A microbiological test for the diagnosis of death by drowning

The present study was aimed at demonstrating the diffusion of sea water or freshwater into the bloodstream as a consequence of water aspiration due to drowning. The study was carried out on 42 study group subjects who died by drowning in salt water (20 cases) and freshwater (22 cases) and 30 control group subjects who died from causes other than drowning. For 25 cases we obtained water samples from the aquatic locations where the victims were found. The blood samples of study and control groups were analyzed to search for faecal coliforms (FC) and faecal streptococci (FS) bacteria. The presence of FC and FS was showed by the development of blue and red colonies, respectively. From left ventricular (LV) and right ventricular (RV) blood cultures of the 20 sea drowning victims we always isolated FS and FC, whereas 19 (95%) femoral arterial (FA) and 18 (90%) femoral venous (FV) blood cultures were positive for both faecal bacteria. Related to freshwater victims, LV blood cultures showed FS presence for all the 22 cases studied (100%) and FC presence for 20 cases (90.91%). Blood cultures from RV, FV, and FA showed various patterns of faecal bacteria presence. The analysis of 25 water samples from the aquatic locations where the victims were found showed the presence of FC and FS bacteria. Blood cultures from the 30 control subjects uniformly proved the absence of faecal bacteria.     

溺死的法医学鉴定

溺死的鉴定一直是基层法医鉴定工作中的难点,这是由于大部分溺死案例的特征性尸检所见很少,同时国际上很多学者对溺死的实验室检验存有疑义。本文查阅了国内外相关文献并结合作者多年来对溺死案例的实际鉴定经验,对溺死的法医学鉴定作出较系统的综述。     

PCR-DGGE法检测浮游生物16S rDNA在溺死鉴定中的应用

目的建立并评估PCR-DGGE法检测浮游生物对溺死鉴定的应用价值。方法大白兔30只随机分为3组:溺死组(n=12),死后抛尸组(n=12)和对照组(n=6);溺死组和死后抛尸组又分为2个亚组:东湖水域组(n=6)和墨水湖水域组(n=6)。死后提取心血和肺、肝、肾、脑等组织,匀浆后,采用Percoll密度梯度离心法分离浮游生物并提取其DNA,PCR扩增浮游生物特异的16S rDNA片段后分别用琼脂糖凝胶电泳及DGGE检测分析。2个溺死案例检材同法检验。结果溺死组各组织器官中浮游生物检测多呈阳性:肺(100%)、肝(83%)、肾(75%)、心血(83%)、脑(42%);死后抛尸组仅2例肺组织(16.7%)检出阳性;对照组全部阴性。溺尸肺组织DGGE分型图谱与相应溺死点水样分型图谱相似,而与非溺死点水样分型结果差异显著。2实际案例均呈阳性。结论本方法不仅有助于定性诊断溺死,而且通过比较产物的多样性可以推断溺死地点,在法医学溺死鉴定中具有较大实用价值。     

溺死鉴定中硅藻检验的应用

在法医学检案中,溺死诊断以及入水地点的判定一直是重点和难点之一,硅藻检验被认为是一种相对可靠的诊断溺死的方法,而根据硅藻的群落特征推断其入水区域具有一定的可信度。对不同水域内硅藻进行研究,可为溺死鉴定及入水区域的判定提供参考。本文就硅藻相关的生物学特性、检验方法等相关的国内外研究进展进行综述,供法医学工作者在相关科研和检案实践中参考。     

微波消解-扫描电镜联用法在溺死诊断中的应用

目的探讨微波消解-扫描电镜联用法在溺死诊断中的应用价值。方法收集已知死因的尸体标本105例,其中水中尸体85例(生前溺死70例,死后抛尸入水15例),陆地自然死亡尸体20例。水中死亡案例同时收集落水处水样。分别用微波消解-扫描电镜联用法(方法 A)和硝酸破机-光镜联用法(方法 B)对上述尸体的离体肺、肝、肾、骨髓组织及水样进行硅藻定性、定量检测。结果①溺死尸体的肺、肝、肾、骨髓中及落水处水样硅藻检出率:A法分别为100%、94.3%、92.9%、82.9%、100%,硅藻检验阳性率为100%;B法分别为90%、62.9%、51.4%、28.6%、92.9%,硅藻检验阳性率为65.7%。②两种方法检出的硅藻种类与落水处水样中硅藻的种类均一致。③两种方法在死后入水尸体离体的肺中也检出少量硅藻(<3个/2g肺组织),但在死后入水尸体的其它脏器及陆地自然死亡尸体脏器中均未检出硅藻。结论微波消解-扫描电镜联用法较硝酸破机-光镜联用法对尸体离体组织脏器中的硅藻检出率高,方法灵敏,定性准确。     

