To approach the criminal characteristics and responsibility of murder committed by psychotics.Case control study between psychotic(74 cases)and non psychotic(77 cases)were studied.The murders committed by psychotics were characterized with the abruptness,overt and cruelty.The symptom of delusion(47 2%)and auditory hallucination(31 1%)contribute the major causes of committing murder.Murderer with schizophrenia rank the first,while who with the manic depressive psychosis rank the second(14 8%).The criminal characteristic and intent of murder are the basis for assessment of criminal responsibility.

This work observed on isolated perfused rat hearts, that 10~(-9)mol/L endothelin (ET) induced myocardial contracture, decrease of heart function and coronary flow, intramyocardial Ca~(2+) accumulation and Mg~(2+) loss and etc. These cardiac action of ET were obviously more prominent when Mg~(2+) in the perfusion fluid was lowered to 0.12 mmol/L, and were significantly alIeviated when Mg~(2+) content was increased to 4.8mmol/L (normal plasma Mg~(2+) content is about 1.2 mmol/L). The mechanism of the Mg~(2+) effect on the cardiac action of ET may be related to its inhibition of Ca~(2+) influx into the myocytes. These results suggested that without magnesium defficiency, suitable replenishment of Mg~(2+) probably have practical clinical significance in the prevention and therapy of myocardial injury occurred during diseases with elevated circulatory ET level.

Objective To evaluate the killing efficacy of chlorine-releasing agents (CRAs) with different concentrations on multidrug-resistant Acinetobacter baumannii.Methods Totally 30 clinical strains of multidrug-resistant Acinetobacter baumannii were collected from November 2008 to December 2009.Killing efficacy of CRAs on these strains was evaluated by quantitative suspension test.The one-way analysis of variance was performed.Results The log values of killing to 30 strains of multidrug-resistant Acinetobacter baumannii were all ≥5.00,when the bacteria were exposed to available chlorine concentrations 400 mg/L of CRAs for 10 min,600 mg/L for 10 min,800 mg/L for 3 min and 1000 mg/L for 1 min,respectively.And effective rates were all 100％. Furthermore,there were significant differences among different available chlorine concentrations exposed for the same time ( except 10 min) ( F =72.72,64.79 and 32.33,P =0.00),and among different exposure time in the same available chlorine concentration ( except 1000 mg/L) ( F =110.42,20.41 and 3.20,P=0.00,0.00 and 0.03).Conclusion Satisfactory killing efficacy of CRAs to multidrug-resistant Acinetobacter baumannii can be achieved with available chlorine concentration 500 mg/L to 1000 mg/L and exposure time 10 min to 30 min.

Objective To study the methodology of the ear reconstruction using Medpor framework. Methods Using Medpor material as ear framework, 112 cases of ear reconstruction were performed using the expanded skin flap on the mastoid region(method Ⅰ) and the temporal fascia flap adding skin graft ( method Ⅱ) to cover ear framework. Twenty-three cases adopted method Ⅰand 89 cases adopted methodⅡ. Results One hundred and nine cases of the reconstructed ear were successful with a good appearance and 3 cases were failure. The exposure of Medpor framework occurred in 17 cases in this series. Among them the method Ⅰ occurred in 8 cases (34 %) and the method Ⅱ was used in 9 cases (10%). The exposure of Medpor framework in 14 cases were repaired using local skin flap or local fascia flap and skin graft. In 3 cases Medpor framework had to be removed due to the sever exposure. Conclusion It seems that Medpor framework is a good alternative for the ear reconstruction.

Objective To explore the validity and security of Simulect (basiliximab) induction immunosuppressive therapy in terms of prevention of acute allograft rejection in sensitive recipients.Methods Thirty-six adult recipients of cadaveric kidney transplant with panal reactive antibody 30 %～ 50 % were assigned randomly in a 1∶1 ratio to receive either two doses Simulect or matching placebo. Both patient groups also received baseline triple immunosuppression with the cyclosporine microemulsion, MMF and steroids. A total 40 mg Simulect was given in two doses of 20 mg eachon day 0 about 2 h before transplantation and the day 4 after transplantation respectively.Results No hyperacute rejection and delayed graft function occurred in the two groups. No apparent adverse and toxic events were recorded in the Simulect group. The incidence of acute rejection 3 months after transplantation was 11.1 % in Simulect group compared with 50 % in the placebo group ( 77.8 % reduction, P

