OBJECTIVE: To summarize the key points, difficulties and relevant practical experiences for analyzing the scene of solved intentional homicide cases. METHODS: The data of 88 solved intentional homicide cases in a county from 2004 to 2013 were collected and the retrospective analysis was performed. RESULTS: The number of local female victims obviously higher than non-local female victims and the number of non-local suspects is obviously higher than local suspects. The number of Male suspects showed higher compared with the female. Most of them were temporary workers, unemployment or farmers with less education backgrounds. The main causes of victims' death were mechanical injury or asphyxia. The murders were acquaintances in most intentional homicide cases. The motive of the stranger murders was commonly money. The murder behavior types of homicide cases were related with people, money and sexual assault. Camouflage and guilty behavior showed the most significance. CONCLUSION The accurate identification of suspects is one of the most important task in forensic investigation and reflects the importance of the criminal scene analysis for intentional homicide cases. It also provides the direction of future research.
Asphyxia ; Cause of Death ; Crime Victims ; Criminals ; Female ; Homicide/statistics & numerical data* ; Humans ; Male ; Mental Disorders ; Motivation ; Retrospective Studies ; Sex Offenses

Adenocarcinoma ; pathology ; Aged, 80 and over ; Colonic Neoplasms ; pathology ; Humans ; Male ; Nasal Septum ; pathology ; Neoplasm Metastasis ; Nose Neoplasms ; secondary

The electroencephalography (EEG) has a wide range of content, complex graphics and abstract theory. Meanwhile, there are differences in professional level, learning ability and subjective initia-tive among refresher doctors. In order to improve the quality of teaching, and to better serve the refresher doctors, the following strategies have been applied in the teaching process. We not only make the training target according to the actual condition of every refresher doctors, but also make them take a correct atti-tude towards study and follow the teaching arrangement. Besides, we not only orient at the operational skills training, including electrode installation, EEG evoked test, Point-of-Care test to eliminate the interference, but also promote the refresher doctors to seek the law of the diagram in the actual interpretation process with longitudinal development view and horizontal comparison perspective. Furthermore, we not only stan-dardize their report, but also broaden their view.

Objective To investigate the indication, feasibility and technique of minimally invasive nuss procedure with thoracoscope by using double braces in the treatment of wide-scope pectus excavatum repairing in adolescence. Methods 31 patients including 24 boys and 7 girls, suffered from pectus excavtum were corrected by nuss procedure under thoracoscope.The average age was (15.32 ± 3.89)years (ranged, 14 years and 18 years). All cases were moderate to severe degree according to Hallar index with depression scope of 4 ribs or more. A couple of braces of two-point or multipoint fixation for thoracoscopic-assisted nuss procedure were used. Results The procedure was successfully completed under thoracoscopy in all patients. Double braces were utilized in 27 cases, double are bars were required in 4 cases, and multipoint fixations were in 6 patients. The postoperative hospital stay was 5-11 days [average, ( 7.48 ± 1.95 ) days]. The duration of following up was one month to three years. The perioperative complications included intraoperative hemorrhage in 2 patients, bar invertion with displacement in 1, and interrupted pain for two months in 1. All patients recovered after expectant treatment. Conclusion Nuss procedure with double braces for the correction of a large area of asymmetric pectus excavatum under thoracoscopy is safe and effective technique for adolescence.

