[Objective]To analyze and prevent postoperative dislocation after total hip replacement(THR). [Method]Among 311 cases of THR treated from Jan 2001 to Dec 2006,15 developed dislocation.These cases were retrospectively reviewed and their risk factors were investigated.[Result]Six months after THR,15 patients(4.82%) had postoperative dislocation.Among them 11 had primary procedure and 4 had revision procedure.The dislocation rates were 4.00% and 11.11%,respectively.This difference was statistically significant(P

Local anesthetics have neurotoxicity, which can lead to temporary or permanent sensory and motor dysfunction.And regional anesthesia is commonly used in diabetics undergoing limbs or lower abdominal surgery, so that local anesthetics were widely used in them.However local anesthetics sensitivity in patients with diabetics is not yet clear.In this paper, we will discuss the problem and make a summary.

To evaluate the treatment effect of the late avascular necrosis of femoral head with concentrated autologous bone marrow and impaction autologous bone graft. The clinical data of 35 patients with late avascular necrosis of femoral head treated with the above methods was analyzed retrospectively with the University of Pennsylvania staging system, and evaluated with Harris hip score system. Among the 35 patients, there were 8 at stage Ⅲ, 23 at stage Ⅳ and 4 at stage Ⅴ. The preoperative Harris hip scores ranged from 43-72 with the average scores of 49. The patients were followed up for at least one year with the mean time of 2 years and 3 months. Two patients (preoperative at stage Ⅴ) had received total hip replacement duo to severe pain and ostarthritis. The imageology in 5 patients showed that the femoral head appearance collapsed little compared with that before operation, but their subjective feelings were well. All the femoral heads of left patients remained the shape after operation, complains of pain disappeared or lessened. The overall successful rate was 94% (33/35). In Harris scale, there was 1 patient with 92 scores, 17 with 80-89 scores, 3 with 70-79 scores and 2 patients

Objective To investigate effects of neuromuscular electrical stimulation (NMES) on pulmonary arterial hypertension induced by chronic hypoxic hypercapnia in rats.Methods Eighteen male Sprague-Dawley rats were randomly divided into a normal control group (the control group),a hypoxic hypercapnia group (the model group),and a hypoxic hypercapnia + NMES group (the NMES group),each of 6.The rats in both the model and NMES groups were placed in an isobaric cabin with an O2 concentration of 9％ to 11％ and a CO2 concentration of 5％ to 6％ for 8 hours a day for 4 weeks.After leaving the cabin,NMES was performed on the NMES group's bilateral calf muscles for 30 minutes every day.The heart was removed,and the right ventricle (RV) and the left ventricle plus the septum (LV+S) were dissected.An index of right ventricular hypertrophy was calculated as RVHI=RV/(LV+S).Any changes in the pulmonary vasculature were observed using an optical microscope.WT％ and WA％ were calculated.The expression of hypoxia-inducible factor-1α (HIF-1α),PDH-E1α and PDK1 in the lung tissue were determined using western blotting.The LDH activity and the concentration of PDH in the lung tissue homogenate were measured was measured by spectrophotometric method using the LDH assay kit and ELISA,respectively.Results Compared with the control group,the average RVHI,WT％ and WA％,the protein expression of HIF-lα and PDK1,and LDH activity had all increased significantly in the NMES group,while the average expression of PDH-1Eα had decreased significantly.Compared with the model group,significant decrease was observed in the average RVHI,WT％,WA％,protein expression of HIF-1α and PDK1,and LDH activity in the NMES group,but the average expression of PDH-1Eα increased significantly.No significant differences in PDH concentration were detected among the 3 groups.Conclusions NMES may alleviate pulmonary artery hypertension induced by chronic hypoxic hypercapnia,at least in rats.The mechanism may be attributed to inhibiting the expression of HIF-1α protein,which may inhibit the activity of PDH-E1α and LDH,then the aerobic metabolism into glycolysis,finally improving the remodeling of the pulmonary vascular structure.

Objective To evaluate the effect of Astragalus injection on serum SOD and MDA in patients during supratentorial tumor resection. Methods Twenty-four patients with ASAⅠorⅡ degree, aged 20~55 years old, undergoing supratentorial tumor resection were randomized into the control group (group C) and the Astragalus group (group R), with 12 cases in each group. Patients in group R received 250 mL 0.9% sodium chloride in addition with 20 mL Astragalus injection. Patients in group C received the same amount of 0.9%sodium chloride. Blood samples were taken from jugular venous bulb before induction of anesthesia (T1), intubation (T2), open dura instantly (T3), 1 h after the dura opened (T4), 24 h after the dura opened (T5), and 48 h after the dura opened (T6). The levels of serum SOD and MDA were determined. Results The serum SOD in both group R and group C was lower at T3~6 than that at T1 , but the serum SOD in group R reduced significantly compared with group C (P < 0.05); The serum MDA in both group R and group C at T4~6 was higher than that at T1, but the serum MDA in group R increased significantly compared with group C (P <0.05). Conclusion Astragalus injection can enhance the serum SOD activity and reduce MDA output in patients during supratentorial tumor resection.