溺死的法医学检验现状及进展

本文概括阐述了近年来,国内外学者将硅藻的检验、内脏异物颗粒和微量元素成分的检验、血液化学的检验、电子显微镜的观察等方法应用于溺死的诊断,试图为溺死的法医学鉴定提供准确的诊断指标。     

检测浮游生物叶绿素相关基因诊断溺死的实验研究

目的评估浮游生物叶绿素相关基因检测用于溺死诊断的价值。方法将18只大白兔随机分为溺死组（n=10）、死后抛尸组（n=6）和对照组（n=2）,各组分别取心血及肺、肝、肾、脑组织,分离浮游生物并提取其DNA,用PCR技术检测叶绿素相关基因EG（EG1和EG2）及SK（SK1和SK2）。同时用硝酸消化法检验肺和肝组织中的硅藻。结果溺死组心血及肺、肝、肾、脑组织中EG1分别检出9、10、9、7和8例阳性,EG2分别检出8、10、7、5和7例阳性;死后抛尸组仅在心血和肺组织中各检出1例EG1阳性;对照组各组织均未检出EG1和EG2。SK1、SK2除在溺死组心血、肺和肾有少数检出外（≤2例）,在其他组未检出扩增产物。硝酸消化法从溺死组肺、肝组织中分别有9例及3例检出硅藻,死后抛尸组仅在1例肺组织中检出。结论浮游生物叶绿素相关基因EG用于溺死诊断的阳性检出率要高于硝酸消化法,在溺死诊断中具有较高的应用价值。     

The significance of detecting serum fluorine level in the diagnosis of drowning

In view of the high content of fluorine in the water of a vast area of Guangdong Province, we detected the serum fluorine level in rabbits that died of drowning and compared them with those obtained from rabbits immersed in water after death from hanging. The fluorine content in water is about 15-fold higher than in the normal serum content. In drowned rabbits, the serum fluorine values are significantly higher than normal while in control cases the serum fluorine values are slightly lower than normal. The fluorine content in human serum is similar with that of rabbits. It suggests that detection of serum fluorine content might be a valuable method for the diagnosis of drowning in those areas where there are high water fluorine content.     

溺死法医学鉴定的研究新进展

综述了近年来在硅藻检验、水中浮游生物叶绿素（A）检测、血液化学和组织化学检验等方面的最新文献报道,并对各种溺死检验方法的优缺点进行了评价：在硅藻检验中,硝酸乙醇法、破机罐法及微波消解法,可缩短检验时间,提高办案效率;酶消化法及PCR法硅藻检出率高,适用于可疑水样中硅藻密度低等情况。早期器官组织中浮游生物叶绿素（A）、血液和组织中其他生化指标,可作为鉴定溺死的重要参考。微量元素锶检测可用于鉴定海水中溺死。另外,硅藻及其他浮游生物遗传多态性片断PCR,可望成为新的、灵敏的溺死检测方法。     

医源性溺死1例分析

医源性溺死是指医疗行为中由于治疗不当引起液体进入气管、支气管和肺部,妨碍气体交换而导致窒息死亡.     

医源性溺死1例分析

医源性溺死是指医疗行为中由于治疗不当引起液体进入气管、支气管和肺部 ,妨碍气体交换而导致窒息死亡。在临床上因为洗胃直接导致的死亡较为鲜见 ,笔者曾遇一例因可疑鼠药中毒在医院用自动洗胃机洗胃过程中死亡的医疗纠纷案例。死者家属认为患儿的死亡是由于洗胃操作不当不慎所致 ,而院方则称患儿系鼠药中毒抢救无效死亡 ,与医院洗胃无关。为正确处理此案 ,卫生部门组织法医等有关专家对死者进行解剖检验发现洗胃液未进入胃内 ,毒化检验排除中毒 ,尸体外表征象及内部改变符合缺氧窒息死亡特点 ,病理检验结果提示肺脏兼有水肿和气肿两种特征…     

The reliability of cardiac haemodilution as a diagnostic test of drowning.

The diagnosis of drowning is one of the most challenging problems in forensic pathology. The estimation cardiac haemodilution is a simple method, but its use is limited by its lack of specificity and sensitivity. We have studied the limitations of this method and have defined the circumstances in which such a technique can be used.     

The use of bacteriological analysis of the blood in the diagnosis of death by drowning

Investigation of blood samples from the femoral vein of subjects drowned in water and died of other causes (control) was carried out. Penetration of microflora contained in water into the bloodflow of the drowned people was shown. Possibility of using bacteriologic analysis of the postmortal blood to diagnose death from drowning was stated. Ps. putida and Ps. fluorescens. that were not present in the blood of persons who had died of causes other than drowning were recommended as test bacteria. Selective media and methods to isolate the bacteria from the cadaveric blood were chosen.     

