生前伤与死后伤皮肤弹力纤维变化研究

采用Ｈａｒｔ氏弹力纤维染色对不同时间的皮肤生前伤和死后伤进行组织学观察研究，结果表明：生前伤和死后伤真皮中的弹力纤维在形态和分布上无任何区别，因此，在法医实践中依据真皮中弹力纤维形态变化区别生前伤与死后伤无诊断价值     

大鼠纤维连接蛋白诊断生前伤的实验研究

本实验采用我室自己制备的免抗鼠纤维连接蛋白抗血清作为第一抗体，ＡＢＣ免疫组化技术观察不同损伤时间鼠损伤皮肤Ｆｎ的渗出及分布变化．探讨应用纤维连接蛋白诊断生前伤、死后伤的价值．其结果表明：伤后５分钟，创缘深层出现纤维连接蛋白细网．其渗出量与损伤时间密切相关．死后标本均无纤维连接蛋白渗出．因此．我们认为该方法可为法医学研究生前伤和死后伤的鉴别诊断开辟另一新的途径．     

家兔死后体表锐器伤出血现象的研究

目的对家兔死后体表锐器损伤出血现象进行研究,以期能够贴近实际办案需要,找到一个更为实用的鉴别生前锐器伤和死后锐器伤的方法。方法家兔脱毛,制作锐器损伤模型,采用大体观察结合HE染色镜下组织病理学观察。结果死后锐器损伤出血量均较少,随着时间延长出血量减少,出血速度慢。死后30min的锐器损伤在形成过程与生前损伤有所区别,但在死后12h肉眼观察结果与生前损伤难以区别。死后1h以上的锐器损伤与生前损伤不同之处在于创缘不会被血染。结论位于尸体低下位置的死后30min内的锐器创与生前锐器创的区别是出血量相对较少。死后60min-90min的锐器伤出血量少,创缘皮肤不被血染,肌肉的出血较局限,与生前损伤相鉴别较容易。     

用RT-PCR法区别生前与死后伤

12只SD大鼠随机分为生前伤、死后伤、麻醉伤和正常对照四组，损伤时间为15min，取创缘皮肤为检材；IL－6引物为寡聚核着酸引物（27hP），内对照引物为Tx基因（20hP），用TRIZOLTMTotalRNA提取试剂盒抽据总RNA，AMV逆转录酶使mRNA逆转录成cDNA，PCR扩增得出：在生前伤、麻醉伤以及正常皮肤中均能扩增出IL－6cDNA片段（590hp）和内对照Tx基因片段（188b），在死后伤组只能扩增出Tx基因片段；图像分析凝胶灰度扫描；生前损伤组与麻醉组无显著性差异，而二者与正常皮肤组有统计学差异。藉此，运用RT－PCR法可以准确区别大鼠实验性损伤的生前伤与死后伤。     

枪弹创纤维蛋白形成能力的免疫组化研究

采用免疫组化PAP染色法，对57例人体枪弹创标本的纤维蛋白形成能力进行检测。结果发现，所有生前枪弹创均有纤维蛋白形成祖创缘邻近皮肤组织内毛细血管内皮细胞以及血管内充盈的红细胞膜上亦呈棕色阳性染色；死后30min内形成的枪弹创均有纤维蛋白形成；死后37min后形成的枪弹创无纤维蛋白形成，说明死后30min，纤维蛋白形成能力仍存在。作者认为，仅根据损伤局部有纤维蛋白形成即判断为生前伤是不恰当的，尚应结合损伤部位、损伤程度、损伤类型以及其它生活反应综合评定，不宜单凭纤维蛋白判断。     

大鼠皮肤损伤纤维蛋白形成能力荧光法定量研究

本文报告采用荧光分光光度法检测损伤皮肤纤维蛋白形成能力,以探讨生前伤与死后伤的区别及不同存活时间的生前损伤之间的关系。实验结果证明,生前1min至3h的损伤皮肤纤维蛋白形成能力逐渐升高,生前30min损伤与死后伤的形成能力相比有显著差异,形成能力的检出率与死后放置时间长短和温度有关,而与该部位有无尸斑无关。     

水中切创创壁纤维蛋白的扫描电子显微镜观察

水中尸体损伤鉴定是法医损伤鉴定中的一个难题。水中尸体上的损伤由于受到水的浸泡和腐败作用,致使创壁受到影响,常规组织学检查和一些生化、生物测定所获得的结果也因此在很大程度上失去了可信性。七十年代以来,国外有学者报告了应用 SEM观察生前、死后皮肤切创创壁纤维蛋白的情况,借以推断生前伤和死后伤。     

大鼠腹部皮肤切创缘电镜酶组织化学研究

大白鼠腹部皮肤切创组织电镜酶组织化学研究发现:三磷酸腺苷酶(ATPase)定位于皮肤毛细血管质膜内侧和毛囊外根鞘。生前损伤15分钟,毛细血管质膜 ATPase 活性降低,酶颗粒减少;毛囊外根鞘酶活性丧失。死后酶活性与对照组无差异。     

