This report is an overview of continuing medical education project launched and managed by Office of Continuing Education,Peking University Health Science Center.It summarized the procedure management of the continuing medical education project,the design of Internet-based continuing education information management systems,project supervision,attention to the implemen-tation of attendance system,strict issue of credit certificates,and other measures.Finally,some thoughts on continuing medical education project management were proposed to be discussed with peers.

Objective To build a nomogram of normal fetal lung volumes (left,right and total)throughout gestational age estimated by 3-dimensional ultrasonography.Methods Left and right lung volumes were assessed in 324 normal and singleton fetuses of gestational age 16-37 weeks by 3-dimensional ultrasonography using the technique of virtual organ computer-aided analysis(VOCAL) at a rotational step of 30 degrees.The relationships between left,right,and total lung volumes,and gestational age were assessed by correlation and regression analysis.Results The right,left,and total lung volumes were highly correlated with gestational age (P＜0.001),and the correlation coefficient was 0.966,0.973 and 0.990respectively.The best-fit exponential curve regression equations of left lung volume was:y=0.207exp~(0.143X);right lung volume was:y=0.301 exp~(0.14X);total lung volume was:y=0.508 exp~(0.142X).Conclusions A nomogram of fetal lung volumes estimated by 3-dimensional ultrasonography from 16 to 37weeks gestation is described,and reference values may be useful for the prenatal prediction of pulmonary hypoplasia.

The properties and functions of mouse pluripotential stem cells (CFU-S) were studied with spleen colony technique and other related methods. The data expressed that there is a linear relationship between the number of transplanted marrow cells and the number of spleen colonies that developed. Among various hematopoietic tissues, bone marrow is the richest source of CFU-S. Spleen and peripheral blood also contain a few of such cells. The percentages of CFU-S in these organs are 0.7%, 0.05% and 0.01% in sequence. No CFU-S can be found in thymus or lymph nodes. Under normal conditions, most of the CFU-S are in G_o phase with a small proportion (6.7%) in S phase.Self-renewing capacity, an important hematopoietic function of CFU-S, was measured by the experiments of single spleen colony retransplantation. The value of the probability of self-renewal, p, is calculated as 0.76. CFU-S has an active ability of migration. It was found that a number of CFU-S either from the marrow cell suspension injected intraperitoneally or from an entire encapsulated spleen which was placed free in the peritoneal cavity after ligation of its blood vessels can penetrate through a lot of barriers to develop spleen colonies in the lethally irradiated mice. A dose of 500～700 rad ?-irradiation apparently stimulates the CFU-S migrating from bone marrow to circulation.

Objective To evaluate the production and regulation of platelet derived growth factor (PDGF) in the skin. Methods Normal human keratinocytes (NHKs) and human dermal fibroblasts (HDFs) were cultured, PDGF peptides were measured by ELISA and PDGF B chain mRNA was detected by Northern hybridization. Results The results showed that NHKs constitutively produced PDGF molecules, phorbol 12 myristate 13 acetate (PMA) inhibited PDGF production, while 1, 25 dihydroxyvitamin D 3 enhanced its production. TNF alpha, interferon ? and interleukin 1 alpha all failed to affect PDGF production. On the other hand, HDFs produced no PDGF molecule in spite of a low level of PDGF B chain mRNA expression in Northern hybridization, suggestting a post transcriptional blocking of PDGF production in HDFs. Conclusion The results obtained above indicate that epidermal keratinocytes may be the major PDGF generating cells, whereas dermal fibroblasts the PDGF responsive cells in the skin.

This paper described the existing problems of transformation benefit from a target,two ideas,three questions,four reasons,and five measures.Through establishing clear objectives,combing the status of the achievement trasformation some problems were raised.Also,it Was analyzed for the reasons of deficient transformation benefit and suggested the taken measures.

