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.

Humans ; Precision Medicine ; Temporomandibular Joint Disorders ; diagnosis ; psychology ; surgery ; therapy

Humans ; Temporomandibular Joint Disorders ; diagnosis ; therapy

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 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 the effect of rutin on growth and proliferation of human hepatic cancer line(HepG2).Methods HepG2 cells were cultured in vitro,then cocultured with 50 to 250 ?mol/L rutin for 24 h.The inhibition rate of rutin on growth and proliferation of HepG2 was determined by MTT,~(3)H-TdR,and apoptotic cells were observed in fluorescent staining by Olympus fluorescent microscopy,and cell cycle was analysed by flow cytometry.Results Rutin inhibited HepG2 cells from growth and proliferation,and evoked apoptosis.Flow cytometry showed that 50 to 250 ?mol/L rutin caused an increase at G_(0)/G_(1) phase and a decrease at G_(2)/M phase and arrest at G_(0)/G_(1) phase in the cell cycle.Conclusion Rutin markedly inhibits the proliferation of HepG2 cells and induces apoptosis in a concentration-dependent manner.

Objective To discuss the application of Apofix interlaminar clamp for the treatment of atlantoaxial instability. Methods From April 2000 to July 2004, 30 patients with atlantoaxial instability were treated with posterior atlantoaxial fusion and Apofix fixation. There were 24 males and 6 females. The mean age of the patients was 41 years (range, 19 to 67 years). The patients included 5 with atlantoaxial dislocation, 25 with odontoid fracture (including fresh fracture for 21, old fracture and nonunion for 4; Anderson Ⅱ for 23 and Anderson Ⅲ for 2). After reducted by skull traction, atlanto-occipital space, arcus posterior atlantis and axial laminar were exposed during operation, upper and lower hooks were inserted. The iliac bone graft was inserted into the space of C1 and C2, the connecting rod of the clamp was compressed and fixed. Results The follow-up of all cases ranged from 8 months to 3 years and 10 months (with the mean of 27 months). There were 28 cases with complete reduction of fracture and dislocation, 2 cases in incomplete reduction. The operation time was 70 to 150 minutes, and the average blood loss was 65 ml. Patients could sit up 3 days (2 to 6 days) after surgery with soft collar. The mean off-bed time was 7 days (2 to 10 days) after operation in the patients without or less spinal cord injury. All cases obtained solid bony fusion 3 months postoperatively. No severe complications such as injuries of vertebral artery, nerve root and spinal cord or aggravation of spinal cord injury occurred. Conclusion Apofix interlaminar clamp has advantages of convenience in operation, provided reliable and safe stability for atlatoaxial segment. The results suggested that this technique is an efficient, reliable segmental posterior fixation.

[Objective]To explore the vascularization within spherical porous ?-TCP scaffolds in vivo.[Method]Thirty adult rabbits were selected and divided into 5 groups randomly.Spherical porous ?-TCP scaffolds(the diameter was 2 cm,the pore size was 500～600?m,the interconnection size was 110～120 ?m) were harvested at 1,2,4,8 and 12 weeks after embedded into muscle-fascia lumbodorsalis pouches in each rabbit separately,in order to observe the vascularization by means of morphological and quantificational analysis.[Result]No vessel was detected at one week after surgery,and only a few immature vascular buds could be seen at the 2nd week.The first vascularization peak could be observed at 4 weeks,characterized by the growth of quantity of new blood vessels(P0.05).[Conclusion]The process of vascularization comprises two phases,the quantity increasing in the early stage and the quality enhancing in the later stage.The special architecture and biodegradation characters of scaffolds could influence the vascularization.

Objective To understand current prevalence of fluorosis, of drinking tea type in Pengyang County of Ningxia to offer scientific basis for preventing and curing, monitoring, health education. Methods Four towns were chosen as investigating spots in Pengyang County of Ningxia in 2007, from each 50 children aged 8-12 year old and 50 adults who either had tea or did not were investigated. Dean method was used to measure dental fluorosis of children and adult; meanwhile fluoride content in water, urine and drinking tea was tested using the fluoride ionic electrode method and that in brick tea using water immersion electrode method. χ2 testing, analysis of variance, u test, q test were performed. Results In adult drink tea group, control group, and children, the detaction rate of dental fluorosis were respectively 24.75%(99/400),9.5%(38/400)and 15.96%(71/445), obviously higher in drink tea group than the control group(χ2= 32.73, P<0.05). Urine average concentration of fluoride was (3.38±2.37), (2.09±1.33 ). (1.41±0.67)mg/L, obviously higher in drink tea group than the control group(u= 9.49, P<0.05). In 4 investigation spots tea fluoride averaged at (3.63±2.05)mg/L, fluoride content in drinking water was averagely (1.01±0.49) mg/L, with that of Wangwa Town [(1.31±0.33)mg/L] exceeding the national standard for drinking water (1.0 mg/L), where dental fluorosis rate was higher and fluoride content was higher than that in 3 other investigation spots (P<0.05). Conclusions Residents in Pengyang County in Ningxia who drink brick tea can cause accumulation of fluorine to poison in Ningxia, leading to fluorosis of drinking tea type; Wangwa Town have both drink tea and water fluorine poison.