福尔马林对中毒检材化验影响的探讨

对中毒鉴定，应该收集新鲜组织和体液，冷藏保存，不宜使用防腐剂，以免化验时发生错误。因有的防腐剂本身即为毒物或其中含有毒物，如乙醇或甲醇中毒的检材，不能加酒精或福尔马林作防腐剂，且若干防腐剂如福尔马林还原性强，与许多物质易发生反应，使化验发生困难；防腐剂的存在还干扰有些毒物的提取，固定过程本身也能改变、掩盖及破坏许多物质，所以法医工作者一直认为福尔马林固定过的检材是最难分析的检材之一。在实际工作中，常遇到解剖时没有特殊中毒迹象，未留取新鲜检材，尔后怀疑中毒，这时福尔马林固定过的组织成为唯一可提供化…     

常见蔬菜、调料、空白脏器对硫靛反应化学检验氟乙酰胺干扰的实验研究

氟乙酰胺类鼠药(含氟乙酸,氟乙酸钠)是水溶性毒物,极性大,毒性也大.中毒死亡后在体内含量呈微.人及动物死亡后,难以用常见的TLC方法进行分析.几年来,经改进后的硫靛反应化学法,一直在各实验室办案中应用.该法对氟乙酰胺类鼠药中毒案件鉴定起了很大作用.但经过多年的研究实验及案件应用,笔者认为硫靛反应不是氟乙酰胺鼠药的专属性反应,有干扰,方法灵敏度低.仅靠该法出现阳性结果和阴性结果,均不能对检材作肯定或否定结论,应配合其它方法或案情进行综合评价.     

浅述由中毒性案件引致的医疗纠纷

中毒性案件是法医学鉴定的一个重要内容。目前中毒法医学鉴定的任务主要是解决是否中毒、中毒时间、毒物种类及毒物量、案件性质等。然而随着人们的医疗意识的增强．近年来由中毒后产生的医疗纠纷案件时有报道．尤其集中在患者的死亡是由中毒直接导致．还是由医疗行为的不当引起。这为中毒的法医学鉴定提出了新的课题。由于中毒性案件的鉴定有时本身就存在相当大的难度．病史采集的不确定性及中毒者不配合治疗又可使这类案件更加复杂，     

法医毒物鉴定的发展及其问题分析

文章阐述了法医毒物鉴定在对象种类、适用检材、技术方法、应用领域和结果运用方面的发展趋势,分析了现阶段我国毒物鉴定实验室在规范建设、鉴定能力、技术系统和质量控制中存在的问题和缺陷,提出要通过加强鉴定机构及鉴定人的准入控制,建设一支高资质、高水平的队伍;通过执业监管、认证认可、水平测试和质量评估,保障毒物鉴定结果的可靠、准确.     

浅述由中毒性案件引致的医疗纠纷

中毒性案件是法医学鉴定的一个重要内容。目前中毒法医学鉴定的任务主要是解决是否中毒、中毒时间、毒物种类及毒物量、案件性质等。然而随着人们的医疗意识的增强,近年来由中毒后产生的医疗纠纷案件时有报道,尤其集中在患者的死亡是由中毒直接导致,还是由医疗行为的不当引起。这为中毒的法医学鉴定提出了新的课题。由于中毒性案件的鉴定有时本身就存在相当大的难度,病史采集的不确定性及中毒者不配合治疗又可使这类案件更加复杂,因此,中毒引起的医疗过失的判断主要还是遵循中毒性疾病的诊治原则。笔者就我院发生的中毒救治医疗纠纷案件,结…     

QuEChERS方法在法医毒物分析领域的研究进展

在中毒或疑似中毒案件中,毒物鉴定对于提供侦查线索与犯罪证据、澄清案件性质、还原犯罪过程具有重要意义。基于液液萃取和分散固相萃取原理而建立起来的QuEChERS方法,由于其快速、简单、廉价、高效、可靠、安全等优势,正逐渐应用于法医毒物分析的样品前处理过程中。本文综述了QuEChERS方法的基本原理及其在提取和净化等过程中的优化改进,重点详述近年来QuEChERS方法在法医毒物分析领域的应用现状,并对未来发展方向进行展望。     

