Objective To investigate a clinically perspective way of inducing transplantation tolerance. Methods Kidney transplantation model was established using Lewis (RT1 l) rats as recipients and DA (RT1 a) rats as donor. Before transplantation the recipient rats were conditioned with anti lymphothyte serum (ALS) injected for three times, followed by 10 8 donor bone marrow cells transfusion (BMT) and injection of 100 mg/kg cyclophosphamide (CP), survival time of kidney allografts, mixed lymphocyte reaction (MLR) and delayed type hypersensitivity (DTH) of recipient to donor spleen cells were observed and studied. Results 5 of the 7 kidney allografts survived 73 to 90 days without sign of rejection. The donor specific MLR and DTH were suppressed. Conclusions Induction of transplantation tolerance is a prospective way for the prevention of allograft rejection.

Objective To explore the diagnosis,treatment,risk factors and prognosis factors of postpancreaticoduodenectomy hemorrhage (PPH).Methods The retrospective case-control study was adopted.The clinical data of 703 patients who underwent pancreatoduodenectomy at Hospital 401 of the People's Liberation Army from January 2008 to July 2013 were collected.Standard pancreatoduodenectomy was carried out for the malignant tumors of the head of pancreas or ampulla,pylorus-preserving pancreatoduodenectomy was operated for the benign tumor or the duodenal papilla tumor.The corresponding treatment was adopted for PPH.The observation indicators included:(1) the surgical situation (surgical method,operation time and the volume of intraoperative blood loss),(2) diagnosis of PPH,(3) treatment of PPH,(4) univariate and multivariate analyses for the risk factors affecting the occurrence of PPH,(5) univariate and multivariate analyses for the risk factors affecting prognosis of PPH patients.The measurement data with normal distribution were represented as x ± s.The measurement data with skewed distribution were represented as M (range).The chi-square test or Fisher exact probability was used for univariate analysis.Logistic regression model was used for multivariate analysis.Results (1) The surgical situation:among 703 patients,409 patients underwent standard pancreatoduodenectomy and 294 underwent pylorus-preserving pancreatoduodenectomy,including 1 combined with right hemihepatectomy,27 with portal vein reconstruction and 2 with hepatic artery reconstruction.Pancreaticojejunostomy was applied to 658 patients using mucosa anastomosis of the pancreatic duct to jejunum and 45 patients using invagination anastomosis.Supporting tube was routinely deposed in the pancreatic duct,598 patients had internal drainage and 105 patients had external drainage.The end-to-side anastomosis between common bile duct and jejunum was used for choledochojejunostomy.The 409 patients received the gastrojejunostomy using side-to-side anastomosis of gastric part and jejunum and 294 patients using end-to-side anastomosis of duodenum and jejunum.Operation time and volume of intraoperative blood loss were (324 ± 54) minutes and (428 ± 118) mL.(2) The diagnosis of PPH:among 703 patients after pancreatoduodenectomy,62 patients had PPH,the hemorrhage reasons of 38 patients had been identified,and the hemorrhage reasons of 24 patients had not been identified (A level in 5 patients,B level in 17 patients,C level in 2 patients).① The site of hemorrhage:the hemorrhage outside the cavity were detect in 27 patients,the hemorrhage inside the cavity in 28 patients,and the hemorrhage from both outside and inside part of the cavity in 7 patients.② The time of hemorrhage:early-stage hemorrhage were detected in 5 patients and the delayed hemorrhage in 57 patients.③The volume of postoperative blood loss was (885 ± 253)mL,30 patients had mild hemorrhage and 32 patients had severe hemorrhage.④ The clinical classification of PPH:5,32 and 25 patients were detected in level A,B,C,and 19 patients combined with sentinel hemorrhage.(3) The treatment of PPH:①5 patients with PPH in A level were given clinical observation,blood volume supplement and other treatment,then the symptoms gradually turned better.② Among 32 patients with PPH in B level,15 patients became better after symptomatic and supportive treatments,6 patients received successful hemostasis after guglielmi detachable colis embolization,4 patients received successful hemostasis under gastroscopic hemostasis,7 patients received emergency exploratory laparotomy.Thirty-two patients were improved and then out of hospital after treatment,without occurrence of death.③ Among 25 patients with PPH in C level,4 patients received successful hemostasis after guglielmi detachable colis embolization,17 patients received hemostasis by emergency exploratory laparotomy,4 patients with undiscovered bleeding points received the treatment of fluid infusion,blood volume supplement and antacid.Among 25 patients after corresponding treatment,10 patients were improved and 15 patients were dead.(4) The result of univariate analysis showed that the combined hypertension,vascular resection and reconstruction,postoperative pancreatic leakage and postoperative intraabdominal infection were risk factors affecting the occurrence of PPH (x2 =4.950,5.300,7.568,5.505,P ＜ 0.05).The results of multivariate analysis showed that the combined pancreatic leakage and postoperative intraabdominal infection were independent risk factors affecting the occurrence of PPH [OR =2.761,2.216,95％ confidence interval (CI):1.389-5.489,1.198-4.101,P ＜ 0.05].(5) The risk factors affecting the prognosis of PPH patients:the results of univariate analysis showed that postoperative sentinel hemorrhage,postoperative pancreatic leakage,site,degree and level of hemorrhage were risk factors affecting the prognosis of PPH patients (x2 =8.022,4.448,11.853,18.551,28.285,P ＜ 0.05).The results of multivariate analysis showed that postoperative sentinel hemorrhage and site of hemorrhage (outside and inside part of the cavity) were independent risk factors affecting the prognosis of PPH patients (OR =5.550,0.233,95％ CI:1.595-19.314,0.086-0.635,P ＜ 0.05).Conclusions Pancreatic leakage and intraabdominal infection are independent risk factors after pancreatoduodenectomy.The treatment effect of the early-stage hemorrhage is better than that of the delayed hemorrhage,and angiographic embolization is the first choice of diagnosis and treatment for the delayed hemorrhage.Sentinel hemorrhage could result from aneurysm or continuous arterial hemorrhage of vascular erosion,it is the independent risk factor affecting the death of hemorrhage after pancreatoduodenectomy.

