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.

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.

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.

Objective To evaluate the incorporation of BPA, which was synthesized by ourselves, by two different glioma cell lines, and to observe its relationship with the time of cultivation and cell cycle. Methods Two glioma cell lines of C6 and SHG-44 were studied and the primarily cultured rat astrocytes were used as control. The growth curves of the two glioma cell lines and rat astrocytes were plotted, and their doubling time was identified respectively from the curves. All three kinds of cells were incubated in a culture medium, in which 10 B concentration was 50?g/ml for 4h, 8h, 16h, 20h or 24h. Boron concentration in the cells was measured by induced couple plasma atomic emission spectroscopy (ICP-AES) after respective culture period. After 24h of incubation, the cells in the G 0 /G 1 phase and those in the G 2 /M phase were isolated by flow cytometry, and boron concentration in each fraction was obtained by ICP-AES. Results The doubling time was 18.5h for both C6 and SHG-44 cells, but 28h for the astrocytes. The boron concentration in glioma cells was constantly higher than that in astrocytes throughout the experiment(P

ObjectiveTo explore the advantages and disadvantages of different local anesthetic subarachnoid block in patients with cesarean section.Methods120 patients to be in the spinal-epidural cesarean section down,were randomly divided into 3 groups(n =40):lighter than restructuring( Q group),so the proportion of(D),heavy weight ( Z group).Q Group:0.75 ％ bupivacaine 2ml + sterile water for injection 1ml,D group:0.75 ％ bupivacaine 2ml + CSF 1 ml,Z group:0.75％ bupivacaine 2ml + 10％ glucose,1 ml,2ml of each group were given(10mg).Characteristics in each group anesthesia,blood pressure,heart rate,complications and postoperative neurological effects were observed.ResultsThree groups made the same anesthesia,patients satisfaction with anesthesia had no significant difference.Z group was significantly improved compared with block group D and Q group( t =8.3,7.3,all P ＜ 0.05 ),Z group was the highest plane analgesia group than the high D and Q,Z group was significantly longer than the duration of sensory block and Q group(P ＜0.05),Z group and D duration of sensory block had no significant difference.Z group was significantly greater than the impact of the cycle Q and D groups.Anesthesia hypotension,nausea and vomiting,weight was significantly lighter than the restructuring,such as the proportion of high group.ConclusionCesarean section in the three groups in the proportion of different local anesthetic achieved the same anesthesia,and spinal anesthesia and other medication had the proportion of liquid single,and it was relatively simple,safe and more suitable for cesarean section anesthesia.

Objective To evaluate the diagnostic value of chest X-ray film of pulmonary emphysema (PE)signs for infantile bronchitis.Methods Clinical data of 60 infants with bronchitis (case group)in a hospital between Janu-ary 2010 and December 2014 were analyzed retrospectively,and compared with data of 30 infants with non-respira-tory diseases (control group).Results Of 60 infants with bronchitis in case group,95.00%(57/60)showed mani-festations of PE on X-ray,and 18.33% (11/60)of whom were with mild PE(apical or intercostal pneumocele), 76.67%(46/60)were with typical PE (diaphragm descent);one case (3.33%)in control group showed intercostal pneumocele,the other 29 cases (96.67%)were normal X-ray findings and without signs of PE.The sensitivity, specificity and accuracy of PE signs on chest X-ray film for diagnosing infantile bronchitis were 95.00%,96.67%, and 95.56% respectively.Conclusion Signs of PE on chest X-ray film have important diagnosis value for infantile bronchitis.

Objective To explore the clinical effect of traditional Chinese medicine and western medicine in treatment of patients with angina pectoris. Methods 120 cases with angina pectoris admitted in the Fourth Hospital of Baotou City from May 2012 to August 2013 were randomly divided into treatment group (n=60)and control group (n=60). All patients were given secondary prevention of coronary heart disease,and besides this, treatment group were added nitrates medications and traditional Chinese medicine treatment,while control group were only given nitrates medications.The treatment course was 14 days. The efficacy of angina pectoris,nitroglycerin loss rate and electrocardiogram efficacy were compared and the safety were evaluated between two groups. Results The efficacy of angina pectoris in treatment group was 90.00%,while control group was 71.67%,the difference was statistically significant(P<0.05 ). ECG efficiency in treatment group was 68.33%,while control group was 48.33%,the difference was statistically significant(P<0.05 ). The reduction of nitroglycerin was 86.67%,while control group was 61.67%,the difference was statistically significant(P<0.05). In addition,there were no adverse reaction in two groups. Conclusion Compared with nitrates medications,combined Chinese and Western medicine in treatment of patients with angina pectoris on basis of secondary prevention of coronary heart disease has better therapeutically effective rate.

