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.

Background::Bladder cancer, characterized by a high potential of tumor recurrence, has high lifelong monitoring and treatment costs. To date, tumor cells with intrinsic softness have been identified to function as cancer stem cells in several cancer types. Nonetheless, the existence of soft tumor cells in bladder tumors remains elusive. Thus, our study aimed to develop a microbarrier microfluidic chip to efficiently isolate deformable tumor cells from distinct types of bladder cancer cells.Methods::The stiffness of bladder cancer cells was determined by atomic force microscopy (AFM). The modified microfluidic chip was utilized to separate soft cells, and the 3D Matrigel culture system was to maintain the softness of tumor cells. Expression patterns of integrin β8 (ITGB8), protein kinase B (AKT), and mammalian target of rapamycin (mTOR) were determined by Western blotting. Double immunostaining was conducted to examine the interaction between F-actin and tripartite motif containing 59 (TRIM59). The stem-cell-like characteristics of soft cells were explored by colony formation assay and in vivo studies upon xenografted tumor models. Results::Using our newly designed microfluidic approach, we identified a small fraction of soft tumor cells in bladder cancer cells. More importantly, the existence of soft tumor cells was confirmed in clinical human bladder cancer specimens, in which the number of soft tumor cells was associated with tumor relapse. Furthermore, we demonstrated that the biomechanical stimuli arising from 3D Matrigel activated the F-actin/ITGB8/TRIM59/AKT/mTOR/glycolysis pathways to enhance the softness and tumorigenic capacity of tumor cells. Simultaneously, we detected a remarkable up-regulation in ITGB8, TRIM59, and phospho-AKT in clinical bladder recurrent tumors compared with their non-recurrent counterparts.Conclusions::The ITGB8/TRIM59/AKT/mTOR/glycolysis axis plays a crucial role in modulating tumor softness and stemness. Meanwhile, the soft tumor cells become more sensitive to chemotherapy after stiffening, that offers new insights for hampering tumor progression and recurrence.

BACKGROUND: The purpose of this study was to investigate the specific effects of signal transducer and activator of transcription 4 (STAT4)-induced long intergenic nonprotein coding RNA 1278 (LINC01278) on the growth of non-small cell lung cancer (NSCLC) cells involved in the microRNA (miR)-877-5p/activated transcription factor 4 (ATF4) axis. METHODS: NSCLC tumor tissue and adjacent normal tissue were collected. Human normal lung epithelial cell BEAS-2B and human NSCLC cell lines (H1299, H1975, A549, H2228) were collected. The expression levels of STAT4, LINC01278, miR-877-5p, and ATF4 were detected. A549 cells were screened for subsequent experiments. The proliferation ability of cells was detected by colony formation experiment. Cell apoptosis was tested by flow cytometry. Scratch test and transwell assay were used to detect the migration and invasion ability of cells. Biological function of LINC01278 in NSCLC was confirmed by xenograft experiments. RESULTS: Low expression miR-877-5p and high expression of STAT4, LINC01278 and ATF4 were detected in NSCLC.Silenced LINC01278 in A549 cell depressed cell proliferation, migration and invasion, but facilitated cell apoptosis.LINC01278 was positively correlated with STAT4 and could directly bind to miR-877-5p. Upregulating miR-877-5p suppressed NSCLC cell progression, while downregulating miR-877-5p had the opposite effect. Upregulating miR-877-5p abrogated the effects of silenced LINC01278 on NSCLC cell progression. MiR-877-5p targeted ATF4. ATF4 upregulation could partly restore the carcinogenic effect of LINC01278 in vitro and in vivo. CONCLUSION Our data supports that STAT4-induced upregulation of LINC01278 promotes NSCLC progression by modulating the miR-877-5p/ATF4 axis, suggesting a novel direction for NSCLC treatment.

Objective To observe the risk factors of recurrence after ultrasound-guided thermal ablation for treating uremia secondary hyperparathyroidism(SHPT).Methods Totally 59 patients with uremia SHPT who underwent ultrasound-guided thermal ablation were enrolled,including 23 cases with(relapse group)and 36 without SHPT recurrence(non relapsed group).Clinical data were compared between groups,univariate and multivariate logistic regression analysis were performed to screen independent risk factors of SHPT recurrence.Results There were significant differences of serum free thyroxine(FT4),urea,intact parathyroid hormone(iPTH)1 day after ablation,1 day decrease rate of iPTH,the maximum diameter of the largest nodule,ablation time,total ablation energy,energy to volume ratio and the proportion of 1 day decrease rate of iPTH≤90%between groups(all P＜0.05).Higher urea,lower energy to volume ratio and 1 day decrease rate of iPTH≤90%were all independent risk factors of SHPT recurrence(all P＜0.05).Conclusion Higher urea,lower energy to volume ratio and 1 day decrease rate of iPTH≤90%were independent risk factors of recurrence after ultrasound-guided thermal ablation for treating uremia SHPT.

Objective The Kellinghaus grading method was used to manually read and grade the thin-layer CT of sternal end of clavicle,and a variety of traditional statistical methods as well as machine learning methods were used to construct age estimation models for adolescents and adults in early adulthood,to explore the value of the application of machine learning technology in the study of age estimation of the Han Chinese population in Sichuan.Methods Thin-section CT images of the chest were retrospectively collected from 491 individuals aged 10～30 years,and the collected samples were assigned a reading grade with reference to the Kellinghaus grading method.10%of the xases were randomly selected as the test set,and the remaining data were used as the training set to construct a variety of traditional statistical regression models and machine learning models for estimating the age of adolescents and adults in early adulthood,and the performance of the models was evaluated by using the mean absolute error(MAE).Results The statistical regression model with the best efficacy was the cubic regression model,with an MAE value of 1.34 for males and 1.57 for females;of the three machine learning models,the Random Forest model had the best predictive efficacy for males,with an MAE value of 1.39,and the Support Vector model had the best predictive efficacy for females,with an MAE value of 1.51.Conclusion In the construction of age estimation models for sternal end of clavicle,the machine learning model has a certain improvement in the accuracy of age prediction,but there is no obvious advantage compared with the traditional statistical regression model,and the use of the machine learning method in age estimation based on sternal end of clavicle still needs further exploration.

