Informed consent right is not just for basic ethical consideration, but is important for protecting patient's right by law, which is expressed through informed consent contract. The appraised individuals of forensic clinical examination have the similar legal status as the patients in medical system. However, the law does not require informed consent right for the appraised individuals. I recommend giving certain informed consent right to the appraised individuals in the forensic clinical examination. Under the contracted relationship with the institution, the appraised individuals could participate in the examination process, know the necessary information, and make a selected consent on the examination results, which can assure the justice and fairness of judicial examination procedure.
Forensic Medicine ; Humans ; Informed Consent ; Patient Participation

Objective To observe the effect of different analgesic methods including patient controlled epidural analgesia (PCEA) and patient controlled intravenous analgesia (PCIA) on stress response and anxiety in surgical patients with lower limb fracture. Methods A total of 120 surgical patients with lower limb fractures were employed and divided randomly into Groups PCEA, PCIA and C (40per group). All patients were anaesthetized by using combined spinal-epidural anesthesia. After operation, PCEA and PCIA were applied in the patients of Groups PCEA and PCIA, respectively. No analgesic method was employed in the Group C. The dynamic indices including mean blood press (MAP) and heart rate (HR), blood serum cortisol (COR) and blood sugar (BS) were measured at different time points,ie, T0 ( pre-anesthesia), T1 ( the end of the operation), T2 (24 hours after operation) and T3 (48 hours after operation). The visual analogue pain score was conducted at time points of T1, T2 and T3. The measurement of anxiety score was done at pre-operation and at days 1 and 7 after operation. Results There were no significant changes in HR and MAP of Groups PCEA and PCIA (P＞0.05, compared with T0) at every time point after operation. Whereas, HR and MAP of Group C were increased at time points of T1 and T2 (P ＜ 0.05, compared with T0 ), with statistical difference compared with Groups PCEA and PCIA at the same time points (P ＜ 0.05 ). VAS in Group PCEA was lower than that in Group PCIA at time points of T2 and T3 ( P ＜ 0.05). Meanwhile, VAS in Groups PCEA and PCIA was lower than that in Group C (P＜0. 05). COR and BS in Group PCEA were significant lower than those in group PCIA at time points of T2 and T3 (P ＜ 0. 05 ). Meanwhile, COR and BS in Groups PCEA and PCIA was lower than that in Group C (P＜0.05 or ＜0.01 ). Moreover, the changes were more significant in Group PCIA than that in Group PCEA (P ＜ 0. 05 ). The anxiety score in Groups PCEA and PCIA was lower than that in Group C (P ＜ 0.05). Conclusions Two analgesic methods of PCEA and PCIA can provide safe and effective postoperative analgesia and attenuate the stress response and anxiety in surgical patients with lower limb fracture. Meanwhile, PCEA takes more advantages than PCIA.

OBJECTIVETo explore mechanism of acupuncture for renal interstitial fibrosis (RIF) in hypertension rats.

METHODSTwenty-four 24-week-old male spontaneously hypertensive rats were randomly divided into a model group, a perindopril group and an acupuncture group, eight cases in each one. In the acupuncture group, with rats tied up, electroacupuncture was applied at bilateral "Quchi" (LI 11) and "Zusanli" (ST 36) under mild vibration of needle handle for 20 min, once a day. In the perindopril group, perindopril (0.4 mg/kg) suspension liquid was applied for intragastric administration, once a day. In the model group, rats were tied up for 20 min a day without any treatment. Eight same-age same-race Wistar Kyoto (WKY) rats with normal blood pressure were taken as a control group, which was given with free diet but no treatment. The treatment was reuqired for six weeks. The systolic blood pressure of caudal artery was tested. Kidney morphological structure was observed by HE coloration. Deposition optical density of type I and III collagen in kidney was tested by immunohistochemistry. Expression of transforming growth factor-beta1 (TGF-beta1) mRNA was tested by reverse transcription polymerase chain reaction (RT-PCR) method.

RESULTSCompared with the model group, the blood pressure was significantly decreased in the acupuncture group (P < 0.01), the damage of kidney morphology was minor, positive depositional area of type I and III collagen was obviously decreased (both P < 0.05), and the expression of semi-quantitative analysis of TGF-beta1 mRNA was decreased (P < 0.05), which had similar effect as western medication perindopril.

CONCLUSIONAcupuncture at "Quchi" (LI 11) and "Zusanli" (ST 36) probably intervenes the process of RIF by reducing synthesis of kidney type I , III collagen and restraining expression of TGF-beta1.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Collagen Type I ; genetics ; metabolism ; Disease Models, Animal ; Humans ; Hypertension ; genetics ; metabolism ; therapy ; Kidney ; anatomy & histology ; metabolism ; Male ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY ; Transforming Growth Factor beta1 ; genetics ; metabolism

OBJECTIVETo investigate the genetic polymorphism and applied value in forensic medicine of five short tandem repeats (STRs) loci(DXS7130, DXS7132, DXS7133, DXS6804 and DXS8378) on X-chromosome in Achang ethnic group.

