BACKGROUND:The outcomes of SL-Plus? stem in primary total hip arthroplasty have been proved good, but whether SLR-Plus? revision stem can obtain a good outcome in revision hip arthroplasty needs more studies. OBJECTIVE:To observe the clinical results of revision hip arthroplasty with Zweymül er SLR-plus ? stem. METHODS:Revision hip arthroplasty of 41 hips in 39 patients was performed from November 1997 to May 2013 using SLR-plus ? stem. There were 26 hips (male) and 15 hips (female). They were at the age of 34-73 years old, 53 on average. In the 41 hips, 36 cemented and 5 uncemented femoral prostheses were used. Prosthetic changes on radiographs were observed. In accordance with Brooker classification, heterotopic ossification was classified to record the region and incidence of heterotopic ossification. Hip joint function was evaluated using Harris Hip Score, and survival rate of the prosthesis was analyzed. RESULTS AND CONCLUSION:A total of 31 patients (33 hips) were fol owed up for 1 to 16 years. The mean preoperative Harris hip score of 34 (range, 13-64) points improved to 85 (range, 55-94) points at the time of final fol ow-up. 32 hips (97%) had an excellent result. A 1 mm width radiolucent line was found in 1 femoral component without any symptom. Osteolysis and migration were seen in 1 hip, which needed re-revision. Heterotopic ossification developed in 9 hips, including 2 hips of Brooker grade 1, 4 hips of grade 2 and 3 hips of grade 3. No re-infection was found. Kaplan-Meier survivorship was 92%with radiographic loosening as the end point. Results demonstrated that the SLR-Plus? stem has sufficient immediate and long-term stability, which is reliable for patients undergoing hip revision surgery.

To evaluate the immunities of biodegradable microsphere as a release delivery system for DNA vaccine against Infectious Bursal Disease Virus, in our study, silk fibroin/chitosan microsphere adjuvant was prepared with a precipitation/coacervation method. Both glutaraldehyde and Na2SO4 solution were used in cross-linking. No immune chicken were intramuscularly inoculated at 14 day-old and boosted 2 weeks later. The results show that glutaraldehyde destroyed the DNA activity of the vaccine whereas Na2SO4 solution did not. Factors of the chitosan concentration 0.5% (pH 5.0), silk fibroin concentration 0.6%, plasmid DNA (500 microg/mL) dissolved in 2% Na2SO4 solution were optimized to produce microsphere, with a loading capacity of 89.14%. The average particle size of SF-CS/pCI-VP2/4/3 microsphere is 1.98 microm, and it can protect the loading DNA vaccine from DNase I digestion. Data from anti IBDV ELISA antibodies in the serum show that immunization activity of the microsphere groups were generally higher than plasmid vaccine group (P < 0.05), and the SF/CS compound microspheres group was better than that of sole CS microsphere group. The developed SF/CS microspheres are a very promising vaccine delivery system.
Adjuvants, Immunologic ; chemistry ; Animals ; Birnaviridae Infections ; prevention & control ; veterinary ; Chickens ; Chitosan ; chemistry ; Fibroins ; chemistry ; Infectious bursal disease virus ; Microspheres ; Plasmids ; Poultry Diseases ; prevention & control ; Vaccines, DNA ; chemistry ; Viral Vaccines ; chemistry

