Background:Primary health care system is a critical component of diabetes care and management.This article aimed to analyze the availability of glucose-lowering drugs in primary health institutions (PHIs) in China,and to explore the relationship between availability of glucose-lowering drugs and medication adherence among type 2 diabetes mellitus (T2DM) patients.Methods:This cross-sectional study conducted in Shandong Province,eastern China (hereafter referred to as Shandong),between August and December 2017.In total,2520 community-managed T2DM patients were se-lected from 68 PHIs in Shandong,including 62 village-level and 6 township-level PHIs.The self-developed ques-tionnaire was used to survey the availability of glucose-lowering drugs in PHIs.Patients' medication adherence was assessed by four self-reported questions,and was classified as either adherent or non-adherent.Descriptive statistics was used to analyze the availability of glucose-lowering drugs in PHIs and the medication adherence among the T2DM patients.Multilevel logistic regression models were used to explore the relationship between the availability of glucose-lowering drugs in PHIs and patients' medication adherence.Results:A total of 1866 T2DM patients prescribed with at least one glucose-lowering drug were included in analysis.Among them,58.5％ patients followed their antidiabetic treatment well.In village-level PHIs,the pa-tient's adherence rate was lower than in township-level PHIs (55.9％ vs.61.1％,P ＜ 0.05).Among the 68 PHIs,average (2.53±0.97) glucose-lowering products (generic names) were available,which in village-level PHIs were less than in township-level PHIs (2.47 vs.3.17,P ＜ 0.05).And the number of available glucose-lowering products in PHIs was associated with the adherence of T2DM patients.Conclusion:Poor availability of glucose-lowering products was found in PHIs in Shandong.The availability of glucose-lowering products in PHIs was positively associated with patients' medication adherence,and could be enhanced to improve the control of diabetes in primary care settings.

Objective To observe the effect of mesenchymal stem cells ( MSC) in treating ischemic diabetic ulcers, and to explore its clinical perspectives. Methods Prepared electro-spinning biomaterials and cultured MSC to study effect of MSC composite biomaterials in vitro by scanning electron microscope,MTT array and influence of MSC conditioned medium on endothelial cells. The use of 5 to 8 week old male C57BL/6J mice were prepared into diabetic mice,femoral artery ligation in the proximal thigh,in dorsal skin full-thickness wounds caused by the diameter 5 mm. Then the effect of MSC composite biomaterials on ischemic diabetic ulcers was determined. Results This study found that the MSC grow well on electro-spinning biomaterials. Cells foot extension and connections between cells were observed by scanning electron microscope. Stimulated by high glucose,growth and proliferation of MSC has a stronger ability on biomaterials. MSC condi-tioned medium on biomaterials increased human umbilical vein endothelial cells proliferation ability. Conclusion MSC composite biomateri-als can effectively improve the treatment effect of MSC on ischemic diabetic ulcers. The study indicated stem cells composite biomaterials have great potential and application prospect in the treatment of ischemic diabetic ulcers healing.

Objective To study the feasibility of model building methods by analyzing the advantages and disadvantages between the two different methods to build off-pump coronary artery bypass graft animal model. Methods Twenty dogs were randomly divided into two groups:brachiocephalic artery group and descending aorta group. Small-caliber heterogeneous vascular vessels were used as bridge vessels. The incision was in the fourth intercostal space of the left chest. Vascular anastomosis was firstly done between the brachiocephalic artery and bridge vessels,or between descending aorta and bridge vessels,prior to coronary vascular and bridge vessels anastomosis. Results The dogs of two groups were not dead during operation. Brachiocephalic artery group and the descending aorta group:aortic vascular anastomosis times were (33.9 ±4.8) min and (29.6 ±3.5) min respectively (P<0.05),coronary vascular anastomosis time were (28.5 ±3.0) min and (28. 1 ± 2. 3) min respectively (P>0. 05). The surgical blood losses of the two groups were (77. 5 ± 16. 2) mL and (66. 5 ± 12. 3) mL re-spectively (P>0. 05). After side clamping descending aorta,femoral blood pressure significantly decreased in descending aorta group,and the two dogs had melena after operation. Conclusion Off-pump coronary artery bypass graft models were both constructed successfully by the two ways. Descending aorta group of femoral artery blood pressure violently fluctuated and had abdominal organs’ ischemia reperfusion in-jury. Though brachiocephalic artery group anastomosis group spent a little longer time,they had stable artery blood pressure during operation. As a result,the way of constructing animal model of brachiocephalic artery group is safer.

