Objective To explore the clinical significance of the inferior displacement sign on the initial anterioposterior (AP) view X-ray for fractures of humeral greater tuberosity.Methods This study retrospectively analyzed the imaging and clinical data of 24 patients with isolated fracture of humeral greater tuberosity who had sought medical treatment during the period from January 2008 to June 2015.They were 10 males and 14 females,with an average age of 54 years (from 19 to 68 years).Laterality:8 left sides and 16 right sides.The AP view X-ray films of the 24 patients present the inferior displacement sign defined as the inferior cortical margin of the greater tuberosity overlapping the proximal humeral shaft on the initial AP view.The patients received further CT examination to determine the displacement direction and whether the humeral neck fracture was complicated.Results A slight displacement of humeral anatomic neck fracture was shown on the initial AP view X-ray in 10 patients.Further CT examination revealed that humeral anatomic neck fracture was confirmed in 23 patients,the greater tuberosity was displaced posteriorly in 22 patients and posteroinferiorly in 2 patients.Radiographic measurements showed:the mean posterior displacement was 10.5 ±4.5 mm;the displacement between the humeral head and the humeral shaft was 2.5 ± 1.5 mm;the neck shaft angle was 147.2° ± 9.2°;the distance between the humeral head and greater tuberosity was 10.8 ± 3.4 mm;the overlap between the inferior edge of greater tuberosity and the upper edge of lateral humeral shaft was 12.5±5.9 mm.Pearson correlation analysis showed no correlation between the overlap and the head-tuberosity distance (P ＞ 0.05),but a significant correlation between the overlap and the neck-shaft angle (P ＜ 0.05).Conclusions The inferior displacement sign on the initial AP view X-ray is actually the overlap of posterior displaced greater tuberosity fracture shown on the X-ray.The posterior displaced greater tuberosity fracture complicated with slight displaced anatomic neck fracture is a presentation of the valgus impacted fracture of the proximal humerus.The inferior displacement sign in the fracture of humeral greater tuberosity can highly suggest the presence of occult or slight displacement of the humeral anatomic neck fracture.

The time-to-event index is a kind of common evaluation index. It measures the speed of intervention effect. It is different from other index in research design, source material filling, data checking and statistical analysis. To obtain the time-to-event index, investigators can fill in the table directly and statistical analyst can compute after clinical observation. When filling in the source material or data checking, it is should be noticed that the logical relation between the time-to-event index and the visiting point and between the time-to-event index and the correlative other indicator. When statistical analyzing, it is an important issue how to deal with the cases whose time-to-event index does not appear till the observation period ends. Understanding the difference clearly can make the time-to-event index evaluate the effect of the intervention truly and make the clinical observation results reliable.
Clinical Trials as Topic ; Female ; Humans ; Male ; Observational Studies as Topic ; Research ; Research Design

Objective　To evaluate adbomen surgery in patients who are found to have poorly controlled or untreated hypertension before operation.Methods　From January 1997 to December 1998,the perioperative clinical data of 531 patients with hypertension and undergoing abdomen surgery in our hospital were retrospectively analyzed.Results　The incidences of perioperative hypertensive events were not significantly different,between controlled and uncontrolled patients with grade one and grade two (P>0.05).In grade three and systolic hypertension,certain perioperative complications in patients with poorly controlled hypertension were higher than in those with well-controlled hypertension(P<0.05).Conclusion　The patients with grade on e and grade two hypertension are not at increased operative risk.In Patients with grade three and systolic hypertension,perioperative complications are increased and elective surgery should be postponed until their blood pressure is brought under 180/110 mmHg over 1 to 2 weeks.

Taking the network course of pediatric dentistu-occlusal inducement as an example,this paper put forwards several aspects that should be focused on,including building a strong team to implement the project; taking advantage of muhimedia and providing rich teaching resources in various forms,breaking traditional teaching modes and taking full advantage of the characteristics of the network platform to provide students with individualized teaching service ; building self-regulatory system and real-time interactive platform for teachers and students; establishing long-term mechanism,cultivating a network course reserve team with modernization quality and updating teaching content constantly to let it become an open teaching platform Finally the paper explained the significance of network course construction and promotion.

