[Distribution and reference intervals of daytime intraocular pressure in the eye health screening population of Handan]

Objective: To describe the distribution and establish reference intervals (RI) of daytime intraocular pressure (IOP) in the eye health screening population of Handan. Methods: This cross-sectional study included subjects who participated in eye health screening at the Physical Examination Center of Handan First Hospital from May 2021 to June 2022. A complete general and ocular examination was performed, including measurements of visual acuity and IOP (using Goldmann tonometry), slit lamp microscopy, fundus photography, and anterior and posterior segment optical coherence tomography. Subjects with factors that could cause significant changes in IOP or affect the accuracy of IOP measurement, or with an inability to measure IOP were excluded. Simple random sampling was used to select participants, who were grouped by gender and age (18 to <30, 30 to <40, 40 to <50, 50 to <60, 60 to <70, and ≥70 years). Central corneal thickness and IOP at 8 to 11 o'clock in one eye of each participant were recorded. The independent sample t test and ANOVA were used for statistical analysis, and the RI of IOP values was calculated by x¯±1.96s. Results: A total of 9 310 subjects had their IOP measured, and 3 491 participants (3 491 eyes) were randomly selected from 7 886 healthy subjects. The age of the participants was (47.74±14.47) years old, ranging from 18 to 90 years old. There were 1 694 males and 1 797 females. The central corneal thickness of all participants was (525.56±49.39) μm. The daytime IOP of all participants was (15.40±2.54) mmHg (1 mmHg=0.133 kPa), and the RI was 10.42 to 20.39 mmHg. The IOP was (15.49±2.58) mmHg for males and (15.29±2.49) mmHg for females, and the gender difference was statistically significant (P<0.05). The RI of daytime IOP values was 10.43 to 20.54 mmHg for males and 10.41 to 20.18 mmHg for females. There were significant differences in daytime IOP [(15.13±2.58), (15.33±2.53), (15.49±2.50), (15.53±2.55), (15.39±2.62), and (15.28±2.52) mmHg] among 6 age groups (P<0.05). Conclusions: The distribution of daytime IOP in different gender and age groups in the eye health screening population of Handan and the RIs derived from the distribution were roughly the same as the international normal IOP RI (10 to 21 mmHg). It is recommended to refer to the RI of daytime IOP values of different genders and ages for clinical decision.

[Analysis of spontaneous nystagmus and the frequency characteristics of affected semicircular canals in patients with vestibular neuritis]

Objective: To investigate the spontaneous nystagmus (SN) and the frequency characteristics of affected semicircular canals in patients with vestibular neuritis (VN). Methods: This is a cross-sectional study. A total of 61 patients with VN admitted to the Department of Neurology of Shanxi Bethune Hospital from June 2020 to October 2021, 39 were male and 22 were female, with a mean age of (46±13) years old and male to female ratio of 1.77∶1. According to SN characteristics, 61 patients were divided into non-nystagmus group(nSN), horizontal nystagmus group(hSN) and horizontal-torsional nystagmus group (htSN). Clinical data were collected, and SN, unilateral weakness (UW), directional preponderance (DP), and video head impulse test (vHIT) gain were used as observation indicators. Statistical analysis by SPSS23.0 software. Normal distributed quantitative data (age, semicircular canal gain, SN intensity) were expressed by x¯±s, non-normal distributed quantitative data (disease course, UW, DP) were expressed by M(Q₁,Q₃), qualitative data were expressed by rate and composition ratio, difference analysis by one-way ANOVA, rank sum test, Chi-square test or Fisher's exact probability method, considered by P value<0.05. Results: (1)The disease course of nSN, hSN and htSN was 7.0 (4.0, 12.5), 6.0 (3.5, 11.5), and 3.0 (2.0, 6.5) days respectively, and there were statistical differences (χ2=7.31,P=0.026).(2)The horizontal nystagmus intensity of htSN was (16.8±8.6)°/s, which was significantly higher than that of (9.8±4.7)°/s in hSN (t=3.71, P<0.001). There was no significant difference in the positive rate of UW between the three groups (P=0.690), and there was a significant difference in the positive rate of DP in the three groups (χ2=12.23, P=0.002). The horizontal nystagmor intensity in the htSN was positively correlated with the vertical nystagmus intensity (r=0.59, P=0.001).(3)The gain of the affected horizontal canal of the three groups was statistically different (F=8.28, P=0.001), and the gain of the horizontal canal of hSN and htSN was significantly lower than that of nSN (t=2.74, P=0.008; t=4.05, P<0.001); The gain of the affected anterior canal in the three groups was statistically different (F=5.32, P=0.008). The gain of the anterior canal in both nSN and hSN was significantly higher than that in htSN (t=3.09, P=0.003; t=2.15, P=0.036). The horizontal canal gain of htSN is positively correlated with the anterior canal gain (r=0.74, P<0.001).(4)The affected semicircular canals in the two groups with no-vertical-component nystagmus (nSN and hSN) and the htSN were counted. The composition ratio of the affected semicircular canals in the two groups was different (χ2=8.34, P=0.015). Conclusion: The occurrence of SN in patients with VN is related to many factors, such as the disease course, low and high frequencies, and the severity of the condition in the affected semicircular canal.

