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.

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.

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.

At present, there is no cure for acquired immune deficiency syndrome (AIDS) due to HIV-1 latent reservoirs. Therefore, it urgently requires novel HIV-1 latency-regulating agents with high potency, low toxicity and favorable drug-like properties to achieve a functional cure for AIDS. Herein, we reviewed the advances in HIV-1 latency-regulating agents since 2019, including the drug discovery strategies, bioactivities, and mechanisms of these compounds. It is of great guiding significance in the development of latency-regulating agents with clinical value.

Objective To discuss the application of run?through wire stretch technique in the procedure of endovascular therapy for complex subclavian artery occlusive diseases. Methods The clinical data of 22 patients who were diagnosed complex subclavian artery occlusive diseases were retrospectively analyzed from June 2013 to January 2016 in vascular surgery department of Wangjing Hospital .The patients were treated endovascular therapy using run?through wire stretch technique in all procedures successfully. Results The complex subclavian artery occlusive diseases were including long segment occlusion of the left subclavian artery and ostial stenosis or occlusion of the right subclavian artery. The left subclavian artery occlusion patients was 16 and right subclavian artery ostial stenosis or occlusion was 6. The technical success rate was 100%. All patients were using combination of femoral artery and brachial artery approach. Run?through wire stretch technique was used in the procedure of endovascular therapy, which had improved the technical success rate. After the treatment the symptom improvement rate was 88%. The symptoms of upper limb and posterior circulation ischemia were improved. Conlusion Upper limb artery combined femoral artery approachand run?through wire stretch technique can improve the recanalization in the procedure of endovascular therapy for complex subclavian artery occlusive diseases.

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.

Objective To investigate the misdiagnosed vascular vagovagla reflexes (VVR) and the treat-ments during interventional therapy for peripheral anerial disease (PAD). Methods The clinical data of 5 patients with VVRs from 128 PAD patients undergoing interventional therapy so as to analyse the causes for the misdiag-noses and then render pertinent treatment. Results The VVR in the 5 patients belonged to mixed type and all cas-es occurred after intervention and initially misdiagnosed. All patients were recovered well without adverse reaction. Conclusion Intervention therapy for PAD may be susceptible to VVR. Prompt management may bring in a good prognosis when VVR happens.

Objective To observe the changes of serum calcium, phosphorus, calcium-phosphorus product and para-thyroid hormone(PTH)levels after treatment with different concentrations of calcium dialysate in combination with calcitri-ol. Methods Thirty-six patients on maintenance hemodialysis were randomly divided into Dca1.25 group and Dca1.5 group, 18 cases in each group. Patients took different doses of calcitriol on the different values of PTH basis. Changes of se-rum calcium, phosphorus, calcium-phosphorus product,PTH and bone alkaline phosphatase (BAP) levels were recorded re-spectively on four time points from prior treatment and 1, 3 and 6 months of therapy. The levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were also observed. Results There was an interaction between treatment effects and time effects in serum calcium, phosphorus, calcium-phosphorus product levels in two groups (P＜0.05). With the dura-tion of treatment, there was a trended to decrease and increase respectively in DCa 1.25 group and DCa 1.5 group, and trend-ed to stabilize for therapy 3 to 6 months. There was no interaction between serum PTH and BAP levels and time effects in two groups. There was no statistical difference in simple treatment effects and time effects. The serum PTH level showed a trend of increase gradually in DCa1.5 group with the duration of treatment. In DCa 1.25 group, the serum PTH level trended to stabilize after 3-month therapy and showed a trend of decrease gradually. There was an interaction between treatment effects and time effects in SBP in two groups, but no interaction in DBP. There was a significant difference in SBP before and after treatment in two groups. The level of SBP reduced tardily with time of treatment and reduced significantly after 3 and 6-month therapy. Conclusion The application of DCa1.25 dialysate in combination with calcitriol decreased serum calci-um effectively and kept the lower limit of normal value, which increased tolerability of active vitamin D and calcium carbon-ate therapy, and decreased SBP in maintenance hemodialysis patients.

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.