Accidents, Traffic ; Forensic Medicine ; Hoarseness ; Humans

OBJECTIV: e To find the correlation between real best corrected visual acuity (BCVA) and testing results of microperimetry and visual evoked potential (VEP) and to explore a new method in recording BCVA in macular disease. METHODS: Sixty-two patients with macular disease (macular disease group, 62 eyes) and eighteen healthy volunteers (control group, 36 eyes) had BCVA, microperimetry and VEP recorded. RESULTS: (1) By microperimetry, the values of retinal mean sensitivity and fixation percentage in macular disease group were lower than that in control group. The bicurve ellipse area in macular disease group was higher than that in control group. By VEP, P100 amplitude under 0.5 cpd and 2 cpd in macular disease group were significantly higher than that in control group and the latency was prolonged (P < 0.05). (2) In macular disease group, BCVA had significant positive correlation with retinal mean sensitivity, bicurve ellipse area, macular central 2 degrees and 4 degrees fixation percentage, respectively (P < 0.05). There was a significant correlation between retinal mean sensitivity and P100 amplitude (P < 0.05). (3) Multiple linear regression equation was y = 0.053 x1+0.008 x3+3.897 (y was BCVA, while x1 was retinal mean sensitivity and x3 was P100 amplitude under 2 cpd). CONCLUSION Combined use of microperimetry and VEP is useful in the assessment of BCVA in macular disease.
Case-Control Studies ; Evoked Potentials, Visual/physiology* ; Eye ; Humans ; Macula Lutea/physiopathology* ; Retina ; Retinal Diseases/pathology* ; Tomography, Optical Coherence ; Visual Acuity/physiology* ; Visual Field Tests/methods*

OBJECTIVE: To compare the vision objectively assessed by SPVERA with the illiterate E Acuity in normal subjects. METHODS: The effect of artificially induced image defocusing on visual acuities (Vas) measured by SPVEP and illiterate E chart measurement was studied in 14 normal subjects. SPVEP was recorded using vertical gratings of 8 different spatial frequencies ranging from 0.235 9 to 30.203 2 c/deg. The responses were averaged and displayed through the discrete Fourier transform on the monitor display. SPVERA was determined by extrapolating the PVER amplitude -spatial frequency function to baseline. SPVERA was compared with illiterate E visual acuity measured under the same conditions of optical defocus. RESULTS: With moderate defocusing (<+1.0 diopter (D),VA > 0.42), the SPVERA were equal to or poorer than the illiterate E visual acuity. With more defocus (> +2.0 diopter (D), VA < 0.3),the SPVERA became better than the illiterate E chart Visual Acuity. The correlation between the two acuities was r2 = 0.919. CONCLUSION SPVERA and the illiterate E visual acuity correlated to a certain degree. We conclude that the SPVERA is effective in estimating vision objectively.
Adult ; Evoked Potentials, Visual/physiology* ; Female ; Fourier Analysis ; Humans ; Male ; Middle Aged ; Pattern Recognition, Visual/physiology* ; Photic Stimulation ; Vision Disorders/physiopathology* ; Vision Tests/methods* ; Visual Acuity/physiology*

Objective:To observe the influence of pressing force and time on the thermal effect of An-pressing manipulation.Methods:Eight healthy volunteers were recruited to receive An-pressing manipulation at Xinshu (BL 15) on the right side.The pressing force and time were both divided into five levels:the force described as extremely mild,mild,moderate,strong and extremely strong and time given by 2.5 min,5.0 min,7.5 min,10.0 min and 15.0 min.The real-time change in local acupoint temperature as well as the change during 1.0-15.0 min after the manipulation were observed.Results:Compared with the baseline data,the real-time changes in the temperature after An-pressing Xinshu (BL 15) on the right side with different levels of force (from mild to strong) were respectively (1.88t0.64) ℃,(2.05±0.68) ℃,(2.25±0.59) ℃,(2.35±0.61) ℃ and (2.32±0.69) ℃;the changes in 15.0 min after the manipulation were respectively (-0.11±0.11) ℃,(0.03±0.14) ℃,(0.59±0.58) ℃,(1.38±0.70) ℃ and (2.09±0.98) ℃.The real-time temperature changes after the manipulation for different durations (from short to long) were respectively (1.94±0.37) ℃,(2.33±0.29) ℃,(2.49±0.31) ℃,(2.51±0.39) ℃ and (2.41±0.55) ℃;the changes in 15.0 min after the manipulation were respectively (0.53±0.49) ℃,(0.33±0.30) ℃,(0.52±0.33) ℃,(0.55±0.38) ℃ and (0.76±0.36) ℃.Conclusion:The thermal effect presented an increasing tendency with the extension of pressing time,and the temperature reached the top at 7.5 min;the thermal effect showed an increasing tendency with the rise of pressing force,and the temperature reached the top upon a moderate level of force.The pressing time can produce a greater influence on the real-time temperature than the pressing force;the pressing force can produce a greater influence on maintaining the temperature than the pressing time.