[Liver transplantation for the treatment of acute liver failure in 3 cases with NBAS gene deficiency and literature review]

Objective: To investigate the clinical efficacy of liver transplantation in the treatment of acute liver in children with NBAS gene deficiency disease and their outcome. Methods: This retrospective study enrolled children with NBAS gene deficiency who were admitted to the Children's Hospital of Fudan University for liver transplantation from January 2013 to June 2022. The clinical data were collected and analyzed. Medical literature published before June 2022 was searched with the keywords of "NBAS" "neuroblastoma amplified sequence recurrent" "acute liver failure" "SOPH syndrome" "short stature with optic nerve atrophy" "Pelger-Huët anomaly" in PubMed, China National Knowledge Infrastructure and Wanfang database. Results: Liver transplantation was performed in 3 patients (2 males and 1 female) with NBAS deficiency. All patients presented with fever-triggered recurrent acute liver failure. The genetic detection found compound heterozygous NBAS gene pathogenic variants in them. The total episodes of acute liver failure before liver transplantation were 11, 2, and 4 respectively, and the age at liver transplantation was 3.5, 2.3, and 2.0 years respectively. During liver transplantation, patient 1 was in the convalescent phase of acute liver failure, patient 2 was in the acute phase, presenting with hepatic encephalopathy (grade V) and respiratory failure, and patient 3 was considered to be in the acute phase. After liver transplantation, patient 1 recovered normal liver function within 1 month and had no liver transplantation-related complications. Patient 2 had secondary epilepsy, intellectual disability, movement disorder, and transiently elevated transaminases. Patient 3 died of severe infection within 1 month. There was no literature in Chinese, 6 in English, 8 NBAS-deficient patients who were treated with liver transplantation. Total 11 patients presented with fever-triggered recurrent acute liver failure. Their age at liver transplantation ranged from 0.9 to 5.0 years. Postoperative complications occurred in 3 patients. Until the last visit, they were followed up for 0.7 to 14.0 years. Total 2 patients died and the 9 surviving patients did not develop acute liver failure. Conclusions: Liver transplantation is effective for the treatment of acute liver failure associated with NBAS gene disease. However, postoperative complications of liver transplantation may occur. The timing of liver transplantation still needs further research.

[Enterostomy based on abdominal wall tension and fascial locking: a theory of preventing stoma complications and parahernia]

No consensus on standardized technique of enterostomy creation has been made meanwhile high heterogeneity of surgical procedure exists in 'stoma creation' chapters of textbooks or atlases of colorectal surgery. The present article reviews the anatomy of tendinous aponeurotic fibers which is crucial for abdominal wall tension and integrity. Through empirical practice we hypothesize a procedure of enterostomy creation basied on abdominal wall tension plus anchor suture for fascia fixation which could theoretically decrease short-term stoma complication rates and long-term parastomal hernia rates. Surgical techniques are as followed: (1) preoperative stoma site mark for de-functioning ileostomy should be positioned at the lateral border of rectus abdominis muscle (RAM) to decrease the difficulty of stoma reversal and for permanent colostomy should be placed overlying the RAM to promote adhesion; (2)Optimal circular removal or lineal opening of skin, and avoid dissection of subcutaneous tissue; (3) Lineal dissection of natural strong fascia (rectus sheath) at stoma site and blunt separation of muscular fibers. The tunnel of the fascia should be made with appropriate size without undue tension. To prevent the formation of dead space, additional suturing at fascia layer is unnecessary. (4) Anchor suture for fascia fixation at two ends of fascia opening could be considered to avoid delayed fascia disruption and parastomal hernia. (5) After pull-through of ileum or colon loop, 4-8 interrupted seromuscular sutures could be placed to attach loop to skin. For ileostomy, self-eversion of mucosa can be successful in vast majority of cases and a Brooke ileostomy is not necessary. The efficacy and safety of this procedure should be tested in future trials.

Parameterized Analysis of Craniocerebral Injury Caused by Fist

Abstract

Objective Based on the theory of biomechanics, the finite element method was used to study the injury characteristics of different parts of brain hit by fist with different force and to predict the risk of craniocerebral injury, in order to provide reference for actual medical protection and forensic identification. Methods The finite element model of fist was constructed by using DICOM data modeling method and related software, and the effective mass and speed of fist were used to represent the kinetic energy of fist, and combined with human finite element model THUMS 4.02, the characteristics of craniocerebral injury caused by frontal and lateral blows were parametrically simulated. Results The probability of direct death from a blow to the head was low, but as fist power increased, so did the risk of craniocerebral injury. The characteristics of craniocerebral injury were also significantly different with the different fist hitting head locations. When the frontal area was attacked, the maximum equivalent stress of skull was 122.40 MPa, while that of brain tissue was 4.31 kPa. When the temporal area was attacked, the maximum equivalent stress of skull was 71.53 MPa, while that of brain tissue was 7.09 kPa. Conclusion The characteristics and risks of skull fracture and brain tissue injury are different when different parts of the brain are hit by fist. When the frontal area is hit, the risk of skull fracture is significantly higher than when the temporal area is hit. The risk of brain tissue injury is the opposite. The position with the highest probability of skull fracture is generally the place where the skull is directly impacted, and with the conduction of stress waves, it will spread to other parts of the skull, while the position with the highest risk of brain tissue injury is not the place where the brain is directly impacted.

[Research Status of Postmortem MSCT Angiography in Forensic Science]

Abstract

Virtual autopsy is a new technique for investigating the morphological changes of cadaveric tissues and organs by medical imaging technology. It has been widely used in the identification of causes of death. Multislice spiral computed tomography （MSCT） has become a routine inspection method in some identification institutions, although it cannot completely replace traditional autopsy, it plays a key auxiliary or substitute role in the identification of certain abnormal causes of death. Plain MSCT scan cannot visualize cadaveric vessels, but can perform cadaveric angiography to determine vascular injury or disease. This technology has entered a rapid development period in recent years, and has made a considerable progress in contrast agent, perfusion methods and imaging methods. This article summarizes several common cadaveric MSCT angiography methods, such as systemic angiography, angiography through cardiopulmonary resuscitation, targeted angiography, and angiography by cardiac puncture, and analyzes and compares the application prospects.

