OBJECTIVE: To analyze the features of orbital fracture and to discuss its forensic expertise points. METHODS: One hundred and thirty cases of simple orbital fracture from 2010 to 2012 collected from one public security bureau were retrospectively analyzed such as age, gender, tools, position and morphology of the fracture, periorbital and orbital compound injury and the follow-up results after 6 months. RESULTS: In the 130 cases, the wounded were mainly young men and hit by fist. The fracture of simple medial orbital wall accounted for up to 81.5% in all cases. In the periorbital and orbital compound injury, laceration and contusion of eyelid and ethmoidal cellules and maxillary sinus always occurred. After 6 months follow-up, there were 30 cases of comminuted fracture remained enophthalmos compared with the uninjured side. CONCLUSION It is inappropriate to judge the fracture of simple medial orbital wall as minor injury. We should judge the degree of simple orbital fracture after the injury is stable. Detailed ophthalmology inspection is necessary for forensic expertise of simple orbital fracture.
Craniocerebral Trauma ; Enophthalmos ; Female ; Fractures, Comminuted/pathology* ; Humans ; Male ; Ophthalmologic Surgical Procedures ; Orbit ; Orbital Fractures/surgery* ; Retrospective Studies ; Severity of Illness Index ; Trauma Severity Indices

Objective To evaluate the diagnostic value of surface enhanced laser desorption/ionization time of flight mass spectrom-etry(SELDI-TOF-MS) for Paget disease. Methods The relative contents of serum proteins of 15 healthy people,15 patients with chronic eczema and 20 patients with Paget were detected by Weak cation exchanger protein chip (WCx2) and SELDI-TOF-MS. Results The con-tents of two proteins (3868Da,8876Da) had significant difference in healthy people and Paget disease patients(P<0.01). 291IDa, 3868Da and 5097Da protein peaks had significant difference in chronic eczema and Paget disease(P<0.05). Conclusion It shows great potentiality for early diagnosis and screening the tumor biomarkers of Paget disease with SELDI-TOF-MS.

Adult ; Bone Neoplasms ; diagnosis ; surgery ; Humans ; Ilium ; Magnetic Resonance Imaging ; Male ; Osteoma, Osteoid ; diagnosis ; surgery ; Tomography, X-Ray Computed

Child, Preschool ; Coronary Aneurysm ; etiology ; pathology ; Coronary Vessels ; pathology ; Female ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; pathology

Objective To evaluate the value of differential diagnosis on congenital biliary atresia(BA) and infantile hepatitis syndrome(IHS) by technetium-99m-diethyl-iminodiacetic acid(99Tcm-EHIDA)hepatobiliary scintigraphy with phenobarbitol sodium.Methods Fifty-eight infants with persistent jaundice were taken phenobarbitol sodium[5 mg/(kg?d)] ,bid ?7 d).Those who had not bowel and gallbladders radioactivity within 24 hours were diagnosed as the diagnostic criterion of BA.Those with bowel and gallbladders radioactivity within 24 hours were diagnosed as the diagnostic criterion of IHS,who then received 99Tcm-EHIDA hepatobiliary scintigraphy with single photon emission computed tomography(SPECT) instrument.The results of all children were analyzed and compared with pathology and clinical follow up results.Results 99Tcm-EHIDA hepatobiliary scintigraphy correctly diagnosed 24 infants with last diagnosis BA and 29 infants with last diagnosis IHS,5 neonates false positive in all 34 IHS patients.The sensitivity in the diagnosis of BA was 100%,the specificity and accuracy were 85.3% and 91.4%,restectively.The sensitivity was 85.3% in the diagnosis of IHS;the specificity and accuracy were 100% and 91.4%,respectively.Conclusions 99Tcm-EHIDA hepatobiliary scintigraphy with phenobarbitol sodium can accurately differentiate BA and HIS at early stage.

Objective To investigate the impact of a single sub-anesthetic dose of ketamine on postoperative emotional reactions of anxiety and depression during colorectal tumors surgery. Methods A total of 42 patients undergoing selective colorectal surgery,aged 18 to 65 years,were randomly divided into ketamine group (group K)and control group (group C).After induction of an-esthesia,a single intravenous injection of 0.3 mg/kg ketamine and saline were used in Group K and group C 5 minutes before the operation respectively.The intravenous analgesia program was identical between the two groups.The patients??emotional reactions (anxiety,depression)were assessed using the Hospital Anxiety and Depression Scale (HAD),the quality of recovery was assessed using the QoR-40 questionnaire on the day before operation and within postoperative 48 hours respectively.Pain was estimated by the visual analog scale (VAS)and sedation was assessed with Ramsay score 30 mi-nutes after extubation.The time of anesthetic end and extubation were recorded.The complications during anesthesia and recovery such as cough, agitation 30 minutes extubation were recorded. Results The HAD-A and HAD-D scores of group K were lower than group C (P <0.05)48 h post-operatively.There was no difference on the QoR-40 score postoperative 48 h between the two groups. The patients??emotional state QoR-40 score of group K were higher than group C (P <0.05 ).The VAS scores 30 minutes after extubation of group K were lower than group C (P <0.05).There was no significant difference on sedation score 30 minutes postoperatively between the two groups.There was no significant difference in extubation time,cough,agitation and delirium between the two groups.There was no dizziness, nausea, vomiting or diplopia 30 minutes after extubation. Conclusion A single subanesthetic dose of ketamine can significantly reduce the scores of postopera-tive anxiety and depression,improve the quality of recovery,and no postoperative adverse reactions increased.

