Based on the characteristics of forensic pathology, this paper explains the concept, connotation and advantages of holistic medicine and integrated medicine in the teaching of forensic pathology. Then, through the introduction of the specific teaching process design and effect analysis of the death cause analysis practical cases, it clarifies the necessity and effectiveness of integrated medicine and holistic medicine in the teaching of forensic pathology, and provides new ideas for the reform of the overall teaching of forensic pathology.

Objective:To investigate the correlation between UGT1A1 polymorphisms and the irinotecan plus S-1 regimen-induced toxicities in Chinese advanced esophageal squamous cell carcinoma (ESCC) patients.Methods:A total of 46 recurrent or metastatic ESCC patients selected from ESWN 01 trial were randomly assigned to irinotecan plus S-1 group [intravenous infusion of irinotecan (160 mg/m 2) on day 1 and oral S-1 (80-120 mg) on days 1-10, repeated every 14 days]. Peripheral venous blood at baseline was collected and genomic DNA was extracted. The genetic polymorphisms of UGT1A1*6 and UGT1A1*28 were analyzed by polymerase chain reaction (PCR) amplification. Irinotecan plus S-1 regimen-induced toxicities of patients with different UGT1A1 polymorphisms were observed. The correlation between UGT1A1 polymorphisms and the adverse effects was analyzed. Results:Among the 46 patients, the numbers of UGT1A1*6 wild type genotype (GG), mutant heterozygote (GA) and mutant homozygote (AA) were 30, 15 and 1, while those with UGT1A1*28 wild type genotype (TA6/6), mutant heterozygote (TA6/7) and mutant homozygote (TA7/7) were 36, 8 and 2, respectively. Only one patient with UGT1A1*6 AA genotype occurred grade 3 diarrhea, while one of the 2 patients with UGT1A1*28 TA7/7 genotype occurred grade 4 diarrhea. No neutropenia was observed in the patient with UGT1A1*6 AA genotype, however, both of the two patients with UGT1A1*28 TA7/7 genotype occurred grade 3-4 neutropenia. Patients with UGT1A1*28 genetic polymorphism (TA 6/7 or TA7/7) had a higher response rate compared with wild-type TA6/6 carriers. (55.6% versus 26.5%).Conclusions:The homozygous genotype of UGT1A1*6 AA and UGT1A1*28 TA7/7 are rare (<5%) in Chinese ESCC population. Not all homozygous AA and TA7/7 carriers occur severe dose limited toxicities (DLT) when treated with irinotecan (160 mg/m 2) plus S-1 regimen for 2 weeks. However, it′s still necessary torigorously observe the occurrence of severe diarrhea and neutropenia in patients with UGT1A1*6 AA and UGT1A1*28 TA7/7 and adjust the dose timely.

Objective:To investigate the correlation between UGT1A1 polymorphisms and the irinotecan plus S-1 regimen-induced toxicities in Chinese advanced esophageal squamous cell carcinoma (ESCC) patients.Methods:A total of 46 recurrent or metastatic ESCC patients selected from ESWN 01 trial were randomly assigned to irinotecan plus S-1 group [intravenous infusion of irinotecan (160 mg/m 2) on day 1 and oral S-1 (80-120 mg) on days 1-10, repeated every 14 days]. Peripheral venous blood at baseline was collected and genomic DNA was extracted. The genetic polymorphisms of UGT1A1*6 and UGT1A1*28 were analyzed by polymerase chain reaction (PCR) amplification. Irinotecan plus S-1 regimen-induced toxicities of patients with different UGT1A1 polymorphisms were observed. The correlation between UGT1A1 polymorphisms and the adverse effects was analyzed. Results:Among the 46 patients, the numbers of UGT1A1*6 wild type genotype (GG), mutant heterozygote (GA) and mutant homozygote (AA) were 30, 15 and 1, while those with UGT1A1*28 wild type genotype (TA6/6), mutant heterozygote (TA6/7) and mutant homozygote (TA7/7) were 36, 8 and 2, respectively. Only one patient with UGT1A1*6 AA genotype occurred grade 3 diarrhea, while one of the 2 patients with UGT1A1*28 TA7/7 genotype occurred grade 4 diarrhea. No neutropenia was observed in the patient with UGT1A1*6 AA genotype, however, both of the two patients with UGT1A1*28 TA7/7 genotype occurred grade 3-4 neutropenia. Patients with UGT1A1*28 genetic polymorphism (TA 6/7 or TA7/7) had a higher response rate compared with wild-type TA6/6 carriers. (55.6% versus 26.5%).Conclusions:The homozygous genotype of UGT1A1*6 AA and UGT1A1*28 TA7/7 are rare (<5%) in Chinese ESCC population. Not all homozygous AA and TA7/7 carriers occur severe dose limited toxicities (DLT) when treated with irinotecan (160 mg/m 2) plus S-1 regimen for 2 weeks. However, it′s still necessary torigorously observe the occurrence of severe diarrhea and neutropenia in patients with UGT1A1*6 AA and UGT1A1*28 TA7/7 and adjust the dose timely.

