固定双上肢并悬挂家兔死亡机理的研究

目的观测固定双上肢并悬挂家兔的血气变化及膈肌的肌电变化,探讨体位性窒息死亡的发生机制。方法建立家兔体位性窒息死模型,在实验前、后分别抽取家兔耳缘动脉和左心室血2m l进行血气分析,并监测实验过程中家兔膈肌肌电图(EMGd i)的变化。结果实验组与对照组均有缺氧、二氧化碳储留以及氧饱和度下降,但是实验组的二氧化碳储留比对照组低,氧饱和度比对照组高,缺氧情况比对照组低。在连续记录的EMGd i中,早期EMGd i较晚期EMGd i的高频与低频(H/L)比值显著降低,超过20%。结论固定双上肢并悬挂家兔死亡与膈肌疲劳导致缺氧窒息有关     

悬挂双前肢致死兔的膈肌超微结构的研究

目的研究悬挂体位下窒息死亡动物的膈肌超微结构变化。方法取悬挂双前肢体位家兔的膈肌和腓肠肌组织,以勒颈致死家兔的膈肌和腓肠肌组织为对照,采用透射电镜方法观察其超微结构的变化。结果悬挂组膈肌的细胞核、细胞质、细胞膜均有缺氧损伤的征象,其中肌纤维内的肌原纤维、线粒体病变尤为严重;勒颈组膈肌的改变与悬挂组膈肌相类似,但程度上较轻微;悬挂组腓肠肌轻微病变,但肌原纤维无明显改变;勒颈组腓肠肌无明显改变。结论悬挂体位造成了膈肌纤维超微结构的损伤,形成了机体缺氧的病理基础,可导致死亡;本实验的结果可为限制性体位窒息死亡的法医学鉴定标准提供实验性的形态学依据。     

兔悬挂双前肢致死组织中PKC、AchE、HSP70的活性变化

目的观察兔悬挂双前肢致死不同组织中PKC、AchE、HSP70的活性变化,探讨其在死亡机制中的作用。方法家兔双前肢悬挂致死亡,取膈肌、肋间肌、心肌、腓肠肌、大脑、脑干、肝、肾、肺等组织,以勒颈、颅脑损伤和疾病死亡相应组织为对照。采用SP法对上述组织中蛋白激酶C(PKC)、乙酰胆碱酯酶(AchE)和热休克蛋白70(HSP70)进行免疫组化染色,观察其活性,并采用多组独立样本的Kruskal-Wallis秩和检验方法,对结果进行统计学分析。结果膈肌、肋间肌和大脑组织细胞质中PKC免疫组化阳性染色,悬挂组较其它组增强(P0.05);膈肌、肋间肌、心肌、大脑和肝细胞质及肌组织神经束中AchE免疫组化阳性染色,悬挂组较其它组增强(P0.05);大脑、心、肺中HSP70免疫组化阳性染色,悬挂组较其它组增强(P0.05)。结论PKC、AChE、HSP70通过不同机制,在悬挂双上肢体位性窒息死亡中起到一定作用,本文结果可为相关研究及鉴定提供实验依据。     

家兔限制性体位窒息模型中的LDH/CHE活性变化

目的 探讨家兔体位性窒息模型中乳酸脱氢酶(LDH)和胆碱脂酶(CHE)活性变化与窒息死亡的关系。方法 建立动物模型，检测膈肌、腓肠肌，以及血清中LDH、CHE的活性变化。结果 实验组家兔膈肌与腓肠肌相比，LDH活性明显下降，且差异显著(P＜0.05)，CHE活性差异无显著性(P＞0.05)；2组膈肌比较，LDH活性明显下降，有显著性差异(P＜0.05)，CHE活性无显著性差异(P＞0.05)；实验组血清中LDH活性比对照组明显升高，有显著性差异(P＜0.05)，2组CHE活性无显著性差异(P＞0.05)。结论 膈肌中LDH活性的降低与固定双上肢悬挂体位具有相关性。     

