OBJECTIVE: To analyze the features of death cases in the urban rail traffic accidents in order to prevent the similar accidents in the future and to provide reference for forensic expertise. METHODS: Eighteen death cases in urban rail traffic accidents between 2005 to 2008 in Shanghai were collected. The forensic characteristics were summarized in aspects of the nature of cases, the injury mechanism and characteristics, etc. RESULTS: There were total 18 cases with 14 suicide and 4 accidental incidents, aged from 21 to 55 years. Of those dead, 14 died of craniocerebral injury and 4 died of traumatic shock. The injury mechanism included hit, fall and rolling. CONCLUSION The injury in urban rail traffic accidents have their own characteristics, mainly due to suicide, and partly due to accidental incident, and most of these cases are probably preventable.
Accidents, Traffic ; Adult ; Cause of Death ; China/epidemiology* ; Craniocerebral Trauma/mortality* ; Female ; Forensic Pathology ; Humans ; Male ; Middle Aged ; Railroads ; Retrospective Studies ; Suicide/statistics & numerical data* ; Wounds and Injuries/mortality* ; Young Adult

Objective To evaluate the psychological intervention ettectiveness ot socioenvironmental therapyfor heroin addicts accepting compulsory isolation.Methods Totally 100 male heroin addicts accepting compulsory isolation and Labour Camp Rehabilitation were selected and randomly assigned to socioenvironmental therapeutic group (ST group,50 cases) and control group (CT group,50 cases).A two-month socioenvironmental therapy was selectively proceeding in ST group by a same psychological team,while CT group still received conventional rehabilitation.During the 6-month follow-up,self-rating anxiety scale(SAS),self-rating depression scal (SDS) and self-made questionnaires were used every 3 months,to statistically estimate psychological status of subjects.Results Before treatment,no statistically significant difference between the two groups;after treatment,SDS score of CT group was 56.16 ± 9.12,and was lower than that in ST group(48.28-± 9.55) (P ＜ 0.01) ; SAS score of ST group was 46.28 ± 7.78,and was lower than that in CT group (50.72 ± 8.32) (P ＜ 0.01).In the 3-month follow-up evaluation,depression,anxiety scores in CT and ST group were significantly lower,the difference was statistically significant (P ＜ 0.01) ; 6 months after treatment,depression,anxiety score showed was significant difference between two groups(P＜ 0.01).Conclusion Group psychotherapy especially socioenvironmental therapy is quick and long-acting in improving the psychological status of heroin addicts in aspects of depression and anxiety levels,which is distinctly evidenced by the short-term and long-term curative results.

Following an overview of the present big medical data sharing abroad, the paper identified the problems of the regional health information platform in data sharing and utilization as follows. Namely, poor data integration, low data availability, poor data security and privacy, unclear data sharing model, and poor data management accountability. On such basis, the authors made thoughtful studies in data quality management, information security and privacy protection and data sharing model. These efforts provide useful references for big health data integration sharing and open access.

ObjectiveTo assess the efficacy of adjuvant therapy with fenofibrate for primary biliary cirrhosis (PBC). MethodsCNKI, Wanfang Data, China Biology Medicine, PubMed, Embase, and Cochrane library were searched for the pertinent literature of randomized controlled trials (RCTs) of adjuvant therapy with fenofibrate for PBC published up to December 31, 2014. Data extraction and quality assessment were carried out, and the data were statistically analyzed by Stata10.1 software. Respectively, for heterogeneity test. The fixed effect model is chosen for homogeneity, and the random effect model is chosen for heterogeneity. ResultsSix RCTs met the inclusion criteria. Treatment with fenofibrate was associated with significantly reduced levels of gamma-glutamyl transpeptidase, alanine aminotransferase, and alkaline phosphatase in PBC patients (SMD=-1.595, -0.447, and -2.125, respectively, all P＜0.05). There were no significant changes in the levels of aspartate aminotransferase and total bilirubin after adjuvant therapy with fenofibrate (both P＞0.05). Also, fenofibrate led to no significant improvement in immunoglobulin M (P＞0.05). ConclusionFenofibrate, which improves the indicators of liver function but leads to no changes in immunological indicators, appears to be an effective adjuvant therapy in PBC patients. There is a critical need for more large-scale, multi-center, high-quality RCTs to determine its effect on liver disease-related morbidity and mortality.

Objective To knockout the MATP gene of mouse melanoma cell line B16F10 using CRISPR/Cas9 system,and to lay foundation for the functional study of MATP gene.Methods Specific primers of MATP were designed according to the report in http://crispr.mit.edu/ website.The primers were linked to pCAS9/gRNA1 vector.Then the positive vector was transfected into mouse melanoma B16F10 cells,and monoclonal cell lines were obtained by the infinite dilution method.After the genomes of different monoclonal cell lines were extracted and sequenced,the cell lines with MATP gene cleavage were screened,and the expression of MATP in these cell lines was verified by Western-blot analysis.Results Three MATP gene knockout cell lines were successfully obtained.The western-blot results showed that the cell lines did not express MATP protein.Conclusions The knockout of MATP gene in B16F10 cell line can be successfully achieved using the pCAS9/gRNA1 vector.

