Forensic Identification and Evaluation of 25 Obstetric Brachial Plexus Palsy Medical Damage Cases / 法医学杂志

Objective To analyze the high risk factors of obstetric brachial plexus palsy(OBPP),and to explore how to evaluate the relationship between fault medical behavior and OBPP in the process of medical damage forensic identification.Methods A retrospective analysis was carried out on 25 cases of medical damage liability disputes related to OBPP from 2017 to 2021 in Beijing Fayuan Judicial Science Evidence Appraisal Center.The shortcomings of hospitals in birth weight assessment,delivery mode selection,labor process observation and shoulder dystocia management,and the causal relation-ship between them and the damage consequences of the children were summarized.Results Fault medi-cal behavior was assessed as the primary cause in 2 cases,equal cause in 10 cases,secondary cause in 8 cases,minor cause in 1 case,no causal relationship in 1 case,and unclear causal force in 3 cases.Conclusion In the process of forensic identification of OBPP,whether medical behaviors fulfill diagno-sis and treatment obligations should be objectively analyzed from the aspects of prenatal evaluation,de-livery mode notification,standardized use of oxytocin,standard operation of shoulder dystocia,etc.Meanwhile,it is necessary to fully consider the objective risk of different risk factors and the diffi-culty of injury prevention,and comprehensively evaluate the causal force of fault medical behavior in the damage consequences.

Research Progress on Biological Evidence Identification in Fire Scenes / 法医学杂志

Biological evidence is relatively common evidence in criminal cases,and it has strong pro-bative power because it carries DNA information for individual identification.At the scene of fire-related cases,the complex thermal environment,the escape of trapped people,the firefighting and res-cue operations,and the deliberate destruction of criminal suspects will all affect the biological evi-dence in the fire scene.Scholars at home and abroad have explored and studied the effectiveness of biological evidence identification in fire scenes,and found that the blood stains,semen stains,bones,etc.are the main biological evidence which can be easily recovered with DNA in fire scenes.In order to analyze the research status and development trend of biological evidence in fire scenes,this paper systematically sorts out the relevant research,mainly including the soot removal technology,appearance method of typical biological evidence,and possibility of identifying other biological evidence.This pa-per also prospects the next step of research direction,in order to provide reference for the identifica-tion of biological evidence and improve the value of biological evidence in fire scenes.

Advance on anti-tumor theranostics and biosafety of bismuth-based nanomedicine / 药学学报

Nanomedicine is one of the most promising fields in biomedicine. Inorganic nanomaterials stand out among many nanomaterials due to their excellent physicochemical properties, stable chemical properties and high biocompatibility. As an inorganic nanomaterial, bismuth-based nanomaterials have the advantages of adjustable band gap, low toxicity, easy functionalization, large X-ray attenuation coefficient, high photothermal conversion efficiency and long cycle half-life, so they have good promising application in cancer diagnosis and treatment. This review summarizes the recent research progress of bismuth-based nanomaterials in tumor diagnosis, treatment and biosafety, which provides a theoretical basis for the design and exploitation of a new generation of bismuth-based nanomedicine systems.

A novel method for electroencephalography background analysis in neonates with hypoxic-ischemic encephalopathy / 中国当代儿科杂志