家兔双前肢悬挂致死过程中的电生理研究

目的探讨悬挂体位致窒息死亡的电生理方面的机制。方法成年家兔12只,雌雄不限。随机分为两组:一组监测膈肌肌电图,另一组监测肋间肌肌电图、心电图、脑电图。取仰卧位固定,手术暴露膈肌和肋间肌,引导肌电图;同时引导标准Ⅱ导联心电图和脑电图。然后将家兔固定双前肢悬挂,连续监测实验过程中家兔的心电、脑电、肌电图的变化情况,直至其死亡。结果悬挂末期和悬挂初期相比,膈肌肌电频率下降(P<0.05)、呼吸波持续时间、振幅和面积均有延长或增多(P<0.05)、最大传导速度无变化;肋间肌仅见肌电频率下降(P<0.05);脑电振幅降低(P<0.01)、δ波增多(P<0.01)、β波减少(P<0.05);心电仅见各波形振幅的降低(P<0.01)。膈肌肌电频率的下降最早,脑电频率的下降次之,肋间肌肌电的下降最晚(P<0.01)。结论悬挂体位致窒息死亡的机制的始动因素是呼吸运动受限,并最终形成外周性呼吸肌疲劳和呼吸中枢缺氧性衰竭而发生死亡。     

订购信息

固定双上肢悬挂致死的初步报道陈玉川，竞花兰，祝家镇，罗汉川，吴伟康，贺华（中山医科大学；广州５１００８９）固定双上肢将身体悬挂（有时足尖点地）致死在法医学实践中时可见到。有些案例伴有下肢的局部或广泛挫伤，但有些案例并无这些挫伤。对于这类死亡案例，如何...     

固定双上肢悬挂致死机理初探

为探索固定双上肢悬挂致死的死因及其死亡机理，本研究对１０只家兔进行案例的模拟实验及血气分析．实验结果表明：实验动物悬挂一段时间后开始出现紫绀、呼吸困难、呼吸停止，继而心跳停止、实验后与实验前相比，ＰＨ值、ＰａＯ２、ＨＣＯ３－、ＢＥ水平明显下降（Ｐ＜０．０５，Ｐ＜０．０１）；ＰａＣＯ２、Ｋ＋、Ｃａ２＋水平明显升高（Ｐ＜０．０１）．这说明其死因属窒息死．其死亡机理为固定双上肢悬挂后，呼吸肌协调失常致呼吸衰竭死亡．     

利用表面肌电检测评估外伤性上肢外周神经损伤程度

目的尝试利用表面肌电(surface electromyographys,sEMG)来检测评估外伤性上肢外周神经的损伤程度。方法选取8位诊断为单侧上肢外周神经(尺神经、正中神经、桡神经)损伤的成年男性伤者,以固定姿势做指定动作,同时在其双侧前臂及手腕采集sEMG,综合分析计算所采集到的sEMG数据,评估上肢外周神经的损伤程度。结果sEMG检测评估值与外伤性上肢外周神经损伤程度存在高度相关性。结论可以利用sEMG检测评估外伤性上肢外周神经的损伤程度。     

膈肌非全层破裂法医学分析1例

<正>1案例资料徐某,男,19岁,被人持刀砍伤左胸部。入院查体:体温36.0℃,脉搏104次/min,呼吸20次/min,血压100/70mm Hg。左季肋部可见一斜行创口,长约13.0cm,创缘整齐伴流血,深至肋间肌,可触及肋骨断端,创口处未见泡沫溢出。CT示左侧胸膜壁部分缺如及皮下积气,左侧少量气胸。急诊行创口缝合、膈肌修补及肋骨固定术。术中见左侧腋后线第10肋间斜行     

外伤性膈疝损伤程度鉴定2例

在法医学损伤程度鉴定中,常遇到胸、腹损伤,未伤及各脏器,仅造成膈肌的损伤,往往需手术治疗,而在现行《人体重伤鉴定标准》对此并未做出明确规定,仅能比照相应的条款做出鉴定结论。本文结合2例外伤性膈疝的案例,对在实际鉴定中如何操作进行分析探讨。1案例案例1:某男,32岁,左胸部被人用尖刀刺伤,当即被110车送当地医院治疗。病志记载:T36.2℃,R20次·min-1,BP100/70mmHg;左胸部有一2.0cm刺创口,深度不详,伴活动性出血及胸痛,左胸较右胸呼吸音弱,上腹有压痛、反跳痛伴腹肌紧张,无移动性浊音;胸部X线检查见左侧少量液气胸。入院后即于急诊…     

Hands Tied with Bag Full of Books in Suicidal Hanging

Hanging deaths associated with binding of limbs, masking of a face, and gagging are always suspicious. In suicidal hanging, the victim uses these added techniques to prevent him from backing out of his decision and to ensure death. However, binding of limbs and adding extra weight to the suspension in hanging are not reported. Herein, we report a case where the victim tied a bag containing books weighing 7 kg (15.4 lbs) to both his hands during hanging. The forensic specialist must be aware of the unusual presentation of suicidal hanging which may suggest foul play. The manner of death must be established after detailed analysis of circumstantial evidence, information obtained from the witnesses, complete autopsy, and toxicological examination.     

