尸体血液中乙醇质量浓度的分析评价

血液中乙醇质量浓度是分析评价机体内乙醇水平的重要证据,由于尸体内检测到乙醇可能受死后生成、乙醇扩散等因素影响,尸体血液中乙醇质量浓度检测结果未必能反映其死亡时机体内乙醇的真实水平。鉴别尸体内乙醇是否为原始浓度是分析评价的关键。本文对乙醇在体内的分布特点、如何合理取材及死后乙醇扩散、尸体腐败产生的乙醇对乙醇质量浓度分析的影响进行了综述,并对死后乙醇质量浓度检测的分析评价策略进行了讨论。     

人体内乙醇含量检测的影响因素分析

人体内乙醇含量检测不仅是法医鉴定工作中常规检测项目,也是交通肇事案件最终的仲裁依据,其检测结果直接影响着受检人员的责任判罚。本文根据乙醇的毒理特征及在人体内的代谢过程,就不同检材、送检时效性、尸体腐败、血液检品中不同成分和保存方式、以及检测结果的不确定度等对乙醇含量检测结果的影响进行分析,以利于对受检者是否饮酒及其程度做出科学、公正的判定。     

春季尸体腹腔腐败气压在法医学死亡时间推断中的应用研究

目的 研究尸体腹腔腐败气压在春季的发展变化规律及其用于推断死后经过时间的方法。方法用实验动物山羊57只,分陆地处死和水中溺死两大组,用自行研制的“腐败气压测定仪”,定时系统测量动物尸体腹腔内的腐败气压。结果 得出尸体腹腔内腐败气压的发展变化规律,并据此建立测量腹腔腐败气压推断死后经过时间的方法。研究了数种死亡方式、尸体所处环境和个体差异等的影响。结论 该研究成果填补了法医学中尸体腐败气压发展变化规律研究、检测腐败气压推算死后经过时间和腐败气压测定仪等的多项空白,丰富了该领域的法医学内容。     

四种穿刺法抽取尸体血液的比较分析

正在法医学尸体检验中常需要采集死者血液进行相关项目的检验[如碳氧血红蛋白(carboxyhemoglobin,Hb CO)饱和度的测定、乙醇、毒品、毒物、DNA检测、个体识别等],尸体解剖过程中可以采集心脏或血管内血液,但实践中部分案件需要在尸表检验过程中通过体表定位取血,这就要求法医工作人员掌握多种体表穿刺或微创下尸体血液抽取的方法。笔者认为,不论哪种方法,穿刺点定位是否精准是取血成功的关键,     

13例腐败尸体死亡时间推断错误原因分析

死亡时间推断有十分重要的法医学意义,对查明案件真相常常起到关键作用。在实践中,腐败尸体的死亡时间推断历来是法医学的难点,推断的死亡时间同实际死亡时间存在误差常是难以避免的,但若误差较大,对案件的侦办就失去了实际意义,甚至会误导案件的侦查方向,产生冤假错案。此时的“误差”就应称为错误。本文对13例腐败尸体死亡时间错误推断的原因进行回顾性分析,并就腐败尸体死亡时间推断应注意的问题进行讨论,旨在提高基层法医工作者对腐败尸体某些尸体现象的认识和重视。1案例资料1.1一般资料13例腐败尸体案例来自于南京市公安局法医中心199…     