OBJECTIVES@#To explore a new method for electroencephalography (EEG) background analysis in neonates with hypoxic-ischemic encephalopathy (HIE) and its relationship with clinical grading and head magnetic resonance imaging (MRI) grading.@*METHODS@#A retrospective analysis was performed for the video electroencephalography (vEEG) and amplitude-integrated electroencephalography (aEEG) monitoring data within 24 hours after birth of neonates diagnosed with HIE from January 2016 to August 2022. All items of EEG background analysis were enrolled into an assessment system and were scored according to severity to obtain the total EEG score. The correlations of total EEG score with total MRI score and total Sarnat score (TSS, used to evaluate clinical gradings) were analyzed by Spearman correlation analysis. The total EEG score was compared among the neonates with different clinical gradings and among the neonates with different head MRI gradings. The receiver operating characteristic (ROC) curve and the area under thecurve (AUC) were used to evaluate the value of total EEG score in diagnosing moderate/severe head MRI abnormalities and clinical moderate/severe HIE, which was then compared with the aEEG grading method.@*RESULTS@#A total of 50 neonates with HIE were included. The total EEG score was positively correlated with the total head MRI score and TSS (rs=0.840 and 0.611 respectively, P<0.001). There were significant differences in the total EEG score between different clinical grading groups and different head MRI grading groups (P<0.05). The total EEG score and the aEEG grading method had an AUC of 0.936 and 0.617 respectively in judging moderate/severe head MRI abnormalities (P<0.01) and an AUC of 0.887 and 0.796 respectively in judging clinical moderate/severe HIE (P>0.05). The total EEG scores of ≤6 points, 7-13 points, and ≥14 points were defined as mild, moderate, and severe EEG abnormalities respectively, which had the best consistency with clinical grading and head MRI grading (P<0.05).@*CONCLUSIONS@#The new EEG background scoring method can quantitatively reflect the severity of brain injury and can be used for the judgment of brain function in neonates with HIE.

A preliminary study on a new method for evaluating brain maturation in preterm infants / 中国当代儿科杂志

OBJECTIVES@#To establish a new method for evaluating the brain maturation of preterm infants based on the features of electroencephalographic activity.@*METHODS@#A prospective study was conducted on the video electroencephalography (vEEG) and amplitude-integrated electroencephalography (aEEG) recordings within 7 days after birth of preterm infants who had a postmenstrual age (PMA) of 25-36 weeks and met the inclusion criteria. The background activity of aEEG+conventional electroencephalography (cEEG) was scored according to the features of brain maturation as a new evaluation system and was compared with the aEEG evaluation system. The correlations of the evaluation results of the two methods with gestational age (GA), PMA, and head circumference were evaluated. The intervals of the total scores of aEEG+cEEG and aEEG were calculated for preterm infants with different PMAs and were compared between groups. The consistency of the new scoring system was evaluated among different raters.@*RESULTS@#A total of 52 preterm infants were included. The total scores of aEEG+cEEG and aEEG were positively correlated with GA, PMA, and head circumference (P<0.05), and the correlation coefficient between the total scores of the two systems and PMA and GA was >0.9. The normal score intervals for aEEG+cEEG and aEEG scoring systems were determined in preterm infants with different PMAs as follows: infants with a PMA of less than 28 weeks had scores of 13.0 (11.0, 14.0) points for aEEG+cEEG and 6.0 (4.0, 7.0) points for aEEG; infants with a PMA between 28 and 29+6 weeks had scores of 16.0 (14.5, 17.0) points for aEEG+cEEG and 8.0 (6.0, 8.0) points for aEEG; infants with a PMA between 30 and 31+6 weeks had scores of 18.0 (17.0, 21.0) points for aEEG+cEEG and 9.0 (8.0, 10.0) points for aEEG; infants with between 32 and 33+6 weeks had scores of 22.0 (20.0, 24.5) points for aEEG+cEEG and 10.0 (10.0, 10.8) points for aEEG; infants with a PMA between 34 and 36 weeks had scores of 26.0 (24.5, 27.5) points for aEEG+cEEG and 11.0 (10.0, 12.0) points for aEEG. There were significant differences in the total scores of aEEG+cEEG and aEEG among the different PMA groups (P<0.05). There was a high consistency between different raters when using the scoring system to evaluate the brain maturation of preterm infants (κ=0.86).@*CONCLUSIONS@#The aEEG+cEEG scoring system established in this study can quantitatively reflect the brain maturation of preterm infants, with a good discriminatory ability between preterm infants with different PMAs and high consistency between different raters.

Influence of systemic diseases on the diagnosis and treatment of dental diseases and prevention of related risks / 中华口腔医学杂志

Patients with dental problems may suffer from various systemic diseases at the same time. The concomitant systemic diseases can have impacts and risks on the diagnosis, treatment planning and therapeutic practice in dentistry. The author briefly expounds the influences of systemic diseases on dental diagnosis and treatment and the prevention of risks from seven aspects: cardio-cerebral vascular system, blood system, respiratory system, endocrine system, digestive system, genitourinary system, nervous system and mental system, in order to provide references for the dental clinicians.

Effects of different times bone marrow mesenchymal stem cell transplantation on treatment of brain injury in rats / 中国免疫学杂志

Objective:To investigate the effects of exogenous BMSCs transplantation at different time points on the treatment of traumatic brain injury in rats. Methods: Male 3-week-old SD rats were taken,BMSCs was isolated and cultured in vitro to 3 genera-tions. Fifty healthy female SD rats were randomly divided into 5 groups,10 rats in each group:control group,brain trauma model group, early treatment group,middle treatment group,late treatment group. A traumatic brain injury model was made by using cortical trauma instrument in rats,after the establishment,the treatment group:early treatment group(1 day),middle treatment group(28 days),late treatment group model(56 days),were given BMSCs (1×106ml-1) intervention treatment,the control group and model group were given equal dose of normal saline. In addition,40 rats were tested by water maze,and each group was divided into four points:6 d,7 d, 8 d and 9 d after injury,the spatial memory ability of rats was detected. All the experimental groups were sacrificed at 14 days after treatment. Morphological changes of brain tissue were observed by HE staining;the expression of LC-3 and Beclin-1 protein was detected by Western blot. Results: The brain trauma model group was compared with the control group,the shape of neuronal cell bodies appears to change,a clear gap was seen between the cells,and necrotic neurons appeared. Compared with the brain trauma model group,the morphological changes of neurons were alleviated,and the expression of protein was obviously weakened in the early stage of traumatic brain injury (1 d) and the medium term group (28 d) (P＜0. 05). BMSCs was not effective in the treatment of advanced traumatic brain injury (56 d). Conclusion: In the early and middle stage of traumatic brain injury in rats,the transplantation of BMSCs may alleviate the extent of traumatic brain injury to some extent,and the effect of late treatment is not obvious.

Ultrasound-induced transdermal drug delivery to the stellate ganglion as a countermeasure to sub-health state / 中国组织工程研究

BACKGROUND:Stellate ganglion block is feasible for the patients in sub-health status,but it is invasive and the patient compliance is poor.OBJECTIVE:To investigate the clinical effectiveness of ultrasound-induced transdermal drug delivery for reducing the hyperactivity of the cervical sympathetic ganglia in the sub-health status.METHODS:Sixty-nine participants in sub-health state from different age levels and professions were recruited and were randomly divided into treatment (n=31) and control (n=38) groups.The treatment group underwent ultrasound-induced transdermal drug delivery to the cervical sympathetic ganglia,while the control group received psychological counseling on sub-health education and behavior intervention.All patients were assessed with Sub-Health Measurement Scale Version1.0,and the Medical Outcomes Study 36-Item Short-Form Health Survey prior to and post treatment,along with clinical curative effect assessment.RESULTS AND CONCLUSION:After treatment,29 participants in the treatment group were improved or recovered from sub-health,with an effective rate of 93.5％.Compared with the control group,the scores were significantly improved in the treatment group.To conclude,ultrasound-induced transdermal drug delivery to the stellate ganglion has a significant effect on sub-health state.

Types of acute hypoxic-ischemic brain injury due to perinatal sentinel events in neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical and imaging characteristics of acute hypoxic-ischemic brain injury (HIBI) due to perinatal sentinel events in neonates.</p><p><b>METHODS</b>Forty-six neonates with acute HIBI who were admitted between January 2004 and May 2013, and who had a history of major cardiopulmonary resuscitation, were enrolled in the study. They were classified into full-term and preterm infants to analyze the clinical and imaging characteristics.</p><p><b>RESULTS</b>Among full-term infants, the incidence rates of white matter injury, cortical injury, basal ganglia /thalamic injury, and brain stem injury were 95%, 90%, 75%, and 65%, respectively; among preterm infants, the incidence rates of white matter injury, cortical injury, basal ganglia/thalamic injury, and brain stem injury were 73%, 23%, 19%, and 15%, respectively. Compared with full-term infants, preterm infants had a significantly lower incidence of gray matter injury in the cortex, basal ganglia/thalamus, and brain stem (P<0.05). About 46% of all subjects had multiple organ dysfunction. The 20 full-term infants with HIBI had typical clinical manifestations; 19 (95%) of them had moderate or severe neonatal encephalopathy, with mixed lesions on magnetic resonance imaging (MRI), and moderate or severe basal ganglia/thalamic injury was found in 68% of these patients. Multiple organ dysfunction, various abnormal neurological manifestations, and arterial blood pH less than 7.1 were closely related to moderate or severe brain injury.</p><p><b>CONCLUSIONS</b>White matter injury is the most common type of HIBI. Gray matter injury can be found in preterm infants, but the incidence is lower than that in full-term infants. Moderate or severe neonatal encephalopathy is mainly manifested as basal ganglia/thalamic injury on MRI. Evaluation of multiple organ dysfunction and abnormal neurological manifestations and early blood gas analysis are very important for the diagnosis of neonatal HIBI.</p>

application of gamma stereotactic body radiation therapy in stage I/II non-small-cell lung cancer. Promising and encouraging outcome

To further evaluate the efficacy and toxicity of the gamma-ray stereotactic body radiation therapy [gamma-SBRT] in patients with stage I/II non-small-cell lung cancer [NSCLC]. Twenty-nine newly diagnosed patients with stage I/II NSCLC who had no previous treatments, underwent OUR-QGD type of the gamma-SBRT at the Radiation Oncology Department, People's Liberation Army Airforce General Hospital, Beijing, China from January 2007 to July 2010. All patients were immobilized by vacuum bag, and then a slow CT scan was performed without any respiration gating. The total radiation dose of 50%, 60%, and 70% isodose line were prescribed in 50, 60, and 70 Grey [Gy] correspondingly, covering 100% of the planning target volume [PTV], 90% of the clinical target volume [CTV], and 80% of the gross target volume [GTV] in 10 fractions. The CT scans of the chest were required at one, 3, 6, 12, 18, and 24 months to evaluate the efficacy of the treatment. The median follow-up duration was 24 months, and the final follow-up rate is 96.6%. Local control rates of one and 2 years were all 93.1%. The progression-free survival rates versus overall survival rate of one year was 89.7% versus 96.6%, and 2 years was 86.1% versus 89.4%. Acute radiation reactions was diagnosed in 34.5%, and late radiation reactions in 37.9% of patients. The gamma-SBRT results in a good curative effects, and minimal toxicity in the treatment of stage I/II NSCLC

Regional prevalence and transmission route of Kaposi's sarcoma-associated herpes virus in Zhejiang, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The infection of Kaposi's sarcoma-associated herpes virus (KSHV) is most likely the cause of clinical Kaposi's sarcoma, primary effusion lymphoma, and multi-center Castleman's disease. KSHV infection has very limited epidemiological survey data in China, and its definite mode of transmission remains controversial. This study aimed to determine the infection status and the main transmission route of KSHV in Chinese population.</p><p><b>METHODS</b>An enzyme-linked immunosorbent assay (ELISA) utilizing KSHV ORF65 recombinant protein was employed to analyze the antibody response to KSHV ORF65 in sera from 122 healthy physical examination people, 107 intravenous drug users, 135 non-intravenous drug users, 211 hepatitis B (HBV) patients infected via blood transmission, 107 kidney transplant recipients, and 72 female sex workers in Zhejiang Province in Southeast China.</p><p><b>RESULTS</b>KSHV infection occurred relatively common (13.1%) in healthy population in Zhejiang, China. Infection rate was 16.7% in female sex workers, but significantly elevated in intravenous drug addicts (58.9%), blood-transmitted HBV patients (28.0%) and kidney transplant patients (41.1%).</p><p><b>CONCLUSION</b>Blood borne transmission of KSHV is probably the main route of infection in Zhejiang Province.</p>

