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.

Non-small-cell lung cancer (NSCLC) patients with the same TNM stage may suffer from large prognosis variations. Even patients with early-stage NSCLC still demonstrated lower-than-expecting survival rates after surgical resection, indicating that the current staging methods which were based on anatomy do not adequately predict outcome. Especially the insufficient growth of very early period tumors limited the prognostic prediction of anatomy characteristics, therefore studies focusing on tumor biologic characteristics were developed in order to identify prognostic gene markers. A variety of prognostic genomic models were based on microarray analysis and quantitative polymerase chain reaction (PCR) and analyzed by bioinformatics data processing. However, the prognostic gene lists reported to date overlapped poorly in the studies with similar background. To improve the cloudy situation, the research protocol should be standardized.On the other hand, instead of simple addition of several genes, sequential combination of prognostic gene markers based on signal pathway should be developed which may possess much more rationality and systematicness.

Objective To explore the incidence, etiological and protective factors, and preventive countermeasures of deep venous thrombosis (DVT) in patients undergoing hip surgery. Methods Four hundred and forty-one patients who had hip fracture surgery in our department from January, 2005 to May, 2010were analyzed retrospectively. They were 223 males and 218 females, aged 65.7 years. (range, 22 to 87). A binary logistic regression was performed, using gender, age, duration of surgery, surgery type, anesthesia type, blood transfusion, physical therapy, thrombo-prophylaxis and complication as covariates, taking DVT incidence as the dependant variable. Results The patients obtained a median follow-up of 17.2 months (range, 3 months to 4 years and 7 months). Sixty-nine patients developed DVT (incidence, 15.6%).Analysis of multiple variables showed that duration of surgery, anesthesia type, blood transfusion, hypertension and diabetes were risk factors to DVT. Physical therapy and thrombo-prophylaxis were protective factors.Age, gender and surgery type had no statistically significant influence on DVT (P ＞ 0.05). Conclusions The DVT incidence after hip fracture surgery is high. In order to decrease the DVT incidence, surgeons should try their best to estimate risk factors for every patient perioperatively, avoid general anesthesia or blood transfusion, shorten operating duration, effectively control complications, actively perform physical therapy or thrombo-prophylaxis, and prolong the anticoagulant therapy for patients with higher risk factors.

Eighty percent of unexplained syncope children can be diagnosed of vasovagal syncope (VVS). Positive head-up tilt test (HUTT) leads to the diagnosis of VVS. However,organical diseases which can cause syncope should be excluded before HUTT was taken. The therapies of VVS include nonpharmacological therapy (health education, head-up training, water and salt supplement), pharmacological therapy (β-blockers, α-receptor agonists, fludrocortisone, selective serotonin reuptake inhibitors, angiotension converting enzyme inhibitors, et al.) and pace maker.

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 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.

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.

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 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.