Objective To analyze the characteristics in the incarcerated inm ate’s death, investigate the m ain cause of death of the incarcerated inm ate and provide som e inform ation for forensic investigation. Methods The cases from the forensic m edical center of Shanxi Medical U niversity from 2005 to 2013 were selected. The statistical analysis w as perform ed by using the incarcerated inm ate’s gender, age, cause of death, m anner of death, and disease as the m arkers. Results There were 100 men, 5 w omen in the 105 incarcerated inm ates;the age range w as from 16 to 65 years;Inm ates were mostly died of nat-ural diseases, m ainly in the respiratory and cardiovascular diseases;the m ain unnatural death w as suicide w ith a rate of 54.5%. Conclusion Atpresent, most incarcerated inm ate’s death are due to natural dis-eases. The prison should im prove incarcerated inm ate’s lives, w ork and health care conditions, and strengthen supervision of law enforcement.

Objective To summarize the computed tomography (CT),magnetic resonance imaging (MRI) and fluorine-18 fluorodeoxy glucose (18 F-FDG) positron emission tomography (PET)/CT features of abdominal non-organi lymphangioma.Methods The retrospective cross-sectional study was conducted.The clinical data of 16 patients with abdominal non-organi lymphangioma who were admitted to the Affiliated Hospital of Ningbo University (11 patients) and the Changhai Hospital Affiliated to the Second Military Medical University (5 patients) between January 2009 and December 2015 were collected.All the patients received CT,MRI and 18F-FDG PET/CT examinations.Observation indicators:(1) imaging examinations;(2) imaging features of CT and MRI;(3) imaging features of PET/CT;(4) treatment and follow-up.Operations were applied to patients based on agreements of patients and families after finishing preoperative examinations,and postoperative pathological examinations were also performed.Follow-up using outpatient examination and telephone interview was performed once every 6-12 months postoperatively up to July 2016.Results (1) Imaging examinations:of 16 patients,12 underwent plan and contrast-enhanced CT scans,5 underwent plan and contrast-enhanced MRI scans,2 underwent plan MRI scans and 1 underwent 18 F-FDG PET/CT scan.One patient underwent simultaneously CT,MRI and 18 F-FDG PET/CT examinations and 2 patients underwent simultaneously CT and MRI examinations.(2) Imaging features of CT and MRI:① Classification of lymphangioma:unilocular cyst,plurilocular cyst and lymphangiomatosis were detected in 6,9 and 1 patients,respectively.② Lymphangioma location:9 of lymphangioma located in the single regions (6 with unilocular cyst and 3 with plurilocular cyst),7of lymphangioma involved multiple regions (6 with unilocular cyst and 1 with lymphangiomatosis).③ Lymphangioma diameter:lesion diameter was 4-25 cm,with an average of 12 cm,and diameter in 9 of lymphangioma was more than 10 cm.④ Lymphangioma shape:3 lymphangiomas were regular-shaped,showing round-like changes,and 13 lymphangiomas were irregular-shaped,showing'moulding'-like changes.⑤ Internal structure of lymphangioma:internal structures in 12 patients undergoing plain CT scans presented as liquid low density,with homogeneous density and-10-19 HU of CT value.MRI scans in 7 patients showed low signal on T1WI and high signal on T2WI,with homogeneous signals.No bleeding was found inside the abdominal non-organi lymphangiomas of 16 patients.The fluid-fluid level was detected in 1 patient with lymphangioma due to bleeding in pathological changes of liver.The septa and wall thickness was less than 2 mm in 15 patients with lymphangiomas,and was more than 3 mm in 1 plurilocular cyst lymphangioma,showing a equal density and isointensities on T1WI and T2WI.There was no nodule and calcification in 16 patients.⑥ Lymphangioma boundary:15 patients had clear boundary of lymphangioma and 1 had an unclear boundary of lymphangioma.⑦ Extrusion of adjacent organs:lymphangiomas in 10 patients were local concave,showing arc-shaped impression and hilar depression,lymphangiomas in 4 patients showed surrounding blood vessels,and fat density or signal inside lymphangioma was found in 2 patients.There were no surrounding intestine and lymph node enlargement in 16 patients.