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.

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

This review describes the main technology for non-invasive glucose monitoring and introduces relevent devices.For technology,the physical principle underlying the techniques,the limitations,the measurement sites and their individual features are considered.For devices,the information listed are their approval condition (FDA Approval and/or CE Mark),the techniques adapted the manufacturer and the information available about the device on the internet.From what we reviewed,although some promising techniques and devices are already available,further efforts are still required to reach a satisfactory solution to the non-invasive glucose measurement problem.

Objective To evaluate the statues of P-selectin and chang of D-dimer in vivo in patients with deep venous thrombosis(DVT)and to observe how to vary under interneving of medicines.Methods P-selectin and D-dimer of fourty patients and twenty normal subjects were fluo-rescencelabled with its corresponding monoclonal antibodies by flow cytometry(FCM)and immune method respectively.Results In the early stage,P-selectin and D-dimer of patients with DVT is higher than that in normals,and they significantly decreased in different time after patients were treated.Compared with patients who were used on-sodium ozagrel,patients used sodium ozagrel have different P-selectin(P＜0.05),but D-dimer was similar(P＞0.05)after fourteen days.One month later,P-selectin and D-dimer of DVT patients were lower.However,the positive rate of P-selectin of DVT was still higher than normal subjects.Conclusions The platelet has been actived in vivo in patients with DVT,so do fibrinolysis.Sodium ozagrel can decrease the action of platelet.P-selectin and D-dimmer may be used in diagnose.Post-discharge patients are still high-risk group and must be followed-up regularly.

Objective To investigate the expression of OX40 on CD4+T cells in patients with ulcerative colitis (UC)and the role of OX40/OX40L interaction for the cytokine production of lamina propria(LP)-CD4+T cells from UC.Methotis LP-CD4+T cells were purified.The expression of OX40 molecule was measured with FACS.LP-CD4+T cells were cultured with different stimuli and proliferation was assessed.The cytokines concentrations of the culture supernatant were detected.Results No difference of the OX40 expression was observed among the CD4+T cells from peripheral blood(PB)of UC patients,LP of non-inflammatory colonic tissue in UC patients and control PB.However.the expression of OX40 was significantly higher on LP-CD4+T cells from inflammatory colonic tissue in UC patients.In vitro culture with antigen presenting cells,the levels of IFNγ and TNFα secreted by LP-CD4+T cells from the inflammatory colonic tissue were significantly higher than those from the non-inflammatory colonic tissue(both P＜0.01).The levels of IFNγ and TNFα secreted by LP-CD4+T cells from the inflammatory colonic tissue were further increased by anti-OX40 MoAb stimulation.but suppressed significantly by adding anti-OX40L MoAb (compared with non stimulation,P＜0.01,respectively).The IFNγ and TNFα secretion of the LP-CD4+T cells from the non-inflammatory colonic tissue were not significantly different with and without anti-OX40 or anti-OX40L MoAbs stimulation.IL-4 and IL-10 produced by LP-CD4+T cells from the inflammatory or non-inflammatory colonic tissue were not significantly changed when adding different stimuli.Conclusions OX40 is highly expressed on LP-CD4+T cells from inflammatory colonic tissue in patients with UC.AntiOX40L MoAb can inhibit the proinflammatory cytokines secreted by these cells.It is indicated that OX40+T cells are involved in the immunopathological process in UC and blockage of the interaction of OX40 and OX40Lis a new strategy to be considered for the treatment of the disease.

Objective To observe the variations and distribution of the pulmonary fissures of normal subjects in China on multi-planar recontruction (MPR) images of 64- slice helical CT.Methods A total of 1235 subiects underwent 64- slice helical CT scan with a slice thickness of 0.6 mm.The MPR images were observed to find normal interlobar fissures and the variations including the accessory fissures occurred in lobar or segmental lungs.Results Of the all cases,no variation was seen in 80.08%(989/1235),and pulmonary fissure variations occurred in the remaining 19.92%(246/1235).Among pulmonary fissure variations,20.33% (50 cases) occurred bilaterally,with the other 79.67%(196 cases) unilaterally.Of the unilateral pulmonary fissure variations,63.01%(155 cases) was seen in right lungs,and 16.66% (41 cases)was found in left lungs.There was neither oblique nor horizontal fissure in 1.22%(3 cases) of right lungs.Absence of oblique fissure happened more frequently in left lungs (6.91%,17 cases) than right lungs(3.65%,9 cases).Incomplete oblique fissure happened more frequently in left lungs (8.53%,21 cases)than in right lungs(4.06%,10 cases).Totally,absence of the horizontal fissures were found in 27.24%(67 cases) of the subjects,and incomplete horizontal fissures were found in 9.76% (24 cases).Accessory fissure were found in 83.33%(205 cases) of the subjects,and they happened more frequently in right lungs than in left lungs(53.66%,132 cases on the right,while 29.67%,73 cases on the left).Accessory fissures on right lower lobe and segments happened much more than on the left(40.65%,100 cases on the right,while 7.72%.19 cases on the left).Lingular fissures in the lungs were found in 15.85%(39 cases).The changes in shape and location of the oblique and horizontal fissures were found in 41.06%(101 cases),and happened more frequently in right lungs than left lungs (35.37%,87 cases on the right,5.69%,14 cases on the left).Conclusions Sixty-four-slice helical CT with MPR can clearly display pulmonary fissures and their variations,and it can distinguished small lesions from small vessels.

Objective To compare and evaluate the reliability and validity of the application of three pressure ulcer risk assessment scales in hospitalized elderly patients by Norton,Braden and Waterlow pressure ulcer risk assessment scales. Methods We selected 271 elderly patiehts from a certain thirdclass and first-grade hospital and assessed their pressure ulcer risks by 3 assessment scales.The reliability and validity of these Scales were evaluated and compared by the following methods such as Cronbaeh's α coefficient,content validity index,factor analysis and ROC curve. Results The Cronbach's α coefficient of these 3 scales were 0.71,0.79 and 0.32 respectively.The content validity indices of them were 0.85,0.91and 0.87.The cumulative variance explained were 71.73%,70.34%and 65.76%respectively.The sensitivity and specificity upon cut-off points were(0.75,0.62),(0.74,0.59)and(0.86,0.59).Conclusion The Waterlow scale showed insufficient internal consistency but good predictive ability.The Braden scale showed moderate reliability and validity but with a lower predictive ability compared with the Norton and Waterlow scales.

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 investigate the effect of subretinalfluid (SRF) with different grades of proliferative vitreoretinopathy (PVR) onｂcl-2 oncoprotein expression in retinal pigment epithelium (RPE) cells and fib roblast (FB)．Methods Using immunohistologicalstain ingtechniｑue and Westernblotting method to detect the expression of ｂcl-2 protein in RPE cells and FB under the stimulation of SRF．Res u ltsThe expression levels of ｂcl-2 increased in both types oｆcells to a certain extent compared with those of the control group 4 hours afterthe cells subjected to SRF； 36 hours later, the expression levels of ｂcl-2 o f experimental groups decreased more quickly thanthose of the controlgroup， and the controlgroup showed relatively higher ｂcl-2 protein levels at the end of observation． Conclusions SRF may stimulate the e xpression of ｂcl-2 in RPE cells and FB under culture at early stage, but accel arate the declining of ｂcl-2 protein levels a certain time after subjected toSRF．

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.