[Objective] To approach the causes and managements of dislocation after total hip arthroplasty.[Methods]850 total hip arthroplasties were done in our department from 1996 to 2004,in which 7 cases experienced post-operative dislocation.Whith 4 males and 3 females,the average age was 67 years old.Causes and managements have been studied retrospectively through analysis of history,surgical approach,timing and direction of the dislocations and predisposing factors of the dislocations occurred.[Results]There wer 7 cases of dislocations of which 5 patients(71%)were primary cases and 2 patients(29%)were revision cases;4 patients(57%)had history of hip surgery;1 case had mental disorder after cerebral surgery.Direct lateral approach was used for all these patients,and only anterior dislocation was occurred in this group.Through study the AP X-rays postoperatively,the abduction angle were more than 55 degree in 2 of these cases.The time of dislocation was from right after operation to 27 months after operation;5 of them experienced their dislocation within 3 months after operation.Closed reduction and 6 weeks traction were selected for all these patients,and 6 of them were successful.Recurrent dislccation occurred twice in another one patient within 3 months after reduction,and the acetabular cup was loosened during closed reduction.A stable joint was achieved after revision and modifying the abduction angle of the cup.[Conclusion]Causative risk factors for dislocation after total hip arthroplasty include surgery history on the same hip,inability to comply with instructions of rehabilitation,approach of surgery and malposition of the prosthesis.Closed reduction and traction for 6-week afterwards are usually successful for most of the dislocated cases.Revision could be done in the base of analyzing the reasons for recurrent dislocation,and then stale joint could be achieved.

Objective To evaluate the effect of propofol infusion on hepatic blood flow (HBF) and oxygen delivery and consumption in rabbit. Methods Thirty adult male rabbits weighing 1.6-2.4 kg were randomly allocated into 3 groups: group I high dose propofol (HP) ( n = 11); group II low dose propofol (LP) (n = 10) and group III control group (C) ( n = 9). The rabbits were anesthetized with intravenous 3 % pentobarbital 45 mg ?kg-1 and mechanically ventilated (VT = 10 ml?kg-1 RR = 40 bpm, I:E= 1:2) after tracheal intubation. ECG, urinary output and rectal temperature were continuously monitored. Portal vein and hepatic artery were dissected and exposed for measurement of blood flow using electromagnetic flowmeter. Catheters were inserted into carotid artery, portal vein and hepatic vein via the mesenteric vein and right femoral vein for collection of blood samples. After the circulation was stabilized for 30 min, propofol infusion was started at a rate of 1.2 mg ? kg-1 ? min-1 ( HP) or 0.4 mg?kg-1 ?min-1(LP). In control group normal saline was infused instead of propofol. Portal venous and hepatic arterial blood flow were continuously measured. Blood samples were obtained from carotid artery, portal vein and hepatic vein before ( baseline) and at 30, 50, 70 and 90 min of propofol infusion for determination of Hb, SO2, PO2 and PCO2. The hepatic O2 delivery (DO2 ) and consumption (VO2 ) were calculated. Results The three groups were comparable with respect to body weight, duration of operation, the volume of fluid infused and blood loss and urinary output. HBF was significantly higher at 30-90 min of propofol infusion in HP group than in C group, meanwhile DO2 and VO2 in HP group were significantly higher during propofol infusion than the baseline value before infusion and those in C group. However, there was no significant difference in DO2/VO2 ratio between HP and C group. Conclusion High dose propofol infusion improves liver blood flow and O2 delivery but it also increases hepatic O2 consumption. However the balance between hepatic O2 supply/demand remains unchanged.

Electrophysiology examination is an important technique in studying amblyopia, which mainly includes electrooculography( EOG), electroretinography ( ERG), visual evoked potential( VEP). This study does not only summarizes the definition, the mechanisms and the meaning of these indexes in the relevant research progress in recent years, but also makes a comment on the controversies among the relevant research conclusions.

Objective To evaluate the clinical effect of bandage contact lens on patients after the pterygium excision surgery.Methods 200 patients with pterygium excision were used retrospectively analysis and were divided into control group and observation group by random digital table method.Patients in observation group wore bandage contact lens while those in control group did not (traditional method).The degree of pain in both groups was evaluated at 8 hours,24 hours and 48 hours after surgery.In addition,patients were surveyed for the satisfaction of our treatment when discharge.Results The ocular foreign body sensation,eye burning,tears and eye open difficult were obviously decreased in observation group (t=5.643,10.315,P ＜ 0.01).The overall comfort level of the patients in observation group was obviously improved.pain feeling of the eye after surgery in 8h,24h and 48h markedly decreased in observation group (t=6.196-12.495,P ＜ 0.01).The degree of satisfaction scores of preoperative guidancein,postoperative pain control,emotion,mental nursing,self-care ability,comfort in observation group were (1.59-0.62) points,(1.83±0.70) points,(1.42±0.68) points,(1.42±0.68) points,(1.48±0.67) points,(1.29±0.77) points,(1.43-0.64)points which were obviously increased than (0.76±0.55) points,(0.83±0.64points,(0.82±0.56) points,(0.80±0.47) points,(0.79±0.61) points,(0.66±0.54) points (t=4.311-9.354,all P＜ 0.01).Conclusions Compared with traditional treatment,bandage contact lens can significantly reduce the discomforts after the pterygium excision surgery,and increase the postoperative comforts of patients.It proves that bandage contact lens have extensive clinical value.

