391例高坠死亡案件鉴定分析——以上海市徐汇区为视角

目的对上海市徐汇区近十年高坠死亡案件的检验资料进行回顾性研究,对比其他区域统计数据,并结合国内外进展,以期对同行处理高坠死亡案件有所帮助。方法对上海市徐汇区2005-2013年度发生的391例高坠死亡案件的资料进行分项统计分析。结果 391例高坠中自杀案例占了多数(82.6%),意外案例占了少数(17.4%),在意外高坠中男性占了多数(86.3%),并且随着年龄的上升,自杀的比例逐渐上升,意外的比例逐渐下降。意外案件的坠落高度可高可低,但总体高度较低,自杀案件的坠落高度一般较高。意外案件中头部着地的比例较高(56.3%)。结论本区目前高坠案件勘验工作仍有不足,运用CT进行虚拟解剖,数字人体模型进行现场模拟等方法是未来的发展方向。     

52例坠崖自杀案例分析

目的：通过对山岳型景区高坠自杀案件的现场分析、损伤形态及案情调查情况进行分析,为高坠死亡案件的定性提供参考。方法收集52例黄山景区2002—2012年内坠崖自杀案例的资料,从年龄、性别、籍贯、事发时段、坠落地点、损伤检验、行为方式等方面进行分析。结果52例坠崖自杀案例中,男性的自杀率明显高于女性,外省籍比例明显高于本省籍,年龄分布于19~50岁,案发时间段多在16：00~24：00,损伤形态以复合伤为主,均不同程度伴有颅脑损伤、胸腹腔器官损伤及体表划擦伤。结论高坠死亡案件的定性需要进行现场勘验、案情调查走访等综合分析。     

246例高坠案件中坠落高度与损伤分析

目的对高坠案件进行统计分析,为相关鉴定研究提供参考。方法收集上海市浦东地区最近十年来记录有坠落距离的246例高坠案件,对人体损伤的特点进行比较分析。结果自杀高坠的高度显著高于意外高坠的高度(25.70m:13.98m);所有高坠中,头部损伤概率较高(75.2%),颈部损伤概率较低(6.5%);意外高坠的头部损伤概率高于自杀组(89.4%:75.2%)。结论意外高坠的死者比自杀高坠的死者更缺乏四肢对于头部的保护;过低的颈部损伤发现率提示国内法医工作者应该更加重视在高坠案件中的对于颈部损伤的检查。     

昆明市103例高坠死亡案件的坠落高度以及案件性质分析

目的对103例高坠死亡案例进行回顾性分析,研究尸体损伤与坠落高度、坠落高度与水平移行距离、水平移行距离与案件性质之间的关系。方法收集2001~2015年间昆明市公安局所受理的高坠案例共103例,所得数据均经spss17.0进行统计检验。结果颅骨骨折在坠落高度为11米以上时的概率较大,四肢骨折在各高度出现的概率均比较大,肋骨骨折在坠落高度为21米以上时的概率较大,尸体的坠落高度与水平移行距离存在正相关关系。坠落高度在11米以上时自杀多见,水平移行距离在1.1m以上时自杀多见。结论尸体损伤、水平移行距离可作为辅助手段估算坠落高度,水平移行距离可作为判断案件性质的参考数据。     

152例高坠死亡案件回顾性分析

目的对于高坠死亡案例进行回顾性调查分析,为相关研究和鉴定提供参考。方法收集2011年至2014年间,武汉市汉阳区范围内公安部门受理的所有高坠案件,共152例,对案件性质、高坠地点特征、死者年龄、性别、损伤情况等项目进行统计分析。结果 152例高坠死亡案件中自杀118例、意外28例,6例性质未能确定;高坠案件无论性质为何,发生地点均以居民住宅区最多;女性在自杀中占比略高,且年龄偏大(50岁),而意外高坠中全部为男性;损伤在两类性质的案件中均以头部和四肢为最多;自杀案件中有四分之一左右的死者有精神疾病史。结论国内高坠案件随着社会生活的发展有其独特的特征,而对高坠的尸体检验需要更加仔细和全面。     

