Cytotoxicity of 4 Wild Mushrooms in a Case of Yunnan Sudden Unexplained Death / 法医学杂志

OBJECTIVES@#To explore the cytotoxicity of four wild mushrooms involved in a case of Yunnan sudden unexplained death (YNSUD), to provide the experimental basis for prevention and treatment of YNSUD.@*METHODS@#Four kinds of wild mushrooms that were eaten by family members in this YNSUD incident were collected and identified by expert identification and gene sequencing. Raw extracts from four wild mushrooms were extracted by ultrasonic extraction to intervene HEK293 cells, and the mushrooms with obvious cytotoxicity were screened by Cell Counting Kit-8 (CCK-8). The selected wild mushrooms were prepared into three kinds of extracts, which were raw, boiled, and boiled followed by enzymolysis. HEK293 cells were intervened with these three extracts at different concentrations. The cytotoxicity was detected by CCK-8 combined with lactate dehydrogenase (LDH) Assay Kit, and the morphological changes of HEK293 cells were observed under an inverted phase contrast microscope.@*RESULTS@#Species identification indicated that the four wild mushrooms were Butyriboletus roseoflavus, Boletus edulis, Russula virescens and Amanita manginiana. Cytotoxicity was found only in Amanita manginiana. The raw extracts showed cytotoxicity at the mass concentration of 0.1 mg/mL, while the boiled extracts and the boiled followed by enzymolysis extracts showed obvious cytotoxicity at the mass concentration of 0.4 mg/mL and 0.7 mg/mL, respectively. In addition to the obvious decrease in the number of HEK293 cells, the number of synapses increased and the refraction of HEK293 cells was poor after the intervention of Amanita manginiana extracts.@*CONCLUSIONS@#The extracts of Amanita manginiana involved in this YNSUD case has obvious cytotoxicity, and some of its toxicity can be reduced by boiled and enzymolysis, but cannot be completely detoxicated. Therefore, the consumption of Amanita manginiana is potentially dangerous, and it may be one of the causes of the YNSUD.

Pneumonia, Multiple Pulmonary Infarction and Abscess Caused by a Bamboo Stick Accidentally Piercing into Chest: a Case Misdiagnosed as Pulmonary Tuberculosis / 中国医学科学杂志(英文版)

Computed tomography (CT) examination is the major measure for detecting and diagnosis of foreign bodies in human body. Although CT has high sensitivity in diagnosis of foreign body, some interference factors may still lead to missed diagnosis or misdiagnosis. Here we report a rare case that a bamboo stick accidentally pierced into the left chest of a young man who was drunk and unware of this hurt. The patient experienced cough, chest pain, fever, hemoptysis, and was misdiagnosed as primary and secondary tuberculosis based on chest CT examinations at a local hospital, although no tubercular bacillus detected by sputum smear. He subsequently received anti-tuberculous treatments in the following three years, but no improvement of his symptoms was observed. Until one month before his death, the bamboo stick was detected by spiral CT examination as well as three-dimensional image reconstruction at another hospital. Postmortem examination revealed pneumonia, pulmonary infarction, and abscess as the causes of his death. We analyze the potential reasons of misdiagnosis in this case, aiming to provide reference for the diagnosis and treatment of pulmonary inflammation associated with foreign body in the future.

Cardiac Disease Associated Genetic Variants in Yi Nationality in Regions with High Incidence of Yunnan Sudden Unexplained Death / 法医学杂志

Objective To explore the association of cardiac disease associated genetic variants and the high incidence of Yunnan sudden unexplained death （YNSUD） in Yi nationality. Methods The genomic DNA was extracted from peripheral blood samples collected from 205 Yi villagers from YNSUD aggregative villages （inpatient group） and 197 healthy Yi villagers from neighboring villages （control group）. Fifty-two single nucleotide variants （SNVs） of 25 cardiac disease associated genes were genotyped using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry （MALDI-TOF-MS）. The SPSS 17.0 was used to analyze data. The pathogenicities of variants with differences between the two groups that have statistical significance were predicted by protein function prediction software PolyPhen-2 and SIFT. All villagers from inpatient group were given electrocardiogram （ECG） examination using a 12-lead electrocardiograph. Results The allele frequency and the genotype frequency of missense mutation DSG2 （rs2278792, c.2318G>A, p.R773K） of pathogenic genes of arrhythmogenic right ventricular cardiomyopathy （ARVC） in inpatient group was higher than that in control group （P<0.05）. Abnormal ECG changes were detected in 71 individuals （34.6%） in the inpatient group, among which 54 individuals carried R773K mutation, including clockwise （counterclockwise） rotation, left （right） axis deviation, ST segment and T wave alteration and heart-blocking. Conclusion Definite pathogenic mutations have not been found in the 52 cardiac disease genes associated SNVs detected in Yi nationality in regions with high incidence of YNSUD. The cause of high incidence of YNSUD in Yi nationality needs further study.

