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 clinical application of 18F-FDG PET/CT in thyroid tumor is primarily for restaging of patients with DTC but having a negative 131i whole-body scan in the presence of elevated serum Tg and TgAb levels.In parallel with the accumulation of clinical experience and increasing clinical utilization of 18F-FDG PET/CT,the application of 18F-FDG PET/CT in thyroid tumors is also broadened.This review aims at updating the application of 18F-FDG PET/CT in different types of thyroid tumors.

[Summary] Adrenocortical carcinoma is a rare disease with poor prognosis, and its pathogenesis is mainly related to genetic mutations, abnormal expressions of steroidogenic factor-1, insulin-like growth factor 2,cell growth factors including vascular endothelial growth factor, dysfunction of Wnt pathway, as well as dysregulation of microRNA and DNA methylation. In recent years, the intensive molecular studies provide a brand-new methodology to distinguish adrenocortical carcinomas from benign tumors in early stage.

Objective To investigate the expression of S100A4 and hypoxia-induced factor 1α (HIF-1α) protein in type Ⅰ endometrial carcinoma,and to analyze their relationship.Methods The expressions of S100A4 and HIF-1α protein were detected in 65 cases of type Ⅰ endometrial carcinoma and 40 normal endometrial tissues.Results The positive rate of S100A4 in endometrial carcinoma was 47.7 ％ (31/65),the normal tissues was 0 (0/40),and there was significant difference (x2 =27.069,P =0.001).The positive rate of HIF-lα was significantly higher in endometrial carcinoma [63.1％ (41/65)] than that in the normal tissues [7.5 ％ (3/40)] (x2 =31.417,P =0.001).The expressions of S100A4 and HIF-1α were positively related with FIGO staging,pathological grades,myometrial invasion and lymphatic metastasis (all P ＜ 0.05).The expressions of S100A4 and HIF-1α were positively correlated in type Ⅰ endometrial carcinoma (r =0.348,P =0.005).Conclusion The expression levels of S100A4 and HIF-1α are closely related with the oncogenesis and progression of type Ⅰ endometrial carcinoma,and their co-detection may be useful in prognosis assessment.

A large metaanalysis showed that immediate anticoagulation of patients with acute ischemic stroke was not associated with a significant reduction in death or dependency.The heparin data from the International Stroke Trial(IST) suggest that the use of early unmonitored subcutaneous heparin will reduce early stroke recurrence risks,but these benefits can be eliminated by increased hemorrhagic complications.The use of lower doses of heparin may provide more benefits rather than hemorrhagic side effects.We recommend early anticoagulation for various specific stroke subgroups including cardioembolic stroke,progressing stroke,stroke due to large-artery atherosclerotic stenosis,documented intra-luminal thrombus,and deep venous thrombosis prophylaxis.

Objective To observe the effectiveness of botulinum toxin A (BTXA) in the treatment of small sample patients with acute acquired concomitant esotropia. Design Retrospective case series. Participants 6 patients (3 female and 3 male) with acute acquired concomitant esotropia aged 6 to 34 years. Methods All the patients were received 2.5 units of BTXA injected into the bilateral medial rectus muscles once under electromyographic control. They were performed alter prism-cover test,synoptophore and stereoscopic charts test. Main Outcome Measures The alignment of eyes and binocular vision. Results The follow-up of patients was 4 to 39 months. The pre-injection angle of deviation was 43.3?1.0△; the angle of deviation at the last follow-up was 3.3?8.2△,and 5 patients achieved alignment. In pre-injection,one patient had distance stereopsis,2 patients had near stereopsis with 600 seconds and 40 seconds; after injection,5 patients demonstrated distance and near stereeopsis (3 patients 40 seconds,1 patient 60 seconds,and 1 patient 200 seconds). Conclusion This small sample study shows that BTXA injection is effective alternative in treating acute acquired concomitant esotropia.

