Objective This study aims to explore the collaborative governance model of medical and elderly care integra-tion to promote the participation of medical institutions in integrated services and provide policy recommendations.Methods Based on the perspective of welfare pluralism,combined with the practical experience of an A hospital-managed nursing home in Guangzhou,the roles of different welfare subjects such as the government,market,community,and family in the medical and elderly care integration service system were discussed.Results The integration of medical and elderly care faces issues such as inadequate government guarantees in terms of space and medical insurance,insufficient vitality of social capital participating in medical and elderly care integration in the market,weak linkage between integrated care institutions and community organizations,and heavy burden on elderly families in accessing integrated services.Conclusion The government should improve top-level insti-tutional design,the market needs to optimize the supply of medical and elderly care integration services,the community should play a pivotal role as a platform,and families should create a supportive environment for respecting and caring for the elderly.

Objective This study aims to explore the collaborative governance model of medical and elderly care integra-tion to promote the participation of medical institutions in integrated services and provide policy recommendations.Methods Based on the perspective of welfare pluralism,combined with the practical experience of an A hospital-managed nursing home in Guangzhou,the roles of different welfare subjects such as the government,market,community,and family in the medical and elderly care integration service system were discussed.Results The integration of medical and elderly care faces issues such as inadequate government guarantees in terms of space and medical insurance,insufficient vitality of social capital participating in medical and elderly care integration in the market,weak linkage between integrated care institutions and community organizations,and heavy burden on elderly families in accessing integrated services.Conclusion The government should improve top-level insti-tutional design,the market needs to optimize the supply of medical and elderly care integration services,the community should play a pivotal role as a platform,and families should create a supportive environment for respecting and caring for the elderly.

【Objective】 To establish a routine screening method for unexpected antibodies of blood donors, analyze the results of centralized screening for unexpected antibody of blood donors in the blood center, and compare the cost of centralized and decentralized screening modes. 【Methods】 A total of 35 591 blood donors were screened for unexpected antibodies from March 31, 2021 to July 31, 2021, using microcolumn gel method. Unexpected antibody screening reactive samples were further confirmed by the Transfusion Research Institute of Shenzhen Blood Center, and the demographic characteristics were further determined through the analysis of unexpected antibody positive population. The direct cost and indirect cost of centralized and decentralized unexpected antibody screening mode were compared. 【Results】 Forty unexpected antibody positive samples were confirmed in Shenzhen, with the positive rate at 0.11%(40/35 591), among which MNS, Rh and Lewis system accounted for 35% (14/40), 32.5% (13/40) and 17.5% (7/40), respectively. Males and females accounted for 45% (18/40) and 55% (22/40), respectively (P<0.01). No significant difference was noticed by age and repeated-donor or not (P>0.05). Unexpected antibody screening in a centralized way saved about 1.16 million yuan per year. 【Conclusion】 It is necessary to carry out unexpected antibody screening for all blood donors, and centralized screening is more economical than decentralized screening.

Objective:To investigate the effects of posterior condylar offset (PCO) change on functional recovery after high-flexion posterior-stabilized total knee arthroplasty (TKA).Methods:From December 2018 to May 2019, a total of 76 patients (7 males and 69 females) who underwent primary TKA were included. The age of patients was 67.78±5.13 years (56-75 years). Preoperative and postoperative radiological PCO were measured by lateral knee X-ray. The true preoperative PCO was defined as the sum of radiological PCO and the thickness of posterior condylar cartilage. According to the changing of PCO (ture preoperative PCO - postoperative PCO), the subjects were divided into four groups, namely 28 cases in ≤-3 mm group, 23 cases in -3 mm- group, 15 cases in 0 mm- group and 10 cases in ≥3 mm group. The parameters, including age, body mass index, range of motion (ROM), Knee Society Scores (KSS) and visual analogue score (VAS) before the operation, were not significantly different among four groups. ROM, KSS, VAS at 2 weeks, 1 month, 3 months, 6 months after the operation were compared among the four groups.Results:There were good inter-observer reliabilities regarding the parameters measured in this study ( ICC>0.75). The KSS, ROM, VAS of all the subjects after operation were significantly better than those before the operation ( F=318.768, 64.983, 361.749; P=0.000). In all groups, the recovery of KSS and VAS last to 6 months after the operation. The ROM trended to be stable at the 3 months after the operation. At 6 months after operation, ROM, KSS and VAS of ≤-3 mm group was 116.07°±9.66°, 156.25±21.49, and 1.18±0.94, respectively. These parameters of -3 mm- group was 119.57°±7.52°, 162.17±17.09, and 1.26±0.86. However, these parameters of 0 mm- group was 126.07°±5.25°, 161.86±8.86, 1.00±0.55, respectively. These of ≥3 mm group was 118.00°±4.21°, 156.60±16.98 and 1.30±0.95. The KSS, KSS anatomy score, KSS function score and VAS were not significantly different at any follow-up point among four groups. The ROM of 0 mm- group at 1 month, 3 months and 6 months after operation (118.57°±13.07°, 25.00°±6.20°, 126.07°±5.25°) was significantly different from other three groups ( F=4.966, P=0.003; F=4.179, P=0.006; F=5.262, P=0.003), while 0 mm- group's ROM were greater than other three groups ( P<0.05). Conclusion:Increasing within 3 mm of PCO was related to larger postoperative ROM in high-flexion posterior-stabilized TKA. However, change of PCO had no influence on the outcomes of KSS recovery and pain relief.

