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Objective:To investigate patients' compliance of endoscopic surveillance after endoscopic submucosal dissection (ESD) and the influencing factors.Methods:This study was a cross-sectional survey. The data of patients who underwent ESD in Xijing Digestive Hospital of Air Force Military Medical University from January 2014 to December 2015 were collected through questionnaire and telephone call. The questionnaire survey was conducted from May 1, 2019 to July 31, 2020. Patients' compliance for endoscopic surveillance and influencing factors were evaluated. Logistic regression model was used for multivariate analysis to determine independent risk factors affecting compliance of endoscopic surveillance.Results:A total of 413 questionnaires were collected, of which 331 (80.1%) patients were well complied with endoscopic surveillance, and 82 (19.9%) were not. Univariate analysis showed that gender ( χ2=4.68, P=0.034), lesion type ( χ2=10.10, P=0.002), educational background ( χ2=4.00, P=0.049), disposable income ( χ2=7.00, P=0.009), employment ( χ2=11.29, P=0.004) and medical insurance ( χ2=13.59, P=0.001) affected patients' endoscopic surveillance compliance. Logistic regression analysis indicated that patients with submucosal lesions were less likely to be compliant than patients with mucosal lesions with the same type of medical insurance ( P<0.001, OR=0.383, 95% CI: 0.227-0.644); and with the same lesion type, patients with urban medical insurance were more likely to be compliant than those with rural cooperative medical insurance ( P<0.001, OR=2.938, 95% CI: 1.696-5.090). Conclusion:The endoscopic surveillance compliance for post-ESD patients is related to the lesion type, the type of medical insurance, and the awareness of the disease. More attention should be paid to those with submucosal lesions and rural cooperative medical insurance due to their poor compliance. And it is necessary to improve health education on the disease for better surveillance compliance.
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Objective:To explore a scoring system of preoperative evaluation for high-risk gastric stromal tumors.Methods:A total of 275 consecutive patients with gastric stromal tumors of diameter ≤5 cm who underwent surgical or endoscopic resection at Xijing Hospital between 2008 and 2018 were retrospectively enrolled in the study. Multivariate logistic regression analysis was performed to investigate independent risk factors for high-risk gastric stromal tumors.Weighted points was proportionally assigned based on β regression coefficient value to establish the scoring system. The receiver operator characteristic (ROC) curve was plotted, the scoring system as the test variable, and the area under curve (AUC) was calculated.Results:Multivariate analysis revealed tumor size>1.75 cm ( OR=6.474, 95% CI: 2.335-17.948), irregular tumor shape ( OR=3.548, 95% CI: 1.745-7.216) and mucosal ulceration ( OR=2.412, 95% CI: 1.154-5.041) were independent risk factors for high-risk gastric stromal tumors of diameter ≤5 cm ( P<0.05). These risk factors for high-risk gastric stromal tumors were weighted with value: one point for mucosal ulceration, two points for irregular tumor shape and three points for tumor size>1.75 cm. The AUC value of the scoring system was 0.781, of which the cut-off value was 4. According to the cut-off value, 0-3 points was categorized as the low risk group and 4-6 points as the high risk group for gastric stromal tumors. The incidence of high-risk gastric stromal tumors of the low risk group and the high risk group were 13.3% (26/196) and 48.1% (38/79), respectively, with significant difference ( χ2=38.266, P<0.001). Conclusion:Tumor size larger than 1.75 cm, irregular tumor shape and mucosal ulceration can be applied to establish a preoperative scoring system to predict high-risk gastric stromal tumors of diameter ≤5 cm.
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As a rising histological specimen carrier,digital slide has advantages of easy search and fast browse.By digital scanning and stitching of traditional slides and uploading traditional slides as well as pathological information to network servers,the construction of digital slides data can take its own superiority to assist forensic medicine teaching.Combined with our research and teaching experience,this article discussed the application prospects of digital slide technology and digital slides data so as to provide references for the improvement and reformation of forensic medicine education.