The usefulness of lung surfactant phospholipids (LSPs) in the diagnosis of drowning

The authors have studied the usefulness of some lung surfactant phospholipids (LSPs) isolated from lung tissues as markers of drowning. Two different groups of rabbits were sacrificed by drowning in fresh and salt water, and their phospholipid compositions were compared with those of a non-drowned control series. For the phospholipids studied in lung lavages (phosphatidyl choline, phosphatidyl ethanolamine, and phosphatidyl glycerol) the proportions differed between the control group and the drowned group, and between the fresh-water and salt-water drowned animals. According to these results, the lipids we have analyzed can be employed as markers in forensic autopsies, where it is necessary to differentiate between death by drowning and postmortem immersion and between fresh-water and salt-water drowning. In lung tissue, only phosphatidyl choline and phosphatidyl inositol showed significative differences. These results also confirm that LSPs are strongly affected in drowning.     

微波消解-扫描电镜联用检测脏器内硅藻

目的介绍一种微波消解-扫描电镜联用检测脏器内硅藻的新方法。方法大白兔30只,随机分为生前溺死组（n=15）和死后溺尸组（n=15）。提取兔肺、肝、肾、股骨骨髓和现场珠江水样,采用建立的微波消解-扫描电镜联用法检测脏器组织和水样中的硅藻,并与硝酸乙醇消解-扫描电镜联用的方法进行比较。结果生前溺死组的兔肺、肝、肾、股骨骨髓组织中大多数观测到与现场珠江水样一致的硅藻,微波消解-扫描电镜联用法检测脏器内硅藻的平均含量分别为：2505.2个/2g肺,18.7个/10g肝,6.5个/10g肾,6.3个/0.5g骨髓;肺与肝、肾、骨髓检出硅藻的阳性比例为86.7%,脏器硅藻检出含量和硅藻检验阳性比例均明显高于硝酸乙醇消解-扫描电镜联用法所测值。死后溺尸组的兔脏器组织均未观测到硅藻。结论微波消解-扫描电镜联用法检测脏器内硅藻,高效、安全、环保,硅藻检验灵敏度高,降低了劳动强度,提高了定性定量分析准确度,且能有效避免污染,在法医学溺死鉴定中具有良好的应用价值。     

The forensic medical evaluation of the results of determining diatomaceous plankton in the diagnosis of drowning

Evaluation of demonstrative value of method based on diatom plankton determination as a diagnostical sign of death due to drowning was performed. Plankton was detected in the viscera in 37% of cases (as a whole 376 bodies of people who drowned in fresh water were examined). Plankton was detected in aspiration type of drowning and its mixed variant. In spastic and reflector types of drowning plankton wasn't detected. According to author's opinion this method is an objective diagnostical test to determine the cause of death of people when their bodies are found in water.     

A study on the diagnosis of drowning by examination of lung chlorophyll(a) of planktons with a spectrofluorophotometer.

An investigation on the diagnosis of drowning by analysis of chlorophyll(a) (Chl.(a)) of planktons in the lung sample with a spectrofluorophotometer (SFPM) is reported. The diagnostic criteria or main points of death by drowning are suggested are according to our experimental studies. Meanwhile two cases of submersion in water were investigated and the causes of death were diagnosed correctly. It is concluded that examination of lung Chl.(a) of planktons could be used as a reliable diagnostic method in forensic practice.     

A delayed drowning death with histological findings of shock

A delayed drowning death case with histological findings of shock was described. The person was sustained by continuous positive-pressure respiration and died 2 days after resuscitation from drowning. The histological findings were intravascular microthrombi, hyaline bodies and fibrin thrombi in the brain, multiple megakaryocytes in the pulmonary capillaries, hyaline membranes of the lung, multiple small hyaline bodies in the liver sinusoids, and erosion of the mucous membrane of the stomach as well as histological findings of shock kidney. Drowning and systemic hypotension during resuscitation seemed to cause irreversible oxygen debt of the organs and the tissues to lead to shock.     

浮游生物PCR检测及其在溺死鉴定中的研究进展

溺死鉴定是法医学中的重点和难点之一,目前在相关法医学案件中,主要采用法医病理学尸检与传统硅藻检验等方法综合分析进行鉴定。传统硅藻检验存在灵敏性较低,易于污染等不足。采用PCR法检测尸体不同脏器组织中是否存在水中浮游生物的DNA标记,适用范围广,信息量丰富,灵敏性和特异性较高,有较好的法医学应用前景,有望成为鉴定溺死的新方法。本文对相关研究进展进行综述,为相关研究和实践参考。