[Analysis of Influencing Factors of Single Camera Photogrammetry in Forensic Three-Dimensional Reconstruction]

Abstract

Objective To evaluate the influence of factors such as the selection of equipment, focal length and the selection of reconstruction quality in the reconstruction software on the reconstruction results of single camera photogrammetry and provide reference for the forensic application of single camera photogrammetry. Methods The 19 skulls were measured by traditional measurement method and single camera photogrammetry. The differences between the two measurement methods and within the group with same equipment but different focal length were analyzed. One skull and one corpse were selected as the research objects. According to the reconstruction quality selection conditions in the photogrammetric software, the experimental group was divided into five grades. The model reconstructed by optical scanner was defined as reference model, while the model reconstructed by single camera photogrammetry was defined as test model. The test model was aligned with the reference model, 3D deviation analysis was carried out and the mean error and root mean square （RMS） values were calculated. Results The differences between EOS 7D zoom group and traditional measurement, and within the group with same equipment had statistical significance （P<0.05）. The mean error value and minimum RMS value of the skull reconstructed by single camera photogrammetry and the three-dimensional model of the corpse existed in the medium quality group, and the trend was basically the same. Conclusion The equipment and focal length has no obvious influence on the results of single camera photogrammetry. Lower reconstruction quality can easily cause distortion, while higher reconstruction quality can easily generate noise, so medium quality is preferred.

Exploring of the Mechanism of Rib Fracture Caused by Landing on Different Parts of the Trunk after Falls from Height Using Finite Element Method

Abstract

Objective To study the mechanism of rib fracture caused by landing on different parts of the trunk using finite element method, and to provide some new techniques and new ideas for the reconstruction of the whole process of falls from height. Methods The finite element method was used to study the rib fracture of human security model THUMS4.0 caused by landing on different parts of the trunk. Then the model was compared with actual cases and the mechanism of rib fracture caused by falls from height was analyzed from a biomechanical point of view. Results There were some differences in the stress and strain distribution as well as the rib fracture sites when different parts touched the ground. Ribs on both sides of the body were fractured when the front of the trunk touched the ground, and the fractures were mainly located in the junction of the ribs and costal cartilage and the midaxillary line area. When the right anterior part of the trunk touched the ground, rib fracture occurred first on the side that touched the ground, and rib fractures were mainly located in the area from the right midaxillary line to the posterior axillary line, and junction of ribs on both sides and costal cartilage. When the back of the trunk touched the ground, the fracture sites were mainly located on the back of the ribs on both sides. When the right posterior part of the trunk touched the ground, multiple rib fractures were likely to occur in the parts that touched the ground. The plastic strains were mainly concentrated at the fracture sites, while the von Mises stresses were not only concentrated at the fracture sites, but also at other sites. Conclusion There are some differences in rib fracture location sites and injury mechanisms when different parts of the trunk touch the ground.

[The effects and mechanism of baicalin in a mouse acute hypertensive glaucoma model]

Objective: To explore the potential neuroprotection effects and associated mechanism of baicalin in a rodent acute hypertensive glaucoma model and oxygen-glucose deprivation/reperfusion (OGD/R) induced retinal ganglion cell (RGC) injury. Methods: Experiment research. A rapid and substantial elevation of intraocular pressure was performed to establish an acute hypertensive glaucoma model, and retinal thickness was assessed at 1, 3, 5, and 7 days. The mice were then randomly divided into three groups: normal control group, hypertension group, and baicalin (50 mg/kg) for hypertension group. The effects of baicalin on the RGCs were evaluated by retrograde transporting of Fluoro-Gold. The mRNA levels of tumor necrosis factor-α, interleukine-1β (IL-1β), and inducible nitric oxide synthase were detected by real-time PCR, and the protein levels were measured by Western blot in the retina tissue of acute hypertensive glaucoma model. Purified primary RGC survival under OGD/R stress was measured by flow cytometry, which was also performed to measure the survival rate of RGCs pretreated by different doses of baicalin (2.5 μmol/L, 5.0 μmol/L, and 10.0 μmol/L). The effects of baicalin on primary RGCs co-cultured with mouse microglia cell line BV2 were evaluated by flow cytometry. The cytokine IL-1β in the culture supernatant was measured by immunochemical analyses. Statistical analysis was performed using analysis of variance. Results: Retinal tissue injuries and RGC loss were observed both in vivo and in vitro. Retinal thickness was decreased to 87.32%±0.94% at 3 days (t=6.73, P<0.01), 74.86%±2.43% at 5 days (t=13.40, P<0.01), and 63.53%±2.15% at 7 days (t=19.46, P<0.01). Treatment of 50 mg/kg baicalin significantly promoted the RGC survival from 61.32%±5.94% to 89.93%±10.08% (t=4.84, P<0.01). Baicalin alleviated the retinal damages by suppressing the expression of inflammatory cytokines as revealed by Western blot and real-time PCR. In vitro the RGC survival under OGD/R stress was increased from 51.53%±1.36% to 69.37%±7.09% and 66.23%±4.25% with 5.0, 10.0 μmol/L baicalin administration (t=5.50, 4.53; both P<0.01). BV2 under OGD/R stress did extra damage to RGCs, and baicalin could reverse the damages and increase the survival from 69.37%±7.09% to 73.00%±5.20% (t=2.82, P=0.048) by reducing the release of IL-1β [(39.97±8.76) pg/ml vs. (61.33±5.78) pg/ml, t=4.19, P=0.010]. Conclusion: Baicalin could alleviate retina tissue injury directly and promote the survival of RGCs by downregulating the expression of inflammatory cytokines and protecting RGCs from ischemia reperfusion injury. (Chin J Ophthalmol, 2020, 56: 376-382).

Evaluation of 3D Measuring Methods for Body Surface Damage and Scars

Objective To assess the accuracy and reliability of the two 3D measuring methods, structured-light scanning and single-camera photogrammetry in forensic body surface damage and scar measurement. Methods The measuring results of 86 injuries by the ruler method, structured-light scanning and single-camera photogrammetry were compared and evaluated. The area measuring results of 13 simulated scars by the structured-light scanning, single-camera photogrammetry, Photoshop lasso pixel method and PDF reading software were compared and evaluated. The time consumed was recorded. The known specification information of the stickers was used as the standard value to compare the measuring accuracy of the ruler method, structural-light scanning and single-camera photogrammetry, and to calculate the root mean square error （RMSE）. The consistency evaluation of intraclass correlation coefficient （ICC） for the repeatability of 3 measuring results obtained by different operators and the same operator. Results The differences in results of the two 3D measuring methods and the ruler method had no statistical significance; the differences between measuring results made by the structured-light scanning, single-camera photogrammetry and PDF reading software and that of the Photoshop lasso pixel method had no statistical significance. The post-processing of the single-camera photogrammetry consumed more time than that of other methods. When the long-distance group （10-40 cm） was measured, the results obtained by the ruler method were shorter than the standard value. The RMSE value results were structured-light scanning < single-camera photogrammetry < ruler method. The ICC value intragroup and intergroup were greater than 0.99. Conclusion Both structured-light scanning and single-camera photogrammetry can be applied in recording and measuring forensic body surface damage. The former has better performance in measurement accuracy and stability, while the latter has better color performance but longer post-processing time.