The Influence of Case Teaching of Forensic Pathology Based on Network Platform on Critical Thinking Skills among Forensic Students / 昆明医科大学学报

Objective The paper aimed to discuss the influence of case teaching of forensic pathology based on network platform on the critical thinking ability of forensic students.Methods Students majoring in forensic were randomly divided into the experimental group and the control group with 20 students per group. According to heterogeneity classification, the experimental group was divided into 4 subgroups. The subgroups participated in network cases learning whereas the control group received traditional case teaching. Participants were required to fill in California Critical Thinking Disposition Inventory-Chinese Version (CCTDI-CV) before and after learning. CCTDI-CV scores, the scores of final exam and the number of students who had improved in CCTDI-CV scores were compared between the two groups. Results For the experimental group, the total score of CCTDI-CVand the scores of items including looking for the truth, systematized ability, self-confidence, thirst for knowledge were significantly improved after learning. The performance of the experimental group was better than that of the control group at the end of teaching (P＜0.05) . The scores of final exam were higher in the experimental group compared to the control group (P＜0.05) .Conclusion Forensic pathology cases teaching based on network platform is an effective way to stimulate students'critical thinking ability and to improve the study ability.

Forensic Pathology Analysis of 363 Sudden Death Cases in Yunnan Province / 法医学杂志

OBJECTIVES@#To study the epidemiological and pathological features of sudden death （SD） in Yunnan Province and to provide scientific evidence for prevention and forensic identification of sudden death.@*METHODS@#Totally 363 SD cases were collected from the autopsies between 2009 and 2017 in the Forensic Centre of Kunming Medical University. The related factors such as etiology, age, inducing factor, time interval between the onset of disease and death, morbidity season and pathological change were retrospectively analysed.@*RESULTS@#The incidence of SD in males was significantly higher than that of females. The peak age was ≥35-55 years. The mortality rate was relatively high within 6 h after the onset of disease. The season order with descending number of deaths was spring, summer, winter and autumn. The top ten causes of SD were coronary heart disease, sudden unexplained death （SUD）, cerebral hemorrhage, acute hemorrhagic necrotic pancreatitis, aortic dissection rupture, cardiomyopathy, pneumonia, pulmonary thromboembolism, amniotic fluid embolism and allergy. Exercise, infusion, surgery, medication and minor injury were the most common predisposing factors of sudden coronary death. Consciousness disorder or coma, chest pain or chest tightness, and abdominal pain were the most common premortem symptoms of sudden coronary death.@*CONCLUSIONS@#The SD is more common in middle-aged males, which is the key population for the prevention of SD. For the forensic identification and prevention of SD, the attention on SUD should be paid.

Ethnic differences on nutritional status of children under 3 years old in poor counties of the western China / 中华流行病学杂志

Objective To explore the ethnic differences on nutritional status of children under three years old,in the western areas of China and to indentify the affecting factors.Methods 14 072children under the age of three years and their mothers were recruited,using the proportion population sampling method in 45 counties in the western areas of China.Height and weight were used as the measurement on nutrition of children.Results Height and weight of children with Han,Uyghur,Tibetan and Zhuang ethnicities were all lower than the WHO standards and with differences on height and weight among them.There were also ethnic differences on the status of malnutrition.Prevalence rates of stunting were 14.7％,20.3％,26.9％ and 26.5％ for Han,Uyghur,Tibetan and Zhuang ethnicities,respectively.Prevalence rates of underweight were 6.1％,10.7％,6.8％ and 15.5％ among the Han,Uyghur,Tibetan and Zhuang ethnicities,respectively.The prevalence rates of wasting were 4.2％,5.3％,2.9％,8.9％,and of under nutrition were 19.2％,25.5％,30.3％ and 36.5％ for the Han,the Uyghur,the Tibetan and the Zhuang ethnicities,respectively.When factors as family size,years of schooling of parents,family numbers,sex,age (months),mother' s height and weight,ways of feeding and sources of family income etc.were adjusted,children with Uyghur,Tibetan,Zhuang and other ethnicities were still presented more malnutrition than the children with Han ethnicity.Conclusion There were differences on malnutrition status of children under the age of three years among the studies on different ethnicities.Undemutrition was less than nutritional status,seen in children of the Han nationality than other minority ethnicites.Ethnicity seemed to be related to differences in the nutritional status of children in western China while children of the Han nationality would be better than other minorities on nutritional status if they were in same living conditionals.