ObjectiveTo explore the current situation of forensic ethics practice and education by designing a questionnaire on forensic ethics， with a view to exploring the path of forensic ethics education construction. MethodsA total of 667 valid questionnaires were collected using the online survey method， basically covering various regions across the country and all sub-specialties of forensic medicine. Descriptive analysis was used to analyze the relevant data. ResultsMost practitioners had relevant ethical reflections in the process of forensic practice. 69.12% of the respondents indicated that they had studied the relevant rules， but approximately half stated that there were no corresponding ethical norms or standard operating manuals. The specific behaviors violating ethics in different units were diverse. 23.04% of the respondents reported that they had encountered unethical behaviors， but only 4.9% of them reported such violations. In terms of forensic ethics education， 87.75% of the respondents believed that there were issues with the current model of forensic ethics education. Meanwhile， the respondents showed a high degree of recognition for receiving forensic ethics education， with 84.15% of respondents expressing willingness to participate in relevant courses. More than half of respondents were willing to participate in forensic ethics education during undergraduate studies， new employee training， and regular post-employment training. ConclusionCurrently， there is a problem of ethical neglect in forensic work in China. Combining ethics courses with professional courses at the practitioner training stage and providing regular training at the practice stage are effective measures to popularize forensic ethics knowledge， enhance ethical awareness， and improve the quality of practice.

OBJECTIVE: The investigation of the correlation between ecological factors and the genetic characteristics or metabolites of plants offers valuable insights into the regional causes of genetic and metabolic diversity. Here, Gastrodia elata, a medicinal plant, is employed as a model to explore the environmental factors that influence its genetic characteristics and metabolic accumulations. METHODS: A total of 23 G. elata populations from six cultispecies and 11 cultivated regions were selected based on the predictions of the global geographic information system. The genetic characteristics of these populations were evaluated using highly polymorphic simple sequence repeat markers. Additionally, the metabolic accumulations and antioxidant capacity of mature tubers were measured employing colorimetry and high performance liquid chromatography (HPLC). Ecological data of each region were obtained from the WorldClim-global climate database and harmonized world soil database. To assess the influence of ecological factors on the genetic characteristics and metabolic profiles of G. elata, Pearson's correlation analysis was conducted. RESULTS: Genetic variation among G. elata populations exceeded that within populations. Genetic diverisity, distance and structure manifested regional and species-specific patterns. Metabolic profiling and antioxidant capacity exhibited regional variations. Notably, the Lueyang region demonstrated that a content range of total polysaccharide, total protein, and phenolic glycosides was 9.34%-189.67% higher than the average. Similarly, in the Hubei region, total phenolic content, p-hydroxybenzyl alcohol content, and antioxidant indicators were observed to be higher than the average levels, by 106.57%, 136.47% and 12.50%-91.14%, respectively. Furthermore, ecological factors had a significant comprehensive impact on G. elata genetic characteristics (r > 0.256 and P < 0.05). Multivariate metabolite accumulations in G. elata were influenced by dominant ecological factors. Temperature notably impacted the accumulation of total protein (|r| > 0.528 and P < 0.05). Moisture, encompassing precipitation and soil content, significantly affected the production of phenolic glycosides (|r| > 0.503 and P < 0.05). CONCLUSION The genetic characteristics of G. elata manifested regional and species-specific patterns, with the metabolic accumulations and antioxidant capacity of mature tubers exhibited regional variations. Specifically, multivariate ecological factors comprehensively influenced genetic characteristics. Temperature and moisture played pivotal roles in regulating the accumulations of proteins and phenolic glycosides, respectively. These findings underscore the significant impact of ecological factors on the shaping of G. elata, highlighting their crucial role in enhancing the quality of Chinese medicinal materials.

Objective:To observe the efficacy and safety of albumin-bound paclitaxel in the treatment of metastatic breast cancer.Methods:Multi-center data of patients who accepted single-drug albumin-bound paclitaxel or combination regimens from 2013 to 2019 were collected and the efficacy and safety were evaluated. Kaplan-Meier method was used for survival analysis, while Log-rank test was used to compare the survival rates.Results:A total of 203 advanced breast cancer cases were enrolled. The median progression-free survival time (PFS) lasted for 4 months, the median overall survival(OS)was 14 months, objective response rate (ORR) was 36.0% while the disease control rate (DCR) was 81.3%. The ORRs of Luminal, human epidermal growth factor receptor 2 (HER2) overexpression and triple-negative breast cancer patients underwent albumin-bound paclitaxel treatment were 37.3%, 45.5% and 31.0%, respectively, the DCRs were 85.5%, 68.2% and 78.9%, respectively. The OS of patients with relapse or metastasis who accepted less than two and more than two chemotherapy regimens were 22 months and 11 months ( P<0.000 1), the ORRs were 44.9% vs 30.4%, DCRs were 87.2% vs 77.6% ( P=0.018). The ORR and DCR of patients who accepted traditional paclitaxel treatment before the albumin-bound paclitaxel treatment were 35.8% and 82.1%, respectively. The common adverse reaction of these patients was numbness of limbs, which incidence rate was 64.5% (131/203), and 61.1% (124/203) were degree 1 to 2. Other adverse reactions including decreased white blood cells, which incidence rate was 56.1% (114/203); nausea and vomit, which incidence rate was 36.9% (75/203); anemia, which incidence rate was 21.2% (43/203); decreased platelet, which incidence rate was 18.7% (38/203); hepatic dysfunction, which incidence rate was 18.2% (37/203). Conclusions:Albumin-bound paclitaxel single or combination regimen is still significant efficient for various molecular subtypes of breast cancer patients or patients with traditional paclitaxel resistance or multi-line chemotherapy failure. Early usage has better prognosis, controllable adverse reaction and prominent clinical application value.