Objective To use the deep learning methods to extract features of the 1st to 7th adult costal cartilage CT reconstruction images to realize the automatic estimation of adult costal cartilage bone age.Methods 625 male and 625 female samples aged between 20 and 70 years old were collected retrospectively,and the corresponding VRT images were reconstructed by volume rendering technology(VRT).After image preprocessing and data augmentation,500 cases were used as the training set and 125 cases as the test set.The performance of ResNet,ResNeXt,DenseNet and GoogleNet networks was evaluated by using 5-fold cross-validation,and the average value of 5-fold cross-validation results was taken as the final estimation result.Results The ResNet50 network achieved the best results in both male and female datasets.The mean absolute error was 4.56 years and 3.91 years,the accuracy rate was 64.00%and 70.88%in the range of±5.0 years,88.96%and 94.40%in the range of±10.0 years,respectively.Conclusion Compared with traditional methods and machine learning methods,the deep learning models can avoid the influence of human factors,greatly improve the accuracy of adult costal cartilage bone age estimation,and reduce the error between predicted age and real age,which has high clinical application value.

Cranial defect restoration is popular in forensic anthropology,craniofacial surgery,and archaeology.Virtual 3D restoration developed fast and has a broad prospect since computer assisted method applied in cranial facial defect restoration based on CT scans.In recent years,with the continuous development of computer algorithms and software,the 3D cranial facial defect restoration methods have been increasing.The purpose of this paper is to summarize the computer-aided 3D cranial facial defect restoration based on CT scans published in the past two decades and to research the current progress.

Objective:To propose a method of image similarity measurement based on structure information and intuitionistic fuzzy set and measure the similarity between CT image and CBCT image of radiotherapy plan positioning, aiming to objectively measure the setup errors.Methods:A total of four pre-registration images of a nasopharyngeal carcinoma patient on the cross-sectional and sagittal planes and a pelvic tumor patient on the cross-sectional and coronal planes were randomly selected. Five methods were used to quantify the setup errors, including correlation coefficient, mean square error, image joint entropy, mutual information and similarity measure method.Results:All five methods could describe the deviation to a certain extent. Compared with other methods, the similarity measure method showed a stronger upward trend with the increase of errors. After normalization, the results of five types of error increase on the cross-sectional plane of the nasopharyngeal carcinoma patient were 0.553, 0.683, 1.055, 1.995, 5.151, and 1.171, 1.618, 1.962, 1.790, 3.572 on the sagittal plane, respectively. The results of other methods were between 0 and 2 after normalization, and the results of different errors of the same method slightly changed. In addition, the method was more sensitive to the soft tissue errors.Conclusions:The image similarity measurement method based on structure information and intuitionistic fuzzy set is more consistent with human eye perception than the existing evaluation methods. The errors between bone markers and soft tissues can be objectively quantified to certain extent. The soft tissue deviation reflected by the setup errors is of significance for individualized precision radiotherapy.

An epidemiological investigation was carried out on a local cluster of outbreak caused by imported cases of Coronavirus Disease 2019 (COVID-19) in rural areas of Chengdu in December 2020, to find out the source of infection and the chain of transmission. According to
COVID-19 ; Disease Outbreaks ; Epidemics ; Humans ; Quarantine ; SARS-CoV-2

Objective:To explore a method of improving the nursing service ability after total hip arthroplasty (THA) among nurses in villages and towns medical health institutions under the county medical community model and to evaluate its effects.Methods:From June 1 2018 to September 30 2019, we took Department of Orthopedics, Dazhu County People's Hospital of Dazhou of Sichuan Province, as the core, and united with county medical community built by villages and towns medical health institutions with the country in organizing the nursing theoretical knowledge and specialist service ability training after THA for 140 nurses of villages and towns medical health institutions within county medical community. Before and after training, we carried out the theoretical test and practice ability test in trainers, and implemented the consistency analysis in scores of nursing assessment scales for specialist service so as to evaluate the subjective training effect. We also compared the incidence of postoperative complications, functional recovery of hip joint as well as the satisfaction among 30 THA patients before (October 2017 to September 2018) and after (October 2018 to September 2019) training so as to explore the clinical effect.Results:Before and after training, scores of theoretical achievements of nurses of villages and towns medical health institutions were 60 (56, 62) and 82 (79, 85) respectively, and scores of practice ability were 52 (47, 62) and 86 (81, 91) respectively with statistical differences ( P<0.01) . After training, the incidence of postoperative complications was lower than that before training (6.67% vs. 26.67%) ; the postoperative satisfaction, scores of Harris Hip Score (HHS) one month and three months after surgery were higher than those before training [90.00% vs. 66.67%, (73.1±6.00) vs. (57.6±6.67) , (86.6±4.49) vs. (74.5±6.20) ]among 30 THA patients with statistical differences ( P<0.05) . Conclusions:Training with the county medical community model can improve the nursing service ability of nurses in villages and towns medical health institutions among THA patients, postoperative function of hip joint of THA patients as well as patient satisfaction.