⑧ Lymphangioma reinforcement:of 14 patients with contrast-enhanced scans,septa and wall of lymphangiomas demostrated slight enhancement in 13 patients and moderate enhancement in 1 patient,and all contents showed no enhancement.(3) Imaging features of 18F-FDG PET/CT:inhomogeneous uptake of FDG was manifested in 1 plurilocular cyst lymphangioma,metabolic activity of the lesion was slightly higher than liver,SUVmax=3.71.(4) Treatment and follow-up:14 patients underwent single resection of lymphangioma (6 with unilocular cyst and 8 with plurilocular cyst);1 patient with plurilocular cyst lymphangioma underwent resection of lymphangioma,descending part of duodenum,pancreatic head and ascending colon;1 patient with lymphangioma underwent splenectomy due to smaller lesion.Sixteen patients were confirmed with lymphangioma by postoperative pathological examinations.Of 16 patients,13 were followed up for 6-31 months,with a median time of 15 months.During the follow-up,12 patients had no recurrence,with satisfactory outcomes,and 1 with recurrence of lymphangioma underwent multiple cervical and thoracic resections under right arm and sclerotherapy.Conclusion Abdominal non-organi lymphangioma has some imaging characteristics,it usually manifests as a larger mass with plurilocular cyst,moulding,liquid density/signal,thin septa and wall and clearly boundary.Plurilocular cyst lymphangioma has uptake of 18F-FDG.

Objective To investigate the diagnosis and differential diagnosis value of multisequences magnetic resonance imaging (MRI) in autoimmune pancreatitis (AIP).Methods The MRI data of twelve AIP patients were retrospectively analyzed.The sequences of MRI included T1 weighted imaging,T2-weighted imaging,magnetic resonance cholangiopancreatography (MRCP),diffusionweighted imaging (DWI) and dynamic enhancement images.The location and involving extent of lesions,signal,patterns of dynamic enhancement,changes of pancreatic and biliary duct,pseudo-capsule sign and other accompanying signs were observed.Twelve pancreatic cancer patients and twelve other patients with normal pancreas were set as controls.The imaging signs of AIP group and pancreatic cancer group were compared with Fisher's exact test.On the sequence of DWI,the apparent diffusion coefficient (ADC) values of pancreatic interested region of the three groups were tested and compared with least significant difference t test.At each period of enhanced MRI,the intensity ratios of pancreatic interested region to the left paraspinal muscle at the same level of the three groups were measured and compared with Pillai's Trace test.Results Among 12 patients with AIP,seven were diffused lesion,four were localized lesion,and one was multiple lesions.Among 12 pancreatic cancer patients,one was diffused lesion,and eleven were localized lesion.The difference of these two groups was statisfically significant (Fisher's exact test,P＜0.01).Among 12 AIP patients,on the T1-weighted image,intensity decreased in nine lesions,two cases without obvious intensity decreasing,and one case unevenly increased.On the T2 weighted image,intensity slightly increased in nine lesions,equal in one case,and slightly lowered in two cases.The ADC value of the lesions of AIP group ((1.011 ± 0.118) × 10 3 s/mm2) was lower than that of normal pancreas group ((1.489 ± 0.072) × 10 3 s/mm2) and pancreatic cancer group ((1.274 ± 0.120) × 10 3 s/mm2),and the differences were statistically significant (t=-11.793,-4.300; both P＜0.01).Among 12 AIP patients,the pancreatic duct of the lesions was irregular segmental sclerosis and stenosis in four patients.Pseudo-capsule sign around the lesions of pancreas was seen in seven patients.Among 12 pancreatic cancer patients,the pancreatic duct of the lesions was stenotic in two patients while the pseudo-capsule sign wasn't found.The differences of these two groups were statistically significant (Fisher's exact test,both P＜0.01).Dynamic enhanced MRI showed that enhancement patterns of the lesions of both AIP and pancreatic cancer presented progressive enhancement.However,during the balanced period,the signal intensity ratio of AIP group (3.34±1.40) was significantly higher than that of pancreatic cancer group (2.38 ± 0.18),and the difference was statistically significant (F =60.703,P ＜ 0.01).Conclusion Combination of a variety of sequences of MRI can help to fully reflect the pathological and biological characteristics of AIP and increase the accuracy of diagnosis.