大鼠皮肤切创后E-选择素表达及稳定性研究

目的探讨大鼠皮肤切创后E-选择素表达规律及法医学意义。方法健康SD大鼠90只,随机分成4组：正常对照组、活体切创组（30min～7d12个时间点）、死后切创组（30min～3h3个时间点）、死后稳定性组（-20％6h-7d9个时间点,25％6h～3d5个时间点）。在大鼠头部建立皮肤切创模型,按设定的时间点取皮肤检材,运用免疫组化和图像分析技术,检测血管内皮E-选择素的表达规律。结果在活体切创组中,伤后1hE-选择素在血管内皮细胞内即呈阳性表达,持续至伤后7d,且随时间变化呈规律性表达。在正常对照及死后切创组未见阳性表达。死后-20％稳定性组各时间点E-选择素表达与死后即刻比较无显著性差异（P〉0．05）。25％各时间点与死后即刻比较有显著性差异（P〈0．01）。结论E-选择素在创伤后血管内皮细胞内特异性的表达具有时序性规律,且低温条件下稳定性较好。     

RT-PCR检测不同时间大鼠皮肤切创TGF-β_1mRNA表达

目的 探讨TGF-β_1mRNA在不同时间的表达变化及其与伤后经过时间的关系。方法 应用逆转录-聚合酶链反应(RT-PCR)分别对大鼠生前0.5h、1h、3h、6h、12h、48h、72h、96h、168h和死后0.5h、1h、3h的皮肤切创组织中的TGF-β_1mRNA表达变化进行检测,采用ID软件对凝胶扫描的数据进行密度分析。结果 TGF-β_1mRNA在生前皮肤切创后0.5h上升,3h开始急剧升高,48h含量达到峰值;死后皮肤切创未见TGF-β_1mRNA的表达。结论 大鼠皮肤切创TGF-β_1mRNA的表达具有时间相关性,RT-PCR是检测细胞因子在基因水平表达的灵敏方法。     

Bilateral First Rib Anomalous Articulations with Pseudarthroses Mimicking Healing Fractures in an Infant with Abusive Head Injury

Bilateral symmetric bone nodules were observed in the anterolateral first ribs of an infant with shaking injuries at autopsy. The location prompted diagnostic considerations of healing fractures versus anomalous articulations with pseudarthroses. The forensic pathologist worked with forensic anthropologists and pediatric radiologists to evaluate autopsy findings and compare premortem and postmortem X‐rays. Gross examination of the bones by the pathologist and anthropologists confirmed bilateral, callus‐like bone nodules in first‐rib locations associated with pseudarthroses. Histologic examination of one of the bones further showed features most consistent with pseudarthrosis, not a healing fracture. Radiologists then compared multiple premortem and postmortem radiographs that showed no remodeling of the bone over a 2‐week interval between the time of injury and death, which would be unexpected for a healing fracture in an infant. This multidisciplinary approach resulted in the appropriate diagnosis of pseudarthroses due to anomalous articulations, an uncommon finding in forensic pathology.     

Disopyramide and Mianserin Intoxication: A Unique Fatal Case – Review of the Literature

Lethal occurrence is exceptional after disopyramide or mianserin poisoning. A case of intentional lethal intoxication with these drugs was reported, as well as a review of the literature. Pre‐ and postmortem blood concentrations of disopyramide or mianserin were assessed in a woman who died from acute cardiac failure after ingestion. The premortem blood concentration of disopyramide alone was considered lethal, and a toxic premortem concentration of mianserin was observed that may have increased cardiovascular failure induced by disopyramide because the metabolism of both drugs is mediated via cytochrome P450. Moreover, it was shown that the postmortem redistribution of disopyramide was limited, as pre‐ and postmortem concentrations were 48 and 65 mg/L, respectively. As regards mianserin, redistribution was observed after death with pre‐ and portmortem concentrations at 0.23 and 0.79 mg/L, respectively. This case illustrates that if postmortem blood concentration of disopyramide is known, the premortem concentration can be deduced.     

PAP免疫组织化学技术检测血小板膜糖蛋白

<正> 血小板膜糖蛋白 GPⅠ_b 和 GPⅢa 在血小板粘附、聚集中起着极其重要的作用。为了直接检测组织中血小板粘附、聚集和血栓形成,我们建立了应用抗人血小板膜糖蛋白 GPⅠ_b和 GPⅢa 的单克隆抗体的 PAP 免疫组织化学技术,并首次对该技术在法医学中的应用进行了初步探讨。     

Forensic dermatopathology and internal disease

The gross and microscopic analysis of skin lesions at autopsy can help the pathologist understand diseases and injuries inflicted premortem, perimortem, or postmortem. From January 2003 to January 2004, skin findings at autopsy were closely examined by a dermatologist and sampled for microscopic analysis at the Southwestern Institute of Forensic Sciences. Dermatologic abnormalities in some of these cases led to the discovery of internal disease and allowed for a more complete understanding of the pathologic disease processes affecting the individual. We present four autopsy cases with skin manifestations of internal disease, including pseudoxanthoma elasticum, calciphylaxis, the sign of Leser Trelat, and papular mucinosis, and demonstrate the usefulness of the dermatological assessment at autopsy. In all cases, discovery of these skin lesions and internal disease manifestations allowed contributing factors to the death of the individual to be uncovered.     

