Objectives: To monitor stroke morbidity and mortality in 2 rural communities of Shanghai and to provide a reference for stroke prevention and epidemiological study. Methods: A modified cluster-sampling method was used to extract about 100 000 natural populations in the 2 communities of Fengxian District, Shanghai. The demographic data were collected annually. In the monitored populations, the tertiary monitoring network was established to investigate the morbidity and mortality of stroke, and to analyze and monitor the morbidity and mortality and the distribution of clinical types of stroke in the populations from 2008 to 2010. The morbidity and mortality of stroke were adjusted by the National Population Sample Survey 2009. Results: Circled digit oneA total of 100 622 subjects were monitored from 2008, and 304 306 person times were monitored cumulatively up to 2010. A total of 585 subjects had first attack of strokes and 313 died. The morbidity in the 3 years was 275.3/100 000, 173.5/100 000 and 129.3/100 000, respectively, and the average annual stroke morbidity was 192.2/100 000; the standardized morbidity was 180.7/100 000, 115.3/100 000 and 81.7/100 000, respectively. The stroke mortality was 113.3/100 000, 102.1/100 000 and 93.3/100 000, respectively. The average annual stroke mortality was 102.9/100 000; the standardized mortality was 73.5/100 000, 67.5/100 000 and 57.2/100 000, respectively. Circled digit twoIn the <45, <45 to 64 and ≥65 age groups, the average annual morbidity was 4.9/100 000, 122.8/100 000 and 913.8/100 000, respectively, and the average annual mortality was 2.8/100 000, 22.6/100 000 and 591.8/100 000, respectively. The differences were statistically significant (P < 0.01). Circled digit threeThere was no significant difference in the average annual morbidity and mortality between the genders. In the 45 to 64 age group, the average annual morbidity and mortality were 156.7/100 000 and 32.0/100 000 in males; while the average annual morbidity and mortality were 90.4/100 000 and 13.6/100 000 in females. The differences were statistically significances (P < 0.01). Circled digit fourThe constituent ratios of intracerebral hemorrhage, cerebral infarction, subarachnoid hemorrhage and unclassified stroke were 22.6%, 75.7%, 0.9% and 0. 9%, respectively. Conclusion: The stroke morbidity and mortality in the rural communities of Shanghai are 192.2/100 000 and 102.9/100 000. The morbidity and mortality increased with age. The stroke morbidity and mortality in males is higher than those in females in the 45 to 64 age group. The proportion of patients with cerebral infarction is significantly higher than intracerebral hemorrhage.

OBJECTIVE: To explore the application value of postmortem multi-slice spiral computed tomography (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 examined using MSCT and three-dimensional reconstruction technique. Analyzing the manner and cause of death through combination of MSCT and systemic autopsy was also implemented. The differences between autopsy and MSCT in getting information of injuries were compared. RESULTS: Fractures involving multiple body regions and liver rupture were found through MSCT and three-dimensional reconstruction. The autopsy got the same results with imageological examination. The case of death was deduced to be fall leading to systemic polytrauma. CONCLUSION Application of MSCT can be used as the complimentary for traditional autopsy in the analysis of injury manner of fall from height.
Autopsy ; Death ; Forensic Pathology ; Fractures, Bone ; Humans ; Multiple Trauma ; Tomography, Spiral Computed

Karoshi remains one of the most troublesome issues in forensic identification. It is rather a social medicine than a clinical disease. Japanese scholars pioneered examining the relation between sud- den cardiac death (SCD) and chronic fatigue from long time and/or high-tension work. In the current case, a 55-year-old man, whose job was loading and carrying heavy cement bags, was found dead after 11 days of continuous hard work. His family members sued the cement factory for his death and claimed for compensation. The problem was the difficulty of identifying the causative relation without the precedent or the relevant regulations. However, the forensic problems were finally acknowledged after autopsy and calculation of labor intensity. The lawsuit was won as the first case pertaining to Karoshi in the Chinese court.
Autopsy ; Death, Sudden, Cardiac/etiology* ; Fatigue/mortality* ; Forensic Pathology ; Humans ; Male ; Middle Aged ; Risk Factors ; Workload/legislation & jurisprudence*

