Objective Study on the stability of carbofuran and its metabolite carbofuran phenol in blood preserved at different conditions,in order to provide a scientific evidence for forensic identification of carbofuran poisoning death. Methods The dogs were given intragastric administration with 4LD50(13.5mg/kg) of carbofuran, the blood were collected and divided into five equally groups preserved at 20℃(NC2.5mg/mL), 20℃(1%NaF), 20℃, 4℃ and -20℃, respectively. The concentrations of carbofuran and carbofuran phenol in above samples were detected by GC-MS/MS with MRM at 0d、5d、7d、15d、40d、83d and 150d. Results The concentration of carbofuran in preserved blood were found to be significant decrease at 7d(P < 0.05), then a steady decline. In each condition, the concentration of carbofuran phenol in preserved blood showed an increasing trend firstly, then a declined tendency. The concentration of carbofuran and carbofuran phenol descending fast in blood at 20 ℃ (NC) and 20 ℃ (1%NaF).Conclusion Carbofuran and carbofuran phenol in preserved specimens are found to be decomposed. The decomposition is quick at 20℃ and slow at -20℃. Citrate sodium and sodium fluoride are not suit for anticoagulation and antiputrefactiva. Biological specimens used for forensic identification of the carbofuran poisoning should be stored at refriferated or freezed, and be analyzed as soon as possible.

Objective To develop a method of support liquid-liquid extraction (SLE) and simultaneous determination of 4 components in somedon and its 8 metabolites by GC–MS/MS. Methods Somedon and its metabolites were extracted by SLE and determined by GC-MS/MS in MRM mode. The qualitative analysis was based on retention time and ratio of ions. The quantitative analysis was based on internal standard method and calibration curve. Results After SLE and determination of 4 components in somedon and its 8 metabolites, the extraction rate were 37.57%~95.87%, the linear range were 0.12μg/mL~16.00μg/mL, the correlation coefficient(r)were 0.989 6~0.999 7, LOD were 0.08ng/mL~14.48ng/mL, the accuracy were 79.63%~122.90%, the interday and intraday precision were 0.99%~7.43% and 2.19%~10.60% respectively. Conclusion Simultaneous determination of somedon and its metabolites by GC–MS/MS in biological samples, which was rapid, simple, accurate and was high precision and recovery, can be used for qualitative and quantitative analysis in forensic cases.

Objective:To design a patient self-rating wrist scale suitable for Chinese patients, and evaluate its reliability and validity.Methods:The primary entry pool was established by referring to the existing foreign scales and the opinions of domestic experts. Opinions of 11 hand surgeons and 10 patients with wrist diseases were referred to select better items into the primary scale. During September 2015 to November 2016, 100 inpatients with wrist diseases in the hand surgery department of Beijing Jishuitan Hospital were selected by convenient sampling method, and the primary scale was conducted on them. Eight indices including item response rate, item differentiation, item-dimension attribution, variability, responsiveness, overall item attribution, internal consistency and factor loading were summarized. All the 8 indices were evaluated to establish the wrist patient self-evaluation instrument for Chinese. Test-retest reliability, Cronbach coefficient, expert score, KMO value, explanatory power, χ 2/df, root mean square error of approximation (RMSEA) and comparative fit index (CFI) were used to evaluate the reliability and validity of the scale. Results:A total of 40 subjective items in the primary entry pool were selected to form the primary scale, including 32 items (A1-D4), and 4 dimensions (physiology, safety, pain and emotion). There were 92 valid scale results in 100 cases. All cases' response rate were over 90%. In terms of item differentiation, only the high grouping score [3.20±0.577 points (range, 1-3 points)] and the low grouping score [2.68±0.627 points (range, 2-5 points)] of item B10 had no statistical significance ( t=5.11, P=0.340). There were 17 items: A1, A2, A5, A6, A7, A8, A9, A10, A11, A12, B4, B6, B7, C5, D1, D2, and D3 were considered to be deleted according to the result of item-dimension attribution. A total of 11 items had a variation less than 0.65: A4 (0.645), A7 (0.593), B1 (0.590), B5 (0.617), B8 (0.578), B9 (0.612), B10 (0.526), D1 (0.644), D2 (0.320), D3 (0.169), D4 (0.526). A2, A4, A6, A8, B4, B6, D1, D2, D3, C2, C3, C4, C5, C6 did not meet the reactivity requirements. Items with factor loads less than 0.4: D2 (-0.051), D3 (-0.127), and D4 (0.267). C4 (0.026), C5 (0.023), D1 (0.103), D2 (0.434), D3 (0.387), D4 (0.062) did not meet the internal consistency requirements. In multiple linear regression analysis, 19 items were not included in the final regression equation. Based on the above analysis, D1, D2, and D3 were finally deleted and the rest 29 valid items were remained to form the wrist patient self-evaluation instrument for Chinese. Reliability and validity of the scale: the test-retest reliability of physiology, safety, pain, emotion dimensions were 0.984, 0.976, 0.985 and 0.802 ( P<0.001), respectively. Except for there was only one item in emotion dimension, the Cronbach coefficients of total score, physiology, safety and pain dimensions were 0.943, 0.973, 0.944 and 0.881, respectively. KMO was 0.894 ( P<0.001). Except for there was only one item in emotion dimension, whose validity could not be evaluated. The χ 2/df, CFI, RMSEA results were as follows, physiology: 5.152, 0.817, 0.022, respectively; safety: 5.378, 0.795, respectively; pain: 7.439, 0.865, 0.028, respectively. Conclusion:The wrist patient self-evaluation instrument for Chinese is consisted of 4 dimensions and 29 items. As a subjective wrist self-rating scale suitable for modern Chinese patients, the scale has good reliability and validity, and can be one of the choices of the subjective evaluation for Chinese patients with wrist diseases.