Objective To determine whether field triage would reduce median contact-to-device ( C2D ) time in patients with ST-segment elevation acute myocardial infarction ( STEMI ) . Methods Consecutive patients with STEMI underwent primary percutaneous coronary intervention( PCI) from March 2010 to February 2014 in Shanghai Pudong Gongli Hospital were analyzed. Patients were divided into two groups. A total of 121 patients were admitted by field triage and 101 patients by non-field triage. The primary study point was C2D time and the study points secondary included ( door-to-balloor, D2B) time, peak Troponin I ( TnI) levels, hospital mortality and 30 days follow-up mortality. Results Baseline and procedural characteristics between the two groups were comparable. Comparing to non-field triage group, the C2D time was reduced [(92. 0 ± 56. 0)min vs. (131. 0 ± 61. 0)min,P﹤0. 01]. The D2B time was lower in the field triage group vs. the non-field triage group [(55. 0 ±26. 0)min vs. (96. 0 ±31. 0)min,P﹤0. 01]. The percentage of patients with C2D time less than 90 minutes increased significantly from 85. 1% to 98. 3%( P﹤0. 01 ) in the field triage group. Peak TnI level was significantly reduced in the field triage group [(23. 5 ±22. 0) μg/L vs. (43. 5 ± 39. 0) μg/L,P﹤0. 01]. In-hospital mortality and 30 days follow-up mortality did not significantly differ between the 2 groups (3. 3% and 3. 0%, P=0. 885;3. 3% and 5. 0%, P=0. 544, respectively). Conclusions In STEMI patients, field triage was associated with significantly reduced C2D and D2B times.

Objective To evaluate the effects of preventive cardiac pacing on acute inferior wall myocardiac infarction ( AIMI ) . Methods A total of 52 patients were given preventive cardiac pacing before Percutaneous coronary intervention (PCI) (group T),while another 68 patients were not (group N).Heart rate and average blood pressure level before reperfusion, average blood pressure level after reperfusion,TIMI flow grade before and after reperfusion,the incidence of malignant ventricular arrhythmia after reperfusion and adverse cardiovascular events during hospitalization were compared in two groups. Results There were no significant differences in heart rate before reperfusion , average blood pressure levels before and after reperfusion , and the TIMI flow grade before and after reperfusion between two groups. The malignant ventricular arrhythmia after reperfusion in group T was significantly higher than that in group N while heart failure and nonfatal myocardial infarction were no significantly different between them. Mortality rate and mortality rate of cardiovascular disease in group T were higher than those in group N, but there were no significant differences between them. Conclusions The temporary cardiac pacing has no additional preventive effect on hemodynamic , but increases the occurrence of malignant ventricular arrhythmia , and the risk of death and cardiovascular events.

Objective To explore the application value of detection of Mycoplasma,Chlamydia and anti-sperm antibodies for male infertility.Methods Culture method,immune chromatography,and enzyme linked immunosorbent assay were adopted for the detection of Mycoplasma,Chlamydia,and anti-sperm antibodies respectively in 102 cases of infertile males and 42 cases fertile males.And the routine semen analysis was proceed as well.All the subjects were divided into 4 groups according to the detection re-sults:simple Mycoplasma or/and Chlamydia positive group(71 cases),simple anti-sperm antibodies positive group(21 cases),My-coplasma and Chlamydia or/and anti-sperm antibodies positive group(8 cases),Mycoplasma,Chlamydia and anti-sperm antibodies negative group(44 cases).The main indexes of semen routine were compared among 4 groups.Results The positive rates of Myco-plasma,Chlamydia and anti-sperm antibodies in infertile males were significantly higher than those of fertile males (P <0.05).The sperm densities,activity rates,activity of simple Mycoplasma or/and Chlamydia positive group,simple anti-sperm antibodies posi-tive group,and Mycoplasma and Chlamydia or /and anti-sperm antibodies positive group were significantly lower than the nega-tive group,while the sperm malformation rates,liquefaction times,white blood cell counts of the three groups were significantly higher than the negative group(P <0.05 ).Conclusion Mycoplasma,Chlamydia infection and anti-sperm antibodies production have significant effect on the indexes of semen,which cause decline in semen quality and the occurrence of male infertility.

