Eighteen cases of forensic re autopsy and histopathological re examination were analyzed retrospectively. The manner and the impression of original autopsy,times of autopsy,the reason and manner of forensic re autopsy,the interval betwwen the original autopsy and the re autopsy as well as the last conclusions were analyzed.It was found that the forensic re autopsy always occured in cases of medical disputes(3 cases,16 7%) and death related to the police investigation(4 cases,22 2%).Only external examination and incomplete forensic autopsy were done originally in 13 out of 18 cases(72 2%).The conclusions of re autopsy were completely different from that of the original autopsy in 5 cases.Attension must be paid and prevention measures for re autopsy must be adopted were also discussed.

AIM: To study the relationship between the disturbance of nitric oxide/endothelin-1(NO/ET-1) and hepatic ischemia/reperfusion(I/R) injury as well as the regulation of NO/ET-1 system by hepatic ischemic preconditioning(IPC). METHODS: The changes of NO/ET-1 system and their relationship with hepatic I/R injury were compared between I/R group and IPC+I/R group in a rat hepatic I/R model. Two hours after reperfusion, the liver tissues were detected by RT-PCR to see whether there was inducible nitric oxide synthase (iNOS) mRNA expression. RESULTS:In the acute phase of hepatic reperfusion, the ratio of NO/ET-1 was reduced, which was due to a significant reduction of NO - 2/NO - 3 (the metabolic product of NO) and significant elevation of ET-1 in the blood plasma. The content of ALT, AST, LDH and TNF-? in blood plasma, and of MDA in liver tissue were increased but ATP in liver tissue was reduced, the hepatic damage was deteriorated. The protection of the hepatic IPC was concerned with the elevation of the ratio of NO/ET-1 caused by the elevation of NO - 2/NO - 3, and reduction of ET-1 as well. There was no iNOS mRNA detected in the liver tissues.CONCLUSION: Hepatic I/R injury is related to the disturbance of NO/ET-1. The protection of the hepatic IPC in the acute phase might be conducted by its regulation of NO/ET-1 system. The cNOS rather than the iNOS generated the NO in this situation.

To find novel antihepatitis drugs, a series of nitrate-oleanolic acid (OA) hybrids (10a, 10b, 11a-11e and 12a-12c) were designed and synthesized on the basis of previous studies using OA as lead compound, which is widely found in natural plants and liver-specific metabolism. In the present study, ten novel NO-releasing derivatives of OA were synthesized by connecting nitrate to the OA-3-OH through varying lengths of linkers containing antioxidants which were designed to increase the ability of these target compounds to scavenge free radicals. The structures of these objective compounds were determined by IR, MS, 1H NMR and elemental analysis. Their protective effects on anti-Fas mediated HepG2 cell apoptosis were in vitro evaluated by LDH assay. Compound 12a is the most potent inhibitor. Its effect on anti-Fas mediated HepG2 cell apoptosis and amount of NO-releasing in vitro are similar to those of positive control NCX-1000.

Objective to investigate therapeutic methods and effect of X-knife for on intracranial diseases. Method Recent effect of 44pqtients with cranial diseases by X-knife was observed. Radiological follow-up was performed on 40 cases with mean 5.65 months of followup time. Result 92.5% of tumors were controlled locally, stability and recovery rate was 90.0%. The local control of metastatic tumors of brain was higher, but most patients with metastatic tumors died of primary lesion. New metastatic lesions appeared in patients without panencephalic radiotherapy in 1～5months. Tumors of pineal region were sensitive to X-knife. Conclusion X-knife has a definite effect on intracranial diseases. For patients with tumors of pineal region complicated by serious hydrocephalus, shunting should be conducted before X-knife treatment. For patients with mild or morderate hydrocephalus, X-knife chould be utilized only under correct interventions such as dehydration. The local control rate of intracranial metastatic tumors was high, but survival time postoperation depended on panencephalic radiotherapy or control of primafry lision. For tumors with diameter＞ 3cm, pituitary tumors, brains stem tumors and tumors in cerebellopontine angle region repeated X-knife were suggested, which could improve cure rate and decrease complications.

Objective To find out the epidemic characteristics and the prevalent tendency of transmission of HIV infection in Zhaotong City from 1997 to 2007. Methods Statistical analysis was applied to the data of 1997-2007 Zhaotong City local monitoring detection of HIV-infected persons and AIDS epidemic Tables Network reported. Results From 1997 to 2007, the cumulative report of the city's HIV-infected persons was 914 cases. Before 2002 the report was 144 cases as intravenous drug users. From 2003 to 2007 cumulative reports of 770 cases were infected with HIV, of which 524 were of local detection, accounting for the 68% of reports; field reports were 246 cases, accounting for 31.95%. 260 cases were intravenous drug users, accounting for 33.8%; 155 cases of heterosexual contact, accounting for 20.1%; 20 cases were of mother to child transmission, accounting for 2.6%; 335 were unknown cases, accounting for 43.5%. Report of infection from 0.19/100 000 in 1997 rose to 3.51/100 000 in 2007. The infection rate for migrant workers was 23.43/100 000. Conclusions From 1997 to 2007, transmission of HIV infection in Zhaotong City had a great change, and the rate of infection rose continually. The proliferation from high-risk population groups such as drug user to the general population increased rapidly, and it was the same case with floating population.