Metatarsal Bones/surgery* ; Thumb/abnormalities* ; Metacarpal Bones/surgery* ; Plastic Surgery Procedures

The overall efficacy of neoadjuvant chemotherapy for locally advanced gastric cancer has been recognized. However, neoadjuvant chemotherapy is ineffective in a subset of patients due to tumor heterogeneity. The tumor regression grade (TRG) has unique advantages in assessing the efficacy of neoadjuvant chemotherapy for gastric cancer. Nonetheless, since TRG is dependent on postoperative pathology, it becomes a significant topic today to mine TRG predictors to more accurately select appropriate patients for neoadjuvant chemotherapy. Therefore, to understand the relevant research progress and current research challenges of TRG predictors after neoadjuvant chemotherapy for gastric cancer from the aspects of biomarkers, immunity, inflammatory indicators, body composition, imaging indicators, etc., is conducive to further clinical research and practice.

Objective:This study aimed to investigate the functional and aesthetical outcomes after index pollicization for severe congenital thumb hypoplasia.Methods:From June 2010 to November 2018, 26 patients (29 hands) with Manske modified Blauth type ⅢB-V thumb hypoplasia who were admitted to Department of Hand Surgery, Beijing Ji Shui Tan Hospital were treated with index pollicization. Thumb abduction angles, Kapandji score, pinch forces, interphalangeal and metacarpophalangeal ranges of motion were measured. The stability of carpometacarpal joint was checked. Goldfarb function score and Likert scale score were used to evaluate overall function of thumb. Whether new first metacarpal’s physeal closure presence was observed on X-ray film. Postoperative complications were recorded. The patients’guardian’s and follow-up doctor’s subjective satisfactions on thumb appearance and function were surveyed. The correlation between guardian’s satisfaction and objective indicators, the differences between guardian’s and doctor’s satisfactions, the difference between operation satisfaction before and after 3 years old were analyzed.Results:Among 26 patients(4 type ⅢB, 16 type Ⅳ, and 9 type V), there were 19 males and 7 females with an average age of 37 months (range: 15-89 months) during surgery, including 8 left hands, 15 right hands and 3 bilateral hands. The average follow-up was 42 months. Average thumb radial abduction was 46.2°, average palmar abduction was 34.1°, and average Kapandji score was 7.1. Average angle of interphalangeal joint extension was 3.4°, flexion 40.7°, metacarpophalangeal joint extension 4.1°, flexion 38.6°. The average pinching forces (key pinch, tip pinch and tripod pinch) were 0.5 kg, 0.8 kg and 1.2 kg respectively. All carpometacarpal joints were stable. The average Goldfarb score was 4. The average Likert scale was 22. All epiphyses were open. First web contracture and superficial skin necrosis were respectively observed in 1 and 6 cases. There was no correlation between the guardian’s satisfaction and the objective indicators. The guardian’s satisfaction on thumb appearance and function was significantly lower than that of doctors’. There was no significant difference in guardian’s and physician’s satisfaction between patients before and after 3 years old.Conclusions:Satisfactory functional outcomes can be obtained after index pollicization for patients with Manske modified Blauth ⅢB-V thumb hypoplasia, with weak strength of thumb opposition and flexion. The subjective satisfaction of doctors was higher and that of guardians was lower.

Objective:This study aimed to investigate the functional and aesthetical outcomes after index pollicization for severe congenital thumb hypoplasia.Methods:From June 2010 to November 2018, 26 patients (29 hands) with Manske modified Blauth type ⅢB-V thumb hypoplasia who were admitted to Department of Hand Surgery, Beijing Ji Shui Tan Hospital were treated with index pollicization. Thumb abduction angles, Kapandji score, pinch forces, interphalangeal and metacarpophalangeal ranges of motion were measured. The stability of carpometacarpal joint was checked. Goldfarb function score and Likert scale score were used to evaluate overall function of thumb. Whether new first metacarpal’s physeal closure presence was observed on X-ray film. Postoperative complications were recorded. The patients’guardian’s and follow-up doctor’s subjective satisfactions on thumb appearance and function were surveyed. The correlation between guardian’s satisfaction and objective indicators, the differences between guardian’s and doctor’s satisfactions, the difference between operation satisfaction before and after 3 years old were analyzed.Results:Among 26 patients(4 type ⅢB, 16 type Ⅳ, and 9 type V), there were 19 males and 7 females with an average age of 37 months (range: 15-89 months) during surgery, including 8 left hands, 15 right hands and 3 bilateral hands. The average follow-up was 42 months. Average thumb radial abduction was 46.2°, average palmar abduction was 34.1°, and average Kapandji score was 7.1. Average angle of interphalangeal joint extension was 3.4°, flexion 40.7°, metacarpophalangeal joint extension 4.1°, flexion 38.6°. The average pinching forces (key pinch, tip pinch and tripod pinch) were 0.5 kg, 0.8 kg and 1.2 kg respectively. All carpometacarpal joints were stable. The average Goldfarb score was 4. The average Likert scale was 22. All epiphyses were open. First web contracture and superficial skin necrosis were respectively observed in 1 and 6 cases. There was no correlation between the guardian’s satisfaction and the objective indicators. The guardian’s satisfaction on thumb appearance and function was significantly lower than that of doctors’. There was no significant difference in guardian’s and physician’s satisfaction between patients before and after 3 years old.Conclusions:Satisfactory functional outcomes can be obtained after index pollicization for patients with Manske modified Blauth ⅢB-V thumb hypoplasia, with weak strength of thumb opposition and flexion. The subjective satisfaction of doctors was higher and that of guardians was lower.