METHODSAllele frequency and genotype distribution of five X-STR loci among 100 unrelated individuals from Achang ethnic group were analyzed by PCR following polyacrylamide gel electrophoresis and silver staining. Hardy-Weinberg equilibrium of females was tested and forensic parameters were calculated.

RESULTAll the five STR loci were polymorphic in Achang ethnic group. Chi-square test indicated that genotype distribution of females was in accordance with Hardy-Weinberg equilibrium.

CONCLUSIONThese results enrich Chinese genetic database and can be applied to individual identification, paternity testing and population genetics.

Alleles ; China ; Chromosomes, Human, X ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Microsatellite Repeats ; genetics ; Polymorphism, Genetic

OBJECTIVETo investigate the rehabilitation effect of electroacupuncture (EA) at early stage on hemiplegia in the postoperative patient of hypertensive hemorrhage.

METHODSSeventy-two cases of postoperative patient of hypertensive hemorrhage were divided into an EA group (n = 42) treated with EA at Quchi (LI 11), Shousanli (LI 10), Hegu (LI 4), Zusanli (ST 36), etc., from 1-3 days after operation, twice each day; and a control group (n = 30) with functional exercises. Their rehabilitation effects were compared after treatment of one month.

RESULTSThe rehabilitation effect in the EA group was significant better than that in the control group (P < 0.01).

CONCLUSIONEA at early stage has good recovery effect for the patient of hemiplegia after operation of hypertensive hemorrhage.

Acupuncture Points ; Electroacupuncture ; Hemorrhage ; Humans ; Hypertension ; Postoperative Period

OBJECTIVETo study the effects of beta-amyloid peptide (Abeta) on cell membrane lipids and cholinergic receptors of human neuroblastoma cells.

METHODSHuman SH-SY5Y neuroblastoma cells were treated with different concentrations of Abeta(1-42) with and without pretreatment of vitamin E. MTT [3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide] reduction, lipid peroxidation, protein oxidation and phospholipids were measured by spectrophotometry. Levels of cholesterol and unbiquinone were determined by high-performance liquid chromatography (HPLC). The numbers of cholinergic receptor binding sites were determined by receptor binding assay and the protein levels of nicotinic receptor alpha3 and alpha7 subunits were studied by Western blotting.

RESULTSSH-SY5Y cells showed decreased reduction rates of MMT and phospholipids, and increased lipid peroxidation and protein oxidation after exposure to Abeta (0.1 micromol/L) as compared to the control. The number of cholinergic receptor binding sites, the protein level of nicotinic receptor alpha3 and alpha7 subunits and the content of ubiquinone decreased in cells treated with high dose of Abeta (1 micromol/L). Although the level of cholesterol was not changed in any way, vitamin E partially prevented the neurotoxic effects of Abeta.

CONCLUSIONbeta-amyloid peptide reduces the level of cell membrane lipids and cholinergic receptors in human SH-SY5Y neuroblastoma cells, likely through the induction of an enhanced oxidative stress.

Amyloid beta-Peptides ; administration & dosage ; metabolism ; toxicity ; Cell Line, Tumor ; Cell Membrane ; metabolism ; Cholesterol ; metabolism ; Dose-Response Relationship, Drug ; Humans ; Lipid Peroxidation ; drug effects ; Malondialdehyde ; metabolism ; Membrane Lipids ; metabolism ; Neuroblastoma ; metabolism ; pathology ; Oxidative Stress ; drug effects ; Peptide Fragments ; administration & dosage ; metabolism ; toxicity ; Phospholipids ; metabolism ; Receptors, Nicotinic ; metabolism ; Ubiquinone ; metabolism ; Vitamin E ; metabolism ; pharmacology

OBJECTIVETo determine the location of the vertebral artery foramens from C(3) to C(6) and their relationship to the point 1 mm medial to the center of the lateral mass and to identify the value of oblique radiograph for cervical lateral mass screw trajectory by a cadaveric study.

METHODS(1) Twenty-eight cervical specimens (C(3)-C(7)) of human cadavers aged from 28 to 79 years were analysed. The transverse radiographs of C(3)-C(6) vertebrae were taken and the angle between the parasagittal plane and the line connecting the point of the lateral mass with the lateral limit of the transverse process foramen of C(3)-C(6) were measured. (2) The K-wires were drilled into lateral mass of C(3)-C(6) starting 1 mm medial to the center of the lateral mass and exiting by the juncture between the transverse process and the facet in ten specimens. Four wire placements under direct visualization, including placement of the wire tip staying the ventral cortex and 2, 4, 6 mm over-penetration of the ventral cortex of lateral mass, were performed separately on each specimen. After each placement, radiographs were taken on 45 degrees oblique left and 45 degrees oblique right views. Each intervertebral foramen on the oblique radiographs was divided into two parts: superior and inferior parts. The former is the true intervertebral foramen, while the latter is the intertransverse foramen on the gross specimen. The number of wire tips in each part was quantified for each placement. All results on the radiographs were compared with those on the gross anatomy.