唾液在毒物的法医学检测中的应用价值

<正> 在对中毒活人体内毒物的法医学检测中(如取血进行滥用药物的检测),有时检材量太少。近年来,已有人提出唾液代替血作为检材或作为血的补充检材。本文综述毒物在唾液中的排泄资料,以探讨唾液在毒物的法医学检测中的应用价值。     

琥珀胆碱及其代谢物琥珀单胆碱的检验

目的建立液质联用分析琥珀胆碱和琥珀单胆碱的检验方法。方法通过动物实验,采集死前血液与死后心脏血;通过优化色谱-质谱分析条件以及进样顺序,实现了空白干扰物与代谢物的有效分离。结果首次检验了中毒死亡检材中的琥珀单胆碱,并分析琥珀胆碱与琥珀单胆碱的丰度比例以及通过实际案例推断体内琥珀单胆碱的来源。结论提出了必须将琥珀单胆碱列入琥珀胆碱中毒案件的毒物检验目标,可以大大提高生物检材阳性检出率。     

动物试验在基层法医检案中的运用

动物试验在法医学领域,主要应用于法医毒理学及法医毒物分析的科学研究,通过对动物的研究解决一些毒物的毒理作用,本文所叙述的是在基层法医检案中,如何充分运用动物学试验为侦察服务,为刑事案件的初步定性。对于怀疑毒物中毒的刑事案件,在检材容许的情况下,先做动物学试验,通过动物的毒理学反应,初步确定是否有毒,及时为侦察提供线索。也为下一步送检提供了检验方向。动物试验在基层法医学检案中可以发挥重要的作用,尤其适用偏远山区。2002年某县发生一起14人中毒6人死亡的特大投毒杀人案件,当地人曾以为是瘟疫流行,搞得人心惶惶,技术人员…     

四种水溶性毒物中毒机理及检测方法研究进展

水溶性毒物是指在水中具有较高溶解度的毒物,一般具有吸收迅速及毒性较高的特点,极易通过血液循环分布到体内各器官组织,从而对人体造成危害。本文选择氰化物、亚硝酸盐、氟乙酸钠和硼砂四种常见水溶性毒物,对其理化性质、毒理机制、中毒症状、体内代谢过程及国内外检测技术发展现状和未来趋势进行综述,希望为法庭科学水溶性毒物检验鉴定和中毒死亡案件原因调查提供参考。     

Elucidation of a poisoning case from the analysis of formalin in which brain tissue was preserved

The toxicological analysis of post-mortem materials often help determine the cause of death. When tissues have been fixed in formalin it may be possible to extract several drugs from the tissue and/or the preserving fluid. An unusual case of multiple poisoning is discussed from the aspect of laboratory analysis.     

Seven cases of fatal aconite poisoning: forensic experience in China

This paper presents seven fatal cases of aconite poisoning encountered in the Tongji Center for Medicolegal Expertise in Hubei (TCMEH), China, from 1999 to 2008 retrospectively. In six of the cases, deaths occurred after drinking homemade medicated liquor containing aconite, and in one case death was due to ingestion of traditional Chinese medication containing aconite. Forensic autopsy and pathological examinations ruled out the presence of physical trauma or life-threatening diseases. Diagnosis of aconite poisoning was made after postmortem toxicological analysis. Animal experiment was performed in one case demonstrating that the medicated liquor could cause death rapidly. We present the autopsy and histopathological findings, toxicological analysis, and results of animal experiment done on samples from those seven cases. As an important herbal Chinese medicine, Aconitum species deserve special attention, especially because it contains poisonous alkaloids.     