Objective To assess the public health service quality objectively in Shenzhen,and promote the equity of basic public health services.Methods The criterion and method of the assessment were established by municipal health administrative department,the assessment of institutions and regions were conducted by experts selected by municipal professional institutions.Regional assessment was the comprehensive evaluation of public health service qualities of professional public health institutions,medical institutions and the community health centers.The assessment of the degree of public health service quality satisfaction was accomplished by a third-party institution.Results The accomplishment ratio of indicators for public health service quality was 93.2％.This ratio has witnessed a high increase with mental health institutions,occupational disease prevention and control institutions and health education institutions on one hand.On the other,it has dropped with institutions of disease control,chronic disease control and medical institutions within the region.On the whole,this ratio has increased with all the districts to different extents.Despite the overall improvement of public health capabilities citywide,imbalances are found among districts and institutions as well.Conclusion It is imperative to further improve the public health service system and equity while carrying out specific tasks in this respect.

BACKGROUND:Screw loosening and shedding may occur after osteoporosis associated with lumbar degenerative disease treated with pedicle screw fixation. Application of pedicle screw enhanced with cured materials can improve the therapeutic effect.
OBJECTIVE:To compare the clinical effect of pedicle screws enhanced with poly(methyl methacrylate) and injectable calcium sulfate cement in the lumbar internal fixation of osteoporosis.
METHODS:Sixty-one patients diagnosed with osteoporosis combined with lumbar spondylolisthesis, lumbar spinal instability, and severe lumbar spinal stenosis were col ected. Al patients were divided into two groups according to the treatment method:poly(methyl methacrylate) bone cement enhanced pedicle screw group and calcium sulfate bone cement enhanced pedicle screw group.
RESULTS AND CONCLUSION:There were no significant differences in the operation time, blood loss, preoperative and postoperative visual analog scale score, Japanese Orthopedic Association scores and the Japanese Orthopedic Association score improvement rate between two groups (P>0.05). The results showed that two patients had bone cement leakage in poly(methyl methacrylate) group which had no neurological symptoms caused by new symptoms during fol ow-up period. The bone mineral density was not improved gradual y in poly(methyl methacrylate) group with fol ow-up time prolonging;however, in calcium sulfate group, the bone mineral density was increased significantly after treatment, and the change of bone mineral density was linearly related with Japanese Orthopaedic Association score improvement rate in calcium sulfate group. No screw loosening, pul ing out or neurological dysfunction occurred in both groups. The results indicate that like poly(methyl methacrylate), balcium sulfate bone cement can increase the stability of pedicle screws.

