Objective To establish the model of pancreatoduodenal allotransplantation in pigs with enteric drainage (ED) and portal venous drainage (PVD). Methods Forty-six hybrid landraces were divided into two groups (donor and recipient groups) randomly, for pancreatoduodenal allotransplantation. Donors were perfused via abdomial aorta without clamping the portal venous outflow with UW solution after heparinization. Whole pancreatoduodenal graft was harvested with segments of abdomial aorta and portal vein and shaped under cold UW solution. Then, the end-to-end anastomosis was performed with the donor iliac artery bifurcation “Y” graft to the recipient superior mesenteric arteries and celiac artery. Furthermore, type Ⅰdiabete model was made by removal of the recipient pancreas. The venous anastomosis was reconstructed between the donor portal vein and the recipient superior mesenteric vein. Meanwhile, the end-to-side anastomosis was performed with the donor common iliac artery bifurcation “Y” graft to the recipient abdomial aorta and the side-to-side intestinal anastomosis was performed between the donor duodenum and the recipient jejunum. External jugular vein was intubated for transfusion. The levels of blood glucose, insulin and glucagon in blood were measured before and during the operation and 1, 3, 5, 7 d after operation. Results Twenty-three cases of pancreatoduodenal allotranplantations were performed on pigs. One died from complication of anesthesia. Success rate of operation was 95.7%.Complications of operation happened in 2 cases in which one was phlebothrombosis, incidence 4.5% and the other was duodenojejunal anastomotic leak, incidence 4.5%. The level of blood glucose increased within 30 min and recovered on the 2nd day after removal of pancreas. The levels of insulin and glucagon decreased within 30 min and recovered on the 2nd day after removal of pancreas. Rejection curred at the 1st day and reached the worst level on the 9th day after transplantation without the change of insulin and glucagon in blood and clinical symptoms of rejection. Conclusion Pancreatoduodenal transplantation in pigs can treat type Ⅰ diabete. ED and PVD can keep the function of endocrine in normal. The techni- que of duodenal transplantation with ED and PVD may pave the way for the further development of pancreas transplantation in clinic.

Objective To optimize the prescription of preparation technology of Xiaoer Qingfei Dispersible Tablets. Methods The filler, disintegrant, adhesive, lubricant, and drug loading were screened by single factor tests. The combined application proportion of three disintegrating agents, PVPP, CMS-Na, and L-HPC, were optimized by orthogonal test. Results The best prescription of preparation technology of dispersible tablets:microcrystalline cellulose as filler;silica gel powder as lubricant;75%alcohol as the adhesive;PVPP, L-HPC, and CMS-Na as combined disintegrants (L-HPC∶PVPP∶CMS-Na=4∶3∶6). The disintegration time of prepared dispersible tablets was less than 3 minutes, and all through the No.2 sieve. Dispersible uniformity was in accordance with the provisions. Conclusion Xiaoer Qingfei Dispersible Tablets prepared by the optimized preparation process are stable and feasible, and suitable for clinical application.

BACKGROUND:The good rotational alignment of femoral prosthesis was very important in total knee arthroplasty. The research has shown that the posterior condylar angle was important to determine the alignment. The posterior condylar angle is the angle between the posterior condylar axis and the femoral epicondylar axis. MRI can clearly show the condylar cartilage, the projections of lateral epicondyle and the medial epicondyle depression, thus ensuring accuracy of measurement data. OBJECTIVE:To measure the posterior condylar angle of knee joint in the northern part of Baoding City in China, and to provide image evidence for identifying the rotational alignment of femoral prosthesis during total knee arthroplasty. METHODS:The knee was extended on a neutral position when MRI machine was applied to scan knee joint. The scanning plane was perpendicular to the mechanical axis of the knee. The best T1 axial plane of the knee was chosen, and two observers analyzed images independently. Existence rate of femoral medial epicondyle was observed using Bravo viewer 6.0 imaging software. The posterior condylar angle between posterior condylar axis and the femoral condyle axis was measured. RESULTS AND CONCLUSION:The posterior condylar angle was (2.73±1.28)° in males and (2.35±1.37)° in females on average, which did not show significant difference. The results showed that the MRI had great superiority in measuring the posterior condylar angle. The variability of the epicondylar axis was smal in total knee arthroplasty. Posterior condylar angle can be referenced to position femoral prosthesis and to avoid the complications after knee replacement.

