Forensic injury analysis is of great significance in the field of forensic medicine,but the complexity of injury formation process and individual differences make it highly professional.The finite element method(FEM),with its wide applicability,controllable accuracy and efficient computing power,combined with visualization,has shown great application potential in the field of forensic science.Through literature analysis,this paper introduces the basic principles of FEM and discusses its application in analysis of injuries caused by traffic accidents,shooting,tool injury and fall from height.By analyzing the simulation parameters,simulation results and research focus of each application scenario and collision site,this study evaluates the feasibility and limitations of FEM in forensic injury analysis,thereby providing reference and technical approaches for forensic injury analysis.

Multimodal biometric identification technology,which combines multiple biometric methods,is being increasingly used in forensic science due to its advantages such as difficulty of forgery and great accuracy.However,the current identification mainly relies on unimodal biometrics including facial recognition,hand recognition,iris recognition,gait recognition,and voice recognition.Thus,to a large extent,the accuracy of identification depends on the quality of the unimodal data,which faces multiple challenges.In contrast,multimodal biometrics has more obvious advantages in the field of identification,which can not only effectively resist attacks,but also enrich the feature representation with complementary information from multimodal sources,mitigate the impact of environment on the identification performance,and enhance the robustness of the system.To this end,this paper combs through the relevant work in this field,and comprehensively reviews the current research status and development trend of biometric identification technology.First,based on bibliometrics,the paper combs through the relevant research results in the past ten years,analyzes,summarizes,and discusses the commonly used deep learning models in this field,respectively,from unimodal recognition to multi-modal fusion recognition.Then the paper discusses the future development direction of the multimodal biometric identification field in the light of the practical needs of court science and provides reference for identification research.

Multimodal biometric identification technology,which combines multiple biometric methods,is being increasingly used in forensic science due to its advantages such as difficulty of forgery and great accuracy.However,the current identification mainly relies on unimodal biometrics including facial recognition,hand recognition,iris recognition,gait recognition,and voice recognition.Thus,to a large extent,the accuracy of identification depends on the quality of the unimodal data,which faces multiple challenges.In contrast,multimodal biometrics has more obvious advantages in the field of identification,which can not only effectively resist attacks,but also enrich the feature representation with complementary information from multimodal sources,mitigate the impact of environment on the identification performance,and enhance the robustness of the system.To this end,this paper combs through the relevant work in this field,and comprehensively reviews the current research status and development trend of biometric identification technology.First,based on bibliometrics,the paper combs through the relevant research results in the past ten years,analyzes,summarizes,and discusses the commonly used deep learning models in this field,respectively,from unimodal recognition to multi-modal fusion recognition.Then the paper discusses the future development direction of the multimodal biometric identification field in the light of the practical needs of court science and provides reference for identification research.

Forensic injury analysis is of great significance in the field of forensic medicine,but the complexity of injury formation process and individual differences make it highly professional.The finite element method(FEM),with its wide applicability,controllable accuracy and efficient computing power,combined with visualization,has shown great application potential in the field of forensic science.Through literature analysis,this paper introduces the basic principles of FEM and discusses its application in analysis of injuries caused by traffic accidents,shooting,tool injury and fall from height.By analyzing the simulation parameters,simulation results and research focus of each application scenario and collision site,this study evaluates the feasibility and limitations of FEM in forensic injury analysis,thereby providing reference and technical approaches for forensic injury analysis.

