ObjectiveTo screen and collect the cases of unnatural death in custody and analyze the in-fluences and forensic characteristics.MethodsTotal 25 cases of unnatural death in detainees in custody form 2000 to 2015 were collected. Some forensic characteristics such as gender, age, yearly incidence, causes of death, manner of death were analyzed. The public security custodies were also compared with the prisons.ResultsAll dead involved were male, mostly were young and middle-aged adults. It showed that the number of cases tended to decrease year by year. The incidence of the injury cases were higher in public security custodies(64.7%)than that in the prisons(12.5%). However, there was a higher sui-cide rate in prisons(62.5%)than that in public security custodies(23.5%). The mainly cause of death were injury and asphyxia, there were also some cases died from intoxication and electricity.Conclusion The cases of unnatural death in custody expose some problems such as the imperfectness of law en-forcement standardization, supervision loopholes and poor medical standards. A comprehensive and de-tailed autopsy has important implications for the identification of cause of death in custody.

ObjectiveTo evaluate morphometric changes of brain in patients with alcohol addiction by voxel-based morphometry. MethodsFifteen patients with alcohol addiction and 15 health controls were recruited and underwent fluid attenuated inversion recovery (FLAIR) and 3D fast spoiled gradient echo (FSPGR) T1 -weighted sequences on a 3.0 T MRI system. 3D FSPGR T1 structure images were normalized,segmented and smoothed, and then underwent voxel-based morphometry. An ANCOVA was applied with age,body mass index ( BMI ), and education years as covariates because of exact sex match.A statistical threshold of P ＜ 0. 01 (uncorrected) and more than continuous 50 voxels were determined as significant.ResultsRegional results showed there was a significant reduction of gray matter volume in left middle frontal gyrus, superior frontal gyrus, precuneus, gyrus rectus, right medial superior frontal gyrus and orbital gyrus in patients with alcohol addiction compared with health controls, and the regional reduction of white matter volume in patients with alcohol addiction mainly located in the white matter of bilateral superior frontal gyrus. Global brain volume analysis showed there was a significant smaller volume in white matter [ (675. 14 ± 70. 62) ml]and brain parenchyma [ ( 1578. 81 ± 199. 05 ) ml]for patient group than that in white matter [ ( 841.33 :± 177. 35 ) ml]and brain parenchyma [ ( 1722. 13 ± 117.62) ml]for control group (t ＝ 11.37,5. 764, respectively, P ＜0. 05 ), but there was no difference in the gray matter volume between patient group [(903.67 ±1±9.87) ml]and control group [(880.79 ±1±7.10) ml](t ＝0.177, P＞0. 05 ). ConclusionsRegional gray and white matter atrophy can be the initial changes in patients with alcohol addiction and the frontal region is a relative specific damaged brain region.VBM has a potential value for the detection of subtle brain atrophy in patients with alcohol addiction.

OBJECTIVE:To evaluate the effects of PDCA cycle management method on clinical application of Fat-soluble vita-min for injection (Ⅱ). METHODS:By retrospective analysis,500 discharge medical records of Fat-soluble vitamin for injection (Ⅱ)were collected from our hospital during Jul.-Aug. in 2015(before intervention),Sep.-Oct. in 2015(after first intervention cy-cle),Nov.-Dec. in 2015(after second intervention cycle),respectively. RESULTS:After 2 PDCA cycles,the proportion Fat-solu-ble vitamin injection (Ⅱ) use without indication decreased from 65.4% to 39.2%;the reasonable rate of drug dosage increased from 53.2% to 97.2%,and that of usage increased from 96.4% to 99.8%;the reasonable rate of medication course increased from 69.6% to 96.6%;the reasonable rate of the clinical application of Fat-soluble vitamin injection (Ⅱ) increased from 18.8% to 56.4%,with statistical significance (P<0.05). CONCLUSIONS:PDCA cycle can effectively promote the clinical reasonable of Fat-soluble vitamin for injection(Ⅱ).

Purpose At present,morphological observation and CT value measurement were mainly used to evaluate ground-glass nodule (GGN),and there was no effective image feature-quantization evaluation method.Therefore,in this study,a follow-up quantization analysis was conducted on GGN within 2 years using texture feature analysis method to confirm reasonable GGN follow-up time.Materials and Methods Baseline and highresolution CT images of 100 GGN follow-up patients were retrospectively analyzed.They were assigned into three groups,3 months follow-up (group A),6 to 12 months follow-up (group B) and 2 years follow-up (group C).For each group,using firstly founded GGN image as baseline,GGN texture features (including energy,contrast,autocorrelation,inverse difference moment and entropy) were analyzed.Results There were 1 case of narrowed nodules in group A,1 case of increased nodules and 1 case of narrowed nodules in group B,and 4 cases of increased nodules in group C,2 of which showed density differences.There was no significant change in shape,density and size of the remaining nodules.There were no significant differences in texture features (energy,contrast,autocorrelation,deficit,entropy) among group A,group B and group C (P＞0.05).Conclusion Texture feature analysis can quantitatively evaluate the change of GGN attribute characteristics,and as a GGN follow-up quantitative tool,it can guide patients to choose reasonable follow-up mode.

