钾中毒死亡家兔的尸体化学变化

目的研究家兔钾中毒死亡后的尸体化学变化特征,为钾中毒的法医学鉴定提供参考。方法采用浓度为0.3%和1%的KCl葡萄糖溶液分别以全速和100滴/min的速度输给家兔,至其死亡,测定家兔输液前后血、尿电解质浓度,比较两种不同输液方式所致钾中毒死亡后尸体化学变化特征。结果输钾前后,家兔血清K (SK)浓度升高,血清Na 、Ca2 、Cl-及HCO3-浓度均降低,全血K (TK)及血清Mg2 浓度变化无显著性差异。0.3%KCl组致死输液时间长于1%组(P=0.006),致死输钾量无显著性差异(P=0.062);TK、血清Na 、Mg2 及Cl-浓度变化值具有显著差异,SK、Ca2 、HCO3-浓度变化值无显著差异;尿量和尿液各电解质浓度指标未见显著性差异。结论尸体SK、TK及血清Mg2 浓度升高,有助于钾中毒的法医学死后诊断。     

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。     

10例原发性脑干损伤法医病理学分析

原发性脑干损伤在颅脑损伤中较为少见,笔者总结近几年来遇到的10例伤害致死、致残案件,进行回顾性分析研究,就其损伤形成原因、机理、形态学改变及法医学鉴定的规律特点,进行探讨.案例资料本文所报10例,系近年故意伤害致死或致残案件.提取的尸体脑组织经10%的福尔马林固定后,进行组织学检查,其中3例进行了神经轴索特殊染色,最后认定系由于头颅外伤致原发性脑干损伤死亡.     

结核播散累及心脏传导系统致死1例

结核虽是一种常见病,但心肌结核很少见,且结核累及心脏传导系统更是罕见。作者通过尸检发现1例结核播散累及心脏传导系统致死,并结合复习相关文献,对心肌结核的发病机制、死亡机制和法医学鉴定要点进行分析,供同仁参考。     

1例活埋致死案例报道

机械性窒息死亡的案例在各类非正常死亡中比较多见,但活埋致死的案例较为少见。作者将遇到的1例报告如下,并对其死亡机制、尸体现象及法医学鉴定做分析报道。     

心传导系统的常见疾病(讲座3)

心脏传导系统疾病常是全身或心脏病变的一部分 ,也可以是独立的发生。心脏传导系统疾病虽不多见 ,但它可诱发心律失常导致猝死。心源性猝死是法医学中的重要组成部分 ,故法医应该了解、掌握心脏传导系统病变 ,以便在损伤与疾病并存中作出准确鉴定 ,为执法部门提供量刑定罪的依据。日常尸体解剖中 ,常规心脏传导系统检查 ,都可见到心脏传导系统存在某些异常变化 ,但不要随意轻率地定为猝死原因 ,认定心脏传导系统疾病是其死亡原因 ,需具备以下条件 :1 没有可致死的暴力损伤 ,排除暴力致死 ;2 排除中毒致死 ;3 排除心脏外疾病致死 ;4 排除心…     

胰岛素中毒法医学研究进展

胰岛素作为一种临床上常见的降血糖药物,可以有效控制糖尿病患者血糖,使之维持在正常范围。但过量胰岛素可导致死亡,其中以意外中毒最多见,其次为自杀,胰岛素他杀虽极为罕见,但值得高度重视。胰岛素中毒致死的法医学鉴定极为困难,虽然相关研究已取得一定的进展,但在法医学实践中,这类案件仍然是一大难题。本文从法医病理学的角度,对胰岛素中毒的死亡机制、病理学改变、检测手段、注意要点及诊断要点进行综述,为法医学实践提供帮助。     

致死性心脏压塞38例法医病理学分析

目的探讨致死性心脏压塞的法医病理学特点和鉴定要点。方法对成都中医药大学附属医院病理科2005~2015年完成的38例心脏压塞致死案例进行回顾分析。结果致死性心脏压塞好发于男性(71.1%),平均年龄44岁;直接死因血性积液34例,非血性4例;根本死因以疾病多见(73.7%),主要为夹层动脉瘤、冠心病、恶性肿瘤;发病12小时内死亡占75%;涉及医疗行为30例(78.9%),26例无医疗过错(86.7%);疾病致死案件涉及伤病关系15例(39.5%)。结论掌握致死性心脏压塞的法医病理学特点和鉴定路径是准确完成该类案件法医学鉴定的基本要求。     

致死性心律失常的法医学研究进展

据文献报道,有很多心源性猝死是由于致死性心律失常所致。在法医学鉴定工作中,心律失常所引起的猝死往往很突然,尸检及镜下病理学检查又缺乏特征性的改变,使得鉴定其死亡机制成为一大难点。因此,寻找一种客观、准确的心律失常鉴定方法,对于致死性心律失常所致心源性猝死的鉴定尤为重要。本文将就上述问题,从致死性心律失常的定义、分类、产生原因、致死机制、形态学所见及死后生化检测指标等方面进行综述,以期为心源性猝死致死原因的法医病理学分析、鉴定提供帮助。     

