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 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.

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 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 pre-hospital delay factor of coronary reperfusion therapy for ST-elevation acute myocardial infarction (STEAMI) patients presenting with non-chest pains. Methods A retrospective observation was conducted. The clinical data of STEAMI patients underwent emergency percutaneous coronary intervention (PCI) admitted to Luoyang Central Hospital Affiliated to Zhengzhou University from August 2013 to August 2015 were analyzed. The patients were divided into chest pain group and non-chest pain group according to the presence of chest pain or not. Clinical characteristics were compared between the two groups, and incidence of major adverse cardiac events (MACE), door-to-balloon time, door-to-electrocardiograms (ECG) time and ECG-to-balloon time were evaluated. Influencing factors of pre-hospital delay was analyzed by logistic multiple stepwise regression. Results A total of 259 patients with STEAMI were enrolled, including 154 patients with chest pain and 105 presented with non-chest pains. Compared with chest pain group, the patients in the non-chest pain group were older (years: 68.12±8.93 vs. 62.34±7.12, P < 0.05), less female (26.67% vs. 42.20%, P< 0.05), and had a higher past history of angina, stroke and heart failure (27.61% vs. 13.63%, 31.42% vs. 18.83%, 26.67% vs. 11.68%, respectively, all P < 0.05), and higher percentage of Killip ≥ Ⅲ patients (15.24% vs. 6.49%, P < 0.05), the lower ambulance use (26.67% vs. 44.81%, P < 0.01), longer hospitalization time (days: 12.50±2.89 vs. 9.50±2.67, P < 0.05), higher incidence of MACE (19.05% vs. 9.09%, P < 0.05), longer door-to-balloon time and door-to-ECG time (minutes: 159.01±51.21 vs. 115.31±36.74, 53.06±18.17 vs. 30.35±9.93, both P < 0.01). It was shown by logistic multivariate regression analysis that no-chest pain [odds ratio (OR) = 5.14, 95% confidence interval (95%CI) = 2.34-10.81, P < 0.001], age ≥ 65 years old (OR = 1.43, 95%CI = 0.93-2.99, P = 0.022), diabetes (OR = 1.57, 95%CI = 0.66-2.15, P = 0.015) and no-ambulance transport (OR = 1.55, 95%CI = 0.73-2.75, P < 0.001) were risks factors of coronary reperfusion delay ≥ 2 hours. Conclusions STEAMI patients presenting without chest pain showed higher incidences of MACE, longer time of ECG obtained and initial PCI time delay. Clinicians should try to reduce the delay time of the patients in order to improve patient survival rates.

OBJECTIVE To evaluate the value of serum procalcitonin(PCT) levels for differentiating Gram-positive and-negative bacteria infected critically ill patients in intensive care unit(ICU). METHODS Serum PCT levels were measured in 80 patients with sepsis and severe sepsis in ICU.Of the 80 patients,40 were infected with Gram-positive bacteria and 40 were infected with Gram-negative bacteria.Another 40 patients with fungi or viruses infection or non-infection from ICU were measured in parallel as control. RESULTS Serum levels of PCT in patients with Gram-negative bacteria were significantly higher than in those with Gram-positive bacteria and control ones(18.5?5.8ng/ml vs 3.9?2.1ng/ml and 0.3?0.2 ng/ml,respectively,P