Through analysis and summary of the biological characteristics of various biomarkers, to explore the reliability of different markers for early diagnosis of osteoarthritis. Cartilage oligomeric matrix protein, N-terminal crosslinked telopeptide of type Ⅰ collagen and C-terminal crosslinked telopeptide of type Ⅱ collagen are the possible effective markers in osteoarthritis early diagnosis. Hyaluronic acid and C-terminal crosslinked telopeptide of type I collagen are more suitable for evaluating the ollurrence and derelopment of osteoarthritis. The efficacy of miRNA and lncRNA in osteoarthritis diagnosis and evaluation remains to be proved. Each marker may has two or more biological effect, this paper will focus on finding out an accurate and stable marker with the analysis and summary of present bio-markers.

To study the protective effect of Xingnaojing Injection on early global brain ischemia-induced deep coma in rats.
 Methods: The deep coma model was induced by global brain ischemia by using four-vessel occlusion method in male SD rats. According to the body weight, the rats were randomly divided into 8 groups: a model control group, three different dose of Xingnaojing Injection (1.8, 3.6 and 5.4 mL.kg-1) groups, a Xingnaojing Injection (3.6 mL.kg-1) plus PI3K inhibitor group, a naloxone injection (0.04 mL.kg-1) group and a naloxone injection (0.04 mL.kg-1) plus Xingnaojing Injection (3.6 mL.kg-1) group (n=8 per group). In addition, eight animals served as the sham group were performed same operation with the model group excepting no blockage of the blood vessels. After the operation, three different doses of Xingnaojing Injection and/or naloxone injection were given intravenously once a day for three days. Ten μL PI3K inhibitor (LY294002, 10 mmol/L) was injected via anterior cerebral ventricle at once after global brain ischemia. The awakening time after the first drug treatment, the grasping power and the autonomous activity within 10 min after the last drug treatment were recorded. The levels of both dopamine (DA) and glutamate (Glu) in cerebrospinal fluid were detected by ELISA. The pathological changes were observed in brain tissue slices with HE staining and the protein levels of Akt/p-Akt and cAMP-response element binding protein (CREB)/p-CREB in hippocampus were detected by Western blotting.
 Results: Comparing with the model group, single administration of Xingnaojing Injection could significantly shorten the waking time (P<0.05) and continuous administration of Xingnaojing Injection for 3 d could increase grasping power, distance, frequency and duration of autonomous activities (P<0.05 or P<0.01) in the deep coma rat. Also, Xingnaojing Injection could inhibit these increases in neurotransmitters DA and Glu contents (P<0.05 or P<0.01), and improve pathological changes of hippocampal tissue. Xingnaojing Injection significantly induced protein phosphorylation of both Akt and CREB (P<0.05 or P<0.01); this effect was inhibited by PI3K inhibitor (P<0.05 or P<0.01). Moreover, the protective effects of naloxone on awakening time, grasping power, the autonomous activity and hippocampus damage in global brain ischemia-induced deep coma could be enhanced by joint use of Xingnaojing Injection (P<0.05 or P<0.01).
 Conclusion: Xingnaojing Injection could significantly improve deep coma induced by global brain ischemia in rat, which is related to inducing PI3K/Akt-dependent protein phosphorylation of CREB, and reducing hippocampal damage. The protective effect of Xingnaojing Injection is synergistically enhanced by naloxone.
Animals ; Brain ; Brain Ischemia ; Coma ; Drugs, Chinese Herbal ; Male ; Phosphatidylinositol 3-Kinases ; Rats ; Rats, Sprague-Dawley

Adipocytokines are polypeptides or proteins that are secreted by fat cells with a wide range of biological activities. Adiponectin is a fatty cytokine with insulin sensitization. It possesses the function of anti- diabetes, atherosclerosis and anti-inflammation. Adiponectin may participate in regulating the development of cognitive impairment, which is considered as a new regulatory factor for cognitive impairment.
Adiponectin ; Cognitive Dysfunction ; Diabetes Mellitus ; Humans ; Insulin ; Insulin Resistance

