[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

0.05).The activities degrees of ankle joint also had no statistical difference.[Conclusion]According to the extent of the displacement of Cotton's fracture,we should make the right operative order and the incision,thus we can get results with anatomic reduction and shorten the operative time,which can help the patients make early exercises and get satisfactory effect.

[Objective]To discuss bone marrow derived mesenchymal stem cells(MSCs) culture in vitro and the curative effect of repairing cancellous bone defects in rabbits with the compound of allogenic MSCs and fibrin.[Method]MSCs were isolated and culture-expanted from rabbit bone marrow.Cancellous bone defects were created on bilateral femur condylar in 15 Japanese big ear rabbits,the left bone defects were treated with allogenic MSCs and fibrin,the right were treated with fibrin only.The bone defects were examined radiologically and histoloyically at the 2nd,5th,8th week after operation.[Result]The defects with only fibrin implantation couldn't heal spontaneously and no bone formation were found at any time-point.In the defects with compound of MSCs and fibrin implantation,there were a few bone formation within 2 weeks.By the 5th week plentiful callus were found,at the end of the 8th week,the defects healed.There was no immune respone except a few inflammatory cells infiltrate.[Conclusion]The compound grafts of allogenic MSCs and fibrin shows low immunogenicity within 8 weeks and is an effective method for repairing cancellous bone defects.

[Objective]To analyze the causes for postoperative incisal effuscin following posterior lumbar spinal surgery, to study a protocl for classification of effusion and afford according treatments.[Method]1186 cases of posterior lumbar spinal surgery were completed in the hospital from june 2001 to june 2005,877 operations with instrumentation, Il09 oprations with non-instrumentation, to compare the rate of incisal effusion between the two groups. The patients of incisal effusion were divided into three types:Type Ⅰ:the causes are ascertained, 28 cases: Type Ⅱ: infection, 11 cases; Type Ⅲ:the causes are uncertain, 14 cases o Patients of type Ⅰ were received puncturation, etiological treatment, nutrient therapy. Patients oftype II were received invisal drainaga,debridement, surgical irrigation and culture-directed antibiotic. Patients of type Ⅲ were received puncturation, and prophylactic antibiotics. [Result]The occurrences of incisal effuson were higher in instrumental group (4.33%)thannon-instrumental group(1.35%),P

[Objective]To explore the diagnosis and surgical procedure of soft tissue tumors!in the wrist.[Method]A retrospective study was conducted to evaluate surgical excision of 132 cases of wrist soft tissue tumors in our hospital from jan 2003 to jun 2004.The preoperative diagnosis was compared with pathologic diagnosis and surgical complications was analyzed.[Result]Totally 132 cases included 110 ganglion and 22 non-ganglion were related to 11 disease.The correct rate of preoperative diagnosis was 86.4%(ganglion 95.5%,non-ganglion 40.9%).All cases were recieved surgical excision and were followed up 2 years except 5 cases,123 cases were cured,3 cases were recurrence and 1 died.Complications were seen in 2 dorsal cases and 6 volar cases.[Conclusion]Soft tissue tumors in the wrist are related to much broader spectrum of diseases.On cureing ganglion it is important to master surgical indications and crucial points of operation procedure for different sites.Because histological features of non-ganglion is difficult to determine,surgical treatment should be adviced for initial choise.

Objective To investigate the influnce factors of new diagnosed abnormal glucose metabolism in patients with acute cerebral ischemic stroke .Methods One hundres and twenty stroke patients without history of diabetes were divide into large artery atherosclerotic stroke (LAA), small arterial occlusive stroke(SAO), cardiac embolic stroke(CES), undeterminined etiology stroke (UND) subgroups according to the Trial of ORG 10172 in Acute Stroke Treatment(TOAST) classfication.The patients were tested oral glucose tolerance test (OGTT) one week later after stroke. The impaired glucose regulation ( IGR ) and diabetes patients called the abnormal glucose metabolism group ,compare related indicators and make multivariate Logistic regression analysis .Results There were 68 patients(56.7%) with normal metabolism, 52 patients (43.3%) with abnormal glucose metabolism.Among them, 38 cases were IGR (31.7%), 14 cases were diabetes (11.7%).The rate of abnormality of impaired glucose metabolism in LAA subgroup(63.8%) was significantly higher than the other subgroups (27.3%-31.4%)(all P<0.05).There was no statistically significant difference between the other subgroups .Compared with normal glucose metabolism group, age, the rate of hyperlipidemian and family history of diabetes were significant higher in abnormal glucose metabolism group (P<0.05 -0.01).Multivariate logistic regression analysis showed that hyperlipidemia ( OR=1.671,95%CI:1.208 -2.311,P=0.012), family history of diabetes (OR =1.421,95%CI:1.114 -1.813,P=0.042) and LAA(OR=2.825,95%CI:1.706-4.674,P=0.023) were independent risk factors of new diagnosed abnormal glucose metabolism in ischemic stroke .Conclusion There is a high prevalence of new diagnosed abnormal glucose metabolism in ischemic stroke .Hyperlipidemia , family history of diabetes and LAA are independent risk factors of it .

