Research progress on risk factors and identification tools for child abuse / 中国学校卫生

Abstract@#Child abuse is a global public health problem, which has emerged as a neglected yet pressing issue in global development. Early and accurate identification of abuse at a lower-age group is of great significance for treatment, which might reduce the risk of re-maltreatment and promote children s physical and mental health development. Therefore, by reviewing the clinical characteristics, risk factors and existing abuse identification and screening tools of child abuse, the study aims at providing basic evidence for the development of child abuse risk identification tools and the establishment of child maltreatment system in China, so as to take timely intervention measures to prevent adverse outcomes or reduce their severity.

Investigation on prevalence of Schistosoma japonicum infections in wild mice in Shitai County, Anhui Province, 2018 / 中国血吸虫病防治杂志

Objective To investigate the prevalence of Schistosoma japonicum infection in wild mice in Shitai County, Anhui Province, so as to provide insights into precise control of the source of S. japonicum infections. Methods Wild mice were captured using the trapping method for three successive nights at snail-infested settings from Jitan Village of Jitan Township, and Shiquan Village and Xibai Village of Dingxiang Township, Shitai County, Anhui Province in June and October, 2018. All trapped wild mice were sacrificed and liver and mesenteric vein specimens were collected for detection of S. japonicum eggs using microscopy, while the fecal samples in mouse intestines were collected for identification of S. japonicum infections using Kato-Katz technique. In addition, the population density of trapped wild mice was estimated and the prevalence of S. japonicum infection was calculated in trapped wild mice. Results A total of 376 wild mice were trapped from three villages in Shitai County. The population density of trapped wild mice was 9.1% (376/4 124), and the prevalence of S. japonicum infection was 24.2% (91/376) in trapped wild mice. The highest prevalence of S. japonicum infection was detected in Shiquan Village of Dingxiang Township (30.1%), and the lowest prevalence was seen in Xibai Village of Dingxiang Township; however, there was no significant difference in the prevalence of S. japonicum infection in trapped wild mice among three villages (χ2= 4.111, P > 0.05). In addition, there was no significant difference in the prevalence of S. japonicum infection in wild mice captured between on June (26.8%, 34/127) and October (22.9%, 57/249) (χ2 = 0.690, P = 0.406). The trapped wild mice included 6 species, including Rattus norvegicus, Niviventer niviventer, R. losea, Apodemus agrarius, Mus musculus and N. coning, and the two highest prevalence of S. japonicum infection was detected in R. losea (34.9%, 22/63) and R. norvegicus (31.2%, 44/141). Conclusions The prevalence of S. japonicum infections is high in wild mice in Shitai County, and there is a natural focus of schistosomiasis transmission in Shitai County.

Skin Ultrastructure and the Changes of HIF-2α, H-FABP Expression in the Myocardium of Electric Shock Death Rats / 法医学杂志

Objective To observe the skin ultrastructure change of electric shock death rats and to test the expression changes of hypoxia-inducible factor-2α （HIF-2α） and heart type-fatty acid-binding protein （H-FABP） of myocardial cells, in order to provide basis for forensic identification of electric shock death. Methods The electric shock model of rats was established. The 72 rats were randomly divided into control group, electric shock death group and postmortem electric shock group. Each group was divided into three subgroups, immediate （0 min）, 30 min and 60 min after death. The skin changes of rats were observed by HE staining, the changes of skin ultrastructure were observed by scanning electron microscopy, and the expression of HIF-2α and H-FABP in rats myocardium was tested by immunohistochemical staining. Results The skin in the electric shock death group and postmortem electric shock group had no significant difference through the naked eye or by HE staining. Under the scanning electron microscope, a large number of cellular debris, cells with unclear boundaries, withered cracks, circular or elliptical holes scattered on the cell surface and irregular edges were observed. A large number of spherical foreign body particles were observed. Compared with the control group, the expression of HIF-2α in all electric shock death subgroups increased, reaching the peak immediately after death. In the postmortem electric shock group, HIF-2α expression only increased immediately after death, but was lower than that of electric shock death group （P<0.05）. Compared with the control group, the expression of H-FABP in all subgroups of electric shock death group and postmortem electric shock group significantly decreased. The expression of H-FABP in all subgroups of electric shock death group was lower than that of the postmortem electric shock group （P<0.05）. Conclusion Electric shock can increase HIF-2α expression and decrease H-FABP expression in the myocardium, which may be of forensic significance for the determination of electric shock death and identification of antemortem and postmortem electric shock.