Research Progress on Postmortem Changes of Computed Tomography Imaging Characteristics on Corpses

Abstract

Postmortem changes on corpses appear immediately after death, and can transform the original structure characteristics of the corpse to different degrees as well as show specific changes on computed tomography （CT） images, sometimes with false positives and false negatives, influencing the identification of injuries or diseases. This paper systematically summarizes the postmortem changes of computed tomography imaging characteristics on corpses, to further expand the application of virtopsy in the practices of forensic pathology identification, and provide reference for the identification of injuries, diseases and changes after normal death.

[Organizing an assembly to eliminate hepatitis B virus through a project zero mother-to-child transmission of hepatitis B virus]

The China Foundation of Hepatitis Prevention and Control (CFHPC) initiated a project named, "getting to zero mother-to-child transmission of Hepatitis B," in July 2015, which aims to further reduce the incidence of mother-to-child transmission through standardized follow-up management of pregnant women and their infants with chronic hepatitis B virus infection by means of mobile medical application. Over the past three years, the project has established a nationwide collaborative network for interruption of mother-to-child transmission of hepatitis B virus, with 123 hospitals as project members. In addition, it has formulated a technical guidance document (Clinical Management Algorithm for Interrupting Mother-to-Child Transmission of HBV), which is designed and developed as a mobile medical application (SHIELD APP), and was released in an international conference on the theme to eliminate viral hepatitis. Following the measures mentioned above, the public's awareness rate of hepatitis B have been raised, and a good social atmosphere has been formed, which has played a positive role in promoting the prevention and control of viral hepatitis in China.

[The clinical characteristics and two different treatment outcomes of 321 patients with hypopharyngeal squamous cell carcinoma]

Objective:To investigate the clinical characteristics, two different treatment outcomes and prognostic factors of hypopharyngeal carcinoma. Method:The life table method was used to calculate the overall survival rates, Log-rank test was used to compare the overall survival rates between the two groups．The Cox proportional hazard model was used to perform the multivariate analysis to confirm independent treatment modalities as prognostic factors. Result:Among the 321 patients, 197 patients received surgery combine with radiotherapy or concurrent chemoradiotherapy treatment（S+R/CRT） and 124 patients received radiotherapy or concurrent chemoradiotherapy treatment(R/CRT). For 321 patients, the 1,3,5year overall survival rates were 75.87%,49.39%,41.38% and the median survival time was 37.65 months. The difference in throat retention ratio between the radiotherapy or concurrent chemoradiotherapy treatment(41.94%) and surgery combine with radiotherapy or concurrent chemoradiotherapy treatment（11.17%) was statistically significant (P<0.01).Univariate analysis showed that clinical stage of tumor, T stage, N stage, M stage and two different treatment modalities have impact on survival prognosis. Cox regression multivariate analysis showed that T stage, N stage, two different treatment modalities were independent risk factors of prognosis. Conclusion:The overall prognosis of hypopharyngeal carcinoma was poor and dismal. Hypopharyngeal carcinoma is characterized by high degree of malignancy, difficult to be found early, prone to recurrence and metastasis after operation, large trauma and poor prognosis. Comprehensive examination should be conducted to define the stage of tumor and choose the rational treatment plan before treatment. Surgery combine with radiotherapy or chemotherapy treatment modality is still the main treatment strategy for advanced-stage hypopharyngeal carcinoma..

[Dynamic investigation of nutritional risk in patients with malignant tumor during hospitalization]

Objective: To prospectively investigate the changes in nutritional status of patients with malignant tumors during hospitalization by using nutritional risk screening (NRS2002), and to analyze the correlation between the nutritional status and clinical outcomes . Methods: This was a prospective and parallel research done by multi-center collaboration from 34 hospitals in China from June to September 2014.Hospitalized patients with malignant tumors inthese departments (Department of Gastroenterology, respiratory medicine, oncology, general surgery, thoracic surgery and geriatrics)were investigated. Only the patients with age≥ 18 years and hospitalization time between 7-30 days were included. During hospitalization, the physical indexes of human bodywere measured, and the NRS 2002 scores, and monitored the nutritional support at the time points of admission and 24 hours before discharge were recorded.And whether there was a nutritional risk in hospitalized patients and its association with clinical outcomes were investigated. Results: A total of 2 402 patients with malignancies were enrolled in this study. Seventy fourpatients who did not complete NRS2002 were eliminated, and 2 328 patients were included. The number of the main diseases was the top five, including 587 cases of colorectal cancer, 567 cases of lung cancer, 564 cases of gastric cancer, 146 cases of esophageal cancer, and 119 cases of liver tumor. At the time of discharge, compared with admission, the BMI, body weight, grip and calf circumferences of patients with malignant tumor were significantly decreased (P<0.05). The total protein, albumin, prealbumin and hemoglobin were significantly lower than those at admission (P<0.05). In 2 328 patients who were completed nutritional risk screening, the rate of malnutrition at admission was 11.1% (BMI =18.5, 258/2 328) and the rate of malnutrition at discharge was 10.9% (BMI =18.5, 254/2 328), there were no significant differences (χ(2)=0.019 7, P=0.888). There were 1 204 patients with nutritional risk at admission (51.7%, NRS2002 score≥3)and 1 352 patients with nutritional risk at discharge (58.1%, NRS2002 score≥3), with significant differences (χ(2)=49.9, P<0.001). The incidence of nutritional risk in patients with colorectal, stomach, and lung tumors at discharge was significantly higher than that at admission (P<0.05). The infective complications and other complications of patients with nutritional risk were significantly greater than those without nutritional risk at admission and at discharge.ICU hospitalization stay of patients with nutritional risk was increased significantly than those without nutritional risk at admission(P=0.042). Hospitalization expenses of patients with nutritional risk was increased significantly than those of patients without nutritional risk at discharge(P<0.01). Conclusion: The patients with malignant tumor have a higher incidence rate of malnutrition at both admission and discharge and malnutritionhas correlation with adverse clinical outcomes.The aboveindicators did not improve significantly at discharge.Doctors should pay more attention to the nutritional status (screening and evaluation)of patients before discharge and use appropriate and adequate nutrition support in order to prevent the weight loss and improve the life quality of patients.

