Reform and practice of blended teaching of biochemistry and molecular biology in the context of new medicine / 中华医学教育探索杂志

Objective:To investigate the application effect of the blended teaching model of "pre-class synchronous small private online course (SPOC)+ flipped classroom+post-class knowledge expansion" in the theoretical teaching of biochemistry and molecular biology. Methods:A total of 951 students majoring in clinical medicine, preventive medicine, and pharmacy in the class of 2020 in Qiqihar Medical College were selected as teaching reform research group (experimental group), and their curriculum relied on the self-built massive open online course (MOOC) curriculum and the MOOC resources of Chinese universities to construct a blended teaching model; the reform methods such as small class grouping, case-based learning, and diversified examination were adopted to carry out theoretical flipped teaching activities with cross integration of cases and knowledge points as the main line. A total of 847 students majoring in clinical medicine, preventive medicine, and pharmacy in the class of 2019 were selected as control group, and the traditional teaching method was used for theoretical courses. The courses were evaluated by offline assessment and online assessment, and feedback information was collected through examination scores, questionnaire survey, and online voting. SPSS 20.0 was used for statistical analysis, and the t-test was used for comparison between groups. Results:The experimental group had a significantly higher total score of final examination than the control group [(92.12±3.88) vs. (86.73±5.27), P<0.05]. The questionnaire survey showed that the students in the experimental group showed a relatively high degree of satisfaction with the blended teaching reform, which increased their participation, experiencing, and sharing activities. The students majoring in clinical medicine in the class of 2020 believed that they had established clinical thinking ability (263, 92.61%) and become familiar with the clinical manifestations and pathogenesis of common diseases (262, 92.25%); the students majoring in preventive medicine in the class of 2020 believed that they had increased their awareness of serving the public (151, 93.21%) and developed the ability to teach and guide healthy living (148, 91.36%); the students majoring in pharmacy in the class of 2020 believed that they had mastered the mechanism of action of drugs for disease treatment (138, 93.24%) and understood the importance of rational drug use in clinical practice (135, 91.22%). Conclusion:The blended teaching model realizes student-centered teaching, stimulates the interest and initiative in learning, and improves learning outcome, thereby improving teaching quality to a certain extent.

Systematic review and Meta-analysis of efficacy and safety of Ningxinbao Capsules in treatment of arrhythmia / 中国中药杂志

To systematically evaluate the efficacy and safety of Ningxinbao Capsules in treatment of arrhythmia by Meta-analysis. Randomized controlled trial(RCT) or quasi-randomized control trial(Quasi-RCT) on Ningxinbao Capsules treating arrhythmia were obtained by computer-based retrieval in CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Cochrane Library and EMbase as well as manual retrieval, with time limit from database establishment to April 7, 2020. According to the inclusion and exclusion criteria of trials, all RCTs were screened and evaluated. Then the effective data were collected and RevMan 5.3 Meta-analysis software was used for analysis. Thirteen trials were included, involving 1 379 patients in total. Ningxinbao Capsules combined with anti-arrhythmia Western medicine were adopted as the intervention, and the patients in control group were treated with the anti-arrhythmia Western medicine alone. Meta-analysis results showed that as compared to control group, Ningxinbao Capsules combined with anti-arrhythmia Western medicine group was superior in clinical efficacy, dynamic electrocardiogram and average heart rate in patients with bradycardia, with indicated statistically significant differences. Ningxinbao Capsules had fewer adverse reactions and could relieve the toxic and side effects of anti-arrhythmia medicine possibly. The study showed that Ningxinbao Capsules played a role in treatment of arrhythmia and was relatively safe. However, due to the limited quality of the included studies, high-quality clinical trials are needed to verify the conclusions.

Interpretation of International consensus on electroencephalogram reactivity testing after cardiac arrest on 2018 / 中华危重病急救医学

In patients being resuscitated successfully after cardiac arrest, electroencephalogram reactivity (EEG-R) is considered as a prognostic indicator. However, there are no clear guidelines on how to test EEG-R and exact definition of EEG-R. The International consensus on electroencephalogram reactivity testing after cardiac arrest on 2018, which is jointly developed by expert in relevant fields from many countries, reach a partial consensus on the test stimulation plan and definition of EEG-R. This paper interprets the main points of the consensus to provide reference for doctors majored in relevant fields in China.

