Objective To Study the criteria of assessment on the degree of mental damage due to in-jury. Methods A retrospective study of 297 mental damage cases caused by injury expertised by the depart-ment of legal psychiatry of Tongji Medical College, Huazhong University of Science and Technology from July 1986 to December 2002 was conducted. Results In 297 cases, 91 were heavily injury, 93 were moder-ate. 44 cases were slight injury, and 69 cases between injury and disease. Conclusion The Study proposed a concrete and practical assessment criteria of forensic expertise of mental damage by the analysis of these 297 cases. We hope this criteria is developed into perfection in future forensic expertise.

BACKGROUND:A high incidence of deep vein thrombosis after total hip replacement does great harm to patients,so it is necessary to look for a safe and effective prevention program after total hip replacement to reduce the harm of deep vein thrombosis.OBJECTIVE:To observe the influence of comprehensive prevention scheme on deep vein thrombosis after total hip replacement.METHODS:102 cases undergoing total hip replacement were randomly divided into observation group and control group with 51 cases in each group.Patients in the observation group received the comprehensive prevention program,which is composed of three interventions: sequential cross combined with low molecular heparin,intermittent pneumatic pressure therapy and continuous femoral nerve block analgesia.In the control group,patients received low-molecular-weight heparin for anticoagulation therapy by the doctor according to his clinical experience,or intermittent pneumatic pressure therapy.The occurrence and distribution of deep vein thrombosis were compared in patients of both groups.At the same time,platelet and hemoglobin were recorded.RESULTS AND CONCLUSION:In the observation group,three patients suffered from deep vein thrombosis with an incidence of 6％.In the control group,11 patients affected deep vein thrombosis,with an incidence of 22％.There were significant differences between the two groups (P＜ 0.05).No significant difference in constituent ratio of the distribution of deep vein thrombosis was detected in the distal vein and proximal vein in patients of both groups (P＞ 0.05).Hemoglobin value was lower at 1 day after surgery compared with that pre-operation in the two groups (P＜0.05).Platelet value was lower at 1 day after surgery compared with that pre-operation in the two groups (P＞0.05).No significant difference in hemoglobin and platelet values was detected between two groups at 1 and 6 days after surgery (P＞ 0.05).Results indicated that the comprehensive prevention program containing the sequential and cross combined with low molecular heparin,intermittent pneumatic pressure therapy and continuous femoral nerve block analgesia can significantly reduce the incidence of deep vein thrombosis,and no serious complications occurred,and the effects are affirmative and reliable.

Objective To establish a swine model of 10 min prolonged cardiac arrest (CA) induced by electrically triggered ventricular fibrillation,and then evaluate the quality of the model and the value in the establishment of post-cardiac arrest syndrome.Methods Fourteen domestic healthy swine weighing 38 ±3 kg were selected for study.Ventricular fibrillation was induced for 10 min,and then cardiopulmonary resuscitation (CPR) was initiated and continued for 5 min.The resuscitated animals were observed for 72 h after resuscitation.The resuscitation outcomes and survival rate were recorded.The functions of heart,lung and brain,and systemic inflammatory response and tissue perfusion were regularly evaluated for 72 h post-resuscitation.Results Eleven of the fourteen swine obtained restoration of spontaneous circulation (ROSC),and the rate of successful resuscitation and 72 h survival were both 78.6％.Significantly worse post-resuscitation myocardial function was found in all animals compared to the value prior to CA and the myocardial function was evaluated by decreased stroke volume and global ejection fraction,and increased levels of serum cardiac troponin-Ⅰ and n-terminal pro brain natriuretic peptide.Postresuscitation extra-vascular lung water index and pulmonary vascular permeability index were significantly increased accompanied with significantly decreased oxygenation index compared with the values before CA,indicating the occurrence of acute lung injury.In addition,post-resuscitation systemic inflammatory response and tissue low perfusion evidenced by significantly higher levels of serum tumor necrosis factor-α and interleukin-6 and arterial blood lactate were observed.Consequently,severe neurological deficit with significantly higher levels of serum neuron-specific enolase and S-100B was observed following 72 h postresuscitation.Conclusions This swine model of prolonged cardiac arrest induced by electrically triggered ventricular fibrillation was a well established model with high success rate of resuscitation,significant vital organ injury and relatively long duration of survival;it is an excellent model for the study of post-cardiac arrest syndrome.