Objective To analyze the clinical features and the application of bronchoscopy in diagnosis and treatment of children with bronchiectasis.Methods All cases with bronchiectasis were collected from in-patient department of the Children's Hospital Affiliated to Nanjing Medical University from December 2011 to November 2015.Clinical manifestations,results of bronchoscopy examination were retrospectively analyzed.Results Of the 33 children,32 cases (97.0％) had chronic cough and sputum.Lung infection was the main cause (50％,16/33 cases).High resolution CT showed signet ring sign and/or double-track sign in lungs,and bronchiectatic lesions were most commonly found in the lower lobes (60.6％).Eighteen cases underwent bronchoscope ciliary biopsy,and the number of cilia decrease was found in 2 cases,and cilia ultrastructure abnormalities were found in 6 cases,with 2 cases diagnosed as Kartagener syndrome.The treatment included the following:treatment of the underlying disease,aggressive treatment of infections,promotion of mucociliary clearance,and bronchoscopy.The symptoms of the most patients were relieved through the symptomatic treatment.Follow-ups after discharge,showed that 15 cases had a slight cough without obvious sputum,11 cases with recurrent lung infections,regular bronchoscope lavage treatment;4 cases underwent surgical lung resection and recovered well postoperative,and 2 cases died.Conclusion The bronchoscopy should be performed early in the children with bronchiectasis,which can clearly detect pathogens and causes,so as to undertake lavage treatment to improve clinical symptoms.

OBJECTIVETo explore the clinical application of mandibular-driven simultaneous maxillo-mandihular distraction to correct hemifacial microsomia with rapid prototyping technology.

METHODSThe patient' s skull resin model was manufactured with rapid prototyping technology. The osteotomy was designed on skull resin model. According to the preoperative design, the patients underwent Le Fort I osteotomy and mandibular ramus osteotomy. The internal mandible distractor was embedded onto the osteotomy position. The occlusal titanium pin was implanted. Distraction were carried out by mandibular-driven simultaneous maxillo-mandihular distraction 5 days after operation.

RESULTSThe distraction in five patients was complete as designed. No infection and dysosteogenesis happened. The longest distance of distraction was 28 mm, and the shortest distance was 16 mm. The facial asymmetry deformity was significantly improved at the end of distraction. The ocelusal plane of patients obviously improved.

CONCLUSIONSRapid prototyping technology is helpful to design precisely osteotomy before operation. Mandibular-driven simultaneous maxillo-mandibular distraction can correct hemifacial microsomia. It is worth to clinical application.

Face ; abnormalities ; surgery ; Facial Asymmetry ; congenital ; surgery ; Goldenhar Syndrome ; surgery ; Humans ; Hyperplasia ; surgery ; Mandible ; surgery ; Maxilla ; surgery ; Osteogenesis, Distraction ; methods ; Osteotomy ; methods ; Osteotomy, Le Fort

OBJECTIVETo explore the effectiveness of absorbable hemostatic fluid gelatin in preventing postoperative cerebrospinal fluid leakage.

METHODSThe clinical data of 17 patients with dura mater tear were retrospectively analyzed from March to September in 2003. There were 16 males and 1 female, aged from 16 to 67 years old with an average of (39.6 ± 15.4) years. The injury site was at cervical vertebrae in 1 case, thoracic vertebrae in 9 cases, thoracolumbar junction in 4 cases, lumbar vertebrae in 3 cases. There were burst fracture in 4 cases and fracture-dislocation in 13 cases. According to ASIA grade, 12 cases were grade A, 2 cases were grade B, 2 cases were grade D, 1 case were grade E. Two cases caused by traffic accident, 10 by high falling, 4 by heavy parts crash, 1 by stairs fell during the earthquake. Absorbable hemostatic fluid gelatins were used to plug the dura mater tear,in order to prevent postoperative cerebrospinal fluid leakage. Postoperative drainage were recorded every day.

RESULTSOf 17 patients, 15 cases did not develop with cerebrospinal fluid leakage. Two cases develop with cerebrospinal fluid leakage after operation and their drainage were removed at 6 to 7 days after operation. In all cases, no complications related with cerebrospinal fluid leakage occurred, such as headache, dizzy, fever,neck resistance, rash, incision disunion, incision infection, hematoma, neurologic symptoms aggravation. No abnormal phenomena was found on incision surrounding at follow-up of 9 months.

CONCLUSIONUsing absorbable hemostatic fluid gelatin to plug the dura mater tear during operation is an effective method in preventing postoperative cerebrospinal fluid leakage.