54例氯化琥珀胆碱中毒案件的法医学分析

目的观察分析氯化琥珀胆碱中毒案件的法医学表现,以期提高氯化琥珀胆碱中毒的检验鉴定。方法收集54例氯化琥珀胆碱中毒案例,通过病理学、毒理学变化及案件特点进行回顾性分析,观察氯化琥珀胆碱中毒的检验鉴定规律。结果氯化琥珀胆碱中毒的病理学表现以急性肺淤血、肺水肿等一般猝死改变为主,部分死者心肌排列紊乱及断裂。死者心血中均检见琥珀胆碱成分,皮肤组织部分检见琥珀胆碱成分。结论氯化琥珀胆碱中毒具有死亡快、手段隐蔽、难以抢救、易漏检等特点。对于猝死案件、死因可疑案件应将氯化琥珀胆碱作为常规检验指标,防止此类案件的未检或漏检。     

Rare Death Via Histamine Poisoning Following Crab Consumption: A Case Report

Histamine poisoning (scombroid food poisoning) is a toxicity syndrome that results from eating spoiled fish. To date, however, few poisoning (or mortality) cases have been reported in relation to crab consumption. Here, we describe a very uncommon case in which a 37‐year‐old woman and her 14‐year‐old son ate cooked crabs (Scylla serrata), resulting in the death of the female. Samples of vomitus, food residue, liver tissue, gastric content, intestinal content, and cardiac blood were analyzed by high‐performance liquid chromatography. Toxicological analysis revealed that histamine concentrations were very high in the cooked crab (47.08 mg/100 g) and intestinal content (22.54 mg/100 g). Comparing our toxicological results, police investigations, and family member statements, it can be assumed that the decedent ingested spoiled crabs, and by excluding other causes of death, lethal intoxication with histamine poisoning was confirmed.     

一起毒鼠强食物中毒的调查分析及其实验室筛查探索

目的　探讨原因不明性食物中毒的检查策略。　方法　结合一起发生的原因不明性食物中毒案例 ,应用流行病学和简易急性动物试验等方法 ,对导致中毒的致病因素进行分析与判定。　结果　中毒案例的暴露时间为早餐时 ,平均潜伏期为 4 7.84分。中毒反应以神经症状和消化道症状为主。依病例的客观特征分层对其食谱分析 ,筛选出水煮豆腐是本次中毒的可疑食物。 7种剩余食物进行的急性动物试验中发现 ,水煮豆腐的小白鼠灌注量与中毒反应呈剂量反应关系 ,半数致死剂量为LD5 0 =1.68mg/ g。气相色谱 - -质谱仪分析确定水煮豆腐中的毒性性质为四次甲基二砜四胺。　结论　本案通过采用症状分析、急性动物实验和毒物分析测定方法确定了一起原因不明性食物中毒的中毒原因。这种检查策略有助于原因不明性食物中毒及其它突发中毒事件的性质判定。     

Sniffing-associated deaths in Denmark

An account is given of 20 deaths, which occurred in association with sniffing during the period 1959 – 1978. The annual number of deaths was almost constant during the period. Most of the deaths occurred in males. Ether and trichloroethylene were the predominant toxic substances. The material was divided into two groups. Group A, 14 cases, included real sniffing deaths, the cause of death being poisoning by the substance inhaled. In group B, 6 cases, sniffing was a contributory factor to death: 2 cases of suffocation by obstruction, one case of carbon monoxide poisoning during fire, one case of septicemia/severe anemia caused by bone marrow depression, and one case of bleeding to death from stab wounds inflicted by a sniffer against a non-sniffer. The circumstances before and at the time of death are reported, together with the autopsy and toxicological findings when these were performed.     

Amphetamine derivative related deaths in northern Greece

Until 1997, only one amphetamine related derivatives (AMPs) fatality had been reported in Greece. Since then, amphetamine (AMP) or AMPs have been found in seven out of 1,500 post-mortem toxicological cases. The cause and manner of death of these seven cases were: 3,4-methylenedioxy-N-methamphetamine (MDMA) and 3,4-methylenedioxy-N-ethylamphetamine (MDEA) poisoning (n = 1), drowning in water (n = 4), cranial injuries caused by a traffic accident (n = 1) and heart failure (n = 1). In the case where the use of AMP or AMPs was considered, the immediate cause of death post-mortem toxicological analysis revealed 2 microg/ml MDMA and 0.7 microg/ml MDEA in blood. MDMA was identified in two cases of drowning (2 microg/ml in blood in the first case and 1.7 microg/g in liver in the second case) and in the traffic accident case (0.4 microg/g in liver). Methamphetamine was detected in two cases of drowning (2.5 microg/ml in blood in the first case and 6 microg/g in liver in the second case). AMP was found in the heart failure case (0.2 microg/g in liver). Alcohol was present, together with AMP or AMPs, in four cases. These findings indicate an increase in the illegal abuse of AMPs in Greece. Because of this, we now routinely screen for AMPs.     