[Reconstruction of Vehicle-human Crash Accident and Injury Analysis Based on 3D Laser Scanning, Multi-rigid-body Reconstruction and Optimized Genetic Algorithm]

OBJECTIVES

To reconstruct a vehicle-bicycle-cyclist crash accident and analyse the injuries using 3D laser scanning technology, multi-rigid-body dynamics and optimized genetic algorithm, and to provide biomechanical basis for the forensic identification of death cause.

METHODS

The vehicle was measured by 3D laser scanning technology. The multi-rigid-body models of cyclist, bicycle and vehicle were developed based on the measurements. The value range of optimal variables was set. A multi-objective genetic algorithm and the nondominated sorting genetic algorithm were used to find the optimal solutions, which were compared to the record of the surveillance video around the accident scene.

RESULTS

The reconstruction result of laser scanning on vehicle was satisfactory. In the optimal solutions found by optimization method of genetic algorithm, the dynamical behaviours of dummy, bicycle and vehicle corresponded to that recorded by the surveillance video. The injury parameters of dummy were consistent with the situation and position of the real injuries on the cyclist in accident.

CONCLUSIONS

The motion status before accident, damage process by crash and mechanical analysis on the injury of the victim can be reconstructed using 3D laser scanning technology, multi-rigid-body dynamics and optimized genetic algorithm, which have application value in the identification of injury manner and analysis of death cause in traffic accidents.

[Study on the metastatic sequence of cervix lymph node in hypopharyngeal carcinoma]

Objective: To investigate the metastatic sequence of cervical lymph node in hypopharyngeal carcinoma aimed at guiding neck exploration. Methods: Seventy-five serial sections of integrally dissected lateral neck specimens from 67 patients of hypophayryngeal carcinoma were histopathologically observed, and the metastatic sequence of cervical lymph node of hypophayryngeal carcinoma were analysed. Results: In 75 integrally dissected lateral neck specimens, 63 laterals were found to occur cervical lymph node metastases, the metastatic ratio was 84.0%. The analytic result of 63 dissected lateral neck specimens with positive lymph nodes showed that the metastatic lymph node ratio in descending order was level Ⅱ (90.5%), level Ⅲ (76.2%), level Ⅳ (41.3%), level Ⅴ (15.9%), level Ⅰ (7.9%) and level Ⅵ (3.2%). The metastatic ratio of lymph node between level Ⅰ~Ⅵ were significantly different from each other (P<0.01). When the tumor metastasized to one cervical lymph node, this could be found in levels Ⅱ or Ⅲ, when metastasized to two cervical lymph nodes, these could be found in levels Ⅱ, Ⅲ, Ⅳ, and when metastasized to more than 5 of cervical lymph nodes, these could be found in levels Ⅱ, Ⅲ, Ⅳ, Ⅴ, Ⅰand Ⅵ. According to the occurring sequence, metastatic ratio and number of cervical lymph node metastasis (LNM), levels Ⅱ and Ⅲ were identified as the first station, level Ⅳ was the second station and levels Ⅴ, Ⅰ and Ⅵ were the third station of cervical LNM in hypopharyngeal carcinoma. Conclusion: The confirmation of metastatic sequence of cervical lymph node in hypophayryngeal carcinoma provides a reliable evidence for neck lymph node dissection and reference value for clinic therapy.

[Research Progress of MALDI-TOF-IMS in Biomedicine and Its Application Prospect in Forensic Sciences]

Matrix-assisted laser desorption/ionization time-of-flight imaging mass spectrometry （MALDI-TOF-IMS） can analysis unknown compounds in sections and obtain molecule imaging by scanning biological tissue sections, which has become a powerful tool for the research of biomarker, lipid distribution and drug metabolism, etc. This article reviews the application of this technique in protein identification, clinical application, drug discovery, lipid research and brain injury.

[Diagnostic Value of Postmortem CT Angiography in Coronary Atherosclerosis]

OBJECTIVES

To explore the application value of postmortem computed tomography （CT） angiography on diagnosis of coronary atherosclerotic stenosis degree.

METHODS

Based on the previous experimental results, the postmortem CT angiography device of human isolated heart was improved. Different coronary atherosclerotic stenosis degree of sudden death cases was selected. Before the cardiac anatomy, hearts were removed out completely and CT angiography was performed immediately. The CT angiography results were compared with histopathological findings. Meanwhile, the advantages and disadvantages of the angiography device before and after improvement were compared.

RESULTS

The improved angiography device of isolated heart could get better imaging results. The postmortem CT angiography results had high consistency with the histopathological findings on diagnosis of coronary atherosclerotic stenosis degree. And the coronary artery lesions could be revealed more objectively and vividly by 3D reconstruction technology. However, CT angiography could only be used to examine the pathological changes of blood vessels, which might have some limitations on the diagnosis of cause of death.

CONCLUSIONS

Postmortem CT angiography can be used as an additional method for the conventional autopsy in the cases of coronary atherosclerosis.

[Research Progress on Biomechanics of Craniocerebral Injury in Children]

In the researches of biomechanics for child craniocerebral injury, the research progress of performance parameter detection for brain, skull, cranial suture and dura mater, and the finite element model construction for child's head were reviewed. Meanwhile, the shortcomings of the established finite element model construction of child's head were analyzed. Thus, it is necessary to strengthen the material properties parameter detection of child's head, and establish the relevant database, so as to lay the foundation for establishing an accurate finite element model of child's head.