Objective:To observe the efficacy and safety of albumin-bound paclitaxel in the treatment of metastatic breast cancer.Methods:Multi-center data of patients who accepted single-drug albumin-bound paclitaxel or combination regimens from 2013 to 2019 were collected and the efficacy and safety were evaluated. Kaplan-Meier method was used for survival analysis, while Log-rank test was used to compare the survival rates.Results:A total of 203 advanced breast cancer cases were enrolled. The median progression-free survival time (PFS) lasted for 4 months, the median overall survival(OS)was 14 months, objective response rate (ORR) was 36.0% while the disease control rate (DCR) was 81.3%. The ORRs of Luminal, human epidermal growth factor receptor 2 (HER2) overexpression and triple-negative breast cancer patients underwent albumin-bound paclitaxel treatment were 37.3%, 45.5% and 31.0%, respectively, the DCRs were 85.5%, 68.2% and 78.9%, respectively. The OS of patients with relapse or metastasis who accepted less than two and more than two chemotherapy regimens were 22 months and 11 months ( P<0.000 1), the ORRs were 44.9% vs 30.4%, DCRs were 87.2% vs 77.6% ( P=0.018). The ORR and DCR of patients who accepted traditional paclitaxel treatment before the albumin-bound paclitaxel treatment were 35.8% and 82.1%, respectively. The common adverse reaction of these patients was numbness of limbs, which incidence rate was 64.5% (131/203), and 61.1% (124/203) were degree 1 to 2. Other adverse reactions including decreased white blood cells, which incidence rate was 56.1% (114/203); nausea and vomit, which incidence rate was 36.9% (75/203); anemia, which incidence rate was 21.2% (43/203); decreased platelet, which incidence rate was 18.7% (38/203); hepatic dysfunction, which incidence rate was 18.2% (37/203). Conclusions:Albumin-bound paclitaxel single or combination regimen is still significant efficient for various molecular subtypes of breast cancer patients or patients with traditional paclitaxel resistance or multi-line chemotherapy failure. Early usage has better prognosis, controllable adverse reaction and prominent clinical application value.

Objective:To compare the clinical effect of percutaneous sacroiliac screw fixation assisted by O-arm navigation or C-arm X-ray fluoroscopy in the treatment of sacroiliac joint complex injury.Methods:A retrospective case-control study was conducted on 32 patients with sacroiliac joint complex injury admitted to Second Affiliated Hospital of Army Medical University from July 2016 to January 2019.There were 21 males and 11 females, aged from 20 to 59 years (mean, 41.3 years). According to Tile classification, there were 7 patients with type B1 fracturs, 13 with type B2, 5 with type B3, 5 with type C1, and 2 with type C1. Group A ( n=17) had percutaneous sacroiliac screw fixation assisted by O-arm navigation, while Group B ( n=15) had percutaneous sacroiliac screw fixation assisted by C-arm X-ray fluoroscopy. Time of single screw placement, time of intraoperative fluoroscopy, intraoperative bleeding volume and bone union time were measured. Reduction quality was evaluated by Matta standard score. Majeed function score was assessed 6 months at the latest follow-up. Complications were also observed. Results:All patients were followed up for 6-37 months (mean, 18.6 months). The time of sacroiliac joint screw placement [(27.3±5.1)minutes] and time of intraoperative fluoroscopy [(43.3±3.2)s] in Group A were significantly less than those in Group B [(52.3±5.9)minutes, (64.6±5.4)s] ( P<0.05). There were no significant differences between Group A and Group B in intraoperative bleeding [(17.8±2.6)ml vs. (20.7±3.1)ml] and bone union time [(13.4±1.4)weeks vs. (14.1±1.9)weeks] ( P>0.05). According to the reduction quality evaluated by Matta standard score, the good and excellent rate was 88% (15/17) in Group A and 87% (13/15) in Group B ( P>0.05). The good and excellent rate of the Majeed function score was 94% (16/17) in Group A and 87% (13/15) in Group B at the latest follow-up ( P>0.05). One patient in Group B demonstrated one screw slightly penetrating the anterior cortex of vertebral body. No neurovascular injury, wound infection, or screw loosening occurred. Conclusion:For sacroiliac joint complex injury, percutaneous sacroiliac screw fixation assisted by O-arm navigation has advantages in the duration of screw placement and intraoperative fluoroscopy over percutaneous sacroiliac screw fixation assisted by C-arm X-ray fluoroscopy.

OBJECTIVETo study the analgesic effects and mechanism of Yuanhuzhentong capsule.

METHODThe rats trigeminal nerve headache model, the migraine model caused by nitroglycerim, and the mice hot plate test. The rat formalin test were used to evaluate the analgesic effects. The effects on mice automative activities, the content of monoamine neurotansmitters in rats trigeminal nerve headache model and the hemorrheology in model of blood stasis were investigated to analyze the analgesic effects.

RESULTYuanhuzhentong capsule can prolong the latency of the rats trigeminal nerve headache model and reduce the durante dolors. It can relieve the reaction caused by nitroglycerim in different times and increase the threshold in mice hot plate test. It can decrease obviously the response time of the chronicity pain model rat caused by formalin in second phase and also decrease the counts of automative activities in 5 min. It can increase the content of 5-HT and decrease blood viscosity in blood stasis model rats.

CONCLUSIONThe results indicated that Yuanhuzhentong capsule has obvious analgesic effects, and the mechanism concernes with the sedation, adjusting the secretion of NT in brain and improving the blood circulation.

Analgesics ; administration & dosage ; Animals ; Capsules ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Headache ; drug therapy ; physiopathology ; Humans ; Male ; Mice ; Mice, Inbred ICR ; Pain ; drug therapy ; physiopathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley