Today, the direction of litigation reformation is changing trial pattern to be trial-centered and making the trial substantialized. Under this background, the relevant provisions have been launched from the supreme people's court and other departments to make sure that the forensic expert will appear in court and accept cross-examination, and this phenomenon should be normalized and substantiated. In order to ensure the expert opinion can be fully and effectively cross-examined, the medico-legal expert should fulfill obligations, such as respect for the court, answer questions honestly and explain expert opinions. We find that some problems show up in this process: the rate of forensic expert appearing in court is low; the legal nature of expert opinion is not clear; the requirements are not clear;the conflict between forensic expert opinion and other forms of expert evidence, including auxiliary expert, is very clearly. Based on this situation, the author give some suggestions to the forensic expert: keep on learning to improve professional skill; improve the legal knowledge; pay attention to practice and strengthen the ability of expression.

OBJECTIVETo summarize the experience of percutaneous fixation of scaphoid fractures with Herbert screws through volar approach, and provide a reliable and efficient treatment method for scaphoid fractures.

METHODSFrom April 2008 to September 2012,15 patients with scaphoid fractures were treated by percutaneous fixation with Herbert cannulated screws through volar approach including 14 males and 1 female with an average age of 35 years ranging from 25 to 45 years old. Among them, 10 cases were on left side and 5 cases were on right side. Durations from injury to operation ranged from 3 to 10 days with an average of 5 days. All these cases were identified as B2 type according to the Herbert classification based on X-ray and CT scan. In order to assess the function of wrist, all patients were calculated according to Krimmer's score postoperatively.

RESULTSThe follow-up period were from 5 to 18 months with an average of 10 months. At 3 months after operation,X-ray was re-checked every month. All the patients achieved bone union with a mean time of 10 weeks (ranged from 7 to 14 weeks) postoperatively. According to Krimmer's score, 14 cases gained 100 scores as perfect and one case got 90 scores as good. The small volar incision of all patients were union at the first period. No operation complications such as infection and nonunion occurred.

CONCLUSIONPercutaneous fixation with Herbert cannulated screws through volar approach is a reliable and efficient treatment method for scaphoid fractures with small invasion, high bone union rate, and fewer complications.

Adult ; Bone Screws ; utilization ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; physiopathology ; surgery ; Fractures, Ununited ; surgery ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery

AIM:To evaluate the poor vision condition and analyze the myopia etiological factor in primary school He'xi district of Sanya.
METHODS: A cohort of 1 218 subjects were recruited randomly from grade 1~6 of two primary schools. Visual activity test, dioptroscopy and risk factor questionnaire were evaluated.
RESULTS: The prevalence of poor vision was 29. 55%. The incidence of myopia increased with grade, and was significantly higher in girls than that in boys. The outdoor activity time of myopic pupil ( 7. 25 ± 5. 35h/wk ) was significantly lower than emmetropic pupil (11. 86±6. 65h/wk) ( P < 0. 05 ). The usage of electronic product ( TV, computater and cell phone) time of myopic pupil (13. 36±8. 35h/wk) was significantly higher than emmetropic pupil (7. 75±5. 83h/wk) (P<0. 05).
CONCLUSION: The increase of myopia incidence is closely related with sparing outdoor activity and excess usage of electronic product.

Percutaneous coronary intervention(PCI) is widely used in the treatment of coronary heart disease because of its tiny trauma,short treatment,rapid effect.However,if the patients after PCI can not effectively control the risk factors,their quality of life will be affected.In this paper,we review the study of self efficacy and quality of life in patients after PCI in recent years,thus to lay the foundation for the subsequent clinical care.

Objective To separate the side population cells(SP) from breast cancer MCF-7 cell line,and observe its biological characteristics.Methods Flow cytometry and Hcechst 33342 dye efflux assay were used to isolate SP cells and non-SP cells from the MCF-7 cell line of human breast cancer.Tumorigenicity of the two subpopulations was observed by a soft agar cloning method.Results The results of FACS analysis indicated that (6.5 ± 0.4 ) ％of the MCF-7 cells were SP cells;The vitro colony formation rate of SP cells was(38.5 ±9.4)％,and higher than that of non-SP cells ( 8.4 ± 2.6 ) ％ ( t =5.34,P ＜ 0,05 ).Concluslon The SP cells sorted from MCF-7 cell line enriched tunor stem cells,which exhibited high tumorigenicity.It indicated that SP cells should play a principal role in breast cancer.

Objective This research is to observe the treatment effects of hip bath and oxygen blowing on severe neonatal diaper rash.Methods 289 neonates with severe diaper rash were randomly divided into three groups.91 cases in the flat tube group,102 cases in the round tube group and 96 cases in the control group.Three groups of neonates were cleaned on the hips and perineuma after poops and then dried with wet tissues and Mupirocin Ointment.The control group was treated with the above-mentioned method.The oxygen blowing groups were treated with hip bath of 1:5000 chameleon solution twice a day.Blowing the hips with oxygen five minutes every time after hip bath.The method of blowing oxygen was that oxygen humidifying containers as normal oxygen aspiration facilities was not filled with water,whose oxygen flowing volume standed at 10 L/min and whose tube blew at the afflicted parts until being dry.The oxygen blower held the oxygen exit and blowed at the afflicted parts in the round tube group and the oxygen blower flattened the oxygen exit and blew at the afflicted parts in the fiat tube group.The treatment effects will be compared among the three groups four days later.Results The cure period of the round tube group was obviously shorter than that of the control group,and the cure period of the fiat tube group was remarkably shorter than that of the round tube group.The total effective rate in the round tube group was obviously higher than that of the control group and the total effective rate in the fiat tube group was obviously higher than that in the round tube group.The difference had a statistical significance.Conclusions The treatment effects for the severe neonatal diaper rash with hip bath and oxygen blowing are remarkable and the oxygen blowing effects with fiat tubes are better than those with round tubes.