探究尸体血样中乙醇、乙基葡萄糖醛酸苷和硫酸乙酯的产生

目的探索尸体血样保存过程中乙醇的产生情况及乙基葡萄糖醛酸苷(EtG)和硫酸乙酯(EtS)的产生可能。方法对照组为7例阳性静脉血,而实验组则为7例阴性尸体血。每例血样分成3份并保存在室温(18~22℃),4℃及-20℃等3种不同的条件下,在保存天数为0、2、3、5、7、9、11、13、15、17、19、21等时间点取样。使用顶空气相色谱法(HS-GC)检测乙醇,采用固相萃取提取EtG和EtS,使用高效液相色谱-三重四级杆质谱(LCMS/MS)法检测EtG和EtS。结果保存期间,对照组各血样中的乙醇、EtG和EtS浓度均呈下降趋势;实验组中1、2、4、5、6、7号血样的室温及4℃的样本在保存第2~3天时检出乙醇,而7号-20℃的样本在第6天检出乙醇。其中,6号室温血样的乙醇峰值浓度为64.27mg/100mL。各血样中均未检出EtG,EtS。结论室温及4℃保存的尸体血可产生乙醇且产生速度较快,反复冻融可导致-20℃保存的尸体血产生乙醇,乙醇峰值浓度可超过法定酒驾标准,但实验组血样中均无EtG和EtS产生。因此,尸体血中的EtG,EtS可以作为乙醇生前入体的特异性标志物,区分乙醇生前入体和腐败产生乙醇的依据。实际工作中,乙醇原体检测的酒精认定应注意血样保存和运输条件造成的影响。为了避免假阳性结果,涉及死亡的案件进行酒精认定时有必要辅以EtG和EtS的检测。     

“破溃点”——尸体腐败过程中腹腔自然破裂时刻的实验研究

目的 本文聚焦腐败这一重要晚期尸体现象,以期找到更客观的晚期尸体现象关键事件或特征节点,为准确评估尸体腐败程度、进而推断死亡时间（PMI）提供有力依据。方法 本研究通过对晚期尸体现象进行观测,对尸体腐败过程中肠道和尸坑土微生物菌群结构变化,以及尸坑土理化性质的检测,从宏观和微观两个层面,分析尸体腐败过程中腹腔自然破裂这一关键事件发生的时刻前后变化。结果 研究发现尸体腹腔自然破裂前后,腐败现象和相关微生物菌群结构以及环境理化性质三方面均有显著差异,且可观测性强,可以通过法医学观察、生物学和理化相关检测手段准确判断。本研究将这一关键事件发生时刻命名为“破溃点”。结论 本文认为“破溃点”可以作为法医实践中尸体腐败程度评估的重要节点,也可以作为基于微生物菌群结构变化等表征构建PMI推断模型时的分界点,分段构建模型以提升PMI推断模型的准确度。     

血、尿中乙醇含量的测定及其评价

在法医学非正常死亡的尸体检验以及酒后驾车肇事的司法鉴定中,测定尸体或活体血液、尿液中的乙醇含量,推测案发时血液乙醇浓度对于判断其中毒程度和死亡原因,具有重要意义。近年来,对乙醇的吸收、代谢、测定等的法医学研究,国外已有很多文献报导:而国内对此研究甚少。因此,     

腐败尸体的法医学检验

腐败尸体的检验鉴定在法医学上有重要意义。尸体腐败会毁坏损伤和病变，给尸体检验造成困难。关于腐败尸体的法医学检验，国内外文献报道较少，一般多着重于组织微观形态改变和生化分析，研究其分子保存水平，而与实际检案要求不能完全适应。本文拟将对腐败尸体大体检验与实际检案的要求作一专题讨论。 1 腐败及影响因素 　　腐败是人死后，机体组织中的复杂有机物，受腐败细菌的作用分解为简单的有机物和无机物，并产生大量腐败气体，使尸体液化失去原形的过程。机体死亡后，一般经过 24小时左右，就开始出现腐败现象。尸体外观常见的腐…     

腐败血液中自生醇现象及法医学应用研究

目的检测分析腐败血液中乙醇、甲醇等物质的生成过程,为正确判断案发时人血液中醇类物质的实际浓度提供实验依据。方法以正常健康人血液制作腐败样本,分别模拟人死亡后正常人血液和糖尿病人高糖血液的腐败过程,借助顶空气相色谱仪测定两种血液腐败后醇/醛类物质的生成情况并对比含量差异。结果相同实验条件下,高糖血液较正常健康血液更早腐败产生乙醇,但前者乙醇浓度低于后者;血液腐败过程中还会产生乙醛、甲醇、异丙醇、正丙醇等物质,其中正丙醇含量与乙醇生成量存在一定相关性。结论血液腐败能够产生乙醇、甲醇等多种物质。研究还为糖尿病人血液腐败产生醇类物质的差异性评价提供了依据。     

A rapid method for blood alcohol determination by headspace analysis using an electrochemical detector.

