BACKGROUND: The proliferative capacity of in vitro cultured chondrocytes is gradually reduced following several passages. Many studies have demonstrated that basic fibrublast growth factor (bFGF) can promote chondrocyte proliferation, and influence its phenotype and differentiation. OBJECTIVE: To observe the influence of bFGF on the proliferation and differentiation of growth plate chondrocytes and to screen the best dosage for in vitro culture of chondrocytes. DESIGN, TIME AND SETTING: For observation and comparison of cells, the experiment was performed at Tissue Engineering Laboratory, Department of Biochemistry, Jinan University Medical School between October 2004 and February 2005. MATERIALS: Twelve New Zealand rabbits were selected for chondrocyte isolation; bFGF was purchased from PeproTech, UK. METHODS: Rabbit growth plate chondrocytes were isolated and cultured in low serum. Different doses of bFGF (0, 1, 2.5, 5, 10, 25, 50 and 100 μg/L) were added. MAIN OUTCOME MEASURES: Cell proliferative multiple was determined using modified MTT method; chondrocyte collagen content was determined using hydroxyproline method; alkaline phosphatase activities were detected by enzyme kinetics. RESULTS: bFGF (5-100 μg/L) could promote chondrocyte proliferation, especially at dose of 25 μg/L. bFGF at dose of larger than 25 μg/L would inhibit collagen production; bFGF at dose of larger than 1 μg/L would inhibit alkaline phosphatase activities. CONCLUSION: bFGF can stimulate growth plate chondrocyte proliferation, and inhibit growth plate chondrocyte differentiation at dose25 μg/L.

Objective To study gastroscopic features and clinical diagnosis of prepyloric mem-brane. Methods Clinical characteristics,gastroscopic manifestation and operational findings of 18 pa-tients,whose prepyloric membrane have been confirmed by operations,were retrospectively reviewed. Results Gastroscopie findings showed that all the 1 8 patients suffered gastric retention and pyloric obstruc-tion to some degree,with 4 cases of esophageal erosion and/or esophageal ulcer,five cases of erosive hemor-rhagic gastritis,one case of ulcer at gastric antrum,gastric comer and pylorus respectively. There were 2 ca-ses of aperture like narrowing in prepyloric region. And there were 9 cases that showed obvious congestion and edema in the prepyloric mucus,with uniform circular mucusal protrusion around the stenosing stoma,and volcano-like depression in the middle,three cases of which showed mucosal membrane standing out to the gastric cavity. The membrane found in the above 11 cases located in pyloric exit or tube,and they under-went membrane excision and py|oroplasty. The other 7 cases showed thick mucosal folds at the distal antrum with radial arrangement. Round or irregular stenosing stoma were observed. These cases proved to be antral membrane,1-3 cm away from the duodenum and pylorus,and underwent simple membrane resection. Conclusion Congenital prepyloric membrane is rare and it likely mis-diagnosed. The onset and the degree of symptoms depend on the diameter of aperture of the membrane. Early endoscopy,in addition to barium contrast,should be performed on those children who have intermittent bilious vomiting,where false-positive radiological findings can be avoided,therefore,to facilitate right diagnosis and appropriate operation.

Objective To assess the relationships between bile reflux gastritis (BRG) and Helicobacter pylori infec-tion in children. Methods A total of 258 BRG cases were included in BRG group and 1 749 gastric mucosal inflammation cases without bile reflux were used as control group. Children with BRG were divided into three groups according to the dis-ease classification and they were also sub-divided into three groups according to the bile reflux indexing. The infection rates of Helicobacter pylori were analyzed in different groups. Results Compared to control group (34.02%), the infection rate of Helicobacter pylori was significantly higher in BRG group (46.12%). The infection rates of Helicobacter pylori infection were 40.86%(38/93), 45.53%(56/123) and 59.52%(25/42) in patients with mild, moderate and severe infections. There was no significant difference between them (χ2=4.089, P>0.05). The positive rates of Helicobacter pylori infection were 37.32%(53/142), 53.68%(51/95) and 71.43%(15/21) in children withⅠ,ⅡandⅢreflux indexing, and there was significant differ-ence between them (χ2=12.022,P<0.01). Conclusion Helicobacter pylori infection is one of the causative factors leading to BRG in children. The bile regurgitation increased with the increasing of Helicobacter pylori infection.

