The article briefly reviewed the different perspectives on the definition of medical professionalism and summarized the current status of medical professionalism studies in China and foreign country represented by the United States.In terms of medical moral values , conflict of interest , autonomy and the professionalism training , based on the status quo of physician professionalism in China , some ideas to improve and build medical profession-alism in China are proposed .

Objective Through investigating the current situation of first national Standardized Medical Resident Training Bases construction in Xinjiang to provide the basis for the administrative department of public health to improve their resident training bases.Methods Selecting standardized training related personnel 133 people of 20 base hospital to conduct a questionnaire survey,and selecting the base hospit.al leaders,the management staff of functional departments,teachers and residents,a total of 254 people were given in-depth interviews.We conducted data collection mainly around the basic situation of the base hospitals and departments,to understand the basic situation,difficulties and problems of the standardized training of resident doctors in the base hospitals,and suggestions and opinions on the training work.We used x2 test,Wilcoxon rank test to make statistical analysis.Results Basic conditions of the hospital was not balanced,70％ of the base hospital library number was 10 thousand ～5 million,75％ of the base hospital computer had a volume of less than or equal to 30.There was statistical significance in the difference of the rate of operation between the cases and the skills in the southem/northeru region teaching/non professional teaching base hospital.Teacher level was not balanced,and only 5 hospital teacher training rate was greater than or equal to 80％,which met the national requirements.Enrollment of each department had a rising trend,including the department of pediatrics,psychiatry and other major shortage of profes-sional year by year,the increase in the proportion of 1 ～2 times.National financial aid was implemented,but lacked local financial input.Conclusion The balanced development of base construction,the continuous improvement of system construction and organization management,the improvement of the teachers' teaching and training quality,the improvement of the resident treatment and striving for more national and local financial allocation will be the focus of the construction and development of Xinjiang resident standardized training base.

Objective To learn the training effect and main influencing factors for residents′ standardized training in Xinjiang.Methods In the convenience sampling principle, 220 trainees subject to training at 10 training centers in Xinjiang were surveyed with questionnaire.Measurement indicators were described with frequencies and relative number, and x2 test was used to compare overall training outcomes among individual measurement indicators.Results Significant gaps were found among the respondents in terms of training outcomes.A comparison of six level-1 indicators and 25 level-2 indicators found that the respondents gave average comment to teaching and research training.Logistic regression analysis identified education (x2=7.575,P=0.006) and hospital (employer) or school (x2=10.770,P=0.001) as the main influencing factors for training outcomes.Conclusions The standardized training of residents in Xinjiang calls for greater improvement, namely enhanced leadership and powerful assurance mechanism, scientific planning, appraisal regulations and motivation mechanism, as well as encouraging academic environment.

Objective To construct evaluation system of residents standardization training's effect in Xinjiang. Methods According to the principles of combinations of comprehensiveness and direction, sci-entificity and operability, initial questionnaire regarding for residents' attitude, knowledge and ability was modified to form the final questionnaire through the first round of the survey using literature research and expert interviews. Internal consistency check was carried out for all valid questionnaires by SPSS 18.0, the reliability coefficient was calculated by Alpha test and the analytic hierarchy process was used to determine the indicators' weights of evaluation system of residents standardization training's effect in Xinjiang. Results The cronbach coefficient of the questionnaire was 0.894, with a higher reliability. Evaluation system of resi-dents standardization training's effect in Xinjiang included 6 first-level indicators and 23 second-level indi-cators, and calculated their respective weight coefficients. Conclusion Evaluation system of residents stan-dardization training's effect which was constructed and was in accordance with the reality of Xinjiang was more reasonable. It is of guiding significance to comprehensively and objectively measure the training effect of trainees and to strengthen and improve residents' standardization training in Xinjiang.

Objective:To evaluate the short-term outcomes of aortic root repair using a pericardial autograft for acute type A aortic dissection.Methods:Between January 2020 and August 2021, 12 patients underwent aortic root repair using a pericardial autograft for type A aortic dissection. There were 8 males and 4 females, aged from 32.0 to 71.0 years, with a mean of (49.1±13.0) years, weight from 40.0 to 100.0 with a mean of (78.6±20.5) kg. Short-term outcomes were assessed by cardiopulmonary bypass time, cross-clamp time, circulatory arrest time, mechanical ventilation time, ICU time, postoperative stay time. The diameter of Valsalva sinus and aortic regurgitation were assessed before, after operation and during follow-up.Results:There were no postoperative and follow-up death. Cardiopulmonary bypass time was(256.4±60.6)min, ranging from 182.0 to 243.0 minutes; cross-clamp time was(195.0±52.5)minutes, ranging from 127.0 to 284.0 minutes; circulatory arrest time was(19.9±3.6)min, ranging from 15.0 to 25.0 min; mechanical ventilation time was (69.1±72.1)hours, ranging from 6.4 to 250.3 h; ICU time was (143.6±81.7) h, ranging from 56.9 to 288.0 h; postoperative stay time was (12.8±4.1) days, ranging from 8.0 to 20.0 days. One patient had transient paralysis (8.3%), and one patient needed hemofiltration due to acute kidney failure (8.3%), they all completely recovered before discharge. Follow-up time ranged from 10.0 to 21.0 months, with a median of 13 months. Heart function (NYHA) was I to II degrees. The mean diameter of aortic root was (36.7±5.8)mm(27.0-45.0 mm) preoperatively, (35.8±5.1)mm (25.0-44.8 mm) before discharge, and (35.7±5.9)mm (25.1-44.8 mm) during follow-up, respectively. There was no significant difference between them ( P>0.05). The preoperative aortic regurgitation was as follow: severe aortic regurgitation 2, moderate 1, mild to moderate 3, mild 1, trivial 1, none 4; postoperative aortic regurgitation: mild 2, trivial 2, none 8; follow-up aortic regurgitation: mild 3, trivial 1, none 8. Conclusion:Aortic root repair with a pericardial autograft is a safe and effective technique to treat acute type A dissection involving the sinus. Using this technique, residual dissection tissues could be significantly reduced, which subsequently decreases the risk of proximal bleeding, maintains the function of sinus, and increases long-term durability. Short-term results are satisfactory, and the long-term results need further follow-up.