Identification of Hypertension Subgroups through Topological Analysis of Symptom-Based Patient Similarity / 中国结合医学杂志

OBJECTIVE@#To obtain the subtypes of the clinical hypertension population based on symptoms and to explore the relationship between hypertension and comorbidities.@*METHODS@#The data set was collected from the Chinese medicine (CM) electronic medical records of 33,458 hypertension inpatients in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine between July 2014 and May 2017. Then, a hypertension disease comorbidity network (HDCN) was built to investigate the complicated associations between hypertension and their comorbidities. Moreover, a hypertension patient similarity network (HPSN) was constructed with patients' shared symptoms, and 7 main hypertension patient subgroups were identified from HPSN with a community detection method to exhibit the characteristics of clinical phenotypes and molecular mechanisms. In addition, the significant symptoms, diseases, CM syndromes and pathways of each main patient subgroup were obtained by enrichment analysis.@*RESULTS@#The significant symptoms and diseases of these patient subgroups were associated with different damaged target organs of hypertension. Additionally, the specific phenotypic features (symptoms, diseases, and CM syndromes) were consistent with specific molecular features (pathways) in the same patient subgroup.@*CONCLUSION@#The utility and comprehensiveness of disease classification based on community detection of patient networks using shared CM symptom phenotypes showed the importance of hypertension patient subgroups.

Endemic situation of schistosomiasis in national surveillance sites of Anhui Province from 2015 to 2018 / 中国血吸虫病防治杂志

Objective To analyze the endemic situation of schistosomiasis in national surveillance sites of Anhui Province from 2015 to 2018, so as to provide scientific evidence for schistosomiasis control and prevention in Anhui Province. Methods According to the National Schistosomiasis Surveillance Programme (2014 version), a total of 51 national schistosomiasis surveillance sites were assigned in Anhui Province in 2015, and Schistosoma japonicum infections in humans and livestock and snail distribution were monitored from 2015 to 2018. Results A total of 89 638 local residents and 42 609 mobile populations received serological screening of schistosomiasis in 51 national surveillance sites of Anhui Province from 2015 to 2018, and the sero-prevalence of S. japonicum infections was 1.41% to 3.69% in local residents and 0.84% to 2.13% in mobile populations, respectively. There were 5 egg-positive local residents and 1 egg-positive mobile populations detected in 2015, with occupations of farmers and fishermen. There were 6 405 livestock detected for S. japonicum infections, and no egg-positives were identified. Among an area of 12 661 hm2 surveyed in the national schistosomiasis surveillance sites of Anhui Province from 2015 to 2018, the areas of snail habitats were 2 461.27 to 2 628.96 hm2, andthemeandensityoflivingsnailswas 0.3757 to 0.4330 snails/0.1 m2, with no S. japonicum infections identified in snails. Conclusions The endemic situation of schistosomiasis is at a low level in Anhui Province; however, the risk of schistosomiasis transmission remains in local regions of the province. The construction of the surveillance-responsesystemshouldbereinforcedtoconsolidatetheachievementsofschistosomiasis control in Anhui Province.