205例高坠案件局部机械性损伤与死亡性质关系分析

目的探讨高坠案件中局部机械性损伤行为心理分析与死亡性质的关系,为此类案件的定性提供参考。方法收集2008—2013年高坠死亡案件311例,其中存在高坠难以形成的局部机械性损伤案例205例。对损伤形成特点、现场痕迹、高坠致命伤、文字信息等进行分析。结果 205例中,根据初步现场痕迹、高坠致命伤、文字信息等分析后,明确自杀86例,意外24例,性质不明95例。95例性质不明案例经对局部机械性损伤进行行为心理分析后,认定自杀80例,意外11例,他杀4例。结论高坠难以形成的局部机械性损伤与死亡性质具有关联性,根据局部机械性损伤行为心理分析推断高坠死亡性质基本准确。     

上海地区成人高坠死亡45例尸体解剖分析

对45例成人高坠死亡的尸体解剖资料进行了分析。其中42例为意外，3例为自杀。42例意外高坠中，38例发生在工作时。高坠死亡者的年龄从18岁到50岁，21～40岁占77．7％。性别以男性居多，占93．3％。着地部位最常见的是头部。由于高坠后引起机械性损伤所致死亡有43例，其中包括脑损伤（60％），肺损伤（44．4％），脾破裂（33．3％），肝破裂（26．7％），脊柱损伤（26．7％），大血管破裂或断裂（20％），心脏破裂（15．6％）。另2例则是因机械性窒息而死亡。随着坠落高度的增加，胸腹部致命性损伤数目随之增多。坠落的高度较低时，最常见的死亡原因是颅脑损伤。     

68例高坠损伤分析

<正> 作者分析了杭州市1955～1987年所积累的68例高坠损伤死亡案例的尸检资料,并探讨其中26例(经全面尸检)高坠损伤的特征与尸体着地部位关系。资料分析一、一般资料 68例中,男性52例,女性16例,为3.3:1;年龄2～73岁,以18～50岁中、青年居多43例占63.2％。自杀多于意外,和文献报告有差异。     

昆明市五华区124例自杀案例分析

目的研究自杀者的性别、年龄、学历、自杀原因与自杀方式之间的关系,为自杀的法医学鉴定提供依据。方法通过现场勘验、尸表检验、尸体解剖、调查走访来确定自杀案件,收集昆明市五华区近三年来的124例自杀案例,然后采用SPSS 22.0进行卡方检验、描述性统计等分析。结果自杀者男女性比例为1.53∶1;自杀方式多选择高坠、自缢和溺死;自杀者昆明户籍与非昆明户籍的比例约为1∶1;小学和初中文化程度者自杀最多;10~50岁年龄段的人群多选择高坠自杀,60岁以上的老年人选择自缢自杀的较多;不同学历层次的人群均以高坠自杀为主;因精神疾病、自身疾病和经济问题自杀者多选择高坠、自缢,而因感情问题自杀者多选择高坠、服毒。结论自杀是一类十分复杂的案件,对于疑似自杀的案件要多方面勘查、全方位思考,综合各方面因素来确定案件的性质。     

锐器致伤死亡自杀案9例

利用锐器致伤死亡的自杀案件 ,由于尸体上有明显损伤 ,现场有大量血迹 ,极易引起人们的质疑。掌握锐器致伤死亡自杀案的特点 ,对于确定案件性质十分重要。本文作者收集近 5年间本地区所检验的 9例锐器致伤死亡的自杀案例资料 ,就其有关问题进行分析 ,供同行参考。1　案例资料1 1　一般资料9例锐器致伤死亡自杀案资料来源于本区 1997年至 2 0 0 1年间法医检验案例 ,其中自伤直接导致死亡 7例 ,自伤未死再自缢、服毒死亡各 1例。死者男性 7例 ,女性 2例 ;年龄 2 4～ 6 2岁 ,其中 4 0岁以上者 7例。 7例因失恋、离异、夫妻不和等自杀 ,其中5例…     

Intra- and perioral shooting fatalities.