Full Sibling Testing Based on NGS-SNP Genotyping Method and IBS Strategy / 法医学杂志

Objective To evaluate the effectiveness of single nucleotide polymorphism （SNP） genoty-ping in combination with identity by state （IBS） strategy in full sibling testing. Methods Thirty-five blood samples were collected from a four-generation family. Ninety autosomal SNPs were genotyped using Precision ID Identity Panel. The distribution of IBS scores for full siblings and other relationships were calculated and compared. The relationships were determined using Fisher discriminant function and threshold method, respectively. Results Based on family members and previous research, 44, 30, 111, 71 and 1 000 pairs of full siblings （FS）, grandparent-grandchild （GG）, uncle/aunt-nephew/niece （UN）, first cousins （FC） and unrelated individuals （UI） were obtained, respectively. The average IBS scores were 148, 130, 132, 124 and 120, respectively. Except for the GG and UN pairs, the distribution differences among the other relationships had statistical significance （P<0.05）. The false rates of Fisher discriminant function to determine relationships were 1.3%, 22.3%, 17.0% and 38.7% for FS, GG, UN and FC, respectively. Based on the simulation data, the thresholds t1=128 and t2=141 were recommended to determine full sibling relationships （the false rate ≤0.05%）. Conclusion The 90 SNP genetic markers included in the Precision ID Identity Panel meet the testing requirements for full sibling relationships. The threshold method based on IBS has a relatively lower false rate and is more flexible.

A 3D-printed template for preparation of tibial tunnel in reconstruction of anterior cruciate ligament / 中华创伤骨科杂志

Objective@#To evaluate the accuracy of a 3D-printed template used to assist the preparation of tibial tunnel in reconstruction of anterior cruciate ligament (ACL).@*Methods@#Twenty healthy adult cadaveric knees were scanned by computed tomography(CT) and magnetic resonance imaging (MRI). The knees were from 11 males and 9 females who had died at an average age of 36 years (range, from 27 to 68 years) and from 8 left and 12 right sides. Individualized 3D reconstruction models of the knee joint were established based on their imaging data. According to the anatomic footprints of the virtual tibial tunnel, 20 individualized navigation templates were designed and printed by 3D printing. The templates were used to assisst preparation of tibial tunnels in the ACL reconstruction for the 20 cadaveric knees. After operation, CT scanning was conducted again to compare the corresponding postitions between the preoperative virtual tunnel and the postoperative actual tunnel. The positions of the tibial tunnel were described by the Tsukada method.@*Results@#The ratio of the distance between the tunnel outlet center and the medial edge of the tibia to the distance between the median and lateral edges of the tibial plateau was 49.7%±2.1% for the preoperative virtual tibial tunnel and 48.8%±2.8% for the postoperative actural tunnel, showing no significant difference between them (t=1.971, P=0.063). The ratio of the distance between the tunnel outlet center and the anterior edge of the tibia to the distance between the anerior and posterior edges of the tibial plateau was 41.3%±1.3% for the preoperative virtual tibial tunnel and 40.3%±3.7% for the postoperative actural tunnel, showing no significant difference between them(t=1.494, P=0.152).@*Conclusion@#3D printing can be used to design and manufacture a navigation template which can accurately assist preparation of tibial bone tunnel in ACL reconstruction.

A 3D-printed template for preparation of tibial tunnel in reconstruction of anterior cruciate ligament / 中华创伤骨科杂志

Objective To evaluate the accuracy of a 3D-pfinted template used to assist the preparation of tibial tunnel in reconstruction of anterior cruciate ligament (ACL).Methods Twenty healthy adult cadaveric knees were scanned by computed tomography (CT) and magnetic resonance imaging (MRI).The knees were from 11 males and 9 females who had died at an average age of 36 years (range,from 27 to 68 years) and from 8 left and 12 fight sides.Individualized 3D reconstruction models of the knee joint were established based on their imaging data.According to the anatomic footprints of the virtual tibial tunnel,20 individualized navigation templates were designed and printed by 3D printing.The templates were used to assisst preparation of tibial tunnels in the ACL reconstruction for the 20 cadaveric knees.After operation,CT scanning was conducted again to compare the corresponding postitions between the preoperative virtual tunnel and the postoperative actual tunnel.The positions of the tibial tunnel were described by the Tsukada method.Results The ratio of the distance between the tunnel outlet center and the medial edge of the tibia to the distance between the median and lateral edges of the tibial plateau was 49.7％ ±2.1％ for the preoperative virtual tibial tunnel and 48.8％ ± 2.8％ for the postoperative actural tunnel,showing no significant difference between them (t =1.971,P =0.063).The ratio of the distance between the tunnel outlet center and the anterior edge of the tibia to the distance between the anerior and posterior edges of the tibial plateau was 41.3％ ± 1.3％ for the preoperative virtual tibial tunnel and 40.3％ ± 3.7％ for the postoperative actural tunnel,showing no significant difference between them (t =1.494,P =0.152).Conclusion 3D printing can be used to design and manufacture a.navigation template which can accurately assist preparation of tibia] bone tunnel in ACL reconstruction.