Estimation on Formation Time of Thrombus / 法医学杂志

OBJECTIVES@#To observe the changes of the formation time of venous thrombus in rats, and to provide new ideas and methods for the estimation on thrombus formation time of the forensic cases died from thrombosis.@*METHODS@#Totally 80 rats were randomly divided into 10 groups （0 h, 3 h, 6 h, 12 h, 1 d, 3 d, 1 week, 2 weeks, 3 weeks and 4 weeks after operation）. A vein thrombosis model was established by the "narrow" method. The processes of thrombosis, organization, recanalization and the features of change on hemosiderin and calcium salt were observed by HE stain, Perls stain and Von Kossa stain. The expression changes of CD61, α-SMA and CD34 were observed by immunohistochemical staining technique.@*RESULTS@#Platelets adhered to the exposed blood vessel intima 3 h after operation, and platelet trabeculae were formed by the repeated accumulation of platelets 1 d after operation. The thrombus organization formed through the fibroblasts from vessel wall that grew into the interior of the thrombus 3 d after operation. Endothelial cells covered the surface of thrombus and then the new blood vessels were reformed, and the vessels were reconstructed. The expression of CD61 upregulated at the stages of the thrombus formation （3 h） and thrombus reformation （4 weeks）, and reached the peak 1 d after thrombus formation. The release of hemosiderin and the initial expression of α-SMA were detected 3 d later. Calcium deposit and expression of CD34 were observed 1 week later.@*CONCLUSIONS@#The hemosiderin, calcium salt, CD61, α-SMA and CD34 show time-dependent changing characteristics, which is expected to provide a reference for the estimation on thrombus formation time of the forensic cases died from thrombosis.

Construction of semantic relations of the top-level ontology of military medicine / 军事医学

Objective To explore a construction method of semantic relations of the top-level ontology of military medicine in order to construct the top-level ontology semantic network.Methods The military medical corpus was selected,and the relationships between the concepts were extracted using text analysis.On the basis of inheriting the semantic relations of UMLS,the special semantic relations of military medicine were added.Results A method of establishing the semantic relations of the top-level ontology of military medicine was proposed,the applicability of which was verified by example of the branch of military medical equipment.Conclusion The proposed method is effective and feasible,which can provide important support to the establishment of top-level semantic networks of military medicine.

Effects of Cervical Kyphosis on Recovery From Dysphagia After Stroke

OBJECTIVE: To determine the effects of cervical kyphosis on the recovery of swallowing function in subacute stroke patients. METHODS: Baseline and 1-month follow-up videofluoroscopic swallowing studies (VFSSs) of 51 stroke patients were retrospectively analyzed. The patients were divided into the cervical kyphosis (Cobb's angle <20°, n=27) and control (n=24) groups. The penetration-aspiration scale (PAS), American Speech-Language-Hearing Association National Outcomes Measurement System swallowing scale (ASHA NOMS), and videofluoroscopic dysphagia scale (VDS) were used to determine the severity of dysphagia. Finally, the prevalence of abnormal VFSS findings was compared between the two groups. RESULTS: There were no significant differences in baseline PAS, ASHA NOMS, and VDS scores between the two groups. However, the follow-up VDS scores in the cervical kyphosis group were significantly higher than those in the control group (p=0.04), and a follow-up study showed a tendency towards worse ASHA NOMS scores (p=0.07) in the cervical kyphosis group. In addition, the cervical kyphosis group had a higher occurrence of pharyngeal wall coating in both baseline and follow-up studies, as well as increased aspiration in follow-up studies (p<0.05). CONCLUSION: This study showed that stroke patients who had cervical kyphosis at the time of stroke might have impaired recovery from dysphagia after stroke.

Cardiac Ultrastructure and Changes of HSP70 and HIF-1α Expression in Electric Shock Death Rats / 法医学杂志

OBJECTIVE@#To observe cardiac ultrastructure and the expression of heat shock protein 70 (HSP70) and hypoxia inducible factor-lα (HIF-lα) in electric shock death rats and to explore the application of these indexes as the basis of medical identification in electric shock death.@*METHODS@#Seventy-two SD rats were randomly divided into electric shock death group, postmortem electric shock group and the control group. The changes of myocardial ultrastructure were observed by transmission electron microscope, and the expressions of myocardial HSP70 and HIF-1α were observed by immunohistochemical technology.@*RESULTS@#Myocardial myofibril fracture, mitochondrial cristae and membrane dissolution, and disordered arrangement of Z lines and M lines were observed in electric shock rats. HSP70 and HIF-lα were strong positive expressions in the electric shock death group, significantly compared with the control and postmortem electric shock groups (P < 0.05).@*CONCLUSION@#The expressions of HSP70 and HIF-lα were obviously increased in electric shock death group, which may be used as the diagnostic indicator of electric shock death.