Objective To evaluate early occult brain damage by diffusion tensor imaging in patients with type Ⅱ diabetes mellitus.Methods High resolution three-dimensional T1-weighted fast spoiled gradient recalled echo MRI images and diffusion tensor imaging were obtained from 16 patients with type Ⅱ diabetes mellitus (T2DM) and 16 normal controls (NC).Average apparent diffusion coefficient (ADC) map and fractional anisotropy (FA) map were calculated and analyzed with voxel-based analysis.Analysis of covariance was performed to compare ADC and FA between T2DM and NC.Results Increased ADC values of gray matter were demonstrated in right superior temporal gyrus,middle frontal gyrus,anterior cingulate gyrus,middle cingulate gyrus,inferior occipital gyrus,and left lingual gyrus,operculum orbitale,fusiform gyrus and parahippocampal gyrus in T2DM (voxel numbers in clusters were 176-3125,P ＜ 0.01).And increased ADC values of white matter were demonstrated in the regions of right middle temporal lobe,linual lobe,middle frontal lobe,calcarine gyrus,superior parietal lobe,and left operculum orbitale in T2DM patients compared with NC (voxel numbers in clusters were 200-781,P ＜ 0.01).Decreased FA values of gray natter were mainly located in left thalamus,bilateral caudate nuclei and right cuneus in T2DM(voxel numbers in clusters were 210-1402,P ＜0.01).Decreased FA values of white matter were demonstrated in the regions of right cuneus and the body of corpus callosum in T2DM (voxel numbers in clusters were 206,253,P ＜ 0.01).Conclusions The occult brain damage is demonstrated as increased ADC values and decreased FA values in regional brain parenchyma in type Ⅱ diabetes mellitus.Voxel-based analysis of diffusion tensor indices may be a simple and effective tool for the evaluation of occult brain damage in type]][diabetes mellitus.

Objective To compare the efficacy and prognosis of epirubicin combined with paclitaxel and epirubicin combined with docetaxel in the treatment of breast cancer.Methods Patients in the study group were treated with epirubicin and paclitaxel, while the control group was treated with epirubicin plus docetaxel.Results The two groups of breast cancer patients by the end of the treatment were valid for 5 years of follow-up, five year survival rate(86.67%)than the control group(68.89%), the study group the recurrence rate(4.44%)than in the control group(15.56%), the data had significant differences(P<0.05).Conclusion The epirubicin is conducive to breast cancer patients for better disease control effect and prognosis than star, paclitaxel combined with chemotherapy.

Objective:To study the bone regeneration capacity of the complex of bone marrow mesenchymal stem cells(BMSCs) and platelet rich plasma (PRP) with decellularized cartilage matrix (DCM).Methods:BMSCs were isolated from young rabbit and cultured;PRP were prepared from the fresh blood of rabbit and the DCM were come from the fresh ears of rabbits and processed into a mixture of BMSCs-PRP-DCM.The mixture was injected subcutaneously into nude mice,8 weeks after injection bone regeneration was examine by HE staining and Massons staining decellularization.Results:The BMSCs show good differentiation capacity in vitro and the cartilage fragments were well decellularized.Excellent endochondral ossification ability of the complex was observed by in vivo experiment.Conclusion:The BMSCs-PRP-DCM complex has good capacity of endochondral ossification.

Objective To investigate the effect of Avastin (bevacizumab) combined with preoperative FOLFOX neoadjuvant chemotherapy on the prognosis of patients with locally advanced rectal cancer (LARC).MethodsA total of 80 cases of patients with LARC treated with total mesorectal excision (TME) in our hospital from January 2013 to January 2016 were randomly divided into the control group and the observation group, 40 cases in each group.The control group were treated with preoperative FOLFOX chemotherapy while the observation group were treated with bevacizumab injection, based on the treatment in the control group.21 days was a cycle of chemotherapy, and both groups were treated for at least 4 cycles.After 6 cycles of chemotherapy, operation was carried out, following TEM principle.The short-term and long-term prognosis, rate of R0 resection, the incidence of postoperative complications and side effects of chemotherapy were compared between the two groups.ResultsThere was no significant difference between the two groups in the good response rate of chemotherapy, the rate of R0 resection, the incidence of postoperative complications, the 1-year and 3-year survival rates and 1-year disease-free survival rate.The incidence rates of gastrointestinal reactions and bone marrow suppression in the observation group were 52.5% and 52.5%, respectively while in the control group were 25.0% and 20.0%, respectively (P<0.05), but there was no significant difference in the incidence rates of grade Ⅲ~Ⅳ gastrointestinal reaction and bone marrow suppression between the observation group and the control group (5.0% and 15.0% vs 2.5% and 5.0%).The 3-year disease-free survival rate of the observation group was higher than that of the control group (82.5% vs 60.0%) (P<0.05).ConclusionThe application of bevacizumab combined with preoperative FOLFOX chemotherapy in the treatment of LARC can improve the 3-year disease-free survival rate, without increasing postoperative adverse reactions and serious side effects of chemotherapy.