Objective To investigate the characteristic and its clinical value of tumor necrosis factor (TNF)-α and its receptor, interleukin (IL)-1β and its receptor in serum and bronchoalveolar lavage fluid(BALF) in patients with pulmonary tuberculosis and to determine the role of them in the immunopathogenesis of tuberculosis. Methods The concentrations of TNF-α,soluble TNF receptor (sTNF-R) Ⅰ, IL-1β and IL-1 receptor were measured using sandwish ABC-enzyme-linked immunosorbent assay (ELISA) method in serum and BALF of 46 patients with active tuberculosis and 21 patients with inactive tuberculosis, and in the serum of 20 cases of healthy control. Meanwhile the above-mentioned cytokine levels in serum and BALF of 19 patients with active tuberculosis were followed up. Differences between groups were assessed for significance by t test. Results The TNF-α,sTNF-R Ⅰ, IL-1β and IL-1 receptor levels and TNF-α/sTNF-R Ⅰ ratios in BALF of active tuberculosis group were (286.2±96.3) pg/L,(2 431.5±1 124.6) pg/L,(58.6±3.2) pg/L,(162.4±17.1) pg/L and 0.06±0.01, respectively, which were all significantly higher than those with inactive tuberculosis group (t=3.36,3.25,2.95,2.27 and 3.12 respectively; P<0.05). The TNF-α,sTNF-R Ⅰ,IL-1β and IL-1 receptor levels and TNF-α/sTNF-R Ⅰ ratios in BALF of cavernous tuberculosis group were (381.4±106.4) pg/L,(2 824.7±1 318.5) pg/L,(66.4±4.6) pg/L,(176.4±18.7) pg/L and 0.07±0.01, respectively,which were all significantly higher than those of non-cavernous tuberculosis group (t= 3.46,2.37, 3.19, 2.99 and 3.22, respectively; P<0.05). After 2-month' antituberculosis treatments, among 19 cases, the TNF-α,sTNF-R Ⅰ,IL-1β and IL-1 receptor levels and TNF-α/sTNF-R Ⅰ ratios in BALF of 16 cases were significantly lower than those at the beginning of treatments (t= 3.26,3.17, 3.28, 2.92 and 3.12 respectively; P<0.01). Meanwhile, their clinical symptoms improved, sputum smear negative, lesions on chest X-ray resolved and the cavity shrinked or closed. Conclusions TNF-α, sTNF-R Ⅰ, IL-1β and IL-1 receptor are likely to be involved in the immunopathogenesis of tuberculosis. Detection of TNF-α, sTNF-R Ⅰ, IL-1β and IL-1 receptor levels in the serum and BALF is helpful to understand the activity of disease, determine the clinical pattern of disease,assess the prognosis of disease and monitor the therapeutic effect in patients with pulmonary tuberculosis.

OBJECTIVETo analyze the characteristics of autopsies in medical dispute.

METHODSThe data of 202 autopsy cases in medical disputes performed by the Department of Pathology of Jiangxi Medical College from January 2001 to December 2010 were retrospectively analyzed.

RESULTSThe number of autopsy in medical disputes increased year by year. Neonatal, infant and 30 ≊ 60y were more common age groups in dispute; the gender ratio of male to female was 2:1 and more cases were from hospitals in rural areas. Most medical disputes came from in departments of pediatric, obstetrics and gynecology and general surgery. Death caused by cardiovascular diseases ranked at the first place.

CONCLUSIONAutopsy is important in medical disputes to define the cause of death and to preserve evidence.

Adolescent ; Adult ; Aged ; Autopsy ; statistics & numerical data ; Cardiovascular Diseases ; mortality ; Cause of Death ; Child ; Child, Preschool ; Dissent and Disputes ; Female ; Hospital Departments ; statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Male ; Malpractice ; Middle Aged ; Retrospective Studies ; Sex Ratio ; Young Adult

