The professionalism view of qualified person and some reasonable proposals for the promotion of the professionalism are put forward. The necessity of the professionalization of qualified person and the effective measures of perfecting the professionalization are studied by the comparative analysis between home and abroad combined with the game model analysis. Under the current national conditions, qualified person are repositioned, and after learning the advanced experience of the EU, the registration system is strictly carried out, which can promote the professionalism of qualified person and make relevant measures in order to restrict the behavior of qualified person.

Objective:To investigate the effects of deguelin on the viability and apoptosis of Neuro-2A ( N2A) cells. Methods:The cell viability of N2A cells with the density of 5 × 104 ·ml-1 on the time points of 6, 12, 24, 48 and 72 hours after 1 × 10 -8 mol ·L-1 deguelin treatment using CCK-8 kits was determined, and that on the time point of 48 hours after 0, 1 × 10 -11 , 1 × 10 -10 , 1 × 10 -9 , 1 × 10 -8 , 1 × 10 -7 , 1 × 10 -6 or 5 × 10 -4 mol·L-1 deguelin treatment was also detected. The activity of caspase 3 was deter-mined in N2A cells treated by 2 × 10 -8 mol·L-1 deguelin for 24 hours. Results:N2A cells with the density of 5 × 104 ·ml-1 reached the peak level in the growth curve 48 hours after the incubation in DMEM medium with 10% fetal bovine serum. The cell viability of N2A cells was decreased after the treatment of 1 × 10 -8 mol·L-1 deguelin for 24-72 hours in a time-dependant manner or after the treatment of 1 × 10 -8 ~1 × 10 -6 mol·L-1 deguelin for 48 hours in a dose-dependant manner (P<0. 05) with IC50 of 1. 6 × 10 -8 mol ·L-1 . The activity of caspase 3 was increased after the treatment of 2 × 10 -8 mol·L-1 deguelin for 24 hours, which was 5. 6-fold of that in the control group. Conclusion: Cell viability of N2A cells is inhibited by deguelin in a time- and dose-dependent manner, which may be related to the activity increase of caspase 3.

OBJECTIVE:To explore the training method for the postgraduates majoring in medicine management,and provide reference for the teaching effect of medical management. METHODS:Based on the existing problems in the training mode of post-graduates majoring in medical management,the foundation,feasibility implementation process of the coalition of college and enter-prise were analyzed. RESULTS & CONCLUSIONS:The training mode of coalition of college and enterprise can really make teach-ers,students and enterprises to achieve a win-win situation;at the same time,through the feasibility analysis of the training mode, the performance evaluation method of multi-level evaluation system and fuzzy comprehensive evaluation are put forward to finally achieve the exploration of training management mode of undergraduates from the perspective of operational level. But in the owner-ship of intellectual property rights,technology security,personal safety of graduate and other aspects still exist some problems and need further improvement.

The efficacy and safety of Saccharomyces boulardii in treatment of candida esophagitis was investigated by a single center, prospective, open label and non-inferiority trial.Eighty nine patients with candida esophagitis attending in Shanxi Provincial People′s Hospital during April 2015 to March 2016 were randomly divided into Saccharomyces boulardii group (45 cases) and nystatin group (44 cases), and oral Saccharomyces boulardii powder and Nystatin tablets were given to two groups respectively.The curative effect was evaluated by gastroscopy after the treatment.The results showed that the cure rate of Saccharomyces boulardii group and nystatin group was 68.9%(31/45)and 63.6%(28/44), and the Saccharomyces boulardii was noi inferior to nystatin (x2=3.027, P<0.05).Chi-square test showed that there was no significant difference in effective rate between two groups [91.1%(41/45)vs.93.2%(41/44), x2<0.001, P>0.05].The incidence of adverse reactions in boulardii group was significantly lower than that in nystatin group [2.2%(1/45) vs.22.7%(10/44), x2=8.636, P<0.05].The study suggests that the cure rate of Saccharomyces boulardii is not inferior to nystatin in treatment of candida esophagitis, while the incidence of adverse reactions of Saccharomyces boulardii is lower.

