Eighteen cases of forensic re autopsy and histopathological re examination were analyzed retrospectively. The manner and the impression of original autopsy,times of autopsy,the reason and manner of forensic re autopsy,the interval betwwen the original autopsy and the re autopsy as well as the last conclusions were analyzed.It was found that the forensic re autopsy always occured in cases of medical disputes(3 cases,16 7%) and death related to the police investigation(4 cases,22 2%).Only external examination and incomplete forensic autopsy were done originally in 13 out of 18 cases(72 2%).The conclusions of re autopsy were completely different from that of the original autopsy in 5 cases.Attension must be paid and prevention measures for re autopsy must be adopted were also discussed.

Humans ; Blast Crisis/genetics* ; Leukemia, Promyelocytic, Acute/genetics* ; Oncogene Proteins, Fusion/genetics* ; Tretinoin

Metastatic encephaloma from lung carcinoma is one of the nost common intracranial tumors,which is paid to more and more attentions in Neurosurgery.Patients with metastatic neoplasm suffer great physiological and psychological pain for short survival time and survival of poor quality.In terms of treatment,surgery is the major method for metastatic encephaloma of lung cancer.But the subject range of surgery is limited to many factors,therefore many patients can not be treated with surgery.In order to solve the issue of applicability restriction,diversified adjuvant treatment strategies appear successively,such as chemotherapy,targeted therapy,immunotherapy.It has been verified by a number of clinical evidences that these therapies can prolong lifetime and improve living quality of patients.But at the present stage,there is no an uniform standard for the treatment of metastatic encephaloma from lung carcinoma.To give full play the role of each treatment,it is important to understand the advantages and disadvantages.Only in this way,can the patient's interests be optimized.

Arthroplasty, Replacement, Hip ; Female ; Femoral Neck Fractures/surgery* ; Humans ; Osteoporosis/surgery* ; Pregnancy

Objective Tricuspid regurgitation is often associated in patients with congenital heart disease. Significant morbidity and mortality are related to tricuspid valve replacement. Tricuspid valve plasty is still a preferred choice. This report deals with our surgical experience in using edge-to-edge valve plasty technique to correct severe tricuspid regurgitation in patients with congenital heart disease. Methods From April 2001 to Mar. 2010, severe tricuspid regurgitation was corrected with a flexible band anuloplasty and edge-to-edge valve plasty technique in 14 patients with congenital heart disease. The age ranged from 7 years to 62 years [average (31.2 ± 16.1 ) years]. Congenital cardiac anomalies include: atrioventricular canal in 5 cases, secundum atrial septal defect in 6 cases, secundum atrial septal defect with mitral valve regurgitation in 2 cases and cor triatriatum in 1 case. Results No hospital death or postoperative morbidity occurred. No or trivial tricuspid regurgitation was present in 11 cases and mild tricuspid regurgitation in 3 cases at discharge. The follow-up ranged from 3 month to 97 months [average (51.6 ± 26.8 ) months]. No tricuspid stenosis was found. No or trivial tricuspid regurgitation was present in 5 cases. Mild tricuspid regurgitation was present in 8 cases, and moderate tricuspid regurgitation in 1 case at the latest followup. Conclusion Edge-to-edge valve plasty is an easy, effective and important procedure to correct severe tricuspid regurgitation in patients with congenital heart disease.

OBJECTIVETo investigate the applied anatomy of the superficial peroneal artery perforator flap and report the clinical results of repairing the soft tissue defects with free perforator flaps.

METHODS15 fresh cadavers were injected with a modified lead oxide-gelatin mixture for three-dimensional visualization reconstruction using a 16-slice spiral computed tomography scanner and specialized software (Materiaise's interactive medical image control system, MIMICS). The origin, course and distribution of the superficial peroneal artery perforator in the anterolateral leg region were observed. Clinically 6 cases with hand defects and 6 cases with feet defects were treated with free superficial peroneal artery perforator flap transplantation. The defect size ranged from 3.0 cm x 4.5 cm to 5.0 cm x 11.0 cm.

RESULTSThe diameter of the superficial peroneal artery is (1.2 +/- 0.3) mm at its origin from the anterior tibial artery 5 cm below the fibula head. It is (5.6 +/- 1.8) cm in length. This artery is truly anastomosed with other perforators to form the chain of superficial peroneal nerve accessory artery. The superficial peroneal artery perforators [outer diameter (0.7 +/- 0.2) mm] with a vein are in the anterolateral leg region, supplying the skin in proximal-middle region. All the 12 cases were treated successfully. The clinical results were satisfactory after 3-12 months of following-up.

CONCLUSIONSThe superficial peroneal artery perforator flap has constantly, reliable blood supply, and good texture. It is a good option for repairing soft-tissue defect with free transfer.

Cadaver ; Fibula ; Foot ; Foot Injuries ; surgery ; Free Tissue Flaps ; blood supply ; innervation ; transplantation ; Hand Injuries ; surgery ; Humans ; Leg ; Perforator Flap ; blood supply ; innervation ; transplantation ; Peroneal Nerve ; Soft Tissue Injuries ; surgery ; Tibial Arteries