Value of MRI in the diagnosis of cerebral abscess caused by Candida albicans in premature infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore the value of serial magnetic resonance imaging (MRI) in the diagnosis of cerebral abscess caused by Candida albicans in premature infants.</p><p><b>METHODS</b>The clinical data of 8 premature infants with central nervous system invasive fungal infection (IFI) were retrospectively studied. The infants underwent serial cerebral MRI scans (T1WI, T2WI and DWI).</p><p><b>RESULTS</b>Candida albicans was found as pathogen in all of the 8 infants. Seven infants presented with cerebral abscess and 4 infants had concurrent meningitis. Widespread involvements were found on MRI, particular in white matter area of subcortex, centrum semiovale and periventricle. The MR imaging findings in 4 infants within 11 days after IFI showed diffusive and multiple miliary nodes and hyperintense signals on DWI, but obvious changes were not found on T1WI and T2WI. The most striking hyperintense signals on T1WI and hypointense signals on T2WI appeared between 2 and 4 weeks after IFI, and some nodes of rim-like hyperintensity and marked contrast enhancement were also noted on T1WI. Smaller and smaller changes of the miliary foci were seen on T1WI and T2WI 4 weeks later. Delayed myelination and thinner corpus callous were shown in 2 patients at three months.</p><p><b>CONCLUSIONS</b>MRI-DWI and serial MRIs are helpful in the early diagnosis of candida cerebral abscess and the evaluation of treatment outcome in premature infants.</p>

Three-dimensional conformal radiotherapy for locoregionally recurrent non-small cell lung cancer after initial radiotherapy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility, therapeutic effects and normal tissue complications of three-dimensional conformal radiotherapy (3DCRT) for locoregionally recurrent non-small cell lung cancer after initial radiotherapy.</p><p><b>METHODS</b>Between August 1999 and August 2003, 27 such patients were treated with 3DCRT after initial radiotherapy. This series consisted of 25 men and 2 women with a median age of 64 years. Radiotherapy was delivered at 2 Gy per fraction, 5 fractions per week, to a median dose of 50 Gy. Treatment results and normal tissue complications were assessed with WHO and RTOG/EORTC criteria.</p><p><b>RESULTS</b>Based upon a median follow-up time of 20.6 months, 25 patients (92.6%) completed the planned 3DCRT treatment. Their clinical symptom relief rate was 79.1%, and the response rate was 59.3% with a complete remission rate of 14.8% (4/27), partial remission rate of 44.4% (12/27). The overall 1- and 2-year survival (OS) rates were 73.8% and 25.4% with a median survival time (MST) of 20 months. The 1- and 2-year local progression free survival (LPFS) rates were both 88.8%. Grade 2 and grade 3 acute radiation pneumonitis developed in 7.4% (2/27) and 11.1% (3/27). Grade 2 late radiation pneumonitis developed in 11.1% (3/27).</p><p><b>CONCLUSION</b>3DCRT is feasible and advisable for locoregionally recurrent non-small-cell lung cancer, giving a good immediate tumor response and acceptable normal tissue complications.</p>

SPECT lung perfusion scans in predicting radiation pneumonitis in lung cancer patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate single photon emission computed tomography (SPECT) lung perfusion in predicting radiation pneumonitis in lung cancer patients.</p><p><b>METHODS</b>From April 2003 to March 2004, 31 lung cancer patients treated with radical radiotherapy received SPECT lung perfusion scans, among whom, 23 had had perfusion scans both before and at the time of 40 Gy irradiation. The perfusion changes in the region of interest (ROI) after irradiation were obtained through comparing post-radiotherapy with pre-radiotherapy average proportion of SPECT counts within the ROI relative to average counts of the whole lung. Endpoint was defined as grade 2 and above radiation pneumonitis according to RTOG criteria.</p><p><b>RESULTS</b>Lung perfusion defect was observed in all the patients at baseline. > or = grade 2 lung perfusion defect was found in 68.2% (15/22) of patients with central lesion and in 22.2% (2/9) of patients with peripheral lesions (P = 0.04). Seventy percent of the patients (16/23) experienced improved perfusion at 40 - 50 Gy. > or = grade 2 radiation pneumonitis was observed in 12 patients (38.7%) in the whole group, with 6 in those with grade 1 perfusion defects and another 6 in > or = grade 2 group, respectively; Of the 23 patients who had had both pre- and post-radiotherapy SPECT perfusion scan, 5 > or = grade 2 radiation pneumonitis occurred in the 16 perfusion-improved patients and 3 in the 7 unimproved patients.</p><p><b>CONCLUSION</b>There is no significant correlation between radiation pneumonitis and the extent of perfusion defect either before or after 40 - 50 Gy irradiation based on our limited data analysis in this series.</p>