Objective To study the arthroscopic operative procedure and the result for knee osteoarthritis. Methods 49 patients with knee osteoarthritis treated by arthroscopic operation from May 1993 to September 1999 were reviewved.Arthroscopic lavage,debridement or debridement Combined with drilling was performed on different patients. Results The average follow-up period was 5 years.The scale improved 36.0 after operation.No serious complication was found. Conclusions Arthroscopic debridement for osteoarthritis is satisfactory in the long-term efficacy and drilling of grade Ⅳ subchondral bone does not improve long-term outcome.

Objective To study the values of arthroscopy in the diagnosis and treatment of knee osteoarthritis. Methods A retrospective survey of 75 patients with knee osteoarthritis treated by arthroscopic operation from May 1993 to Sep 1999 was conducted.the Tindings by radiograph and those in operation were compaired. Results The average follow-up period was nearly 5 years.The scale improved 35.7 after operation.No serious complication arose. Conclusions The more severe the condition, the more consistent radiographic diagnosis is with arthroscopic findings.Radiography reflects the site of the lesion better.50% of the patients at the intermediate and late stage have meniscal lesions.It seems that meniscal lesion does not affect surgical results;having loose body indicates better results.

Objective To evaluate the sensitivity,specificity and accuracy of the algorithm for electrocardiographic identification of the IRA and exact site of occlusion of the IRA.Methods According to the algorithm for electrocardiographic identification,we predicted the IRA by analyzing ECG in 896 patients with ST-segment elevation myocardial infarction(STEMI),who were enrolled in this study and underwent primary coronary angiography.Results The results indicated that left main coronary disease showed a sensitivity of 100%,specificity of 99% and accuracy of 99%;and at the same time the left anterior descending artery(LAD) with 99%,99% and 99%(proximal LAD: 84%,90% and 88%;middle and distal LAD: 57%,94% and 88%);the left circumflex artery with 64%,95% and 91%;the right coronary artery(RCA):89%,92% and 91%(proximal RCA: 51%,96% and 88%;middle and distal RCA: 68%,92% and 85%) respectively.Conclusion This study suggests that electrocardiogram is a crucial tool in the identification of the IRA in left main coronary,LAD and proximal RCA with predicting exact site of culprit lesion.The LCX or middle and distal RCA can be difficult to discriminate.

Objective To investigate the effects of adenosine postconditioning (AP) on serum IL-10 and TNF-α concentrations following myocardial ischemia-reperfusion(VR)in rats.Methods Twenty-four SD ratsweighing 180-250 g were randomly divided into 4 groups(n=6 each):group I sham operation (group S);group Ⅱ myocardial I/R;group Ⅲ ischemic postconditioning(group IP)and group Ⅳ AP.Myocardial I/R was induced by 30 rain occlusion of anterior descending branch of left coronary artery followed by 120 min reperfnsion.IP was induced by 3 cycles of 30 s myocardial ischemia followed by 30 s reperfusion at the end of ischemia.In AP group adenosine 1.5 mg/kg was infused at 40μg·kg-1·min-1 before the onset of reperfusion.SP,DP and HR were recorded before ischemia (baseline) at 30 min of ischemia and 30 and 120 min of reperfusion.Arterial bloodsarnples were collected at 120 min of repednsion for determination of serum TNF-α and IL-10 concentrations.Theanimals were then killed.Their hearts were removed for microscopic examination.Myocardial infarct size wasmeasured and myocardial MDA content was determined.Results BP and HR were signilicandy decreased duringreperfusion while myocardial infarct size.MDA content and serum concentrations of IL-10 and TNF-α weresignificantly increased in I/R group compared with group S.Ischemic and adenosine postconditioning significantlyattenuated hypotension,reduced infarct size,myocardial MDA content and serum TNF-α concentration and increased serum IL-10 concentration in group AP and IP as compared with I/R group.There was no significant difference in the above changes between group AP and IP. Myocardial injury was ameliorated in group AP and IP as compared with I/R group. Conclusion Adenosine postconditioning can protect myocardium from I/R injury by increasing IL-10 production and inhibiting TNF-a release.

Objective To explore the application of scene simulation teaching combined with research design in the teaching of Community Nursing and evaluate its effects.Methods The scene simulation teaching combined with research design was used in the teaching of Community Health Promotion and Health Education in 68 nursing undergraduate students.The student groups were required to do the scenario case preparation and presentation,and conduct the research design according to specific situations of community health education.The mastery of related knowledge of students before and after the class was compared.Results All the student groups completed the course requirements.After class,the students better grasped the community health education,research design and other related knowledge compared with before class.Sixty-one students (89.71％) regarded the scene simulation teaching combined with research design was suitable for the teaching of Community Health Promotion and Health Education,and over 80％ students regarded this teaching was benefit for the development of their ability of self-learning,teamwork and flexible application of knowledge.Conclusions The scene simulation teaching combined with research design can not only help students master related knowledge,but also focuses on students' ability training,which is suitable for comprehensive application of knowledge.

The advantages and disadvantages of 13 representative literature information analysis tools were com-pared in aspects of their support data formats, data preprocessing, constructed relationship matrixes, standard pro-cessing, analysis methods and results visualization, with certain suggestions put forward for the users in selecting proper literature information analysis tools.