For the cultivation of medical students medical professionalism and evaluation has become a hot is-sue in the medical colleges medical education at home and abroad, but for junior medical students′professional spirit evaluation research is less.This paper introduces the basic concept of responsibility index and application by introducing foreign medical schools responsibility index for evaluation in school doctor students physician profession-alism, analysis the advantages and disadvantages of the method.Think the responsibility index is based on the spe-cific behavior evaluation, the result is more accurate, is suitable for junior medical students′professional spirit e-valuation system, compared with other evaluation system, responsibility index, pay more attention to guidance and specification in advance.But responsibility index also has some disadvantages.Such as responsibility index evalua-tion process must face some ethical challenges, lack of integrity and evaluation framework design.

Ophthalmic imaging including radiographic imaging, acoustic imaging and optical imaging,as a branch of medical imaging has developed rapidly. Optical imaging is very suitable for fundus examination because of the physiological characteristics of the eye. Ophthalmoscope and fundus fluorescein angiography are two historical stages of fundus optical imaging, which become an independent new discipline now, including infrared fundus photography, fundus autofluorescence, fundus fluorescein and indocyanine green angiography and optical coherence tomography. Comprehensive optical imaging plays an irreplaceable role in the diagnosis and treatment evaluation of ocular fundus diseases. Appropriate understanding the principles and significance of various optical imaging methods is very important for their clinical applications.

Under pathologic conditions, nitric oxide causes peripheral insulin resistance by impairing key signal molecules of insulin signaling pathway and mediates dysfunction of islet ? cells caused by lipids, cytokines and hyperglycemia, which plays an important role in the pathogenesis of type 2 diabetes mellitus.

Objective To discuss the change of androgen level in postmenopausal women with coronal atherosclerosis heart dis-ease,and to discuss its clinical significance.Methods According to the results of coronary angiography,218 cases of possible coro-nal atherosclerosis heart disease patients were divided into the observational group with 93 cases of coronal atherosclerosis heart disease patients,and the control group with non-coronal atherosclerosis heart disease patients.The levels of TC,TG,LDL-C,HDL-C,testostemne and andmstenedione in blood were investigated in two groups.Results The level of blood glucose was not statisti-cally different between the two groups(P >0.05),however,the levels of systolic and diastolic blood pressure,TC,TG,LDL-C and HDL-C were statistically different between the two groups (P < 0.05 ).Conclusion The level of androgen in postmenopausal women with coronal atherosclerosis heart disease are higher than postmenopausal women without coronal atherosclerosis heart dis-ease.Androgen detection is useful for the monitoring and diagnosis for postmenopausal women with coronal atherosclerosis heart disease.

The choline acetyltransferase (CHAT) and the molecular forms of acetyl-cholinesterase (ACHE) activites in various brain regions of 20-day-old hypothyroid and hyper-thyroid rats were measured. The results provided the following information: 1) CHAT and ACHE activities were directly interrelated with thyroid hormones. 2) In both hypothyroid and hyperthyroid rats the nonextractable ACHE activity was distinctly decreased in every brain region, suggesting that both conditions were affected in the critical period of cholinergic synaptic development. 3) The ratio of membrane-bound ACHE to soluble ACHE decreased;it showed that thyroid hormone deficiency might distrub development and maturation of cholinergic neurons. 4) In most regions of the central nervous system,the CHAT seemed to be more affected than ACHE by thyroid hormones.

The Medical College of Panzhihua University has developed a series of curriculum reform based on Medical Professionalism, investigating the basic idea, curriculum design and assess-ment system of Medical Professionalism curriculum reform, emphasizing the combination of medical professionalism curriculum with clinical courses, in the hope of providing a unified and acknowledged medical professionalism curriculum.

Objective To investigate the relationship between social support,coping style and general well-bing in armymen.Methods 280 armymen were tested by General Well-Being Schedule(GWB),coping style questionnaire and social support scale.Results There was a significant difference between the common soldiers and the other armymen(P<0.05);all the factor scores of GWB were related highly with all the factors of coping style and social support(P<0.05～0.01).Conclusion Coping style and social support in armymen are related to the general well-being.