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Death following situations of intense emotional stress has been linked to the cardiac pathology described as stress cardiomyopathy, whose pathomechanism is still not clear. In this study, we sought to determine, via an animal model, whether the transcriptional coactivator peroxisome proliferator-activated receptor γ coactivator-1alpha (PGC-1α) and the amino peptide neuropeptide Y (NPY) play a role in the pathogenesis of this cardiac entity. Male Sprague-Dawley rats in the experimental group were subjected to immobilization in a plexy glass box for 1 h, which was followed by low voltage electric foot shock for about 1 h at 10 s intervals in a cage fitted with metallic rods. After 25 days the rats were sacrificed and sections of their hearts were processed. Hematoxylin-eosin staining of cardiac tissues revealed the characteristic cardiac lesions of stress cardiomyopathy such as contraction band necrosis, inflammatory cell infiltration and fibrosis. The semi-quantitative RT-PCR analysis for PGC-1α mRNA expression showed significant overexpression of PGC1-α in the stress-subjected rats (P<0.05). Fluorescence immunohistochemistry revealed a higher production of NPY in the stress-subjected rats as compared to the control rats (P=0.0027). Thus, we are led to conclude that following periods of intense stress, an increased expression of PGC1-α in the heart and an overflow of NPY may lead to stress cardiomyopathy and even death in susceptible victims. Moreover, these markers can be used to identify stress cardiomyopathy as the cause of sudden death in specific cases.
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Animais , Ratos , Cardiomiopatias , Metabolismo , Miócitos Cardíacos , Metabolismo , Neuropeptídeo Y , Metabolismo , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo , Ratos Sprague-Dawley , Estresse Fisiológico , Fisiologia , Fatores de Transcrição , MetabolismoRESUMO
Death following situations of intense emotional stress has been linked to the cardiac pathology described as stress cardiomyopathy, whose pathomechanism is still not clear. In this study, we sought to determine, via an animal model, whether the transcriptional coactivator peroxisome proliferator-activated receptor γ coactivator-1alpha (PGC-1α) and the amino peptide neuropeptide Y (NPY) play a role in the pathogenesis of this cardiac entity. Male Sprague-Dawley rats in the experimental group were subjected to immobilization in a plexy glass box for 1 h, which was followed by low voltage electric foot shock for about 1 h at 10 s intervals in a cage fitted with metallic rods. After 25 days the rats were sacrificed and sections of their hearts were processed. Hematoxylin-eosin staining of cardiac tissues revealed the characteristic cardiac lesions of stress cardiomyopathy such as contraction band necrosis, inflammatory cell infiltration and fibrosis. The semi-quantitative RT-PCR analysis for PGC-1α mRNA expression showed significant overexpression of PGC1-α in the stress-subjected rats (P<0.05). Fluorescence immunohistochemistry revealed a higher production of NPY in the stress-subjected rats as compared to the control rats (P=0.0027). Thus, we are led to conclude that following periods of intense stress, an increased expression of PGC1-α in the heart and an overflow of NPY may lead to stress cardiomyopathy and even death in susceptible victims. Moreover, these markers can be used to identify stress cardiomyopathy as the cause of sudden death in specific cases.
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As a core curriculum of forensic medicine,it is of great importance to improve the quality of forensic toxicological education for cultivating high-quality forensic professionals.Basing on the rich experiences of forensic teaching and expertise,well teaching effects were achieved by the reform and explorations in teaching contents and methods,development of curriculum and teachers as well as other aspects aimed to improving the quality of forensic toxicological teaching.
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Forensic medical talents with creative ability should have ability to find.analyze and solve problems from complex cases.According to teaching practice on the basis of PBL this article illustrates application methods of PBL teaching characters in the training of forensic medical talents with creative ability.
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Corneal opacity is one of the most commonly used parameters for estimating postmortem interval(PMI).This paper proposes a new method to study the relationship between changes of corneal opacity and PMI by processing and analyzing cornea images.Corneal regions were extracted from images of rabbits' eyes and described by color-based and texture-based features,which could represent the changes of cornea at different PMI.A KNN classifier was used to reveal the association of image features and PMI.The result of the classification showed that the new method was reliable and effective.
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Corneal opacity is one of the most commonly used parameters for estimating postmortem interval (PMI). This paper proposes a new method to study the relationship between changes of corneal opacity and PMI by processing and analyzing cornea images. Corneal regions were extracted from images of rabbits' eyes and described by color-based and texture-based features, which could represent the changes of cornea at different PMI. A KNN classifier was used to reveal the association of image features and PMI. The result of the classification showed that the new method was reliable and effective.
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In order to investigate the impact of fulvic acid (FA) on the hydroxylysyl glycosylation in collagen bio-synthesis, 40 NMRI mice were divided into two groups (n = 20 in each group, consisting 10 females and 10 males). The animal was maintained for two generations by different diets: control group with normal water and food and study group with water containing 30 mg/L FA and normal food. The second generation of the animal was slaughtered, and the biochemical parameters of collagen content and the degree of collagen hydroxylysyl glycosylation in skin, rib and tibia were detected by biochemical methods. The mean value of collagen in the study group was increased slightly, and no significant difference between study group and control group was found (P > 0.05), but the content of glucose-glactose-hydroxylysine (GGH) was significantly decreased in the study group in comparison with the control group (P<0.01). It was suggested that through the decrease of GGH 30 mg/L FA could inhibit the activity of galactosyl-hydroxylysylglucosyl-transferase and further disturb the post-translational modification of collagen intracellularly.