失血死亡及休克早期心肌病理学研究

应用电镜,组织化学,免疫组化及形态计量分析等方法和技术,观察了失血致死和休克早期不同时间家兔心肌超微结构、琥珀酸脱氨酶（SDH）活性、肌红蛋白（Mb）脱失的变化特点。结果发现：失血致死和休克早期，不同时间兔心肌超微结构、SDH活性和Mb含量有不同程度的改变。病变程度随休克时间的延长而加重。本文还讨论了这些改变在法医学上的意义。     

甲氰菊酯在家兔体内的死后分布研究

目的建立甲氰菊酯家兔灌胃染毒致死模型和生物检材中甲氰菊酯的气相色谱和气相色谱-质谱联用检测方法,研究甲氰菊酯在家兔体内的死后分布规律。方法家兔6只,甲氰菊酯经口灌胃染毒,死亡后迅速解剖,取心血、外周血、肝等组织,气相色谱和气相色谱-质谱联用法检测甲氰菊酯含量;部分组织经甲醛固定,HE染色,光镜观察其病理改变。结果家兔染毒后2～3h出现中毒表现,染毒后4.5～8h死亡。气相色谱和气相色谱-质谱联用法均检测到甲氰菊酯。甲氰菊酯在家兔体内死后分布为胃壁（458.92±32.82）μg/g、肾（46.47±6.30）μg/g、肝（35.79±20.11）μg/g、大脑（28.77±10.52）μg/g、心（26.49±4.10）μg/g、脾（22.23±5.37）μg/g、胆汁（10.87±1.42）μg/mL、肺（10.32±0.78）μg/g、周围血（8.14±1.12）μg/mL和心血（8.20±1.83）μg/mL。结论甲氰菊酯的灌胃染毒致死模型、气相色谱和气相色谱-质谱联用检测方法及死后分布规律可应用于甲氰菊酯中毒死亡案件的法医学鉴定及法医毒物动力学研究。     

家兔死后体内2-氨基噻唑啉-4-羧酸分布研究

目的 建立家兔氰化钾灌胃给药致死动物模型,研究氰化物代谢物2-氨基噻唑啉-4-羧酸(ATCA)在家兔体内的死后分布规律.方法 雄性家兔7只(体重约2.0kg～2.5kg)经口灌胃2LD50(10mg/kg)氰化钾水溶液,观察家兔反应,待家兔呼吸、心跳和反射全部消失后立即对家兔进行解剖取心、肝、脾、肺、肾、脑、睾丸、胃壁...     

Thanatogenesis in poisoning with psychopharmaceuticals

Discussed in the paper are thanatologically significant morphological signs in intoxication with some of psychic drugs. It was demonstrated that, in intoxication with azaleptin, phenazepam and aminazin, death comes mostly from affection of the brain including its edema and irreversible severe changes of neurons. In intoxication with tizercin, benzodiazepines and barbiturates, cardiac thanatogenesis as fibrillation of heart chambers combined with foci of myocytolysis. Sodium oxybutyrate brings about vascular collapse with subsequent development of fibrillation of heart chambers and of pulmonary edema. Intoxication with amitriptyline causes naturally necrotic nephrosis entailing uremic pneumonia and edema of the brain and heart.     

Histomorphometric characteristic of human brain in acute alcoholic intoxication

Different brain sections were studied in 20 subjects, who died of ethanol intoxication and in 14 subjects who died of injuries of the heart and main vessels, in order to detect histological changes in the brain and for the purpose of defining spatial and quantitative ratios between cerebral tissue structures in alcoholic intoxication. Different histological, stereometric and morphometric tools were made use of. It was demonstrated that, in alcoholic intoxication, there occur severe disorders of the circulation with affection of vessels in the brain; there are also dystrophic and necrotic changes in neurocytes, glial cells and white substance. The square of neurons shrinks due to death of some of them in the cortex of hemispheres, thalamus and cerebellum. As for the medulla, they are more resistant, there, to ethanol. The diameter of capillaries in the studied brain sections diminishes due to a reduced tonus of cerebral arteries; the quantity of such vessels increases within a standard area, which is conditioned by the compensatory opening of reserve capillaries. All this can be important in dealing with issues of thanatogenesis and of forensic medical diagnosis in death of alcoholic intoxication.     