Objective To explore the relationship between H.pylori (HP) infection and the functional dyspepsia (FD) by 4-lead electrogastrography (EGG). Methods The data of the gastric electrical activity of 163 children with FD, includ-ing 103 children with HP infection (group A), 60 without HP infection (group B) and 22 healthy controls (group C) were mea-sured by 4-lead EGG, which included normal slow wave percentage (N%), bradygastria percentage (B%), tachygastria per-centage (T%) and motilin uneven rhythm percentage (A%). EGG frequency and power examination included the main fre-quency (DF), the main power (DP) and postprandial/pre-prandial gastric electrical main power ratio (P/R). EGG data was compared between three groups. Results There was significant difference in pre-prandial and postprandial percentage of different slow wave frequency between group A and group B. There were no significant differences in pre-prandial and post-prandial changes of DF and DP between group A and group B. There was no significant difference in the pre-prandial and postprandial percentage change of different slow wave frequencies in 84 HP negative patients. But the significant change was found in pre-prandial and postprandial change of DF, DP and P/R. Conclusion The eradication of HP improved the gas-tric electrical activity and relieved the postprandial symptom in children with functional dyspepsia under HP infection.

Objective To analyze the clinical manifestations,diagnosis,treatment and prognosis of patients with splenic abscess.Method The clinical data,including baseline clinical data,clinical features,past history,pathogen culture result,treatment and the prognosis were retrospectively analyzed in the patients with the discharge diagnosis splenic abscess from January 1991 to March 2012 in Peking Union Medical College Hospital.Results The media time from onset to Peking Union Medical College Hospital of the 19 patients were 29 days.Among them,9 patients were cured,8 were improved and 2 died.Risk factors,such as tumor burden,diabetes,and using immunosuppressive agents etc,can be found in most patients with splenic abscess.All the 19 patients had splenic image changes and non-specific clinical features.The most common three clinical symptoms were fever(18 cases),chills (12 cases) and shivering (11 cases).The most common three signs were abdominal tenderness (9 cases),left upper quadrant sensitive to percussion (7 cases) and splenomegaly (4 cases).The most common etiological culture results were gram negative bacilli (9 cases),gram positive coccus (8 cases),and fungi (4 cases).Conclusions Clinical features are non-specific in splenic abscess patients.Related exam such as ultrasound should be performed on patients with splenic abscess risk factors to avoid misdiagnosis.Empiric antibiotic administration should begin right after the diagnosis based on the image.Pathogen culture should be timely conducted after pus collection.Individual therapeutical protocol should be chosen according to patient's condition.

Objective:To probe into the status characteristics and the dynamic change trend of the psychological stress among medical staff at four time points after exposed to blood-borne pathogen.Methods:A longitudinal study was carried out among 78 medical personnel in this study,with 67 of hepatitis B virus,5 of hepatitis C virus,4 of HIV and 2 of treponema pallidum respectively.Perceived stress scale (PSS-4),Post-traumatic stress disorder Checklist-5 (PCL-5),Hospital anxiety and depression scale (HADS) were used to assess the psychological status,including perceived stress,post-traumatic stress symptom,anxiety and depression at the four times.Data analysis was performed using repeated measures analysis of variance (RMANOVA) and paired sample t test to explore time effect of the psychological stress reaction in the exposed population.Results:The scores of PSS-4,PCL-5,HADS-A,and HADS-D increased from exposure,and gained highest at one month after exposed,then gradually declined with time (Ps ＜ 0.05).Conclusion:It suggests that the levels of perceived stress,post-traumatic stress symptom,anxiety,depression may be the highest at one month after exposed.

OBJECTIVE: Through the application of eustachian tuboplasty assisted with hypothermy plasma ablation, we evaluate its efficacy in the threatment of adult refractory otitis media with effusion. METHOD: We retrospectively reviewed the charts of 48 cases (61 ears) suffering from adult refractory otitis media with effusion from January 2012 to December 2013. According to the admission date, the patients were divided into the control group (17 cases, 22 ears) and the treatment group (31 cases, 39 ears). In the control group, the patients were treated with drugs and physical therapy. In the treatment group, the hypothermy plasma ablation technology was used to ablates the hypertrophic tissues around the eustachian orifice besides the pharmaedogical interventions. The recurrence rate of the two groups were analyzed and compared in 1 year after treatment. Pure tone audiometry and acoustic immittance measurement were taken for the two groups in differernt periods (one week prior to operation, one months, three months, six months and one year after operation respectively) to evaluate their hearing change and the recurrence rate (within six months after treatment and one year respectively) objectively. RESULT: In the control group, 2 cases (2 ears) were lost to follow-up, and the recurrence rate was 65% (13/20) in 1 year. In the treatment group, four case were lost to follow-up,and the recurrence rate was 14.3% (5/35) in 1 year. The difference was statistically significant (P<0. 01). There were similar hearing improvement in the two groups after treatment in 1 month, but the hearing improvement in the treatment group increased with time. There were no complications occuring during the operation and post-operation. Within a month after operation, the majority of ears(28/35) obtained significant hearing improvement with the decreasing air-bone-gap comparision with the pre-operation (P < 0.01), and the preoperative tympanogram of 16 ears with type B or C turned to type A (P < 0.01). There were no both statistical significance in the variation of air-bone-gap and tympanogram of comparison with results between three months and six months, six months and one year postoperatively (P > 0.05). CONCLUSION This study confirmed the efficacy of eustachian tuboplasty assisted with hypothermy plasma ablation in the threatment of adult refractory otitis media with effusion caused by eustachian tube opening disorder was significant. It can reduce the recurrence rate significantly in one year and allow sustained hearing improvement within three months postoperatively.
Acoustic Impedance Tests ; Adult ; Audiometry, Pure-Tone ; Cryosurgery ; Eustachian Tube ; surgery ; Humans ; Lost to Follow-Up ; Otitis Media with Effusion ; drug therapy ; surgery ; Plasma Gases ; Postoperative Period ; Recurrence ; Retrospective Studies ; Tympanoplasty

Objective To compare the long-term outcomes of partial hepatectomy versus choledocholithotomy both combined with choledochoscopy,for the treatment of hepatolithiasis.Methods Patients who underwent either type of the operations were followed up and examined using hepatobiliary magnetic resonance (enhanced MRI + MRCP).The incidences of abnormal imaging in the two groups were compared.Results Of 268 patients,138 patients underwent partial hepatectomy and the remaining 130 patients underwent choledocholithotomy.When hepatectomy was compared with choledocholithotomy,the recurrence rate of acute cholangitis combined with bile duct stone (5.8％ vs.21.5％),the reoperation rate (5.8％ vs.21.5％),the bile duct stricture rate (8.0％ vs.44.6％),the abnormal liver parenchyma perfusion rate (4.3％ vs.23.1％),the incidence of intrahepatic bile duct enhancement or thickening (1.5％ vs.26.9％),the incidence of hepatic atrophy (3.0％ vs.30.0％) and the incidence of cholangiocarcinoma (0 vs.2.3％) were better.Conclusions The long-term adverse outcomes were significantly worse in the choledocholithotomy group than in the partial hepatectomy group.Choledocholithotomy combined with choledochoscopy should only be considered as a complementary procedure to partial hepatectomy in hepatolithiasis.

OBJECTIVE:To improve the teaching quality of TCM processing experiment for pharmacy major. METHODS:With the entry point of TCM processing experiment for pharmacy major in our school,it was reformed from the aspects of teaching mode,teaching method,teaching content and assessment method. RESULTS:It changed the original teaching mode,introduced 4 teaching approaches(compulsory experiment elective experiment,open experiment and exploratory experiment),established speci-men bank for common TCM processing and teaching methods (including audio and video),designed contents for basic experi-ment,comprehensive experiment,design experiment and research experiment and established 4 assessment contents(pre-experi-ment,operation,experimental design and experimental test). CONCLUSIONS:According to the reform of teaching method and means of the course,the teaching quality of TCM processing experiment is improved,and the students,innovation and practice abil-ity are developed.

Laparoscopic surgery develops fast in China in recent years,and it is widely applied in different fields in the digestive surgery and satisfactory results are achieved.However,uniformed training,technique standard and quality control standard are missing in the education of laparoscopic surgery in China.Fundamentals of laparoscopic surgery (FLS) program is developed by the Society of American Gastrointestinal and Endoscopic Surgeons in 2004.It is composed of congenital assessment and manual skills assessment.Twelve surgeons from China have taken FLS examination in April of 2014,and they introduced the content,features of FLS examination,some thoughts and inspirations on the training of laparoscopic surgery in China in this article.