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.

Asthma is the most common chronic respiratory disease in children. Currently,inhaled corti-costeroids is the most effective drug for asthma,however,there are some adverse effect by long-time using. Ac-cording to recent literature,long-time treatment with inhaled corticosteroids may inhibit height growth. But this suppression only occurs within early stage of asthma treatment, and have no effect or slight effect on adult height. The adverse effects of inhaled corticosteroids for height are also related to its iypes,dose and usage.

OBJECTIVE:To realize reasonable regression of Chinese medicinal material price to deal with Chinese medicinal material“nominal high price”. METHODS:From the perspective of whole industry chain management,reasons for Chinese medici-nal material“nominal high price”were discussed and feasibility analysis of whole industry chain management of Chinese medicinal material was carried out by using Macro-environment analysis(including politics environment,economic environment,social envi-ronment and technology environment). RESULTS & CONCLUSIONS:At present, Chinese medicinal material“nominal high price”mainly results from lack of core organization,supply deficiency,demand expansion,nonstandard storage and circulation and other factors. Relevant management departments and enterprises should set up whole industry chain management model of Chinese medicinal material from aspects of political environment,economic environment,social environment and technology environment, including to establish industry chain management organization core,to practice standardized production in the upstream industry chain,to appropriately extend industry chain for middle and downstream and to build up modernized logistics service system.

Objective To investigate the belief about medicines in cerebral ischemic stroke (CIS) patients and its influencing factors .Methods The belief about medicines in 212 CIS patients was investigated using questionnaire and compared .Its influencing factors were analyzed by multivari‐ate linear regression analysis .Results The score of belief about medicines was 6 .06 ± 1 .86 in 212 CIS patients .The score of necessity belief was significantly higher than that of concern belief in CIS patients (16 .19 ± 2 .05 vs 10 .13 ± 1 .72 ,P<0 .01) .The score of belief about medicines dif‐fered greatly in CIS patients with different gender ,family income ,occupation ,NIHSS ,hemiplegia , aphasia ,drug taking time ,adverse effect of drugs and depression (P<0 .05) .Multivariate linear regression analysis showed that adverse effect of drugs ,depression ,NIHSS ,hemiplegia ,aphasia , occupation and gender were the influencing factors of belief about medicines in CIS patients (P<0 .05 ,P< 0 .01 ) .Conclusion T he belief about medicine is considerably poor in CIS patients , which is affected by a number of factors .Measures should thus be taken to improve their belief about medicines .

Objective To explore the influence of preferred contract-altering system on contracted nurses to provide reference for stabilizing a team of high quality nursing.Method A scale on effort-reward unfairness(ERI)was used to investigate the ERI conditions among 348 contracted nurses before and after the enforcement of preferred contract-altering system.Results The scores on satisfaction with nursing work and the security in nursing work after the enforcement of the system were higher than before the enforcement(P<0.01).The ratio between effort and reward after the enforcement was lower than before the enforcement(P<0.01). Conclusions The preferred contract-altering system may enhance the job security and sense of belonging.It may decrease the ERI condition among contracted nurses,which are beneficial for stabilizing the nurses team,retaining talents and increasing the group’s competitiveness and vigour.

Objective To study the effect of 17α-hydroxyprogesterone caproate (17P) and medroxyprogesterone acetate (MPA) on expression of tumor necrosis factor-α (TNF-α)and cyclooxygenase-2 (COX-2) in placenta and uterine myometrium of inflammation-induced preterm birth mouse model to investigate the mechanism of preventing inflammation-induced preterm birth by progestogen.Methods Thirty clean CD-1 mice were divided into 6 groups (5 mice in each group) at 15th day of gestation:control group,lipopolysaccharides (LPS) group,17P 1 mg+LPS group,17P 2 mg+ LPS group,MPA 1 mg+LPS group and dimethyl sulfoxide (DMSO) + LPS group.Progestogens at different dosage were administered 1 h before LPS and 6 h after LPS administration.After these mice were sacrificed,TNF-α and COX-2 levels in the myometrium and placenta were detected by real-time PCR and immunohistochemistry.Data were analyzed by ANOVA,and comparisons between groups were adopted LSD method.Results 1.The comparison of relative expression of COX-2 mRNA and TNF-α mRNA in myometrium and placenta among groups:(1) Expressions of COX-2 mRNA and TNF-α mRNA in myometrium and placenta in the study groups were obviously higher than those of control group (P＜0.05).(2) COX-2 mRNA expression in myometrium of 17P 1 mg+LPS group (11.410±3.931),17P 2 mg+LPS group (8.352±3.209) and MPA 1 mg+LPS group (11.920± 2.905) were obviously lower than that of LPS group (20.540± 4.147) and DMSO+ LPS group (18.620 ± 4.156) (P＜0.05,respectively) ; although TNF-α mRNAexpression had similar trends among these groups,there were no statistical significance (P＞0.05,respectively).(3) COX-2 mRNA expression in placenta of 17P 1 mg+LPS group (10.864±3.777),17P 2 mg+LPS group (7.084±1.667) and MPA 1 mg+LPS group (11.830±3.652) were obviously lower than that of LPS group (18.920±4.106) and DMSO+LPS group (23.820±7.554)(P＜0.05,respectively).(4) TNF-α mRNA expression in placenta in 17P 1 mg+LPS group (14.340±1.618),17P 2 mg+ LPS group (11.488 ± 2.910) and MPA 1 mg+ LPS group (13.040 ± 2.982) were obviously lower than that of LPS group (24.240±7.059) and DMSO+LPS group (23.040±5.896) (P＜0.05,respectively).2.The comparison of protein expression of COX-2 and TNF-α in placenta among groups:(1) The expression of COX-2 protein in placenta of the study groups was significantly higher than that of control group (P＜0.05).(2) There were no differences among the COX-2 protein expression of 17P 1 mg+ LPS group (14 360.92± 1766.01),17P 2 mg+ LPS group (13 340.18±965.35) and MPA 1 mg+LPS group (12 870.81±1521.97)(P＞0.05),while the COX-2 protein expressions of them were significantly lower than that of LPS group (16 426.64 ± 1823.87) and DMSO+LPS group (16 761.23±2388.17)(P＜0.05,respectively).(3) There were no differences among the TNF-α protein expression of 17P 1 mg+LPS group (22 750.96±4656.68),17P 2 mg+LPS group (22766.24± 3500.34) and MPA 1 mg+LPS group (20770.01±3318.48)(P＞0.05),while the TNF-α protein expressions of them were significantly lower than that of LPS group (26204.49±5090.34) and DMSO+LPS group (27346.18±3269.30)(P＜0.05,respectively).Conclusions 17P and MPA might prevent the preterm parturition of inflammation-induced mouse model by inhibiting inflammation cytokines and prostaglandins.