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Benzopiranos/farmacologia , Desenvolvimento Ósseo , Osso e Ossos/química , Osso e Ossos/metabolismo , Colágeno/biossíntese , Glicosilação , Hidroxilisina/metabolismo , Camundongos Endogâmicos , Osteoartrite/etiologia , Selênio/deficiênciaRESUMO
In order to investigate the impact of fulvic acid (FA) on the hydroxylysyl glycosylation in collagen bio-synthesis, 40 NMRI mice were divided into two groups (n = 20 in each group, consisting 10 females and 10 males). The animal was maintained for two generations by different diets: control group with normal water and food and study group with water containing 30 mg/L FA and normal food. The second generation of the animal was slaughtered, and the biochemical parameters of collagen content and the degree of collagen hydroxylysyl glycosylation in skin, rib and tibia were detected by biochemical methods. The mean value of collagen in the study group was increased slightly, and no significant difference between study group and control group was found (P > 0.05), but the content of glucose-glactose-hydroxylysine (GGH) was significantly decreased in the study group in comparison with the control group (P<0.01). It was suggested that through the decrease of GGH 30 mg/L FA could inhibit the activity of galactosyl-hydroxylysylglucosyl-transferase and further disturb the post-translational modification of collagen intracellularly.
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Animais , Feminino , Masculino , Camundongos , Benzopiranos , Farmacologia , Desenvolvimento Ósseo , Osso e Ossos , Química , Metabolismo , Colágeno , Glicosilação , Hidroxilisina , Metabolismo , Camundongos Endogâmicos , Osteoartrite , SelênioRESUMO
Objective To explore the temporal expressions of interleukin-10(IL-10)and interleukin-4(IL-4)and their relationship with the wound age during skin incised wound healing in mice.Methods Immunohistochemical and image-analysis techniques were employed in vital skin wounds 0.5h～168h after incision and postmortem incision 0.5h～6h after death.Results Weak expression of IL-10 was detected at 0.5h after incision,which increased subsequently,and peaked at 3h post-injury.Then decreased to the pre-incision level at 24h,but peaked again at 72h after injury.Immunostaining revealed that epidermal cells and infiltrating mononuclear cells were the major source of IL-10.IL-4-positive cells were observed in the dermis at 24h,and reached the maximum level at 96h,which maintained until 168h post-injury.IL-4 was mainly expressed in the fibroblast-like cells of the granulation tissue and dermis.In addition,faint IL-10-positive cells were merely identified in the epidermal cells in the postmortem incision skin within 1～3h after incision.No IL-4-postitive cells were found in the postmortem incision skin.Conclusion The time-dependent expressions of IL-10 and IL-4 during cutaneous wound healing may be used for the estimation of wound age.
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Objective To study the relationship between the ultrastructural changes of corneal matrix collagen fibrils diameter and the postmortem interval.Methods Twenty-eight rabbits were killed by the method of air embolism and the samples of cornea were separately cut down in 0,6,12,18,24,48 and 72h after death.The ultrastructure of the collagen diameter was observed by transmission electro microscopy(TEM)and the 4 parameters of area(Y1),perimeter(Y2),average-diameter(Y3)and mean-diameter(Y4)were measured by a computer image technique and analyzed by Excel 2000 and SPSS 10.0 software.Results The 4 parameters of Y1,Y2,Y3 and Y4 were respectively increased from 1 131?53nm to 1 628?26nm,from 132.8?23nm to167.5nm,from 38nm to 45nm and from 37.71?6nm to 44.89?5nm within 72 hours after the death.Conclusion The corneal matrix collagen diameter increase regularly with the postmortem interval in 72h after death,and the parameters of Y1,Y2,Y3 and Y4 could be used as a new reference mark for timing the postmortem interval after death.
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Ryanodine receptor is a Ca2+ release channel in cadiocyte.It is reported recently to the obvious change of its function and quantity in such pathological process as the myocardial ischemia and cardiac hypertrophy.These changes will affect the ability of cadiocytes processing intracellular calcium or lead to the calcium overload in the myocardial cells and then induces fatal ventricular arrhythmia,even sudden cardiac death.