Objective To analyze the CT features of intestinal tumor obstruction, and explore its CT value.Methods CT manifestation and clinical materials of intestinal tumor obstruction proved by surgical findings or endoscopy biopsy in 35 cases were analyzed restrospectively, and compared with the results of surgery-pathology and endoscopy. Results CT findings were consistence with the results of surgery-pathology and endoscopy in 33 of 35 cases. The CT diagnostic accuracy of intestinal obstruction was 100%. And the accuracy of the cause was 94%, including colon carcinoma in 25, lyphoma in 5, gastrointestinal stromal tumor in 2, and lipoma in 3.Conclusion CT has unique advantage in examining intestinal tumor obstruction, not only for definiting the existence of the obstruction, but also locating the site of obstruction diagnosing the cause and chosing the appropriate treatment.

Background:Gastric xanthelasma is a benign and uncommon lesion with unknown etiology. It has been noted thatatrophic gastritis is frequently seen in patients with gastric xanthelasma. Aims:To investigate the relationship betweengastric xanthelasma and atrophic gastritis and its clinical significance. Methods:A total of 10645 consecutive patients whohad undergone gastroscopy from Apr. 2015 to Mar. 2016 at the Shanxi Provincial People's Hospital were enrolled andanalyzed retrospectively with respect to their demographic,clinical,endoscopic and histological features. Results:Theprevalence of gastric xanthelasma in patients recruited in this study was 2. 9％ . The mean age and prevalence of atrophicgastritis (47. 9％ vs. 16. 6％ )were significantly higher and the gastric atrophy was more severe in patients with gastricxanthelasma than those without (P all < 0. 001). Multivariate Logistic regression analysis revealed that age ≥50 years(adjusted OR =1. 349,95％ CI:1. 042 ～ 1. 747,P = 0. 023)and atrophic gastritis (adjusted OR = 3. 892,95％ CI:3. 076 ～4. 924,P <0. 001)were independently related to the presence of gastric xanthelasma. Likewise,the prevalence ofgastric xanthelasma in patients with atrophic gastritis was significantly higher than those without (7. 9％ vs. 1. 8％ ,P <0. 001). Age- and sex-matched control analysis proved the correlation between gastric xanthelasma and atrophic gastritis(P <0. 001). In addition,multiple xanthelasma was more prevalent in gastric xanthelasma patients with atrophic gastritisthan those without (32. 0％ vs. 13. 8％ ,P <0. 001). Conclusions:Gastric xanthelasma is correlated with age and presenceand severity of atrophic gastritis. Atrophic gastritis might be one of the etiological factors of gastric xanthelasma,and gastricxanthelasma might be an atypical mucosal lesion caused by gastric atrophy.

OBJECTIVE:To study the effects of Thymalfasin for injection on the apoptosis of human lung cancer A549 cells. METHODS:After treated with 0(blank control),25,50,100,200 and 400 mg/L Thymalfasin for injection for 24,48 and 72 h, the cell proliferation inhibitory rate was analyzed with MTT and calculated. After treated with 0(blank control),50 and 100 mg/L Thymalfasin for injection for 48 h,cell apoptosis was detected by flow cytometry,and the expression of Caspase-3,Bcl-2 and Bax and the phosphorylation level of Akt were deteced by Western blot. RESULTS:Compared with blank control group,proliferation in-hibitory rate of A549 cells increased after treated with Thymalfasin for injection,in concentration and time-dependent manner(P<0.05). The apoptotic rate of A549 cells increased after treated with Thymalfasin for injection 50,100 mg/L for 48 h (P<0.05). The expression of Caspase-3 increased while the Bcl-2/Bax and phosphorylation level of Akt decreased in A549 cells after treated with Thymalfasin for injection 100 mg/L (P<0.05). CONCLUSIONS:Thymalfasin for injection can inhibit the proliferation of A549 cells by activating Caspase-3,decreasing Bcl-2/Bax ratio,inhibiting Akt signal pathway and induce the apoptosis of A549 cells.