Objective To investigate the relationship between the plasma NT-pro BNP level and the hear function in children pa-tients with heart failure.Methods 30 children patients with heart failure and 30 healthy children were selected as the patients group and the control group respectively.The plasma NT-pro BNP level was detected in the patients group before and after treatment and the control group.The changes of heart functional indexes and the clinical symptoms in the patients group were detected,the detec-tion results and the plasma NT-pro BNP levels were performed the correlation retrospective analysis.Results The plasma NT-pro BNP level before treatment in the patients group was significantly higher than that in the control group,there was the statistically significant difference between them(P <0.05 ).After treatment,the clinical symptoms in the patients group were obviously im-proved,the plasma NT-pro BNP level was significantly decreased and LVEF by ultrasound was also increased,the differences were statistically significant(P <0.05).The plasma NT-pro BNP level after treatment in the patients group was obviously higher than that in the control group with statistical difference between them(P <0.05).The plasma NT-pro BNP level before and after treat-ment in the patients group demonstrated a negative correlation with LVEF(r=-1.32,r=-1.78).Conclusion Detecting the plas-ma NT-pro BNP level in children patients with heart failure has the important clinical guidance significance for the diagnosis,disease condition evaluation,prognostic evaluation and cardiac function grading in the children patients with heart failure.

Objective To investigate changes ane clinical significance of renal pathomorphology ane transforming growth factor-β1(TGF-β1 ),connective tissue growth factor(CTGF)of rats with eifferent stages of eiabetes mellitus(DM). Methods Thirty-six SD rats were raneomly eivieee into control ane DM group. Rats in DM group were given streptozotocin(STZ)at a eose of 65 mg/ kg boey weight ane rats in control group were given same amount citric acie/ soeium citrate buffer solution. Rats were killee at 4th,12th ane 24th weeks after DM moeels establishment. The renal hyeroxyproline concentration(HPC)was measuree. Masson′s trichrome was performee to observe perivascular collagen area(PVCA). Glomerular collagen eeposition score(GCDS),tubular interstitial eisease score(TIDS)in kieney interstitial tissue were measuree. Immunohistochemical staining were usee to measure the expression of type Ⅰ ane Ⅲ collagen,TGF-β1 ,CTGF. Renal path morphology change were observee with light microscope ane transmission electron microscope. Results (1)HPC levels of rats in DM group at 4th,12th,24th weeks were(216. 50 ± 10. 05)μg/ g,(267. 67 ± 11. 29)μg/ g,(340. 67 ± 39. 22)μg/ g,higher than that of control group((123. 00 ± 6. 00)μg/ g,(158. 50 ± 8. 89)μg/ g,(201. 00 ± 7. 69)μg/ g). The PVCA score in DM group were higher than that of control group( 4 weeks:(0. 45 ± 0. 07)vs (0. 96 ± 0. 11);12 weeks:(0. 60 ± 0. 06)vs(1. 65 ± 0. 18);24 weeks:(0. 72 ± 0. 07)vs(2. 63 ± 0. 0. 40);P< 0. 05). Meanwhile the scores of GCDS ane TILS in DM group)at 4th,12th,24th weeks increasee comparee with control group(4 weeks:((0. 34 ± 0. 03)vs(0. 14 ± 0. 01))× 103 / μm2 );12 weeks:((0. 49 ± 0. 03)vs (0. 26 ± 0. 04))× 103 / μm2;24 weeks:((0. 62 ± 0. 06)vs(0. 33 ± 0. 03))× 103 / μm2 )). The expression of CollagenⅠane Collagen Ⅲ in DM group were higher than that of control at 4,12,24 weeks after DM moeel establishment(Collagen Ⅰ:4 weeks:((4. 56 ± 0. 75)vs(1. 34 ± 0. 34))× 103 / μm2;12 weeks:((6. 07 ± 0. 74)vs(2. 17 ± 0. 12))× 103 / μm2;24 weeks:((7. 22 ± 0. 19)vs(3. 00 ± 0. 33))× 103 / μm2;CollagenⅢ:4 weeks:((3. 44 ± 1. 41)vs(1. 58 ± 0. 24))× 103 / μm2;12 weeks:((5. 60 ± 1. 34)vs(2. 95 ± 0. 41)) × 103 / μm2;24 weeks:((6. 22 ± 0. 18)vs(3. 27 ± 0. 27))× 103 / μm2 )),ane the eifferences between the groups all significant(P < 0. 05). Diffuse thickening of glomerular capillary basement membrane ane interstitial collagen hyperplasia in eiabetic rats were observee by electron microscope.(2)TGF-β1 expression in DM group were(2. 16 ± 0. 50)× 103 / μm2 ,(5. 31 ± 0. 25)× 103 / μm2 ,(6. 44 ± 0. 74)× 103 / μm2 respectively at 4th, 12th,24th weeks after DM moeel establishment,higher than that of control group((1. 18 ± 0. 15)× 103 / μm2 , (2. 99 ± 0. 25)× 103 / μm2 ,(3. 28 ± 0. 66)× 103 / μm2 )ane the eifferences were significant(P < 0. 05). The same trene was also seen in terms of CTGF expression((6. 02 ± 1. 39)vs(2. 32 ± 0. 87))× 103 / μm2 ,((6. 51 ± 0. 51)vs(3. 96 ± 0. 92))× 103 / μm2 ,((7. 89 ± 1. 46)vs(4. 58 ± 1. 02))× 103 / μm2;P < 0. 05) Conclusion Early eiabetic rats show renal fibrosis ane it may be relatee with overexpression of CTGF ane TGF-β1.

