[Objective]To discuss the outcome of acetabular protrusion after total hip arthroplasty. [Method]Fifteen patients(M=7,F=9) having painful acetabular protrusion received total hip arthroplasty with reinforcement of the acetabulum with bone grafts(autogenous or allogeneous bone).The results were reported at 1~4 years(mean,3 years) of follow-up.Of the 15 cases,5 were mild protrusion and 10 were moderate protrusion.The Harris hip-rating and radiographs were taken pre-and postoperatively. [Result]The average Harris hip-rating was improved from 45 points(range,39~60 points) preoperatively to 85 points(range,70~100 points) postoperatively.The average preoperative protrusion of the femoral head medial to the Kohler line was 8.8 mm(6~18 mm).The average postoperative placement of the prosthetic femoral head was 10 mm(6~13 mm) lateral to the Kohler line.None acetabulum prothesis failure or bone grafts absorption was seen.The grafts were well incorporated on radiograms in all patients one year after operation by radiographs. [Conclusion]Good results can be obtained in hips with acetabular protrusion after reconstructed with autogeneous or allogeneous bone grafting and total hip arthroplasty.

Objective To explore the influence of new Xuefuzhuyu decotion on IgG,C3 and C4 of peripheral blood in atherosclerosis rats.Methods Healthy adult Wister rats were selected and randomly divided into blank group,AS model group,new Xuefuzhuyu decoctioin low dosage group,the new Xuefuzhuyu decoctioin high dosage group,and positive control group,with 13 cases in each group.Vitamin D3 joint high fat feeding method was adopted to establish atherosclerosis rat model.Medicine lavage began on the first day of experiment.Low dosage new Xuefuzhuyu decoctioin,high dosage new Xuefuzhuyu decoctioin,and atovastatin were administrated to the new Xuefuzhuyu decoctioin low dosage group,the new Xuefuzhuyu decoctioin high dosage group,and positive control group respectively,and distilled water 15 ml/kg · d-1 was administrated to both the blank group and the AS model group.The weight of body was detected each week in each group for regulating the administrated dosage.After medicine lavage was performed for successive 8 weeks,blood was obtained from abdominal aorta for detecting IgG,C3,C4 by immune scattering method.Results The value of IgG,C3 and C4 were (8.110±0.720)g/L,(1.591±0.143)g/L,(0.390±0.33)g/L in the AS model group,(8.000±0.840)g/L,(1.564± 0.132) g/L,(0.396±0.36)g/L new Xuefuzhuyu decoctioin low dosage group,(7.250±0.740)g/L,(1.390±0.150)g/L,(0.326±0.153)g/L new Xuefuzhuyu decoctioin high dosage group and (7.240±0.400) g/L,(1.414 ± 0.104) g/L,(0.330±0.164) g/L in the positive control group,all of which werehigher than the blank group (5.810±0.820)g/L,(0.943±0.124)g/L,(0.330±0.164)g/L with statistically significant difference (P＜0.05).Each value of IgG,C3 and C4 in the new Xuefuzhuyu decoctioin high dosage group and the positive control group were lower than the AS model group and the new Xuefuzhuyu decoctioin low dosage group,with a statistically significant difference(P＜0.05).There was no significant difference between new Xuefuzhuyu decoctioin high dosage group and the positive control group (P＞0.05).Conclusion New Xuefuzhuyu decoction can ameliorate IgG,C3 and C4 of peripheral blood in atherosclerosis rats.Its function was similar to atorvastatin.

