Humans ; Organophosphorus Compounds ; analysis ; pharmacokinetics

OBJECTIVE: To observe the characteristics of vertical cast-off bloodstain pattern by different hitting-tools. METHODS: The regular hitting tools, a kitchen knife, a dirk, a plane set-hammer and an iron pipe, were selected. At a distance of 30 cm away from the wall, the hitting tool with 5 mL fresh chicken blood made the cast-off bloodstain from top to bottom. Then the holistic distribution characteristics (length, width and density) of cast-off bloodstain and morphology characteristics (length, width and contact angle) of first single cast-off bloodstain were analyzed. RESULTS: The distribution length of cast-off bloodstain formed by dirk was minimum (P < 0.05). The distribution width of cast-off bloodstain formed by kitchen knife was minimum (P < 0.05). Except the pair of kitchen knife and plane set-hammer, the distribution density between each two tools had statistical differences (P < 0.05). The length of first single cast-off bloodstain formed by plane set-hammer was longest compared (P < 0.05). The width of first single cast-off bloodstain had statistical differences between kitchen knife and plane set-hammer, and between dirk and plane set-hammer (P < 0.05). CONCLUSION The type of hitting tool could be inferred by the specific characteristics of cast-off bloodstain pattern formed by every specific type of hitting tool in crime scene.
Blood Stains ; Computer Simulation ; Crime ; Forensic Ballistics/methods* ; Forensic Medicine/methods* ; Humans

Objective To understand the specimen sources,clinical characteristics,and antimicrobial resistance of Burkholderia cepacia (B .cepacia )isolated from infected patients in intensive care unit(ICU),so as to provide reference for guiding rational use of antimicrobial agents.Methods Clinical data of patients with B .cepacia infec-tion in an ICU between 2011 and 2014 were analyzed retrospectively,antimicrobial resistance of strains was ana-lyzed.Results A total of 267 B .cepacia strains were isolated,the major specimen sources were sputum (80.15%, n=214),blood(14.23%,n =38),and urine(3.37%,n =9).Antimicrobial susceptibility testing results revealed that B .cepacia had multiple resistance,and was naturally resistant to multiple clinically used antimicrobial agents, such as ampicillin,cefazolin,ampicillin/sulbactam,nitrofurantoin,and cefuroxime,resistant rates were all 100%;resistant rates to ceftazidime and levofloxacin were 4.12% and 3.00% respectively;resistant rate to compound sulfa-methoxazole had increased tendency(χ2 =5.885,P =0.015).Conclusion Isolation of B .cepacia in ICU increased year by year,antimicrobial resistance is serious,management and targeted monitoring of prevention and control of healthcare-associated infection should be strengthened,antimicrobial agents should be chosen according to antimi-crobial susceptibility testing results.

OBJECTIVESTo evaluate the clinical application of one-stage repair of hypospadias using pedicled penis and scrotal septal symphysis skin flap.

METHODSOne hundred and forty-nine cases of hypopadias were treated with the skin flap and followed up.

RESULTSAfter the operation, one hundred and twenty-two cases of patients obtained satisfactory outcomes, twenty-seven cases happened urethral leakage and preputial uredema were observed, and three cases suffered from urethral-skin fistula.

CONCLUSIONSThis technique was an optimal choice to penis hypospadias, Penoscrotal hypospadias and light-duty scrotal hypospadias. It was simple and convenient and could prevent infection but manage of drain must be done postoperatively.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Scrotum ; surgery ; Skin Transplantation ; methods ; Surgical Flaps ; Treatment Outcome

Objective To investigate low density lipoprotein receptor (LDLR)gene mutation in familial hypercholesterolemia (FH) patients. Methods The proband was given clinical diagnosis of homozygous FH based on marked features and blood lipid tests results. After apoB100R3500Q mutation was excluded, the promoter region and all of the 18 exons of LDLR gene were amplified by touch-downpolymerase chain reaction (PCR). The PCR products were analyzed by single-strand conformationalpolymorphism (SSCP). The PCR products with abnormal single strands were sequenced directly. Thesecondary structures of the mutational and wild type proteins were analyzed and compared byANTHEPROT5.0, and then the tertiary structures of the mutant and wild type LDLR were predicted atSWISS MODEL homepage online. Results A homozygous mutation A606T at exon 13 of the patients wasfound by SSCP and confirmed by DNA sequencing. GOR Ⅰ method in ANTHEPROT5.0 indicates that therandom coils and turns would replace some helixes at the mutation site. The online prediction from theSWISS MODEL homepage indicates the backbone structure of the mutant LDLR has no difference from thewild type one. Conclusion The results suggest the A606T mutation of LDLR gene is the cause of the FH inthis pedigree.

