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.

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.

Objective To observe the heart rate variability in patients with hypothyroidism, and to analyze the effect of 131Ⅰ therapy on autonomic nervous system of patients with the diseases. Methods A total of 56 cases of hyperthyroidism from the Second Affiliated Hospital of Harbin Medical University and the Second Hospital of Harbin City were enrolled as research subjects. 12-synchronous dynamic 24-hour monitoring and man-machine dialogue were used 6 months before and after 131Ⅰ treatment, and 49 cases of healthy volunteers were selected as controls.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), very low frequency power(VLF), low frequency power(LF), high frequency power(HF), and low frequency power/high frequency power(LF/HF). Results In hyperthyroidism group before 131Ⅰ therapy, SDNN[(85.25 ± 13.59)ms], SDANN [( 95.47 ± 33.15)ms], PNN50 [( 15.26 ± 4.84) %], rMSSD [( 14.47 ~ 3.49) ms], LF [(435.57 ± 75.74)ms2/Hz], and HF[(129.81 ± 63.21 )ms2/Hz] were significantly lower than those of the control group [(155.24 ±15.87), ( 134.02 ± 24.15)ms, (29.41 ± 6.21 )%, (26.64 ± 6.11 )ms, (515.69 ± 74.83)ms2/Hz, and (265.93 ± 58.84)ms2/Hz, all P < 0.05], VLF[(1765.21 ± 315.22)ms2] and LF/HF(3.95 ± 1.89) were significantly higher than that of the control group[(374.25 ± 54.47)ms2, 2.94 ± 1.55, all P < 0.05]. In hyperthyroidism group after treatment,SDNN [(126.91 ± 16.32)ms], SDANN[(125.2 ± 43.22)ms], PNN50[(26.34 ~ 7.56)%], rMSSD[(24.85 ± 7.85)ms],LF [(489.35 ± 91.49)ms2/Hz], and HF [(209.45 ± 75.32)ms] were also significantly higher than those before 131Ⅰ therapy, VLF[(571.80 ± 97.41)ms] and LF/HF(2.41 ± 0.93) were lower than that before 131Ⅰ therapy,but SDNN, PNN50 and HF were lower and VLF was higher than those of the control group (all P < 0.05). Conclusions The heart rate variability in patients with hyperthyroidism is lower in the overall performance, sympathetic activity is dominate, 131Ⅰ therapy partly corrects abnormal autonomic nerve function.

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 systematically evaluate the effects of compression stockings for preventing post-thrombotic syndrome after giant surgery in department of orthopaedics.Methods Randomized controlled trials about compression stockings were searched and analyzed no matter written in Chinese or English.The effects of compression stockings is determined by Meta-analysis with Review Manager 5.0.Results 4 papers were included in this research,among which,one was domestic,and another three were abroad.Heterogeneity was small when the data was merged,which suggested that compression stocking for preventing post-thrombotic syndrome was effective.Conclusions Compression stockings can be safely used to prevent post-thrombotic syndrome after giant surgery in department of orthopaedics.

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.