[The clinical characteristics and treatment strategies of differentiated thyroid carcinoma in adolescents and children]

Objective:To study the clinical characteristics and treatment strategies of differentiated thyroid carcinoma in adolescents and children.Method:From 1983 to 2014, total 2936 patients with the thyroid cancer were collected in our hospital, among which there were 85 patients of adolescents and children with 61 female and 24 male. The age was from 9 to 21 years old (median 18.3 years). There were 12 cases less than 14 years.The pathologic diagnoses were papillary carcinoma 76 cases and follicular carcinoma 9 cases. The clinical material, history of disease, clinical presentation, TNM classification, histopathological features, treatment method, and the final follow-up results were analyzed and studied. Result:Overall survival rate was 100%, follow-up from 0.5 to 31 years(medium 10.9 years), 10 year progression free survival rate was 87.1%. There was no mortality and 8(9.4%)cases occurred recurrence,who followed by surgery and resumed finally. There were 20 cases found extrathyroid extention, including 8 cases less than 14 years and 12 cases older than 15 years. The extrathyroid extention rate was significantly higher in cases of lower years(66.7%)than other group(16.4%)(P<0.01). Forty-nine(57.6%) cases were found lymphanods metastases, among them ≤14 years metastases rate 92.0%（11/12）significantly more than ≥15 years metastases rate 52.1%(38/73) (P<0.05). Three patients suffered with pulmonary metastases and all of them were ≤14 years patients. All of 85 patients were received surgery treatment included total, subtotal and oneside thyroidectomy. The neck lymph nodes were underwent modefied, radical or no neck dissection. Fifteen patients were received 131I therapy postoperatively, the dosage was 50～170 mCi. All of 85 patients were received TSH suppression therapy. 13 cases(15.3%) occurred complications,such as laryngeal recurrent nerve paralysis and hypoparathyroidism commonly. Conclusion:Majority of thyroid cancer for adolescents and children are papillary and follicular carcinoma. The histopathologic feature has significant invasion beyond thyroid capsula, and metastasis to the lymphanods and distante area,especially ≤14 years patients significant more than ≥15 years. The prognosis is favorable, it is few death from thyroid cancer. The treatment means is surgery to resect all of the disease, sometimes should perform total or neartotal thyroidectomy if there are distant metastasis and extensive invasion. It should pay attention to preserve the function of recurrent laryngeal nerve and parathyroid gland. Most of them can be performed unilateral lobectomy if the tumor located oneside thyroid gland. The lymphanode metastasis should be undertaken modified neck dissection, make effort to avoid radical neck dissection. It should be carful to use 131I internal radiation therapy and avoid the excessive treatment.

[Finite element analysis of astigmatic keratotomy based on corneal biomechanical properties]

OBJECTIVE

To establish a finite-element biomechanical model of astigmatic keratotomy, and to investigate the impact of surgical parameters on corneal deformation, stress distribution and astigmatism correction.

METHODS

With Rhinoceros modeling and Abaqus finite element analysis software, a three-dimensional finite-element model of astigmatic cornea was developed, and surgical parameters such as incision optical zone, incision depth and length were varied. Postoperative corneal stress, apical deformation and astigmatism correction were assessed.

RESULTS

A significant increase of stress was noticed near corneal incisions, and maximum corneal stress decreased with the increase of incision depth. Both anterior and posterior corneal surface moved slightly forward postoperatively. Maximum corneal stress was 340 392, 361 022 and 214 187 Pa, and anterior and posterior apical deformation was 49.80, 51.64, 55.53 μm and 54.15, 55.91, 59.67 μm, with 45°, 60° and 90° in arc length of the incision, respectively. The refractive power decreased in steep meridian and increased in flat meridian, resulting in a total decrease of corneal astigmatism. The magnitude of astigmatism correction was 0.85, 1.59, 2.23 and 3.06 D with 30°, 45°, 60° and 90° in arc length of the incision, respectively.

CONCLUSIONS

The finite-element biomechanical model of astigmatic keratotomy could be used to predict the optical outcomes after surgery. The magnitude of astigmatism correction is positively correlated with the surgical incision arc length. (Chin J Ophthalmol, 2016, 52: 674-680).

Enhanced electrochemical performance and thermal stability of a CePO4-coated Li1.2Ni0.13Co0.13Mn0.54O2 cathode material for lithium-ion batteries

CePO₄ coating via a simple precipitation method enhances the thermal stability of the layered Li_1.2Ni_0.13Co_0.13Mn_0.54O₂ cathode material.

Support vector machine-based nomogram predicts postoperative distant metastasis for patients with oesophageal squamous cell carcinoma

Background:

We aim to develop effective models for predicting postoperative distant metastasis for oesophageal squamous cell carcinoma (OSCC) for the purpose of guiding tailored therapy.

Methods:

We used data from two centres to establish training (n=319) and validation (n=164) cohorts. All patients underwent curative surgical treatment. The clinicopathological features and 23 immunomarkers detected by immunohistochemistry were involved for variable selection. We constructed eight support vector machine (SVM)-based nomograms (SVM1–SVM4 and SVM1'–SVM4'). The nomogram constructed with the training cohort was tested further with the validation cohort.

Results:

The outcome of the SVM1 model in predicting postoperative distant metastasis was as follows: sensitivity, 44.7% specificity, 90.9% positive predictive value, 81.0% negative predictive value, 65.6% and overall accuracy, 69.5%. The corresponding outcome of the SVM2 model was as follows: 44.7%, 92.1%, 82.9%, 65.9%, and 70.1%, respectively. The corresponding outcome of the SVM3 model was as follows: 55.3%, 93.2%, 87.5%, 70.7%, and 75.6%, respectively. The SVM4 model was the most effective nomogram in prediction, and the corresponding outcome was as follows: 56.6%, 97.7%, 95.6%, 72.3%, and 78.7%, respectively.Similar results were observed in SVM1', SVM2', SVM3', and SVM4', respectively.