AIM:To investigate the dissolvability of thundergodvine extract(Tripterygium wilfordii) and triptolide in different dissolvent in transdermal drug delivery system and to study the relationship among dissolvability of extract,and its active component and mean diameters of suspension. METHODS:To determine dissolvability of extract,dissolvability of active component and mean diameters by precipitation method,dissolvability of active component method and mean diameters method. RESULTS:① solvents in sequence of dissolvability of extract,alcohol,isopropanol,ethyl,IPM,water,glycerol;② solvents in sequence of dissolvability of active component alcohol,isopropanol,ethyl,IPM,water,glycerol;③ mean diameters of suspension in sequence:IPM,ethyl,alcohol,isopropanol. CONCLUSION:① The change in dissolvability between extract and active component is identical;② The relationship between the changes in mean diameters and the dissolvent of active component is negative correlation on the whole.

Objective To explore the potential clinic value of NSE and S-100 in the serum as early diagnosis in the Bilirubin Encephalopathy(BE)of newborns.Methods 46 neborns were choosed as group A with TSB≥342μmol/L;48 with TSB(256-342)μmol/L as group B;and 30 full term deliveries newborns as normal control group C.Their TSB,NSE and S-100 in the serum were measured.Meanwhile,the BAEP scores were carried out.Results The concentrations of NSE,S-100 and the BAEP scores in newborns of group A and B had significant differences as compared with group C (P <0.05 ).Correlation analysis showed that there was a significant positive correlation between serum NSE,S-100 protein and TSB(P <0.05),while there was a negative correlation between serum NSE, S-100 protein and BAEP scores(P <0.05).Conclusion Serum NSE and S-100 protein can use as early diagnosis targets for the the Bilirubin Encephalopathy(BE)of newborns clinically.

Objective:To investigate the status of vitamin D deficiency in middle aged and elderly patients at an orthopedic department.Methods:The data of 25-hydroxy vitamin D[25(OH)D]in patients aged over 55 years at an orthopedic department in Beijing Hospital from November 2014 to January 2020 were collected.The differences in serum 25(OH)D status were compared in different gender and age.Results:A total of 3004 subjects were included with 725 males and 2279 females, ranged from 55 to 102 years old with an average of(71.1±9.7)years.The average serum 25(OH)D level was(17.77±9.92)ng/ml, which was diagnosed as vitamin D deficiency status.Serum 25(OH)D levels were(19.66±9.77)μg/L, (18.34±9.78)μg/L, (16.19±9.51)μg/L and (14.74±10.49)μg/L, at different age groups of 55-64, 65-74, 75-84, 85 years and over, respectively, with statistically significant differences( F=29.357, P<0.05). Serum(OH)D levels of patients were severely deficient, deficient, insufficient and sufficient, with their proportion of 21.3%, 44.6%, 23.3% and 10.8%, respectively.The proportion of patients achieving from vitamin D levels severe deficiency to deficiency to insufficient to sufficient were 18.2%, 44.8%, 25.1% and 11.9% in men, and 22.2%, 44.6%, 22.7% and 10.5% in women, respectively. Conclusions:The deficiency of vitamin D is prevalent in elderly patients visiting at orthopedic department.Serum 25-hydroxy vitamin D has a decreased trend along with age increasing, showing an increased trend of vitamin D deficiency.Patients with severe vitamin D deficiency are the focus for the intervention.