Objective To set up the methods of establishing rat primary benign prostatic hyperplasic glandular epithelial cell line.Methods Male spontaneously hypertensive rats were raised to 29 weeks,and then evaluated the situation of BPH with HE staining.The prostate tissue from ventral prostate lobe was aseptically removed,dissected,minced,and then dissociated in collagenase type Ⅰ.Isolated cells were collected,seeded in WAJC-404 and PrEGM medium separately,then cultured and passaged.Specificity of primitive cultured prostatic epithelial cells was identified by cell immunochemistry with CK8/18,and the cell growth curves were drawn.Then the situation of growth of the two prostatic hyperplasic glandular epithelial cell lines were analysed and compared.Results The prostatic hyperplasic glandular epithelial cell lines of the spontaneously hypertensive rats in WAJC-404 and PrEGM medium were successfully primarily cultured,purified and passaged in vitro.Cell immunochemistry proved that the cell lines specifically express cytokeratin 8/18.Cell growth curve showed that prostatic epithelial cells in PrEGM,compared with prostatic epithelial cells in WAJC-404,possessed better cell morphology,more exuberant cell vitality,faster growth rate to enter the logarithmic growth period(4 d vs.7 d)and higher peak of cell growth curve(15.3× 104/ml vs.12.8×104/ml).Conclusions Rat primary benign prostatic hyperplasic glandular epithelial cell line can be established conventionally in vitro.PrEGM medium is more suitable for primary culture of the rat benign prostatic hyperplasic glandular epithelial cell line than WAJC-404 medium.

Objective To study the effects of salt and cooking oil intervention among hypertensive patients on knowledge-attitude-practice. Method Three thousand hypertensive patients from 20 community health service centers in Shenzhen were chosen by multi-stage cluster random sampling method. Salt measuring spoons and scaled oil pots were provided during six-month health intervention. Before and after the six-months health intervention, 2 976 and 2 864 valid questionnaires were collected respectively. After intervention, 40 families were randomly selected to perform an investigation of cooking oil and salt weighing during 3 d 24 h. Result Before the intervention, the rates of awareness on the intake of salt and cooking oil were 29.94% and 16.23% respectively. After intervention, the rates increased to 88.58% (P<0.000 1) and 84.29%(P<0.000 1) respectively. The rates of restriction on the intake of salt and cooking oil were 62.97% and 59.07%, respectively, after the intervention, the rates were 97.14% and 96.79% (P<0.000 1), respectively. By using the salt measuring spoons and scaled oil pots, the intake of cooking oil and salt reached the recommended amount in Chinese dietary guideline. Conclusion The implementation of health education combined with appropriate tools could promote the knowledge and behavior of the salt and cooking oil consumption.

Objective To investigate the efficacy and safety of amisulpride and clozapine in schizophrenia patients with predominantly negative symptoms.Methods Totally 166 cases of schizophrenia patients with predominantly negative symptoms from May 2013 to May 2016 in The Sixth People's Hospital of Hebei were divided into observation group and control group,83 cases in each group.Patients in the observation group were treated with amisulpride,and control group were treated with clozapine.The clinical effect,SANS scores,and occurring rate of abnormal electrocardiogram were compared.Results The clinical effect,emotional insipid (blunting),and attention dysfunction scores from SANS of observation group were significantly better than those of control group on week 4,8,and 12,respectively (P ＜ 0.05);The occurring rate of abnormal electrocardiogram in observation group was significantly lower than that of control group on week 12 (P ＜ 0.05).Conclusion Compared with clozapine,amisulprid has better efficacy and safety in schizophrenia patients with predominantly negative symptoms,and can effectively improve of symptom of insipid (blunting) and attention dysfunction.