Conclusion:

The SVM-based models integrating clinicopathological features and molecular markers as variables are helpful in selecting the patients of OSCC with high risk of postoperative distant metastasis.

Comparing three different surgical techniques used in adult bilateral varicocele

INTRODUCTION

Varicocele is a common disease in adult men that can be treated with one of several surgical methods. Each technique has advantages and disadvantages, and conflicting results have been obtained by different studies. To evaluate the most effective surgical techniques used in adult bilateral varicocele, including minimally invasive procedures, we compared the outcomes of three common surgical approaches in this prospective randomized study.

METHODS

The study included 153 patients with bilateral varicoceles who underwent varicocelectomy. These patients were randomly divided into three equal groups according to surgical approach used - open inguinal, retroperitoneal or laparoscopic. The assessment included operative time, length of hospital stay, clinical outcome and, in cases of infertility, semen analysis. The mean follow-up was 12 months (range, 8 to 15 months).

RESULTS

The operative time and hospital stay in the laparoscopic group were significantly shorter than in the other groups (P < 0.01). Of the 51 cases in each group, there were seven cases (13.73%) of recurrence in the open inguinal group, six cases (11.76%) in the retroperitoneal group, and one case (1.96%) in the laparoscopic group. This lower rate of recurrence was statistically significant in the laparoscopic group (P < 0.05). Among the three groups, comparisons between preoperative and postoperative semen parameters showed visible improvements in sperm concentration and motility (P < 0.01), but there were no significant differences between the three groups for postoperative changes in semen parameters (P > 0.05).

CONCLUSIONS

Compared with open inguinal and retroperitoneal varicocelectomy, laparoscopic varicolerectomy offers the best outcome.

Effects of Sophy β-glucan on growth performance, carcass traits, meat composition, and immunological responses of Peking ducks

The response of Peking ducks to supplements of Sophy β-glucan was studied. A total of 160 healthy 1-d-old mixed-sex ducklings were randomly allocated to 3 groups: Sophy β-glucan (n = 80), bacitracin zinc (n = 40), and control (n = 40), which received the same antibiotics-deficient diet supplemented with 1% β-glucan, 5% bacitracin zinc, or nothing, respectively. During 2 mo of the study, growth performance, carcass composition, and meat quality of Peking ducks were evaluated. Additionally, a separate immunological study was conducted with a total of 105 healthy male Peking ducks in 7 groups (n = 15) and immunized with different doses of β-glucan (0, 0.5, 2.5, 12.5, and 62.5 μg/duck) and BSA (200 μg/duck). Blood was taken for detection of anti-BSA-IgG antibody and peripheral blood mononuclear cells proliferation assays. Groups subjected to different dietary treatments showed almost no differences in growth performance and slaughter traits except breast muscle percentage and intestinal length. These 2 indicators were significantly higher in the bacitracin zinc group than in the control and β-glucan groups (P < 0.05). Similarly, chemical compositions, fatty acids, and amino acids of breast muscle were not significantly influenced by the diet. Ducks immunized with Sophy β-glucan did not have enhanced level of anti-BSA-IgG antibodies but had significant peripheral blood mononuclear cells proliferation compared with unchallenged ducks (P < 0.01). With an increase in the glucan concentration, the proliferative responses approximately linearly increased. These findings indicate that 1% Sophy glucan did not improve duck growth performance, carcass composition, and meat quality significantly under the conditions of the present experiment and mainly had regulatory or enhancing properties on poultry nonspecific cellular immunity.

Early embryonic blood cells collect antigens and induce immunotolerance in the hatched chicken

Earlier experimental data in our laboratory showed that introduction of an exogenous protein into early chicken embryonic blood leads to immunotolerance of hatched chicken to that protein. However, the underlying mechanism is yet unknown. In the present study, we show that the blood cells collecting circulating antigen might contribute to the establishment of immunotolerance. In this experiment, most of the chicken embryo blood cells took up injected fluorescein isothiocyanate-BSA at approximately embryonic d 3. At the same stage, 1 microL of embryo blood was taken out and incubated with BSA. After being loaded with BSA in vitro and washed, these cells were injected back into the original embryo. The BSA-specific lymphocytes were depleted in chickens whose early embryo cells had been loaded with BSA, as evidenced by a significant decrease in anti-BSA antibody after challenge with BSA when the chickens were 3 wk old. In addition, by direct injection of BSA to embryonic d 3 embryo blood, the hatched chickens had decreased amounts of anti-trinitrophenol antibody after the chickens were challenged with trinitrophenol-BSA, indicating that the helper function of BSA-specific T cells was impaired. In conclusion, these observations suggest that some early embryo blood cells possibly collect and store antigen for the establishment of self-tolerance before the maturation of B and T cells.

HPLC determination of telmisartan in human plasma and its application to a pharmacokinetic study

A sensitive, simple, and accurate HPLC method was developed for the assay of telmisartan in human plasma. Using naproxen as internal standard, the assay involved liquid-liquid extraction of the compound from acidified plasma into organic solvent and reversed-phase chromatography with fluorescence detection. The assay was shown to be linear from 0.5 to 1000 ng/mL. In 24 healthy volunteers, the plasma concentrations of the drug were determined after a single oral dose of 160 mg.

Production of duck-chicken chimeras by transferring early blastodermal cells

Duck blastodermal cells isolated from Stage X embryos of Maya ducks were injected into subgerminal cavity of recipient Stage X chicken embryos treated with gamma-irradiation or untreated. Eleven somatic chimeras were obtained based on plumage color and were raised to sexual maturity. To test for germline chimerism, progeny tests were performed by mating the chimeras with Maya ducks. A total of 622 eggs was collected and incubated. Fertility rate and hatchability were 2.9% (18/622) and 1.0% (6/622), respectively. The six duck hatchlings were from Chimera 9801 and were considered to be derived from the germ cells developed from the donor Maya blastodermal cells, indicating that Chimera 9801 is a germline chimera.

