Objective To investigate physicians' awareness of diagnostic criteria for irritable bowel syndrome (IBS). Methods Questionnaire was used to investigate awareness of diagnostic criteria for IBS among 782 physicians in 34 hospitals in Shanghai during August 2008. Results Overall, 82. 7 percent (647/782) of physicians surveyed thought they knew or partly knew diagnostic criteria for IBS. More than 70. 0 percent of physicians knew Rome criteria, but less than 25.0 percent knew other criteria. Awareness of current Rome criteria, whether mental symptoms included in it, and its time frame differed significantly among physicians in varied specialties (P ＜ 0. 01 ). Gastroenterologists had more knowledge about Rome criteria than other specialists, but most physicians, including gastroenterologists, did not fully understand its applicability. Conclusions Although gastroenterologists knew more about diagnostic criteria for IBS, their knowledge still needed to be perfected and updated. Awareness of diagnostic criteria for IBS was poor in nongastroenterological physicians and general practitioners knew it to certain extent.

Objective To investigate clinical significance of small airway function and eosinophil (Eos) percentage,levels of eosinophil cationic protein (ECP) and IL-5 in induced sputum among patients with clinically controlled asthma. Methods Sixty-two patients with clinically controlled asthma were selected for the study. Lung function was performed and percentage of Eos, levels of ECP and IL-5 in induced sputum were measured by Wrights' stain, fluorescence immuno-CAP system and ELISA,respectively. Thirty patients of asthma at acute exacerbation period and 20 healthy subjects were selected as controls. Results In 62 patients with clinically controlled asthma, 43 (69. 4% ) showed abnormal small airway function and 19(30. 6% ) normal one. Percentage of Eos [(5. 6 ±2. 9)%], levels of ECP [( 129 ±100) μg/L] and IL-5 [(21± 12) μg/L] in induced sputum were significantly lower in patients with clinically controlled asthma than those of asthma at acute exacerbation period [( 16. 2 ± 9. 7 ) %, ( 362 ±182) μg/L and IL-5(51 ±26) μg/L, respectively] (all P ＜0. 01 ), but significantly higher than those in healthy controls ( all P ＜ 0. 01 ). Percentage of Eos, levels of ECP and IL-5 in induced sputum were significantly higher in patients with clinically controlled asthma with abnormal small airway function than those with normal ane [(6.9±3.1)% vs. (2.0±1.1)%, (148±90) μg/Lvs. (54±29) μg/L and (24 ±12) μg/L vs. ( 13 ± 5 ) μg/L, respectively] ( all P ＜ 0. 01 ). Conclusions Abnormal small airway function and airway inflammation persistently exist in patients with clinically controlled asthma and it may be helpful to guild treatment during clinical control to determine small airway function and inflammatory markers in their induced sputum.

Type B ultrasonic scanning was performed routinely for 10 944 pregnant women at their third semester when they visited outpatient department or were admitted to our hospital during January 2004 to December 2008, and their fetal heart rate, amniotic fluid, umbilical cord and neonate conditions were monitored and recorded during delivery. The sensitivity and specificity of type B ultrasonic were 95.74% (3301/3448) and 96. 25 % (7215/7496). Umbilical abnormality was diagnosed in 3448 pregnancies by type B ultrasonic scanning, with prevalence of 31.51%, cesarean section was performed in 44.00 %, fetal distress occurred in 18. 27% of them, 15.46% of them with Apgar score equal to or less than seven, and fetal death occurred in 2. 41% of them, all significantly higher than those in pregnant women without umbilical abnormal (23. 77%, 8. 56%, 7.84% and 1.36%, respectively, all P ＜0. 01 ). Cesarean section was performed in 41.90 % of those with 0. 8 cm or more in the notch depth of nuchal cord entanglement,fetal distress occurred in 29.76% of them, 25.30% of them with Apgar score equal to or less than seven and fetal death occurred in 4. 05% of them, all significantly higher than those in pregnant women with the notch depth less than 0. 8 cm (20. 22%, 8. 60%, 9. 26% and 0. 54%, respectively, all P ＜0. 01 ). Type B ultrasonic scanning plays an important role in clinical diagnosis for umbilical abnormality, guiding selection of delivery method and improving neonatal prognosis.