Objective To assess the effectiveness of donepezil versus huperzine in the treatment of elderly patients with mild cognitive impairment (MCI).Methods Total 122 elderly patients with MCI were divided into two groups:donepezil treatment (5.0 mg once daily) (n=71) and huperzine treatment group (0.1 mg twice daily) (n=51).All the patients were followed up for 24 weeks.Before and 12 weeks,24 weeks after drug treatment,the cognitive functions were evaluated,including MMSE,MOCA,ADAS-cog,CDR,GDS,ADL,HIS and HAMD.Results There was no significant difference in age,sex,education time and neuropsychology rating scales between the groups before drug use.As compared with the score before drug use,the donepezil group showed a significant increase in MMSE after 12-weeks (t=4.47) or 24-weeks (t=6.16) (P＜0.01),a decrease in the score of ADAS-cog after 12-weeks (t=2.33,P＜0.05) or 24-weeks( t=3.68,P＜0.05),and an increase in the score of MOCA after 24-weeks drug use (t=2.56,P＜0.05).The huperzine group showed significant improvement in MMSE after 24-weeks drug use (t=2.80,P＜0.05),but there was no difference in other time points or in the score of MOCA and ADAS-cog as compared with the score before drug use.After 24 weeks' treatment,the donepezil group had higher MMSE (t=2.01,P＜0.05) and lower ADAS-cog (t=2.09,P＜0.05) scores than the huperzine group.30 patients (total effective rate was 42.3 ％) and 9 patients (total effective rate was 17.6 ％ ) became improved in donepezil and huperzine group,respectively,with significant difference (x2 =8.26,P＜0.01 ).There were 5 cases in the donepezil group and 3 cases in the huperzine group getting slight side-effects which disappeared by continuing to take drugs or by adjusting drug taking time.Conclusions Donepezil and huperzine as the cholinesterase inhibitors are effective and safe,and the efficacy of donepezil is faster and better in treating elderly patients with MCI.

Objective To study the inhibitory effects of δ-opioid receptor activation in serumdeprivation induced apoptosis of human liver cells and the proposed protein kinase C(PKC)pathway mechanism.Methods MTT assay was used to detect the survival rate of human liver cells in vitro and Annexin V-FITC/PI double staining was used to detect the cell apoptosis rate.Flow cytometry was used to analyze cell cycle,RT PCR used to analyze the PKC mRNA and Western Blot analysis was used for detecting the protein expression of PKC and Caspase-3.Results After serum-deprivation for 48h of cultured human liver cells in vitro,significant liver cell apoptosis occurred.The apoptosis was suppressed by δ-opioid receptor activation,which manifested as a slower rate of apoptosis,decreased expression of Caspase-3and increased expression of PKC.After GF109203X was added,the inhibitory effects of DADLE decreased markedly.Conclusion Activation of δ-opioid receptor on the membrane of human liver cells has inhibitory effects on serum-deprivation induced apoptosis of liver cells.The underlying mechanism may be associated with PKC pathway activation.

Objective To design a bank and hospital one card system to optimize outpatient service process and improve service level of outpatient .Methods On the basis of the existing outpatient service process ,we combine transfer function and payment function of bank card ,thus a bank and hospital one card system was designed to utilize the advantage of City Payment Card .Re‐sults The waiting time of outpatients was shortened through the self service of bank and hospital one card system ,the pressure of outpatient service windows was reduced .Conclusion Bank and hospital one card system can optimize outpatient service process , which can improve hospital efficiency and patient satisfaction .