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 appraise determination of serum type Ⅳ collagen protein with latex-enhanced immunoturbidimetry.Methods The evaluation test was performed including precision, linearity determination, prozone reaction, correlation, recovery test and interference test.Results The intra-batch CV% was within 2.47%-3.48%, inter-batch CV% was within 3.46%-4.07%, and recovery rate was within 96.2%-99.3%. There was a good linearity, and the tolerance limit was 800 ng/mL.Regression equation:Y=1.011 8X-1.788 3;detection correlation of different concentrations of standard preparations:r2=0.999 9,Y=1.003 1X-1.236 2.The assay had a very good anti-interference performance to bilirubin, cruorin, and triglyceride without exception.Conclusion Determination of serum type Ⅳ collagen protein attains the demand of the clinic with latex-enhanced immunoturbidimetry in fully automatic biochemical analyzer.

The X protein (HBx) of Human hepatitis B virus (HBV) acts as an indirect transcriptional transactivator to regulate the expression of many viral and cellular genes, as well as playing a critical role in pathogenesis and the development of Hepatocellular carcinoma (HCC). Here we described the biological effects of HBx in association with four cellular factors, including inflammatory factors (COX-2 and iNOS), oncoprotein (Ras), and a newly identified tumor suppressor (YueF). The characteristics of these effectors, which might be associated with hepatocellular carcinoma, are also discussed.

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 analyze the prevalence and risk factors related to the diabetic patients with hypertension in the Kailuan group workers.Methods A total of 9 498 type 2 diabetic patients were followed up for 5 years,regarding myocardial infarction,stroke,and death incident.The cumulative incidence of hypertension in diabetic patients and the evaluated risk factors of hypertension were analyzed.Results The prevalence of hypertension in 9 489 subjects with diabetes was 63.3％,higher than that in subjects without diabetes(42.0％,P＜0.01).Aging,smoking,obesity,high blood levels of triglycerides,total cholesterol,and low-density lipoprotein-cholesterol were the risk factors of diabetic patients with hypertension,in whom the morbidity of myocardial infarction,cerebral infarction,cerebral hemorrhage,and renal dysfunction was 3.3％,6.0％,0.9％,and 18.8％,respectively,all higher than those (2.1％,2.6％,0.3％,and 10.9％) in diabetic patients without hypertension (P＜0.01).By the end of follow-up for 5 years,incidences of cerebral infarction,cerebral hemorrhage,and death in diabetic patients with hypertension were higher than those with normal blood pressure (P＜0.05),but no difference in incidences of myocardial infarction between the 2 groups (P＞0.05).The 5-years cumulative incidence of hypertension in the diabetic population was 40.1％.Male sex,smoking,snoring,obesity,and hypertriglyceridemia were the risk factors of hypertension in diabetic patients (P ＜ 0.05).Conclusion The prevalence and the 5-years cumulative incidence of hypertension in diabetic patients increased significantly.Diabetic patients with hypertension may have higher risk of cerebrovascular events and kidney dysfunction.

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.

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] Preliminary clinical experience of Wang Zuoshun using Da Chaihu decoction contacts with other decoctions in the treatment of re-fractory hypertension in winter. [Methods] From the etiology and pathogenesis, syndrome differentiation and treatment, clinical treatment experience sum-mary of Professor Wang Zuoshun 's treatment of winter refractory hypertension academic ideas and clinical experience, also from the classical articles, the-ory of constitution etc to expound the omechanisationf the clinical experience.[Results] The etiology is phlegm, blood stasis, induced by cold pathogen, its pathogenesis are dysfunction of Shaoyang, accumulation of phlegm-heat and blood stasis, cold accumulation, according to the etiology and pathogenesis, forming a cardinal in Shaoyang, purging heat, resolving phlegm and removing blood stasis, slightly with temperature and the treatment. [Conclusions] In clinical work, Wang Zuoshun director using syndrome differentiation and treatment, researches the pathogenesis, flexibility in the use of traditional Chinese herbal soup recipe in treating winter refractory hypertension, the curative effect is remarkable, and has popularization and application value.

Objective To investigate the expression of S100A4 and hypoxia-induced factor 1α (HIF-1α) protein in type Ⅰ endometrial carcinoma,and to analyze their relationship.Methods The expressions of S100A4 and HIF-1α protein were detected in 65 cases of type Ⅰ endometrial carcinoma and 40 normal endometrial tissues.Results The positive rate of S100A4 in endometrial carcinoma was 47.7 ％ (31/65),the normal tissues was 0 (0/40),and there was significant difference (x2 =27.069,P =0.001).The positive rate of HIF-lα was significantly higher in endometrial carcinoma [63.1％ (41/65)] than that in the normal tissues [7.5 ％ (3/40)] (x2 =31.417,P =0.001).The expressions of S100A4 and HIF-1α were positively related with FIGO staging,pathological grades,myometrial invasion and lymphatic metastasis (all P ＜ 0.05).The expressions of S100A4 and HIF-1α were positively correlated in type Ⅰ endometrial carcinoma (r =0.348,P =0.005).Conclusion The expression levels of S100A4 and HIF-1α are closely related with the oncogenesis and progression of type Ⅰ endometrial carcinoma,and their co-detection may be useful in prognosis assessment.

Objective To analyze clopidogrel combined with aspirin therapy of acute cerebral infarction the safety and efficacy of micro brain hemorrhage patients.Methods Select from May 2015 and May 2015 months in the hospital for diagnosis and treatment of 76 cases of acute cerebral infarction combined micro cerebral hemorrhage patient study,observation group in the conventional treatment at the same time giving oral aspirin and clopidogrel,the control group in the conventional treatment at the same time,only to give oral aspirin.To observe the nerve function defect National institutes of Health stroke scale score(National Institute of Health stroke scale,NIHSS)and daily life activities ability pap index,determination of patients' blood plasma viscosity,whole blood low shear viscosity,AA induction and the platelet maximum aggregation rate induced by ADP(MARAA,MARADP),observation records during the treatment patients with adverse reactions,were analyzed.Results Compared with before treatment,the observation group and control group after treatment for 2 weeks,NIHSS score,score and blood related indexes were significantly improved,statistically significant difference(P< 0.05).Compared with control group,the observation group after treatment the NIHSS score,pap score and blood related indexes were significantly improved,total effective rate increased significantly,the differences were statistically significant(P< 0.05).Two groups of adverse drug reactions occurred situation is no statistical difference.Conclusion Clopidogrel in combination with aspirin can effective treatment in patients with acute cerebral infarction combined micro brain hemorrhage,and security.