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.

After a brief description of standards for HL7 and its application in foreign countries and China, the lo-calization and implementation principles of HL7-based application of integrated medical information system, and its advantages and disadvantages were analyzed with its development trend in China pointed out.

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] 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 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.

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.

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.

ObjectiveTo detect the effect of subretinal fluid （SRF） from different grades of proliferative vitreoretinopathy（PVR） on cultured retinal pigmental epithelial cells（RPE） and fibloblasts（FB）．MethodsThe effect of SRF from different grades of PVR on RPE and FB was determined using Brdu labeling technique and MTT assaying method，respectively．Results All samples showed a stimulating effect on the two kinds of cellular elements in a certain degree．At 1∶10 concentration，the cellular proliferation stimulating activity of SRF with PVR＜C1，PVR C1 and PVR＞C1 on RPE and FB was 128.5%，139.8%，156.8%and 126.3%，143.1%，172.3%of the control groups, respectively after 24 h stimulation.ConclusionsSRF’s proliferation-stimulating activity is correlated with the grades of PVR．