Objective To evaluate the feasibility of dopamine D2 receptor imaging agent (s)-(-)-N-(1-allylpyrrolidine-2-N-methyl)-5-(3-18F)-2,3-dimethoxy Benzamide (18F-Fallypride) for targeting islet cell imaging.Methods (1) Cytology experiment:Islet cells of 15×103 cells/well were incubated with 3.70 kBq/well 18F-Fallypride for 1 h and the uptake rate of cells was calculated (cell counts/(supernatant counts + cell counts)× 100％).Under the same experiment conditions,6 inhibiting groups were administrated with different concentration of dopamine inhibitors droperidol (1.0× 10-6,4.0× 10-6,2.0× 10-5,1.0× 10-4,5.0× 10-4 and 1.0× 10-3 mol/L,respectively).After 30 min,3.70 kBq of 18F-Fallypride was added to each inhibiting group,and the inhibiting rate was calculated.(2) Autoradiography:18 normal ICR mice were divided into 6 groups.For group A,ICR mice were injected with 18F-Fallypride (55 ± 5) MBq/mice through tail vein.For the other 5 inhibiting groups (group B-F),ICR mice were injected with different doses of droperidol (0.2,0.4,0.6,0.8 and 1.0 mg/kg,respectively),and after 30 min 18F-Fallypride were injected through tail vein.Ten minutes later,pancreas of ICR mice was taken for preparation of tissue section autoradiography.The data were analyzed by one-way analysis of variance and the least significant difference t test.Results (1) The 18F-Fallypride uptake rate of control group was (18.40± 1.21) ％.The uptake rates of inhibiting groups were (16.11±1.37)％,(15.76±0.99)％,(13.90±1.02)％,(8.86±0.73)％,(7.26±0.62)％ and (6.92±0.58)％,respectively,which decreased with the decreasing concentration of droperidol (F=50.01,P＜0.01).When the concentration of droperidol was 1.0× 10-4 mol/L,the uptake rate reached the lowest with inhibiting rate of 51.85％.(2) The autoradiography showed that the pancreas gray scale value of group A was 1.21×106 digital light units (DLU)/mm2.The pancreas gray scale value of groups B to F decreased with increasing concentration of inhibitor:0.93× 106,0.77× 106,0.59× 106,0.32× 106 and 0.25×106 DLU/mm2,respectively.Conclusions 18F-Fallypride may specifically and efficiently bind to dopamine receptors of islet cells.It may be a potential tracer for islet cells imaging.

Objective To establish acute hepatotoxic model induced by Amanita exitialis and to study the characteristics of acute toxic liver failure induced by mushrooms containing peptide toxins,in hope for providing some help to experimental research on poisoning induced by mushrooms containing peptide toxins.Methods UPLC-MS/MS (Ultra performance liquid chromatography-tandem mass spectrometry) method was used to detect peptide toxins in Amanita exitialis.To establish acute toxic liver hepatic failure model,the beagles were fed with 60 mg/kg of lyophilized powder of Amanita exitialis fungus which encapsulated in starch capsules.Toxic sighs were observed,coagulation function,hepatic and renal function,liver histopathological morphology,peptide toxin concentration in plasma and urine were detected during the experiment.Results Total peptide toxins in Amanita exitialis was (3 482.6 ± 124.94) mg/ kg.All the beagles had toxic signs including vomiting and diarrhea in 12-48 h after ingestion.On 24 h after ingestion,the beagles' ALT,AST,TBIL,ALP,PT and APTT levels increased obviously.On 36 h after ingestion,the beagles' ALT,AST,PT and APTT values reached their peaks (ALT:283.2 ± 112.9 Kallmann unit;AST:223.9 ±93.8 Kallmann units;PT:132.9 ± 152.6 s;APTT:131.4 ± 153.9 s).On 48 h after ingestion,the beagles' TBIL and ALP levels reached their peaks (TBIL:23.3 ± 14.6 mol/L;ALP:274.5 ± 115.5 U/L).The beagles' TBIL,TP and APTT returned to normal 1 week after ingestion,their ALT,AST and ALP levels returned to normal 3 weeks after ingestion.Three dogs died during 24-72 h after ingestion.Liver histopathological morphology study showed hemorrhagic necrosis of hepatocytes.Peptide toxins can be detected in plasma within 24 h after ingestion.Peptide toxins can be detected in urine within 96 h after ingestion.Conclusion Amanita peptide toxins can cause hemorrhagic necrosis of liver cells and lead to acute liver failure.This model is consistent with clinical pathophysiological process of acute toxic liver failure induced by mushrooms containing peptide toxins,and it can be applied to the study of diagnosis and treatment of poisoning induced by mushrooms containing peptide toxins.

