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

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 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.

180,anti-ds-DNA,anti-Sm and lower C3,are high risk factors in the development of LN.The manifestations were various and misdiagnosis at the early stage was not uncommon.

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.

AIM:To analyze the recovery of visual cortex activation range of color vision in anisometropia amblyopia children after treatment by using blood oxygen level dependence-functional magnetic resonance imaging ( BOLD- fMRI ) and SPM8 software.
METHODS:Self-control study. This fMRI study directly compared activity in visual cortex produced by color monocular stimulation in 13 monocular anisometropia amblyopia children. The project of study was blocked design. The data of functions and anatomical MRI was stimulated by three-primary colors and was preprocessed and analyzed by SPM8 that based on MATLAB software. According to the data, we compared the change of the central area of color vision when first visit and 1, 2 ,4wk after treatment.
RESULTS: The BA17, BA18, BA19 and BA37 of amblyopia children were different activated after they accepted the three-primary colors stimulation (P<0. 01). After 4wk treatment, amblyopia children accepted red stimulation, the visual cortex activation range without expanding; after accepting green stimulus, on the left side of the visual cortex BA37, BA19, BA20, the average t value were 3. 5210, 3. 2716, 3. 1534 ( P< 0. 01 ); after accepting blue stimulation, the scope of the right side of visual cortex at BA19, BA18 were expanded to different extent, the average t value were 3. 7345, 3. 2701 (P<0. 01).
CONCLUSION: After 4wk treatment, visual cortex activation of color vision of anisometropia amblyopic children is expanded, but with low extent, after the short-term treatment of amblyopia, visual cortex activation of color vision has a certain degree of recovery but not obvious.

Objective To investigate the autonomic nervous system function of hyperthyroidism and hyperthyroidism by analyzing the heart rate variability of patients with the diseases. Methods 12-synchronous dynamic 24-hour monitoring and man-machine dialogue were used in 36 patients with hyperthyroidism, 30 patients with hypothyroidism and 26 cases of healthy volunteers(controls), and 24-hour electrocardiogram was analyzed.Heart rate variability indicators observed included 24 h consecutive sinus standard deviation of R-R interval (SDNN), standard deviation of sequential five-minute R-R interval (SDANN), percentage of differences between adjacent NN intervals that ＞ 50 ms(PNN50), root mean square standard deviation from adjacent R-R interval (rMSSD), low-frequency power (LF), high frequency power (HF), low frequency power/high frequency power (LF/HF). Results In hyperthyroidism group, SDNN[(80.48 ± 11.95)ms], PNN50[(18.56 ± 3.50)%], rMSSD [ ( 13.56 ± 3.45)ms] were significantly lower than those of the control group[ ( 128.06 ± 12.8)ms, (32.84 ± 7.21)%,(30.84 ± 6.12)ms, all P ＜ 0.05 ], and LF/HF(3.78 ± 1.63) were significantly higher than that of the control group (2.34 ± 1.06, P ＜ 0.05). In hypothyroidism group, SDNN[(65.65 ± 15.55)ms], SDAN[ (80.2 ± 15.72)ms],PNN50[ (16.34 ± 3.56)%], rMSSD [ (15.77 ± 3.58)ms ], LF[ (279.03 ± 91.49)ms2/Hz ] were also significantly lower than those of the control group[ (128.06 ± 12.87)ms, (132.40 ± 21.95 )ms, (32.84 ± 7.21 )%, (30.84 ± 6.12)ms, (525.60 ± 84.11)ms2/Hz, all P ＜ 0.05], but LF/HF (1.08 ± 0.73) was lower than that of the control group,however, the difference was not significant(P ＞ 0.05). Conclusions The heart rate in patients with abnormal thyroid function is lower in the overall performance, but in patients with hyperthyroidism sympathetic activity is dominate, while in patients with hypothyroidism, vagal nerve activity is dominate.

Electrophysiology examination is an important technique in studying amblyopia, which mainly includes electrooculography( EOG), electroretinography ( ERG), visual evoked potential( VEP). This study does not only summarizes the definition, the mechanisms and the meaning of these indexes in the relevant research progress in recent years, but also makes a comment on the controversies among the relevant research conclusions.