Objective To evaluate the endoscopic findings and clinicopathologic characteristics of ischemic colitis and risk factors in older to avoid misdiagnosis. Methods 101 cases with ischemic colitis underwent endosopy within 14 days of onset of symptom in center of our hospital were retrospectively reviewed for their endosopic findings , clinicopathologic characteristics and risk factors. Results The common features of 101 cases included abdominal pain,diarrhea,or bloody diarrhea and hematochezia. Endoscopic visualization of mild ischemic colitis included pete-chial hemorrhages,edematous and fragile mucosa,segmental erythema,scattered erosion,longitudinal ulcerations,and sharply defined segment of involvement. Stricture ischemic colitis was characterised by full-thickness mucosa, lumens stricture and haustrations disappeared. Clinicpathological examination revealed mucosal inflammation accompanied by erosion,granulation tissue hyperplasis and gland atrophy,lamina propria hemorrhage,especially macrophages with he-mosiderin pigmentation in submucosa. Hypertension pressure, diabetes, atrial fibrilation were risk factors for ischemic colitis ( P < 0.05 ). Conclusion Although there was on specific changes on endoscopic findings and pathologic characteristics , but combined with history, was helpfu in diagnosis of ischemic colitis and reducing the misdiagnosis.

Objective: To observe therapeutic effects of exercise rehabilitation therapy in patients with chronic heart failure (CHF). Method: A total of 60 CHF patients were randomly divided into routine treatment group (n=30) and exercise rehabilitation group (n=30, received exercise rehabilitation therapy based on routine anti heart failure drug treatment). Cardiac function, exercise capacity, 6min walking distance and rehospitalization rate of the patients were observed， therapeutic course was three months. Result: Total effective rate in exercise rehabilitation group was significantly higher than that of routine treatment group (93.3% vs. 80.0%, P<0.05). Compared with routine treatment group after treatment, there was significant improvement in clinic cardiac function [NYHA class: (1.96±0.89) classes vs. (1.48±0.72) classes, P<0.05], significant increase in exercise capacity [(4.01±0.82) METs vs. (5.24±1.16) METs] and 6 min walking distance [(322.5±23.4) m vs. (413.6±26.5) m, P<0.01 both] and significant decrease in rehospitalization rate (56.7% vs. 30.0%, P<0.05). Conclusion: Exercise rehabilitation therapy can improve cardiac function, increase exercise capacity and decrease rehospitalization rate in patients with chronic heart failure.

AIM: To study the effects of neuregulin-1β (NRG-1β) on the nervous behavioral function, cerebral infarction volume, brain water content (BWC), neuroal apoptosis and aquaporin-4 (AQP-4) expression in astrocytes after cerebral ischemic reperfusion in mice. METHODS: Intraluminal thread methods were applied to establish the middle cerebral artery occlusion reperfusion (MCAO/R) model in mice. Neuregulin-1β (2 μg/kg) was injected into the internal carotid artery for treatment. The nervous behavioral function was evaluated by Bedersons test. The cerebral infarction volume was observed with tetrazolium chloride (TTC) staining. The BWC was measured by calculating the dry-wet weight ratio. The apoptotic positive cells were counted by immunofluorescence assay. The expression of AQP-4 was determined by immunohistochemical method. RESULTS: Nervous behavioral malfunction appeared in all the mice with left middle cerebral artery occlusion (MCAO) and/or reperfusion. The infarction focus showed in the ischemic hemisphere following the injury. The BWC, the numbers of neuroal apoptotic cells and AQP-4 expression in astrocytes were higher than those in sham control group. In MCAO/R+NRG-1β treatment group, the nervous behavioral function at ischemia 24 h significantly improved, the numbers of apoptotic positive cells reduced and the infarction volume decreased significantly than those in MCAO/R group (P<0.05). The BWC and AQP-4 expression in astrocytes showed no significant difference compared with MCAO/R group (P>0.05). In the reperfusion 22 h, 46 h and 70 h groups, the five indexes mentioned above were significantly different from those in the corresponding MCAO/R groups (P<0.05). CONCLUSION: NRG-1β might reduce cerebral edema and infarction volume, and improve the nervous behavioral function via down-regulating the expression of AQP-4 in astrocytes and inhibiting the neuronal apoptosis induced by ischemia reperfusion injury.