Objective To explore the therapeutic effect and possible mechanisms of Xuebijing injection for treatment of rabbits with acute pulmonary thromboembolism (APTE). Methods Thirty-two New Zealand rabbits were randomly divided into normal control group, model group, low molecular weight heparin (LMWH) group and Xuebijing group by random number table, 8 rabbits in each group. APTE model was reproduced by re-infusing autologous blood clots, and nothing was done for the normal control group. After the model was established, intravenous injection of Xuebijing 1 mL/kg from ear marginal vein was given to the rabbits in Xuebijing group, the LMWH 100 U/kg was subcutaneously injected in LMWH group, the same amount of normal saline was given intravenously to model group and normal control group, twice daily for 7 days in all the groups. The changes of plasma D-dimer and endothelin-1 (ET-1) levels were detected by enzyme-linked immunosorbent assay (ELISA) after modeling for 8 hours and 1, 3, 5, 7 days;after 7 days the animals were sacrificed and their lung tissues were removed for the examination of ultrastructural changes under an electron microscope. Results With the prolongation of time, the D-dimer level in the model group was gradually increased, and on the 7th day after modeling, the level was significantly higher than that of the normal control, LMWH and Xuebijing groups (g/L:3.98±1.14 vs. 0.43±0.12, 1.05±0.13, 1.04±0.15, all P<0.05). After modeling for 5 days, the ET-1 level reached its peak in the model group, and it was lowered on the 7th day after modeling, but still significantly higher than that in the normal control, LMWH and Xuebijing groups (g/L:63.8±20.9 vs. 20.0±1.4, 36.5±8.3, 34.2±6.3, all P<0.05). The D-dimer and ET-1 levels in the LMWH and Xuebijing groups were significantly higher than those of the normal control group at each time point, but still obviously lower than those of the model group (all P<0.05), and the differences between the two treatment groups were not statistically significant at each time point (all P>0.05). Electron microscopic examination of lung tissue ultra-structure showed:in the model group, there were the lung tissue basement membrane rupture, the organelle structure in vascular endothelial cells and alveolar epithelial cells typeⅠandⅡnot clear, disappearance of microvilli on cell surface, cytoplasm concentration, nuclear chromatin condensation, a lot of debris due to nuclear lysis, formation of apoptotic bodies after shedding, and mitochondrial structural damage. In LMWH group, the capillary endothelial cell swelling, a lot of necrotized blood cells oozing, blockage of lumen, the cytoplasm of typeⅡalveolar epithelial cell loose, edematous and multiple lamellar bodies vacuolized were seen. In Xuebijing group, capillary endothelial cell swelling, necrotized blood cells blocking the lumen and seeping, the link basically normal, the type Ⅱ alveolar epithelial cell edematous, mitigation of lamellar bodies emptying were found. Conclusions Xuebijing can significantly reduce the plasma D-dimer and ET-1 levels, adjust the balance of coagulation and fibrinolysis, simultaneously decrease the pulmonary vascular permeability obviously in rabbits with APTE, thus it possesses certain protective effect for endothelial function leading to amelioration of lung injury and reduction of lung pathological damage in rabbits with pulmonary embolism.