Determination of the manner of death in the case of intra- and perioral firearm wounds can be difficult especially if death scene investigation is unclear and inadequate. In this study, we investigated some characteristics of these firearm wounds which were autopsied in Istanbul. During the 5-year period from 1991 through 1995, there were 15 intra- and perioral firearm fatalities investigated. In all the cases, only one shot was fired into the mouth. They constituted 1% of all the firearm fatalities. The mean age of the victims was 27 years and males constituted 73.3% of the victims. Most of the wounds were caused by handguns. Homicides accounted for 53.3% of these deaths. Three of 15 cases could not be identified as intraoral firearm wounds by general practitioners during the scene investigations.     

The forensic entomologist in the context of the forensic pathologist's role.

An adequate death investigation requires the combined efforts and cooperation of experts in different disciplines: crime scene technicians, death investigators, forensic pathologists, anthropologists, entomologists, other medical and non-medical professionals. These front-line experts play a crucial role in every death investigation process. The forensic pathologist normally has the legal authority to take charge of the dead body at a death scene and his primary functions are the exterior and interior examination of the cadaver by analyzing the extent of antemortem injuries and the postmortem changes and the recovery of physical evidence. He is responsible for determining how, when and why of any death which is the result of violence, suspicious or unexplained circumstances or a death which is sudden or unattended, defending and explaining the reasons for making these diagnoses in a courtroom. The forensic entomologist can provide invaluable aid in death cases where human remains are colonized by insects and in the overall investigation. His principal role is to identify the arthropods associated with such cases and to analyze entomological data for interpreting insect evidence. He is responsible for determining the period of insect activity according to all the variables affecting insect invasion of remains and their development. The major goal of medico-criminal entomology is to contribute to the determination of the time, cause, manner and place of the investigated death (especially on badly decomposed corpses or skeletonized human remains) with the support of all the elements which can be inferred from the study of insects found on the cadaver or nearby. The application of techniques devised recently in forensic entomology can allow experts in the field to collect strong entomological evidence and provide useful information not only in a death investigation including movement or storage of the remains following death, time of dismemberment, postmortem artifacts on the body but also at the scene, and even more in child neglect, sexual molestation and identification of suspects. As the role of the forensic entomologist at the death scene, at the autopsy and in the laboratory is defined and well known, this paper focuses on the difficulties that could arise if forensic pathologists and entomologists are uncertain about the procedures that they have to follow, do not realize the value of objective findings or fail to evaluate them. Although every forensic case presents a slightly different set of circumstances and has to be tackled individually, the forensic pathologist should work with the forensic entomologist from the visual observations of the cadaver on the scene, through the collection of arthropods and temperature data at the death scene and at the autopsy, up to the final report with the interpretation of entomological and other biological evidence.     

Environmental hyperthermic infant and early childhood death: circumstances, pathologic changes, and manner of death.

Infant and early childhood death caused by environmental hyperthermia (fatal heat stroke) is a rare event, typically occurring in vehicles or beds. The aims of this study were to describe the demographics, circumstances, pathology, and manner of death in infants and young children who died of environmental hyperthermia and to compare these cases with those reported in the literature. Scene investigation, autopsy reports, and the microscopic slides of cases from three jurisdictions were reviewed. The subjects in 10 identified cases ranged in age from 53 days to 9 years. Eight were discovered in vehicles and 2 in beds. When the authors' cases were grouped with reported cases, the profile of those in vehicles differed from those in beds. The former were older, were exposed to rapidly reached higher temperatures, and often had more severe skin damage. The latter were mostly infants and were exposed to lower environmental temperatures. Hepatocellular necrosis and disseminated intravascular coagulation were reported in victims who survived at least 6 hours after the hyperthermic exposure. The consistent postmortem finding among nearly all victims was intrathoracic petechiae, suggesting terminal gasping in an attempt at autoresuscitation before death. The manner of death was either accident or homicide. Recommendations for the scene investigation are made.     