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.

Objective To explore the therapeutic effect and possible mechanisms of Xuebijing injection for treatment of acute pulmonary thromboembolism(APE)in rabbits. Methods Twenty-four New Zealand rabbits with big ears were randomly divided into control group,model group and Xuebijing group(each n=8). The model of APE was performed by re-infusing of autologous blood clots. After the model was established,in the rabbits of the Xuebijing group,Xuebijing injection 1 mL/kg was injected into the ear marginal vein,twice daily for consecutive 7 days. In the model and control groups,the same amount of normal saline was given via the same route. The changes in plasma levels of B-type natriuretic peptide(BNP)were detected by enzyme-linked immunosorbent assay(ELISA) at the time points of 8 hours and 1,3,5,7 days,and after 7 days the lungs of the rabbits were removed for the lung histopathological examination. Results The BNP levels of the model group and Xuebijing group were significantly higher compared with the level of control group at 8 hours after embolization,the model group being the most significant(all P<0.05). On day 3,the BNP levels of the model group and Xuebijing group reached their peaks,and then gradually decreased,but the level of model group was significantly higher than that of Xuebijing group(ng/L:581.1±144.6 vs. 251.5±22.5,P<0.05). On day 7,the BNP level of Xuebijing group fell to the level of the control group(ng/L:78.5±9.4 vs. 50.9±11.5),the level of the model group also decreased,but it was still much higher than that of the Xuebijing group(ng/L:214.1±47.6 vs. 78.5±9.4,P<0.05). Histopathological examination showed Xuebijing could significantly reduce the infarct size with mild inflammatory cell infiltration,but the infarct size of the model group was obviously bigger than that of the Xuebijing group and accompanied by relatively more inflammatory cell infiltration. Conclusion Xuebijing injection can significantly reduce the plasma BNP level of the rabbits with pulmonary embolism,and in the mean time ameliorate the degree of inflammatory infiltration in the lung tissue and infarct.

Objective To explore the effect of carbohydrate administration on postoperative insulin resistance after gastroenteric tumor resection.Methods Sixty elective gastroenteric tumor resection patients were divided into observation group and control group by random number table method,with 30 cases in each.Observation group was given carbohydrate administration before surgery,that was 2 h before anesthesia oral carbohydrates 300 ml containing 50 g glucose;control group was treated according to the traditional methods,preoperative fasting 12 h,6 h forbidden to drink.The blood samples were collected to measure the levels of fasting blood glucose (FBG) and fasting insulin (FINS) at 3 h before operation and 1,3,7 d postoperation respectively.Homeostasis model assessment (HOMA) was applied to calculate the insulin resistance index.Results The levels of FBG,FINS,HOMA-IR at 1,3 d postoperation in two groups were significantly higher than those at 3 h preoperation [observation group:(10.65 ± 1.78),(7.32 ± 1.48) mmol/L vs.(5.09 ±0.43) mmol/L,(25.78 ± 12.43),(16.23 ±7.56) mU/L vs.(10.48 ± 1.57) mU/L,11.67 ±6.32,5.12 ± 2.11 vs.2.35 ± 0.54;control group:(11.18 ± 1.25),(8.04 ± 1.53) mmol/L vs.(5.12 ± 0.39) mmol/L,(39.67 ± 10.37),(24.34 ± 6.78) mU/L vs.(9.98 ± 2.04) mU/L,19.07 ± 5.49,8.56 ± 2.87 vs.2.28 ± 0.39](P ＜ 0.05).The levels of FINS,HOMA-IR at 1,3 d postoperation in control group were higher than those in observation group (P ＜ 0.05).The levels of FINS and HOMA-IR at 7 d postoperation in observation group were returned to the 3 h preoperative (P ＞ 0.05),while the levels in control group [(16.32 ± 4.56) mU/L,3.87 ± 1.12] was still higher than those at 3 h preoperation (P ＜0.05).Conclusion Carbohydrate administration may shorten the insulin resistance durion after gastroenteric tumor resection,and reduce the intensity of insulin resistance,thus contributing to the rehabilitation of patients.