Tasks of research in forensic medicine - different study types in clinical research and forensic medicine

In the last years the research output of forensic medicine has sometimes been regarded as insufficient and as of poor quality, especially when parameters as impact factors and external funding were taken into account. However, forensic medicine has different tasks compared to clinical medicine. The main difference between basic subjects, clinical and forensic medicine is not a lack of scientific efficiency in forensic medicine but is a result of the questions asked, the available methods and specific aims. In contrast to natural-scientific research, forensic science has furthermore important intersections with arts and socio-scientific disciplines. Etiologic and pathogenetic research is of only limited relevance in forensic medicine. Thus, forensic medicine is excluded from these research fields, which are mainly supported by external funding. In forensic medicine research mainly means applied research regarding findings, the probative value and reconstruction as well as examination at different points of intersection between medicine and law. Clinical types of research such as controlled randomised, prospective cross-sectional, cohort or case-control studies can only rarely be applied in forensic medicine due to the area specific research fields (e.g. thantatology, violent death, vitality, traffic medicine, analytical toxicology, hemogenetics and stain analysis). The types of studies which are successfully established in forensic medicine are comparison of methods, sensitivity studies, validation of methods, kinetic examinations etc. Tasks of research in forensic medicine and study types, which may be applied will be addressed.     

Demands on scientific studies: vitality of wounds and wound age estimation

Research on vitality and wound age estimation belongs to the classic fields in forensic medicine. Despite large literature data there is still considerable demand of further research and practical transfer of knowledge and techniques to daily casework. Scientific studies must fulfil basic criteria as to appropriate methods, selection of case material, analysis of results and quality control. Nowadays, immunohistochemistry, biochemical tests and molecular biological techniques are mainly used studying questions of vitality and wound age. Investigations can be based on human tissue samples (autopsy material, vital specimens) or animal experiments. The possibilities, advantages and disadvantages of these study designs are described. Indispensable is the use of appropriate control groups or control samples and a sufficient case number which permits statistical analysis. Main strategy is to minimize variations due to methods and investigators as the unavoidable biological variation of vitality processes and wound repair is large enough.     

利用人体标本进行死亡时间推断的研究现状

死亡时间(PMI)推断具有重要的法医学意义,但尚无可以应用在实践领域的PMI推断方法。本文从PMI推断的实践应用角度出发,从脏器、骨骼、骨骼肌、牙齿、牙龈以及大体观、毛发、皮肤和血液等角度,对利用人体标本进行死亡时间推断的研究现状进行了综述。希望对我国开展人体标本的PMI推断实践研究提供借鉴。     

Scanning electron microscopy as an auxiliary method in the study of exhumed bones

Scanning electron microscopy (SEM) has been used in forensic science in many ways. The reports of cases in which SEM has been used as an auxiliary method in the investigation of exhumed bones are rare. In this article, we report an exhumation that was made to determine if a seized weapon could have been used in a homicide. We used SEM to analyze a fracture in the interior of the skull of the victim. The findings described in this article showed us that it is possible to develop new researches in this field.     

Validation of PrepFiler™ forensic DNA extraction kit (Applied Biosystems)

The PrepFiler™ is a new kit recently introduced by Applied Biosystems for DNA extraction from a wide range of forensic samples. In the present study we tested the performance of PrepFiler™ kit against other commonly used commercially available kits on a variety of real forensic casework samples: bloodstains on different substrates, washed bloodstains, semen stains, saliva stains, hairs, bones, tissues, nails, prints after chemical treatments, skin swabs.     

An extremely sensitive species-specific ARMs PCR test for the presence of tiger bone DNA

The survival of the tiger (Panthera tigris) is seriously threatened by poaching to provide raw materials for Traditional Chinese Medicines (TCMs). Most highly prized are the tiger's bones, which are used in combination with other animal and plant derivatives in pills and plasters for the treatment of rheumatism and other ailments. Hundreds of patent remedies have been produced which claim to contain tiger bone, but proof of its presence is needed, if legislation prohibiting the trade in endangered species is to be enforced. A highly sensitive tiger-specific real-time PCR assay has been developed to address this problem. Using primers specific to the tiger mitochondrial cytochrome b gene, successful amplification has been reliably achieved from blood, hair and bone as well as from a range of TCMs spiked with 0.5% tiger bone. Although capable of detecting fewer than 10 substrate molecules, the seven varieties of TCM pills and plasters tested showed no detectable trace of tiger DNA before spiking. Furthermore, sequencing several "tiger bone" fragments seized from TCM shops has shown that they actually originated from cattle and pigs. The potential effects of traditional bone preparation methods, evidence that much lower concentrations are used than alleged on TCM packaging, and substitution of bones from other species all suggest a low likelihood of detecting tiger DNA in patent medicines. Despite this, the basic methods have been thoroughly proven and can be readily applied to derivatives from other CITES protected species providing a rapid and highly sensitive forensic test for species of origin. Potential applications to the monitoring of wild populations are demonstrated by the successful identification of shed hairs and faecal samples.     