OBJECTIVE:To prepare Geinstein (GEN) solid dispersion,and improve the dissolution rate of GEN in vitro. METHODS:Using PVP K30,PEG6000,and PEG4000 as carriers,GEN solid dispersion was prepared by solvent melting meth-od,and its dissolution in vitro was investigated. The structure of the solid dispersion was characterized by FTIR and DSC. RE-SULTS:GEN solid dispersion prepared with PEG4000 as carrier was better than those with other carriers in dissolution,and drug-carrier ratio (1:5) was the best. The results of DSC and FTIR showed that GEN in solid dispersion took amorphous form. CONCLUSIONS:GEN solid dispersion is prepared successfully and significantly improve the dissolution of GEN in vitro.

Body composition measurement could significantly facilitate evaluating the content of various body components,getting information about the health status and assessing the diagnosis,treatment,test,and prognosis of several diseases.Human health will be seriously affected by the imbalance of body composition.Body composition measurement methods are generally divided into local measurement methods and general measurement methods.The former ones include skinfold thickness measurement,ultrasonic measurement,computed tomography and nuclear magnetic resonance measurement;while the latter ones include anthropometry,underwater weighing measurement,air displacement measurement,biological resistance measurement,near infrared absorption measurement,dual-energy X-ray absorptiometry measurement,isotope dilution measurement,potassium isotope measurement and three-dimensional body scanning measurement,etc.This article reviews a variety of body composition measurement methods and their clinical application.

Objective:This study aims at exploring the impact of the health resources allocation on healthcare seeking behavior of inpatients with different income in China. Methods:Data at individual level were collected from China National Health Service Surveys conducted in 2008 and 2013 , interlinked with the data of health resources in county level. Multilevel zero-inflated negative binomial regression and multilevel multinomial logit model were respec-tively used to examine the impact of the health resources allocation on inpatient visits and the influence of the choice of healthcare providers by inpatients. Results: The results show that the increase of the number of beds in primary health centers ( PHCs) and physicians in county hospitals increased inpatient visits within counties. The investments in health resources in PHCs had greater impact on improving the likelihood of inpatient visits within counties for the low-income populations than that for the high-income populations. Conclusion: Investments in health resources in PHCs are vital to improve the healthcare seeking behaviors of the low-income populations in China.

Objective To investigate the efficacy of sling-exercise therapy on cervicogenic headache. Methods 60 patients with cervicogenic headache were divided into 2 groups with 30 patients each. Group I received paravertebral block of C2 once a week for 4 weeks, and Group II received sling-exercise therapy 3 times a week in addition. The Visual Analogue Score (VAS), frequency of pain (per month) before and 1, 3, 6 months after treatment were recorded, and the incidence of improvement was observed. Results In group I, VAS significantly improved 1 and 3 months after treatment (P<0.001), while it lasted 6 months in group II (P<0.001). The VAS improved more in group II 3, 6 months after treatment (P<0.001). It was similar in pain frequency. The incidence of improvement was 33.3% (10/30) and 73.3% (22/30) in group I and group II, respectively (P<0.01). Conclusion Sling-exercise therapy may improve the efficacy of paravertebral block on cervicogenic headache, especially for the long-term.