Objective To investigate the changes of fibrinogen and D -dimer levels in patients with severe burn and their relationship with prognosis .Methods 90 patients with severe burn were selected as the subjects .The patients were divided into the dead group (30 cases) and the survival group (60 cases) according to the prognosis of the patients.The differences and changes of fibrinogen and D -dimer at the same time after admission were compared between the two groups .Results At each time point after admission , the fibrinogen levels of the death group were significantly higher than those of the survival group at the same time [(5.9 ±1.5)g/L vs.(5.1 ±1.3)g/L,(8.8 ± 2.2)g/L vs.(7.4 ±2.5)g/L,(7.6 ±2.8)g/L vs.(5.7 ±1.2)g/L,(7.1 ±2.5)g/L vs.(4.3 ±1.7)g/L],the differences were statistically significant(t =3.892,4.762,5.436,6.987,all P <0.05).At each time point after admission,the D-dimer levels of the death group were significantly higher than those of the survival group at the same time[(743.4 ±226.2)ng/mL vs.(704.1 ±214.6)ng/mL,(935.4 ±256.9)ng/mL vs.(834.6 ±256.2)ng/mL, (846.3 ±291.5)ng/mL vs.(712.1 ±251.3) ng/mL,(756.7 ±232.8) ng/mL vs.(601.5 ±168.7) ng/mL],the differences were statistically significant (t=3.895,5.477,4.743,5.746,all P<0.05).The level of D-dimer in the survival group showed a rise firstly ,then showed a decrease trend after admission ,while the levels of fibrinogen and D-dimer of the death group were altered in double -peak change .Conclusion There is an obvious impairment of coagulation function in severe burn patients , and the level of D -dimer and fibrinogen is higher , the prognosis of patients is worse .

With the construction and development of head and neck tumor, diagnosis and treatment technology and survival rate of patients have been improved in different degrees. Nurses play an important role as managers and practitioners in the treatment and rehabilitation of patients with head and neck tumors, and it is very important to evaluate and manage the treatment and prognosis of head and neck tumor patients scientifically. In this context, the American Cancer Society launched the Head and Neck Cancer Survivorship Care Guideline in 2017 and was endorsed by the American Society for Clinical Oncology. This paper mainly discusses the forming process of the guidelines, the main points of the consensus of experts, the guiding role of the guidelines in clinical work and the obstacles and limitations of the guidelines.

OBJECTIVETo study the immunogenicity and safety of recombinant yeast-derived hepatitis B vaccine (YDV) in adults.

METHODSOne hundred and twenty-four healthy teachers aged 22 approximately 58 years with serum negative HBsAg, anti-HBs, anti-HBc and with normal temperature were randomly selected from Beipiao city, Liaoning province. All the subjects were immunized with 5 microg/0.5 ml of YDV made by Beijing Institute of Biologic Products, for three doses at an interval of one and six months, respectively.

RESULTSThe positivity of serum anti-HBs was 35.0%, 83.3%, 65.5% and 32.7% with a geometric mean titre (GMT) of 12.6 mIU/ml, 402.0 mIU/ml, 70.3 mIU/ml and 20.3 mIU/ml, respectively, three, seven, 12 and 24 months after immunization. The positivity and GMT of serum anti-HBs appeared the highest seven months after immunization, then began to decrease sharply. The positivity and GMT of serum anti-HBs in women was higher than that in men either three, or seven, or 12, or 24 months after immunization. The positivity of serum anti-HBs in those of 35 years or over was lower than that less than 35 years, seven months after immunization, but no age difference could be found 12 months after immunization. No local or systematic adverse reactions were found in all the subjects within three days after immunization.

CONCLUSIONThe recombinant yeast-derived hepatitis B vaccine (YDV) is immunogenic and safe for adults, but the persistency of serum anti-HBs in after immunization should be followed-up further.

Adult ; Age Factors ; Hepatitis B Antibodies ; blood ; Hepatitis B Vaccines ; immunology ; Humans ; Immunization ; Middle Aged ; Sex Factors ; Vaccines, Synthetic ; immunology ; Yeasts ; genetics

Objective:To explore the application effect and learning experience of the medical MOOCs teaching design model based on live streaming platform constructed by the research group in its previous research.Methods:The preparation of the design patterns from the teaching, teaching activities and teaching evaluation of the three dimensions based on the questionnaire, and 368 junior undergraduates majoring in clinical medicine in Batch 2018 of Army Medical University who had applied the online teaching of medical MOOC instructional design mode based on live broadcast platform were selected as the survey objects. And learners' satisfaction and learning experience with this teaching model was analyzed. SPSS 25.0 was used for t test. Results:In the study, 74.2% (273/368) of the learners believed that the teaching design model of medical MOOCs based on live streaming platform had good effect and was helpful to themselves; 60.6% (223/368) of the learners had a high degree of satisfaction, with good teaching effect feedback. In terms of the mastery of MOOCs knowledge content, the final English score of the experimental group (429.03±35.86) was better than that of the control group (401.87±25.85), with statistical significance ( P<0.05). Conclusion:The teaching design model of medical MOOCs based on live streaming platform is applicable, and helpful to improve online learning experience, solve the problem of insufficient interaction in MOOCs learning, and provide practical basis and method reference for the innovative application of teaching model in medical colleges and universities in China.