PurposeTo optimize the imaging parameters of clinical MRI scanner in rat pancreas imaging to improve the image quality and to provide better MRI image quality and more economical research method for imaging study of rat pancreas. Materials and Methods Twenty-four healthy male Wistar rats were randomly divided into the conventional sequence (CS) group, the adjustment sequence (AS) group and the optimization sequence (OS) group, with 8 rats in each group. The rats in the CS group were scanned with conventional parameters using a clinical MRI scanner. The principle of parameter adjustment was: parameters associated with T1WI or T2WI imaging quality (TR, TE, slice thickness, NEX, FOV and matrix) was set with four changes, and only one of the six parameters was changed in each scan, image quality was evaluated by two senior radiologists, the parameter corresponded the best image quality evaluated consistently by two radiologists were selected as the optimal imaging parameter, all the optimized parameters were set up step by step in this way which formed the imaging parameters in OS group. The pancreatic signal intensity and signal to noise ratio was compared between CS group and OS group after imaging.Results The optimized sequence parameters in clinical MRI scanner were listed below: T1WI sequence (M3D/FSPGR/15): TR 6 ms, TE 2.5 ms, slice thickness 2.0 mm, NEX 8, FOV 7 cm×7 cm, Matrix 120×120; T2WI sequence (FSE-XL/90): TR 4000 ms, TE 71 ms, slice thickness 2.0 mm, NEX 1, FOV 8 cm×8 cm, Matrix 192×160. The pancreatic SI in T1WI and T2WI sequence of the OS group were significantly higher than those in the CS group (t=5.16 and 3.80,P<0.01), while the pancreatic SNR in T1WI and T2WI sequence of the OS group were significantly higher than those in the CS group (t=5.65 and 3.26,P<0.01).Conclusion The optimized parameters can improve the imaging quality of rat pancreas MRI significantly, thus provide a reference for the related experimental study.

Objective To explore the neuropsychological development in twin premature infants,and to analyze the risk factors for the retardation of development.Methods The premature infants hospitalized in the Neonatal Ward First Affiliated Hospital of Kunming Medical University from Jun.2010 to Jun.2012 were divided into study groups of twin premature infants and a control group of singleton premature infants.The neuropsychological development of 88 premature infants was evaluated at corrected gestational age of 1 year old by Bayley scales of infant development.According to normal lab findings of the Bayley scales of infant development,the premature infants were then divided into abnormal neuropsychological development group [mental development index(MDI) ≤79 scores] and normal neuropsychological development group (MDI ＞ 79 scores),and the data of 2 groups were statistically analyzed.Results The frequency distribution of MDI score in study group showed a skewed distribution,of which 59％ (27/46 cases) had abnormal neuropsychological development (MDI ≤ 79 scores); However,the frequency distribution of MDI score in control group showed an approximate normal distribution,of which only 12％ (5/42 cases) for abnormal neuropsychological development.Head circumference,body length,body weight,MDI,psycho-motor development index of twin premature infants of one-year old were lower than those of the singleton premature infants of the same age,and the differences were statistically significant (all P ＜0.05).The single factor analysis demonstrated that the risk factors for abnormal neuropsychological development (MDI ≤ 79 scores) of twin premature infants were gestational age,birth weight,mother' s gcstational age,the cultural degree of parents,mode of feeding,neonatal hyperbilirubinemia,neonatal hypoglycemia and neonatal sepsis.Multiple regression analysis showed that neonatal hyperbilirubinemia was the independent risk factor for abnormal neuropsychological development of twin premature infants.Conclusions At same gestational age,neuropsychological development of twin premature infants lagged behind singleton premature infants.Neonatal hyperbilirubinemia may be the risk factors for neuropsychological development of twin premature infants,so the earlier management of neonatal hyperbilirubinemia may be beneficial for the neuropsychological development of twin premature infants.