Application of chitosan hydrogels in cartilage repair / 中国组织工程研究

BACKGROUND: Chitosan has become a research hotspot of cartilage repair materials because of a wide range of biological sources, simple preparation processes and excellent biocompatibility. OBJECTIVE: To review the characteristics of chitosan hydrogels and their application in cartilage repair. METHODS: PubMed and CNKI databases were searched by computer with the keywords of "chitosan; chitosan hydrogel; cartilage repair; tissue engineering" in English and Chinese, respectively. The time range was from January 2000 to March 2018. After initial screening, the retained articles were further analyzed, concluded and summarized. RESULTS AND CONCLUSION: Chitosan has good biocompatibility, low toxicity, low immunogenicity, and can load multiple growth factors and seed cells with different physical or chemical improvements. Encouraging progress in tissue engineering cartilage repair has been achieved. With the development of technology and the understanding of cartilage and subchondral bone structure, the application range of chitosan biomimetic hydrogel has been broadened. However, the molecular mechanism and degradation process of chitosan in vivo still have a lot of controversies, and further research and exploration are needed.

Progress in biological treatment of osteosarcoma / 实用肿瘤学杂志

Osteosarcoma(OS)is a primary malignant bone tumor,characterized by a high degree of malignancy,prone to early metastasis,and poor prognosis. The survival rate of traditional surgical treatment is less than 20% . After the continuous improvement of the OS chemotherapy regimen,the 5-year survival rate of neoadjuvant chemotherapy combined with surgery-based treatment pro-gram is increased to 60% ~70% . However,the current chemotherapy regimen does not increase the survival rate of patients with OS, and the prognosis is extremely poor if patients have developed chemotherapy resistance. In order to solve the" bottleneck" problem of chemotherapy,in recent years,a comprehensive treatment plan combining immunotherapy,gene therapy,targeted therapy and chemo-therapy has been advocated. In this review,the progress of OS in the immunotherapy,gene therapy and targeted therapy is discussed in recent years,and summarized the treatment of OS.