In total, 106 patients with maintenance hemodialysis (MHD) were divided into two groups based on their valsartan administration, and 53 healthy controls were recruited in the study. Plasma concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), resistin and high sensitivity C-reactive protein (hs-CRP) were measured by enzyme-linked immunosorbent assay (ELISA) before and after valsartan treatment. Plasma levels of resistin, IL-6, TNF-α and hs-CRP were all significantly increased in patients with MHD as compared to those in healthy controls (P＜0. 05). Among patients with MHD the plasma levels of resistin, IL-6 and hs-CRP in valsartan group were lower than those in non-valsartan group (P＜0. 05).

A questionnaire survey on learning motivation of standardized training and influence factors was carried out and 94 residents of general practice responded. The results indicated that over 80% respondents showed a positive attitude to study and hoped to obtain opportunity for continuing education;76% thought the training program was basically rational but still need to be improved; 94% felt that the training model should be adapted to the real conditions and work requirements of Chinese community health centers. The authors suggest some measures to improve the training including suitable textbooks, more rational training programs and further improvement of education system.

Objective To investigate relationship between insulin sensitivity and beta-cell function with body mass index (BMI) and age in patients with newly diagnosed type 2 diabetes mellitus (T2DM).Methods Totally, 304 patients with T2DM newly-diagnosed at admission to the first hospital affiliated to Nanjing Medical University, Jiangsu province, during 2006 to 2007 were recruited in the study. The patients were divided into three groups based on WHO criteria of obesity in Asia Pacific Region in 2003, 68 cases with normal weight ( 18. 5≤ BMI ＜ 23.0), 69 in overweight (23.0 ≤ BMI ＜ 25.0), and 167 in obesity (BMI≥25.0). Fasting serum glucose, glycesylated hemoglobin Alc (HbAlc) and lipids were measured for all the subjects, as well as oral glucose tolerance test (OGTr), C-peptide releasing tests and determination of serum insulin performed. Homeostasis model assessment of insulin resistance index (HOMA-IR), insulinogenic index (AI30/AG30) and modified beta-cell function index (MBCI) werecalculated to evaluate their insulin sensitivity and beta-cell function of the islets. All these parameters werecompared between the three groups and subgroups. Results HOMA-IR and MBCI were significantly higherin T2DM patients with obesity than those in the groups with normal weight and over-weight ( P < 0. 05 ).AI30/AG30 in obesity group was significantly higher than that in the group with normal weight (P <0. 05).Multiple linear regression analysis showed that BMI independently correlated with HOMA-IR ( P < O. 05 ).Sub-group analysis showed that △I30/△G30 and MBCI were significantly higher in those aged 60 years and over with obesity than those in the groups aged less than 60 years ( P ＜ 0. 05 ). Conclusions Non-obese patients with newly diagnosed T2DM have more severe impaired insulin secretion than that in obese ones,and their insulin resistance increases with BMI. Age has no significant correlation with pancreatic beta-cell function or insulin sensitivity.

A retrospective survey wag performed among medical staff in a hospital during 2006-2008 with physical examinations and reviews of medical records.Nonalcoholic fatty liver disease(NAFLD)related factors were compared and analyzed for them.Overall detection rate of NAFLD was 13.9%(230/1655)in 2006 and 18.9%(344/1817)in 2008,with statistically significant difference(χ2=15.549,P＜0. 01 ). Among people surveyed over 30 years old, detection rate of NAFLD was 9.4%, 17. 8% and 21.7% for those aged 30 -39, 40 -49 and 50 years and over, respectively in 2006, while 14. 4%, 28. 2% and 30. 5% , respectively in 2008. Detection rate presented a increasing trend in those of younger age. Relative risk for fatty liver was 1. 859 for those with obesity and overweight. Prevalence of NAFLD in medical staff increases year by year. Medical staff should attend for their own health and take measures to prevent them from its potential risk factors and pay more attention to behavioral intervention for NAFLD.