不同死因大鼠死后不同时间红细胞溶血速度比较

目的观察不同死亡原因大鼠尸体血液中红细胞溶血速度的变化规律,为死亡原因的法医学推断提供新思路。方法 40只SD大鼠随机分为4组,分别以断髓、置于99%CO的空间、高坠、勒颈方式处死后,取各组大鼠右心室血液,于死后即刻（0h）、8h、16h、24h、32h、40h、48h、56h、64h、72h,采用显微镜数码图像法进行全血红细胞计数（CBC）,并对组内和组间数据进行统计学比较分析。结果 4组血液红细胞数量在死后即刻至72h期间,均随时间的延长因溶血而减少。其中0~16h,各组溶血速度无明显差异（P〉0.05）;16~48h,速度加快,溶血速度以CO中毒组（88.50±25.99）%最快,其次为高坠（69.33±29.52）%和断髓组（48.78±3.17）%,机械性窒息组（41.90±9.61）%最慢,组间比较具有显著性差异（P〈0.05）;56h后,溶血速度再次减慢,至72h机械性窒息组仍有少量红细胞存在。结论 4组不同死因大鼠死后不同时间红细胞计数均减少,各组间差异具有统计学意义,其变化特征可为死亡原因的推断提供新的思路。     

Suicidal Shotgun Wound Employing a Shotgun Barrel,a Shotgun Shell,and a BB*

Abstract: A vast majority of firearms‐related suicides involve the conventional use of a properly functioning, intact firearm. Occasionally, forensic investigators encounter a case wherein the firearm suicide victim employs some form of unconventional use of a weapon, or utilizes an unusual weapon type. In this case report, the authors present an unusual case in which a man committed suicide by using a shotgun shell, a shotgun barrel (separate from the rest of the gun), and a BB. Some confusion as to the cause and manner of death was present during the initial scene investigation. Examination at autopsy revealed the cause of death to be a shotgun wound of the chest and prompted further scene investigation. Therefore, this case serves as another example of the importance of cooperation between scene investigators and forensic pathologists when investigating a death. A review of suicidal firearm cases using unconventional means and/or firearms is presented.     

美国马里兰州涉及电击枪死亡案例分析

目的 研究美国马里兰州涉及电子武器(电击枪)死亡案件的特点,探讨其法医学鉴定要点.方法 收集2004-2009年美国马里兰州法医局鉴定的涉及电击枪死亡案件13例,案件均经详细的现场调查,尸体进行系统解剖,并进行全面的毒(药)物检测及组织病理学检验.从一般情况、电击枪类型及接触方式、毒物检测结果、死亡方式、死亡原因等方面...     

A Retrospective Study of the Investigation of Homicidal Childhood Asphyxial Deaths

As one of the leading causes of traumatic deaths in newborns, infants, and young children, there is no anatomic or microscopic feature that is pathognomonic for asphyxial deaths. Instead, pathologists rely on investigation information, including confessions and/or witness statements, and potential evidence at the scene. Twenty cases of homicidal newborn, infant, and young children asphyxial deaths were reviewed, which included death and police investigation reports and autopsy reports, as well as histology slides of lung sections. This series of homicidal asphyxial deaths highlight that, in a vast majority of such cases, the final cause and manner of death rulings are dependent on confession by the perpetrator. Furthermore, this series highlights the possible role of histology to help forensic pathologists better certify asphyxial deaths. Finally, this series emphasizes important investigation points and considerations at autopsy during the investigation of asphyxial deaths in newborns, infants, and young children.     

An unusual case of compression asphyxia and smothering

Scene investigation is an important part of the medicolegal autopsy. In many cases the cause of death cannot be determined without knowledge of the circumstances. A case is presented in which the diagnosis of compression asphyxia and smothering was made only after analysis of the scene findings.     

Evaluation of sudden death in psychiatric patients with special reference to phenothiazine therapy: forensic pathology

The investigation of sudden unexpected death in psychiatric patients and the ensuing litigation has brought to our attention many unusual features important in the evaluation of such deaths. Certain pathophysiologic mechanisms of death, rarely encountered in routine forensic science practice, may be important in determining the cause of death in psychiatric patients, especially in cases where the autopsy is unrevealing. Of particular concern is a tendency in the current literature to implicate phenothiazines as a cause of death when the death investigation and the autopsies are incomplete. Thus, based on our experience and on a review of the current literature, we have set forth factors that the forensic pathologist should consider when faced with a sudden psychiatric death. A case report illustrates these unique aspects of scene investigation and analysis of terminal events and autopsy findings.