ObjectiveTo clearly identify the difference between rescue injuries and agonal injuries and to avoid duplicate identifications and misidentifications. MethodsBased on the forensic pathological data of 5 923 cases of death cause identification from 2013 to 2022 in Sun Yat-sen University Forensic Identification Center and Guangzhou Tianhe District Branch of Guangzhou Public Security Bureau， this study retrospectively studied the characteristics of rescue injuries and agonal injuries seen in cause of death identification and their influence on cause of death identification. ResultsAmong all the 5 923 cases， 640 cases were found to have rescue injuries or agonal injuries， and 624 cases received treatment， of which 609 cases were found to have rescue injuries （97.60%）， 44 cases were found to have agonal injuries， and 13 cases were found to have both types of injuries. Among the 640 cases， 441 were male and 199 were female. The age of death was discontinuously distributed from 0 to 95 years old. The leading cause of death was disease， followed by mechanical injury and asphyxia. The main manifestations of rescue injuries were rib and sternum fractures， soft tissue injuries in the prechest area or face， and pericardial rupture. The most common injuries in agonal stage were falling after unconsciousness， inhalation of foreign body in respiratory tract or multiple violent injuries. Among the 640 cases， 19 cases were repeatedly identified， including 15 cases of rescue injuries， 6 cases of agonal injuries， and 2 cases of both types of injuries. Compared with the cases where neither type of injuries was detected， the repeated identification rate of treatment injuries and agonal injuries was significantly increased （χ²=4.04， P=0.044； χ²=43.49， P<0.001）. Among the 640 cases， 11 cases （1.72%） were misidentified as the initial injuries in the first identification， and 13 cases had combined rescue injuries or agonal injuries that were involved in death. ConclusionsBy elucidating the epidemiological characteristics of the two types of injuries， this study proved that the two types of injuries were associated with higher rates of repeated identification and misidentification， which provided a reference for reducing repeated identification and misidentification and improving the accuracy of cause of death identification.

AIM: To investigate the application of optical coherence tomography angiography(OCTA)in observing the relationship between corneal topographic changes and retinal vessel density and thickness in myopic adolescents after wearing orthokeratology lenses.METHODS:Myopic adolescents who treated and wore orthokeratology lenses in our hospital between January and December 2023 were selected for the study, and their clinical data were retrospectively analyzed. Totally 50 cases(50 eyes)of toric orthokeratology lenses(toric group)and 50 cases(50 eyes)of spherical orthokeratology lenses(spherical group)were selected. Changes in corneal topographic indices, retinal vascular density and retinal thickness were examined in the two groups before and at 3 and 6 mo after wear. The relationship between corneal topographic indexes and retinal vessel density and thickness was analyzed.RESULTS: Compared with the pre-wear, average value of ks and kf(Avek)was significantly lower(all P<0.05), and surface regularity index(SRI)and surface asymmetry index(SAI)were significantly increased(both P<0.05)in the two groups at 3 and 6 mo post-wear. Compared with the pre-wearing period, deep retinal vessel density in whole macular area and superficial retinal vessel density in paracentral retina of macula were significantly higher in the two groups at 3 and 6 mo after wearing(both P<0.05), and the superficial retinal vessel density in macular fovea and paracentral fovea of macula of the toric group was significantly higher(all P<0.05), and the superficial retinal vessel density in paracentral macular fovea of the spherical group was significantly increased(all P<0.05). Compared with the pre-wearing period, the thickness of retina in whole macula and paracentral retina of the macula was significantly increased in the both groups at 3 and 6 mo post-wearing(all P<0.05). After wearing lenses for 3 mo, the Avek of the toric group was negatively correlated with the deep vascular density in whole macular area and paracentral macular fovea, the superficial vascular density in macular fovea and paracentral macular fovea, and the thickness of whole macular and paracentral macular fovea(all P<0.05). The SRI and SAI were positively correlated with the superficial retinal vascular density in macular fovea and paracentral macular fovea, and the retinal thickness in whole macular area and paracentral macular fovea(all P<0.05). The spherical group showed a negative correlation between Avek and the deep retinal vessel density in whole macular area and paracentral macular fovea, as well as the superficial retinal vessel density in paracentral macular fovea after wearing lenses for 3 mo(all P<0.05). SRI and SAI were positively correlated with the deep retinal vessel density in whole macular area, macular fovea and paracentral macular fovea, and the superficial retinal vessel density in paracentral macular fovea(all P<0.05). SRI was positively correlated with the retinal thickness in whole macular area(P<0.05), and SAI was positively correlated with the retinal thickness in paracentral macular fovea(P<0.05).CONCLUSION: After wearing toric and spherical corneal orthokeratology lenses, the corneal topography of myopic adolescents changes, and the retinal blood flow density and retinal thickness increase significantly, improving retinal blood circulation. Moreover, there is a significant correlation between changes in corneal topography and retinal blood flow density and retinal thickness, which has certain guiding significance for the control of myopia.