Experimental study on the mechanism of evaporative dry eye treated by Qingxuan decoction in rabbits / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To study the mechanism and effect of Qingxuan decoction on evaporative dry eye in rabbit model. ·METHODS: Totally 25 healthy male Japanese white rabbits were randomly divided into 5 groups: control group, model group, western medicine group, high dose of Qingxuan decoction group, low dose of Qingxuan decoction group. The blank control group did not do any treatment. The improved dry eye model of rabbit was prepared by the improved method of glandular burning of the eyelid plate. The high and low dose group were given daily 27. 2mg/kg, 6. 8mg/kg Qingxuan decoction by gavage. The model group was intragastric with the same amount of normal saline every day. The western medicine group with tobramycin and dexamethasone ophthalmic ointment 1 drops, once a day. The treatment were administered continuously for 28d. At 14d before the experiment, 7d before the experiment, 7d after the model, and 14d after the model, all the rabbits were tested by Schirmer Ⅰ test ( SⅠt) and break-up time (BUT). On the 15d after modeling, the animals were sacrificed by excessive anaesthesia. Rabbit ocular surface tissue sections were prepared. Hematoxylin - eosin staining method was used to observe the corneal morphological changes in each group. The concentrations of TNF-α, IL-1 and IL-6 in the ocular surface of rabbits were detected by ELISA. ·RESULTS: (1) BUT, SⅠt: 7d after the model had been prepared, BUT and SⅠt of the model group and the western medicine group, high dose and low dose of Qingxuan decoction group was improved ( P< 0. 05 );Those of western medicine group, high dose and low dose of Qingxuan Decoction group compared with the model group, were significantly different (P<0. 05). (2) TNF-α, IL-1, IL-6: The ELISA assay showed that TNF-α and IL-1, IL-6 concentration in the model group rabbits was significantly higher than those of the control group, TNF-α and IL-1, IL-6 concentration in western medicine group and high dose group of rabbits was significantly lower than those in the model group, the differences were statistically significant (P<0. 05), and in high dose group the effect was better than that of Western medicine group. ( 3 ) Histopathological examination: on the 14d after the model, the corneal epithelium in the blank control group was stratified well. The cells in the base were columnar, near the surface, the cornea epithelium showed a squamous change. Conjunctiva showed complete epithelial layer and subconjunctival tissue layer, and goblet cells arranged closely. The number of corneal epithelial cells in model group was reduced or even stripped, and the matrix layer was disorder; Irregular loss of conjunctival epithelial cell layer and a large decrease in goblet cells. The corneal morphology of the rabbits in the western medicine group and the high dose group was close to the normal group, and the number of conjunctival goblet cells was not significantly different from that in the blank control group. ·CONCLUSION: The expression of Qingxuan decoction can inhibit the inflammatory reaction through down -regulation of TNF-α and IL-1, IL-6 and in evaporative dry eye rabbit cornea and conjunctiva, so as to improve the ocular symptoms, increase tear secretion, prolong the time of BUT.

Anterior cruciate ligament tear treated by arthroscopic tension-relieving reconstruction and enhanced re-covery after surgery / 中华创伤骨科杂志

Objective To observe the clinical effects of arthroscopic reconstruction for anterior cruciate ligament ( ACL ) tear using tension-relieving technique and enhanced recovery after surgery ( ERAS ) . Methods Between May 2014 and June 2016, 80 patients with ACL tear were randomly di-vided into 2 equal groups. The experimental group was treated with arthroscopic reconstruction using hamstring tendon autograft and tension-relieving technique followed by ERAS; the control group was treated with arthroscopic reconstruction using hamstring tendon autograft only followed by conventional postoperative re-covery. The 2 groups were compared in terms of knee flexion angles at postoperative 2nd, 4th and 8th weeks, and the IKDC ( International Knee Documentation Committee ) , HSS ( Hospital for Special Surgery ) , and Lysholm scores at postoperative 3rd, 6th and 12th months. Results The 80 patients obtained an average follow-up of 12. 3 ± 1. 7 months. Arthroscopy one year postoperation revealed fine ACL growth without laxity or other complications in the experimental group. Joint stiffness appeared in one case at 2 months postoperation and ACL laxity was observed in 3 cases by arthroscopy at 12 months postoperation in the control group. The knee flexion angles at postoperative 2nd, 4th and 8th weeks, and the IKDC, HSS and Lysholm scores at postoperative 3rd, 6th and 12th months in the experimental group were significantly better than those in the control group ( P <0. 05 ) . In both groups, the IKDC, HSS and Lysholm scores at postoperative 3rd, 6th and 12th months and the knee flexion angles at postoperative 2nd, 4th and 8th weeks were all significantly im-proved than the preoperative values ( P <0. 05 ) . Conclusion In arthroscopic reconstruction for ACL tear, tension-relieving technique combined with ERAS can promote functional recovery of the knee and reduce postoperative complications, facilitating early recovery of sports function.

Finite Element Analysis of Stress of Medial and Lateral Compartments of Knee Joints after Unicompartmental Knee Arthroplasty / 中国运动医学杂志

Objective To explore stress changes of articular surface of knees after unicompartmental knee arthroplasty (UKA) using the finite element analysis,so as to make clear the advantages and disadvantages of such a surgery.Methods Dynamic finite element analysis was performed for 6 patients after UKA and 6 healthy subjects,and compared with previous analysis of patients undergoing total knee arthroplasty (TKA).Results The stress of medial compartment was significantly bigger than that of the lateral of normal knees when bending to 30° (P＜0.05).It was the same case for postoperative knees of TKA in the whole flexion movement and those of UKA at the bending angle of 0°,60° and 90° (P＜ 0.05 for both).At the bending angle of 60° and 90°,the stress of the medial compartment of postoperative UKA knees was significantly bigger than that of the TKA knees and in the whole flexion movement,the stress of the lateral compartment of the former was significantly bigger than the latter,The stress of lateral compartment of postoperative UKA knees was bigger than the normal controls at the bending angle of 0°,30°,60° and 120° (P＜0.05).Conclusion UKA may increase the stress of knee joints and accelerate the development of osteoarthritis of the contralateral compartment,leading to poor long-term effect.However,the surgery still has advantages if strictly choosing surgery indications,optimizing the surgical operations,properly improving prosthesis and reasonably guiding patients rehabilitation.