Objective To learn the situation of medical information privacy protection of a hospital and patient′s privacy demand for different medical information .Methods A 300-questionnaire survey was conducted at a tertiary hospital in Shanghai in April 2017 .The data were subject to descriptive analysis .Results The patients were generally satisfied with the hospital′s medical information privacy protection ,as 71％ of them (213/300)were satisfied ,and 13％ (39/300)of them experienced privacy exposure.Patients were most concerned with medical information from which others could identify them .Conclusions The State should promulgate rules and regulations for the protection of medical information privacy as soon as possible ;information technology need to be adopted to encrypt identifiable information ;a system of norms that can be followed need to be developed for the use of medical information ;hospitals should build a patient′s privacy protection system to comprehensively protect the privacy of patients .

Wechat has been widely used in nursing clinical clerkship teaching now. The application of Wechat in nursing clinical teaching mainly takes the form of Wechat group chat, Wechat public signal platform, Wechat friendship circle, online test and so on. Among them, Wechat group chat and Wechat public signal platform are used widely. Wechat enriches the teaching way, and improve the effectiveness of teaching, moreover, it facilitates the relationship between teachers and students. However, there are the ongoing challenges such as lacking of supervision and protection of intellectual property rights.

Postprandial hypotension is an abnormal regulation of blood pressure, which is common in the elderly. Due to insidious symptoms, postprandial hypotension is easily neglected by patients and medical staff in clinical practice, but it has a high degree of harm. There are many factors related to the occurrence of postprandial hypotension, including demographic factors, disease-related factors, lifestyle factors, postprandial postural factors and so on. Among demographic factors, age is positively associated with the occurrence of postprandial hypotension. Among disease-related factors, the existence of some basic diseases such as hypertension and diabetes, and the use of most kinds of anti-hypertensive drugs can increase the risk of postprandial hypotension. Among lifestyle factors, smoking is a risk factor for postprandial hypotension: while reducing the intake of staple foods, drinking large amounts of water or drinking green tea before meals may reduce the risk of postprandial hypotension. By taking different postures after meals, postural factors affect the rate of gastrointestinal emptying and then affect the occurrence of postprandial hypotension. Among the above factors, it is feasible to prevent postprandial hypotension by changing postprandial posture.

Objective To explore the efficacy, safety, and factors that might influence the efficacy of antiPD-1 antibody-based therapy in advanced hepatocellular carcinoma in the real world. Methods The clinical features, efficacy, and safety in patients with advanced hepatocellular carcinoma who received anti-PD-1 antibody-based therapy were retrospectively analyzed. The survival status was followed-up. Results The objective response and the disease control rate were 21.8% and 76.4%, respectively. The overall incidence of adverse events during treatment was 81.8%, of which the incidence of grade 3/4 adverse events was 14.5%. The incidence of immune-related adverse events was 58.2% and the incidence of grade 3/4 immune-related adverse events was 3.6%, and no treatment-related death was observed. The median PFS of the 55 patients was 5.0 (95%CI: 3.9-6.1) months, and the median OS was 11.4 (95%CI: 6.5-16.3) months. Univariate and multivariate analyses showed that liver function Child-Pugh scores and performance status ECOG score were the influencing factors of the objective response rate and survival. Conclusion In the real world anti-PD-1 antibody-based therapy is safe and effective in patients with advanced hepatocellular carcinoma, in which the performance status ECOG score and liver function Child-Pugh score before treatment are independent prognostic factors influencing survival.

Gastrointestinal tract is the main site of human immunodeficiency virus (HIV) infection. Intestinal flora and its metabolites can affect the physicochemical properties, nutritional status and immune function of the intestinal tract. Improving the state of intestinal flora of AIDS patients can improve the immune function of patients and suppress the damage caused by HIV virus to the body. Moringa oleifera combined enteral nutrition can improve the intestinal microecology of AIDS patients and effectively improve the nutritional status of the patients, but there is the possibility of interaction with antiviral drugs, garlic, hypericum perforatum and other herbs. The microbial ecological agents have a weak regulation effect on the intestinal flora of AIDS patients, but it can improve the immune function of patients to a certain extent. Fecal microbiota transplantation does not significantly change the diversity of intestinal flora in AIDS patients, and the long-term complications are still to be clarified, but it can improve the immunity of patients to some extent. The preservation of microbial ecological agents, dietary regulation of intestinal flora and nursing after fecal microbiota transplantation in AIDS patients are still to be studied.