Objective To evaluate the effects of penehyclidine hydrochloride combined with ulinastatin on brain injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-eight patients of both sexes,aged 20-64 yr,weighing 40-66 kg,of ASA physical status Ⅱ (NYHA Ⅱ),scheduled for elective cardiac valve replacement with CPB,were randomly divided into 4 groups (n =12 each) using a random number table:control group (group C),penehyclidine hydrochloride group (group P),ulinastatin group (group U),and penehyclidine hydrochloride and ulinastatin group (group PU).Penehyclidine hydrochloride 0.02 mg/kg was injected via the right internal jugular vein at 15 min before induction of anesthesia in group P.In group U,the total amount of ulinastatin was 2× 104 U/kg,30％ of the total amount was given via the right internal jugular vein after induction and before surgery,40％ was added to the priming solution,and the remaining 30％ was injected via the right internal jugular vein while the aorta was opened.In group PU,penehyclidine hydrochloride or ulinastatin was given according to the method previously described in group P or U.The equal volume of normal saline was given instead in group C.After induction and before surgery (T1),at 30 min of CPB (T2),and at 30 min and 6 h after termination of CPB (T3,4),blood samples were taken from the left internal jugular bulb and radial artery for blood gas analysis and determination of jugular venous oxygen saturation,jugular venous O2 content,arterial O2 content,and plasma concentrations of S-100β protein and neuron-specific enolase (NSE) (by ELISA).Arteriovenous oxygen content difference (Ca-jrO2) and cerebral O2 extraction rate (CERO2) were calculated.Results Compared with group C,SjvO2 was significantly increased,and CERO2 was decreased at T2.3 in P and U groups and at T2.4 in group PU,and Ca-jvO2 and plasma concentrations of S-100β protein and NSE were decreased at T2,3 in P,U and PU groups.The plasma concentrations of S-100β protein and NSE were significantly lower at T2,3 in group PU than in P and U groups.Conclusion The combination of penehyclidine hydrochloride and ulinastatin produces better efficacy than either alone in attenuating brain injury in patients undergoing cardiac valve replacement with CPB.

Objective Provided the basis on psychological treatment for the earthquake wounded, through investigated the psychological healthy condition of them in Yushu, Qinghai Province. Method To investigated the 102 cases earthquake wounded from 15 - 18 April 2010 who transported from Yushu, Qinghai to West China hospital of Sichuan University; Accept standard: The wounded (96 cases) who could cooperated this investigative; Adopted the Hamiton anxiety scale( HAMA) to had a review investigation for the wounded in the from of talk, and used the SPSS statistics software to have the Wilcoxon Mann-Whitney test and correlation analysis for the investigation data. Results There were 55 of the 96 cases have been confirmed anxiety, HAMA > 14 points; 16 cases had serious anxiety (HAMA > 29 points); The average score in all of them equal to (17.3 ±10.8) points. And there was a remarkable difference between male and female. The age is possible have related degree with the wounded anxious. What the main in their characteristics of them was Psychic anxiety. Conclusions There was apparent anxiety of them whom came from Yushu, Qinghai, and they needed proactive psychological treatment, female、 middle-aged and elderly need more.

Objective:To investigate the level of rumination and its influential factors among Chinese psychiatry nurses who go through work place violence.Methods:In this study, 150 psychiatry nurses were recruited from Affiliated Brain Hospital of Guangzhou Medical University (specialize in psychiatry), via the combination of convenient sampling and snowball sampling. Chinese Event-related Rumination Inventory (C-ERRI) was applied in the survey.Results:The total score of C-ERRI was (22.11±9.62) points, and the scores of intrusive rumination subscale and deliberate rumination subscale were (12.99±5.58) and (9.12±6.01) points, respectively. Multiple Linear Regression Analysis show that assault frequency in recent year ( B=-3.195, P<0.01) and whether got injury in the recent assault ( B=8.591, P<0.01) were predictors of deliberate rumination, which account for 26.8% variance of the equation. Gender (male) ( B=-2.415, P<0.01), Injury frequency in recent year ( B=2.864, P<0.01) and whether got injury in the recent assault ( B=8.949, P<0.01) were predictors of intrusive rumination. They account for 36.0% variance of the equation. Conclusion:In this study, the level of rumination among Chinese psychiatry nurses was low. Their rumination style was deliberate rumination.