A method for the determination of blood alcohol concentration by headspace analysis using an electrochemical detector is described. A determination can be made within 2 min, and only 0.1 ml of blood is required for each analysis. The detector response was linearly related to ethanol concentrations up to 3.0 mg/ml. The standard deviation of a single determination was +/- 0.014 mg/ml. The accuracy of the method based on comparison with an enzymatic (alcohol dehydrogenase) technique was high, the mean recovery being 102.2% of the attributed concentration. The ease of the operation and fast analysis time make the method ideal for serial determinations, for example during mass screening of biological samples for ethyl alcohol in forensic and toxicology laboratories.     

生物检材采集与保存套管的应用

目的探讨生物检材采集与保存套管在法医学中的应用价值。方法在不同温、湿度环境下，观察悬空放置在生物检材采集与保存套管、有孔与外界相通的套管及密闭管内的湿润棉签的干燥时间30次；分别用生物检材采集与保存套管和医用棉签采集纸袋保存口腔细胞、血液、皮肤脱落细胞样本各20例，磁珠法提取DNA并进行DNA定量；用生物检材采集与保存套管采集口腔脱落细胞和血样进行DNA直接扩增。结果在温度4～30℃、相对湿度21％～90％的环境下，湿润棉签在套管内的平均干燥时间为7．89h，有孔管内的为23．30h，密闭管内观察15天仍不干燥，出现霉斑。生物检材用套管采集保存比医用棉签采集纸袋保存方式获得的DNA量显著提高，平均高达0．968倍；用套管采集口腔细胞和血样进行直接扩增，操作简单方便，成功率高。结论生物检材采集与保存套管具有快速干燥、对检材无损耗和浓缩等优点，可提高检材DNA的提取效率，且适合直接扩增。     

ELISA-based determination of opiates in purulent transformation of cadaveric material

Abuse of drugs has been a topical issue up to the present-day. Opiates like morphine and heroin are still prevalent. The routine methods of determination of drugs in blood made within the forensic medical expertise are time-consuming and samples must be specially prepared for them. ELISA, when used for the determination of opiates in blood and urine, significantly cuts the test time. According to our research results, the diagnosis of opiates by ELISA is advisable at the preliminary stage of the forensic expertise of cadaver; the method is informative, which is of extra importance in cases of purulent transformation of cadaveric material.     

Tissue storage solution for preservation and transfer of forensic specimen in high ambient-temperature

Storage of tissue samples in high ambient-temperature can affect the quality of forensic evidence. Experiments were conducted to investigate the potential use of 3 tissue storage solutions for the preservation and transfer of forensic specimen in high ambient temperature conditions, i.e., DMSO, Longmire’s buffer, and trehalose solution. Results showed that DNA in tissue was best preserved in DMSO buffer. Samples preserved in Longmire’s buffer gave DNA analysis results for temperatures up to 60 °C, however, amplification between replications were not reproducible. For those tissue samples preserved in trehalose solution, DNA markers larger than 300 bp were absent, and irreproducible amplification results were detected at a higher level when the storage temperature increased, and storage time was over 2 weeks. Tissue storage condition at high temperature over 1 week is not recommended. Experimental results here provided an alternative collection and preservation method for tissue samples at ambient temperature (without cold-storage) for subsequent DNA analysis. These can potentially be implemented in forensic biological evidence collection, preservation and transfer in hot climates.     

Forensic medical estimation of acute blood loss based on morphologic and functional changes in the internal organs

The objective of the present work was to obtain histological and morphometric characteristics of internal organs available for forensic medical examination from 236 corpses of subjects aged between 23 to 48 years whose death was caused by acute blood loss following a mechanical injury and concomitant alcohol or drug intoxication. Diagnostic signs of acute blood loss have been identified that can be used by forensic medical experts to estimate the length of the terminal period and reveal characteristic features of blood loss associated with alcohol and drug intoxication.     