Objective To investigate DNA double-strand breaks and radiosensitization in renal carcinoma 786-O cells induced by fludarabine (FA) combined with different ionizing radiations.Methods The 786-O cells were exposed to FA combined with X-ray or heavy ion beam irradiation.Flow cytometry was used to evaluate the percentage of γH2AX-positive cells and cell cycle.The neutral comet assay was used to detect DNA double-strand breaks.The colony-forming assay was used to evaluate the effects of different treatments on cell survival.Comparison between groups was made by one-way analysis of variance or Dunnet' s t test.Results Compared with FA alone or irradiation alone,FA combined with different ionizing radiations increased DNA double-strand breaks as shown by significantly increased levels of γH2AX (P=0.007,0.001);FA combined with heavy ion beam irradiation lead to a cell cycle block at the radiosensitive G2/M phase and significantly increased the expression of γH2AX in the G2/M phase (P=0.000,0.000);the neutral comet assay revealed that FA combined with irradiation significantly increased DNA sublethal damage (P=0.020,0.060);FA significantly reduced the colony-forming rate after irradiation (P=0.000,0.030;0.001,0.040).Conclusions FA enhances the effects induced by X-ray and heavy ion beam irradiation with different properties.Particularly,FA substantially enhances the cell death induced by heavy ion beam irradiation.

Objective To compare the effect of Baikerui compound lysostaphin (FE complex phosphoesterasum) disinfectant and povidone iodine in treatment of burn wound infection resulted from gram-positive (G ±) coccus.Methods The study involved 60 patients with superficial second degree burns (1％-5％ TBSA； age range of 18-50 years).All the patients received bacterial culturing of wound secretions prior to treatment.Every 20 patients were indentified with infection of staphylococcus aureus (SA),staphylococcus epidermidis (SE),and enterococcus (EC) respectively and randomized into control group and experiment group,with 10 patients per group.Patients allocated to the experiment group were covered with four-layer sterile gauze soaked into the Baikerui compound lysostaphin disinfectant,while the patients in the control group were treated with four-layer sterile gauze soaked into the povidone iodine.Dressing was changed once a day.Wound culturing was performed again at each day of the 5-day treatment.Wound healing was compared among each group.Results SA wound infection turned negative for all the 10 patients in experimental group and three patients in control group (P ＜ 0.01).SE wound infection turned negative for all the 10 patients in experimental group and six patients in control group (P ＜ 0.05).EC wound infection turned negative for nine patients in experimental group and seven patients in control group (P ＞ 0.05).Mean wound healing time was (10.87 ± 1.93) days for experimental group and (13.31 ± 2.89) days for control group (P ＜ 0.05).Conclusion Baikerui compound lysostaphin disinfectant can effectively prevent burn wound infection with common G + coccus and accelerate wound healing.

The First Affiliated Hospital of Zhejiang University founded an online hospital campus leveraging the Internet-plus environment. Supported by the offline hospital, this campus made full use of Internet features and advantages in its attempts to optimize the distribution of medical resources,to improve the accessibility of medical service, to reduce medical costs, and to expand the service coverage among others. Meanwhile,this online system, via interconnection with the hospital′s HIS system, achieved online medical insurance payment,prescriptions checking and drug delivery service.

Objective To retrospectively study the serum IgG and IgM antibodies against toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1&2 in various populations, and analyze the clinical values.Methods From 2008 to 2015, 2 661 pregnant women, 324 infertile women, 2 492 women with abnormal pregnancy history, 623 women with recent abnormal pregnancy, 261 infants with intrauterine growth retardation and other diseases, 170 women for preconceptual examination, and 702 women for physical examination in Beijing were included .Commercial EIA kits were used to detect serum IgG and IgM antibodies to toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1&2. Positive reactions of IgM antibodies to any pathogens were re-tested with another kind of commercial EIA kit. PEMS3.1 software was used for statistical analysis.Results The prevalence of serum IgG or IgM antibodies against toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1& 2 were found within 0.7%-1.6%(0-1.2%) , 85.3%-92.0% ( 0.4%-2.7%) , 89.1%-94.9% ( 0.7%-1.7%) , 74.8%-86.0% ( 0 -0.7%) , 8.1% -17.4% ( 0 -4.1%) respectively in the studied population groups.The prevalence of TORCH IgG and IgM antibodies were not found to be higher in both populations with past suspicious exposure ( infertile women and women with abnormal pregnancy history ) and recent suspicious exposure ( women with recent abnormal pregnancy and infants with intrauterine growth retardation and other diseases) than that in pregnant women and women for preconceptual and physical examination. Conclusion No associations between TORCH infections and the suspicious exposure were found in the populations above.