Objective To assess the clinical therapeutic effects and safety of Jiangtang Shuxin decoction (JTSXD) on diabetic patients complicated with chronic heart failure (CHF),and to search for its possible function mechanisms.Methods A prospective randomized controlled study was conducted,80 diabetic patients complicated with CHF [New York Heart Association (NYHA) functional class Ⅱ-Ⅲ] admitted into the Department of Traditional Chinese Medicine (TCM) or of Cardiology in Affiliated Hospital of Guangxi Youjiang National Medical College from October 2015 to September 2016 were enrolled,they were assigned to an observation group and a control group by randomized method with a computer,and finally 77 patients (39 cases in observation group and 38 cases in control group) completed this trial.The patients in control group received standardized routine western medical treatment,while the observation group was additionally administered JTSXD (including ingredients:astragalus 15 g,ginseng 10 g,radix ophiopogonis 15 g,radix rehmanniae 15 g,comus 10 g,rhizome coptidis 8 g,peach kernel 10 g,salvia mitiorrhiza 10 g,magnoliaceae 10 g,yam 15 g) on the basis of conventional therapy.The therapeutic course for all the patients in both groups was 2 months.Before and after treatment,the 6-minute walking distance (6MWD) was assessed;the TCM syndrome accumulated scores of the two groups were calculated;the left ventricular end-diastolic volume (LVEDV),the left ventricle ejection fraction (LVEF),the stroke volume (SV),the cardiac output (CO),and the maximum blood flow velocity of early diastolic/atrium late diastolic (E/A) were detected by echocardiography.The serum levels of glycosylated hemoglobin (HbA1c),angiotensin Ⅱ (Ang Ⅱ) and plasma B type brain natriuretic peptide (BNP) were tested with enzyme linked immunosorbent assay (ELISA);the level changes of total cholesterol (TC),triglyeride (TG),high density lipoprotein cholesteral (HDL-C) and low density lipoprotein cholesteral (LDL-C) were observed.Results Compared with the control group,after treatment in the observed group,the TCM syndrome score of palpitation,fatigue and thetotal accumulated score were all obviously decreased (palpitation score:0.9 ± 0.4 vs.1.2 ± 0.8,fatigue score:1.1 ± 0.7 vs.1.7 ± 0.8,total accumulated score:4.8 ± 1.2 vs.8.1 ± 1.8,all P ＜ 0.05);the LVEDV,the serum levels of HbA1c,Ang Ⅱ and BNP were also obviously decreased in the observed group [LVEDV (mL):136.28 ± 17.52 vs.158.82 ± 19.03,HbA1c (％):6.11±0.36 vs.6.89 ±0.32,Ang Ⅱ (ng/L):66.48 ± 17.64 vs.84.55 ± 20.39,BNP (μg/L):138.45 ± 87.55 vs.219.14±88.83,all P ＜ 0.05];The 6MWD,LVEF,SV,CO and E/A were all increased plainly in the observed group [6MWD (m):470.47 ± 79.66 vs.428.46 ± 88.56,LVEF:0.51 ±0.05 vs.0.46 ± 0.04,SV (mL):55.36 ± 2.88 vs.50.32±2.76,CO (L/min):5.74±0.91 vs.4.92±0.74,E/A:1.18±0.27 vs.0.83±0.28,all P ＜ 0.05].The degrees of decreased levels in TC,TG,LDL-C and the degrees of increased levels of HDL-C in observed group were superior to those of the control group,but there were no statistical significant differences (all P ＞ 0.05).Conclusion JTSXD shows good therapeutic effect and safety for treatment of diabetic patients accompanied by CHF (NYHA functional class Ⅱ-Ⅲ),and its mechanisms may be related to its regulation of glucose (reduction of HbA1c level),correction of lipid metabolism disorders,improvement of myocardial energy supply,inhibition of the activation of renin-angiotensin-aldosterone system (RAAS) and the secretion of BNP.

Objective To analyze the imaging characteristics of lung cancer detected by LDCT ( low-dose CT )lung cancer screening. Methods Between July 1st, 2007 and June 30th, 2013, 7 141 asymptomatic enrolled participants aged 40-88 years old (male 4 710, female 2 431, median age 47), and 1 071 volunteer participants aged ≤39 underwent chest LDCT. The imaging characteristics were analyzed retrospectively in lung cancer pathologically proved. Three types were classified according to the imaging findings: solid lesion, part-solid lesion and non-solid lesion. Results A total of 31 participants (32 lesions) were diagnosed as lung cancer, including 30 adenocarcinomas, 1 carcinoid and 1 small cell lung cancer. The detecting rate of the lung cancer was 0.4%(31/8 212). The solid lesion was further classified as classical solid nodule, irregular solid lesion and atypical solid nodule, and the part-solid lesion was further classified as part-solid nodule, irregular part-solid lesion and cystic part-solid nodule. Lung cancer or probably lung cancer was diagnosed in 24 cases (77.4%), and uncertainty diagnosis was made in 3 cases (9.7%). Benign or probably benign was diagnosed in 3 cases, and another 1 cases were missed at baseline screening. The false positive rate and the false negative rate was 9.7%and 3.1%, respectively. Conclusion The imaging characteristics of lung cancer detected by LDCT are varied, which provide preliminary experience in lung cancer screening.