Adolescent ; Adult ; Aged ; Cerebrospinal Fluid Leak ; prevention & control ; Female ; Gelatin ; administration & dosage ; Hemostatics ; administration & dosage ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control

Objective To explore the relationship between the diabetic retinopathy (DR) and the carotid artery intima-media thickness(IMT) in type 2 diabetic patients to reveal the relationship between macroangiopathy and microangiopathy in diabetic patients further. Methods One hundred and tweenty-three diabetic cases in patient chosen from 2008 to 2009 were divided into diabetic retinopathy group(DR) and non-diabetic retinopathy group(NDR) by fundus examination. The patients were asked about their disease history including durations, smoking and so on. Meanwhile the carotid artery IMT, systolic pressure (SBP), diastolic pressure (DBP), serum total cholesterol, triglycerides, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, glycosylated hemoglobin(HbAlc), body mass index(BMI) were measured of all the cases. The incidence of increased carotid artery IMT was cmpared with χ2 test, as well as the average IMT between the two groups, the influencing factors artery IMT was 50.98%(26/51) in DR group, and 33.33%(24/72) in NDR group, having a statistically significant showed the diabetic retinopathy risk factors were smoking(χ2=6.20, P<0.05), duration(t=-4.13, P<0.01). carotid artery IMT(t=-2.21, P<0.05), SBP(t=-2.37, P<0.05), and HDL-cholesterol(t=4.49, all P<0.01). 12.77, all P<0.01), carotid artery 1MT and smoking(χ2=6.05,4.15, all P<0.05). Conclusions Type 2 diabetic patients complicated with DR have a prominent increase in IMT thickening proportion and average IMT, which reveals the relationship between the DR and the IMT.

Objective To investigate the current status of treatment on traumatic ruptured spleen in a regional medical center in Tianjin,China.Method Logistic analysis of 16 impact ffactors of treatment decision on 147 patients with traumatic ruptured spleen.Results The type of trauma,pulse rate at admission,result of abdominal puncture and CT grade were related to treatment decision making.Splenectomy was carried out in 89 patients (60.54％) which accounted for 89.90％ of all surgical procedures.Splenectomy was carried out in 50.85％ of patients with CT grade 1 or 2 (or 85.71％ of grade 1 and 2 surgery),and 100％ of CT grade 3 or 4.Spleen preservation surgery was carried out in 7 patients with CT grade 1 or 2.Conclusion Splenectomy was carried out in most cases in this study.It is necessary to investigate the treatment of splenic trauma in regional medical centers,and to develop more reliable surgical techniques to carry out more spleen-preservation surgery ffor CT grade 1 or 2 ruptured spleen.

Objective To summarize the clinical features and technical key points on brain death during decision-made process in children with suspected brain death.Methods Twenty-four coma children with Glasgow coma scale score 3 and no spontaneous respiration were collected from May 2015 to February 2017 in Beijing Children's Hospital,Capital Medical University to make the brain death determination.All children received at least one confirmatory test.According to the Chinese standards for determining brain death (pediatric),all patients were divided into brain death group and non-compliance group.The clinical features were analyzed.The sensitivity,specificity,false positive rate and false negative rate of electroencephalogram (EEG),short latency somatosensory evoked potential (SLSEP) and transcranial Doppler sonography (TCD) were calculated.Results Among these 24 cases,there were 16 males and 8 females,aged 5.6 (2.0,8.8) years old.Ten cases met the criteria of brain death.Twelve (50％,12/24 cases) cases received autonomic breathing test.A total of 25 tests were conducted,of which 21 were successful.The completion rates of EEG,TCD and SLSEP were 100.0％ (24/24 cases),83.3 ％ (20/24 cases) and 54.2％ (13/24 cases),respectively.EEG had the highest sensitivity (100％) and specificity (79％).SLSEP had good sensitivity (100％),but the specificity was only 40％.The combination of EEG with SLSEP had the highest specificity and sensitivity,both of which were 100％,and the false positive rate and false negative rate were 0.Conclusions The key to determine brain death successfully is to make adequate preparations,to receive formal training and to apply standard operation.In the determination of brain death in children,EEG has a good sensitivity and specificity in single confirmation test,which is the priority item.The combination of EEG with SLSEP is the most advantageous.