Objective To investigate the effects of recombinant human connective tissue growth factor (rCTGF) on the expression of osteoprotegerin (OPG) and RANKL ( receptor activator of NF-κB ligand ) in human osteoblasts, as well as the mechanisms involved. Methods Human osteoblasts were treated with rCTGF. The expressions of OPG and RANKL were assessed by Western blotting. The expressions of focal adhesion kinase ( FAK), mitogen-activated protein kinase (MAPK) were also observed. Results rCTGF inhibited RANKL protein expression in a dose-and time-depentent manner in human osteoblasts, while the expression of OPG kept unchanged. rCTGF induced activation of p38MAPK and dephosphorylation of FAK in human osteoblasts, but had no effect on ERK and JNK phosphorylation. p38MAPK inhibitor SB23058 abrogated the inhibitory effect of rCTGF on RANKL in human osteoblasts. Conclusion rCTGF inhibits the expression of RANKL in human osteoblasts via activation of p38MAPK and dephosphorylation of FAK.

Human osteoblast was treated with recombinant human connective tissue growth factor (rCTGF). This experiment showed that rCTGF increased membrane type-1 matrix metalloproteinase and matrix metalloproteinase-2 protein expression in a dose- and time-depentent manner in human osteoblasts. rCTGF induced activation of p38 MAPK in human osteoblasts. p38 MAPK inhibitor SB23058 abrogated the effect of rCTGF on the expressions of membrane type-1 matrix metalloproteinase and matrix metalloproteinase-2 in human osteoblasts.

Objective To investigate the effects of recombinant human connective tissue growth factor (rCTGF) on the proliferation, differentiation and apoptosis in human osteoblasts. Methods Human osteoblasts were treated with rCTGF, cell proliferation was measured by [3 H] -thymidine ([3 H] -TdR) incorporation method,the activity of alkaline phosphatase (ALP) was determined using α-nitrophenyl phosphate as a substrate, the expression of type Ⅰ collagen was determined by Western blotting, osteocalcin in conditioned media was measured by radioimmune assay, and cell apoptosis was assayed by flow cytometry. Results rCTGF promoted proliferation and differentiation of human osteoblasts in a dose-depentent manner, rCTGF increased ALP activity, osteocalcin and type I collagen secretion in a dose-depentent manner, rCTGF inhibited human osteoblastic apoptosis induced by serum deprivation. Conclusion rCTGF can promote osteoblastic proliferation, and differentiation and protect osteoblast against apoptosis, suggesting that CTGF plays an essential role in bone metabolism.

Objective To evaluate the value of endoscopic profile in an adult population with typical heartburn. Methods Clinical and endoscopic data were collected from 5042 consecutive outpatients who underwent routine upper endoscopy without any alarm features between March 2006 and Feb. 2007. Results Three hundred and thirteen (6.2%) patients were diagnosed as having typical heartburn. Of these, erosive esophagitis (EE) was found in 99 (31.6%) patients, Barrett's esophagus (BE) in 10 (3. 2%) patients, peptic ulcer disease (PUD) in 21 (6. 7%) patients and carcinoma in three (0.9 %) patients (1 with esophageal carcinoma and 2 with gastric adenocarcinoma).Multivariate analysis revealed that age＞50, male, overweight and alcohol use were independent risk factors for positive endoscopy findings (P＜0.05) and EE (P＜0.05) in heartburn patients. Male and Helicobacter pylori infection were independent risk factors for PUD (P＜ 0.05). Conclusions In China, patients with typical heartburn but without alarm features, early endoscopic examination may be helpful in avoiding missing diagnosis of tumor.

Objective To evaluate the optimal surgical approach for huge liver neopiasms in the caudate lobe.Methods Thirty-three patients with huge liver neplasms（≥10cm) underwent caudate lobectomy at a single tertiary referral center between January 2001 and June 2007.The surgical out-comes of pateints who underwent isolated caudate lobectomy or caudate lobectomy combined with partial hepatectomy were compared.Result Fifteen（45.5％）of 33 patients underwent isolated total or partial caudate lobectomy（group A）,whereas 18（54.5％) had total or partial caudate lobectomy cellular carcinoma (HCC) (51.5％),followed by hemangioma(21.2％),intrahepatic cholangiocarcinoma(9.1％),angiomyolipoma(6.1％),hepatic adenoma (3％),focal nodular hyperplasia(3％),colorectal liver metastases(3％)and sarcoma(3％).The median diameter of the tumour was 12.3 (range,10.2-21)cm.Patients in group A had significantly longer operative time (280 minutes vs.170 minutes),longer length of hospital stay (17 days vs.12 days)and more blood loss(1250 ml vs.670 ml) than patients in group B.There was no perioperative death in the 2 groups of pateints.Complication rates in group A and group B were 26.7％ and 16.7％ respectively.There was no disease-related death in patients with benign lesions.The1-,3- and 5-year disease-free survivals of patients with malignant lesions in group A and group B were 25.9％,0％,0％and 74.3％,46.7％,31.2％,respectively.The 1-,3- and 5-year overrall survivals were 68.6％,19.7％,0％ and 100％,66.5％,41.8％,respecively.Conclusion The approach to caudate lobectomy depends on the size and location of the lesion and the liver functional reserve.For patients with sufficient liver functional reserve,caudate lobectomy combined with partial hepatectomy is preferred because it is technically less demanding.For patienls with marginal liver functional reserve,isolated caudate lobectomy is the only viable surgical option.

