Objective:To investigate the knowledge, attitudes and practice of child sexual abuse (CSA) prevention education in parents of elementary school pupils.Method:Two hundred and seventy one parents were surveyed by anonymous self-administered questionnaire in five classes of grade 1 to grade 5 of a elementary school. The questions about awareness of CSA and communications on how to prevent CSA with their children were asked.Result:Among this sample, 93.6% of parents approved of school CSA prevention education. Overall, about half parents lack of knowledge of CSA prevention, the communications with their children were also not enough. Only 1.8% of parents had provided books or audiovisuals about CSA prevention for their children. The scores of knowledge, attitudes and practice of CSA prevention education of parents whose parents addressed this in their childhood were significantly higher than those of parents who had no this experience.Conclusions:The research of CSA prevention education in elementary school should be paid more attention, to produce related books and audiovisuals as soon as possible, to increase parents' awareness of CSA prevention.

Objective　To evaluate the changes and clinical s ignificances of serum growth hormore (GH) and GH binding protein (GHBP) in patie nts with obstructive jaundice (OJ). Methods　Serum levels of GH, GHBP, insulin-like growth factor-Ⅰ (IGF-Ⅰ), endotoxin, prealbumin concentr ation and liver function in 60 male in patients with OJ were detected 1 d preope ratively and 1, 3, 7 d postoperatively. And 40 male patients with simple gallbla dder stone hospitalized in the same period were served as control. Resu lts　The levels of GH, GHBP and IGF-Ⅰ were significantly lower in pati ents with obstructive jaundice than in control group(P<0.01), which was corr elated with the levels of bilirubin, endotoxin and prealbumin (P<0.01). Conclusion　The obviously downregulation of GH/GHBP axis in patients with OJ probably results from the inbibition of expression of GH receptor due t o nutritional dysfunction and endotoxemia, and further aggravate the nutritional dysfuction and endoxemia, which may be one of the important factors in the path ophysiological changes of OJ.

Objective To explore the application value of postm ortem m ulti-slice spiral com puted tom og-raphy (MSCT) in cases of fall from height through observing and analyzing the injury features of the fall and reconstructing the process of the fall based on the the above procedure. Methods One real fatal case due to fall from height was fully exam ined using MSCTand three-dim ensional reconstruction tech-nique. Analyzing the m anner and cause of death through com bination of MSCTand system ic autopsy was also im plem ented. The differences betw een autopsy and MSCTin getting inform ation of injuries were com pared. Results Fractures involving m ultiple body regions and liver rupture were found through MSCTand three-dim ensional reconstruction. The autopsy got the sam e results w ith im ageological exam i-nation. The case of death was deduced to be fall leading to system ic polytraum a. Conclusion Applica-tion of MSCTcan be used as the com plim entary for traditional autopsy in the analysis of injury m anner of fall from height.

High flow nasal cannula oxygen therapy (HFNC) is a new type of oxygen therapy. Because of its unique physiological effects, the clinical application is becoming more and more popular. The article summarized HFNC has obvious advantages in oxygenation and comfort. In the clinical, HFNC is widely used in adult patients with acute hypoxemic respiratory failure, respiratory failure after the operation or extubation and respiratory tract invasive operation. But there is no literature reports in improving ventilation to reduce carbon dioxide. If patients′ respiratory, cycle and oxygenation show no significant improvement after application of HFNC for a short time, it should be replaced as soon as possible for the noninvasive and invasive mechanical ventilation. In this article, the characteristic and application of HFNC will be reviewed.

USB interface applied widely in recent years, the developing methods for it are improved day by day. To design USB interface using USB/UART bridge chip is easy and feasible for USB mini system. This paper takes FT8U232BM of FTDI Corporation as an example to introduce the design method above-mentioned.

Objective:To explore the influencing factors of massive blood transfusion during liver transplantation and establish a prediction model for massive blood transfusion.Methods:Clinical data were analyzed retrospectively for 103 patients undergoing liver transplantation performed by the same surgical team of our hospital in 2018 from Department of Blood Transfusion Affiliated Drum Tower Hospital Nanjing University Medical School. According to the intraoperative volume of red blood cells, they were divided into two groups of massive transfusion (≥12U, n=40) and non-massive transfusion (<12U, n=63). General patient data and preoperative laboratory parameters were compared between two groups. Logistic regression analysis was utilized for constructing a prediction model for massive transfusion during liver transplantation. Results:No significant inter-group difference existed in gender, age or blood group ( P>0.05) while preoperative diagnosis, hemoglobin (Hb), hematocrit (HCT), platelet count (PLT), international normalized ratio (INR), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), total bilirubin (TBIL), direct bilirubin (DBIL) and end-stage liver disease (MELD) score were correlated with intraoperative massive blood transfusion ( P<0.05). By Logistic regression analysis, the predictive model of massive blood transfusion in liver transplantation was Y = 3.545-0.112 × HCT-0.009 ×P LT + 0.005×DBIL. The area under ROC curve was 0.813 and the sensitivity and specificity 80.0% and 71.4% respectively. Youden's index of 0.514 indicated that if Y value was greater than or equal to 0.514, massive blood transfusion might occur. Conclusions:Preoperative HCT, PLT and DBIL may be employed as independent predictors of intraoperative massive transfusion during liver transplantation. The prognostic model has demonstrated an excellent sensitivity and specificity.