Objective To investigate the diffusion-weighted imaging (DWI)characteristics and the correlation of diffusion coeffi-cient (ADC)and differentiation grade of rectal tubular adenocarcinoma.Methods The DWI characteristics of thirty-eight patients pathologically comfirmed rectal tubular adenocarcinomas were evaluated respectively.There were 9 highly differentiated tubular ade-nocarcinomas,1 5 moderately differentiated tubular adenocarcinomas and 14 poorly differentiated tubular adenocarcinomas.The ADC value was calculated from two different factors (0 and 1 000 s/mm2 ).The correlation between ADC value and the differentiated de-gree of tumour was statistically analysed.Results The mean ADC for highly differentiated group was (0.92±0.05)×10 -3 mm2/s, and the mean ADC for moderately differentiated group was (0.79 ± 0.10)× 10 -3 mm2/s whereas that for poorly differentiated group was (0.71±0.06)×10 -3 mm2/s.The difference among three groups was statistically significant(P <0.05).The ADC value and the differentiated degree of tumour were negatively correlated(Spearman r =-0.704)P<0.01.Conclusion DWI and ADC value can be a useful estimating for the differentiation of rectal tubular adenocarcinoma.

Objective To establish a method based on 3D printing radiology equivalent phantom for individual radiotherapy dose verification,and to offer an assurance for the safety of 3D conformal radiotherapy.Methods Two patients' CT data was collected,reconstructing the first patient's skull and brain tissue to generate a skull-brain phantom for the purpose of testing the equivalent material.The second patient's data was used for whole head tissue reconstruction to produce a head phantom with equivalent material.By inserting ionization chamber dosimeters to target region for radiotherapy program,equivalent phantom dose distribution of lesions location was obtained in order to verify and calibrate the actual radiation treatment planning for patients.Results DR,CT images of the phantoms revealed that the difference of X-ray gray value between brain skull phantom and patient's skull was 13 721,CT value difference between equivalent tissue of brain skull phantom and that part of the patient was 35-40 HU,and CT difference between head phantom temporalis and that of the patient tissue was 18-28 HU.The imaging data indicated that the radiation equivalence of 3D printing phantom was similar to that of human body tissue,and the equivalent dose distribution accorded well with the normal range of treatment.The dose verification of phantom model can effectively improve the accuracy of the radiotherapy system.Conclusions The personalized radiotherapy phantom which based on the 3D printing and tissue equivalent technology is suitable for personalized radiation therapy validation.With advantages of easy accessibility,highly-personalized degree and high precision,this technology provides a reliable and safe way for radiation therapy.

OBJECTIVETo explore the value of MSCT in the preoperative TNM staging and the longest tumor diameter measurement (RESIST standard) of gastric cancer.

METHODSClinical data of 153 consecutive patients with biopsy-confirmed gastric carcinoma who were preoperatively evaluated with enhanced MSCT scanning in our hospital from January 2012 to March 2013 were retrospectively analyzed. Consistency comparison was performed between preoperative TNM staging and the longest tumor diameter measurement and histopathological findings.

RESULTST-staging consistency of Kappa value was 0.566, and accuracy was 71.2%. N-staging consistency of Kappa value was 0.284, and accuracy was 47.7%. The Kappa value of M-staging consistency was 0.893, and accuracy was 98.7%. The overall accuracy of TNM staging consistency was 66.7% (102/153) with a Kappa value of 0.573. Effective measurement of the longest cancer diameter was carried out in 53 patients. There was no significant difference between preoperative longest tumor diameter acquired by MSCT and postoperative tumor measurement [(68.8 ± 40.6) mm vs. (64.2 ± 36.2) mm, P=0.969].

CONCLUSIONMSCT is accurate in preoperative TNM staging and longest tumor diameter measurement of gastric cancer compared with postoperative pathological examination, and can provide reliable evidence for preoperative staging and neoadjuvant therapy evaluation of gastric cancer, but it is unfavorable to evaluate the lymph node metastasis.

Objective To explore the value of MSCT in the preoperative TNM staging and the longest tumor diameter measurement (RESIST standard) of gastric cancer. Methods Clinical data of 153 consecutive patients with biopsy-confirmed gastric carcinoma who were preoperatively evaluated with enhanced MSCT scanning in our hospital from January 2012 to March 2013 were retrospectively analyzed. Consistency comparison was performed between preoperative TNM staging and the longest tumor diameter measurement and histopathological findings. Results T-staging consistency of Kappa value was 0.566, and accuracy was 71.2%. N-staging consistency of Kappa value was 0.284, and accuracy was 47.7%. The Kappa value of M-staging consistency was 0.893, and accuracy was 98.7%. The overall accuracy of TNM staging consistency was 66.7% (102/153) with a Kappa value of 0.573. Effective measurement of the longest cancer diameter was carried out in 53 patients. There was no significant difference between preoperative longest tumor diameter acquired by MSCT and postoperative tumor measurement [(68.8±40.6) mm vs. (64.2±36.2) mm, P=0.969]. Conclusion MSCT is accurate in preoperative TNM staging and longest tumor diameter measurement of gastric cancer compared with postoperative pathological examination , and can provide reliable evidence for preoperative staging and neoadjuvant therapy evaluation of gastric cancer , but it is unfavorable to evaluate the lymph node metastasis.

