OBJECTIVE:To investigate the transporting function of subretinal fluid in retinal pigment epithelium(RPE) of experimental retinal detachment (RD). METHODS: Twenty-seven pigmented rabbits with one eye as retinal detachment model and the other eye as control were divided into 4 groups ,ic. 7 rabbits in each group at random. The Na十-K+-ATPase activity in RPE-choroidal tissue at the detached region in both experimental and control eyes was determined at the lst,2nd,3rd and 4th week after retinal detachment,and also the ultrastructure of the RPE-choroidal tissues observed. RESULTS:The activity of Na十-K+-ATPase of experimental eyesE[(2.16士1.26)/mu;mol(mgmiddot;h)]was significantly lower than that of the controis[(4.84plusmn;1.59)mu;mol/(mgmiddot;h)]. The degree of decreasing activity was relieving along with increasing of the course of RD. The inward pinocytosis in RPE cells under electron-microscope was found from the 2nd week samples afterwards and becoming obvious along with increasing of the disease course. CONCLUSIONS:The outward transporting function of RPE was increased after RD,it became decreased along with increasing of the course df RD and the inward transporting function then developed.
Objective To study the effect of surgical treatment with core depression and allo-fibular grafting on osteonecrosis of the femoral head in early stages. Methods From June 1998 to August 2004, 22patients with necrosis of the femoral head (39 hips) were treated with core depression and allo-fibular grafting, indluding 17 males and 5 females. Necrosis was classified as Stages Ⅰ-Ⅲ according to ARCO classification system. Their ages ranged from 22 to 60 years and pain duration was 2 to 12 months preoperatively (6.5 months on average). The regular examinations of joint function, X-ray, ECT,CT and MRI were conducted before surgerg and after 15 days, 3 months, and 6 months of surgery. Results All patients were followed up for 3 to 74 months (31.4 months on average). Symptoms 17 of the patients were relievedevidently. Harris hip score from 78 points preoperatively to 91.6 points.The X-ray films 18 of the patients showed that the geography of the hip joint kept intact with no deterioration. Osteogenesis was observed by regular examinations. Two cases (4 hips, 10.25%) were revised by total hip replacement, and 3 cases (4hips, 10.25%) without THR worsened postoperatively. Conclusion The method is less traumatic than common procedures. The joint function can berecovered within 2.4 weeks. Clinical symptoms are greatly improved. This method is effective at least in short term and the long-term effect needs further study.
ObjectiveTo evaluate mid-term results of total hip arthroplasty (THA) for treatment of osteoarthritis secondary to hip sepsis. MethodsBetween February 2003 and January 2009, 62 patients (62 hips) with osteoarthritis secondary to hip sepsis underwent THA. There were 32 males and 30 females with an average age of 39.9 years (range, 18-67 years). The original infection included pyogenic arthritis in 40 hips and tuberculosis in 22 hips. After infection, 35 patients underwent non-operative treatment, and 27 patients received operative management. The average time interval between initial infection and THA was 28.7 years (range, 12-53 years). The preoperative Harris hip score was 24.6±9.2. The Trendelenburg sign was positive in all hips. Leg discrepancy was observed in 25 cases, and the mean discrepancy of bilateral lower extremities was 3.8 cm (range, 2.6-6.5 cm) preoperatively. All hips had no evidence of active hip sepsis. ResultsAll patients were followed up 72 months on average (range, 54-115 months). Intraoperative complications included sciatic nerve injury (2 cases) and femoral shaft fractures (2 cases); postoperative complications included hip anterior dislocation (1 case) and periprosthetic infection (1 case). At last follow-up, 1 hip, 5 hips, 18 hips, and 38 hips were found to have severe pain, moderate pain, slight pain, and no pain respectively. Claudication occurred in 30 patients (mild in 19, moderate in 8, and severe in 3). The Trendelenburg sign was positive in 18 hips. After THA, only 5 patients had a leg length discrepancy of 2.9 cm on average (range, 2.6-3.5 cm). The Harris score was significantly increased to 82.3±11.4 at last follow-up when compared with preoperative one (t=-31.241, P=0.000). The results of subjective satisfaction were very satisfactory in 43 cases, satisfactory in 12 cases, unsatisfactory in 4 cases, and unsatisfactory at all in 3 cases. No sign of aseptic loosening of prosthesis was found during follow-up period. Roentgenographic results showed no radiolucent line or osteolysis in the other patients except 2 patients having local radiolucent. After THA, 12 hips had heterotopic ossification. ConclusionThe mid-term clinical and radiographic results of THA for treatment of osteoarthritis secondary to hip sepsis are good, with the advantages of high satisfactory rate, good function recovery, and low complication incidence.