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 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.

BACKGROUND:The increase of serum cholesterol levels is positively correlated with the increasing incidence of osteoarthritis. Little is known about the role of high-fat diet in the degeneration of articular cartilage and induced arthritis.
OBJECTIVE:To observe the morphology change of the articular cartilage of New Zealand rabbits after high-fat diet, and explore the role of food in the articular cartilage degeneration.
METHODS:Forty New Zealand white rabbits were randomly divided into two groups. In control group, rabbits were fed with basal diet. In high-fat diet group, rabbits were fed with high-fat diet (20%lard and 80%basal diet). Fasting blood samples was taken every 4 weeks, to detect the triglyceride and total cholesterol levels. After rabbit were fed for 28 weeks, the knee joint was grossly observed and the femoral condyle cartilage was scanned by scanning electron microscope.
RESULTS AND CONCLUSION:Compared with the control group, the triglyceride and total cholesterol levels were significantly increased in the high fat group (P<0.05). Under scanning electron microscope, the high-fat group showed rough surface of condylar cartilage, shal ow pouch, messy arrangement, irregular shape and uneven size. The surface of cartilage exhibited focal denudation, irregular arrangement, uneven porosity and fractured cavity. Under higher magnification, smal mountain-like structure of cartilage surface became shal ow and flattened, the pores disappeared. Long-term high-fat diet may induce and aggravate cartilage damage, suggesting it may be involved in the pathogenesis of osteoarthritis.

Objective To investigate the clinical value of the 18F-FDG SPECT-CT combined with the image of CT in the diagnosis of lung cancer.Methods Retrospectively analysis images of 18F-FDG SPECT-CT and CT of 162 patients pulmonary tumor-like lesions from January 2013 to October 2013 were conducted.All the patients have been confirmed by the pathological mechanism or cytologic examination.Each patient has been firstly diagnosed by the 18F-FDG SPECT-CT along and then combined with the images of CT.The sensitive rate and the accurate rate of two methods were compared by x2 test.Results There were 40 benign lesions and 114 malignant ones in 162 patients.The sensitive rates of the two methods were 86.0％ and 96.5％ (x2 =6.63,P ＜ 0.05).The accurate rates of the two ways were 79％ and 96.3％ (x2 =7.76,P ＜ 0.05).The differences were statistically significant.Conclusion 18F-FDG SPECT-CT combined with the images of CT can increase the diagnostic sensitivity and accuracy.It has important clinical value.

Objective To investigate the episode of ischemic stroke in patients with serum homocysteine (Hcy),erythropoietin and its clinical significance (EPO)levels.Methods Detected 120 cases of first ischemic stroke patients serum Hcy,EPO lev-els and test results with 120 cases over the same period outpatient healthy compare.Used Logistic regression analysis and Pearson correlation analysis to determine the relationship between serum Hcy,EPO levels and ischemic stroke,ROC curve a-nalysis of clinical characteristics of Hcy and EPO.Results Serum Hcy,EPO level of ischemic stroke were respectively 23.1 ±12.6μmol/L and 32.4±11.2 mIU/L.The control level were respectively 10.4±2.8μmol/L and 17.6±5.2 mIU/L.Is-chemic stroke group were significantly higher.The results had statistical significance (P<0.05 or<0.01).Pearson correla-tion analysis showed that ischemic stroke serum Hcy levels and EPO levels were positively correlated (r=0.369,P<0.05). Logistic regression analysis showed that Ischemic stroke was positively related to serum Hcy level (P<0.05),and were not related to EPO (P>0.05).Conclusion The serum Hcy,elevated EPO levels associated with ischemic stroke.Serum Hcy is an independent risk factor of ischemic stroke.

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.

Objective To analyze the effect of TSH inhibition on soluble interleukin 2 receptor ( sIL-2R), interleukin 44 variant 6 (CD44V6), tumor specific growth factor (TSGF) and T lymphocyte subsets in elderly patients with thyroid cancer.Methods 50 elderly patients with thyroid cancer in our hospital were collected.The patients were randomly assigned to experimental and control groups, 25 cases in each group, patients in the experimental group were given TSH suppression therapy after surgery , patients in control group were given thyroxine replacement therapy after operation, treatment for 1 month, serum SIL-2R, CD44v6, TSGF and peripheral blood T lymphocyte subsets situation were detected in all patients with .ResuIts After treatment, compared with the control group, ①in the experimental group, the level of serum sIL-2R was significantly lower, the difference was statistically significant(P<0.05);②the serum CD44V6 level was lower in the experimental group (P<0.05);③the serum TSGF level was lower in the experimental group (P<0.05);③in the experimental group,the levels of CD3 + and CD4 +were higher, levels of CD8 + were lower ( P<0.05 ) .ConcIusions TSH suppression therapy can reduce senile thyroid cancer patients serum SIL-2R, CD44v6, TSGF and CD8 +lymphocyte level, peripheral blood T lymphocyte CD3 +, CD4 +levels were elevated,and improve the immune function of patients , the clinical has guiding significance .

Coronary heart disease is a kind of serious heart disease, which is caused by the disease of the coronary artery, which leads to the stenosis or obstruction of the coronary vessels.Danhong injection is made of Salvia miltiorrhiza, safflower extract, chemical composition of two drugs is the key to play a role in treatment.Numerous clinical studies show that the red injection can effectively expand the coronary artery, increase the coronary blood flow, relieve the clinical symptoms of coronary heart disease, improve the ECG and improve the clinical effect.In this paper, the pharmacological properties, clinical research and treatment of CHD were reviewed,In this paper, the pharmacological properties, clinical research and treatment of CHD are reviewed, to provide theoretical basis for the treatment of CHD molecular mechanism and clinical application.