OBJECTIVE: To build an expert system for forensic bones estimation. METHODS: By using the object oriented method, employing statistical data of forensic anthropology, combining the statistical data frame knowledge representation with productions and also using the fuzzy matching and DS evidence theory method. RESULTS: Software for forensic estimation of sex, age and height with opened knowledge base was designed. CONCLUSION This system is reliable and effective, and it would be a good assistant of the forensic technician.
Age Determination by Skeleton/methods* ; Algorithms ; Anthropometry/methods* ; Computer Simulation ; Expert Systems ; Forensic Anthropology/methods* ; Forensic Medicine/methods* ; Humans ; Software Design

OBJECTIVETo investigate the diagnosis and treatment of patients with Crohn disease (CD) complicated with gastrointestinal fistulae.

METHODSClinical data of sixty-two cases with CD complicated with gastrointestinal fistula e from 1978 to 2004 were analyzed.

RESULTSThese were 68 external fistulae in 6 2 patients including recurrent fistulae in 6 cases, internal fistulae in 8 cases . Twenty- seven fistulae were located in the terminal ileum and 21 fistulae wer e located in ileocolic anastomosis site. The main surgery included 14 ileocecal resections with primary anastomosis and 26 resections of original ileocolic anastomosis with fistula and re-anastomosis. The incidence of recurrence was lower (15.4% ) in patients with postoperative medication including sulfasalazine and immunomodulator than that (34.8% ) in patients without postoperative immunomodulator,but the recurrence time was longer [(40+/- 17) months] in patients with postoperative medication than that [(8+/- 3)months] in the patients without postoperative specific medication.

CONCLUSIONSMost CD fistulae are external fistulae,most of the external fistulae are treated by resection of the fistula and anastomosis. Specific medication including sulfasalazine,mesalamine and immunomodulators should be used to prevent postoperative complications and CD recurrence.

Adult ; Crohn Disease ; complications ; diagnosis ; surgery ; Female ; Humans ; Intestinal Fistula ; complications ; diagnosis ; surgery ; Male ; Middle Aged

OBJECTIVETo investigate the effects of Salvia Miltiorrhiza Liguspyragine Hydrochloride and Glucose Injection (, SLGI) on the expression of platelet membrane receptors proteinase-activated receptor-1 (PAR1) and proteinase-activated receptor-4 (PAR4) in end-stage renal disease (ESRD) patients on chronic haemodialysis (HD).

METHODSEighty-six ESRD patients on HD (treated group) were treated with SLGI, 7 days as one therapeutic course, for two successive courses. The previous therapies were unchanged. Flow cytometry was used to assess the expression of platelet PAR1 and PAR4 in the patients, and turbidity method was used to determine the platelet maximum aggregation rate (MAR). Meanwhile, renal function was measured. The final data were compared with those before treatment and with those in the normal control group (54 healthy subjects).

RESULTSCompared with the normal control group, the expressions of PAR1 and PAR4 and platelet MAR in ESRD patients on HD was significantly higher before treatment (P=0.001, P=0.006, and P=0.008); after treatment with SLGI, the above indices in patients were remarkably decreased (P=0.036 and P=0.046), except PAR4 (P=0.067), but still higher than those in the normal control group, however, it was not statistically significant.

CONCLUSIONS(1) The overexpression of PAR1 and PAR4 might lead to increased platelet aggregation and this could be one of the reasons for the thrombotic events in ESRD patients on HD. (2) SLGI was able to down-regulate the expression of PAR1 in ESRD patients on HD, improve platelet function, and regulate platelet activation.

Blood Platelets ; drug effects ; metabolism ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; therapeutic use ; Female ; Glucose ; administration & dosage ; pharmacology ; Humans ; Kidney Function Tests ; Male ; Middle Aged ; Platelet Aggregation ; drug effects ; Receptors, Thrombin ; metabolism ; Renal Dialysis ; Salvia miltiorrhiza ; chemistry

OBJECTIVETo study clinical effects of operation for the treatment of old fractures of the humerus lateral condyle in children.

METHODSFrom January 2012 to January 2014 in our department, 14 children of old humeral lateral condyle fractures were treated with operation. Ten cases were male, 4 cases were female; age from 2 to 12 years old, average 5.8 years old. The initial diagnosis was type IIfracture according to the Milch ciassification, the loss of treatment in 11 cases, conservative treatment in 3 cases of nonunion after fracture displacement. Two cases had mild cubitus valgus deformity; 10 cases had elbow disorders, and the motion range was limited from 15° to 60°; 6 cases had pain in activity. The time from injury to operation was 32 to 176 days(62 days on average) in 14 cases, the 14 cases were treated with open reduction and internal fixation. According to the Modified An-Morrey elbow function assessment criteria after surgery for curative effect.

RESULTSFourteen cases were followed up for 1 to 3 years, average 1.8 years. No nonunion, malunion, aseptic necrosis of the epiphysis, cubitus varus or valgus occurred. Five cases had mild protrusion deformity of external condyle, 3 cases still had mild dysfunction. The time of clinical bone union was 4 to 8 weeks in X-ray films. Five cases had bony spur formation, 3 cases had signs of early closure of epiphysis; 2 cases had a increasing volume of humeral lateral condyle; and 2 cases appeared tail deformity. Modified An-Morrey score averaged(95.2±3.6) points, 13 excellent, 1 good.

CONCLUSIONSFor the old fracture of humeral lateral condyle, operation can effectively restore the appearance and function of elbow joint, and the short-term curative effect is satisfactory, but the long-term effect needs further observation.

OBJECTIVE: To retrospectively analyze the clinical efficacy of olecranon osteotomy approach in the treatment of Dubberley type Ⅲ coronal fractures of the distal humerus and summarize the treatment experience. METHODS: From January 2016 to June 2020, 17 patients (5 males and 12 females) with Dubberley type Ⅲ coronal fractures of the distal humerus were treated by olecranon osteotomy approach. The age ranged from 37 to78 years old with an average of (58.5±12.9) years old. According to Dubberley classification, there were 5 cases of type Ⅲ A and 12 cases of type Ⅲ B. The curative effect was evaluated using the Borberg-Morrey elbow function score. The flexion, extension and rotation range of motion of the elbow joint, complications and postoperative imaging evaluation were recorded. RESULTS: All the 17 patients got bony union. The follow-up time ranged from 12 to 33 months with an average of (15.6±5.6) months. There was 1 case of ischemic necrosis of capitulum humeri, 2 cases of traumatic arthritis and 1 case of heterotopic ossification, 1 case of malunion of fracture. The range of motion was (114.80±19.50) °. The Broberg-Morrey score was 85.3±8.2, excellent in 5 cases, good in 9 cases, fair in 3 cases and poor in 0 case. CONCLUSION Through olecranon osteotomy approach, the articular surface of distal humerus could be fully exposed, and the operation is convenient. Anatomical reduction and rigid fixation of the articular surface of distal humerus are the key factors for the succesful outcome.
Male ; Female ; Humans ; Adult ; Olecranon Process/surgery* ; Elbow Joint/surgery* ; Humeral Fractures/surgery* ; Retrospective Studies ; Fracture Fixation, Internal/methods* ; Humerus/surgery* ; Treatment Outcome ; Range of Motion, Articular