RESULTS(1) The angles between the parasagittal plane and the line connecting the posterior starting point of the lateral mass with the lateral limit of the transverse foramen (C(3)-C(6)) were lateral to the sagittal plane, ranging from 5 degrees to 12 degrees. Among the vertebrae, there were no statistically significant difference (P > 0.05). (2) 15% of the wires without over-penetration and 41.3% with 2 mm over-penetration were found in the inferior parts of the intervertebral foramen in oblique views, while the wires were not noted in the intervertebral foramen by gross anatomy. with 4 mm over-penetration of the ventral cortex, 35% and 65% of wires were noted in the superior and inferior parts of the intervertebral foramen respectively, while only 28.8% of wires were found in the inferior part approximating the nerve roots in gross specimens. With 6 mm over-penetration, the number in the intervertebral foramen were 63.8% superiorly and 36.2% inferiorly on the oblique radiographs while all the tips were at the inferior part (intertransverse foramens) in gross specimens. The tip of wire crossed the line connecting the posterior borders of the intervertebral foramens in oblique radiographs when it penetrated the ventral cortex of lateral mass 4 mm or more.

CONCLUSIONS(1) There is no risk of damaging the vertebral artery if a screw is directed more than 15 degrees lateral to the sagittal plane at C(3 approximately 6) starting 1 mm medial to the center of the lateral mass. (2) Ideal screw tip position on oblique radiograph may not cross the line connecting the posterior borders of the intervertebral foramen on radiograph. If the screw tip is noted in the superior part of intervertebral foramen on the oblique radiograph, the screw may be identified as dangerous.

Adult ; Aged ; Bone Screws ; Cadaver ; Cervical Vertebrae ; anatomy & histology ; surgery ; Humans ; Internal Fixators ; Middle Aged ; Models, Anatomic ; Spinal Fusion ; instrumentation ; methods ; Spinal Nerve Roots ; anatomy & histology ; Vertebral Artery ; anatomy & histology

OBJECTIVETo study the allele genetic polymorphism of five short tandem repeat (STR) loci on X-chromosome in Ewenke population of north China and to provide basic data for forensic identification.

METHODSGenomic DNA was extracted from EDTA-whole blood of Ewenke population by Chelex-100. The DNA samples were amplified by PCR and were analyzed by polyacrylamide gel electrophoresis and silver staining. The sequence length variations of DXS6799, DXS8378, DXS101, HPRTB, and DXS6789 loci on X-chromosome in 98 unrelated Ewenke individuals were investigated.

RESULTSAll five loci analyzed showed high polymorphism and genetic stability. The data of the five X-chromosome STR loci in Ewenke ethnic group of China was in accordance with Hardy-Weinberg equilibrium by Chi-square test.

CONCLUSIONAllele polymorphism of five X-chromosome STR loci can be used as a genetic marker for forensic identification and population genetic research.

Asian Continental Ancestry Group ; China ; ethnology ; Chromosomes, Human, X ; genetics ; DNA ; genetics ; Female ; Forensic Medicine ; Gene Frequency ; Genetic Markers ; Humans ; Male ; Microsatellite Repeats ; Polymerase Chain Reaction ; Polymorphism, Genetic

OBJECTIVE: To study the genetic polymorphism of five STR loci on X-chromosome in 98 Ewenke population of China and establish the related genetic database. METHODS: The sequence variation of DXS7423, DXS7424, DXS7132, DXS7133, DXS6804 loci on X-chromosome were analyzed by PCR following PAG electrophoresis and silver staining. RESULTS: The genetic data of the 5 X-chromosome STRs in Ewenke ethnic group of China is in accordance with Hard-Weinberg equilibrium. CONCLUSION Five X-STR loci could be used in forensic identification and population genetic research.
Chi-Square Distribution ; China/ethnology* ; Chromosomes, Human, X/genetics* ; DNA/genetics* ; Electrophoresis, Polyacrylamide Gel ; Ethnicity/genetics* ; Female ; Forensic Medicine ; Gene Frequency ; Genetics, Population ; Genotype ; Humans ; Male ; Polymerase Chain Reaction ; Polymorphism, Genetic/genetics* ; Tandem Repeat Sequences

In recent years, mental disability estimation are more than ever in the practice of forensic psychiatric expertise. The standards about mental disability estimation in the Disability Evaluation Criteria of Traffic Accident Injury are ambiguous and difficult to operate, it cause to different understanding in one case. This article discuss some common questions through 3 aspects in mental disability expertise according to some typical cases, there are the first, we should compare the IQ score before and after injurious in intelligence estimate. The second, the mental disability estimation should be done at least one year after the end of medicine treatment. The third, mental estimate scale should be used in mental disability estimation.
Accidents, Traffic ; Adolescent ; Craniocerebral Trauma/psychology* ; Disability Evaluation ; Expert Testimony/standards* ; Female ; Forensic Psychiatry/legislation & jurisprudence* ; Humans ; Intelligence ; Male ; Persons with Mental Disabilities ; Wechsler Scales ; Young Adult