Surgical treatment of degenerative lumbar scoliosis with spinal stenosis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effects of limited decomression, fixation, and fusion in treating degenerative scoliosis with spinal stennosis.</p><p><b>METHODS</b>From June 2002 to January 2009, 26 patients of degenerative scoliosis with spinal stenosis were treated with limited decomression, fixation, and fusion. There were 6 males and 20 females with an average age of 61.3 years (ranged, 51 to 72 years). Course of disease of spinal stenosis was from 11 months to 6 years with an average of 36 months. X-ray, CT, MRI examination were performed preoperatively for all the cases and myelography was performed for 6 cases. Preoperative Cobb's angle,focal lordosis angle,the distance between C7 plumb line (C7PL) and upper edge of S1 vertebral body (SVA), and the distance between C7PL and center sacral vertical line (CSVL) were (22.0 +/- 10.1) degrees, (21.6 +/- 10.2) degrees, (7.6 +/- 6.4) cm, (6.8 +/- 5.6) cm respectively. Measured Cobb's angle, focal lordosis angle, SVA, CSVL after operation and final follow-up were compared with preoperative data. JOA score system were used to evaluate clinical effects.</p><p><b>RESULTS</b>The operative time All the patients were followed up from 1.3 to 5 years with an average of 2.5 years. Postoperative and final follow-up, Cobb's angle was (10.5 +/- 8.2) degrees, (8.8 +/- 5.2) degrees, respectively; focal lordosis angle was (25.4 +/- 14.2) degrees, (31.6 +/- 13.2) degrees, respectively; SVA was (0.6 +/- 3.3) cm, (-1.2 +/- 2.5) cm,respectively; CSVL was (2.8 +/- 1.3) cm, (1.6 +/- 1.2) cm, respectively. There was significant difference in data before and after operation. Preoperative, instantly postoperative, final follow-up, JOA score was 11.0 +/- 1.7, 22.4 +/- 2.4, 24.0 +/- 2.1, respectively; 13 cases obtained excellent results, 8 good, 3 fair, 2 poor. Loss of correction occurred in one case. No collapse of intervertebral space, nerve injury, breakage of fixation system were found.</p><p><b>CONCLUSION</b>Surgical treatment with limited decompression, pedicle screw fixation and fusion is effective method for degenerative scoliosis with spinal stenosis, individualized surgery design should be made according to clinical symptoms, signs and imaging features.</p>

Dynamic changes of LDH and HBDH activity in rabbit serum after low voltage electrical injury / 法医学杂志

OBJECTIVE@#To investigate changes of LDH and HBDH activity in rabbit serum after non-thermal low voltage electrical injury and to provide diagnostic criteria for non-thermal low voltage electrical injury.@*METHODS@#Forty New Zealand rabbits were randomly distributed into control group and electrical injury group (EI-groups; designated 7 time points: 0 h, 2 h, 4 h, 12 h, 1 d, 2 d, 3 d), 5 rabbits per each group. EI-groups were treated with the method of non-thermal low voltage electrical injury established in our laboratory. Ventricular blood (5 mL) was obtained under anesthesia at designated time points after electrical injury. The activities of LDH and HBDH were measured.@*RESULTS@#Dynamic changes were observed with certain patterns from target serum enzyme activities after electrical injury. Compared with control group, the activities of LDH increased markedly at 4 h, 12 h, and on days 1, 2, and 3 after injury (4 h, 12 h, and day 1 P<0.01; day 2 and day 3 P<0.05). Activities of HBDH increased markedly at day 2 and day 3 after injury (P<0.05). The ratio of HBDH/LDH decreased markedly at 2 h, 4 h, and 12 h after injury (P<0.01).@*CONCLUSION@#Dynamic changes of LDH and HBDH activities may be useful in diagnosis of non-thermal low voltage electrical injury and in estimation of post injury intervals.