Objective:To explore the effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix (ADM), i.e., early surgery, in the treatment of children with deep burns.Methods:This study was a retrospective cohort study. From January 2017 to December 2022, 278 deep burned hospitalized children aged 1-7 years who met the inclusion criteria were admitted to Central Hospital Affiliated to Shandong First Medical University. According to the differences in treatment processes, 134 children who underwent early surgery+routine dressing change were enrolled in eschar removal+dressing change group (77 males and 57 females, aged 1 (1, 2) years), and 144 children who underwent only routine dressing change were enrolled in dressing change alone group (90 males and 54 females, aged 1 (1, 2) years). Fifty-one children without full-thickness burns in eschar removal+dressing change group were enrolled in eschar removal+dressing change group 1 (26 males and 25 females, aged 1 (1, 2) years), and 57 cases of the 83 children with full-thickness burns who did not undergo autologous skin grafting at the same time of early surgery (namely early skin grafting) in eschar removal+dressing change group were included in eschar removal+dressing change group 2 (37 males and 20 females, aged 1 (1, 2) years). Seventy-six children without full-thickness burns in dressing change alone group were included in dressing change alone group 1 (51 males and 25 females, aged 1 (1, 3) years), and 68 children with full-thickness burns in dressing change alone group were included in dressing change alone group 2 (39 males and 29 females, aged 1 (1, 2) years). For deep partial-thickness burn wounds and small full-thickness burn wounds in eschar removal+dressing change group, the eschar removal was performed on the basis of retaining a thin layer of denatured dermis so as to preserve the healthy tissue of the wound base, and ADM was applied to all wounds externally after eschar removal. For larger full-thickness burn wounds in this group, especially those located in the functional part of joints, eschar removal to the plane layer of viable tissue and early autologous skin grafting was needed. When the superficial wounds of children healed or tended to heal, the residual wounds were evaluated, and elective autologous skin grafting was performed if it was difficult to heal within 14 days. The healing time, intervention healing time, times of operation/dressing change, and times of intervention operation/dressing change in children with deep partial-thickness burn wounds of children in eschar removal+dressing change group, dressing change alone group, eschar removal+dressing change group 1, and dressing change alone group 1 were recorded. At the last follow-up (follow-up period was set to 7-12 months), the modified Vancouver scar scale (mVSS) scores of the most severe area of scar hyperplasia of healed deep partial-thickness burn wounds of 54 children in eschar removal+dressing change group and 48 children in dressing change alone group were recorded. The healing time and times of operation/dressing change of all burn wounds of children in eschar removal+dressing change group and dressing change alone group, and the healing time and times of operation/dressing change of full-thickness burn wounds of children in eschar removal+dressing change group 2 and dressing change alone group 2 were recorded. The incidences of wound infection, sepsis, fever, and fever after 5 days of burns in children of eschar removal+dressing change group and dressing change alone group during wound healing.Results:Compared with those in dressing change alone group, the healing time and intervention healing time were significantly shortened, and the times of operation/dressing change and times of intervention operation/dressing change were significantly reduced in children with deep partial-thickness burn wounds in eschar removal+dressing change group (with Z values of -11.00, -11.33, -12.64, and -11.65, respectively, P<0.05). Compared with those in dressing change alone group 1, the healing time and intervention healing time were significantly shortened, and the times of operation/dressing change and times of intervention operation/dressing change were significantly reduced in children with deep partial-thickness burn wounds in eschar removal+dressing change group 1 (with Z values of 6.57, 6.46, 8.04, and 6.57, respectively, P<0.05). At the last follow-up, the mVSS score of the most severe scar hyperplasia area of healed deep partial-thickness burn wounds of 54 children in eschar removal+dressing change group was 4.00 (3.00,5.00), which was significantly lower than 6.50 (5.00,7.00) of 48 children in dressing change alone group ( Z =-4.67, P<0.05).Compared with those in dressing change alone group, the healing time was significantly shortened, and times of operation/dressing change was significantly reduced in all burn wounds in eschar removal+dressing change group (with Z values of -5.20 and -6.34, respectively, P<0.05). Compared with those in dressing change alone group 2, the healing time was significantly shortened, and times of operation/dressing change was significantly reduced in full-thickness burn wounds in eschar removal+dressing change group 2 (with Z values of -5.22 and -5.73, respectively, P<0.05). During wound healing, the probabilities of fever and fever after 5 days of burns in children of eschar removal+dressing change group were significantly lower than those in dressing change alone group (with χ2 values of 4.13 and 3.91, respectively, P<0.05); only 1 child in dressing change alone group developed sepsis, and there was no statistically significant difference in the wound infection rate of children in the two groups ( P>0.05). Conclusions:For children with deep burns, early surgery, and early skin grafting or elective autologous skin grafting as needed, have better short-term and long-term effects than those without early surgery.

Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

Objective:To investigate the clinical diagnostic value of MRI retention enema cannula enhanced scanning in the high complex anal fistula.Methods:The clinical data of 60 anal fistula patients underwent surgery treatment from May 2020 to May 2022 in Affiliated Hospital of Shanxi University of Traditional Chinese Medicine were retrospectively analyzed. All patients underwent MRI plain scanning and enhanced scanning before operation. Compared with the surgical results, the difference between MRI plain scanning and enhanced scanning in the diagnosis of high complex anal fistula was compared.Results:All of the 60 patients successfully completed surgical treatment, and 58 cases internal orifices, 55 cases complex anal fistulas and 53 cases high anal fistulas were found intraoperatively. MRI plain scanning results showed 32 cases internal orifices, 46 cases complex anal fistulas and 42 cases high anal fistulas were found. MRI enhanced scanning results showed 54 cases internal orifices, 53 cases complex anal fistulas and 50 cases high anal fistulas were found. Based on surgical results, the coincidence rates of internal orifice, complex anal fistula and high anal fistula in MRI enhanced scanning were significantly higher than those in MRI plain scanning: 93.10% (54/58) vs. 55.17% (32/58), 96.36% (53/55) vs. 83.64% (46/55) and 94.34% (50/53) vs. 79.25% (42/53), and there were statistical differences ( χ2 = 21.76, 4.95 and 5.27; P<0.01 or <0.05). Conclusions:The MRI retention enema cannula enhanced scanning has obvious advantages in the diagnosis of high complex anal fistula, which provides scientific reference value for the diagnosis and operation of high complex anal fistula in clinic.

