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.

Berberine is a taste of traditional Chinese medicine.With the progress of research on pharmacology and mechanism of drug action of extensive research,the new mechanism of berberine was revealed through a series of clinical trials,the clinical indications continue to expand,and berberine has a therapeutic effect in digestive and endocrine system disease.The current study confirmed that berberine not only has the broad-spectrum antibacterial activity,but also plays a strong anti-inflammatory and immune regulatory role,which makes more and more research began to concern its application value in the diseases of respiratory system.The strong anti-inflammatory effect of berberine cau effectively relieve the airway inflammation of patients who are suffering from chronic obstructive pulmonary,and the broad-spectrum antibacterial effect brought hope for the treatment of tuberculosis and pneumonia.The subsequent animal and clinical studies have confirmed that berberine can effectively improve the symptoms of respiratory system diseases,and play a role in the treatment.

SUMMARY Anklejointfractureisoneofthemostcommontypesoffracture.Therearemanyresearches on the injury mechanism,treatment principles and surgical techniques.A type of injury which combines posterior dislocation of fibula,known as the Bosworth injury,is relatively rare.In 1947,Bosworth first described this type of injury as an unusual ankle fracture dislocation with fixed posterior fracture disloca-tion of the distal part of the fibula.In this type of fracture,the proximal fibular shaft fragment locks be-hind the tibialis posterior tubercle.This rare ankle fracture variant is often not recognized in initial radio-graphs and requires a computed tomographic (CT)scan for verification.But there are already many re-ports,discussing the injury mechanism,treatment principles and surgical techniques.However,there are few reports of anterior dislocation of the fibula,caused by either injury or surgery.The mechanism of the injury is still not clear.This article reports a case of anterior dislocation of the fibula.We report a patient with left ankle open fracture (Lauge-Hansen pronation-external rotation stage Ⅲ,Gustilo ⅢA).Open reduction and internal fixation was done in the initial surgery,but ended up with poor reduction,resulting in fibula anterior dislocation,anterior dislocation of talus and tibia fibular dislocation.The fibula was dis-located anteriorly of the tibia,which rarely happened.The patient suffered severe ankle joint dysfunc-tion.The second operation took out the original internal fixation,reduced the fracture,and reset the in-ternal fixation.The function of ankle joint was improved obviously after operation.But because of the ini-tial injury and the two operations,the soft tissue around the fracture was greatly damaged.6 months after the second operation,and the fracture still not healed,so the bone graft was carried out in the third sur-gery.Two months after the third surgery,the function of the ankle was significantly better than before, but the fracture healing was poor,which needed further review.Through this case,we understand the rare type of ankle fracture with anterior dislocation of the fibula,and recognize that the timing and quality of initial surgery has a great impact on the patient’s prognosis and rehabilitation period.

Objective To evaluate the clinical application value of computer graphics imaging technology in combination with CT urography in the diagnosis of postoperative complications of kidney stone.Methods 1 7 patients with postoperative complications of kidney stones underwent 64-detector CT urography examination.The images were transferred by network to a separate workstation to perform volume rendering (VR),maximum intensity projection (MIP),multiplanar reconstruction (MPR)and curved planar re-construction (CPR).All the postprocessing images were retrospectively analyzed.Results Postoperative complications were found in 1 7 patients including 13 with urinary residual stones,1 with severe hydronephrosis and twisted ureter,1 with residual stone in du-plex kidneys,1 with renal parenchyma rupture,1 with ureter rupture,1 with urine leakage of postcaval ureter,1 with renal hemor-rhage,1 with pleural effusion,and 1 with residual stone of multiple renal cysts.Conclusion Postoperative complications of kidney stones can be clearly demonstrated by computer graphics imaging technology in combination with CT urography,which may provide more information for treatment.

OBJECTIVE To investigate the advantages of nicardipine induced hypotension in endoscopic sinus surgery.METHODS Eighty patients underwent endoscopic sinus surgery under general anesthesia were randomly assigned into two groups(n=40 each):Group A(Enflurane Group), Group B (Nicardipine Group).The effect of controlled hypotension was compared between the two groups.The changes of MAP, HR were recorded during induced hypotension, the time of induction, maintenance and recovery in induced hypotension were recorded.RESULTS 1.The induced hypotension induction time in group A was significant shorter than that in group B, BP recovery time in group A was obviously longer than that in group B (P

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 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.

Castration-resistant prostate cancer (CRPC) is the lethal form of prostate cancer with developed resistance to androgen deprivation therapy. However, anti-androgen therapy remains an important treatment option because androgen receptor activation is a major driver of the advanced phase of CRPC. Drug resistance is frequently manifested despite the development of various novel anti-an-drogens with significant clinical efficacy. This review introduces several drugs prevalently used to treat CRPC. The mechanisms of ac-tion and pathways to resistance of these drugs are also discussed.

BACKGROUND:Reduction and fixation are presently used for middle and inferior humeral fractures. The methods of fixation approach include anterolateral (including modified upper arm anterolateral), posterior and medial approaches. The repair approach of middle and inferior humeral fractures remains controversial. OBJECTIVE:To compare efficiency and safety of anterolateral and medial approach fixation with compression plate and screw for middle and inferior humeral fractures. METHODS:A total of 90 cases of middle and inferior humeral fractures treated in Chongqing Red Cross Hospital were equaly and randomly divided into experimental group and control group. In the control group, patients were subjected to compression plate and screw through anterolateral approach. In the experimental group, patients were subjected to compression plate and screw through medial approach. Operation time, intraoperative blood loss, complications and the recovery of shoulder joint and elbow joint function were compared in patients of both groups. RESULTS AND CONCLUSION:Intraoperative blood loss was significantly lower in the experimental group than in the control group (P < 0.05). No significant difference in operation time and fracture healing time was found between the two groups (P > 0.05). During 6 months of folow-up, no significant difference in shoulder joint function Neer score and elbow joint function Mayo score was detected between the two groups (P > 0.05). During the folow-up period, no wound infection, bone nonunion or chronic osteomyelitis appeared in both groups. These data confirm that the effects of medial approach and anterolateral approach for middle and inferior humeral fractures are similar. Medial approach leads to less blood loss, can effectively make up for the defects of the traditional repair scheme, and can be considered as one of fixation approach for middle and inferior humeral fractures.