An extremely sensitive species-specific ARMS PCR test for the presence of tiger bone DNA

The survival of the tiger (Panthera tigris) is seriously threatened by poaching to provide raw materials for traditional Chinese medicines (TCMs). Most highly prized are the tiger's bones, which are used in combination with other animal and plant derivatives in pills and plasters for the treatment of rheumatism and other ailments. Hundreds of patent remedies have been produced which claim to contain tiger bone, but proof of its presence is needed if legislation prohibiting the trade in endangered species is to be enforced.A highly sensitive tiger-specific real-time PCR assay has been developed to address this problem. Using primers specific to the tiger mitochondrial cytochrome b gene, successful amplification has been reliably achieved from blood, hair and bone as well as from a range of TCMs spiked with 0.5% tiger bone. Although capable of detecting fewer than 10 substrate molecules, the seven varieties of TCM pills and plasters tested showed no detectable trace of tiger DNA before spiking. Furthermore, sequencing several "tiger bone" fragments seized from TCM shops has shown that they actually originated from cattle and pigs. The potential effects of traditional bone preparation methods, evidence that much lower concentrations are used than alleged on TCM packaging, and substitution of bones from other species all suggest a low likelihood of detecting tiger DNA in patent medicines. Despite this, the basic methods have been thoroughly proven and can be readily applied to derivatives from other Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) protected species, providing a rapid and highly sensitive forensic test for species of origin. Potential applications to the monitoring of wild populations are demonstrated by the successful identification of shed hairs and faecal samples.     

烧骨组织形态变化及DNA技术在个体识别中的应用

烧骨在火灾、焚尸、交通、爆炸等案件和事故的检材中具有特殊的地位。通过对不同条件焚烧下烧骨组织形态及DNA变化规律的研究,可为法医实践中烧骨的种属鉴定、性别及年龄判定提供准确的依据和标准,同时可利用残存的基因位点对烧骨残块进行个体识别和同一认定。烧骨DNA的提取方法及检测技术也在不断探索和改进。本文对烧骨在形态学、组织学和分子生物学水平研究进展以及烧骨评测的方法、技术进行概述,旨在为法医实践及进一步研究提供新的方法和思路。     

色觉电生理学研究进展及其法医学应用价值

色觉是视觉功能的重要组成部分。目前色觉的检查主要依靠主观检查方法,研究和探索色觉客观检查方法具有重要的临床意义和法医学价值。随着现代科学技术的日益进步,视觉电生理学检查方法已逐渐成为色觉临床诊断与研究的重要手段。视网膜电图（electroretinogram,ERG）可以对不同的锥细胞及色觉异常进行区分,不同颜色刺激所产生的视觉诱发电位（visual evoked potential,VEP）也有不同的形态特征。通过对不同视觉电生理学检测方法,尤其是视网膜电图、闪光诱发电位、图形诱发电位等在色觉研究方面的新进展等文献的复习表明,色觉电生理研究技术将为网膜功能、脑功能的法医临床学评定提供重要手段。     

关节活动丧失度测算方法的统一和完善

法医临床学鉴定中,涉及计算关节活动丧失度的案例很普遍,但目前尚无统一的标准和规范,一定程度上造成了鉴定结论的混乱．影响了法律和司法鉴定的公平公正。通过实际案例比较临床医学和法医学文献中记载的关节活动功能丧失程度计算的四种方法：主从法、加和法、方向均分法和轴向均分法发现其各有优缺点,现提出法医学鉴定应用技术的公平公正、科学客观和简便易行三原则,建议尽快达成业内共识．采用统一规范的轴向均分法为计算关节活动丧失程度方法．以期避免这方面的弊端。     