Objective:To investigate the incidence of post-traumatic stress disorder (PTSD) in hospitalized high-risk pregnancy patients and its related influencing factors.Methods:This study was a cross-sectional study. A total of 503 high-risk pregnancy patients who were hospitalized in Department of Obstetrics of the First Affiliated Hospital of Zhengzhou University from May to December 2020 were selected as the research objects by the convenient sampling method. Post-Traumatic Stress Checklist-Civilian Version (PCL-C) , Social Support Scale and Connor-Davidson Resilience Scale (CD-RISC) were used to investigate. Multiple linear regression analysis was used to analyze the influencing factors of PTSD in hospitalized high-risk pregnant patients.Results:A total of 503 questionnaires were sent out, 503 were recovered, 32 invalid questionnaires were excluded and 471 valid questionnaires were valid. The PCL-C score of 471 high-risk pregnant patients was (30.52±10.29) and 87 cases were PTSD positive during pregnancy. The social support score and CD-RISC score of pregnant patients with high-risk pregnancy were negatively correlated with total score of PCL-C and scores of 3 dimensions ( P<0.05) . The results of multiple linear regression analysis showed that social support, psychological resilience and pregnancy risk level were influencing factors of PTSD in hospitalized high-risk pregnant patients ( P<0.05) . Conclusions:Pregnancy risk level, psychological resilience and social support are the influencing factors of PTSD in pregnant patients with high-risk pregnancy.

Objective To investigate the level of glycosylated albumin (GA) in liver cirrhosis patients with different Child-Pugh classes and its application value in predicting liver function. Methods A total of 486 patients with liver cirrhosis who were hospitalized in Tianjin Third Central Hospital from January 1 to December 31, 2019, were enrolled, among whom 227 patients had liver cirrhosis without diabetes and 259 patients had liver cirrhosis with diabetes. The patients were divided into groups according to Child-Turcotte-Pugh (CTP) score, and fasting blood glucose, glycosylated hemoglobin, and percentage of GA (GA%) were measured. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between three groups, and the Dwass-Steel-Critchlow-Fligner test was used for further comparison between two groups. Scatter plots and fitting curves were plotted for CTP score and GA% to evaluate the association between them and calculate the cut-off value. Results For the cirrhosis patients without diabetes, there were significant differences between the patients with different Child-Pugh classes in GA% ( χ 2 =24.809, P < 0.001), fasting blood glucose ( χ 2 =11.899, P =0.003), and glycosylated hemoglobin ( χ 2 =13.607, P =0.001); further pairwise comparison showed that there was a significant difference in GA% between Child-Pugh class A/B liver cirrhosis patients without diabetes and Child-Pugh class C liver cirrhosis patients ( P < 0.05), Child-Pugh class A patients had a significantly higher level of fasting blood glucose than Child-Pugh class B patients ( P < 0.05), and Child-Pugh class A patients had a significantly higher level of glycosylated hemoglobin than Child-Pugh class B/C patients ( P < 0.05). For the patients with liver cirrhosis and diabetes, there were significant differences between the patients with different Child-Pugh classes in GA% ( χ 2 =10.734, P =0.005) and fasting blood glucose ( χ 2 =16.295, P < 0.001); further pairwise comparison showed that Child-Pugh class C liver cirrhosis patients with diabetes had a significantly lower GA% than Child-Pugh class A/B patients ( P < 0.05) and Child-Pugh class A patients had a significantly lower fasting blood glucose level than Child-Pugh class B patients ( P < 0.05). The fitting curve showed that GA% increased with the increase in CTP score in the liver cirrhosis patients without diabetes, reached the highest value at the CTP score of 6.5, and then started to decrease, with the lower value at the CTP score of 11.5, which showed a curvilinear relationship; in the liver cirrhosis patients with diabetes, GA% first increased and then decreased with the increase in CTP score, with a cut-off value of 8. Conclusion GA% first increases and then decreases along with the progression of liver cirrhosis. There is a significant difference in GA between liver cirrhosis patients with different Child-Pugh classes, suggesting that the reduction in GA is closely associated with liver function decompensation in end-stage liver cirrhosis.

Objective:To explore the effect of small private online course (SPOC) in basic nursing course teaching.Methods:In September 2019, convenience sampling was used to select 150 second-year nursing undergraduates of the 2018 grade from the School of Nursing, Qiqihar Medical College, as the research subject. This study relied on the Chaoxing learning platform to build a SOPC-based pre-class + in-class + after-class blended teaching model, and evaluated the implementation effect.Results:Among 150 students, the online learning score was (93.13±7.76) , and the final offline examination score was (85.61±10.09) . The number of visits to the online platform was 9 428 person-times, a total of 55 topics were discussed by teachers and students, and 172 task points were completed. In the evaluation of each item of the teaching effect of basic nursing based on SPOC by 150 students, more than 80% of students strongly agreed and agreed, and there was no evaluation that strongly disagreed.Conclusions:The SPOC-based teaching model is applied to the teaching of basic nursing courses, which can meet the learning needs of students and improve the quality of education and teaching.