[Development of donor cells in chicken-duck chimeric embryos]

Chicken W chromosome-specific DNA fragments were obtained after transformation, extraction, purification and digestion with EcoR I of pUGD1201. The W chromosome-specific DNA probe was a 1.2 kb insert, which was labelled by the random-technique using a Digoxigenin Labeling Kit. Chicken PGCs from a line of White Leghorns were microinjected into Maya duck blastoderms at stage X. The embryos at 6,8,9,12,16,18 days of incubation were used to study the development of chicken PGCs in the chimeric embryos. Used chicken W chromosome-specific DNA probes by in situ hybridization, development of donor cells in chicken-duck chimeric embryos were studied. In 54 chimeric embryos, there were different degrees of chimerism in the organs. The chimeric rate of the livers was the highest, which of the gonads was the lowest. It is demonstrated that somatic and germline chimeras can be yielded successfully by transferring stage X chicken blastodermal cells.

[Human DNA polymorphism of HaeIII system in Chinese oriental, Han population]

DNA typing by restriction fragment length polymorphism (RFLP) analysis was an extremely important technique used in forensic science identification, paternity test and gene diagnosis. While RFLP testing was a highly informative method, it traditionally had several disadvantages. It was time consuming and involved in working with radioactive phosphorus. A chemiluminescent detection of RFLP technique that was faster and safer than isotopic detection. The chemiluminescent system had a good sensitivity of detecting 3-25 ng sample DNA. The development of direct alkaline phosphatase (AP) conjugated probes and improved chemiluminescent substrates provided a non-isotopic detection method that equaled or surpassed 32P detection systems. Population genetic studies were performed using direct alkaline phosphatase (AP) conjugated oligonucleotide probes (AL1874, YNH24, TBQ7, VI) that recognized four hypervariable number of tandem repeats regions (D2S92, D2S44, D10S28, D17S79 loci) respectively in the human genome. DNA from approximately 480 unrelated individuals, subdivided into oriental group were digested with HaeIII enzyme and were successively hybridized to each DNA probe. The number of distinct DNA fragments identified for each of these regions varies from 37 to more than 78. An allele frequency distribution was determined for each locus with the computer and digitizer. The results showed significant differences between different races (American-blacks, Caucasians, and Orientals), in the pattern of distributions as well as in the relative frequency of the most common alleles of D2S92, D2S44, D10S28, and D17S79. The results showed that the analysis of these loci had useful applications in genetics and in forensic identity.

Construction and diversity analysis of a murine IgE phage surface display library

To make further investigation of the IgE antibody repertoire in Trichosanthin (TCS) allergic responses, a murine IgE phage surface display library was constructed (3.0 x 10(5) independent clones). We first constructed the V epsilon cDNA library (4.6 x 10(5) independent clones) and V kappa cDNA library (3.0 x 10(5) independent clones). Then, the V epsilon and V kappa gene segments were amplified from both libraries by PCR respectively, and assembled into Fab fragment by SOE PCR. The phage library containing Fabs was thus constructed. The diversity of V epsilon from this library was analyzed and proved. Fab clones with high specificity to TCS have been screened out.

Structural analysis and molecular modeling of two anti-trichosanthin IgE clones from phage antibody library

Recently we constructed a murine IgE phage surface display library and screened out two IgE (Fab) clones with specific binding activity to Trichosanthin (TCS). In this work, the V epsilon and V kappa genes of the two clones were sequenced and their putative germline gene usages were studied. On the basis of the known 3D structure of Trichosanthin and antibody, molecular modeling was carried out to study the antigen-antibody interaction. The possible antigenic determinant sites on the surface of TCS recognized by both the clones were analyzed, and the reaction forces between TCS and two Fab fragments were also analyzed respectively.

[Clinic analyses of digestive tract bleeding due to hypertension and intracerebral hematomas]

This paper reports 14 cases with digestive tract bleeding due to hypertension, and intracerebral hematomas, among which five cases suffer from severe bleeding. The paper analyses its clinical manifestations, mechanism and treatment. The author believes that digestive tract bleeding easily occurs with consciouslessness, great quantity of intracerebral hematomas into ventricles and injury of brain stem. The bleeding moment may occur in acute period or in recovery period. It will reach a good result to treat comprehensively.

Clinical burn wound infection caused by L-forms of Staphylococcus aureus

A patient with an infection with the L-form of Staphylococcus aureus occurring in burn wounds is reported. The authors conclude that the infection was attributable to a decrease in the host immunological functions and repeated administration of antibiotics resulting in the development of bacterial L-forms.

Quantification of circulating schistosome antigen by monoclonal antibody-based enzyme-linked immunosorbent assay

A two-site enzyme-linked immunosorbent assay (2S-ELISA) was developed for the quantification of gut-associated schistosome circulating anodic proteoglycan (GASCAP) of Schistosoma japonicum using a monoclonal antibody (McAb M120), purified by one-step hydroxylapatite (HAP) chromatography, as both solid phase and peroxidase-conjugated reagent. In this system, a high detectable level of serum GASCAP concentration (0.25 microgram/L) could be achieved with the immunoaffinity purified GASCAP being used as the standard. The specificity of the assay was 97.2%, with minimized interference of rheumatoid factor. The intra-assay (4.01%) and interassay (6.09%) coefficients of variation and the mean analytical recovery (101.4%) for GASCAP demonstrated the precision and accuracy of the assay.

Studies of ovulation in the perfused ovary of the fowl (Gallus domesticus)

A system was developed for the in-vitro perfusion of the fowl ovary. The ovaries were isolated 16-18 h before expected ovulation of the first follicle of a clutch sequence and perfused at 41 degrees C with Eagle's culture medium containing L-thyroxine and insulin. The efferent perfusion pressure was maintained at 30-40 mmHg. This model was used to investigate the mechanism of ovulation. Addition of LH (1 U) to the perfusate induced ovulation (46%) but LH (1 U) + FSH (1 U) was more effective (88%; P less than 0.05). Progesterone at 100 micrograms alone also induced ovulation (80%). Clomiphene prevented gonadotrophin-induced ovulation. These results suggest that progesterone may act directly on the ovary as a final hormone to induce ovulation in the domestic fowl.