ObjectiveTo evaluate the efficacy and safety of Rongjin Tongbi decoction on sciatica caused by lumbar intervertebral disc herniation with liver and kidney deficiency type based on a randomized controlled study. MethodFrom January 2019 to July 2022， 90 patients in the department of Traditional Chinese medicine（TCM） of Beijing Jishuitan Hospital who met the inclusion criteria were selected and divided into two groups according to the random number table， with 45 patients in each group. During the study， 19 cases dropped out， with 41 cases included in the final observation group and 30 cases in the control group. The observation group was given Rongjin Tongbi decoction orally， and the control group was given Loxoprofen Sodium Tablets orally for 28 days. The differences in the visual analog scale （VAS） scores， the Japanese Orthopaedic Association （JOA） scores， activities of daily living （ADL） assessments， TCM clinical symptoms， subjective symptoms， and clinical signs scores between two groups before and after treatment were observed. Liver and kidney functions and gastrointestinal adverse reactions were detected for safety evaluation. ResultBefore treatment， there was no statistically significant difference in scores between the observation group and the control group. After treatment， the absolute values of the differences in VAS and ADL scores in the observation group were higher than those in the control group （P<0.05）. There was no statistically significant difference in the absolute value of the difference in JOA scores between two groups. The absolute value of the difference in TCM clinical symptom scores in the observation group was higher than that in the control group （P<0.01）. There was no statistically significant difference in the absolute values of the differences in subjective symptom and clinical sign scores between two groups. The levels of liver and kidney function indicators in both groups before and after the experiment were normal， and there was no significant difference in gastrointestinal reactions. ConclusionRongjin Tongbi decoction can significantly improve the symptoms of sciatica patients caused by lumbar intervertebral disc herniation with liver and kidney deficiency type. After treatment， the patients exhibited significant improvements in pain， activity and other aspects， and it is proven to be safe and reliable， which is conducive to the recovery of physical function.

Platelet-rich plasma (PRP), the concentration of platelet and plasma, is rich of a variety of growth factors.It plays an important role in anti-inflammatory and tissue regeneration, and has gradually been used in cosmetology in the recent years.This paper introduces the application of PRP in facial rejuvenation, acne and alopecia treatment, as well as improving the survival rate of autologous fat transplantation. The side effects and prospectives of PRP application in cosmetology were also summarized.

Osteoporosis is an important cause of bone weakness and susceptibility to fractures. Anti-osteoporosis drugs of Western medicine cannot reverse its progression， and can only reduce the loss of bone density； long-term use of them is accompanied by certain adverse reactions. Traditional Chinese medicine focuses on syndrome differentiation and holistic approach， which can make up for the shortcomings of Western medicine’s treatment. The mammalian target of rapamycin （mTOR） signaling pathway is involved in the growth， proliferation， and differentiation of bone cells， and is closely related to the occurrence and development of osteoporosis. In recent years， various traditional Chinese medicine monomers （such as flavonoids， polysaccharides， alkaloids， etc.） and traditional Chinese medicine formulas （such as Bushen huoxue decoction， Liuwei dihuang pills， Erzhi pills， etc.） have been proven to promote bone formation， inhibit bone resorption， enhance bone cell autophagy， and delay the progression of osteoporosis by regulating the mTOR signaling pathway. Therefore， the article summarizes the traditional Chinese medicine monomer and formula that intervene in the mTOR signaling pathway for the treatment of osteoporosis， in order to provide medication ideas for the traditional Chinese medicine treatment of osteoporosis.