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.

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.

Objective To summarize the effect of airpump nebulization inhalation combining with vibration sputum discharge device in treatment of infants suffering from severe pneumonia and its main nursing point.Methods 138 infants who were attacked by severe pneumonia were divided stochastically into the control group and the experimental group with 69 infants in each group.Infants in both groups were treated with routine method.After airpump nebulization inhalation,sputum extraction was implemented for infants in the control group on basis of common remedy,while after airpump nebulization inhalation,sputum discharge and sputum extraction by mechanical vibration were implemented immediately for infants in the experimental group on basis of common remedy.The treatment effect was compared between two groups.Results Comparison between the two groups showed that in the experimental group,the time for fever,cough,expectoration and hospitalization was shorter,chest X-ray improved,PaO2 rose and PaCO2 lowered.Medical cost and cost-effect ratio decreased.Conclusions Airpump nebulization inhalation combining vibration sputum discharge device can effectively solve the problem of sputum accumulation for infants,improve physical sign of lung,shorten course of disease and alleviate state of infant's illness.

Objective To investigate the RHD gene polymorphism among the RhD negative Han individuals in Xuzhou.Methods The RhD antigen phenotypes were detected by routine serological techniques,and were identified with indirect antiglobulin test (IAT).The genotypes of RHD were detected by using sequence specific primer polymerase chain reaction(SSP-PCR).Results A-mong 110 RhD negative individuals,there were 5 cases carring RHD positive gene,47 cases carring RHD negative gene,22 cases carring RHD-CE(2-9)-D gene,17 cases carring DVI Ⅲ gene,2 cases carring weak D15 gene,and 17 carring DEL-1227A gene,re-spectively.Conclusion The RhD negative Han individuals present complex RHD gene polymorphism in Xuzhou region,and variant alleles such as RHD-CE(2-9)-D,DVI Ⅲ,DEL-1227A are given priority.

Objective To observe the effect of Xuefu Zhuyu Decoction combined with metoprolol in the treatment of senile coronary heart disease and angina pectoris and its influence on the level of blood lipid and HCY in plasma.Methods 80 cases of elderly patients with coronary heart disease and angina were randomly divided into the two groups of 40 cases according to the random number table method.The study group was treated with Xuefu Zhuyu Decoction combined with metoprolol,while the control group only used conventional western medicine for treatment,the efficacy and changes of plasma homocysteine (HCY) and serum lipid levels before and after treatment of two groups were compared.Results The effective rate of patients in the study group was 92.5 ％,significantly higher than 65％ of the control group (x2 =4.58,P ＜0.05) ;The plasma HCY of the study group after treatment was (15.8 ±3.7) μmol/L,significantly lower than (26.5 ± 10.3) μmol/L of the control group (t =6.18,P ＜0.05) ;The levels of serum LDL,TC,TG and HDL of the study group after treatment were significantly improved than before treatment (t =9.82,7.66,7.89,6.54,all P ＜ 0.05),and it improved significantly than that of the control group (t =8.35,7.67,7.82,6.33,all P ＜ 0.05).Conclusion Xuefu Zhuyu Decoction combined with metoprolol has a better effect than the pure western medicine in treatment of senile coronary heart disease and angina pectoris,which is worthy of clinical application.

Objective To observe the liver protection of Ginsenoside Rg1 and Oxymatrine and research its mechanisms.Methods Nonalcoholic fatty liver disease(NAFLD) model was induced by high-fat diet and hepatic fibrosis(HF) model was caused by CCl4 in rats. Protection effects of Ginsenoside Rg1, Oxymatrine and the combination were obsrved.ResultsBoth Rg1 and OMT significantly reduced serum total cholesterol(TC), triglyceride(TG), alanine aminotransferase(ALT) and aspartate amino transferase (AST) levels of NAFLD rats[Rg1 group (2.76±0.22) mmol/L,(1.24±0.17) mmol/L,(112.39±12.91)U/L, (195.16±12.99) U/L; OMT group (2.35±0.19) mmol/L,(1.09±0.09) mmol/L,(90.57±10.25) U/L, (186.45±13.14) U/L,P<0.05 or 0.01],elevated liver PPARα mRNA and PPARγ mRNA[Rg1 group: (0.64± 0.05),(0.77±0.07);OMT group(0.67±0.07),(0.73±0.06),P<0.05 or 0.01] and alleviated the degree of fatty liver. The effects of the combination group[(1.87±0.21) mmol/L, (0.77±0.10) mmol/L,(58.78± 8.87)U/L,(149.78±11.27)U/L,(0.81±0.09),(0.89±0.05) ] was better than single treatment group (P<0.05 or 0.01). Both Rg1 and OMT significantly reduced the serum ALT, AST levels and liver methane dicarboxylic aldehyde(MDA)content[Rg1 group: (46.75±5.11) U/L,(147.53±7.31) U/L,(5.54±1.06) nmol/g; OMT group:(148.24±4.32) U/L, (93.90±14.22) U/L,(5.85±0.91) nmol/g,P<0.01] in HF model[Rg1 group: (146.75±5.11) U/L,(147.53±7.31)U/L,(5.54±1.06)nmol/g; OMT group:(148.24±4.32) U/L,(93.90±14.22) U/L,(5.85±0.91) nmol/g,P<0.01], enhanced liver SOD activity[Rg1 group:(91.61±9.26) U/mg prot; OM group: (86.19±8.51) U/mg prot,P<0.01] and reduced the semi-quantitative score [Rg1 group:(2.7±0.4); OMT group:(2.9±0.5),P<0.05 or 0.01], the effect of the combination group[(92.21±4.36) U/L,(52.08±7.56) U/L,(3.68±0.54) nmol/g,(99.67±13.13) U/mg prot, (1.2±0.4)] was better than single treatment group.Conclusion Ginsenoside Rg1 and Oxymatrine had synergic of liver protection and the synergic regulation of liver PPARα, PPARγ and antioxidant effect, which should be the potential mechanisms.