Purpose: To investigate the effectiveness of a structured death education program for older adults with chronic illness and their family caregivers. Methods: This study adopted two-group, nonrandomized quasi-experimental design. Patient–caregiver dyads in the intervention group (N = 40 dyads) engaged in the death education program at the bedside once a week for 5 weeks, and were compared with participants (N = 40 dyads) in the control group who received usual health education. The program consisted of five sessions based on the Interaction Model of Client Health Behavior. Death attitude, death competence, well-being, family function, and satisfaction were measured at baseline (T0), immediately after the intervention (T1), and 1 month later (T2). Data collection was conducted from July 30, 2019, to December 30, 2019. Results: The intention-to-treat analysis The intention-to-treat analysis of between groups at 1-month follow-up revealed that the intervention group had greater decreases in the fear of death (p=.002, 95% CI -2.53, -0.47; p<.001, 95% CI -3.61, -1.65) and death avoidance (p<.001, 95% CI -3.46, -1.84; p<.001, 95% CI -3.89, -2.43), had greater increases in the neutral acceptance (p=.032, 95% CI 0.05, 1.38;p<.001, 95% CI 0.99, 2.56) and death competence (p<.001, 95% CI 4.10, 8.01; p<.001, 95% CI 7.80, 12.11) in patients and caregivers, respectively. There were significant intergroup differences over time for patient well-being of (p<.001, 95% CI 3.06, 9.74) and satisfaction of (p<.001, 95% CI 2.01, 4.59). Results were consistent with the results from the sensitivity analysis. Conclusion This study demonstrated the feasibility and benefits of death education in hospitals and provided an implementation plan for nursing professionals. Nurses should consider providing death education for older adults with chronic diseases and their families to promote the development of palliative care and the quality of end-of-life.

Purpose: To investigate the effectiveness of a structured death education program for older adults with chronic illness and their family caregivers. Methods: This study adopted two-group, nonrandomized quasi-experimental design. Patient–caregiver dyads in the intervention group (N = 40 dyads) engaged in the death education program at the bedside once a week for 5 weeks, and were compared with participants (N = 40 dyads) in the control group who received usual health education. The program consisted of five sessions based on the Interaction Model of Client Health Behavior. Death attitude, death competence, well-being, family function, and satisfaction were measured at baseline (T0), immediately after the intervention (T1), and 1 month later (T2). Data collection was conducted from July 30, 2019, to December 30, 2019. Results: The intention-to-treat analysis The intention-to-treat analysis of between groups at 1-month follow-up revealed that the intervention group had greater decreases in the fear of death (p=.002, 95% CI -2.53, -0.47; p<.001, 95% CI -3.61, -1.65) and death avoidance (p<.001, 95% CI -3.46, -1.84; p<.001, 95% CI -3.89, -2.43), had greater increases in the neutral acceptance (p=.032, 95% CI 0.05, 1.38;p<.001, 95% CI 0.99, 2.56) and death competence (p<.001, 95% CI 4.10, 8.01; p<.001, 95% CI 7.80, 12.11) in patients and caregivers, respectively. There were significant intergroup differences over time for patient well-being of (p<.001, 95% CI 3.06, 9.74) and satisfaction of (p<.001, 95% CI 2.01, 4.59). Results were consistent with the results from the sensitivity analysis. Conclusion This study demonstrated the feasibility and benefits of death education in hospitals and provided an implementation plan for nursing professionals. Nurses should consider providing death education for older adults with chronic diseases and their families to promote the development of palliative care and the quality of end-of-life.