Construction of Three-dimensional Model after Unicompartmental Knee Arthroplasty Using Point-to-point Image Registeration Technology / 中国运动医学杂志

Objective To explore the feasibility of constructing three-dimensional model after the unicompartmental knee arthroplasty using the point-to-point image registration technology,so as to provide experimental basis for further application and optimization.Methods Patients of medial compartment knee osteoarthritis undergoing UKA were chosen and their postoperative three-dimensional knee models were established based on the MRI and CT scans.The virtual prosthetic replacement and finite element models were constructed using point-to-point image registration technology,and the kinematic changes were analyzed.Results The complete postoperative three-dimensional knee models of UKA were established,and the kinematic charateristics were similar to those conducted in traditional methods.Conclusion The virtual surgery can be performed using the point-to-point image registration technology,and it is both easier and more convenient than the traditional methods.

The study of targeted blocking SDF-1/CXCR4 signaling pathway in vivo with T140 on SDF-1 and MMPs levels / 实用医学杂志

Objective To explore the effect of T140 on SDF-1 and MMPs levels through targeted blocking SDF-1/CXCR4 signaling pathway , and to investigate the function of T140 to prevent from cartilage degeneration. Methods Thirty-six 9-month-old male healthy Hartley guinea pigs were divided into three groups: experimental group(group A,n = 12),experimental control group(group B,n = 12) and blank control group (group C,n = 12). In the 2nd,4th,6th,8th,10th,12th week, the levels of SDF-1 in serum were quantified with ELISA. In the 12th week, mRNA levels of MMP-3,MMP-9 and MMP-13 in articular cartilages were measured with RT-PCR. Results The serum levels of SDF-1 of the group A decreased gradually but increased in group B and C. Group A had a statistical significance compared with group B and C at the same time point (P< 0.05).The mRNA levels of MMPs in group A were lower than group B and C (P < 0.05). Conclusion T140 could block the SDF-1/CRCR4 signaling pathway and decrease the secretion of SDF-1 and mRNA expression levels of MMPs and reduce the cartilage degeneration.

Efficacy and safety of noninvasive positive pressure ventilation in the treatment of acute respiratory failure after cardiac surgery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although noninvasive positive pressure ventilation (NPPV) has been successfully used for various kinds of acute respiratory failure, the data are limited regarding its application in postoperative respiratory failure after cardiac surgery. Therefore, we conducted a prospective randomized control study in a university surgical intensive care unit to evaluate the efficacy and safety of NPPV in the treatment of acute respiratory failure after cardiac surgery, and explore the predicting factors of NPPV failure.</p><p><b>METHODS</b>From September 2011 to November 2012 patients with acute respiratory failure after cardiac surgery who had indication for the use of NPPV were randomly divided into a NPPV treatment group (NPPV group) and the conventional treatment group (control group). The between-group differences in the patients' baseline characteristics, re-intubation rate, tracheotomy rate, ventilator associated pneumonia (VAP) incidence, in-hospital mortality, mechanical ventilation time after enrollment (MV time), intensive care unit (ICU) and postoperative hospital stays were compared. The factors that predict NPPV failure were analyzed.</p><p><b>RESULTS</b>During the study period, a total of 139 patients who had acute respiratory failure after cardiac surgery were recorded, and 95 of them met the inclusion criteria, which included 59 males and 36 females with a mean age of (61.5 ± 11.2) years. Forty-three patients underwent coronary artery bypass grafting (CABG), 23 underwent valve surgery, 13 underwent CABG+valve surgery, 13 underwent major vascular surgery, and three underwent other surgeries. The NPPV group had 48 patients and the control group had 47 patients. In the NPPV group, the re-intubation rate was 18.8%, tracheotomy rate was 12.5%, VAP incidence was 0, and the in-hospital mortality was 18.8%, significantly lower than in the control group 80.9%, 29.8%, 17.0% and 38.3% respectively, P < 0.05 or P < 0.01. The MV time and ICU stay (expressed as the median (P25, P75)) were 18.0 (9.2, 35.0) hours and 4.0 (2.0, 5.0) days, which were significantly shorter than in the control group, 96.0 (26.0, 240.0) hours and 6.0 (4.0, 9.0) days respectively, P < 0.05 or P < 0.01. The postoperative hospital stays of the two groups were similar. The univariate analysis showed that the NPPV success subgroup had more patients with acute lung injury (ALI) (17 vs. 0, P = 0.038), fewer patients with pneumonia (2 vs. 7, P < 0.001) and lower acute physiology and chronic health evaluation II (APACHE II) scores (16.1 ± 2.8 vs. 21.8 ± 3.2, P < 0.001). Multivariate analysis showed that pneumonia (P = 0.027) and a high APACHE II score >20 (P = 0.002) were the independent risk factors of NPPV failure.</p><p><b>CONCLUSIONS</b>We conclude that NPPV can be applied in selected patients with acute respiratory failure after cardiac surgery to reduce the need of re-intubation and improve clinical outcome as compared with conventional treatment. Pneumonia and a high APACHE II score >20 might be the independent risk factors of NPPV failure in this group of patients.</p>