Objective To compared different fixation methods for acetabular fractures involving the quadrilateral plate using a finite element model of the acetabulum.Methods A model of acetabular fractures with quadrilateral plate involved was developed in the finite element software and processed in Hypermesh V10.0 to generate internal fixation with dual-column titanium plate (Group A),anterior special titanium moulding plate plus quadrilateral screws (Group B),and anterior special titanium moulding plate plus quadrilateral screws combined with posterior column screws (Group C).Pelvic stress in sitting and standing positions were simulated in sequence with constraint of tuber nodes and inferior femur.Maximum stress and displacement of the acetabulum and displacement of nodes on fracture lines were measured after a force of 600 N was applied to S1 verterbrae in line with the direction of gravity in sitting and standing positions.Results In sitting position,the maximum stress and displacement of the acetabulum exhibited a sequence of Group C (9.47,1.08) ＜ Group B (19.84,1.11) ＜ Group A (29.73,1.14).Moreover,the same result was found in standing position with Group C (9.62,1.09) ＜ Group B (12.18,1.10) ＜ Group A (13.28,1.13).Mean displacement of nodes on fracture lines ranked in order of Group C ＜ Group B ＜ Group A (P ＞ 0.05).Conclusions The finite element model can reflect the distribution of pelvic stress effectively.Anterior special titanium moulding plate plus quadrilateral screws combined with posterior column screws provide favorable biomechanical stability in treatment of acetabular fractures involving the quadrilateral area.

Objective To investigate the distribution of carbapenemase-resistant genes carried by multi-drug resistant Acineto-bacter baumannii .Methods 80 strains of multi-drug resistant Acinetobacter baumannii were collected .Polymerase chain reaction (PCR)wasusedtodetectcarbapenemase-resistantgenes,suchasOXA-23,OXA-24,OXA-51,OXA-58,SIM,IMP,VIM ,GIMand SPM ,in multi-drug resistant Acinetobacter baumannii .Results Drug resistant gene OXA-23 [49 (61 .3% )] ,OXA-51 [73 (91 .3% )] ,OXA-58[7(8 .8% )] ,OXA-24[1(1 .3% )] ,IMP[17(21 .3% )] and VIM[2(2 .5% )] were found in 80 strains of multi-drug resistant Acinetobacter baumannii ,while GIM ,SIM and SPM gene were not found .Conclusion IMP ,OXA ,VIM is the main genotypes carried by multi-drug resistant Acinetobacter baumannii .

Objective To evaluate the recent clinical outcomes of fixing posterior acetabular wall fractures combining the AO mini plate with reconstruction plate.Methods From Jan 2009 to Jul 2013,28 patients with posterior acetabular wall fracture were fixed by the AO mini-steel plate combined with reconstruction plate,including 17males and 11 females with the mean age of 45.8 years (range,18-65).After admission,reduce the dislocation of hip joint immediately,and take femoral condyle or tibial tubercle traction.Preoperative and postoperative anteroposterior and Judet oblique radiographs,acetabular CT scan and three-dimensional reconstruction imaging were routine taken.Using Kocher-Langenbeck approach,intraoperative,try to protect the soft tissue attached on the small fragments,and reduct the fracture.Cutting the mini plate into proper length with reconstruction plate fix to its surface crossover.The functional outcomes were evaluated by the modified Merle d'Aubigné and Postel clinical grading system.The radiographs were graded according to the Matta/Judet criteria.Results Twenty-three patients are followed up 13 months(82.2％),and 5 cases lost in 12 weeks (17.8％).By the Matta/Judet criteria,22 cases achieved excellent reduction,4 good reduction and two fair reduction,with a good and excellent rate of 92.8％.By the modified Merle d'Aubigné and Postel criteria,functional recovery of the affected hip six month post-operation was rated as excellent in 15 cases,good in 5 cases,fair in 2 cases and poor in one case.with a good and excellent rate of 87.9％.One case occurred femoral head necrosis.In 2 patients 2 years after surgery developed traumatic arthritis.Two patients had heterotopic ossification after six month operation.One patient with injury to the sciatic nerve recovered 3 months post-operation.Conclusion Using the AO mini plate combined with reconstruction plate can fix the acetabular posterior wall fractures stably.The technique meet the requirements of patients with early functional exercise,which provides an effective method of internal fixation.

OBJECTIVE To explore the positive rate of intercellular adhesion (ica) operon and its production- polysaccharide intercellular adhesion(PIA) and the relationship between the rate and adhesion of Staphylococcus epidermidis. METHODS Amplifying icaA of ica operon by PCR and then detecting it by agarose electrophoresis, detecting PIA by Congo red agar (CRA) to detect its adhesive ability by infusion set. RESULTS The icaA positive rate of S.epidermidis was 51.5%; the PIA positive rate was 50%; there was significant difference between the clone numbers of PIA positives and negatives (P