Objective To investigate the effect of heat stress on the expression of Toll-like receptor 4 (TLR4) and peripheral blood T regulatory cells (Treg) in splenic cells of rats.Methods Senventy-two SD rats were divided into 20 ℃ control group and 37 ℃ group.Each group was divided into non stimulation,bacterial lipopolysaccharide (LPS) stimulation and concanavin A (Con-A) stimulation subgroup.Each subgroup had 1,12,48 h and 168 h observation points,and flow cytometry was used to determine the level of TLR4 and Treg.Results The TLR4+ immunocompetent cells in the spleen was decreased from 1 h to 168 h in every subgroup of the 37 ℃ group compared to the 20 ℃ control group (P＜0.05).The level of CD4+CD25+ Treg in the peripheral blood in rats from 1 to 48 h was significantly decreased (P＜0.05) and slightly increased at 168 h in LPS stimulation subgroup in the 37 ℃ group compared to the 20 ℃ control group.The level of CD4+ CD25+ Foxp3+ Treg in the peripheral blood in rats at 12 h were significantly increased in non-stimulation and concanavalin A (Con-A) stimulation subgroups in the 37 ℃group,and were significantly decreased at 168 h in every subgroup of the 37 ℃ group compared with 20 ℃ control group (P＜0.05).The level of CD8+CD25+ Treg in the peripheral blood in rats was significantly increased at 1 h and 168 h in the 37 ℃ hot and humid group in the every subgroup whencompared with the 20 ℃ control group (P＜0.05).The level of CD8+ CD25+Foxp3+ Treg in the peripheral blood in rats was significantly decreased at 1 h and 48 h in the every subgroup,and was significantly increased at 12 h and 168 h in the non-stimulation and LPS stimulation subgroups in the 37 ℃ group compared to the 20 ℃ control group (P＜0.05).Conclusion High temperature and damp heat can destroy the innate immunity and alter the functional state of adaptive immunity in rats.

OBJECTIVE: To investigate the safety of the controllable ileostomy with pipe in view of histology. METHODS: Twenty-eight Beagle dogs undergoing controllable ileostomy with pipe were studied. The special fistula tube with balloon was placed into the hole locating at the cecal root opposing the mesenteric side, and fixed by double knot compression method. RESULTS: The fistula tube was removed 14 days after surgery, then the safety of the procedure was preliminarily evaluated by gastrointestinal radiography and anatomical observation. The small intestine tissue at the compression suture was used as the experimental segment, and the small intestine tissue at the proximal non-compression suture was used as the control segment. The histological staining and the immunohistochemical staining of S-100 protein, c-kit protein and α-smooth muscle actin(α-SMA) protein between two segment were compared, while quantitative comparison of myenteric plexus, intestinal Cajal cell(ICC) and smooth muscle cells in intestinal wall was carried out. After removal of fistula tube at 14 days postoperative, the dogs were normal in feeding and defecation. The digestive tract radiography showed that the intestine was patent without obvious stenosis and obstruction. The dogs were dissected 21 days after operation. The abdominal sinus ostium was well healed and the internal sinus was well formed. Under gross inspection, blood supply, morphology and motor function of experimental intestine segment were similar from the proximal and distal segments of control intestine. S-100 immunohistochemical staining showed that the morphology and distribution of S-100 protein positive cells and "blank area" cells in the experimental and control segments were consistent. Myenteric plexus counting showed that the experimental segment was 3.62±1.82/field and the control segment was 3.27±1.62/field, whose difference was not statistically significant(t=1.30, P=0.20). Immunohistochemical staining of c-kit showed that the distribution of c-kit positive cells in both segments was consistent. Counting of the number of ICCs in myenteric plexus revealed that experimental segment was 2.96±2.57/plexus, and control segment was 2.49±1.80/plexus without significant difference(t=1.81, P=0.07). Immunohistochemical staining of α-SMA showed that the morphology and distribution of smooth muscle cells in whole intestinal wall(muscle layer, longitudinal muscle, ring muscle) in experimental and control segments were consistent. The average absorbance(A) value of α-SMA staining in ring muscle layer was detected and quantified. The experimental segment was 0.15±0.03 and control segment was 0.14±0.04 without significant difference(t=1.16, P=0.25). CONCLUSION The technique of controllable ileostomy with pipe is safe in view of histology, which may replace the traditional protective ileostomy.
Animals ; Dogs ; Ileostomy ; methods ; standards ; Intestine, Small ; surgery ; Models, Animal ; Proto-Oncogene Proteins c-kit ; metabolism ; Treatment Outcome

Postpartum depression(PPD)is one of the most common types of postpartum psychiatric syndromes. Because of the complex and changeable characteristics in PPD disease and the special period after childbirth, there are many clinical limitations in the study of this disease. Therefore,the preparation and establishment of a proper animal model closed to clinical and behavioral evaluation method plays an important role in study of its pathogenesis. This review mainly introduces the commonly used postpartum depression animal models and the behavioral evaluation method. It is hoped to provide a reference for further study of PPD pathogenesis and for the drug research and development.