Misdiagnosis and missed diagnosis are common in forensic appraisal of orbital fracture. Now imaging technology is very important for studying the forensic features of orbital fracture and evaluating the degree of injury. This article reviews the classification, pathogenesis and imaging diagnosis of orbital fracture. It may do some help to forensic appraisal of orbital fracture.
Forensic Medicine ; Humans ; Magnetic Resonance Imaging ; Orbital Fractures/diagnosis* ; Tomography, X-Ray Computed

ObjectiveTo observe the relationship between astrocytes and neurons in rat's medulla oblongata after exposed to 8Hz, 90dB/130dB infrasound for different times. MethodsRats were exposed to 8Hz, 90dB/130dB infrasound for 2 hours per day.At the 1st,7th,12th,21th and 28th day, the expression of glial fibrillary acidic protein (GFAP) and Fos in medulla oblongata were detected using double-labling immunohistochemical method.Results GFAP-positive astrocytes and Fos-positive neurons were increased after exposure for one time. They showed similar topographic localization and formed close relationship. Their number increased as the exposure times increasing, and decreased gradually after 14 days. The reaction of 130dB group was stronger than that of 90dB group.Conclusions 8Hz, 90dB/130dB infrasound can activate both astrocytes and neurons in rats' medulla oblongata which might participate and regulate the response to infrasound.

Objective To analyze the ultrasonic features of thyroid microcarcinoma (TMC) and the causes of misdiagnosis. Methods The ultrasonic features including shape, margin, echogenecity, microcalcification, vascularity and lymphadenopathy were analyzed retrospectively in 26 pathologically-proven TMC patients. Results In 26 cases, 11 cases were diagnosed correctly before operation (11/26, 42.31%), 12 cases were misdiagnosed (12/26, 46.15%) as adenoma or benign nodule, and 3 cases were missed diagnosed (3/26, 11.54%). Among the 23 cases detected on ultrasound, 21 cases were solid and hypoechoic (21/23, 91.30%);19 cases were ill-defined (19/23, 82.61%);12 cases were taller than wide in shape (12/23, 52.17%); 14 cases had microcalcification (14/23, 60.87%); 7 cases showed central or peripheral blood flow signals (7/23,30.43%) with arterial resistance index>0.70 in 3 lesions and<0.70 in 4 lesions. Conclusions Several ultrasonographic features are helpful in identiifcation of TMC, including hypo/iso-echogenecity, ill-deifned margin, taller-than-wide shape, microcalciifcation, arterial signals with high resistance index, and abnormal lymphadenopathy. Moreover, for cases with multiple lesions, to the potential co-existence of benign and malignant lesions should be considered.

Follicular dendritic cell sarcoma is a rare malignant neoplasm and little is known about its radiological features. We present here four cases of follicular dendritic cell sarcomas and we provide the image characteristics of these tumors to help radiologists recognize this entity when making a diagnosis.
Adult ; Dendritic Cell Sarcoma, Follicular/pathology/*radiography ; Diagnosis, Differential ; Female ; Gastrointestinal Neoplasms/radiography ; Head and Neck Neoplasms/pathology/radiography ; Humans ; Male ; Mediastinal Neoplasms/radiography ; Middle Aged ; Tomography, X-Ray Computed

BACKGROUNDIsoflurane, a commonly used inhaled anesthetic, induces apoptosis in primary rat cortical neurons of rat in a concentration- and time-dependent manner by an unknown mechanism. We hypothesized that isoflurane induced apoptosis by causing abnormal calcium release from the endoplasmic reticulum (ER) via activation of inositol 1, 4, 5-trisphosphate (IP(3)) receptors. Sevoflurane has a reduced ability to disrupt intracellular calcium homeostasis and is a less potent cytotoxic agent. This study examined and compared the cytotoxic effects of isoflurane and sevoflurane on rat primary cortical neurons and their relationship with disruption of intracellular calcium homeostasis and production of reactive oxygen species (ROS).

METHODSPrimary rat cortical neurons were treated with the equivalent of 1 minimal alveolar concentration (MAC) of isoflurane and sevoflurane for 12 hours. MTT reduction and LDH release assays were performed to evaluate cell viability. Changes of calcium concentration in the cytosolic space, [Ca(2+)](c), and production of ROS were determined after exposing primary rat cortical neurons to isoflurane and sevoflurane. We also determined the effects of IP(3) receptor antagonist xestospongin C on isoflurane-induced cytotoxicity and calcium release from the ER in primary rat cortical neurons.

RESULTSIsoflurane at 1 MAC for 12 hours induced cytotoxicity in primary rat cortical neurons, which was also associated with a high and fast elevation of peak [Ca(2+)](c). Xestospongin C significantly ameliorated isoflurane cytotoxicity in primary cortical neurons, as well as inhibited the calcium release from the ER in primary cortical neurons. Isoflurane did not induce significant changes of ROS production in primary rat cortical neurons. Sevoflurane, at equivalent exposure to isoflurane, did not induce similar cytotoxicity or elevation of peak [Ca(2+)](c) in primary rat cortical neurons.

CONCLUSIONThese results suggested that isoflurane induced elevation in [Ca(2+)](c), partially via elevated activity of IP(3) receptors, which rendered cells vulnerable to isoflurane neurotoxicity. ROS production was not involved in isoflurane-induced neurotoxicity. Sevoflurane, at an equivalent exposure to isoflurane, did not induce similar elevations of [Ca(2+)](c) or neurotoxicity in primary cortical neurons of rat.

Anesthetics, Inhalation ; toxicity ; Animals ; Calcium ; metabolism ; Cell Survival ; drug effects ; Cells, Cultured ; Inositol 1,4,5-Trisphosphate Receptors ; drug effects ; physiology ; Isoflurane ; toxicity ; Methyl Ethers ; toxicity ; Rats ; Reactive Oxygen Species ; metabolism

Objective:To study the application of objective structured clinical examination (OSCE) based on organ system in the practice teaching for clinical interns.Methods:Undergraduate interns majored in clinical medicine in grade 2017 (control group) and 2018 (experimental group) of Jiangjin Central Hospital of Chongqing were selected as the research objects and divided into control group and experimental group. In the control group, the interns received traditional practice teaching, and the interns in the experimental group received traditional bedside teaching combined with OSCE based on organ system. Results of theoretical examination and OSCE test were used to evaluate the teaching effect, and feedbacks were obtained from teachers and students through questionnaire survey and field discussion, so as to compare the differences between the two teaching methods in cultivating clinical ability of medical students.Results:The average scores of theoretical examination of the two groups were similar, the difference was not statistically significant ( P>0.05). In OSCE test, the average scores and total scores of medical history collection station, physical examination station, skill operation station, doctor-patient communication station in the research group were significantly higher than those in the control group ( P<0.05). The average scores of the two groups in the auxiliary examination interpretation station and literature retrieval station were similar, and the differences were not statistically significant ( P>0.05). Conclusion:The OSCE based on organ system is obviously superior to traditional practice teaching in the development of medical students' comprehensive clinical capacity such as medical history collection, physical examination, skill operation and doctor-patient communication.

OBJECTIVETo evaluate the brain pathological changes following exdogenous neural stem cells (NSCs) intraventricular transplantation in neonatal rats with periventricular leukomalacia (PVL), and to explore the feasibility of NSCs transplantation for the treatment of PVL in premature infants.

METHODSNSCs were prepared from E14 embryonic rat brain. Two-day-old neonatal rats were randomly divided into six groups: PVL, PVL+culture medium, PVL+NSCs, sham operation, sham operation+culture medium, and sham operation+NSCs (18-21 rats each group). Intraventricular transplantation of exdogenous NSCs was performed 72 hrs after PVL induction or sham operation. The cerebral pathological evaluation was undertaken by light microscopy 7, 14 and 21 days after transplantation.

RESULTSThe pathological changes in the cerebral white matter were gradually improved with the prolonged time after transplantation. After 21 days of transplantation, 50% of the cerebral white matter showed mild pathological changes and 50% of that showed severe pathological changes, with neuronal pathological scores of 1.28+/-0.86, in the untreated PVL group. In the PVL+NSCs group, 30% of normal white matter, 40% of mild and 30% of severe pathological changes in the white matter were observed, with neuronal pathological scores of 0.32+/-0.16, 21 days after transplantation. There were very significant differences in both of pathological changes in the cerebral white matter and neuronal pathological scores between the PVL and PVL+NSCs groups (x2=10.7, P<0.01; F=29.664, P<0.01).

CONCLUSIONSIntraventricular transplantation of exdogenous NSCs can apparently improve cerebral white matter damage. It is suggested that intraventricular transplantation of NSCs is of a great potential feasibility for the treatment of PVL in premature infants.

Animals ; Animals, Newborn ; Brain ; pathology ; Female ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; pathology ; therapy ; Neurons ; cytology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Stem Cell Transplantation

The purpose of this study was to determine whether the fully automated ORTHO AutoVue Innova system, which based on the microcolumn glass sphere technology, is accurate enough to meet immunohematology testing needs at blood banks. 16 IgM anti-C, anti-c, anti-D, anti-E and anti-e dilution series were tested respectively, with corresponding antigen positive red blood cell solutions, by ORTHO AutoVue Innova system and saline medium test. 16 IgG anti-D dilution series were tested respectively with RhD positive red blood cell solutions by ORTHO AutoVue Innova system, polybrene test and antiglobulin test. The accuracies of microcolumn glass sphere technology were analysed, by comparing to the reference assays. The results showed that the sensitivities of the ORTHO AutoVue Innova tests were 1:69.8, 1:33.4, 1:1448.1, 1:139.6 and 1:32.0 for IgM anti-C, anti-c, anti-D, anti-E and anti-e respectively; the corresponding value of saline medium tests were 1:16.7, 1:16.6, 1:430.5, 1:34.9 and 1:9.9. There were statistically significant differences between the groups of each tests (t values were 14.38, 5.48, 10.25, 12.65 and 9.59 for IgM anti-C, anti-c, anti-D, anti-E and anti-e respectively, p < 0.05). For IgG anti-D, the sensitivities of the ORTHO AutoVue Innova test, polybrene test and antiglobulin test were 1:980.6, 1:181.0 and 1:304.4 respectively. There was statistically significant difference among the 3 groups (F = 51.15, p < 0.01). It is concluded the use of ORTHO AutoVue Innova system for blood group compatibility test can obtain more accurate results than traditional tube tests, it is reliable and safe for routine tests performed in immunohematology laboratories.
Blood Grouping and Crossmatching ; methods ; Coombs Test ; methods ; Humans ; Isoantibodies ; blood ; Materials Testing ; Rho(D) Immune Globulin ; Sensitivity and Specificity

OBJECTIVETo observe the effect of pubic fractures reducted and fixed thorough the punctiform incision approach.

METHODSFrom 2002 to 2005, 10 cases with 18 fractures of pubis rami (8 male and 2 female) were treated with inserting construction plate by the punctiform incision approach. The average age of these patients was 37.2 years (range, 24 to 56 years). The mean duration between injury and operation was 8.7 days (range, 4 to 14 days).

RESULTSInternal fixation for eighteen pubis fractures were accomplished by 28 punctiform incisions. The blood loss for each incision was averagely 30 ml, operation time of each pubic was about 45 minutes. Function restoration was evaluated by Majeed' score and all patients gained excellent result.

CONCLUSIONThe fracture of pubic rami can be fixed sucessfully by punctiform incision approach. It provides smaller incision, less postoperative complications and excellent function rehabilitation.

Adult ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pubic Bone ; surgery

OBJECTIVETo identify factors associated with YMDD mutation in patients with chronic hepatitis B before and after lamivudine treatment in Zunyi region.

METHODS53 patients with chronic hepatitis B were enrolled in this study, HBV DNA,HBV markers, ALT, AST, TBil, albumin in the serum were examined at 0, 3, 6, 12, 18 and 24 months after lamivudine treatment. HBV genotype and YMDD mutation were determined by sequencing before lamivudine treatment. YMDD mutation was checked again if serum HBV DNA rebound to more than 1 x 10(4) copies/ml after the initial decrease.

RESULTSHBV genotype in Zunyi region is constitute of B, C and B+C genotype. YMDD mutation occurred in 18 cases after lamivudine treatment, the rate of YMDD mutation was 15.1%, and 34.0% after 1 year and 2 years treatment. There are four types of mutation: rtL180M/M204V, rtL180M/M204I, rtM204I, rtL180M. rtM204V mutation in C gene was always accompanied by rtL180M mutation (100%). The rate of rtL180M/M204V mutation in genotype C group was significantly higher than that in genotype B group (77.8% to 25.0%), the same was true for the rtL180M/ M204I mutation (22.2% to 12.5%). There was no point mutation in genotype C group. The point mutation of rtM204I and rtL180M appeared only in genotype B group. Gender, nation, family history of hepatitis B and HBeAg were not associated with YMDD mutation (P more than 0.05), while the mutation rate was associated with the disease course and severity of disease. YMDD mutation did not occur in patients with low HBV DNA level (less than 10(5) copies/ml).

CONCLUSIONYMDD mutation after lamivudine therapy is associated with HBV genotype and P gene mutation type, and prolonged treatment increases the the mutation rate. In order to reduce the incidence of YMDD mutation, patients with shorter disease course, lower HBV DNA level, more serious liver damage should be treated with lamivudine.

Adult ; Alanine Transaminase ; blood ; Antiviral Agents ; pharmacology ; therapeutic use ; Aspartate Aminotransferases ; blood ; China ; epidemiology ; DNA Mutational Analysis ; DNA Primers ; DNA, Viral ; blood ; genetics ; Drug Resistance, Viral ; Female ; Genotype ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; blood ; drug therapy ; virology ; Humans ; Lamivudine ; pharmacology ; therapeutic use ; Male ; Mutation ; Polymerase Chain Reaction