The significance of inner ear fluid (perilymph) in forensic medicine (author's transl)]

An original method for collecting the perilymph in the inner ear by chiselling the pyramid of the temporal bone is presented; From 300 to 350 mul of fluid may be obtained each time. Various types of determination were performed on 399 human cadavers. The alcohol level was tested in 140 cases, the ABO(H) group antigens were determined in 89 cases, the phenotypes of the gamma-globulin (1) group system in 152 cases, and the alpha1-antitrypsin (Pi) system in 18 cases. Determinations of the alcohol level in the perilymph has been confirmed to be useful, as they allow not only determination of the degree of intoxication in cadavers in an advanced state of decomposition, but also by comparing the alcohol concentration in the cerebrospinal fluid, the vitreous humour, and the blood, the phases of elimination and absorption of alcohol may be more precisely determined. It was also found that the perilymph is a good medium for the determination of the group antigens of the red blood-cells and the gamma-globulin system, the serum and the alpha1-antitrypsin enzyme. These data suggest that the method may be more widely used in various forensic medical tests.     

血液乙醇检测内外标法比较研究

目的通过比较内标法和外标法对血液乙醇含量检测结果,探讨外标法在法医学实践中的应用价值。方法通过收集2005年10月~2006年12月间本中心符合检测要求的血液样品263例,每例分别采用内标法和外标法进行血液样品乙醇含量检测,比较其检测结果。结果外标法检测时间短(2.5min),用量0.5ml,而内标法检测时间长(6.5min),样品量1.0ml;外标法检测血乙醇平均浓度为89.30mg/100ml,内标法检测血乙醇平均浓度为92.37mg/100ml,P=0.001。结论外标法检测时间短(2.5min),用量少,节约检材,可作为大量待测血液样本的筛选检查手段。     

A study of ethyl glucuronide in post-mortem blood as a marker of ante-mortem ingestion of alcohol

The possibility of post-mortem production of ethanol makes correct interpretation of ethanol detection in forensic autopsy samples difficult. Even though the levels of ethanol formed post-mortem are generally low, this may be highly relevant in cases where intake of alcohol was forbidden, for instance for pilots, professional drivers and countries with low legal alcohol limits for driving. Different criteria are used to determine whether a finding of ethanol is of exogenous origin, but there is no marker for alcohol ingestion that has been studied in detail. In this study, we wanted to evaluate the sensitivity and specificity of ethyl glucuronide (EtG), a direct minor metabolite of ethanol, measured in blood, as a marker of ante-mortem alcohol ingestion. Forensic autopsy cases were divided into groups with and without ante-mortem alcohol ingestion, according to strict inclusion criteria. In 93 cases with information on ante-mortem alcohol ingestion, EtG was detected in blood in all cases, even when levels of ethanol were low. In another 53 cases where there were no indications of ante-mortem alcohol intake, EtG could not be detected in blood in a single case, also in 11 cases in which ethanol was detected and considered to be most probably formed post-mortem. In conclusion, blood EtG determination seems to be a reliable marker of ante-mortem ingestion of alcohol, and it could be considered in forensic autopsy cases when post-mortem formation of ethanol is questioned.     

The epidemiological characteristics of fatal subdural hematomas in forensic medical practice

A retrospective analysis of subdural hematomas is carried out: 493 in subjects dead from mechanical injuries (from files of forensic medical morgues in Tver', 1992-1994), and 37 cases with chronic subdural hematomas (from files of forensic medical morgues No. 2 and 6 in Moscow, 1995-1997). Age and sex of victims, time and circumstances of injuries, topographic and morphological features of subdural hemorrhages and their relation to concomitant injuries, and presence of ethyl alcohol in the organism are studied. The data on chronic subdural hematomas are presented. The authors emphasize the need in forensic medical studies of this condition.