Objective To evaluate imaging features and clinical significance of anatomical variations of the dorsal pancreas.Methods CT and MR imaging data of 47 cases with variations of the dorsal pancreas were collected.Imaging characteristics of the dorsal pancreas were analysed.Results (1) Narrow dorsal pancreas:the agenesis of dorsal pancreas (7 cases) appeared as short pancreas,their length was (91.59 ± 22.39) mm.4 cases of pancreatic head volume increased,with tadpole-like retention of the pancreas,including 3 cases of annular pancreas.2 cases with polysplenia syndrome and congenital abscence of the hepatic segment of inferior vena cava.(2) Abnormaly enlarged dorsal pancreas:①the broadening of the pancreatic tail (n =18):the maximum diameter of pancreatic tail was (36.12 ± 6.59) mm,the pancreas was similar to the dumbbell-shaped.②Processes locally of pancreatic contour (n =13),which were local process at the ventral aspect of pancreas,the height was (15.72 ±2.65) mm,the width was (18.59 ± 3.64) mm,most often seen on the neck of the pancreas.(3) Dorsal pancreas related divisium:①Pancreas separated by fat spatium (n =7),the width was (3.51 ± 2.42),the deepness was (19.45 ± 5.84),it showed the crack-like fat density (signal) shadow,5 cases (5/7) located in the pancreatic body and tail,2 cases (2/7) located at the junction of ventral pancreas and dorsal pancreas.②The bifurcation of the pancereatic tail (n =3),limitations forked tail of the pancreas was dovetail-like performance.The maximum width diameter was (26.63 ± 1.75) mm,the bifurcation angle was (99.27 ± 30.73) degrees.Conclusions The developmental anomalies of dorsal pancreas can lead to a number of variations of pancreas,some of which can induce corresponding disease and be mistaken for neoplasm.

Objective To investigate the effect of exogenous vascular endothelial growth factor (VEGF) on bone activity of rabbit heterotopic allograft decalcified bone.Methods 140 adult healthy China white rabbits were selected,no limitation with sex,20 rabbits as the donor preparation of allogenic decalcified bone,according to the random number table,the rest was divided into the experimental group (allograft decalcified bone ± VEGF) and the control group (Allograft decalcified bone),each group contained 60 rabbits.For the experimental group,the prepared 1.5 cm long homologous decalcified tibia was placed in rabbit right thigh of rectus femoris and vastus medialis muscle gap near by saphenous artery,and fixed on the femur with two 0.8 mm Kirschner wire.In the vicinity of the skin,implanted an osmotic pump which contain the VEGF solution 200 μl with concentration was 0.5 μg/ml.In the control group,implanted the isometric allograft decalcified bone in rabbit right thigh corresponding parts with the same method.Each group respectively at 0,2,4,6,8,10 weeks to death 10 white rabbits,By specimen observation,HE dyeing observation and detection of type Ⅰ glue protein fluorescence intensity,Analysis the bone activation degree of two groups of bone allograft decalcified.Results Experimental allograft decalcified bone gradually wrapped by connective tissue membrane,its surface appear different size of the pits and gradually increased and become deep,while the control group pits relatively little and shallow.In the experimental group and control group,the fluorescence intensity of type Ⅰ collagen reached its peak respectively at 8 weeks (47.57 ±3.50) and 10 weeks (45.07±6.02),with no statistically significant (P ＞ 0.05).Conclusion Rabbit allograft decalcified bone implanted in the muscle clearance with abundant blood supply can be transformed into activated bone after 10 weeks,and after applying exogenous VEGF,allograft decalcified bone can be transformed into activated bone after 8 weeks,the bone activation process obviously speed up.The reaults confirmed the exogenous VEGF can obviously promote the ectopic rabbit bone allograft decalcified bone activation process.

