BACKGROUND: Psychological behaviors play an important role in children accidental injury, and children with a tendency of accidental injury display specific psychological properties in characters and behaviors.OBJECTIVE: To investigate the difference of personality and behavioral characters between normal children and children with a tendency of accidental injury.DESIGN: Case controlled analysis based on suffered children and normal hildren.SETTING: Department of pediatric in a civic hospital.PARTICIPANTS: Totally 131 accidental injured children aged from 7 to 11 years were admitted at Tengzhou Civic center hospital between January and December 2001. Those with congenital intellectual disturbance and brain trauma were excluded and the rest 89 cases were asked to fill questionnaire, 8 were removed from the study due to unintegrated data and 81pieces of integral data were collected (reclaiming rate of 91.01%), including 50 males and 31 females with the mean age of (8.59±1.86) years, the intelligence quotient was(96±15) determined by Peabody picture vocabulary test(PPVT); and 81 children in control group matched in age and sex were selected from healthy children of school age without injury history and similar in some aspects, such as parents' culture degree, economic condition, educational state and the economic and culture state of inhabitancy with control group, including 45 males and 36 females with the mean age of (8.92±1.73) years, the intelligence quotient was(98±18) by PPVT. Two groups were matched in sex, age and IQ(P＞0.05).METHODS: Eysenck personality questionnaire and Achenback children behavioral rating scale(parents rating scale) were used.RESULTS: Data of two groups with 81 questionnaires in each entered into the final analysis without loss. ① Scores for psychoticisim, introverted and extroverted character and neurological quality in Esonk personality question naire were(50. 01±10.58, 55.19±12.1, 57.35±10.12) in injury group, higher than corresponding(45.63±13.81, 48.09±6.49, 50. 01±10.39)in control group( t = 2. 27-4.65, P＜0.05) . Scores for modified rating scale was(49.42±10.42) in control group, higher than(39.65±13.03)in injury group( P＜0.001); ② The median was found higher in hyperactivity, aggression, violation of discipline, bad communication, split anxiety,depression and physical complaint in boys of injury group; as well as in hyperactivity, cruelty, aggression, depression, physical complaint, social retreat, violation of law in girls of injury group, comparing to control group(P＜0.001); ③ Positive behavioral detecting rate of injury group was 32.09% (26/81), higher than 11.11% (9/81) of control group(P ＜0.001), OR was 3.78, and 95% CI was 1.66-8.59. Behavioral factors was proved of lower sensitivity(32. 1% ) with specificity of 88.9% and higher prognostic value of 74. 3%; ④ The mean score for Achenback children behavioral rating scale was(39. 84±10. 99) in boy which was obviously higher than(34.26 ± 10.43) in girls of injury group( P ＜0.05). The edian for violation of discipline and aggression in boys and depression in girls were significantly higher than the opposite sex group(P＜0.05 or 0.01) . The mean score for Achenback children behavioral rating scale was (37.62±11.03) in injury group, which were obviously higher than (17.77±12.12) of control group( P＜0.01) . ⑤Results of multiple factors Logistic analysis revealed that the risk factors for accidental injury included: aggression, hyperactivity and iolation of discipline in boys and aggression, violation of discipline and depression in girls.CONCLUSION: Children with a tendency of accidental injury has obvious ehavioral problems, behavioral factors were proved of lower sensitivity, but of igher specific positive prognostic value. Both boys and girls displayed speific characters in aggression and violation of discipline, and lack of pretendng capability comparing to normal children, thereby liable to response in on-rational manner.

In drowning cases, it is difficult to judge whether the deceased died from drowning or throw-ing into the water after killed or identificate the cause of death of the decom posed corps in forensic practices. The diatom test is still considered as the im portant assistant evidence in drowning cases. This paper reviews research progress on technologies in recent years of forensic diatom test, and the applica-tion value of the newdeveloping approach in the field of forensic m edicine.

Objective T o explore the application value of postm ortem com puted tom ography (C T ) an-giography on diagnosis of coronary atherosclerotic stenosis degree. Methods B ased on the previous ex-perim ental results, the postm ortem C T angiography device of hum an isolated heart w as im proved. D iffer-ent coronary atherosclerotic stenosis degree of sudden death cases w as selected. B efore the cardiac anatom y, hearts w ere rem oved out com pletely and C T angiography w as perform ed im m ediately. T he C T angiography results w ere com pared w ith histopathological findings. M eanw hile, the advantages and disad-vantages of the angiography device before and after im provem ent w ere com pared. Results T he im proved angiography device of isolated heart could get better im aging results. T he postm ortem C T angiography results had high consistency w ith the histopathological findings on diagnosis of coronary atherosclerotic stenosis degree. A nd the coronary artery lesions could be revealed m ore objectively and vividly by 3D reconstruction technology. H ow ever, C T angiography could only be used to exam ine the pathological changes of blood vessels, w hich m ight have som e lim itations on the diagnosis of cause of death. Con-clusion Postm ortem C T angiography can be used as an additional m ethod for the conventional autopsy in the cases of coronary atherosclerosis.

Objective To evaluate the clinical effect of treatment for deep burn wound on finger by proper digital artery flap.Methods From March 2013 to October 2016, 24 patients with deep burn wound on finger were treated by proper digital artery flap.Postoperative observation included wound repair, flap survival, complications and functional recovery of fingers.Results All the 24 flaps survived and no necrosis happened.The marginal abnormal circulation of flap occurred in only 5 cases, which cured by dress changing.All flaps kept well in contour, skin color, temperature and texture.Movement function of donor and recipient fingers was nearly normal.Conclusion Proper digital artery flap avoided the deficiencies distant pedicled flap, so it is a favorite choice for digital soft tissue defect caused by deep burn injury.

A 45-year-old male car driver died in a traffic accident of four cars rear-end collision on the highway. He was found to have died after a respiratory and cardiac arrest at the scene. No sign of skin injuries was observed from the external inspection. The autopsy was not permitted by the family members because of the local culture. Multislice computed tomography (MSCT) was applied to the current case, showing dislocation of C3~4 cervical vertebrae with Ⅱ degree, C4 vertebral plate fractures, and spinal stenosis. Post-mortem MSCT confirmed the diagnosis as whiplash injuries. MSCT was verified to be effective in showing the severity of whiplash injuries, thus providing certain objective evidence for medicolegal expertise.

Postm ortem chem istry is becom ing m ore and m ore essential in routine forensic pathology and has m ade considerable progress over the past years. B iochem ical analyses of vitreous hum or, blood, urine and cerebrospinal fluid m ay provide im portant inform ation in determ ining the cause of death or in elucidating forensic issues. Postm ortem chem istry m ay be essential for the determ ination of cause of death w hen m orphological m ethods (diabetes m ellitus, alcoholic ketoacidosis and electrolytic disorders) cannot detect the pathophysiological changes involved in the death process. It can also provide m any in-form ation in other forensic situations, including m yocardial ischem ia, sepsis, inflam m ation, infection, ana-phylaxis and horm onal disturbances. T he m ost recent relevant research advances on glucose m etabolism , liver function, cardiac function, renal function, sepsis, inflam m ation, infection, anaphylaxis and horm onal aspect are hereby review ed.

Objective To explore the application value of multi-slice spiral computed tomography (MSCT) in traffic accidents through observing and analyzing the injury features of the accidents. Methods Two fatal cases caused by traffic accidents were fully examined using MSCT, 3D imaging reconstruction and angiography through cardiac puncture. The features of traffic injury mechanism were analyzed through combination of MSCT and postmortem external examination. Results In case 1, right cardiac rupture was found by MSCT and angiography through cardiac puncture. The cause of death was cardiac tam-ponade and right ventricular rupture due to the crush injury of chest in the traffic accident. In case 2, splenic rupture and intra-abdominal hemorrhage was found and caused by injury of left trunk by MSCT. The cause of death was hemorrhage and traumatic shock. Conclusion MSCT could observe skeletal in-jury, soft tissue injury, and hematologic disorder well. The combination use of MSCT and angiography through cardiac puncture provided assistance to the diagnosis of cardiovascular system injury.

Objective To explore the curative effects of external fixation in the treatment of infected nonunion.Methods From June 2009 to December 2016,45 patients with infected nonunion were treated by external fixation at Department of Orthopaedics,West China Hospital.They were 36 males and 9 females with an average age of 45.3 years (range,from 14 to 65 years).The sites of fracture included tibia in 31 patients,femur in 12,humerus in one,and ulna-radius in one.The median time from injury to application of external fixation was 16.8 months and the average number of previous operations was 2.3 times.After debridement,24 cases had a bone defect of 6.0 cm in length on average (range,from 3.5 to 10.4 cm).After discharge,the patients were regularly followed up at the outpatient department and any of their complications was recorded in detail.At the final follow-ups,the protocol of ASAMI (Association for the Study and Application of the Method of Ilizarov) was used to evaluate their bone and functional results.Results All the 45 patients were followed up for 16 to 106 months (average,43.9 months).One patient had to receive amputation because of uncontrollable infection and all the other 44 cases achieved bony union.The bone defects were successfully reconstructed by external bone transport in 24 patients.The time for external fixation averaged 20.5 months.According to the evaluation by ASAMI at the final follow-ups,the bone was rated as excellent in 28 patients,as good in 12,as fair in one and as poor in 3,giving an excellent to good rate of 90.9％;the function was rated as excellent in 11 patients,as good in 21,as fair in 8 and as poor in 4,giving an excellent to good rate of 72.7％.Conclusion In eradication of infection and treatment of fracture nonunion,external fixation can be used not only to avoid the infection risk due to internal fixation but also to correct a complex deformity and repair a large bone defect,allowing early weight-bearing for the patients.

OBJECTIVETo report a case of primary cardiac plasmablastic lymphoma to investigate its clinical feature, diagnosis, therapy and prognosis.

METHODSA case of primary cardiac plasmablastic lymphoma was studied. The imaging examination, conventional histopathological and immunohistochemical staining of this case were detected. The clinical feature, pathogenesis, diagnosis, therapy and prognosis of primary cardiac plasmablastic lymphoma were further investigated through literatures review.

RESULTSThe tumor was located in the right atrium. Microscopic examination showed diffuse proliferation of large lymphoid cells. The neoplastic cells were positive for CD38 and CD79a. The patient was treated with chemotherapy combined with autologous stem cell transplantation.

CONCLUSIONPrimary cardiac plasmablastic lymphoma was extremely rare. Its pathogenesis remained to be unclear. With non- specific clinical manifestations, the diagnosis was mainly confirmed by histopathological and immunohistochemical staining method. Without standard treatment, more patients were treated with chemithreapy regimens similar to the treatment used in aggressine lymphoma. Patients usually had a poor prognosis.