OBJECTIVE: To analyze risk factors associated with post-traumatic retinal detachment and to identify the cause-effect relationship between retinal detachment and blunt ocular trauma in forensic medical assessment. METHODS: 112 cases of forensic medical examination on post -traumatic retinal detachment were retrospectively analyzed. RESULTS A variety of retinal abnormalities were found in these cases, including tearing of the ora serrata retinae (4.28%), macular perforation (12.50%), small (<90 degrees) nonmacular retinal perforation (56.25%), larger (>90 degrees) retinal perforation (5.00%), and tractive retinal detachment without perforation (11.6%). Proliferative vitreoretinopathy (PVR) was found in 45 eyes examined. In most cases, retinal detachment occurred between 1 week to 2 months after blunt ocular trauma (61.60%), with 83.93% accompanied with severe myopia (>-3.00D) and 52.67% accompanied with vitreous floaters. Of all cases, 41.07% were directly and 52.68% were indirectly resulted from blunt ocular trauma, and the rest (6.25%) showed no association with blunt ocular trauma. CONCLUSION Many risk factors may result in retinal detachment including blunt ocular trauma and other causes. Accurate assessment of the relationship between blunt ocular trauma and retinal detachment is an important part of forensic examination.
Adolescent ; Adult ; Contusions/complications* ; Eye Injuries/complications* ; Female ; Forensic Medicine/methods* ; Humans ; Male ; Middle Aged ; Retinal Detachment/pathology* ; Retrospective Studies ; Time Factors ; Wounds, Nonpenetrating/complications* ; Young Adult

At present the sight impairment evaluation in forensic medicine of China is based on the international classification of disease by WHO in 1973. The main measured indicator is "best corrected visual acuity". It is different from "presenting distance visual acuity" in some situations. In the new blindness and vision loss classification made by WHO in 2003, "presenting distance visual acuity" took the place of the "best corrected visual acuity". In the practice of forensic medicine, "presenting distance visual acuity" can not reflect the real visual acuity duo to the exaggeration or disguise of the wounded. We suggest to use "the best corrected presenting distance visual acuity" instead of "presenting distance visual acuity" in order to avoid the influences of the exaggeration or disguise of the wounded.
Activities of Daily Living ; Blindness/diagnosis* ; China ; Expert Testimony ; Forensic Medicine ; Health Services Accessibility ; Humans ; Vision Disorders/diagnosis* ; Visual Acuity ; Visual Field Tests/standards* ; Visual Fields ; Visually Impaired Persons ; World Health Organization

Objective: To investigate the value of pulmonary ventilation/perfusion (V/Q) SPECT imaging in fibrosing mediastinitis (FM). Methods: From January 2015 to July 2018, 14 FM patients (6 males, 8 females, average age 74 years) who underwent V/Q SPECT imaging in China-Japan Friendship Hospital were retrospectively studied. The data of V/Q SPECT imaging were analyzed and the defect extent was classified as mild (<20%), moderate (20%-50%) and severe (>50%) according to the percentage of pulmonary perfusion and ventilation defect in total lung volume (%). χ² test was used to analyze the incidence rates of the impaired blood perfusion of each lung lobe. Results: According to the results of Q SPECT imaging, all 14 patients had impaired blood perfusion in the superior lobe of left lung, and the number of patients with/without impaired blood perfusion in the inferior lobe of left lung, superior lobe of right lung, middle lobe of right lung, inferior lobe of right lung were 11/3, 14/0, 13/1, 12/2, respectively. The incidence rates of impaired blood perfusion in different lobes were not significantly different (χ²=6.198, P=0.185). The range of lung perfusion defect was mild in 1, moderate in 7 and severe in 6 patients. The incidence rates of impaired blood ventilation in different lobes were not significantly different (χ²=1.587, P=0.811). The range of lung ventilation defeat was mild in 11, moderate in 2 and severe in 1 patients. The defect extent of lung segments and subsegments in Q SPECT imaging and V SPECT imaging were 119 and 41, respectively (χ²=28.42, P<0.05). There was more defect in Q SPECT imaging, but both methods showed segmental or subsegmental distribution. Conclusions The defect of V/Q SPECT imaging in FM patients is segmental in distribution, and more is observed in Q SPECT imaging. Pulmonary V/Q SPECT imaging can evaluate the defect range and extent of pulmonary perfusion and ventilation in FM patients.