ObjectiveTo study the effect of allo-human bone marrow mesenchymal stemcells (bMSCs) on the secretion of interleukin(IL)-1, tumor necrosis factor(TNF)-α and transforming grouth factor (TGF)-β of patients with rheumatoid arthritis (RA) in vitro. MethodsBMSCs were isolated from bone marrow of healthy volunteers and purified by density gradient centrifugation and cultured in vitro. The mononuclear cells from the peripheral blood of patients with RA and healthy controls were isolated respectively.bMSCs and mononuclear cells were co-cultured in vitro and the density of IL-1, TNF-α and TGF-β3 in the co-culture system were detected by ELISA. ANOVA and Pearson correlation were used for statistical analysis.ResultsMononuclear cells from peripheral blood of patients with RA were co-cultured with bMSCs for seven days. There were an decreased density ofIL-1[(38.4±0.5) vs(6.2±1.0) ng/L], TNF-α[(29.4±1.3) vs (4.6±1.2) ng/L]and an increased density of TGF-β[(2.6±1.0) vs (22.5±2.2) ng/L]in the co-culture system (P＜0.05). But on the other hand, for healthy volunteers there were no significant change in the density of IL1[(4.4±1.1) ng/L]and TNF-α[(5.0±1.7) ng/L]in the coculture group, as compared with the mononuclear cell group[(4.4±1.3) vs(5.3±1.7) ng/L](P＞0.05). There was an increased density of TGF-β in the coculture system[(4.8±1.4) vs(10.5±1.2) ng/L](P＜0.05). IL-1 was positively correlated to TNF-αt (r=0.896,P=0.000), TNF-β1 was nagative correlation with 1L-1 and TNF-α (r=-0.356,P=0.019; r=-0.380,P=0.000).ConclusionHuman bone marrow MSCs have modulatory effects on main cytokines of patients with RA in vitro. bMSCs could down-regulate the levels of IL-1 and TNF, but up-regulate the density of TGF-β. These immune-modulatory effects are not MHC restricted. The results of this study have provided evidence for the development of effective therapy for RA.

Objective To explore the characteristics of executive function and the changes of executive function in schizophrenics with and without homicide behaviors during follow-up.Methods Twenty-two schizophrenics with homicide behaviors (homicide group)and twenty-one schizophrenics without homicide behaviors (without-homicide group) were examined by Wisconsin Card Sorting Test(WCST),and followed up 3 months.All patients'clinical symptoms were evaluated by positive and negative symptom scale(PANSS)at the same time.Re-suits (1)At the baseline,homicide group showed higher score in complete lst category(R1st)than without-homicide group((28.64±32.73)vs(11.71±8.10),P=0.027)and no difference on other index.(2)No difference on WCST in homicide group between at the baseline and at three-month treatment (P>0.05).Without-homicide group at the baseline showed higher score in conceptual level responses than that of at three-menth treatment((46.80±27.04)vs.(65.02±21.32),P=0.048).(3)Homicide group at three-month treatment showed lower scores in positive scale,general psychopathology scale,PANSS total,thought disorder,activation,paranoid,aggressive than that of at the baseline(P<0.05).Without-hemicide group at three-month treatment showed lower scores in positive scale,negative scale,general psychopathology scale,PANSS total,thought disorder,activation,aggressive than that of at the haseline(P<0.01).(4)At the baseline,there was no correlation between WCST and PANSS in homicide group,only R1st score correlated with activation positively in without-homicide group(P<0.05).At three-month treatment, homicide group showed the score of failure to maintain set negatively correlated with negative scale,PANSS total, and aggressive(P<0.05).Conclusions Schizophrenics with homicide and without-homicide behaviors show executive function deficits.Homicide group shows more deficits in abstraction capacity than without-homicide group.