Objective To investigate the expression of HA117 in bone marrow mononuclear cells (BMMNCs) of acute leukemia patients, and its correlation with multidrug resistance( MDR), as well as its correlation with antigens presentation and its clinical significance. Methods HA117 gene expressions in 36 patients with acute myeloid leukemia (AML) and 14 patients with acute lymphocytic leukemia (ALL),10 patients with idiopathic thromnocytopenic purpura (ITP) were tested by using reverse transcriptase polymerase chain reaction (RT-PCR) technique. Thirty bone marrow specimens of AML patients at different phase were selected, and immunophenotypes were assayed by flow cytometry. ResultsThere was no significant difference ( P ＞ 0.05 ) in HA117 gene expression between ALL (78.57％) and A ML (72.22％). The expressions of HA117 gene in both ALL and AML were significantly higher than in ITP patients ( P ＜ 0.05 ). The HA117 gene was expressed in 75.00％ of the initially diagnosed patients and 77.78％ of the remission patients and 69.23％ of the nonremission patients, all of them had higher expression than the patients with ITP, but there was no significant difference among the three groups. There were 47.06％ and 87.88％ with HA117 gene expressioned in non-resistance group and resistance group respectively, and the difference between the two groups was significant(P=0.005). HA117 had positively correlation with CD11b(OR =0.59, P=0. 001 ),CD33(OR=0.704, P=0. 000) expression in 30 patients of AML, and had negative correlation with MPO (OR=－0.611, P=0.001). ConclusionHA117 gene overexpression is significantly associated with the clinical resistance. It may also be associated with MDR of acute leukemia. HA117 gene can be used as an important indicator for investigating clinical MDR and predicting prognosis of acute Ieukemia patients. HA1 17 is closely related to CD11b, CD33, MPO expression in AML, and they can be used as biomarkers for evaluating therapy efficacy in AML.

ObjectiveTo observe the effects of clopidogrel on inflammatory cytokines in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods68 cases diagnosed of CHD were randomly divided into clopidogrel 1 month group( group A), clopidogrel 6 months (roup B), every group had 34 cases. Before and after treatment adopt fasting blood respectively and in determination of serum interleukin-18 (IL-18)and C-reactive protein(hs-CRP). ResultsIL-18 and CRP were reduced more apparently in group B. Compared with group A,there were significant differences (P ＜ 0.05 ). ConclusionClopidogrel could significandy reduce coronary heart disease patients in which based on conventional treatment postoperative PCI inflammatory reaction, reduce the patients with coronary artery disease postoperative PCI vascular inflammatory reaction.

Objective To explore the effect of emergency corpus luteum cystectomy for the prevention of persistent ectopic pregnancy(PEP).Methods The clinical data of 68 patients with ectopie pregnancy in emergency conservative operation were analyzed retrospectively.All patients were divided into the observation group(treated with corpus luteum cystectomy,40 cases) and control group (without corpus luteum cystectomy,28 cases).The declining of β-HCG,incidence rate of PEP were compared between the two groups.Results The incidence rate of PEP of the observation group was 0,which was obviously lower than that of the control group(10.7％) (x2 =4.47,P ＜ 0.05).Conclusion The emergency corpus luteum cystectomy can effectively prevent PEP and the operation is simple and convenient.

Brain natriuretic peptide(BNP) is a cardiac hormone mainly secreted by myocytes in the ventricular wall. It has strong action of natriuresis, diuresis, vasodilation, inhibition of renin-angiotensin-aldosterone system and sympathetic nervous system. The increased levels of BNP and NT-proBNP have been reported in children’s cardiovascular diseases in numerous stu-dies and can reflect cardiac function. This article simply reviews the BNP and NT-proBNP about its biology character, detection method, medical reference range and its progress in pediatric cardiovascular disease.