The reproductive system impairment of adult male rats induced by cocaine / 法医学杂志

OBJECTIVE@#To investigate the reproductive system impairment induced by cocaine in adult male rats and the possible underlying mechanism.@*METHODS@#Thirty adult male rats were randomly divided into experimental and control groups, with 15 rats in each group. Rats of the experimental group were injected cocaine hydrochloride (15 mg/kg body weight) subcutaneously daily for four weeks. The weight of body and testis, as well as the level of serum hormone of the rats were examined. In addition, the apoptosis rate of testicular tissue by TUNEL and the expression of Fas gene in testicular tissue were examined by immunohistochemistry.@*RESULTS@#Compared with the control, the weight of testis in the cocaine exposed group decreased significantly (P<0.05), and the serum testosterone level decreased significantly (P<0.05). Moreover, both the apoptosis rate and the expression of Fas gene increased in the testicular tissue of rats in the cocaine exposed group in comparison to the control group (P<0.05). The apoptosis rate was significantly correlated with the expression of Fas gene (r=0.9012, P<0.05).@*CONCLUSION@#Cocaine may cause reproductive system injury in adult male rats, and Fas-mediated apoptosis may be one of the functional mechanisms involved in the reproductive system injuried by cocaine.

Adverse drug events and its forensic medical identification / 法医学杂志

OBJECTIVE@#To investigate the basic principles and important rules of forensic identification of adverse drug events and to accumulate basic data and to provide references for forensic identification of similar cases.@*METHODS@#Thirty-three cases of adverse drug events in our forensic identification files were retrospectively reviewed, analyzed, and summarized.@*RESULTS@#There were 27 live and 6 dead victims included in this study. Our study showed a gradually increasing numbers of adverse drug cases in forensic identification year by year with a slight female predominance (20/33 cases, 60.6%). Of the 33 victims, nearly two-thirds (21/33, 63.6%) were due to hospital errors including only one case of drug overdose (1/21, 4.8%), whereas the rest were not related to the hospital errors. Eight cases (8/33, 24.2%) were caused by illegal medical practitioners due to improper use of medication.@*CONCLUSION@#Investigators need to pay more attention to the characteristics and complexities of adverse drug events on a case by case basis encountered in increasing numbers of more and more such forensic identification.

A debate about mental disability expertise of the disability evaluation criteria of traffic accident injurious / 法医学杂志

In recent years, mental disability estimation are more than ever in the practice of forensic psychiatric expertise. The standards about mental disability estimation in the Disability Evaluation Criteria of Traffic Accident Injury are ambiguous and difficult to operate, it cause to different understanding in one case. This article discuss some common questions through 3 aspects in mental disability expertise according to some typical cases, there are the first, we should compare the IQ score before and after injurious in intelligence estimate. The second, the mental disability estimation should be done at least one year after the end of medicine treatment. The third, mental estimate scale should be used in mental disability estimation.