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 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.

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.

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.

BACKGROUND: Astragalus root can inhibit apoptosis through reducing the release and interstitial accumulation of excitatory amino acids, alleviating calcium overloading and antioxidative effect.OBJECTIVE: Astragalus root was used to treat anoxic-ischemic brain injury in immature brain. We evaluated the effect of astragalus root on caspase-3 mRNA expression, and meanwhile, labyrinth test was employed to investigate the intervention of astragalus root on learning and memory function of mature rats after anoxic-ischemic brain injury.DESIGN: Randomized and controlled study.SETTING: Pediatric Department, Zhongda Hospital Affiliated to the Medical College of Southeast University; Pathological Department, the Basic Medical Sciences Institute of Southeast University.MATERIALS: From October 2002 to June 2003, this study was conducted at the Experiment Center of the Medical College, Southeast University.A batch of 114 seven-day-old SD rats were selected from the same brood and divided into 3 groups, namely, sham-operation group (n=18), model group (n=48) and astragalus root group (n=48). Astragalus injection was produced by Chengdu DIAO Pharmaceutical Factory, with 10 mL astragalus injection corresponding to 20 g raw material.METHODS: Animal model of anoxic-ischemic brain injury was established in model group and astragalus root group, but was not established in sham-operation group. In astragalus root group, immediately after establishing anoxic-ischemic model and at the same time point each day, 0.08 mL astragalus injection was administered intraperitoneally until the 7th postoperative day. In model group, 0.08 mL normal saline was administered at the same time points. In sham-operation group, no treatment was given. In astragalus root group and model group, animals were decollatedat 24 hours and 5 days postoperatively to take out the brains. In sham-operation group,animals were decollated and their brains were taken out at 24 hours postoperatively. In all the groups, hippocampal brain injury was detected using histopathological method combined with semi-quantified RT-PCR methods for detecting caspase-3 mRNA. Adult rats aged 90 days were used in modified y maze to examine their learning and memory functions. All these three experiments were independent.MAIN OUTCOME MEASURES:① Hippocampal brain injury in each group was evaluated using pathological method.② Caspase-3 mRNA in the ligated side of hippocampus was detected.③ Results of modified Y maze test were analyzed.RESULTS:All of the 114 rats entered the statistical analysis.① Assessment ofhippocampal brain injury in each group with pathological method:In sham-operation group, the bilateral hippocampus showed no swelling or necrosis, and neural cells in this area had normal morphological features with a density of (87.7±0.6) × 103 per high amplification field. In model group, the ligated side of hippocampus was swollen with a widened spatium and the cell density decreased to (68.8±3.0) × 103 per high amplification field, which significantly differed from that in sham-operation group (P ＜ 0.01). At the fifth day, the volume of ligated side of hippocampus reduced with pyramid layer disorganized and neural cells sparse at a density of (48.7±2.2) × 103 per high amplification field. These changes were significantly different from those of sham-operation group and the same side at 24 hours (P ＜ 0.01). At 24 hours the ligated side of hippocampus was less swollen in astragalus root group than in model group.At day 5, the whole hippocampus was observed. At these two time points,cell death rate in astragalus root group was significant lower than that in model group(P ＜ 0.01).②Caspase-3 mRNA in the ligated side of hippocampus in all the groups: In sham-operation group, the expression of caspase-3 was low, with an absorbency value of 0.220±0.009. In model group, after ischemia and anoxia its expression increased. At 6 hours, it was 11% higher than that in sham-operation group. In astragalus root group, mRNA level reached its peak, which was 260% higher than that in sham-operation group (P ＜ 0.01). The peak of mRNA continued, decreased after 48 hours and returned to baseline at 5 days and 7 days. The fluctuation of mRNA was similar between astragalus root group and model group,but the peak value at 24 hours and 48 hours in astragalus root group was 44％-46％ lower than that in model group (P ＜ 0.01). ③ Results of modified Y maze test: As compared to model group, in astragalus root group, the number of training times for meeting the standard made by the Association was significantly smaller [(45.7±2.7), (16.1±2.5) times, P ＜ 0.01] and at 24 hours after anoxia and ischemia, memory retention was significantly higher [(48.3±11.7), (80.0±9.0)%, P ＜ 0.01].CONCLUSION: Astragalus root can effectively inhibit the apoptosis of neural cells in hippocampus in immature brain after anoxia and ischemia and enhance the survival rate of them. This protective effect may be related to its inhibitory effect on the expression of caspase-3. Meanwhile, astragalus root can dramatically improve learning and memory function of the immature brain after anoxia and ischemia.