment from full-length VEGF-C cDNA in mouse Lewis lung cancer cells.The luciferase expression vectors containing VEGF-C 3'UTR or VEGF-C CR were constructed by subcloning the PCR products to luciferase reporter vector pGL3-Promoter using gene engineering technology,and then they were transfected to mouse Lewis lung carcinoma cells by LipofectamineTM 2000.The activities and mRNA expression of luciferase were detected by Dual-Luciferase Reporter System and quantitative RT-PCR,respectively.Results Mouse VEGF-C 3'UTR(429bp)and VEGF-C CR(312bp)were successfully amplified by PCR.The VEGF-C 3'UTR and VEGF-C CR fragments were successfully inserted into pTA2 vector,and then subcloned to pGL3-Promoter vector at Xba Ⅰ site by using restriction endonucleases analysis.The DNA sequences and insertion orientation of PCR products were all correct by sequencing analysis.The resulted luciferase expression plasmids were named pGL3-VEGF-C 3'UTR and pGL3-VEGF-C CR,respectively.Dual-Luciferase Reporter System detection and quantitative RT-PCR showed that in Lewis lung carcinoma cells,the activities of luciferase and expression of luciferase mRNA in the pGL3-Promoter group were higher than that in the pGL3-VEGF-C 3'UTR group,and there was no significant difference between pGL3-VEGF-C CR group and pGL3-Promoter group.Conclusion VEGF-C 3'UTR can inhibit luciferase gene expression.

Immune cells that undergo increased apoptosis include lymphocytes and macrophages,yet the apoptosis of neutrophils is decreased in sepsis.Increase in apoptosis has also been reported in non-immune cells such as gastrointestinal cells,epithelial cells of lung as well as endothelial cells.The altered apoptotic cell death may contribute to the initiation and aggravation of immune and organ dysfunction in sepsis.Elucidating the changes and mechanism of apoptosis and taking measures to control apoptosis may be an effective strategy for the treatment of sepsis.

Objective To investigate the influence of Xiyanping injections therapy on inflammation factors and lung function for old patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD).Methods Ninety-two patients with AECOPD were randomly divided into the control group (n =46) and observation group(n =46).Patients in control group were given conventional treatment,in observation group were given XiYanPing injections for 2 weeks treatment on the basis of treatment of control group.The C-reactive protein(CRP),blood sedimentation rate (ESR),interleukin 10 (IL-10),1 s forced expiratory volume (FEV1),forced vital capacity (FVC),FEV1/FVC change and clinical effect of the two groups were recorded.Results There was no statistically significant difference in terms of CRP,ESR and IL-10 between the two groups before treatment (P ＞ 0.05).After treatment,CRP and ESR in control group were reduced from (35.6 ±9.8) mg/L and (56.2 ± 16.4) mm/h to (14.2 ± 8.1) mg/L and (22.4 ± 11.6) mm/1 h and the difference was significant (t =-14.515,-12.008;P ＜ 0.05),while in observation group decreased from (36.4 ± 8.2) mg/L,(54.6 ± 15.4) to (8.2 ± 6.2) mg/L,(16.8 ± 9.6) mm/h and the difference was significant (t =-18.468,-15.249;P ＜ 0.05).Meanwhile,the level of IL-10 in the two groups significantly increased and the observation group showed more.IL-10 in control group increased from (168.8 ± 62.4) ng/L to (212.4 ± 85.6) ng/L and the difference was significant(t =5.468,P ＜ 0.05),and in observation group increased from (172.8 ± 65.1) ng/L to (266.4 ± 92.6) ng/L and the difference was significant (t =6.368,P ＜ 0.05).The FEV1 and FVC were markedly increased after treatment and the observation group showed increase more.FEV1and FVC in control group were increased from (1.41 ±0.15) L and (2.62 ±0.88) L to (1.62 ± 0.18) L and (2.89 ± 0.92) L,and the differences were significant (t =2.186,2.415 ; P ＜ 0.05).While in observation group,FEV1 and FVC were increased from (1.42 ± 0.16) L and (2.59 ± 0.84) L to (1.84 ±0.21) L and (3.12 ± 0.94) L,and the differences were significant (t =4.366,4.585 ; P ＜ 0.05).Total efficacy of observation group was 91.3％ (42/46),obviously higher than that of control group(78.3％ (36/46) ; x2 =4.658 ;P ＜ 0.05).Conclusion Xiyanping injections can reduce the inflammatory response in patients with AECOPD,improve lung function and the effect of treatment.