Objective To retrospectively analyze 45 cases of oral and maxillofacial malignant tumors and to assess the efficacy and feasibility of oral and maxillofacial malignant tumors implanted with 125I radioactive seeds under guidance of ultrasound.Methods A total of 47 focuses in these 45 patients were determined with the size of these tumors by imaging study,the section was planed by ultrasound,the number and distribution of radioactive seeds were determined with the help of the particle treatment planning system,and were percutaneously implanted particles under guidance of ultrasound.The number and the distribution of particles were assessed by CT.Efficacy endpoints were reexamined and evaluated regularly by ultrasonic and CT according to the standards of WHO.Results The total percentage of efficacy was 70.2% (including complete remission,partial remission).The treatment effect of metastatic carcinoma of lymph node is superior to the parotid tumor.There was no serious complication during the period of implanting and 2 patients with oral ulcers were found after operation.Conclusion The oral and maxillofacial malignant tumor treated implanted with 125I radioactive seeds under guidance of ultrasound is very effective and safe,which is deserved to popularize.The ultrasound is the first choice as a guided method for oral and maxillofacial malignant tumors.

Objective To investigate clinical outcome of laparoendoscopic single-site compared with traditional three-port in treatment of ovarian cystectomy.Method From February 2012 to June 2013,54 patients with ovarian cyst were randomized to the single-site group (n =24) or the three-port group (n =30) in Peking Union Medical College Hospital.The outcome of laparoscopic single-site and three-port ovarian cystectomy were evaluated.Operation time,blood loss,surgical complications,postoperative pain score,postoperative analgesic requirements,length of hospital stay,cosmetic satisfaction score,postoperative recovery and total cost were compared between both groups.Results No difference was found in blood loss,length of hospital stay,complications and total cost between the two groups(P ＞ 0.05).Operation time was (31-± 10) minute in three-port group and (40 ± 19) minute in single-site group.Visual analogue pain score was 5.6 ± 1.7 in three-port group and 2.7 ± 1.4 in single-site group,cosmetic satisfaction score was 92.5 ± 2.5 in three-port group and 97.4 ± 1.5 in single-site group.Those clinical parameter reached statistical difference (all P ＜ 0.05).Conclusion Laparoendoscopic single site surgery approach is feasible and safe to treat benign ovarian cyst disease.And it offers decreased pain and offer improved cosmesis.

Objective To explore the operation skills of laparoendoscopic single site surgery ( LESS) of total hysterectomy , to expand the application of LESS in the field of in gynecologic surgery . Methods A total of 23 cases of total hysterectomy were completed under laparoendoscopic single site surgery in Peking Union Medical College Hospital from January 2012 to August 2013, applying with combination of the traditional laparoscopic and special LESS apparatuses , intelligent electronic coagulation and excision device and the self-fixed absorbable sutures ( V-LOC).The datas of the patients during the operations and the follow-up were recorded and analyzed Results Twenty-three cases LESS-TH are accomplished.The weight of uterus was (230+38) g.The operation time was (73+22) minutes, with the intraoperative blood loss (99 ±53) ml.The postoperative intestinal function recovery time was (13 +4) hours, and postoperative hospitalized time was ( 1.8 ±0.6 ) days, with the postoperative pain visual analogue scale 3.9 ±1.6.There were no complications reported during intraoperative and postoperative time.All of our patients was finished the follow-up from 14 d to 2 months.As usual, vaginal discharge is normal, wound healed well, most of the wounds healing (19/23) hidden in umbillicus, no obvious scar, vaginal stub wound healed well Conclusions ( 1 ) LESS can accomplish total hysterectomy of uterus of gestational age less than 8 weeks safely and effectively .( 2 ) Combination of traditional laparoscopic and special LESS appatatuses , the use of intelligent energy devices and V-LOC to suture vaginal stub could make the total hysterectomy by LESS much easier and safer .