Objective To evaluate the clinical effect of InterTAN (IT) and dynamic hip screw (DHS) in treatment of femoral intertrochanteric fractures.Methods From July 2008 to November 2011,the patients with femoral intertrochanteric fractures were treated by IT (IT group,21 patients) and DHS (DHS group,35 patients).The intraoperative data (operative time,intraoperative blood loss,incision length and hospitalization period),postoperative complications (wound infection,lower limb deep venous thrombosis,bedsore,urinary tract infection and pneumonia) and fracture healing (fracture healing time,femoral neck crispation,coxa vara and Harris scores) were compared.Results IT group was superior to DHS group in operative time,intraoperative blood loss,incision length and hospitalization period [(62.16 ± 15.26) min vs.(85.78 ± 19.50) min,(237.73 ± 108.51) ml vs.(490.87 ± 127.90) ml,(10.20 ±2.02) cm vs.(19.83 ± 2.98) cm and (10.23 ±5.52) d vs.(15.58 ±5.32) d,P ＜0.01].However,there was no significant difference in postoperative complications (P ＞ 0.05).There was significant difference between IT group and DHS group in femoral neck crispation,coxa vara [9.52％ (2/21)vs.28.57％ (10/35),14.29％ (3/21)vs.31.43％ (11/35),P ＜ 0.01].There was no significant difference in fracture healing time and Harris scores (P ＞ 0.05).Conclusions Compared with DHS,IT has extensive application,shorter surgical time and reliable fixation effect.Therefore,IT is suitable to femoral intertrochanteric fractures.

In this study, we prepared the acellular bone matrix of the inbred-line Banna mini-pig by using tissue engineering method and evaluated its possible application in bone tissue engineering. Histological analysis, xenoantigen expression and biomechanical measurement were performed on the matrix. HE staining and scanning electron microscopy showed the cellular components were almost removed. Immunohischemical result demonstrated that the xenoantigen, alpha-gal,was also eliminated. There was no statistically significant difference between the acellular bone matrix group and control group. The acellular bone matrix can provide appropriate space structure and strength for grafts. In conclusion, our data suggest that acellular bone matrix is a new kind of ideal bone scaffold material.
Animals ; Antigens, Heterophile ; analysis ; Biomechanical Phenomena ; Bone Matrix ; immunology ; Female ; Male ; Stress, Mechanical ; Swine ; Swine, Miniature ; Tissue Engineering ; alpha-Galactosidase ; analysis

This study sought to explore the change of the major histocompatibility complex (MHC) antigen expression and the endothelization of blood vessel in minor pig after trypsin treatment, and to provide data for xenotransplantation and pig vessel for use in tissue engineering. Western blot assays were conducted for detecting the expression of MHC xenoantigens. Scanning electron microscopy was used for checking the endothelization of decellularized blood vessel. The results showed that MHC antigen is not expressed after trypsin treatment. The endothelization is accomplished. The endothelial cells have normal morphological distribution. These demonstrate that the antigen of pig aorta is significantly decreased and it can be used for constructing new vascular grafts.
Animals ; Bioprosthesis ; Blood Vessel Prosthesis ; Cells, Cultured ; Endothelial Cells ; cytology ; Female ; Major Histocompatibility Complex ; physiology ; Male ; Swine ; Swine, Miniature ; Tissue Engineering ; methods ; Tissue Scaffolds