A new sensitive short pentaplex (ShoP) PCR for typing of degraded DNA

Analysis of short tandem repeat makers has become the most powerful tool for DNA typing in forensic casework analysis. Unfortunately, typing of DNA extracted from telogen shed hairs, bones buried in the soil or from paraffin-embedded, formalin-fixed tissue often reveals no results due to the degradation of DNA. The reduction in size of the target fragments by development of new primers and their combination in multiplex approaches open a new field of DNA analysis. Here we present a new sensitive short pentaplex PCR including the loci amelogenin, TH01, VWA, D3S1358 and D8S1179. Validation tests of our new method included sensitivity, mixtures, human specificity, artificial degradation of DNA by DNase I and case work analysis on a panel of different forensic samples. The detection limit was 12.5 pg of human DNA, and mixtures of 50 pg in a total of 1000 pg were clearly detectable and revealed complete profiles. Only DNA extracts of human primates displayed a few signals, whereas other animal, fungal or bacterial DNA showed no signals. Our method proved extremely valuable in the analysis of artificially degraded DNA and in forensic cases, where only poorly preserved DNA was available. This approach and other similar methods can aid in the analysis of samples where allelic drop out of larger fragments is observed. It is highly recommended to develop more of these multiplexes to improve poor quality DNA typing.     

Difficulties of sex determination from forensic bone degraded DNA: A comparison of three methods

Sex determination is of paramount importance in forensic anthropology. Numerous anthropological methods have been described, including visual assessments and various measurements of bones. Nevertheless, whatever the method used, the percentage of correct classification of a single bone usually varies between 80% and 95%, due to significant intra- and inter-population variations, and sometimes variations coming from secular trends. DNA is increasingly used in a forensic context. But forensic DNA extraction from bone raises several issues, because the samples are very often badly altered and/or in very small quantity. Nuclear DNA is difficult to get from degraded samples, according to low copy number, at least in comparison with mitochondrial DNA. In a forensic context (as in a paeleoanthropological context) DNA sex determination is usually complicated by the weak amount of DNA, the degraded nature of nucleic acids, the presence of enzymatic inhibitors in DNA extracts, the possible faint amplification of Y band and the risk of contamination during either excavation or manipulation of samples.The aim of this work was to compare three methods of DNA sex determination from bones: procedure #1 using a single PCR amplification, procedure #2 using a double PCR amplification, and procedure #3 adding bleaching for decontamination of the bone, instead of simply rubbing the bone. These processes were applied to samples of bones (49 samples coming from 39 individuals) that were in various states of post mortem alteration.The main results are the following. (i) No DNA could be extracted from three skulls (parietal bones, mastoid process), the compact bone of one rib, and the diaphysis of one femur; (ii) there was a contamination in three skulls; and (iii) the Y band did not appear in two male cases, with one of the three procedures (male tibia, procedure #2) and with procedures #2 and #3 (male femur).This study emphasises the main issue while working with altered bones: the impossibility to extract DNA in some cases, and, worth of all, the contamination of the sample or the faint amplification of Y band which leads to a wrong sex answer. Multiple and significant precautions have to be taken to avoid such difficulties.     

人骨骼及牙齿DNA提取方法的比较和优化

目的人骨骼和牙齿DNA提取方法的比较和优化。方法收集18份不同个体的长骨、30颗磨牙和同一个体2根股骨、8颗磨牙。利用TissueLyser-Ⅱ组织破碎仪和PreFiler Express BTA^TM法医DNA提取试剂盒（BTA法）,应用Automate Express^TM自动化法医DNA提取系统提取DNA,进行STR分型,与脱钙法进行比较,并进行实验条件优化。结果用TissueLyser-Ⅱ结合BTA法,约2.5h即可完成骨骼和牙齿的DNA提取,分型成功率分别为94.4%和96.7%。与脱钙法比较,两种方法获得DNA质量浓度和检出率比较接近（P〈0.05）,但BTA法在操作过程方面更具优势。最佳样本量为100mg,消化时间为2h。结论采用TissueLyser-Ⅱ组织破碎仪结合BTA法对骨骼和牙齿进行DNA提取和分型检验,能满足实际检案的要求,可在法医学实践中选择使用。     

Medical criminalistics

Medical criminalistics is an essential part of legal/forensic medicine. It includes the clinical examination of surviving victims and suspects, the inspection of the scene in suspicious deaths with subsequent performance of medico-legal autopsies, the assessment of (biological) traces and the reconstruction of criminal events under medical aspects. Just as the circumstances of life and the manifestations of crime are changing with time, there is a permanent alteration regarding the issues of medical criminalistics. Legal/forensic medicine is a university subject in most countries and therefore, research work is one of the main tasks also in medical criminalistics. In contrast to clinical medicine and basic research, some common study designs are not suitable for the special needs of medical criminalistics, whereas other types are more appropriate like epidemiological evaluations, cross-sectional studies and (retrospective) observation studies. Moreover, experimental model tests and case reports also rate high in medical criminalistics.     