AIM:To explore the changes of intraocular pressure measured by noncontact tonometer (IOPNCT) with high myopia and analyze the relative fators after small incision lenticule extraction(SMILE).METHODS:A retrospective study.Totally 108 cases (216 eyes) with high myopia received SMILE during March 2015 to October 2016 were involved.The IOPNCT, corneal central thickness (CCT) and corneal curvature for 3mo were recorded and analyzed by ANOVA, LSD t test.The Pearson correlation analysis and multiple linear regression model analysis were used to evaluate the relationship between IOPNCT and its influence factors.RESULTS:(1) There was significant statistical difference in IOPNCT after SMILE at 1d, 1wk, 1 and 3mo compare with preoperative (t=17.785, P=0.019;t=17.981, P=0.016;t=18.841, P=0.012;t=19.364, P=0.001);the IOPNCT after SMILE decreased.The IOPNCT values at every time after SMILE was no statistical difference (t=1.871, P=0.818;t=3.062, P=0.328;t=1.143, P=0.373).(2) The IOPNCT in high myopia were positive correlated with CCT and corneal curvature after SMILE (r=0.4356, 0.295;P<0.05), respectively.(3) The multiple linear regression model analysis revealed that Y=-14.601+0.348X1+0.03X2 (Y was IOPNCT, X1 was corneal curvature, X2 was CCT,P<0.001);Y=3.679+0.28X1+0.012X2 (Y was△IOPNCT,X1 was variation of corneal curvature,X2 was△CCT, P<0.001).CONCLUSION:The IOPNCT decreased after SMILE in high myipia, and it showed that there was no significant influence to use glucocorticoid eye drops in short terms.There was positive correlation among IOPNCT, CCT and corneal curvature after SMILE.

Objective To resolve the sharing of the images which are dispersed in multiple mini-PACS in one hospital or in the distributed PACS in the different hospitals.Methods The grid technology and the medical image network were integrated to research some key technologies on a medical image storage grid.Results Basing on the services provided by grid and considering the hospital's situation,two layers architecture of storage grid that was adapted with the sharing character of the medical information were put forward.Using the services provided by the storage grid,the dynamic storage extension was realized.Conclusion The medical image storage grid can integrate multiple storage systems in the image network.It supports the effective usage of the storage system and transparent accessing for users.

Objective To explore the value of laparoscopic ovarian-conserving restoration for ovarian cyst torsion . Methods A total of 62 cases of ovarian cyst torsion , 12 of which were combined with pregnancy , between January 2007 and June 2012 were retrospectively analysed .The surgical management involved laparoscopic high ligation of ovary blood vessels , restoration of the ovary, and resection of ovarian cysts . Results All the 62 cases of laparoscopic restoration were successfully performed with ovarian reservation.The cysts twisted for 180°~1080°, including 19 cases of <360°, 21 cases of 360°~720°, and 22 cases of >720°.The cysts were coloured purple black in 26 cases, purple or normal in 36 cases.The operation time was (57 ±23) min, the intraoperative blood loss was 5-130 ml (mean, 50.6 ml), and anal exsufflation time was (24 ±13) hours.No embolism, infection, and abortion occurred during post-operation.The level of estrogen recovered to normal in 1-3 months postoperatively .Ovulation at the procedure side was found in 43 cases in 6-24 months. Conclusions Laparoscopic ovarian-conserving surgery is a safe procedure for ovarian cyst pedicle torsion .High ligation of ovarian blood vessles and resection of ovarian cysts can not only avoid the possibility of thrombosis but also preserve the ovarian functions .The shortage of this operation is complicated to perform .