The incidence of childhood inflammatory bowel disease has gradually increased in recent years.The disease is a chronic intestinal inflammatory disease, and its susceptible age is school age, which seriously affects the growth and development of children and brings psychological and spiritual trauma.The etiology and pathogenesis of inflammatory bowel disease is unclear, but with the in-depth study of the intestinal flora in recent years, it has been shown that intestinal flora imbalance plays an important role in the occurrence and development of the disease, and it has also been widely confirmed in clinical practice.Therefore, people try to use probiotics in the treatment of children with inflammatory bowel disease.This article mainly reviews the progress of the application of probiotics, prebiotics, fecal bacteria transplantation and other microecological agent in children with inflammatory bowel disease, analyzes the therapeutic effects of probiotics on children with inflammatory bowel disease, and provides new ideas for clinical practice.

Objective: In this study,we evaluatedthe influence of different nutritional support routes and nutrients on the intestinal barrier function and bacterial translocation in rats with gut I/Rinjury. Methods: Eighty rats were divided randomly into: I/R group,control group,and nutrition-supportgroups. Bacterial culture, D-lactate and endotoxin levels was assayedafter 7 days of nutrition support. Results: There was serious damagein intestinal tissue of I/R group. Remarkably higher value of bacterial translocation occurred in PN group (P0.05).The endotoxin level was the highest in PN group. Conclusions: TPN alone could impair gut immune barrier function and thereforefacilitate bacterial translocation.The use of immunonutritionindicates limited efficacyin preventing bacterial translocation compared with common enteral nutrition.

Objective To investigate the effects of oxiracetam combined with Shuxuetong injection on hemorheology and serum Hcy levels in patients with cerebral infarction. Methods 60 patients with cerebral infarction were randomly divided into 2 groups, 30 cases in the observation group and were treated with oxiracetam combined with Shuxuetong injection. 30 cases in the control group were treated with Shuxuetong injection. The hemorheology and serum Hcy levels in the two groups were compared. Results After treatment, the hemorheological indexes and serum Hcy levels in the observation group were lower than those in the control group (P<0.05). The treatment effect of the observation group was better than that of the control group (P<0.05). The scores of neurological deficits in the observation group were significantly better than those in the control group (P<0.05). The number of complications in the observation group was 2 cases, the incidence of complications was 6.7%, which were significantly lower than 9(30.0%) in the control group, the differences between the two groups was statistically significant (P<0.05). Conclusion The application of oxiracetam combined with Shuxuetong injection in patients with cerebral infarction can effectively improve the hemorheology and reduce the serum Hcy level.

Recently,the Society of Critical Care Medicine and the European Society of Intensive Care Medicine sponsored a 19-member Task Force to update the definitions of sepsis and septic shock at the forty-fifth Critical Care Medicine Annual Meeting in February 2016.Owing to an increased understanding of the harmful systemic response to infection,members of the multidisciplinary task force proposed that sepsis now be defined as life threatening organ dysfunction caused by a dysregulated host response to infection.To standardize the assessment of organ dysfunction,the Task Force members propose that provider use the sequential organ failure assessment(SOFA) score and quick SOFA (qSOFA).Although the systemic inflammatory response syndrome(SIRS) standard has high sensitivity and low specificity,the mortality of sepsis in the world has decreased significantly in the past 20 years.With the gradual realization of sepsis 3.0,will SIRS really be completely out of the stage of history? The SOFA and qSOFA criteria is not suitable for children.The author thinks that SIRS standard still has its practical application value.We need further studies on how to improve the sensitivity and specificity of sepsis diagnosis at the same.We should continue to validate sepsis 3.0.