OBJECTIVE: To compare the agreement of anterior chamber angle examination by ultrasound biomicroscope (UBM), slit lamp optical coherence tomography (SL-OCT), and gonioscopy in angle recession and angle closure. METHODS: The anterior chamber angle was measured with UBM, SL-OCT and gonioscopy in turns for temporal, nasal, superior and inferior quadrant in the same dark room. The results were compared with the agreement of the three methods in angle recession and angle closure by χ2 test and Kappa test. RESULTS: There were no statistically significant differences of the three methods in testing angle closure and angle recession (P>0.05). The consistency of UBM and gonioscopy was better (Kappa value of 0.882) than that of SL-OCT and gonioscopy (Kappa value of 0.624). CONCLUSION When testing angle recession, UBM is better than SL-OCT with gonioscopy as the standard. When testing angle closure, UBM, SL-OCT and gonioscopy have good agreement.
Anterior Chamber ; Glaucoma, Angle-Closure ; Gonioscopy ; Humans ; Intraocular Pressure ; Microscopy, Acoustic ; Slit Lamp ; Tomography, Optical Coherence

OBJECTIVETo describe a form of interstitial lung disease pathologically characterized by small airway-centered interstitial fibrosis (ACIF).

METHODSWe analyzed the clinical, pulmonary functional, radiographic, and histologic characteristics of one ACIF case in Peking Union Medical College Hospital and reviewed 12 cases in literatures.

RESULTSClinically, patients presented with chronic cough and progressive dyspnea. Pulmonary function tests showed restrictive ventilatory pattern. Bronchoalveolar lavage showed a mild increase in lymphocytes in most cases. Chest radiography revealed diffuse reticulonodular infiltrates, with thickening of the bronchial walls and surrounding fibrosis. The key finding in histopathology was a distinctive pattern of ACIF centered on membranous and respiratory bronchioles.

CONCLUSIONSACIF is a disease that do not fit into any known category of interstitial lung disease. Whether it is a unique disease remains to be determined.

Adult ; Biopsy ; Bronchi ; pathology ; Diagnosis, Differential ; Humans ; Lung ; diagnostic imaging ; pathology ; Male ; Pulmonary Fibrosis ; diagnosis ; diagnostic imaging ; pathology ; Respiratory Function Tests ; Tomography, X-Ray Computed ; methods

OBJECTIVE: Developing teeth are used to assess maturity and estimate age in a number of disciplines. The aim of this study was to determine the accuracy of Demirjian method (Panoramic radiographs were examined and seven mandibular teeth staged according to Demirjian's dental maturity scale) in the forensic clinical medicine. METHODS: Tooth formation was assessed with orthopantomographs in healthy children in dental teaching hospital. There were total 828 children, with 279 boys and 549 girls, aged from 11 to 19 years. The difference between dental and real age was compared and measured, using t-test. RESULTS: The Demirjian method overestimated age in the aged 11-16 years group and had limitations in aged group over 17 years. CONCLUSION The 95% confidence interval of the mean was least for mean of all developing teeth using Demirjian method (age 11-16 years).
Adolescent ; Age Determination by Teeth/methods* ; Age Factors ; Child ; China ; Dentition, Permanent ; Female ; Forensic Dentistry/methods* ; Humans ; Male ; Mandible/diagnostic imaging* ; Radiography, Panoramic ; Reproducibility of Results ; Tooth/growth & development* ; Young Adult