Objective To explore the X-ray ,CT and MR manifestations of spinal giant cell tumor(GCT) for improving the diag-nosis level of this rare disease .Methods The X-ray ,CT and MR data in 16 cases of spinal GCT were retrospectively analyzed on the location ,size ,morphology ,margin ,CT density/MR signal intensity and enhancement pattern .Results 4 cases located in cervical vertebra ,8 cases in thoracic vertebra and 4 cases in lumbar vertebra ;in which ,6 cases only involved in vertebral body and other 10 cases involved in vertebral body and and appendix .The lesion affected two neighboring vertebrae in 8 cases ,and affected only one vertebra in the remaining 8 cases .16 cases were protruded into the spinal canals and oppressed the spinal cord .The prominent X-ray and CT images showed eccentric growth ,osteolytic and swelling bone destruction .MR showed isointensity or slight hypointensity on T1WI ,and isointensity or slight hyperintensity on T2WI .After intensified scanning ,the solid portion showed marked inhomoge-neous enhancement .Conclusion Spinal GCT has certain imaging characteristics .CT and MR examination could accurately display the extent of lesion and tumor involvement ,which provides more accurate image information for formulating the strategy of clinical therapy .

BACKGROUND:Studies have shown that simvastatin can promote bone formation, but there is stil controversial on the osteogenic mechanism and osteogenic effect.
OBJECTIVE:To explore the osteogenesis effect of the composite of simvastatin and Bio-Oss versus simple Bio-Oss material on the repair of rabbit mandibular defects.
METHODS:Twelve New Zealand white rabbits were selected to establish alveolar bilateral mandibular defects models. The composite of simvastatin and Bio-Oss was implanted randomly in one side of defect region;Bio-Oss was simply implanted in the other side of defect region. Both sides were covered with Bio-Gide bilayer col agen membrane. Four rabbits in each group were sacrificed at 4, 8 and 12 weeks after implantation, and the general observation X-ray film, oral cone-beam CT imaging observation and histopathologic study and quantitatively were conducted to quantitatively and qualitatively comparative analyze the alveolar bone formation in the graft region.
RESULTS AND CONCLUSION:At 4, 8 and 12 weeks after implantation, new bone formation was found and increased with time prolonging. With the gradual degeneration of high resistance fire Bio-Oss bone meal, the bone mineral density at different time points of the simvastatin composite Bio-Oss group was lower than that of the simple Bio-Oss group (P<0.05). The percentage of bone formation in the simvastatin composite Bio-Oss group was significantly higher than that in the simple Bio-Oss group (P<0.05). Simvastatin could accelerate Bio-Oss degradation and promote new bone formation in bone defects repairing.

BACKGROUND:Studies have found that the platelet-rich plasma (PRP) can promote bone and soft tissue injury repair, but its effect on the process of bone healing is stil controversial.
OBJECTIVE:To contrastively observe the osteogenesis effect of PRP/Bio-Oss/Bio-Gide in the repair process of alveolar bone defect in rabbits, so as to explore the role of PRP in bone healing.
METHODSixteen New Zealand white rabbits were used to establish animal models of critical-size alveolar bone defect. One side was damaged randomly and repaired by PRP/Bio-Oss/Bio-Gide as experimental side, and the other side repaired by Bio-Oss/Bio-Gide as control side. Four animals were executed at each time-point, postoperative weeks 2, 4, 8, 12. Through general observation, X-ray radiograph, Cone Beam CT assessment, histological examination, the osteogenesis effect in the defect region was qualitatively and quantitatively analyzed.
RESULTS AND CONCLUSION:It could be know from each observation index that as time went on, the experimental and control sides had a different degree of new bone formation and the degradation-absorption of bone graft material. At 12 weeks, continuous cortical bone formation was seen on the surface of the experimental side, new bone formed and tended to be mature, obvious degradation of the bone graft was found, but those in the control side were not as good. At each time-point of 2, 4, 8, 12 weeks, the bone mineral density of the experimental side were lower than that of the control side (P<0.05), but the percentage of new bone area was larger than in the experimental side than the control side (P<0.05). These findings indicate that the PRP/Bio-Oss/Bio-Gide has a better osteogenesis effect than the Bio-Oss/Bio-Gide in the repair process of alveolar bone defect in rabbits, and PRP can promote new bone formation and degradation-absorption of Bio-Oss.

ObjectiveTo summarize the experience of nursing patients with heat illness combined with respiratory failure. Method The nursing records of 13 patients with heat illness combined with respiratory failure were reviewed for summarizing the nursing measures.Result After treatment and nursing care,12 of them were discharged and 1 died from multiple organ dysfunction. Conclusions Rapid cooling is key to the success of rescue.The nursing measures include keeping respiratory tracts unobstructed and preventing complications from artificial airway and mild hypothermia therapy.