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 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 The relationship between XbaI polymorphism of ApoB gene and cerebral infarction(CI)among Chinese population was assessed by Meta-analysis.Methods All related case-control studies were collected from all publications,the relevant studies were identified after eliminating those poor-qualified studies.Meta-analysis was conducted for investigating heterogeneity among individual studies,and summarizing the effects across studies.Results The combined data statistics revealed the frequencies of the X-X+/X+X+ genotypes showed no statistically difference(Z=1.72,P=0.08).Through the subgroup analysis,it was obviously increase the risk of CI in Chinese northern population(OR=2.66,95%CI:1.67~4.24),but no statistically difference in Chinese southern population(OR=1.26,95%CI:0.90~1.77).Conclusions ApoB gene XbaI polymorphism may be significantly associated with susceptibility of CI in Chinese northern population,but not a definite risk for Chinese southern population.

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 .

Objective To evaluate the relationship between plasma substance P (SP) and calcitonin gene-related peptide (CGRP) concentrations and intraoperative cardiovascular events in diabetic patients.Methods Twenty-two patients of either sex with type 2 diabetes mellitus and 22 non-diabetic patients of either sex,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 50-77 yr,undergoing elective knee arthroplasty under neuraxial anesthesia,served as diabetes mellitus group (group DM) and non-diabetes mellitus group (group NDM),respectively.The patients of either group were further divided into 2 subgroups (n =11 each) according to whether or not the patients had cardiovascular diseases before operation:no cardiovascular disease subgroups (NDM-NCVD subgroup and DM-NCVD subgroup) and cardiovascular disease subgroups (NDM-CVD subgroup and DM-CVD subgroup).The plasma SP and CGRP concentrations were dertermined by enzyme-linked immunosorbent assay at 30 min before operation and at the end of operation.The plasma cardiac troponin Ⅰ (cTnI) concentrations were measrued by enzyme-linked immunosorbent assay at 30 min before operation and 24 h after operation.The development of intraoperative cardiovascular events was recorded.Results Compared with group NDM,the incidence of intraoperative cardiovascular events and plasma cTnI concentrations at each time point were significantly increased,and the plasma concentrations of SP and CGRP were decreased in group DM (P＜0.05).Compared with group DM-NCVD,the incidence of intraoperative cardiovascular events and plasma cTnI concen trations at each time point were significantly increased,and the plasma concentrations of SP and CGRP were decreased in group DM-CVD (P＜0.05).Conclusion The development of intraoperative cardiovascular events is related to the decrease in plasma concentrations of SP and CGRP in diabetic patients.

Objective To investigate the effect of dexmedetomidine on liver function,plasma cytokine levels,and oxidative stress due to ischemia/reperfusion injury in patients undergoing hepatolobectomy.Methods A total of 106 patients who underwent hepatolobectomy in General Hospital of Jizhong Energy Fengfeng Group Co.,Ltd.from January 2014 to January 2016 were enrolled and randomly divided into control group and observation group,with 53 patients in each group.The patients in the observation group were given 1 μg/kg/h dexmedetomidine within 10 minutes,followed by continuous intravenous infusion of 0.5 μg/kg/h dexmedetomidine,and those in the control group were given an equal volume of 0.9％ sodium chloride.The two groups were compared in terms of liver function parameters,plasma cytokine levels,and oxidative stress due to ischemia/reperfusion injury after anesthesia (T1),before abdominal closure (T2),and at 1,4,and 8 hours after surgery (T3,T4,and T5,respectively).The chi-square test was used for comparison of categorical data between groups;the t-test was used for comparison of indices between groups,the sphericity test was used for comparison of indices at different time points,and an analysis of variance was performed for repeated measurement data with P ＜ 0.05.Results The two groups had significantly higher alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at T2,T3,T4,and T5 than at T1 (ALT:F =43.72 and 44.16,both P ＜ 0.001;AST:F =53.87 and 65.44,both P ＜ 0.001),and the observation group had significantly lower levels than the control group atT2,T3,T4,andT5 (ALT:t =20.54,22.01,36.68,and 38.15,all P＜0.001;AST:t =32.27,41.08,52.82,and71.89,all P ＜ 0.001).The two groups had significantly higher levels of tumor necrosis factor α (TNFα) and interleukin-8 (IL-8) at T3,T4,and T5 than at T1 (TNFα:F =54.37 and 24.75,both P ＜ 0.001;IL-8:F =47.24 and 27.39,both P ＜ 0.001),and the observationgroup had significantly lower levels than the control group at T3,T4,and T5 (TNFα:t =59.39,86.32,and 83.16,all P ＜ 0.001;IL-8:t =74.47,72.29,and 76.67,all P ＜ 0.001).The two groups had a significantly higher level of malondialdehyde at T3,T4,and T5 than at T1 (F =37.65 and 17.44,both P ＜0.001),and the observation group had a significantly lower level than the control group at T3,T4,and T5 (t =17.35,19.11,and 24.12,all P ＜ 0.001).The two groups had a significantly lower level of superoxide dismutase at T3,T4,and T5 than at T1 (F =36.54 and 33.65,both P ＜0.001),and the observation group had a significantly higher level than the control group at T3,T4,and T5 (t =68.64,66.35,and 59.48,all P ＜0.001).Conclusion Dexmedetomidine can effectively inhibit liver injury,reduce the levels of cytokines,and alleviate ischemia/reperfusion injury in patients undergoing hepatectomy.

Objective·To investigate the role of collagen triple helix repeat containing-1 (CTHRC1) in ovarian cancer cell metastasis and the related mechanism. Methods·The expression of CTHRC1 in ovarian cancer cells was detected by Western blotting. The cell line which had high expression of CTHRC1 was transfected with a CTHRC1 specific shRNA, and the lenti-CTHRC1 was used to overexpress CTHRC1 in the cell line whose expression of CTHRC1 was very low. Then the expression of Slug and MMP-2 was assessed. Transwell assay was used to determine the migration and invasion capability of ovarian cancer cells after transfection. Results·The expression of CTHRC1 in HO8910 cells was the lowest, while the CTHRC1 protein level was dramatically increased after transfection of lenti-CTHRC1. Meanwhile, there was a distinct rise of the migration and invasion ability, as well as the expression of Slug and MMP-2 (all P<0.05). Conversely, CaOV3 cells had a higher protein expression of CTHRC1. By using lenti-shCTHRC1, a remarkable knockdown of CTHRC1 was obtained. Likewise, the capability of migration and invasion was decreased, and the Slug and MMP-2 expression was reduced (all P<0.05). Conclusion·CTHRC1 might positively regulate Slug and MMP-2 to promote ovarian cancer cell metastasis.