Objective To investigate the correlativity between elasticity modulus and pathological severity in chronic pancreatitis (CP).Methods Twenty-one pigs were divided randomly into experimental group (n=18) and control group (n=3) using random number method.The main pancreatic duct (MPD) was incompletely ligated to establish the CP model.In control group, MPD was not ligated.The animals were killed in batches at 4th, 8th and 12th week after surgery.The pancreatic tissue was taken for elasticity modulus test and pathological examination, and the pigs were classified into control, mild, moderate and severe groups based on the severity of fibrosis.Cell density, fat infiltration and extracellular edema were observed and classified into mild and severe.The difference of elasticity modulus among different groups were compared by Variance analysis, the correlation between pancreatic fibrosis and elastic modulus was analyzed with Spearman correlation analysis, and ROC curve was used to evaluate its efficacy of diagnosing CP.Results Sixteen CP models were established successfully expected for 2 deaths (mild, n=7;moderate, n=2 and severe, n=7).All of the control group (n=3) showed normal pancreas.The elasticity modulus of control, mild and moderate to severe group were 0.4268±0.0566, 0.3203±0.0518 and 0.2235±0.0685, respectively.The difference between the groups was statistically significant (F=13.658,P<0.01), and the elastic modulus and pathological grade had a negative correlation (r=0.969, P<0.01).AUC of elasticity modulus for differentiating normal and mild CP was 1.000, the best critical value was 0.3807, and both the sensitivity and specificity of the diagnosis were 100%.AUC for differentiating mild and moderate to severe CP was 0.8730, the best critical value was 0.2646, and the sensitivity and specificity of the diagnosis were 85.7% and 77.8%, respectively.The pancreatic elasticity modulus of low parenchymal cell density group and high parenchymal cell density group were 0.1931±0.0373 and 0.3485±0.0655, respectively, which in the high cell density group was significantly higher than that in the low cell density group (t=-5.719, P<0.01).The elasticity modulus of negative infiltration or slight fatty infiltration group and severe fatty infiltration group were 0.3401±0.0697 and 0.1855±0.0344, respectively, which in the negative infiltration or slight infiltration group was significantly higher than that in severe infiltration group (t=5.102, P<0.01).The elasticity modulus of negative or mild cell edema group and moderate to severe cell edema group were 0.2760±0.0825 and 0.3024±0.1056, respectively;there was no statistically significant(t=-0.586, P >0.05).Conclusions The elasticity modulus can be used to detect the pathological changes of CP, and evaluate the CP pathologic grades.