Objective To investigate the correlation between the prognostic nutritional index (PNI) and clinicopathological features and long-term prognosis of gastric cancer patients after radical gastrectomy.Methods The clinical data of 135 gastric cancer patients who underwent radical gastrectomy in this hospital from 2002 to 2006 was analyzed retrospectively.The PNI value was calculated by serum albumin (g/L) + 5 x lymphocyte count (× 109/L).The receiver operating characteristic (ROC) curve and Youden index was used to determine the cutoff value of the PNI.Survival curves were described by the Kaplan-Meier method and compared by the Log-rank test.The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors.Result The mean PNI value was 47.3 ± 5.9.The mean values of the PNI in age (t =2.909,P =0.004),tumor size (t =2.227,P =0.028),tumor depth (t =3.314,P =0.001),negative lymph node (t =2.381,P =0.019),negative lymphovascular invasion (t =2.781,P =0.006) were significantly higher than those in patients without such factors.When the PNI was 47,the Youden index was maximal,with a sensitivity of 70％ and specificity of 63％.The mean age in high PNI group was significantly lower than that in low PNI group (x2 =6.443,P =0.011).Tumor infiltration depth in high PNI group was less than in low PNI group (x2 =7.394,P =0.007).The proportion of lymphovascular invasion in high PNI group was significantly lower than in low PNI group (x2 =4.540,P =0.033).The overall survival rate in high PNI group was higher than in low PNI group (P =0.002).The univariate and multivariate analyses showed that tumor location (OR,2.144 ; 95 ％ CI 1.239-3.712 ; P =0.006),lymph node metastasis (OR,4.887 ; 95 ％ CI 1.856-12.866 ; P =0.001),lymphovascular invasion (OR,1.842 ; 95％ CI 1.078-3.145 ; P =0.025) and the PNI value (OR,2.282 ; 95 ％ CI 1.344-3.874 ; P =0.002) were independent factors for predicting overall survival rate.Conclusions The PNI value is a simple and useful tool to predict the prognosis of patients with gastric cancer.

Objective:To analyze the implementation and effectiveness of primary health care reform in Feixi county, Anhui province. Methods: This paper uses data analysis of interviews with key insiders, policy documents and archives, as well as institutional questionnaire survey and other methods to collect information, and then it com-bines qualitative and quantitative research to arrive at research findings through cross-analysis and interpretation. Re-sults:From 2010 to 2014, the reform enhanced the capacity of primary health care in four main aspects, including capacity building of primary health care personnel, network construction of primary health care system, improvement of working conditions, and system construction of institutional management. Accordingly, the human capacity of pri-mary health care personnel was improved, their enthusiasm for work increased, their income was raised, the working conditions were improved, the cooperation mechanism for vertical and horizontal health care services was established, and the consultation rate and primary health care utilization in Feixi county increased. Conclusion:Both the“bottom-up” exploration approach and “from point to area” implementation strategy adopted by Feixi county have not only been the core content of primary health care system’s comprehensive reform, but also effectively leveraged the other aspects of the reform. They have played an important role in deepening medical reform and establishing institutional mechanism of health care system.

Objective:The paper aims to explore the structure and effectiveness of three health service systems in Anhui province and provide policy recommendations to promote the integration of health care systems. Methods:By using typical sampling method, this paper conducts case study analysis of health service system in Ma’anshan, Feidong and Feixi county of Anhui province. The data mainly come from questionnaires for the institutions, doctors and patients, as well as from interviews with key informants. By integrating quantitative and qualitative data analysis, this paper uses social network analysis method to analyze the system structure and its degree of integration. Results:The degree of integration of health service structure in Ma’anshan is the highest, followed by Feixi, and Feidong is the lowest. The system effectiveness is same as the degree of integration. All three health service systems have advantages and disadvantages regarding to system integration. Conclusion:The effectiveness of health service system integration and its implementation is the product of combined effects of internal and external environment of each health service system. The reforms in Ma’anshan and Feixi health service systems have not only integrated health care structures, but also had a positive impact on the effectiveness of the health service systems.