Objective To investigate the effect of scan table on size-specific dose estimate ( size-specific dose estimate, SSDE) in children's CT scan. Methods CT imaging data and CTDIvol of 44 children ( 15 heads, 13 chests, 16 abdomen-pelvis) who underwent Siemens SOMATOM Definition AS+ 64 row 128-slice CT scan were retrospectively collected. CTDIvol of each patient was recored, WED ( water equivalent diameter) was calculated by two different methods ( with or without table) , donated as WED-T and WED-NT, then the corresponding SSDEWED ( SSDEWED-T and SSDEWED-NT ) was calculated. And the SSDEWED-NT was used as reference to evaluate the difference between WED and SSDEWED obtained by two different methods. Results Including part of table will lead to the overestimate for WED, with mean differences of 0. 10％, 2. 82％ and 2. 54％ for head, chest and abdomen-pelvis, respectively, while SSDEWED will be underestimated by 0. 06％ ( head ) , 2. 70％ ( chest ) and 1. 59％ ( abdomen-pelvis ) . Conclusions Including par of the patient table has a certain effect on SSDEWED for children, more attention should be paid for the application of SSDEWED.

Objective To explore the value of MSCT in the preoperative TNM staging and the longest tumor diameter measurement (RESIST standard) of gastric cancer. Methods Clinical data of 153 consecutive patients with biopsy-confirmed gastric carcinoma who were preoperatively evaluated with enhanced MSCT scanning in our hospital from January 2012 to March 2013 were retrospectively analyzed. Consistency comparison was performed between preoperative TNM staging and the longest tumor diameter measurement and histopathological findings. Results T-staging consistency of Kappa value was 0.566, and accuracy was 71.2%. N-staging consistency of Kappa value was 0.284, and accuracy was 47.7%. The Kappa value of M-staging consistency was 0.893, and accuracy was 98.7%. The overall accuracy of TNM staging consistency was 66.7% (102/153) with a Kappa value of 0.573. Effective measurement of the longest cancer diameter was carried out in 53 patients. There was no significant difference between preoperative longest tumor diameter acquired by MSCT and postoperative tumor measurement [(68.8±40.6) mm vs. (64.2±36.2) mm, P=0.969]. Conclusion MSCT is accurate in preoperative TNM staging and longest tumor diameter measurement of gastric cancer compared with postoperative pathological examination , and can provide reliable evidence for preoperative staging and neoadjuvant therapy evaluation of gastric cancer , but it is unfavorable to evaluate the lymph node metastasis.

Objective To investigate the feasibility of using contrast-enhanced T1WI radiomics in predicting the pathological grade in rectal adenocarcinoma.Methods The MRI and pathological data of 127 patients with rectal adenocarcinoma were analyzed retrospectively.ITK-SNAP software was used to manually draw region of interest(ROI)in rectal cancer on axial T,WI enhanced images.The radiomics features were extracted by the Pyradiomics software from ROI.The task was divided into two parts:task 1("high & non-high"group)predicted the high-differentiation and moderate/low-differentiation of the tumor;task 2("moderate & low"group)predicted the tumor's moderate-differentiation and low-differentiation in"non-high"group.Maximum relevance and minimum redundancy(mRMR)method was used to screen features.The five methods including least absolute shrinkage and selection operator(LASSO),logistic regression(LR),naive Bayes(NB),random forest(RF),and support vector machine(SVM)were used to build the models,and the efficiency of each model was evaluated and compared.Results In task 1,the area under the curve(AUC)of five methods were 0.86,0.90,0.59,1.00,0.99 in the training cohort and 0.71,0.62,0.53,0.67,0.64 in the testing cohort.In task 2,the AUC of five methods in the training cohort were 0.93,0.85,0.67,0.92,0.89,and in the testing cohort were 0.86,0.80,0.50,0.78,0.71.The models constructed by LASSO in both tasks were the dominant models,the AUC of the fusion model in the testing cohort which combined with age,gender and the dominant Radiomics score(Radscore)was 0.80[95％confidence interval(CI)0.63-0.96]in task 1,and the accuracy,sensitivity and specificity were 78.94％,77.78％,and 79.31％respectively.They were 0.89(95％CI 0.74-1.00),90.00％,95.65％,and 71.43％,respectively in task 2.The calibration curves showed that the fusion models had a good goodness of fit.Conclusion Based on the establishment of two dichotomous models,the radiomics based on the contrast-enhanced T1 WI is feasible in predicting the high,moderate and low differentiation degree of rectal adenocarcinoma.