Preliminary results of three-dimensional conformal radiotherapy for small-cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility, therapeutic effects and complications of three-dimensional conformal radiotherapy (3DCRT) for small-cell lung cancer (SCLC).</p><p><b>METHODS</b>The data of 19 SCLC patients treated between June 2001 and August 2003, with 3DCRT were reviewed and analyzed. Eighteen patients were treated by radiotherapy plus chemotherapy while only 1 patient by radiotherapy alone. Radiotherapy was delivered at 2 Gy/fraction, 5 fractions per week with a median total dose of 54 Gy. Chemotherapy consisted of 4 - 6 cycles of etoposide and cisplatin or carboplatin. The median follow-up time was 24 months.</p><p><b>RESULTS</b>(1) The overall response rate after 3DCRT was 79.0%, with a complete remission rate of 31.6% (6/19), partial remission rate of 47.4% (9/19). The 1- and 2-year overall survival (OS) was 71.7% and 35.8% respectively, with a median survival time (MST) of 19 months, and both the 1- and 2-year local progression free survival (LPFS) were 94.7%. (2) Of these 19 patients, grade 2 acute radiation pneumonitis developed in 5.3%, grade 2 late radiation pneumofibrosis in 5.3%, grade 2 acute radiation esophagitis in 10.5% and grade 2 acute hematologic toxicity in 10.5%.</p><p><b>CONCLUSION</b>Three-dimensional conformal radiotherapy is feasible in the treatment of SCLC with high response rate and acceptable complications. Further observation, more patients treated by 3DCRT and prolonged follow-up are needed to evaluate remote survival.</p>

Preliminary evaluation on the effects of a hybrid bioartificial liver support system in the treatment of hepatic failure / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To construct a novel hybrid artificial liver support system and evaluate its clinical efficacy in the treatment of hepatic failure.</p><p><b>METHODS</b>A hybrid bioartificial liver support system consisting of plasma exchange device, charcoal perfusion column, and bioreactor cultured human or porcine hepatocytes was developed. 30 patients with hepatic failure were treated using this hybrid system.</p><p><b>RESULTS</b>Both the excellent rate and effectual rate of the artificial liver support system were 43.3% (13/30). The total effectual rate was 86.7%. Finally, eleven out of 30 patients recovered completely. Six patients were bridged to liver transplantation. Six patients (20%) died of hepatic failure and seven patients (23.3%) discharged due to worsening of disease.</p><p><b>CONCLUSIONS</b>The hybrid artificial liver support system has prominent liver support effects for hepatic failure, which can be regarded as an efficient measure for the treatment of severe hepatitis.</p>

Preparation of hollow fiber bioreactor for culturing pig hepatocytes / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the method of preparing the hollow fiber bioreactor for culturing pig hepatocytes.</p><p><b>METHODS</b>Hepatocytes were isolated from experimental suckling minipigs by two-step perfusion with collagenase, and seeded onto hollow fiber bioreactor, then cultured with an artificial capillary cell culture system. The albumin-excretion, lidocaine-transforming rate, lactate dehydrogenase (LDH) release and the cell viability in bioreactors were examined.</p><p><b>RESULTS</b>The porcine albumin could be detected by SDS/PAGE on the 2nd, 4th, 6th day. The rates of lidocaine-transforming ranged from 89.6% to 96.1%. The release of LDH into the culture medium increased from (23.7+/-4.6) U/L to (127.8+/-17.4) U/L (F=39.582, P<0.01) during the experiments, and the viability of pig hepatocytes in hollow fiber bioreactor reduced from 95.8%+/-0.3% to 83.8%+/-4.7% (t=5.135, P<0.01).</p><p><b>CONCLUSION</b>The hollow fiber bioreactor for culturing pig hepatocytes can be prepared by artificial capillary cell culture system, which provides a certain liver-specific function in 1 week.</p>