Prolonged activity after an ultimately fatal gunshot wound to the heart: case report

In this article, we describe an unusual case of suicide involving a gunshot wound to the left ventricle. The victim engaged in premortem activity that was both prolonged and methodical. This report stresses the importance of a complete investigation to distinguish such case from an homicide.     

Comparison of injuries sustained by drivers and pillion passengers in fatal head-on motorcycle collision accidents

This study aimed to compare injuries sustained by motorcycle drivers with those sustained by pillion passengers in fatal head-on motorcycle collision accidents. We examined 84 cases of fatal head-on motorcycle collision accidents, causing 79 deaths of drivers and 19 deaths of pillion passengers, using medical and medico-legal examination records. The distribution of superficial injuries, characteristic injuries, injury severity as well as fatal causes was evaluated and compared using χ(2) tests. The results revealed a significant difference in the distribution of superficial injuries between drivers and passengers. The proportions of injuries in the hand and perineum regions were significantly higher in drivers than passengers. Some characteristic superficial injuries on the palms, chest, abdomen as well as the perineum areas were observed in drivers, while none of these characteristic injuries were observed in pillion passengers. Drivers were found to have suffered more severe chest and abdomen injuries than passengers. In addition, there was a higher incidence of fatalities involving run-over injuries for drivers compared with pillion passengers. The proportion of fatal injuries related to tumbling was higher for passengers than for drivers. Overall, our results revealed a difference in injury severity, superficial injury distribution and characteristic injuries between drivers and passengers. Few characteristic injuries were found in pillion passengers. These findings could help to guide medico-legal examinations, particularly in identifying drivers among victims involved in traffic accidents.     

Personal identification by radiographic comparison of vascular groove patterns of the calvarium

A case of forensic identification utilizing the vascular grooves within the skull is presented. The case is unique in that the antemortem radiographs were from childhood, rendering useless the more standard points of comparison. Calvarial vascular grooves represent unique points of comparison when the only available premortem radiographs were obtained during childhood, especially when one is attempting to identify children (living or dead).     

Localization and quantification of histamine in injured skin as parameters for the timing of wounds.

Localization and estimation of the histamine (HA) content in skin wound edges in 86 Sprague-Dawley rats and three cases of human injuries were carried out by a microfluorimetric method specific for this amine which forms a complex with o-phthalaldehyde (OPT). Distribution and density of the mast cells in the same areas were observed at the same time by toluidine blue stain. In all skin specimens with antemortem wounds, both the epidermis and upper dermis exhibit extracellular yellowish fluorescence of the HA-OPT complex. The fluorescent zone spreads in the wound edges with the lapse of time in vital injuries. The HA content increases gradually up to 30 min and then the yellow histamine fluorescence in areas 0-200 microns from the wound edge decreases. None of these features can be observed in normal skin and postmortem-injured skin. Mast cell degranulation can be demonstrated in all antemortem-injured skin. No statistical relationship exists between the number of mast cells and the HA-OPT fluorescence in either ante- or postmortem-injured groups. This study indicates that skin HA microfluorimetry by the OPT method is of practical value for distinguishing ante- from the postmortem wounds and for timing antemortem wounds.     

分泌抗人红细胞膜单克隆抗体细胞株的建立

以人的红细胞膜为抗原，采用选择性免疫抑制的程序，免疫BALB／C小鼠。经免疫的小鼠脾细胞与SP2／0骨髓瘤细胞融合，用血凝法筛选出3株分泌抗人红细胞膜种属特异性单克隆抗体的杂交瘤，即M1A7C4．M3A5B7和M3D9F1。连续传代2个月及复苏冻存半年的杂交瘤，仍能稳定地分泌抗人红细胞膜单克隆抗体。初步鉴定证明：该抗体具有稳定的种属特异性，可鉴别人与其它动物，特别是猴的红细胞，不与己知的血型特异性成分交叉，可凝集成人及脐带血的红细胞。     

Using pre- and post-surgical foot and ankle radiographs for identification

An evaluation of the effect of surgical intervention on foot and ankle radiographic comparisons was performed. In this study, 34 sets of pre-surgical ("premortem") and post-surgical ("postmortem") foot and ankle radiographs were retrospectively evaluated simulating a postmortem identification. In each radiographic set, the films were separated by a surgical event to reproduce the effects of an alteration in the anatomy. The radiographs included both matches and mismatches. This study also presents a numerical representation of the reliability of a radiographic match following a surgical procedure. Results indicate that surgical intervention with subsequent healing does not preclude positive identification in foot and ankle radiographic comparisons.