Objective:To evaluate the effect and adverse reaction of thymosin ?1(T?1) in the treatment of malignant tumor.Methods:MEDLINE,Chinese hospital knowledge database(CHKD),Chinese Biomedical Database(CBM) were searched by key word ,and the obtained references were screened for clinical controlled trials(CCT) on the introduction of T?1 in therapy of malignant tumor.The CCT results of efficacy and safety were pooled and analyzed with a fixed or random effects model after Chi-Square testing for heterogeneity.Results:Six CCTs were included for efficacy analysis.It was found that the efficacy rate in T?1 group(70.63%) was significantly higher than that in control group(52.99%),and the value of odds ratio was 1.28 with the 95% confidence interval from 1.06 to 1.55(P

Objective To discuss the effect of small needle knife therapy on collagensⅠ and Ⅲ in the hypertrophic scar tissues that was subcutaneously transplanted into nude mice. Methods Six samples of human hypertrophic scar tissues without cuticle were subcutaneously transplanted into the back of 24 nude mice to create the animal models of hypertrophic scar. Ten days after of the operation,the mice were divided into control,0.1 mg/ml triamcinolone,0.2 mg/ml triamcinolone,and small needle-knife groups with 6 mice in each. Specimens of the scar tissues were collected in 14 days for immunohistochemistry to detect the collagen Ⅰ and Ⅲ. Results In all the groups,collagens Ⅰand Ⅲ distributed extensively in the cytoplasm of fibroblast and tissues. Image analysis showed that the concentration of collagens Ⅰand Ⅲ in 0.1 mg/ml and 0.2 mg/ml triamcinolone groups were significantly lower than those in the control (0.09?0.03,0.11?0.05 and 0.12?0.02,0.11?0.01 vs. 0.17?0.04,0.19?0.03,P0.05). Conclusions Small needle-knife therapy can reduce the concentration of collagens Ⅰand Ⅲ in transplanted hypertrophic scar tissues in nude mice.

Competency-based medical education and personnel training isbecoming a global trend, and the United States has developed a set of competence evaluation system to evaluate a pack-age of emergency, orthopedics, thoracic surgery physicians etc. in 26 specialties. This paper introduces the development background of the evaluation system, the structure of specialist competency evaluation form, content and methodologies , and uses emergency physicians for further evaluation to illustrate this. American physician competency evaluation system provides a unified framework for the country's medical graduates after graduating from medical education training. It helps tocombine process control withthe results ofthe evaluation, self-evaluation with the evaluation of others to makethe evaluation more objective and comprehensive . It can provide new reference to the evaluation and training of physicians in our country.

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 evaluate the influence of aging on left ventricular systolic and diastolic function by quantitative tissue velocity image(QTVI) and B-type natriuretic peptide (BNP). Methods Sixty healthy participants aged from 36 to 82 years old were divided into age <60 years group (32 cases) and age≥60 years old group (28 cases). Compared traditional echocardiography,QTVI and BNP between the two groups, and analysised the correlation between age and the abovementioned measurements. Results Compared age ≥60 years group with age <60 years group, the ratio of early to late mitral annulus flow velocity(E/A) (0. 92 ±0. 18 vs. 1. 28 ± 0. 18), mean of systolic mitral annulus velocity (Sm) ([6. 04 ± 0.77] cm/s vs.[6. 89 ± 1. 03] cm/s) ,mean of early diastolic mitral annulus velocity (Em) ([5. 67 ±0.99]cm/s vs. [7.29 ± 1. 11]cm/s),the ratio of Em to Am(Em/Am) (0. 79 ± 0. 13 vs. 1.18 ± 0. 33) were significantly decreased (t =5. 396,2.478,4.075,3. 535, respectively, Ps < 0. 05), whereas mean of late diastolic mitral annulus velocity (Am) ([7. 67 ±0. 80]cm/s vs. [6. 80 ± 1. 16] cm/s),the ratio of E to Em(E/Em) (14. 83 ±4.43 vs. 10. 68 ±2. 85), BNP ([51. 25 ± 12. 21] ng/L vs. [14. 15 ± 6. 68] ng/L) were significantly increased (t =-2. 268,-2.995 and-3. 523, Ps < 0.05) . Age was negatively correlated with Sm, Em, Em/Am, E/A (r =-0.411,-0. 631,-0.622,-0. 614,Ps<0.05),and age was positively correlated with Am,E/Em and BNP (r = 0.481,0.614 and 0. 684,Ps <0. 05). Conclusion Left ventricular systolic and diastolic function decreased with aging. QTVI and BNP could evaluate left ventricular function sensitively and easily.