Objective To evaluate the value of rs61330082 and rs4730153 polymorphisms of Visfatin locus for the diagnosis of type 2 diabetes mellitus(T2DM)in a high-risk population.Methods SNPscanTM high-throughput single nucleotide polymorphism typing technique was used to genotype Visfatin gene loci rs61330082 and rs4730153 in 346 T2DM patients(T2DM group)and 1426 normal controls(NC group).Logistic regression analysis was used to analyze T2DM risk factors.ROC curves were used to analyze the optimal cut-off values of Visfatin gene rs61330082 and rs4730153 for the diagnosis of T2DM.Results The proportion of women,age,obesity,smoking,hypertension,FPG,HbA1c and TG were higher in T2DM group than those in NC group(P<0.01)and HDL-C was lower than in NC group(P<0.01).The frequency of G allele and GG genotype was higher in T2DM group compared with NC group(P<0.05).Logistic regression analysis showed that age,female,obesity,hypertension,TG,and GG genotype at rs4730153 locus were risk factors for T2DM,HDL-C was a protective factor for T2DM.The area under the ROC curve of GG genotype at Visfatin rs4730153 mutation for diagnosis of T2DM was 0.668 and the optimal cut-off point for predicting T2DM was 20.04%,with sensitivity 60.1%and specificity 66.1%,respectively.Conclusion The GG genotype of Visfatin gene rs4730153 locus is associated with the risk of T2DM and can beused as a candidate gene for predicting phenotype of T2DM.

BACKGROUND:The type of graft selected during anterior cruciate ligament revision is considered one of the main factors affecting the postoperative outcome,but there are few reports on the comparison between different graft materials. OBJECTIVE:To explore the medium-to-long-term clinical efficacy after anterior cruciate ligament revision with autologous ligament,allogeneic ligament,and LARS artificial ligament. METHODS:A total of 67 patients with the first anterior cruciate ligament revision admitted to the Department of Joint and Sports Medicine,The Second Hospital of Tangshan from May 2011 to May 2020 were selected,including 41 males and 26 females,with a mean age of(45.83±7.39)years.They were divided into three groups according to different grafts used:autologous ligament group(n=24),allogeneic ligament group(n=22),and LARS artificial ligament group(n=21).Follow-up for more than 36 months after revision was performed to evaluate the effect of revision. RESULTS AND CONCLUSION:(1)International Knee Documentation Committee(IKDC)score,Lysholm knee score,and Tegner motor score 1 year after surgery and at the last follow-up in the three groups were higher than those before surgery(P<0.05).There were no significant differences in IKDC score,Lysholm knee score,and Tegner motor score among the three groups 1 year after surgery and the last follow-up(P>0.05).(2)The lateral differences of KT-1000 at 1 year after surgery and the last follow-up among the three groups were lower than those before surgery(P<0.05).The lateral difference of KT-1000 and the positive rate of the axial shift test in the last follow-up of the LARS artificial ligament group were higher than those in the autologous ligament group and allogeneic ligament group(P<0.05).(3)At the last follow-up,X-ray films showed no obvious enlargement of the reconstructed bone tunnel and no obvious failure of the graft fixation device.There was no obvious aggravation of osteoarthritis,but bone density decreased significantly in some elderly patients.(4)These findings suggest that anterior cruciate ligament revision with LARS artificial ligaments can obtain good initial stability,but with the extension of time,the stability of partial cases tends to decrease,even with reconstructed ligament failure.Both allogeneic and autogenous ligaments can obtain good clinical efficacy in anterior cruciate ligament revision.

Objective To investigate the role of hydrogen therapy in reducing radiation-induced lung injury and the specific mechanism. Methods Forty C57BL/6 mice were randomly divided into four groups: normal control group, model group, hydrogen therapy group I, and hydrogen therapy group II. A mouse model of radiation-induced lung injury was established. The pathological changes in the lung tissue of the mice were examined with HE staining. Immunofluorescence staining was used to detect the expression of surface markers of M1 and M2 macrophages to observe macrophage polarization. The expression of interleukin (IL)-6, tumor necrosis factor-α (TNF-α), and IL-10 in the lung tissue was measured by immunohistochemistry. The expression of nuclear factor-kappa B (NF-κB) p65 and phosphorylated NF-κB (P-NF-κB) p65 was measured by Western blot. Results HE staining showed that compared with the control group, the model group exhibited alveolar septal swelling and thickening, vascular dilatation and congestion, and inflammatory cell infiltration in the lung tissue; the hydrogen groups had significantly reduced pathological damage and inflammatory response than the model group, with more improvements in hydrogen group II than in hydrogen group I. Immunohistochemical results showed that compared with those in the control group, the levels of the inflammatory cytokines IL-6 and TNF-α were significantly increased in the model group; the hydrogen groups showed significantly decreased IL-6 and TNF-α levels and a significantly increased level of the anti-inflammatory factor IL-10 than the model group, which were more marked in hydrogen group II than in hydrogen group I. Immunofluorescence results showed that compared with the control group, the expression of the surface marker of M1 macrophages in the model group was significantly upregulated; the hydrogen groups showed significantly downregulated M1 marker and significantly upregulated M2 marker, and hydrogen group II showed significantly increased M2 marker compared with hydrogen group I. Western blot results showed that compared with that in the control group, the ratio of P-NF-κB p65/NF-κB p65 in the model group was significantly increased; the P-NF-κB p65/NF-κB p65 ratio was significantly reduced in the hydrogen groups than in the model group, and was significantly lower in hydrogen group II than in hydrogen group I. Conclusion Hydrogen inhalation therapy may reduce the inflammatory response of radiation-induced lung injury by inhibiting the NF-κB signaling pathway to promote the polarization of the macrophage M1 subtype to the M2 subtype.