Objective To assess the effect of low-dose cytarabine and aclarubicin in combination with gran-ulocyte colony-stimulating factor (G-CSF) protocol (CAG) in patients with acute myeloid leukemia (AML),and to understand the potential factors affecting the outcome of CAG induction therapy, therefore to find the optimum pa-tients for CAG therapy. Methods Twenty-one AML patients were enrolled in the current study. All patients were treated with CAG regimen including cytarabine (10 mg/m~2, subcutaneously, every 12 h, days 1 - 14), lacinomycin (5～7 mg/m~2,intravenously,every day, days 1 -8) ,and G-CSF (200 μg/m~2,subcutaneously, every day,12 h be-fore Ara-C was given) priming. Results The overall complete remission (CR) rate of the 21 AML patients was 66.7% (14/21). The CR rates was 87.5% (7/8) in patients older than 60 yrs,60.0% (9/15) in the refractory or relapsed patients,83.3% (5/6) in the MDS transformed AML patients. The CR rates for patients with hyperprolif-erative BM and median to poor proliferative BM were 33.3% and 91.7% ,respectively(P =0.009). The median o-verall survival (OS) time of the 21 AML patients was 450 days. Two-year survival rate estimated by Kaplan-Meier Method was 30.6%. The overall median disease free survival (DFS) was 165 days. The median OS time for those refractory or relapsed was 435 days. The median OS time for those with poor cytogenetic state or standard or good cytogenetic state was 140 days and 620 days, respectively (P = 0.001). The median OS time for patients with hyperproliferative BM and median to poor proliferative BM was 321 days and 620 days, respectively (P = 0.05). The median recovery time of granulocytes above 1.0×10~9/L was 8 days. The median duration of fever was 3.5 days. The rate of infections exceeding WHO grade Ⅱ was 42.9%. No early death occurred. Conclusions The CAG induction therapy may have a higher CR rate in patients with refractory or relapsed AML, elderly AML and secondary AML from MDS transformation, and extend the median overall survival time in refractory or relapsed patients. CAG therapy can not improve the outcome of patients whose BM was in high grade proliferation state or whose cytogenetic state was poor. CAG therapy can shorten the duration of agranulocytosis and decrease the inci-dence of serious infection. Therefore, CAG therapy is worth recommending to patients who can not endure the rou-tine intensive chemotherapy.

Objective To study the antitumor effects of exosomes derived from heat-shocked E.G7-OVA tumor cells in vivo. Methods Exosomes derived from E.G7-OVA tumor cells were isolated and purified by serial centrifugation and sucrose gradients ultracentrifugation. Exosomes from heat-shocked or non-heat-shocked E.G7-OVA tumor cells were named as Exo/HS and Exo correspondingly. Exosomes were viewed by electron microscopy. Protein components of exosomes were detected by Western blot. Exo, Exo/ HS or PBS were injected into mice before injection of E.G7-OVA tumor cells, and antitumor effects were ob-served in each group. Mouse model bearing E.G7-OVA tumor cells were established to examine immunother-apy effects of Exo or Exo/HS. Cytotoxity of spleen CTL were measured by LDH. Results Exosomes con-tained bi-layer membrane and their diameters are between 40 nm and 100 nm under electron microscopy. The Western blot results showed that HSC70, HSP70, HSP60, HSP90, MHC Ⅰ and OVA were present in both Exo and Exo/HS. However, Exo/HS contained more HSP70 and MHC Ⅰ than Exo. Protective antitu-mor immunity suggested that tumor-free survival (90 days) rate in Exo/HS vaccinated mice was significantly higher than those in Exo or PBS vaccinated mice (50%, 20%, 0%, P<0.01). Therapeutic antitumor effects showed that immunization by Exo/HS resulted in dramatically enhanced antitumor effects when com-pared to the Exo- or PBS-treated groups (P<0.01). CTL results showed that immunization with Exo/HS in-duced higher level of OVA-specific CTL responses as compared with those from Exo or PBS (P<0.01). Conclusion Exosomes derived heat-shocked E.G7-OVA tumor cells may be used as potent cancer vaccine.