OBJECTIVE: To explore the application value of postmortem multi-slice spiral computed tomography (MSCT) by observing and analyzing the injury features in the traffic accident victims. METHODS: Ten traffic accident victims were scanned with whole body MSCT. The systemic autopsy was subsequently performed to compare with the results of MSCT. The advantages and disadvantages of autopsy and MSCT for obtaining the information of traffic accident injuries were then analyzed. RESULTS: MSCT could reveal 3D shape of fractures clearly and detect air accumulation in different positions of the body, which showed the obvious advantages compared with autopsy. However, the resolution of MSCT was limited compared to the detection of organ and soft tissue injuries. CONCLUSION A combination of MSCT and autopsy is the best way for determining the manner and the cause of death in traffic fatality victims.
Accidents, Traffic ; Autopsy ; Fractures, Bone ; Humans ; Soft Tissue Injuries ; Tomography, Spiral Computed

OBJECTIVE: To explore the injury mechanism of the human knee in a traffic accident by establishing a 3D finite element (FE) model. METHODS: The FE model, composed of femur, tibia, fibula, patella, meniscus, knee ligaments and surrounding soft tissues, was reconstructed by CT scanning data from a male volunteer. Validation was performed by the lateral impact simulation, and the stress and strain results were obtained to be compared with those previously reported for injury prediction. RESULTS: The results derived from the FE model were found to be similar with those previously reported, most of the ligaments and meniscus wounded at 40 m/s collision, which was readily observed. CONCLUSION The simulation results generated by FE model can be effectively used for the injury mechanism analysis of initial contact.
Accidents, Traffic ; Biomechanical Phenomena ; Femur ; Finite Element Analysis ; Humans ; Knee Injuries/etiology* ; Knee Joint ; Male ; Models, Theoretical ; Tibia

OBJECTIVETo explore the mechanism of male reproductive toxicity induced by acrylonitrile (ACN).

METHODSMale Sprague-Dawley rats were daily administrated ACN by intraperitoneal injection 5 times a week for 13 weeks at the dose of 0, 7.5, 15.0 and 30.0 mg/kg body weight, respectively. The rats were sacrificed and testes were removed at the end of 4, 8, 13 or 15 weeks, respectively. The activities of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and glutathione S-transferase (GST) and the levels of glutathione (GSH) and malonaldehyde (MDA) were detected in testes.

RESULTSFollowing ACN treatment of 4 weeks, the levels of GSH in ACN 15.0 mg/kg and 30.0 mg/kg group were (7.44 +/- 0.77) mg/g pro and (6.95 +/- 0.77) mg/g pro respectively, and the activity of GSH-Px was (70.89 +/- 4.01) U/mg pro in 30.0 mg/kg group, all of which were significantly higher than the control group (P < 0.05, P < 0.01). After 8 weeks, the levels of GSH decreased to (2.50 +/- 0.94) mg/g pro in ACN 30.0 mg/kg group (P < 0.01); the activities of SOD increased to (102.08 +/- 16.08) NU/mg pro and (113.30 +/- 17.20) NU/mg pro in ACN 15.0 mg/kg and 30.0 mg/kg group (P < 0.01). After 13 weeks, the levels of GSH declined in ACN 15.0 mg/kg and 30.0 mg/kg group, and the activities of GST decreased in ACN 30.0 mg/kg group, and of GSH-Px decreased in both doses group. However, the level of MDA [(0.68 +/- 0.16) nmol/mg pro] were significantly higher in 30.0 mg/kg group than that in control group [(0.38 +/- 0.12) nmol/mg pro] (P < 0.01). 2 weeks after stopping ACN treatment, the level of GSH restored to normal but the levels of MDA or the activity of GSH-Px in 30.0 mg/kg group were still higher or lower respectively than those of control (P < 0.05).

CONCLUSIONACN may impair the balance of antioxidant system, thus induce lipid peroxidation damage to rat testes.

Acrylonitrile ; toxicity ; Animals ; Dose-Response Relationship, Drug ; Glutathione ; metabolism ; Glutathione Peroxidase ; metabolism ; Glutathione Transferase ; metabolism ; Lipid Peroxidation ; drug effects ; Male ; Malondialdehyde ; metabolism ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism ; Testis ; drug effects ; metabolism

OBJECTIVETo study the possibility of measuring quality of life by Medical Outcomes Study 36-Item Short-Form Health Survey scale and to subdivide grade range of Medical Outcomes Study 36-Item Short-From Health Survey (SF-36) total cents through a Quality of Life questionnaire among the elderly Chinese.

METHODSThe quality of life of the 167 elderly Chinese in Suzhou was measured simultaneously by SF-36 and the Quality of Life questionnaire developed by Epidemiology Group of Geriatric Medicine Committee of China for the elderly. Validity and reliability were analyzed and subdivided the grade range of SF-36 total scores by Quality of Life questionnaire for the Chinese elderly.