Objective To discuss the anticancer role of arsenic trioxide (ATO) with cisplatin on human oral carcinoma HSQ-89 cells. Methods The human oral epidermoid HSQ-89 cells were chosen as the subjects. Different concentrations of ATO were added into Cisplatin(DDP)-treated cells. The inhibition rate of tumor cells was detected by MTT assay. Results Different concentrations of ATO (0,2.5,5,7.5,10,12.5 μmol/mL) were added into oral cancer HSQ-89 cells which have been treated with DDP (15 μg/mL). The inhibition rate of tumor cells were 26.9%, 67.5%, 73.0%, 88.5%, 90.4%, 98.7%respectively; The combined application of ATO with cisplatin could improve the inhibition rate of HSQ-89 cells in a dose-dependent relation. Conclusion The combined application of ATO and DDP can produce a synergistic action of inhibition on oral cancer cell.

Objective To evaluate the differences of the thinnest-point corneal thickness (TCT) decrease after three different corneal crosslinking (CXL) protocols for progressive keratoconus.Methyds Retrospective clinical case study.From August 2010 to November 2015,consecutive 85 patients (110 eyes) with progressive keratoconus were enrolled and treated with CXL in Department of Opthalmology,Navy General Hospital.21 patients of 25 eyes underwent standard epithelium-off corneal crosslinking (S-CXL),14 patients of 22 eyes underwent 1 g · L-1 riboflavin-sodium lactate Ringer's solution iontophoresis-assisted CXL (I-CXLa),and 50 patients of 63 eyes underwent 0.1％ riboflavin-distilled water solution I-CXLb.Preoperative and postoperative TCT were measured by ALLEGRO oculyzer.The differences of TCT decrease after treatment were compared among the three CXL protocols.Results The differences of TCT from baseline after 3 months,6 months and 12 months in the S-CXL group were (-14.93 ±27.16) μm,(-31.94 ±22.89) μm,(-27.71 ±26.01) μm,respectively,the I-CXLa group were (-20.14 ± 19.09) μm,(-10.10 ± 24.28) μm,(-7.11 ± 22.26)μm,respectively,the I-CXLb group were (-28.08 ± 26.14) μm,(-21.08 ± 25.62) μm,(-15.91 ± 19.19)μm,respectively.Three months after treatment,the differences of TCT decrease in the three groups was not statistically significant (P =0.188);Six and 12 months after treatment,the differences between S-CXL and I-CXLa were statistically significant (all P ＜0.05),but the differences between S-CXL and I-CXLb,between I-CXLb and I-CXLa showed no significant difference (all P ＞ 0.05).Conclusion Six and 12 months after treatment,TCT decrease is related to the CXL protocol.TCT decrease degree may reflect the intensity of crossinking.TCT decrease in I-CXLb is smaller than that in S-CXL,but there is no statistical difference.

Objective:To discuss the effect of individualized physical exercise prescription on patients’ nutrition status, physical ability and self-care ability in patients with intestinal fistula and severe malnutrition. Methods:Twenty-four patients were divided randomly into two groups, the experiment group exercised according to physical exercise prescription, control group exercised in a routine way. The patients’ weight, physical ability and self-care ability were measured on the day before exercise and the 28th day after exercise. Results:Patients in the exercise group had significant more exercise than those in the routine group, and the physical ability and self-care ability were significant better that those in the routine group. Conclusion:Individualized physical exercise prescription can accelerate the recovery of physical ability and self-care ability, it can be used safely and effectively in patients with intestinal fistula and severe malnutrition.

The mucous barrier is a major physiological obstacle that the mucosal drug delivery system needs to deal with. In response to this physiological barrier, many achievements have been made in research of mucosal adhesion and mucus penetration. This review puts emphasis on the progress of the research on new mucosal adhesion strategies such as cationization, sulfhydrylization, maleimide functionalization, lectinization and catechol conjugation; polyethylene glycol (PEG), polyvinyl alcohol (PVA), poly (2-alkyl-2-oxazoline) (POZ), zwitterionic polymers and other mucus-inert materials, strategies to enhance mucus penetration ability such as enzyme functionalization, reducing agent pretreatment and so on. The problems of each strategy are also analyzed and discussed, which can provide some references for clinical transformation.

Objective To explore correlates of health-care seeking behavior in patients with irritable bowel syndrome (IBS).Methods Four thousand permanent residents were recruited from eight urban communities and rural villages in Guangzhou and Huizhou, Guangdong province during 2009 by cluster stratified sampling for face-to-face questionnaire survey, including symptoms of bowel disease,behavior of seeking for health-care, demographic characteristics, coping style, life events and medical history.IBS was identified based on the Rome Ⅱ Criteria.Patient with IBS were divided into two groups,one seeking health-care at hospitals or clinics and the other non-seeking health-care.Univariate and multivariate logistic regression analysis was used to compare difference between the two groups and explore its related factors.Results A total of 237 IBS patients were identified based on the Rome Ⅱ Criteria, 53 of them (22.4% ) had sought health-care due to their symptoms.Results of multivariate logistic regression analysis showed that preference in seeking for health-care, abdominal pain lasting for more than one hour in each episode and extra-gastrointestinal symptoms were main factors related to their seeking for health-care,adjusted for age and gender, with odds ratios (ORs) of 1.81 (95% CI: 1.27 -2.58), 1.41 (95% CI:1.01 - 5.14 ) and 2.14 ( 95% CI: 1.06 - 4.33 ), respectively.Conclusions Extra-gastrointestinal symptoms and abdominal pain lasting for more than one hour in each episode correlate their health-care seeking behavior in patients with IBS, as well as their preferences in seeking for health-care.