Fatal intoxication with melperone

Melperone is judged to be a safe neuroleptic drug. Until now there has been no report of a melperone fatality, though it has been used in suicide attempts. We report on a case of a 36-year-old woman where no cause of death could be established at autopsy. Criminological investigation pointed to a homicide by poisoning but also the possibility of a suicide had to be taken in account. The toxicological analysis of blood, cerebral spinal fluid and urine revealed extremely high concentrations of melperone which had never been reported before. Furthermore, diazepam, nordazepam and carbamazepine were detected. To our knowledge, this case is the first melperone fatality. Possible interactions with diazepam and carbamazepine are discussed.     

A Fatal Case of Poisoning with Fentanyl Transdermal Patches in Japan

Fentanyl transdermal patches have been used to treat cancer‐ and noncancer‐related chronic pain. However, its inappropriate or illegal application may cause fatal poisoning. We herein present the case of a Japanese woman in her 40s who was found dead with seven 25‐μg/h fentanyl transdermal patches on her body. We established a detailed toxicological analysis procedure to quantify fentanyl, and its metabolite norfentanyl, and other drugs (acetaminophen, allylisopropylacetylurea, celecoxib, estazolam, promethazine, and sertraline) in human whole blood by ultra‐high‐performance liquid chromatography–tandem mass spectrometry. The measured fentanyl and norfentanyl concentrations in the femoral and cardiac blood were 0.051 and 0.072 μg/mL and 0.033 and 0.076 μg/mL, respectively. The decedent's fentanyl concentrations were consistent with previously reported postmortem blood levels for fatal cases of poisoning by fentanyl transdermal patches. Based on the decedent's case history, autopsy findings, and toxicological analyses, the cause of death was identified as intoxication with transdermal fentanyl.     

Fatal alcohol poisoning: medico-legal practices and mortality statistics

Compilation of mortality statistics from death certificate data is based on international and national conventions which in certain situations result in the underlying cause-of-death other than that established and reported by the physician. The present study compares all fatal alcohol poisonings in 1997 as registered on forensic toxicological grounds at the accredited central laboratory and as presented in the national cause-of-death statistics, according to the underlying cause-of-death, by applying international statistical rules and principles in ICD-10. Four groups were formed, and case frequencies in each group were obtained from forensic toxicological data, group "T51" for acute poisonings due to alcohol alone, and group "Comb" for acute alcohol poisonings combined with some drug, medicament or other biological substance, and from cause-of-death statistics data, group "X45", for deaths from alcohol poisoning, and group "F102" for those medico-legal fatal alcohol poisoning deaths which at the statistics office were inferred to be due to alcoholism. The study shows that in Finland the officially compiled statistics on fatal alcohol poisonings, when compared with medico-legal statements based on forensic toxicological examinations, were underrepresented by 31.4% in 1997. About two-thirds of this underrepresentation is explained by preferring, as the underlying cause-of-death, alcoholism to acute alcohol poisoning, and about one-third by preferring, in cases of acute combined poisonings, the drug component to the alcohol. From 1998 onwards, more emphasis has been put on the alcohol component when coding medico-legally proven accidental deaths from simultaneous poisoning with alcohol and a medicinal agent. This change in coding practices presumably explains the subsequent decline in the annual underrepresentation rate of alcohol poisoning in mortality statistics to the level of 15-16%. It is concluded that the present ICD rules inevitably lead to underrepresentation of alcohol poisonings in the mortality statistics, and conceptual and practical proposals for future procedures are made.