Plastic Changes of Synapses and Excitatory Neurotransmitter Receptors in Facial Nucleus Following Facial-facial Anastomosis / 华中科技大学学报（医学）（英德文版）

The remodeling process of synapses and eurotransmitter receptors of facial nucleus were observed. Models were set up by facial-facial anastomosis in rat. At post-surgery day (PSD) 0, 7, 21 and 60, synaptophysin (p38), NMDA receptor subunit 2A and AMPA receptor subunit 2 (GIuR2) were observed by immunohistochemical method and emi-quantitative RT-PCR, respectively. Meanwhile, the synaptic structure of the facial motorneurons was observed under a transmission electron microscope (TEM). The intensity of p38 immunoreactivity was decreased, reaching the lowest value at PSD day 7, and then increased slightly at PSD 21. Ultrastructurally, the number of synapses in nucleus of the operational side decreased, which was consistent with the change in P38 immhnoreactivity. NMDAR2A mRNA was down-regulated significantly in facial nucleus after the operation (P00<0.05), whereas AMPAR2 mRNA levels remained unchanged (P>0.05). The synapses innervation and the expression of NMDAR2A and AMPAR2 mRNA in facial nucleus might be modified to suit for the new motor tasks following facial-facial anastomosis, and influenced facial nerve regeneration and recovery.

Reemergence of the bedbug Cimex lectularius in Seoul, Korea

A healthy 30-yr-old woman carrying an insect that had been caught in her living room visited the International Clinic at Severance Hospital, Seoul, in December 2007. The insect she brought was identified to be a nymph of a bedbug, Cimex lectularius, and her skin rashes looked typical bedbug's bites. Her apartment was investigated, and a dead body of a bedbug, cast skins, and hatched eggs were found in her rooms and neighbors' rooms in the same building. She was living in that apartment in Seoul for 9 months since she had moved from New Jersey, USA. We assume that the bedbugs were introduced from abroad, since there had been no report on bedbugs in Seoul for more than 2 decades at least. This is a report of a reemergence of the common bedbug, C. lectularius in Seoul, Korea.

Experimental study of tissue engineered bone loaded with osteointergrated dental implants / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate osteogenesis and integration of osteointergrated dental implants with marrow stromal osteoblast and cancellous bone matrix compound artificial bone (MCCAB) when embedded subcutaneously.</p><p><b>METHODS</b>Osteointergrated dental implants (3 mm in diameter) were inserted into cancellous bone matrix (CBM) columns (5 mm in diameter). Marrow stromal osteoblast (MSO) were cultured and expanded in the column and on the surface. The osteointergrated dental implants loaded MSO-Alginate-CBM compound was formatted. This compound was then implanted subcutaneously in nude mice, and the osteointergrated dental implants loaded Alginate-CBM compounds were implanted as control. The compound was in the mice for 4 to 8 weeks and then harvested and assessed by means of gross observation, X-ray examination, histologic observation and computerized histomorphometry for evaluation of bone formation.</p><p><b>RESULTS</b>The osteogenesis of the osteointergrated dental implants loaded MSO-Alginate-CBM compound was better than that of the the osteointergrated dental implants loaded Alginate-CBM compound. Both intramembranous and cartilaginous osteogenesis was seen but the former was predominant. A large amount of new bone formed around the implant and integrated well with the implant. In the control, only slight cartilage osteogenesis was seen and no integration was found.</p><p><b>CONCLUSIONS</b>The results suggest that the new bone forms in the scaffolds and on the surface of the implant, and integration between the implant and artificial bone also occurs when they are implanted in the nude mice.</p>

The Effect of the Remnants after Cataract Extraction on the Lens Epithelial Cell Culture

PURPOSE: To assess the effect of the remnants after lens extraction on posterior capsular opacification with lens epithelial cell culture through in vitro capsular bag model. METHODS: After isolating porcine lens capsules, sterile non-toxic PMMA (polymethyl- mathacrylate) tension ring was inserted into the capsule. These were placed in organ culture medium up to 6 weeks. The grade of cell coverage of the posterior lens capsule was recorded to check the proliferative activity. RESULTS: In the process of cell culture, outgrowth of the epithelial cells was observed across the posterior capsule after a lag period. The rate of cell coverage was dependent upon the added factors. The proliferative activity was the greatest in the group where lens cortical and nuclear materials were added, and other groups showed no difference from a control group. CONCLUSIONS: To reduce posterior capsular opacification, it is important that we should not leave the lens cortical material behind during cataract surgery.