Objective:To study the molecular basis for a proband with A subtype B of the ABO blood group and explore the influence of amino acid variant on the activity of glycosyltransferase (GT).Methods:A proband who had presented at the First Affiliated Hospital of Zhengzhou University on July 2, 2020 was selected as the study subject. Serological identification of the ABO blood groups of the proband and her family members were performed by gel card and test tube methods. The ABO gene of the proband was identified by PCR-sequence specific primers (PCR-SSP) and DNA sequencing. A 3D molecular homologous model was constructed to predict the impact of the variant on the stability of α-(1→3)-D-N-acetylgalactosamine transferase (GTA). Results:The red blood cells of the proband, her mother and two younger brothers showed weak agglutination with anti-A and strong agglutination with anti-B. The sera showed 1~2+ agglutination with Ac and no agglutination with Bc. Based on the serological characteristics, the proband was identified as AwB subtype. Pedigree analysis suggested that the variant was inherited from her mother. The blood group of the proband was identified as A223B type by PCR-SSP. ABO gene sequencing analysis showed that the proband has harbored heterozygous variants of c. 297A>G, c. 467C>T, c. 526C>G, c. 657C>T, c. 703G>A, c. 796C>A, c. 803G>C, c. 930G>A and c. 1055insA. Based on the results of clone sequencing, it was speculated that the genotype was ABO* A223/ ABO* B.01. There were c. 467C>T and c. 1055insA variants compared with ABO* A1.01, and c. 1055insA variant compared with ABO* A1.02. Homologous modeling showed that the C-terminal of A223 GT was significantly prolonged, and the local amino acids and hydrogen bond network have changed. Conclusion:Above results revealed the molecular genetics mechanism of A223B subtype. The c. 1055insA variant carried by the proband may affect the enzymatic activity of GTA and ultimately lead to weakening of A antigen.

Objective:To evaluate the short-term outcomes of cuff wrapping technique using remnant aortic wall in modified Bentall procedure.Methods:Between January 2018 and December 2018, 23 patients underwent modified Bentall procedure with the remnant aortic wall as a cuff to cover the sewing area of composite valved graft and the aortic annulus for proximal hemostasis. After the sewing ring of the composite valved graft was sutured to the aortic annulus by continuous suture, the remnant aortic wall was sutured to the graft just distal to the sewing ring by continuous suture. There were 21 males and 2 females, aged from 22 to 72 with a mean of(50.96±13.23)years. Short-term outcomes were assessed by cardiopulmonary bypass time, clamp aorta time, mechanical ventilation time, ICU time, postoperative stay time, effusion drainage till the first postoperative day, Left ventricular end diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF), and follow-up results.Results:There were no postoperative and follow-up death. Cardiopulmonary bypass time was(157.74±39.85)min, ranged from 114 to 275 min; clamp aorta time(122.61±30.25)min, ranged from 84 to 212 min; mechanical ventilation time(11.65±3.08)h, ranged from 7.87 to 20.33 h; ICU time(81.43±45.88) h, ranged from 15.18 to 184.77 h; postoperative stay time(8.73±2.80)days, ranged from 6 to 15 days. Effusion drainage was(336.82±117.65)ml, ranged from 200 to 670 ml till the first postoperative day. Follow-up was performed from 19 to 30 months, with a mean of(23.17±3.17)months. There were significant differences between preoperative LVEDD and postoperative LVEDD before discharge[(49.78±6.21)mm vs.(58.78±10.54)mm, P<0.05]; There were a little decrease of follow-up LVEDD compared with postoperative LVEDD, but no significant difference between them[(48.87±4.63)mm vs.(49.78±6.21)mm, P>0.05] . There were a little decrease of postoperative LVEF compared with preoperative LVEF, but no significant difference between them(0.57±0.07 vs. 0.59±0.05, P>0.05). There were significant differences between follow-up LVEF and preoperative LVEF(0.62±0.04 vs. 0.57±0.07, P<0.05), postoperative LVEF before discharge( P<0.05). Conclusion:Cuff wrapping technique using remnant aortic wall in modified Bentall procedure has got good short-term results. This modification may be a simple, effective way in controlling proximal bleeding.