Objective To Investigate the important perennial inhaled allergens for children with allergic asthma in Daqing.Method Analyzing the data from 134 patients between 4 and 14 years of age with asthma who have a positive skin test to perennial aeroallergen and also have been carried out Allergen-specific immunotherapy in the last four years.Results The important perennial inhaled allergens for children with allergic asthma in Daqing were house dust,dust mites,polyvalent molds Ⅰ(PMⅠ),animal epithelium and polyvalent molds Ⅱ(PMⅡ).Among them the most important allergens were house dust and dust mites.Conclusion It will have practical significance to prevent and treatment children's asthma by taking measures for these allergens.

Objective To discuss the hemodynamics and treatment of silent patent ductus arteriosus (PDA) Methods The heart catheterizations were performed in seven silent PDA patients Results The mean pulmonary artery pressure of seven patients was (16?2 4) mm?Hg The mean Qp/Qs was 1 08?0 02 The mean size of the left right shunt was (0 32?0 08) L/min The proportion of left right shunt size in pulmonary blood flow was 0 098?0 024 on average The mean PDA at its narrowest segment was (0 9?0 2) mm We performed neither surgery nor interventional treatment in all patients In 9 5 months follow up (clinical findings, electrocardiography, echocardiography), no atrioventricular chambers enlargement, pulmonary hypertension, infective endoarteritis and infective endocarditis happened Conclusion In silent PDA patients, there is less size of left right shunt and smaller effect on hemodynamics Its treatment with surgical and interventional closure is under discussion

Objective To evaluate the effectiveness and safety of transcatheter closure of membranous ventricular septal defect (MVSD) using Amplatzer membranous VSD occluder (AMVSO). Methods The patients, who were clinically diagnosed with VSD were recommended for further transthoracic echocardiographic assessment using multiple standard views. If there were left to right shunts across ventricular septum, the margin of defects to the aortic valve was more than 1mm and that to tricuspid valve was more than 3 mm. If there was an aneurysm, it should not interfere with the function of outlet of right ventricule. Finally, if the diameter of VSDs wasless than 14mm, catheter closure of VSDs was suggested in these patients. The patients, having residual shunt after surgical closure of VSD, were included. All procedures were performed under local or general anesthesia. Transthorac echocardiography and X ray were used continuously to monitor the procedure. Transthoracic echocardiography was performed immediately after the release of devices, 24 hours, and 3 months after the procedure, respectively.Results From June 2002 to March 2003, 32 consecutive patients (15 females), underwent transcatheter closure of MVSD. The mean diameters of VSDs measured by echocardiography was 5.1 mm (3～8 mm) and, while that by angiography was 4.4 mm (3～8 mm). The mean size of the occluder was 7.6 mm(4～12 mm). The successful rate of device implantation was 100% (32/32). The residual shunt immediately after the closure was 11.5%, whereas after 24 hours it was only 7.7%, which was not serious. After 3 months′ follow-up, only 3.8% trivial residual shunt existed. No death occurred during and after the procedure. Atrial tachycardia, ventricular tachycardia, and bundle (right and left bundle) branch block, which was considered to relate to catheter manipulation inside the chamber of ventricle, were common and transient. One aortic regurgitation and tricuspid insufficiency became severe after the procedure, but they were not serious. One patient developed III degree A-V block 24 hours after the procedure, and EKG became LBBB 3 days after the temporary pace making. Hemolysis was observed in one patient, and he recovered 7days after the medication therapy. Conclusion Transthoracic echocardiography was very much effective in catheter closure of MVSD. The asymmetric self-expanding nitinol double-disc Amplatzer device designed for the transcatheter closure of MVSD is implanted easily and stably. Due to low ratio of residual shunt and few serious complications, the Amplatzer device is a good choice for the transcatheter closure of MVSD.

Objective To evaluate the effect of transcatheter closure of perimembranous ventricular septal defect (PMVSD) with symmetric ventricular septal occluder (SVSO). Methods Sixty-three patients with UCG confirmed PMVSD underwent transcatheter closure with SVSO. Results The implantation was successful in 58 patients (93.0%). The mean PMVSD diameter was 5.1?1.9 mm by angiography. The distance from the aortic valve to the rim of PMVSD was 2.7?1.0 mm and the mean size of SVSO was 7.2?2.1 mm. There was no residual shunt in 55 patients (94.8%) right after the deployment of SVSO. Arrhythmia was recorded in 15 patients (23.8%) during or after the procedure. New aortic regurgitation was observed in one patient after the implantation SVSO. Two patients developed myocardium injury and one patient developed obstruction of right ventricular outflow tract. Dislocation of the device was found in one patient. During the follow-up of 3 to 12 (means 7.4?2.7) months, no residual shunt, displacement or rupture of divices and endocarditis happened. Conclusion Transcatheter closure of PMVSD using SVSO is safe and effective, meanwhite attention should be paid to the complications such as arrhythmias.