Objective To observe the histopathologic and ultrastructural characteristics of cornea and adjacent conjunctiva in Mooren’s ulcer. Methods The samples of limbal and central cornea and adjacent bulbar conjunctiva taken from active Mooren’s ulcer after lamellar keratoplasty were cut into paraffin sections and ultrathin sections and observed by light and transmission electron microscopy. The samples taken from patients of a Terrien’s marginal degeneration and a bacterial corneal ulcer were used as controls. Results Chronic inflammation including lymphocytes and plasma cells infiltrating existed in bulbar conjunctiva and sclera of Mooren’s ulcer. Limbal corneal epithelium, Bowman’s membrane, anterior stroma and adjacent superficial sclera melted and the inferior stromal collagen disorganized. The epithelial basement membrane of ulcer progressive edge had been destroyed while the epithelium and stroma kept quiescent. Lymphocytes infiltrated in conjunctiva and corneal epithelium of Terrien’s marginal degeneration with normal epithelial basement membrane, while Bowman’s membrane was destroyed. The epithelial basement membrane of bacterial corneal ulcer was intact. Conclusion Bulbar conjunctiva may act as a local lymph node of Mooren’s ulcer. Epithelial basement membrane of Mooren’s ulcer may have some abnormality as it was invaded first during ulcer progressing and it’s valuable to have a further study.

Objective To evaluate the effect of fingolimod(FTY720) on angiotensin Ⅱ(AngⅡ)-induced renal oxidative stress in rats and its possible mechanisms.Methods Thirty-six male Sprague-Dawley rats were divided into three groups through random number tables:AngⅡ infusion group(twelve rats,infusion of AngⅡvia subcutaneous osmotic pumps),0.9% sodium hydrochloride solution infusion group(twelve rats,infusion of equal volume of 0.9% sodium hydrochloride solution via subcutaneous osmotic pumps) and FTY720 intervention group(twelve rats,intra-gastric administration of FTY720 besides AngⅡ infusion).Urine samples were collected for 24 hours every week.Blood samples and kidneys were collected when rats were sacrificed at day 14 and 28 d respectively.MDA and T-SOD assay Kits were used to detect the concentrations of MDA and T-SOD in serum and kidney homogenates.Renal pathological changes were observed by light microscope.The expression of Nox4 in the kidneys was evaluated by immunohistochemistry.Results Compared with 0.9% sodium hydrochloride solution infusion rats of the same period,AngⅡ-infused rats developed significant proteinuria.The concentration of serum creatinine,urea nitrogen,AngⅡ and MDA were increased(P<0.05),T-SOD was significantly decreased on days 14 and 28(P<0.05),the serum albumin was significantly increased on day 28(P<0.05),while FTY720 partially reversed these changes.The renal tissue of AngⅡ-infused rats presented mesangial cells proliferation,mesangial matrix deposition,tubular epithelial cells effacement,sclerosis and atrophy in part of the glomerular.FTY720 can alleviate these changes.Immunohistochemistry showed that Nox4 was primarily located in the distal tubule.The expression of Nox4 was significantly increased in AngⅡ-infused rats as compared with that of 0.9% sodium hydrochloride solution infused group rats,and FTY720 administration prevented the change effectively.Conclusion AngⅡ-induced renal injury could be attenuated by FTY720 via preventing oxidative stress.

Objective To observe the effects of Grifola frondosa polysaccharide on T cell subsets and Th1/Th2 subsets of spleen deficiency mice, and investigate its immunoregulation mechanism. Methods Forty-eight KM mice were divided into 6 groups:normal group, spleen deficiency group, positive group (lentinan), three dosage groups of Grifola frondosa polysaccharide, 8 mice in each group. The mice were injected corresponding drug intraperitoneally for 10 days. Then mice in each group were detected CD3+, CD4+ and CD8+T cell by flow cytometry. IFN-γ and IL-4 levels were detected by ELISA. Results The high dose of Grifola frondosa polysaccharide could significantly increase the CD4+T lymphocytes percentage in peripheral blood (P<0.05). Medium and high dose of Grifola frondosa polysaccharide could significantly increase CD4+/CD8+T cell ratio (P<0.01) and CD3+T lymphocyte percentage (P <0.01) of spleen deficiency mice. Medium and high dose of grifola frondosa polysaccharide could significantly increase IFN-γ level in serum of spleen deficiency mice (P<0.01), and high dose of Grifola frondosa polysaccharide could decrease IL-4 level in serum of spleen deficiency mice (P<0.01). Conclusion Grifola frondosa polysaccharide can improve the decreased CD4+/CD8+T cell ratio which caused by spleen deficiency, and promote the transformation of Th1 to Th2, thus treating spleen deficiency syndrome.

Informed consent right is not just for basic ethical consideration, but is important for protecting patient's right by law, which is expressed through informed consent contract. The appraised individuals of forensic clinical examination have the similar legal status as the patients in medical system. However, the law does not require informed consent right for the appraised individuals. I recommend giving certain informed consent right to the appraised individuals in the forensic clinical examination. Under the contracted relationship with the institution, the appraised individuals could participate in the examination process, know the necessary information, and make a selected consent on the examination results, which can assure the justice and fairness of judicial examination procedure.
Forensic Medicine ; Humans ; Informed Consent ; Patient Participation