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.

Objective To evaluate the influence of ProTaper rotary nickel-titanium files root preparation on root canal filling . Methods 30 cases of molars pulpitis and 20 cases of premolars pulpitis or periapical periodontitis were equally divided into two groups .The group A(30 cases) used the ProTaper rotary nickel-titanium files in root canal preparation and the group B (30 cases) adopted the common K files modified step-back technique for root canal preparation .The influence of the root preparation by 2 sets of apparatus on the effect of root canal filling ,and the several aspects of the root canal filling time ,the matching degree of main root canal file and master gutta-percha ,proper filling rate ,postoperative reaction of root canal filling were compared for conducting the e-valuation .Results In the mean root canal filling time of the group A ,average premolar time was 4 min 25 s and molar was 1 min 30 s ,however in the group B ,average premolar was 5 min 30 s and molar was 11 min 41 s ,the time in the group A was greatly short-ened with statistical difference(P<0 .05);the matching degree of main root canal file and master gutta-percha in the group A was 86 .37% for premolar and 88 .89% for molar ,however in the B group ,which was 62 .50% for premolar and 26 .67% for molar ,the matching degree in the group A was greatly improved with statistical difference between them (P<0 .05);the proper filling rate of upper premolar from the X-ray film was 72 .73% in the group A and 70 .83% in the group B ,while which of molar was 80 .0% in the group A and 77 .78% in the group B ,here was no statistical difference between them (P>0 .05);the postoperative pain reaction of root canal filling in both groups were very low and weak without statistical difference .Conclusion The ProTaper rotary nickel-titanium files root preparation can accelerate the root canal filling speed ,improve the matching degree of main root canal files and master gutta-percha and simplify the root-filling therapy procedure .

Objective To study whether ANCA liter is sensitive serological marker reflecting vasculitis disease activity. Methods MPO-ANCA and IF-ANCA tilers variation in five sera specimen with active MPA diseases were studied after methylprednisolone and cyclophosphamide pulse therapy. The clinical and pathological features of 5 patients with MPA were investigeted comparing pre-treatment with post-treatment. Results (1) Serum ANCA were found positive and increased liter in 5 patients wilh active MPA disease. (2) Titer decreased after Ireatment, while renal function improved. (3) After half year, MPO-ANCA was negative in 5 patients, IF-ANCA was negative in 2 patients. Conclusion There is a close correlation between serum ANCA titer and MPA renal disease activity.

Along with the fast development of medical technology,the theory of holistic medical care is infiltrated into every aspect of clinical medical practices.In this paper,though the treatment of surgical hepatobiliary diseases under the direction of holistic medical care ,we emphasize the significance of holistic medical care in diagnosis and treatment ,recommend and canonize the usage of holistic medical care into the clinical practices.

K-ras gene is one of oncogenes in non-small cell lung cancer,and it can promote tumor cells growth after mutations by several signaling pathways.K-ras mutations frequently occur in lung adenocarcinoma patients with smoking history.In the present study,K-ras mutations are associated with resistence to targated therapy and may be a marker of poor prognosis in patients with non-small cell lung cancer.

Spinal cord injury is a common clinical disease .Cell apoptosis is one of important pathogeneses for spinal cord in-jury, and apoptotic gene plays a very important role in apoptosis on spinal cord injury .Chinese medicine for blood-activating and stasis-dissolving has a good therapeutic effect for spinal cord injury by reducing inflammation , inhibiting apoptosis and improving microcircu-lation.In this paper, we review the research of chinese medicine for activating blood and resolving stasis during the regulation of apoto -sis gene in spinal cord injury based on related documents in the recent five years .

Small cell lung cancer (SCLC), which accounts for about 15%of lung cancer cases, is an aggressive disease characterized by rapid growth and early widespread metastasis. Despite sensitive to chemotherapy and radiotherapy, SCLC is vulnerable to get resistant and has high recurrence rates. Therefore, novel therapies are desperately needed to improve treatment efficacy and increase overall survival. A complex molecular biological alteration of SCLC accounts for its pathogenesis and chemo-resistance. With the understand-ing of SCLC biologic behavior and improvement of detection technique, immunotherapy may be a viable therapeutic approach and bring breakthrough to the treatment of patients with SCLC. In this review, we will discuss the rationale for immunotherapy and recent clinical trials of immunotherapeutic agents for SCLC.

The effects of two lipids lowering drugs, Xu Zhiping and Mixtura Dai Huai, on the LDL metabolism by receptor dependent and independent pathways in experimental hypercholesterolemia rats were obsvered using radioisotopic double-labelling trace technique. The results showed that in the receptor dependent or independent pathways, the FCR of LDL was increased by 43% and 34% respectively in Xu Zhiping group, and by 35% and 40% respectively in Mixtura Dai Huai group as compared with controls. Both drugs appeared to be more effective than colifibrate, in promoting clearance of LDL from plasma suggesting that the role in reducing plasma TC and LDL-C was depended on accelerating LDL degradation through both receptor dependent and independent pathways. It was also suggested that immune stimulus in combination with cholagogus may become a new way for prevention of hypercholesterolemia and atherosclerosis.

The effects of Da Huai Mixture on receptor dependent and independent pathways of LDL catabolism of the experimental hypercholesterolemic rats were observed by isotope trace-labelling, measurement of monocytic macrophage function and dot bloting. The results were as follows: (1) Serum total cholesterol was significantly decrcased(P