Objective To investigate the correlativity between secretin-stimulated magnetic resonance cholangiopancreatography (sMRCP) findings and pathological severity in a swine chronic
pancreatitis (CP) model. Methods Thirty-nine swine were divided randomly into control group (n=12) and experimental group (n= 27). In experimental group, the main pancreatic duct (MPD) was incompletely ligated to establish the model of obstructive CP. In control group, laparotomy was performed but without ligating the MPD. At the 4th, 8th and 12th week after modeling, one third swine of each group were undergone a series of dynamic sMRCP scans before (0 min) and at 1, 3, 5, 7, 9, 11 min after administration of secretin (0.6 μg/kg). And the MPD diameter and duodenum filling (DF) degree were measured. All survivals were sacrificed to pathological examination including HE and Van Gieson staining for histopathological grading. According to pathological severity, swine were divided into normal group, mild CP group and moderate to severe CP group. MRI features and indexes, including baselined diameter (BD), end diameter (ED), maximum diameter (MD), the largest expansion rate (LER), time to peak (Tpeak) and end change rate of pancreatic duct and duodenal filling (DF) scores were measured. The relationships between pathological grading and sMPCP indexes were analysed. The comparison of sMRCP data among the 3 groups were used ariance analysis, χ2 test and U test. Correlations between sMPCP indexes and pathological severity were tested using Spearman rank correlation coefficients. The diagnostic efficiency of sMRCP indexes were evaluated by ROC method. Results (1) In experimental group, 22 CP models were established and 19 CP swine (mild CP, n= 8; moderate and severe CP, n=11) were performed sMRCP successfully. Eleven swine in normal group were obtained satisfactory MRCP images. (2) sMRCP results:BD of 3 groups were (1.56 ± 0.46),(2.95 ± 1.17),(7.41 ± 1.91) mm, respectively. ED were (1.49 ± 0.31),(2.96 ± 1.17) and (7.37±1.90) mm, respectively. MD were (2.39±0.43),(3.91±1.27) and (7.86±1.87)mm, respectively. The median of LER were 42.10%, 34.85% and 6.58%, respectively. The median of DF scores were 3, 3, 2, respectively. The differences of above indexes have statistically significance (P values were all<0.01). There were correlation between sMRCP indexes (BD, ED, MD, LER and DFscores) and pathological severity (r values were 0.89, 0.92, 0.90,-0.85,-0.66, respectively and P values were all<0.01). Tpeak and end change rate of pancreatic duct had no significant differences (P values were>0.05),and no correlation with pathological severity(P values were all>0.05).For differential diagnosis between normal and mild CP, the area under ROC of BD, ED, MD, LER and DFscores were 0.915, 0.977, 0.926, 0.778 and 0.472, respectively and differential diagnosis between mild CP and moderate to severe CP group, the area under ROC were 0.966,0.966,0.960,1.000 and 0.915, respectively. Conclusions sMRCP findings of CP have characteristics and could be used for in vivo evaluation on the CP pathologic grades.

Objective To evaluate preoperative apparent diffusion coefficient (ADC) and exponential apparent diffusion coefficient (eADC) in diffusion weighted imaging (DWI) on microvascular invasion (MVI) of hepatocellular carcinoma (HCC).Methods We retrospectively reviewed 43 HCC patients with DWI data confirmed by surgery and pathology.ADC and eADC values were measured both in neoplasm and hepatic tissue,the ratio of tumor to liver (T/L) on ADC and eADC was calculated.The correlation between MVI and ADC value,T/L of ADC value,eADC value and T/L of eADC value was analysed,the best cut-off value of variables was analysed by ROC curve,multi factor analysis was carried out by Logistic regression model.Results The ADC value,T/L of ADC,eADC value and T/L of eADC were (1.458 ± 0.444) × 10-3 mm2/s,0.787 ± 0.186,0.289 ± 0.144 and 1.383 (1.179,1.655),respectively.Among them,the positive MVI group were (1.232 ± 0.480) × 10-3 mm2/s,0.683 ± 0.229,0.323 ±0.123 and 1.630(1.387,2.066),respectively.The negative MVI group were(1.545 ±0.404) × 10-3mm2/s,0.844 ±0.149,0.277 ±0.152 and 1.303(1.176,1.545),respectively.There was significant difference in ADC value,T/L of ADC value and T/L of eADC value (t =2.164,2.654,z =-2.058,all P ＜0.05),the area under the ROC curve were (1.085 × 10-3) mm2/s,0.685 and 1.475 using MVI as a diagnostic standard.Multivariate analysis showed that T/L of ADC value was an independent factor affecting MVI of HCC (OR=0.002,95％CI:1.380E-5-0.311,P＜0.05).Conclusions The ADC value in HCC patients with positive MVI is lower than in HCC patients with negative MVI,T/L of eADC value is higher than in HCC patients with negative MVI,and T/L of ADC value is an independent factor predicticing MVI of HCC.