A total of 199 patients of infertility caused by occlusion of fallopian tubes who visited Yantai Yuhuangding Hospital, Shandong province, from July 2006 to December 2007 were recruited and divided into three groups, 16 in Group A undergone with a new laparoscopic surgery for hydrosalpinx before in vitro fertilization embrgo transfer (IVF-ET) ,59 in Group B with traditional salpingectomy for hydrosalpinx or ectopic pregnancy prior to IVF-ET,and 124 in Group C without hydrosalpinx and with no interventions for their occluded fallopian tubes, but undergone IVF-ET only as controls. There were no significant difference in number of the antral follicles counted and serum level of estradiol on the day of human chorionic gonadotrupin (HCG) injection between in Group A and C [(8. 6 ±2. 5 ) vs. ( 10. 0± 2. 4), and ( 12 167±2053) vs. (12 278 ±1366) pmol/L, P＞0.05] ,as well as number of mature oocytes retrieved [(13 ±6)vs. and ( 12 ±6), P ＞0. 05]. Higher dose of ovary stimulant agent was used in Groups B, higher than that in Group A and C, but there were no significant difference in Group A and C [( 2325 ± 450 ) vs. ( 2250 ±375) U, P ＞0. 05]. The pregnancy rate was 62.5% in Group A,44. 1% in Group B,39. 5% in Group C.Hydrosalpinx is associated with poor outcomes of IVF-ET. The new methods of laparoscopic fallopian tube resection for patients with hydrosalpinx prior to IVF-ET improves pregnancy rate, but do not impair ovarian reserve and reaction to stimulation, as compared to traditional salpingectomy.

Objective To assess efficacy and safety of enhanced rehabilitation program for patients with colorectal cancer surgery. Methods One hundred and ten consecutive patients admitted to general surgery department at Beijing Chaoyang Hospital during October 2007 to October 2009 undergone with fasttrack colorectal cancer surgery and enhanced rehabilitation were prospectively studied, with 117 patients undergone with same colorectal cancer surgery by traditional perioperative treatment during May 2005 to September 2007 as controls. Restoration of their gastrointestinal function, occurrence of complications, fatality and length of hospital stay after surgical operation were observed in the group of enhanced rehabilitation and control group. Results Demographic characteristics, stage classification of illness and surgical operation methods were comparable in both groups. The first day with air discharge from the flux was earlier in enhanced rehabilitation group than that in controls (2. 5 vs. 3. 5 day after surgery, P ＜ 0. 05 ), and the former could tolerate solid food earlier than the latter (6.0 vs. 6.7 days after surgery, P=0.028). Overall morbidity of complications was less in the group with enhanced rehabilitation than that in controls (23.6% vs. 39. 3%,P =0. 011 ) and shorter length of hospital stay was observed in the former than that in the latter (9. 0 vs. 10. 8 days after surgery, P =0. 041 ). There was no difference in mortality, incidence of anastomotic leakage, and infectious and non-infectious complications between the two groups. Conclusions Enhanced rehabilitation program is safe and effective following colorectal cancer surgery to accelerate restoration of gastrointestinal function, reduce complications and shorten hospital stay after colorectal cancer surgery.

The somatic symptoms of patients with depressive disorder in a general hospital were retrospectively analyzed.From May 2004 to April 2009,736 patients in Psychological Clinic were diagnosed as depressive disorder,among them 723(98.2%)had somatic complains.The somatic symptoms were complex and involving several systems,nervous system,digestive system and cardiovascular system were the most common.It is necessary to recognize the typical somatic symptoms of depressive disorders to avoid misdiagnosis.