Objective To provide experimental data by exploring the anatomic structure of adult corpus penis vein and lymphatic vessel and the length after releasing penile superficial ligament. Methods The penis length of 16 adult corpuses was measured immediately after releasing the superficial ligament, and make a statistical analysis between the prolonged portion and corpus height. A total of 40 cases of fresh penis specimens were divided averagely into two groups which were performed by vascular casting, indirect-injection of lymphatic vessel, shiff stating and dissection to observe their anatomic structure. Results Prolonged penis length ranged from 2-3 cm. Indian ink of 10% injected from penile glans and frenulum of prepuce mainly flew back through dorsal and lateral lymphatic vessel, but not through ventral vessel. Conclusion Penis can be prolonged about 2-3 cm by releasing the superficial ligament out of erectile condition. One-third proximal lateral area is advised for injection of bulbocavernosus body because blood vessels are less here. Obstinate edema after penis lengthening surgery has a close relation with the damnification of dorsal superficial vein and dorsal and lateral lymphatic vessel of penis.

OBJECTIVETo explore the diagnostic value of MRI and SPECT in early postburn brain edema in severely burned dogs.

METHODSTwenty-six mongrel dogs were randomized into control (n = 6) and burned groups in which every 5 dogs were allotted to each of following time points: 6, 12, 18 and 24 postburn hours (PBHs). The dogs in burn groups were inflicted with 50% TBSA of III degree skin burn and were infused with 5% glucose solution after 6 PBHs, so that severe early postburn brain edema was produced. MRI and SPECT were employed to observe dynamically the brain of dogs in all groups. The results were collected and compared with one another.

RESULTSThe results indicated that with MRI brain morphological change of early brain edema could be shown as early as within 12 PBH and diffuse brain edema became more obvious with elapse of time. The changes might be difficult to be found by MRI when T(1)WISIR decreased below 10%. T(2)WI SIR increased by 8.29% at 24 PBH with blurred demarcation between the brain gray and white matters. There was diffused and progressive nuclide ((99)TCm-ECD) concentration in the brain tissue as shown by SPECT at 6 PBH. The radio-nuclide taking ratio increased significantly after 12 PBH, especially at 24 PBH (P < 0.01) when compared with that before burn.

CONCLUSIONCombined application of MRI and SPECT could evidently increase sensitivity and specificity in the diagnosis of early postburn brain edema.

Animals ; Brain Edema ; diagnosis ; diagnostic imaging ; Burns ; complications ; Dogs ; Magnetic Resonance Imaging ; Male ; Tomography, Emission-Computed, Single-Photon

To explore the changes of the antigen expression and the biomechanical characteristics of blood vessel in Banna little ear pig before and after trypsin treatment, and provide data for xenotransplantation and pig vessel using for tissue engineering. Geometric morphology and microstructure of pig cartoid artery were stuided quantitatively by histologic method and computer image analysis. The relationship between pressure and diameter was observed at different period of time before and after trypsin treatment. Affinity-immunohistochemistry assay was conducted to detect the expression of xenoantigens (alpha-Gal). The results showed that alpha-Gal antigen is only expressed in vascular endothelial cellsouly. There is no significant difference in blood vessel compliance. These demonstrate that the antigenicity of pig carotid artery is significantly reduced, however, the mechanical characteristics did not change significantly. We suppose that pig vessels treated by trypsin can be used as the substrate material for vascular tissue engineering.
Animals ; Animals, Inbred Strains ; Antigens, Heterophile ; biosynthesis ; Blood Vessels ; drug effects ; physiology ; Female ; Male ; Stress, Mechanical ; Swine ; Tissue Engineering ; Trypsin ; pharmacology

Objective To study GAP\|43mRNA expression during nerve injure and regeneration. Methods Rat sciatic nerve was crushed then, in situ hybridization technique was used to explore GAP\|43mRNA expressions in spinal cord and dorsal root ganglion (DRG). Results The neurons of spinal cord and DRG were detected to have GAP\|43 hybridization sinal by 2 days after sciatic nerve lesion. At later times(4,7 and 14 days postsurgery) the anterior horn motor neurons and DRG cells showed an increase in the number of GAP\|43mRNA positive neurons, followed by a significant rise in their content of GAP\|43mRNA. The number of GAP\|43mRNA positive neurons was decreased by 30 days postinjure, and was nearly nomal 60 days postinjure.Conclusion GAP\|43mRNA expression was increased during peripheral nerve injure and regeneration. The study showed that GAP\|43 may play a key role in nerve regeneration. [