Interstitial Laser Photocoagulation with Diode Laser Unit in Bovine Liver

PURPOSE: To evaluate the extent of tissue coagulation during interstitial laser photocoagulation (ILP) innormal bovine liver, using a diode laser unit and various parameters, and to determine whether the procedure isapplicable to clinical practice.. MATERIALS AND METHODS: Using an 18-gauge needle, experimental interstitiallaser photocoagulation (ILP) was carried out in normal bovine liver. On the basis of differing parameters, threegroups were established. For group I, a single photofiber with laser power of 1, 3 and 5 watts and an exposuretime of 60, 180, 300, 420 or 600 seconds was used. For groups II and III, four needles were fixed at a distance of1cm and 1.5cm ; in each case a needle fixation device was used, as well as a laser distributor for simultaneouslaser exposure of photofibers. As a control, four photofibers were placed as for groupIII, but to compare groups IIand III, each photofiber was exposed to a laser of 3 watts 300 seconds, without using a laser distributor. Toevaluate the range of tissue coagulation, specimens were analyzed both with regard to cross-sectional grossfindings and histopathologically . RESULTS: The largest diameter of thermal coagulation necrosis in Group I was15x15mm, and this was ball-shaped. Coalescence of coagulation between each photofiber was observed in Group II,and this was up to 25 mm in diameter. In Group III and controls, coalescence was not found, though the extent oftissue coagulation increased with increasing wattage and exposure time. The extent of charring at the center ofcoagulation also increased with increasing wattage. Smoke bubbles emanating from the coagulation area wereobserved, and during ILP involving a single photofiber, increased from 3 watts, applied for 300 seconds.CONCLUSION: Using an 8-gauge needle and a diode laser ILP, we have shown that a range of tissue coagulationacutely ablates normal bovine liver. In selective cases, the procedure could be applied to clinical trials.

A Case of Ota Nevus Associated with Altitudinal Field Defect

The nevus of Ota is a benign nevus characterized by the deposition of pigment in an area of distribution of the first and second branches of the trigeminal nerve. In general it rarely causes ophthalmological problems. We experienced a 23-year-old male patient who complained sudden visual loss in the left eye with the characteristics of the nevus of Ota. On examination we found the altitudinal field defect which we believe is an unusual finding of the nevus of Ota.

Effectiveness of boric acid as a stomach poison for the German cockroach (Blattella germanica L.) Control

The author carried out a study on the effectiveness of the boric acid as a stomach poison for German cockroach control from July to September 1971. The test was performed by the feeding method under conditions of 20 C and 80 per cent relative humidity. The baits were composed of one control group and five different combination groups with boric acid and sugar as follows. 10 g sugar only(control group), 1 g powedered boric acid to 9 g sugar(1:9 poison baits), 2 g powdered boric acid to 8 g sugar(2:8 poison baits), 4 g powdered boric acid to 6 g sugar(4:6 poison baits), 5 g powdered boric acid to 5g sugar(5:5 poison baits), 10 g powdered boric acid only (10:0 poison baits). The insects were composed of 360 female adult German cockroaches collected by traps at the kitchens of restaurants and house holds in Seoul City. The results were as follows: The total mortality by poison baits in 72 hours after treatment were: 44.3 per cent by 1:9 poison baits , 79.4 per cent by 2: poison baits , 96.7 per cent by 4:6 poison baits(the most effective poison baits), 88.3 per cent by 5:5 poison baits, 91.1 per cent by 10:0 poison baits. The peak mortality by the treatment hours were: Up to 21 hours: 23.3 per cent by 5:5 poison baits, 20.0 per cent by 10:10 poison baits, From 24 to 48 hours: 71.1 per cent by 4:6 poison baits, 55.6 per cent by 10:0 poison baits, From 48 to 72 hours: 21.9 per cent by 2:8 poison baits, 19.6 per cent by 1:9 poison baits. The most effective treatment hours was from 24 to 48 hours.