Objective To evaluate monocyte chemotactic peptide-1 (MCP-1) excretion levels in urine of renal transplant recipients and study the relation between urinary MCP-1 levels and acute rejection.Methods Urinary MCP-1 levels were determined by avidin biotin complex-enzyme linked immunosorbent reaction (ABC-ELISA).Results The urinary MCP-1 levels were significantly higher in recipients with acute rejection than in clinically stable ones (P

0.05).The graft function of high dose group returned to normal within 3 to 7 days after operation.Delayed recovery of graft function occurred in 2 cases of routine dose group;in 1 case it returned to normal on the 21st day after operation, in the other the serum creatinine level fell down to 300 ?mol/L on the 45th day.There was no severe adverse event such as fever,chill,headache,heart-throb,dyspnea during ATG intravenous perfusion.And no serious infection occurred in the 2 groups during the first 3 months postoperatively.Hepatic function damage occurred in 1 case of high dose group.Follow-up ranged from 4 to 14 months.All recipients of high dose group survived with good graft function;5 of them could do housework. Only one graft lost its function in routine dose group. Conclusions On the basis of optimal selection of the donor and recipient,preoperative single-bolus high-dose ATG is effective and safe for the sensitive recipients as immune induction therapy, which may become one of the new induction treatments before transplantation.

Objective To find a better method to reconstruct total ear in one stage. Methods In the procedure, a compound framework was formed, in which Medpor acted as ear framework and homogenous rib cartilage as helix-framework after being sculptured, then they were vamped together. The formed framework was covered with adjacent skin flap and homogenous skin graft after it had been covered with superficial temporal fascia flap. Results From January 2001 to Augest 2003, 8 cases of congenital microtia or antotia were treated in this way, and all of them obtained satisfactory appearance in auricle. Conclusion The reconstructed ear has a delicate structure and good appearance, and looks and feels as a real one by this new procedure.

Objective To explore the significance of peritubular capillary C4d deposition in the diagnosis, treatment and prognosis of the patients with acute renal allograft rejection.Methods 86 allograft biopsies obtained from 78 kidney transplants were examined by immunohistochemistry on routine paraffin sections using anti-C4d polyclonal antibody. The relationship of C4d and functions, therapies and prognoses of allografts was analyzed. Results There were 32 allograft biopsies with Banff type Ⅰ rejection, 51 with Banff type Ⅱ rejection and 3 with Banff type Ⅲ rejection. Thirty biopsies were positive in C4d deposition. For 28 patients, at least one biopsy exhibited peritubular C4d deposition. There was no significant difference between type Ⅰ and type Ⅱ rejection ( 21.9 % vs 39.2 % , P= 0.101 ). The C4d~ + group had proportionately more patients with pregnant history (P= 0.020 ), more patients with high panel-reactive antibody levels (P= 0.013 ), and more retransplanted patients (P= 0.016 ). Mean serum creatinine was significantly higher in C4d positive patients than in negative patients[( 312.56 ? 196.26 ) ?mol/L vs ( 210.97 ? 136.59 ) ?mol/L, P= 0.0115 ]. Patients with C4d deposition were more commonly resistant to antirejection therapy with bolus steroids ( 75.0 % vs 28.0 % , P= 0.000 ) and ATG ( 66.7 % vs 12.5 % , P= 0.027 ). More patients with peritubular C4d deposition lost their grafts during the study period (64.3 % vs 90.0 %, P= 0.006 ).Conclusion Acute rejection with C4d deposition were resistant to antirejection therapy with steroids and/or ATG, and associated with inferior graft outcome.

OBJECTIVE To investigate the genes of AmpC and ?-lactamases and antibiotic resistance of A.baumannii strains in elderly.METHODS The sensitivity to 13 kinds antibacterials was analyzed according to CLSI 2005′s Standard.The genes of AmpC and ?-lactamases were detected by polymerase chain reaction(PCR).RESULTS Most of the strains were A.baumannii.In 20 strains of A.baumannii,the positive strains of AmpC(chromosome) were 17(85%),that of TEM and PER 5 strains were 11 strains(55%) and 25%,respectively.CONCLUSIONS High positive percentages of AmpC(chromosome),TEM and PER genes in A.baumannii strains isolated from elderly are found.