Objective: To evaluate the clinical observation of rectal prolapse by partial perineal rectal sigmoidectomy. Methods: Sixty patients with rectal prolapse who met the diagnostic criteria of rectal prolapse in Yiwu Central Hospital from April 2013 to June 2015 were selected as the research subjects.They were divided into two groups according to random number table, with 30 cases in each group.The observation group used Altemeier, and the control group underwent triple surgery (rectal mucosal ligation, periorbital injection, and anal ring retraction). The total effective rate after surgery was compared and analyzed. Results: The operation of the two groups was successfully completed.The total effective rate of the observation group was 96.67%, which was significantly higher than 80.00% of the control group, the difference was statistically significant(χ²=5.856, P=0.048). The Wexner constipation score of the observation group was (1.4±1.6)points, which was significantly lower than that of the control group[(3.2±2.0)points, t=3.849, P<0.05]. The Wexner anal incontinence score of the observation group after 24 months was (2.9±1.8)points, which was significantly lower than that of the control group [(4.4±2.7)points, t=2.532, P<0.05]. The proportions of anastomotic bleeding, pelvic swelling and perianal eczema in the observation group were 0.00%, 0.00% and 3.33%, respectively, which were significantly lower than those in the control group(20.00%, 23.33% and 30.00%, χ²=4.630, 5.822, 7.680, all P<0.05). Conclusion Altemeier can significantly improve the quality of life of patients, with a high cure rate and good clinical results.

OBJECTIVETo investigate the changes in cytokines (IL-1beta, IL-2, TNF-alpha) of peripheral blood and cervical mucous of infertile women with mycoplasma infection and the effect of intervention of traditional Chinese medicines (TCMs).

METHODAccording to the results of culture of mycoplasma from genital tracts, 72 patients with positive mycoplasma were randomly divided into the TCM group (38 cases) and the western medicine group (34 cases). The western medicine group was treated with 0.5 g azithromycin for 3 days and consecutively treated for six courses of treatment, each course of treatment of 4 days. The TCM group were treated with Xiaozhi decoction twice every day for 6 weeks. The IL-1beta, IL-2 and TNF-alpha levels of the peripheral blood and cervical mucous of the two groups were measured by the Ria testing before and after the treatment, and the mycoplasma culture (-) of 32 infertile women as set for control.

RESULTBefore the treatment, TNF-alpha and IL-1beta in levels of the two treatment groups were higher than those of the control group (P < 0.01). In the TCM group, TNF-alpha and IL-1beta levels showed significant differences compared with those before the treatment (P < 0.05) and those of the western group after the treatment (P < 0.01); and IL-2 level didn't have significant change before and after the treatment. The cytokines in peripheral blood of the two treatment groups showed notable difference compared with those of the control group (P < 0.01). In TCM group, IL-2 level had remarkable difference compared with that before the treatment (P < 0.01) and compared with the control group after the treatment (P < 0.01).

CONCLUSIONCytokines (IL-1beta, IL-2, TNF-alpha) in the peripheral blood and cervical mucous increase in infertile women with the mycoplasma infection, suggesting that TCMs can effectively inhibit the levels of IL-1beta, IL-2, TNF-alpha in the peripheral blood and IL-1beta, TNF-alpha in cervical mucous. It is proved that Xiaozhi decoction can be used to treat infertile women with mycoplasma infection.

Adult ; Cytokines ; blood ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Infertility, Female ; blood ; complications ; drug therapy ; immunology ; Mycoplasma Infections ; blood ; complications ; drug therapy ; immunology ; Young Adult

In order to investigate the impact of fulvic acid (FA) on the hydroxylysyl glycosylation in collagen bio-synthesis, 40 NMRI mice were divided into two groups (n = 20 in each group, consisting 10 females and 10 males). The animal was maintained for two generations by different diets: control group with normal water and food and study group with water containing 30 mg/L FA and normal food. The second generation of the animal was slaughtered, and the biochemical parameters of collagen content and the degree of collagen hydroxylysyl glycosylation in skin, rib and tibia were detected by biochemical methods. The mean value of collagen in the study group was increased slightly, and no significant difference between study group and control group was found (P > 0.05), but the content of glucose-glactose-hydroxylysine (GGH) was significantly decreased in the study group in comparison with the control group (P<0.01). It was suggested that through the decrease of GGH 30 mg/L FA could inhibit the activity of galactosyl-hydroxylysylglucosyl-transferase and further disturb the post-translational modification of collagen intracellularly.
Benzopyrans/*pharmacology ; Bone Development ; Bone and Bones/chemistry ; Bone and Bones/*metabolism ; Collagen/*biosynthesis ; Glycosylation ; Hydroxylysine/*metabolism ; Mice, Inbred Strains ; Osteoarthritis/etiology ; Selenium/deficiency

Objective To screen and analyze nucleotide variants in 5'-untranslated region(5'-UTR)in voltage-gated sodium channel α1-subunit gene(SCN1A)in patients with Dravet syndrome and to evaluate the association of the variants with disease.Methods Peripheral blood of 24 patients with Dravet syndrome and 100 unrelated normal persons were collected and genomic DNA was extracted.PCR-sequencing of SCN1 A 5'-UTR in these DNA was performed.To evaluate the possibility of mutation inducing disease,bioinformatics analysis was applied to analyze the conservation of the sequences around the mutation site and predict the potential transcription elements.Results The nucleotide variant of 166.642.520G→A in exon 2 was identified in two patients,but not in normal controls.The mutation was a de novo mutation in a patient with early-onset.In the second proband,the mutation was also carried by his clinically asymptomatic mother.The nucleotide site 166.642.520 was moderately conserved in mammals(62.5%).The average nucleotide identity rate between human and other mammals species in the region adjacent to 166.642.520 was 88.5%.Two potential transcription regulatory elements were predicted on the sequence with the mutation of 166.642.520G>A,and only one on the sequence with wild-type.Conclusions The mutation 166.642.520G>A may be associated with Dravet syndrome and further studied should be performed to verify it and demonstrate its pathogenic mechanisms.