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.

Objective To investigate the influence of Xiyanping injections therapy on inflammation factors and lung function for old patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD).Methods Ninety-two patients with AECOPD were randomly divided into the control group (n =46) and observation group(n =46).Patients in control group were given conventional treatment,in observation group were given XiYanPing injections for 2 weeks treatment on the basis of treatment of control group.The C-reactive protein(CRP),blood sedimentation rate (ESR),interleukin 10 (IL-10),1 s forced expiratory volume (FEV1),forced vital capacity (FVC),FEV1/FVC change and clinical effect of the two groups were recorded.Results There was no statistically significant difference in terms of CRP,ESR and IL-10 between the two groups before treatment (P ＞ 0.05).After treatment,CRP and ESR in control group were reduced from (35.6 ±9.8) mg/L and (56.2 ± 16.4) mm/h to (14.2 ± 8.1) mg/L and (22.4 ± 11.6) mm/1 h and the difference was significant (t =-14.515,-12.008;P ＜ 0.05),while in observation group decreased from (36.4 ± 8.2) mg/L,(54.6 ± 15.4) to (8.2 ± 6.2) mg/L,(16.8 ± 9.6) mm/h and the difference was significant (t =-18.468,-15.249;P ＜ 0.05).Meanwhile,the level of IL-10 in the two groups significantly increased and the observation group showed more.IL-10 in control group increased from (168.8 ± 62.4) ng/L to (212.4 ± 85.6) ng/L and the difference was significant(t =5.468,P ＜ 0.05),and in observation group increased from (172.8 ± 65.1) ng/L to (266.4 ± 92.6) ng/L and the difference was significant (t =6.368,P ＜ 0.05).The FEV1 and FVC were markedly increased after treatment and the observation group showed increase more.FEV1and FVC in control group were increased from (1.41 ±0.15) L and (2.62 ±0.88) L to (1.62 ± 0.18) L and (2.89 ± 0.92) L,and the differences were significant (t =2.186,2.415 ; P ＜ 0.05).While in observation group,FEV1 and FVC were increased from (1.42 ± 0.16) L and (2.59 ± 0.84) L to (1.84 ±0.21) L and (3.12 ± 0.94) L,and the differences were significant (t =4.366,4.585 ; P ＜ 0.05).Total efficacy of observation group was 91.3％ (42/46),obviously higher than that of control group(78.3％ (36/46) ; x2 =4.658 ;P ＜ 0.05).Conclusion Xiyanping injections can reduce the inflammatory response in patients with AECOPD,improve lung function and the effect of treatment.

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 .

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.

?The small incision lenticule extraction ( SMILE ) with femtosecond laser is a new mode of corneal refractive surgeryrecently. The safety, efficacy, stability and predictability of SMILE lead the corneal refractive surgery to a new world that only use femtosecond laser to correct myopia.With the development and popularity of SMILE, the clinical effect has aroused much concern.But there remain exited disputes in refractive stability, visual quality and corneal biomechanical property, contrast sensitivity and glare symptoms, corneal sensitivity and dye eye, corneal endothelial cells and intraocular pressure.These will be summarized in this review.

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.

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.