Analysis of violent deaths of mountaineers and tourists at high altitudes

The principal causes of violent death of mountaineers and tourists at high altitudes are described with special reference to the character of injuries to the skin, soft tissues, bones, and internal organs inflicted by mechanical impacts. The cases of violent death from other factors are described, such as general hypothermia, atmospheric electricity, compression and obturation asphyxia of mountaineers and tourists who died in the epicenter of an avalanche. The additional criteria for forensic medical diagnostics of violent death of montaineers and tourists at high altitudes are considered.     

The computer and the law: coordinate analysis of skull shape and possible methods of postmortem identification.

Mechanisms accelerating or retarding the disintegration of soft tissues are briefly discussed, as well as the need to reconstruct the missing profile for postmortem identification purposes. The application of X-ray and computer-based analyses is discussed in the context of providing data to predict and reconstruct the most probable soft tissue profile of a dry skull. In addition, information from extensive studies of the facial bones and profiles of veterans has been applied to methods in forensic medicine of determining age, sex, and racial background of unknown subjects.     

Significance of mitochondrial DNA for forensic stain analysis, identification and forensic lineage determination

DNA testing using conventional STR systems may produce insufficient results, if the genomic DNA in the specimen is either highly degraded or the available quantity is very small (e.g. skin particles, hair shafts or ancient bones). In some of these cases the examination of mitochondrial DNA, which is present in considerably larger copy numbers in the cytoplasm, is more successful than that of nuclear DNA. Identification of unknown corpses by conventional DNA typing sometimes remains doubtful, if only samples from presumably distant relatives or putative brothers or sisters are available for comparison. Since mitochondrial DNA is generally transmitted in maternal lineages, its sequence pattern can be directly compared with those of other individuals and, in case of the same maternal lineage, corresponding sequence chromatograms are to be expected. In connection with nuclear DNA typing methods certain sequence motives may furnish clues to ethnic groups. The report presents three cases illustrating the application possibilities of mtDNA typing in forensic practice.     

毛发中毒品分析

毛发分析在法庭毒品分析领域有其独特的优势,很多国家的法化学实验室,毛发分析已成为毒品检测的常规操作,并已得到了法庭的承认、采纳。本文对毒品进入毛发的机制、毛发的现场勘查、毛发中毒品分析程序、毛发中毒品分析结果的评判进行了综述。简单地介绍了毛发在现场勘查中采取、包装、送检的基本方法和技术人员在操作过程中的注意事项,以及针对毛发检验中的特殊技术处理;另外,介绍了毛发中毒品分析的特点,通过分析毛发毒品的药理机制,总结出了一些高效、便利、快速的毒品分析方法,并对各种方法进行了介绍,得出了毛发中毒品分析结果的一些特点。     

The effects of skeletal preparation techniques on DNA from human and non-human bone

The forensic pathologist increasingly relies on the forensic anthropologist to be the consulting expert in human identification. Likewise, if identification is not possible from visual inspection of skeletal remains, the forensic biologist may be called upon to conduct DNA analysis. The possibility of downstream DNA testing needs to be considered when skeletal preparation techniques are employed to deflesh human remains, as they have the potential to strongly impact genetic analyses and subsequent identification. In this study, three cleaning techniques, boiling bone in water, in bleach, and in powdered detergent/sodium carbonate, were tested for their effect on nuclear and mtDNA recovery from a variety of human and non-human bones. A statistically significant reduction in DNA yields occurred in non-human bones cleaned with bleach, and DNA degradation was apparent electrophoretically. The human bones also showed much lower yields from bleach cleaning, while the detergent/carbonate method allowed the largest segments of DNA to be amplified, indicating it may have a less degradative effect on bone DNA than either of the other cleaning processes.     

利用AutoMate Express~(TM)自动化法医DNA提取系统提取骨骼及牙齿DNA

目的探讨建立骨骼及牙齿DNA自动化提取的新方法。方法将33份骨骼及15份牙齿样本分别用冷冻研磨和手工处理两种方法研磨成粉,采用AutoMate ExpressTM自动化法医DNA提取系统提取DNA并定量。结果 AutoMate ExpressTM自动化法医DNA提取系统能够在3h左右完成骨骼、牙齿DNA的提取,两种方法处理的骨骼样本所得DNA质量浓度差异无统计学意义。冷冻研磨处理的骨骼和牙齿样本均获得了较好的STR分型结果,且牙齿样本所得DNA质量浓度高于手工提取所得。结论应用AutoMate ExpressTM自动化法医DNA提取系统是自动化提取骨骼、牙齿DNA的一种新方法,可应用于法医实际案件检验。