Diffuse large B-cell lymphoma(DLBCL)in the oral gums is very rare and is prone to misdiagnosis and mistreatment.In this paper,2 cases of oral gingival DLBCL were reported.Their clinicopathological features,diagnosis,and differential diagnosis were discussed based on the literature of 21 cases of gingival DLBCL reported at home and abroad from 2008 to 2023.

Objective To investigate the characteristics and clinicopathology of v-raf murine sarcoma viral oncogene homolog Bl(BRAF)V600E mutations in papillary thyroid carcinoma(PTC)in Air Force flight personnel.Methods Data of cases and test results of BRAF V600E mutation were collected from Air Force aviators pathologically diagnosed with PTC.A univariate analysis of the relationship between BRAF V600E mutations and clinicopathologic features was performed.Results The overall rate of BRAF V600E mutations among 55 PTC flight crew members was 70.91％.The univariate analysis showed that the number of lymph node metastases in the BRAF V600E mutated group was larger than in the BRAF V600E unmutated group,and the proportion of BRAF V600E mutations in flight crews at intermediate risk of recurrence was higher than that in those at low risk of recurrence(P＜0.05).The presence or absence of BRAF V600E mutations did not affect the results of medical evaluation of PTC in flight personnel.Conclusion The rate of PTC BRAF V600E mutations in Air Force flight crews is similar to that of the general Chinese population.BRAF V600E mutations are associated with an increased number of lymph node metastases and risk of recurrence,and follow-up is recommended for flight personnel with PTC,especially those with BRAF V600E mutations.

Objective To investigate the correlation of slow wave power δ/α ratio(DAR)and δ power value on quantitative electroencephalography(QEEG)with cognitive dysfunction in patients with cerebral small vessel disease(CSVD).Methods A total of 80 patients with CSVD who were treated in Department of Neurology,Affiliated Hospital of Chifeng University,from January 2022 to October 2023 were enrolled and evaluated using Montreal Cognitive Assess-ment(MoCA)scale,and QEEG was performed to calculate DAR and δ power value.Related statistical analyses were per-formed.Results There were 40 CSVD patients in the cognitive dysfunction group,with average education years of(8.50±2.00)and a mean age of(62.38±6.32)years,among whom there were 8 female patients(20%)and 32 male patients(80%).There were 40 CSVD patients in the normal cognitive function in group,with average education years of(8.00±4.00)and a mean age of(63.60±7.14)years,among whom there were 10 female patients(25%)and 30 male patients(75%).There were no significant differences in years of education,age,and sex between the cognitive dysfunction group and the normal cognitive function group(P>0.05),while there was a significant difference in MoCA score between the cog-nitive dysfunction group and the normal cognitive function group[8-24(14±9)points and 26-28(26.00±1.00)points,Z=-7.822,P<0.05].The cognitive dysfunction group had significantly higher DAR and δ wave power values than the nor-mal cognitive function group(P<0.05).Cognitive dysfunction in CSVD was negatively correlated with slow wave power DAR and δ power value on QEEG(P<0.05).Conclusion DAR and δ power values on QEEG are correlated with cogni-tive dysfunction in patients with CSVD,suggesting that DAR and δ power values can be used as indicators for identifying cognitive dysfunction in patients with CSVD.

AIM:To explore the effect and mechanism of the interfering Gal-1 on epithelial-mesenchymal transition(EMT),migration and proliferation in MDA-MB-231 cells via transforming growth factor-β(TGF-β)pathway.METHODS:The stable cell lines(shGal-1)which Gal-1 expression were inhibited completely and their control cell lines were used as experimental cells.Western blot assay was used to detect the effects of shGal-1 on EMT process of MDA-MB-231 cells after TGF-β treatment;The effect of shGal-1 on cell migration and invasion after TGF-β treatment was verified by cell scratch and transwell test;The effect of shGal-1 on the TGF-β pathway related proteins were detected by western blot;Finally,the effect of shGal-1 on cell proliferation was detected by MTT and western blot.RESULTS:shGal-1 inhib-ited TGF-β-mediated EMT in MDA-MB-231 cells and regulated phosphorylation of pathway signaling molecules(ERK,AKT and GSK3β);shGal-1 could inhibit the proliferation of MDA-MB-231 cells.CONCLUSION:shGal-1 can inhibit the TGF-β-mediated EMT,migration and proliferation of MDA-MB-231 cells.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.