Objective To explore small size toe tissue flap for aesthetic reconstruction of the thumb and / or finger. Methods Six kinds of small size toe tissue transplants had been applied in repairing skin-bone-joint composite tissue defects of the thumb or finger in 74 cases. Results Among 83reconstructed flaps of the 74 patients, 81 flaps survived completely. Follow-up examination made three to forty-eight months postoperatively showed that the outward appearance were excellent in most cases. The function of the thumbs or fingers were good. The donor feet can walk normally with no pain. Conclusion A variable combinations of toe tissues including skin, soft tissue, bone and joint can be harvested to form a lot of small size transplants for refined aesthetic reconstruction of thumb and finger. The functional and aesthetic results are good and the treatment course is shortened.

Objective To compare the clinical efficacy and safety of isotretinoin erythromycin gel, a gel containing isotretinoin (0.05%) and erythromycin (2%), versus adapalene gel in the treatment of mild to moderate acne vulgaris. Methods A multicenter, randomized, open, parallel-controlled clinical study was conducted. A total of 192 patients with mild to moderate (Grade Ⅰ -Ⅲ ) acne vulgaris were enrolled in this study according to the grading criteria for acne severity in guidelines for the treatment of acne in China. Efficacy analysis was carried out in 169 patients and safety analysis in 190 patients. The patients were classified into trial group (n = 86) and control group (n = 83 ) to be treated with isotretinoin erythromycin gel or adapalene gel once a night for 6 weeks. Patients were evaluated at the baseline, on week 2, 4 and 6 during the treatment for the count of comedones (both open and closed), inflammatory papules and pustules, severity of acne and local or general adverse effects. Results After the start of treatment, the response rate gradually increased and severity of acne decreased in both groups. On week 6, the total response rate was 51.16% in the trial group and 40.96% in the control group (P ＞ 0.05), while a greater reduction in the count of pustules and inflammatory lesions was observed on week 4 and 6 in the trial group with a lower severity grade of acne compared with the control group (P ＜ 0.05 or 0.01 ). Adverse reactions were similar in both groups and manifested as tolerable local irritation. Conclusions The efficacy of isotretinoin erythromycin gel is similar to that of adapalene gel in the treatment of mild to moderate acne vulgaris, however, isotretinoin erythromycin gel seems superior to adapalene gel in reducing inflammatory lesions and rapidly improving severity of acne vulgaris.

Objective:To discuss the relationship between heart rate (HR) and heart rate differences (HRD) at different time points in head-up tilt test (HUTT) and the occurrence of postural tachycardia syndrome(POTS) in children and adolescents.Methods:A total of 217 children and adolescents diagnosed as POTS, who complained of syncope or presyncope, were chosen as POTS group (aged 6 to 16 years). During the same period, 73 healthy children and adolescents with matching gender and age were selected as control group.All subjects underwent HUTT from October 2000 to November 2019.Get HR (HR0, HR5, HR10) in baseline, HUTT 5 min and 10 min, HRD (HRD5, HRD10) of HR in HUTT 5 min and 10 min minus HR in baseline.Results:(1) HR5, HR10, HRD5, and HRD10 were higher in the POTS group than those in the control group( P<0.05). (2) Univariate Logistic regression: There was a correlation between HR5, HR10, HRD5, HRD10 and the risk of POTS( P<0.01). (3) Multivariable Logistic regression: For each additional unit of HRD5 and HRD10, the risk of POTS increased by 27% ( OR=1.27, 95% CI1.16 to 1.36) and 28% ( OR=1.28, 95% CI1.20 to 1.38). Conclusion:HR and HRD are related with the occurrence of POTS in children and adolescents, but HR and HRD at different time points of HUTT play the little role on the effect size of the occurrence of POTS.

ostic sensitivity and specificity of EUS are high in distinguishing benign and malignant character of upper digestive tract GIMTs. EUS plays an important role in guiding the clinical management of upper digestive tract GIMTs.

objective To evaluate the clinical application value of ileum to the S-type of suture pro- duced orthotopic neobladder.Methods Radical cystectomy and ileal neobladder with"S"shape were per- formed in 3patients with transitional cell carcinoma.Ureter implant into neobladder with embedding nipple techniques,bottom of neobladder coincide with urethra stump.Results The average operative time to form a neobladder was 5 hours,average bleeding volume was 366 ml during operation,3 cases can control urine dur- ing daytime,nycturia 1-3 times every night.Neobladder has a large capacity,low pressure,and electrolytes of blood was normal.Conclusion The construction of an ileal neobladder using a smaller part of ileum that has been completely detubularized and fashioned by S shape is easy and agreeable to perform.This mode of oper- ation has low complication rates,achieves adequate capacity at low pressure,and provides satisfactory conti- nence rates.It is a fine scheme to treat invasion and multiple carcinoma of bladder.