无电流斑电击死兔骨骼肌il-6mRNA表达研究

目的探讨生前电击与死后电击的鉴别方法及电流通路的推断方法。方法15只新西兰兔，随机分为3组，每组5只，即电击死组、死后电击组、对照组。电击死组，用220V交流电的两极分别连接实验动物的左后肢与右前肢，通电致死。死后电击组，从耳缘静脉注射50ml空气致死，于死后即刻用220V交流电的两极分别连接实验动物的左后肢与右前肢通电3min。对照组直接从耳缘静脉注射50ml空气致死，不进行电击。用荧光RT—PCR技术检测骨骼肌白介素6信使核糖核酸（il-6mRNA）表达水平，所得结果进行统计学分析。结果电击死兔骨骼肌il-6mRNA水平远高于死后即刻电击者（P〈0．05）；电击死兔对称肢体中通电肢体骨骼肌il-6mRNA水平远高于非通电肢体（P〈0．05）。结论骨骼肌il-6mRNA表达变化可用于生前电击与死后电击的鉴别；机体对称部位骨骼肌il-6mRNA表达差异有助于推断电流通路。     

固定双上肢悬挂致死的SOD,MDA含量变化

固定双上肢将身体悬空致死，是一种罕见的、特殊的窒息死。实验结果表明：实验后与实验前相比，ＳＯＤ活性明显下降，有显著性差异（Ｐ＜０．０１），ＭＤＡ含量明显升高，有显著性差异（Ｐ＜０．０１）。这为进一步阐明这类固定双上肢将身体悬空所致的死亡为窒息死，为法医学鉴定提供科学的依据。     

Mechanism of Death in Hanging: A Historical Review of the Evolution of Pathophysiological Hypotheses

Abstract: In cases of hanging, the exact mechanism leading to death has yet to be elucidated. Most of our contemporary knowledge is still based on writings from the end of the 19th and the beginning of the 20th century. This article reviews the historic experiments that shaped our current theories. Medico‐legal textbooks written in English and French from 1870 to 1930 were reviewed. Various animals, such as rabbits, mice, and dogs, have been used to develop animal models of hanging. Limited human studies on cadavers and judicial hangings have provided some additional insight into the pathophysiology of death by hanging. The main pathophysiological theories described were respiratory asphyxia, interruption to cerebral blood flow because of occlusion of vessels in the neck, and cardiac inhibition secondary to nerve stimulation. The relative contributions of each of these theories to death in cases of hanging is still debated today.     

Six‐Year Retrospective Study of Suicidal Hangings: Determination of the Pattern of Limb Lesions Induced by Body Responses to Asphyxia by Hanging*

Abstract: The objective of the present study was to estimate the proportion of hanging victims presenting with limb lesions, to compare this rate between hanging in restraint spaces and in more open settings, and to describe the usual pattern of limb lesions associated with hanging. Two hundred and seven cases of suicidal hanging were retrospectively reviewed and compared to 45 homicidal nonhanging strangulation victims. Bruises incidence was significantly lower in hanging victims (19.8%) compared to homicidal strangulation victims (55.6%). Bruises were more commonly encountered in restraint areas such as closets and staircases (56.3% and 66.7%, respectively) than in more open settings such as barn, bridge, fence, and park. Limb bruises on hanging victims were generally located on the posterior upper limb or the anterior lower limbs, whereas strangulation victims did not display this preferential bruises concentration. Possible suspicion criteria for limb bruises distribution are discussed, in relation to physiopathology of human asphyxia by hanging.     

体位性窒息对心、肺功能影响的实验研究

通过从股静脉将漂浮导管插入肺动脉的方法 ,检测悬挂前、悬挂期间和临终阶段呼吸、肺动脉压、心输出量的变化,探讨体位性窒息对心、肺功能影响及其在死亡中所起作用。结果:(1)悬挂前呼吸频率平稳 ,悬挂期间逐渐加快 ,临终前呈无规律状态 ;(2)悬挂期间及临终时肺动脉压比悬挂前明显升高;(3)悬挂前及悬挂期间的心输出量基本平稳 ,临终时比悬挂前及悬挂期间明显下降。本研究发现 ,悬挂可致呼吸失调 ,机体缺氧 ,导致心、肺功能障碍 ,属肺性死亡。其特征为呼吸停止是原发性的 ,心跳停止是继发的。