[Objective] To explore the treatment of urinary incontinence after stroke.[Methods]To use the Acupucture and Moxibustion method to treat the 35 patients who met the inclusion criteria,compared before and after treatment of urinary incontinence in patients with the degree of improvement.[Results] After two courses of treatment,the total effective rate 94.286%.[Conclusion]Acupuncture and Moxibustion treatment of urinary incontinence after stroke have a positive effect,and this method is simple and few side effects.

The cartilaginous external nose was observed and measured in a total of 66 adult Chinese cadavers (male 86 sides, female 45 sides). In 57 cases (114 sides) the anatomical method was used and in the remaining 9cases (17 sides), the cartilaginous external nose was removed from the cadaver, embedded in celloidin, and cut into serial coronary sections. Each section was 50～80 ?m in thickness, stained with hematoxylin-eosin and examined microscopically. The following observations were made.1. The morphology and interdigitatum of the nasal cartilage were observed.2. The size of the lateral crus of the cartilago alaris major: The average cephalocaudal length is 9.72?0.11 mm; the average medio-lateral length is 13.51?0.10mm; the average length of the inferior border is 9.36?0.13 mm. 3. The average distance from the middle line to the contact point of the cartilago nasi lateralis and the cartilago alaris major is 3.0?0.11 mm.4. The average distance from the inferior border of the cartilago alaris major to the edge of the alae nasi is 5.01?0.07mm.5. The average angle of rise of cartilago alaris major from cartilago nasi lateralis (cephalocaudad) is 23.06?.6. The interdigitation between cartilago nasi lateralis and eartilago alaris major were classified into the following three types: a) interlocked scroll(82 sides, 62.6％?4.23), b) overlap only (24 sides, 18.32％?3.38) and end-to-end (25 sides, 19.55％?3.34).7. According to applied surgical anatomy, the wall of the cartilaginous external nose can be divided into 4 layers: a) the mucoperichondrium, b) the cartilage, c) the subcutaneous muscular layer and d) the skin.8. Age changes in the configuration of the cartilaginous external nose and the cartilaginous support of the nasal tip were observed and discussed.

AIDS has become a devastating disease facing human around the world.Western medicine can reduce blood HIV load,thereby promoting recovery of immune function. With the extensive application of HAART,many unsolvable problems appear.There is much experience in treatment for infectious diseases in TCM.So,it is necessary and feasible to treat AIDS with TCM.Combination of Chinese and western medicine will achieve complementary advantages and may be a new model for AIDS treatment.Many researchers carry out study on it,but there are still a lot to do to improve the drawbacks.

GERL in fetal hepatocytes of 12, 15, 17, 19 and 21 days Wistar rat fetuses was investigated by means of transmission electron microscopy and ultracytochemistry. The ultrastructural study showed that: on the day 12 fetuses, GERL of fetal hepatoeytes was consisted of rigid lamellae and short tubules. Rigid lamellae were characterized by the relatively rigid, thin tubules and located at the maturation face of Golgi apparatus. On the day 15 and 19 fetuses, GERL was composed of tubulevacuole-like rigid lamellae, some vesicles, short or thick tubules and round dence bodies. GERL was often found tobe contiuned with lysosomes, including coated vesicle, primary and secondary lysosomes. On the day 17 and 21 fetuses, when the structure of fetal hepatocytes was at the stage of differentiation and renewal, GERL degenerated and could notbe identified.Acid phosphatase ultraeytochemieal results showed that the enzyme reaction product was seen in all parts of GERL and lysosomes, however, no portion of the Golgi stack showed AcP activity. AcP reaction product could also demons trated in the network form and degenerated form of GERL.As mentioned above, our study suggested: (1) there was indeed GERL in fetal hepatocytes of rat fetuses; (2) the formation of GERL was related to the differentiation of fetal hepatocytes as well as the formation and function of lysosomes; (3) according to the unique ultrastructure, enzymological and functional features, it be a preference to the view that the GERL might be a distinct cytoplasmic organelle.