Objective To screen the mutation of KATP channel mutations in Chinese pedigrees with infantile onset type 1 diabetes mellitus (T1DM) and neonatal diabetes mellitus.Methods A cohort of 12 children of infant onset T1DM and neonatal diabetes mellitus admitted into Beijing Children's Hospital between March 2004 and June 2013 were selected.PCR amplification and direct sequencing were used to analyze the 39 exons of ABCC8 gene and one exon of KCNJ11.And the mutational sites of the parents of the probands was sequenced in order to identify the inheritance.Results Analysis revealed ABCC8 mutation in 25％ (3/12 cases) of the patients,a case of transient neonatal diabetes (TNDM),a case of permanent neonatal diabetes mellitus (PNDM) and a case of infant onset T1DM.All positive patients showed a known heterozygosis mutation in the ABCC8 gene(R1182Q,c.3545G ＞ A,D209E,c.627C ＞ G,E208K c.622G ＞ A).The residue R1182Q,which was located at a position involved in joining transmembrane domain 2 to nucleotide binding domain 2,the mutations E208K and D209E were located in the intracellular region that links the transmembrane domain with the gatekeeper module.All the three mutations were located throughout the cytoplasm part of SUR1 protein.The TNDM successfully transferred from insulin to oral sulfonylureas therapy.Conclusions There is a complex genetic pathogenesis in neonatal and infant-onset diabetes.The KATP channel activating mutations is one of the main causes of neonatal diabetes mellitus and may cause T1DM in infants in China.Oral Glibenclamide therapy seems highly effective for some patients with the KATP channel activating mutations.

Objective To study the efficacy and safety of rociverine combined with tamsulosin in treatment of overactive bladder after transurethral resection of prostate (TURP).Methods 93 cases of overactive bladder patients who received TURP were collected.They were given rociverine tablets 10 mg 3 times a day and tamsulosin 0.2 mg once a day for 7 to 10 days.The efficacy and safety of treatment were assessed by changes before and after treatment in subjective indicators of overactive bladder syndrome score(OABSS),the international prostate symptom score(IPSS) and quality of life score(QOL) and objective indicators including daily frequency of micturition,urgency,urgency incontinence,nocturia,voiding volumes,combining with the adverse drug reaction incidence.Results The average treating time for the 93 cases was (5 ± 3) days.The average score of OABSS reduced 8.12(P ＜0.01,and each score≤ 4).The average score of IPSS reduced 16.69(P ＜0.01).The average score of QOL reduced 2.18 (P ＜ 0.01).There was statistical difference in objective indicators of patients between before and after treatment(P ＜ O.05).The adverse drug reaction incidence was 2.1％ (2 cases with thirsty symptom).Conclusion Rociverine tablets combined with tamsulosin in treatment of patients with overactive bladder after TURP are effective and safe.

Objective To study the dynamic changes of pulmonary lesions of severe acute respiratory syndrome(SARS)treated by non-invasive positive pressure ventilation(NIPPV)on CT. Methods Serial chest CT images in 18 patients with SARS were retrospectively analyzed before and after NIPPV(4—12 days),and a long-term follow-up(3—36 months)examination by CT was carried out.And 27 SARS cases without NIPPV were enrolled as the control group.Results(1)There were dynamic changes in 15 cases of 18 cases:partial multilobar consolidations of bilateral lungs changed into ground-glass opacities in 7 of 18 cases,a circular pulmonary emphysema around bronchial vascular strains of the lower lobes was seen in 5 of 18,subpleural pulmonary emphysema was seen in 8 of 18,pulmonary barotraumas were showed in 2 of 18.Residual of subpleural curvilinear shadow related to NIPPV was found in 2 cases on the follow-up scan.(2)Above changes on CT were not found in 27 cases without NIPPV.Conclusion There were changes of pulmonary lesions of SARS on CT related to NIPPV treatment,It is beneficial to assess the CT images in the NIPPV treatment of the related pneumonia in SARS.

To investigate the electrophysiologic characteristics of f-wave amplitude and to evaluate its role in development and persistence of chronic atrial fibrillation (AF) associated with rheumatic heart disease (RHD). Methods: Epicardial mapping was performed in 44 patients with chronic AF of RHD who underwent heart valve surgery. Ten patients with supraventricular tachycardia served as the control group. Results:The f-wave amplitude of left atrium (LA) and middle and low LA posterior regions were significantly lower than those of the control group. The f-wave amplitudes of the upper, middle and low sections in LA posterior region were significantly lower than those in right atrium (RA) (P<0.05). The f-wave amplitudes were compared before and after electrocardioversion in 14 patients with chronic AF. The mean atrial electrogram amplitude during sinus rhythm was significantly higher than that during AF (P<0.01).The f-wave amplitude in left appendage was higher than that in LA posterior region (the upper,middle and the lower part),P<0.05.The f-wave amplitude in the upper section of LA was significantly higher than that in the middle section. The f-wave amplitude in AF group was not correlated to the diameter or volume of both atria. Conclusion: There are amplitudes differences between the upper, middle and lower LA,suggesting that the middle and lower sections of LA posterior wall may be the region producing anisotropy and reentrant circle.