Influencing Factors of Horizontal Movement Distance of Bodies in High Falling Deaths / 法医学杂志

OBJECTIVES@#To explore the influencing factors of the horizontal distance of bodies in the high falling scene and the feasibility of inferring the falling mode based on it.@*METHODS@#A total of 614 high falling deaths and 15 cases of corpse dumping from high altitudes were collected. The relationship between the horizontal distance and the falling height, as well as the sex, age and manner of death (suicide, accident and corpse dumping) were observed.@*RESULTS@#The horizontal distance increased with the increase of falling height, and the difference among the height groups was statistically significant. The horizontal distance decreased with the increase of the age of the deceased, in each height group, the difference between the group over 60 years old and other age groups was statistically significant (P<0.05). The horizontal distance of male deceased was (1.99±0.27) m, which was greater than that of female deceased (1.88±0.19) m, and the difference was statistically significant in partial height groups (P<0.05). Roof falls had a greater horizontal movement distance than window falls. Except for the >20-30 m group, there was no significant difference in horizontal distance between suicide high falls and accidental high falls in other height groups.@*CONCLUSIONS@#The horizontal distance is affected by the falling height, the sex and age of the victim, and the spatial characteristics of the falling starting point.

Reconstruction of mandibular defects with tissue-engineered bone using 3D bionic printing technology / 中国组织工程研究

BACKGROUND: The 3D printed polylactic-co-glycolicacid/nano-hydroxyapatite (PLGA/nHA) scaffold carrying human recombinant bone morphogenetic protein 2 (rhBMP-2)/chitosan (CS) sustained release tissue-engineering bone has good biological activity, mechanical properties, and biological activity of its controlled release rhBMP-2. OBJECTIVE: To investigate the repair of mandibular defects with PLGA/nHA scaffold/rhBMP-2/CS sustained release tissue-engineering bone manufactured using 3D bionic printing technology. METHODS: Animal models of bilateral critical mandibular bone defects were established in 27 New Zealand white rabbits, followed by implantation of a 3D-printed PLGA/nHA scaffold/rhBMP-2/CS sustained release tissue-engineering bone on one side (experimental side), and a 3D-printed PLGA/nHA scaffold on the other side (control side). Mandibular specimens were harvested at postoperative days 30, 60 and 90 to carry out cone-beam CT, Micro CT, histological and immunohistochemical examinations. RESULTS AND CONCLUSION: The results from micro-CT analysis revealed that the volume of newly formed bone volume and the amount of bone trabeculae on the experimental side were significantly higher than those on the control side at different postoperative time points (P ＜ 0.05). The results from cone-beam CT examination showed that at 90 postoperative days, bone density of the bone defect on the experimental side was close to that of the surrounding bone, new bone tissues were full of the original bone defect area, and the trabecular bone arranged regularly, while on the control side, worm-eaten discontinuous low-density osteoid tissues were visible in the bone defect area. Osteogenesis on the experimental side was better than that on the control side. Histological findings demonstrated that on the experimental side, a large amount of mature lamellae were detected in the bone defect area, with well-arranged trabecular bones and abundant capillaries, and moreover, the scaffold material had been completely absorbed. However, low-density, loose-meshed, irregular braided bone tissues with rare capillaries were observed on the control side, and the scaffold material had been mostly absorbed. Immunohistochemical findings indicated that the osteocalcin-dyed area on the experimental side was significantly larger than that of the control side at postoperative 90 days. To conclude, 3D-printed PLGA/nHA scaffold/rhBMP-2/CS sustained release tissue-engineering bone is favorable for the repair and reconstruction of experimental mandibular defects in rabbits.

Effects of preoperative oral carbohydrate on postoperative insulin resistance in radical gastrectomy patients / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effects and mechanism of postoperative insulin resistance in gastrectomy patients with preoperative oral carbohydrate.</p><p><b>METHODS</b>From April to October 2011, 60 consecutive gastric cancer patients met inclusion criteria were divided into oral carbohydrate group and placebo group by randomized double-blind principles. Resting energy expenditure (REE), fasting blood glucose, insulin and triglyceride level were detected in 4 hours preoperatively. The 500 ml carbohydrate or placebo were administrated orally 2-3 hours before anaesthesia. Two group patients underwent radical distal subtotal gastrectomy under epidural compounded intravenous anesthesia. After laparotomy and before the abdomen was closed, a piece of rectus abdominis was taken and fixed in 3% glutaraldehyde. REE, fasting blood glucose, insulin and triglyceride level were detected immediately after surgery. The changes of insulin resistance index, blood triglycerides level, REE and respiratory quotient were compared pre- and post-operatively. The changes of rectus abdominis mitochondrial ultrastructure were observed by transmission electron microscopy respectively.</p><p><b>RESULTS</b>There were 48 patients (34 males and 14 females) completed the trial. The 24 and 24 patients in oral placebo and carbohydrate groups respectively. In oral placebo group, post-operative insulin resistance index, REE, respiratory quotient, serum triglyceride level and the rectus abdominis mitochondrial damage index were 12.68 ± 3.13, (1458 ± 169) kcal/d, 0.73 ± 0.42, (0.53 ± 0.24) g/L and 1.14 ± 0.33, respectively. And the above items were 5.67 ± 1.40, (1341 ± 110) kcal/d, 0.79 ± 0.22, (1.04 ± 0.97) g/L and 0.92 ± 0.19 in oral carbohydrate groups respectively. All difference was statistically significant (t = 6.646, 2.851, 6.546, 2.542 and 2.730, all P < 0.05). Oral placebo group showed a markedly swollen mitochondria, steep membrane was not clear, mitochondria appeared vacuolated changes.</p><p><b>CONCLUSIONS</b>Preoperative oral carbohydrate could reduce the insulin resistance and REE, improve the material metabolism status in radical gastrectomy patients. The possible mechanisms should be related to promotion of insulin release and protection of mitochondrial function.</p>

Effect of early oral enteral nutrition on clinical outcomes after colorectal cancer surgery / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of early oral feeding with enteral nutrition after surgery on clinical outcomes in patients with colorectal cancer.</p><p><b>METHODS</b>Forty-eight patients with colorectal cancer undergoing elective operation between January 2012 and May 2012 were randomly divided into study group (n=24) and control group (n=24). Patients in the group were given small amount of water several times and enteral nutrition early after surgery. Patients in the control group received conventional postoperative care protocol. Nutritional status, immune function, time of flatus, postoperative hospital stay, medical cost and incidence of complications between the two groups were compared.</p><p><b>RESULTS</b>As compared to the control group, nutritional status and immune function in the study group were significantly better (P<0.05). In the study group, time to flatus [(54.3±11.9) h vs. (65.7±10.0) h, P<0.05] and postoperative hospital stay [(5.4±1.1) d vs. (7.1±1.4) d, P<0.05] were significantly shorter, and medical cost [(36.3±6.4) thousand RMB vs. (42.8±4.3) thousand RMB, P<0.05] was significantly less as compared with the control group. No difference of the complication incidence was found [12.5% (3/24) vs. 16.7% (4/24), P>0.05].</p><p><b>CONCLUSION</b>Early oral feeding with enteral nutrition after surgery can improve the nutritional status and immune function, and accelerate the recovery of patients with colorectal cancer.</p>