RESULTSEight common factors from factorial analysis were in accordance with their theoretical structure, and the cumulative contribution rates of the Quality of Life questionnaire for the elderly and SF-36 were 74.244% and 72.081%. The split-half reliability of the Quality of Life questionnaire for the elderly was 0.6676. The split-half reliability of SF-36 was 0.9384. In SF-36, the Cronbach's alpha coefficient of internal consistency reliability ranged from 0.81 to 0.89, which was satisfactory for group comparison except 0.63 for the social functioning and 0.42 for mental health scale and 0.69 for vitality scale. The Quality of Life questionnaire for old people seemed to have good validity and reliability but the SF-36 was better. The cent of the furthest truncation between the good quality of life and the medium one in the SF-36 was 117 with a Kappa value of 0.58.

CONCLUSIONThe SF-36 scale could be used for measuring and evaluating the quality of life for the Chinese elderly. The cent of the furthest truncation could provide reference to judge the level of the quality of life of the elderly.

Aged ; Aged, 80 and over ; China ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Random Allocation ; Reproducibility of Results ; Surveys and Questionnaires ; standards

Objective To investigate the proliferation rule after autografl vein in autografl of vein and repairing arterial defect,discuss the minuteness structure changes related to time,and provide morphological date for the prevention and treatment of restenosis in clinic application.Methods Sixty canine femoral veins (3.5 cm and 5.5 cm) were excised,reversed and grafted to repairing femoral arterial defect using end- to-end anastomosis.During the period of 30-180 days excised the grafted veins,observed ultrastrural changes of endothelium,microstructural components relative content and patency in grafted veins through angiography, lipht microscope.Results Angiography show that the grafted vein wall get gradually thicker,vascular cavity get slender,and vessel elasticity shrinkage.Light microscope chalrify the ultrastructural changes of endotheh- um,the three lamine structure of grafted vascular wall could not be identified.Conclusion Grafted femoral veins had obviously arteriosclerosis trend after it was transplanted to the arterial system.Two months after the transplantation is the crisis time of the proliferation of the vascular wall.The effect of the proliferation of the grafted veins vascular wall and the impact of the hi-pressure of blood can lead some canine ruptured to die from pseudoaneurysms.

OBJECTIVE: This study aimed at examining the expression of Beclin1 and LC3 in the skin of rat after contusive injury and at observing the process of autophagy in response to injury or trauma. Their significance in diagnosis of trauma and application in estimation of the post injury time interval were also investigated. METHODS: Immunohistochemistry and imaging analysis were used to examine the expression level of Beclinl and LC3 at the injury site of the rat skin at different post-traumatic times. RESULTS: Expression of Beclin1 and LC3 in normal rat skin or immediately after injury maintained at a very low level, but their level started to elevate 6 hours after injury and showed increasing strong expression at post injury time of day 3, day 5 and day 7. CONCLUSION Over-expression of Beclin1 and LC3 as well as increased autophagy, a response to injury, can be observed in the rat skin at the injury site. The expression level of Beclin1 and LC3 starts to increase 6 hours and shows a linear increase up to 7 days after injury. Beclin1 and LC3 may serve as a marker for estimation of the post injury time interval.
Animals ; Apoptosis Regulatory Proteins/metabolism* ; Autophagy ; Beclin-1 ; Contusions/pathology* ; Forensic Medicine ; Immunohistochemistry ; Male ; Microtubule-Associated Proteins/metabolism* ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Skin/pathology* ; Staining and Labeling ; Time Factors ; Wounds and Injuries/pathology*

OBJECTIVE: To investigate and analyze the changes of postmortem human biochemical indexes. METHODS: Subclavian venous blood samples were collected from 81 cases of traffic fatalities. Thirteen blood biochemical indexes including liver function (ALT, AST, TBIL and DBIL), renal function (UA and Cr), cardiac function (CK, CK-MB and LDH), electrolytes (K+, Na+ and Cl-), and glucose (GLU) were tested by Roche cobas c311 automatic biochemical analyzer. The descriptive analysis was made by SPSS 17.0 statistical software. RESULTS: The values of ALT, AST, CK, CK-MB, LDH and K+ were higher than normal reference values with more fluctuations. The values of TBIL, DBIL, UA, Cr, Na+, Cl- and GLU were relatively stable with less fluctuations. CONCLUSION The postmortem human blood biochemical indexes of liver function, renal function, cardiac function, electrolytes and glucose could be affected by the factors, especially hemolysis and autolysis. The biochemical indexes, particularly enzymes, increased significantly with higher standard deviation.
Accidents, Traffic/mortality* ; Autopsy ; Blood Chemical Analysis/methods* ; Heart Function Tests ; Humans ; Kidney Function Tests ; Liver Function Tests ; Reference Values