Objective To design a questionnaire on factors that affect diagnosis of irritable bowel syndrome for physicians, and determine the retest reliability. Methods The questionnaire was completed after literature review, and 9 experts were invited to revise the questionnaire. Thirty-four physicians filled the questionnaire for pre-test and did it again for re-test 4 weeks later. Kappa value of each question of the questionnaire was calculated. Results Content validity and face validity were assured by experts. Kappa values were over 0.61 in all items, which achieved substantial level. Conclusion The questionnaire designed has fairly good reliability and validity, and can be used in investigation of irritable bowel syndrome for physicians.

Object To investigate the nootropic activity of emodin 8 O ? D glucopyranoside, the active principle of Radix Polygoni Multiflori Preparata(PMEG), and its mechanism of action Methods Nootropic activity was evaluated with step down test of mice, and its nootropic mechanism studied by its antiacetylcholinesterase (anti AchE) effect on mice brain in vivo and in vitro as determined by pectrophotometry Results PMEG (ig) significantly improved the learning and memory of both normal and intelectual deficit mice induced by scopolamine PMEG showed dose dependent inhibition of AchE, and the antiacetylcholinesterase effect is reversible both in vivo and in vitro In acute experiment, the half recovery time of AchE is 115 min, and 165 min in chronic experiment Conclusion PMEG showed good nootropic activity, and it is a reversible AchE inhibitor

Objective To construct and assess the competency scale for emergency physicians in our country. Methods Learning from the milestone project in America, we developed the scale through Delphi method . The application effect was evaluated among 81 emergency physicians by questionnaire survey. Excel was used to do data entry. SPSS 20.0 was adopted to do data analysis. Factor analysis method was employed to verify the structure validity of the scale. Results The competency scale comprises six dimensions and 13 items. The scale of total Cronbach's alpha coefficient was 0.98 and the split half reliability was 0.95. Two factors were extracted by principal component analysis with cumulative contribution rate of 86.5%. The differ-ences of competency score on six aspects of different ages, titles, working years and training situation were tested and all had statistically significant differ-ence (P<0.01). Conclusion The scale developed in our study can reflect the growth stage of the emergency physicians and serve the purpose as an evaluation tool for the competency of emergency physicians in our country.

ObjectiveTo investigate the improvement of speech in patients with increased blood pressure(BP) and stable blood pressure during speech therapy. MethodsAfter monitoring blood pressure with dynamic blood-pressure meter during speech therapy, patients were divided into increased BP group and stable BP group. Patients received two-month speech therapy, then their score changes in ABC examination of pre-treatment and post-treatment were compared. ResultsIn oral expression, score changes in increased BP group were significantly different from those in stable BP group (P<0.05). In listening comprehension, score changes had no significant difference between two groups(P>0.05). Conclusions Patients in increased blood pressure group progressed obviously in oral expression.

Objective To observe liver functional lesion caused by combination chemotherapy containing or not containing oxaliplatin. Methods Data from 42 patients with liver functional lesion caused by chemotherapy between March 2005 and October 2007 were analyzed. All patients were diagnosed through histology or cytology detection and received chemotherapy only. Different drugs were. admitted,based on different tumors. Before chemotherapy, each patient had normal liver function without liver lesions such as liver metastasis, Hepatitis B and C, hepatic cirrhosis, etc. Furthermore, 22 received FOLFOX-4 in containing oxaliplatin group while the remaining 20 received chemotherapy excluding oxaliplatin. When liver functional lesion without the influence of any liver protectant was first observed, ALT, AST, TBIL, DBIL, IBIL, ALP, GGT and the WHO criteria of liver toxicity were analyzed. T test and Wilcoxon rank sum test were used for data analysis. Results All together 90 cycles, median 2.14 cycles, were given. According to WHO criteria of liver toxicity, 13 cases were in grade O, 21 in grade Ⅰ, 7 in grade Ⅱ, and 1 in grade Ⅲ. ALT and AST were significantly high after chemotherapy(P <0.05). Moreover, ALT and AST were significantly higher in containing oxaliplatin group than non oxaliplatin group after chemotherapy(P <0.05). Chemotherapy had no influence on bilirubin. The population distribution of accumulative chemotherapy cycles and WHO criteria of liver toxicity was similar between two groups. Conclusion Before the intervention of liver protectant, combination chemotherapy containing oxaliplatin is more likely to have liver functional lesion than other chemotherapy without oxaliplatin. It mainly presents an increase in transaminase.