This study sought to assess the biocompatibility of P(DA-SA)-Adriamycin, a new controlled-release chemotherapy system, in rabbit brain, and to examine its controlled release effect both in vitro and in vivo and its curative effects in vitro. The reaction of animal brain to the implanted P(DA-SA) or P(DA-SA)-Adriamycin was observed. The controlled-release profiles in phosphate buffer solutions and in rabbit brain were measured by UV spectrometry. Then, through flow cytometer, the rate of apoptosis in cultured glioma cells was tested. The reaction of rabbit brain to P(DA-SA) polymer was moderate and not significantly different from that to Gelfoam. The controlled-release rate of P(DA-SA)-Adriamycin in vitro and in vivo was stable and the duration of controlled-release of P(DA-SA)-Adriamycin spanned three weeks. The rate for apoptosis of glioma cells of P(DA-SA)-Adriamycin group was 69.9%, which was significantly higher than that of the control group. In conclusion, P (DA-SA)-Adriamycin controlled release chemotherapy system that bears curative effect has favorable controlled-release effect and good biocompatibility in rabbit brain. This system has potential value in treatment of malignant brain tumor.
Animals ; Antibiotics, Antineoplastic ; administration & dosage ; pharmacokinetics ; Apoptosis ; drug effects ; Brain ; metabolism ; Decanoic Acids ; metabolism ; Doxorubicin ; administration & dosage ; pharmacokinetics ; Drug Carriers ; metabolism ; Drug Implants ; Materials Testing ; Polyesters ; metabolism ; Rabbits ; Tumor Cells, Cultured

Objective To explore the influencing factors of massive hemorrhage during cesarean section of pernicious placenta previa,and establish a risk prediction model.Methods The clinical data of 340 pregnant women with pernicious placenta previa who underwent cesarean section for termination of pregnancy in this hospital from January 2017 to December 2021 were collected.They were divided into the common hemorrhage group (the amount of intraoperative blood loss<2000 mL,n=200) and massive hemorrhage group (the a-mount of intraoperative blood loss ≥2000 mL,n=140).The clinical characteristics of pregnant women,clini-cal data of this pregnancy,situation of the fetus,and imaging information were compared between the two groups.Combining the variables with a P value<0.05 in the univariate analysis and the possible influencing factors of massive hemorrhage during cesarean section in pregnant women with pernicious placenta previa in clinical practice,the binary multivariate logistic regression analysis was conducted,and a risk prediction model was established.Hosmer-Lemeshow goodness of fit test and receiver operating characteristic (ROC) curve were used to evaluate the fitting effect and discrimination of the model.Results The results of multivariate logistic regression analysis showed that the number of abortions,placental thickness,combining with placental implantation,number of previous cesarean sections and fetal gender were the independent influencing factors for massive hemorrhage (≥2000 mL) during cesarean section in pregnant women with pernicious placenta previa (P<0.05).The prediction model formula:P=Log (Y/1-Y),Y=0.396+1.371×(number of abor-tions=three times)+1.248×(number of abortions ≥ four times)-0.351×(placental thickness)+0.624× (combining with placental implantation)+0.974×(two or more previous cesarean sections)+0.638 × (female=0,male=1).The results of Hosmer-Lemeshow goodness of fit test showed that the prediction mod-el had good calibration ability (x2=77.825,P<0.001).The area under the ROC curve was 0.768 (95％CI:0.717-0.820),the specificity was 83.0％,the positive predictive value was 70.2％,and the negative predic-tive value was 73.5％.Conclusion The risk prediction model of massive hemorrhage during cesarean section in pregnant women with pernicious placenta previa has good performance.It is helpful to identify high-risk pregnant women in the prenatal evaluation,and provide a basis for formulating the blood transfusion plan in clinic,and prevention and treatment of adverse pregnancy outcomes.

Objective To use color Doppler ultrasound to measure the hemodynamic indexes,and to es-tablish the diagnostic prediction model of inflammatory fetal distress.Methods A total of 213 pregnant women admitted to the obstetrics department of the First Affiliated Hospital of Air Force Military Medical U-niversity were collected as the research subjects and divided into the control group and case group according to whether or not fetal distress occurred,including 93 cases in the control group and 120 cases in the case group.The predictive value of PI,RI,S/D values of middle cerebral artery,umbilical artery and uterine artery for pre-dicting fetal distress was analyzed The diagnostic model was constructed by logistic regression analysis.The receiver operating characteristic(ROC)curve,calibration curve and clinical decision curve were adopted to an-alyze and evaluate the diagnostic efficiency of the model for adverse perinatal outcome and the clinical benefit of the patients.Results The univariate analysis results showed that MCA-PI,MCA-RI,MCA,S/D and CPR in the case group were lower than those in the control group,while UA-RI,UA,S/D and UtA-RI were higher than those in the control group.The multivariate regression analysis further showed that MCA-PI,MCA-RI and CPR were the independent protective factors for predicting fetal distress,while UA-R1 and UA-S/D served as the independent risk factors affecting the fetal outcome.Based on five independent influencing fac-tors,the risk prediction model was constructed,and the area under the receiver operating characteristic curve was 0.880(95％CI:0.834-0.925).The sensitivity,specificity and accuracy were 0.93,0.70 and 0.83 respec-tively,and the goodness of fit was good.Conclusion The hemodynamic indexes measured by color Doppler ul-trasound have good predictive value for the diagnosis of fetal distress.The risk prediction model established by the combined indexes has a certain reference value for the intervention in advance of pregnant women with fe-tal distress occurence.