A sudden death with lung embolism after inadvertent infusion of zinc oxide shake lotion

A 74-year old woman in postoperative treatment after a colonic surgery died immediately after perfusion of about 1.5 mL of a white emulsion which was believed to contain 1% propofol via cardiac catheter into the right atrium. It was strongly suspected that a syringe with a zinc oxide shake lotion (consisting of 20% ZnO, 20% talc, 25% glycerol and 35% water) which was intended for external treatment had been mistaken for the propofol syringe. During autopsy, an anatomic cause of death could not be found. In order to exclude an intoxication and to determine the significance of the perfusion fluid in this context, toxicological and histological investigations were performed. Propofol and other drugs applied to the patient were found in therapeutic or sub-therapeutic range. However, in comparison to a control case, the zinc concentrations determined by AAS were about 200 times higher in lung tissue, 10 times higher in heart blood and 3–4 times higher in kidney and liver tissue. No increase was seen in venous blood. Histology showed a strong embolism of the lung tissue with birefingent sharp-edged crystals, which were identified as the talcum, and an amorphous component (ZnO). The same embolism was seen to a medium extent also in the brain sections and to a low extent in heart, liver, pancreas and kidney. Pulmonary embolism by talcum and zinc oxide was established as the cause of death which occurred by syringe swap due to insufficient security precautions in the drug administration. The results are discussed in context of pulmonary microembolism cases frequently described for drug addicts after injection of crashed talcum containing tablets.     

重伤家兔体内Cu及代谢酶变化与MOF及死亡关系

目的探讨兔重伤后机体内铜（Cu）含量及其代谢酶铜锌超氧化物歧化酶（Cu/Zn-SOD）、细胞色素c氧化酶（CCO）活性变化与继发性多器官衰竭（MOF）及死亡的关系。方法参照国际通用的创伤程度量化评分标准（ISS）,建立致MOF的家兔重伤模型,检测伤后不同时段血清及组织Cu含量与Cu/Zn-SOD和CCO的活性,分析其变化规律与继发MOF及死亡的关系。结果①重伤组家兔（包括死亡组家兔）血清Cu含量在伤后12h显著下降,36h后逐步回复;脑、心、肺组织中Cu含量伤后下降,肝脏组织Cu含量于伤后12h显著升高,36h后回落。伤后死亡组家兔脑、心、肺、肝Cu含量均较对照组降低,其中脑、肝组织Cu含量下降显著。②重伤组家兔血清Cu/Zn-SOD活性伤后12h下降3,6h之后呈升高的趋势,肝脏组织中的Cu/Zn-SOD活性伤后持续显著升高。③重伤后家兔（包括死亡组家兔）大脑皮质、心、肝CCO活性变化不明显,但脑干组织CCO活性显著升高。伤后死亡组家兔脑、心、肺、肝等器官的大体及组织学呈MOF改变。结论严重创伤可引发兔血清和组织Cu水平及Cu/Zn-SOD、CCO活性变化,这些变化可能与继发多器官衰竭和死亡相关。     

Time-related changes in cardiac ct images of rabbits died from four kinds of execution

Objective To explore the feasibility and appropriate parameters for estimating postmortem interval (PMI) through time-related CT imaging into dynamically monitoring the cardiac changes of rabbits died from four kinds of execution. Methods The experimental rabbits were executed with four disposals of air embolism, strangulation, drowning and hemorrhagic shock. The dead rabbits were observed of their hearts with CT scanning every 6 hours within 120h from the death moment, having the obtained time-different CT images and mean CT values examined. With the cardiac average CT values of rabbits died from discrepant execution, four relevant regression equations were established against the elapsing time (i.e. PMI). Results The CT images of post-death cardiac tissue of rabbits died from one of four executions did change regularly with the PMI elongating, showing consistent with the autopsy verification. The binomial regressive equations were established between the post-death cardiac average CT value and PMI from four executions, demonstrating statistically significant (P<0.05). Conclusion The postmortem cardiac CT imaging into PMI analysis, plus the relating regression equation, provides a new objective visual quantitative approach and reference for forensic medicine to infer the time of death. © 2021, Editorial Office of Forensic Science and Technology. All rights reserved.     

Changes in DNA induced by toxic agents

This is a preliminary report on significant alterations in the DNA profile caused by toxic substances which potentially has profound implications for the use of DNA techniques in identification. Acute DNA changes in the globus pallidus of the brain in man caused by carbon monoxide poisoning were detected by DNA profiling with probe 33.15. Chronic DNA changes in rabbits caused by methamphetamine were detected by DNA profiling with probe 33.15, AmpFLP on D1S80, TH01, CSF1PO and TPOX loci. Pre-intoxication bands appeared, disappeared or were discoloured after intoxication. With PCR-dot blot hybridization testing for HLADQα, pre-intoxication positive spots became negative after intoxication and pre-intoxication negative spots became positive after intoxication. Intravenous injection of 10 mg/kg of methamphetamine every 2 days for 2 weeks was a large enough dose for inducement of genetic changes. In this investigation, clear changes in DNA due to intoxication were confirmed.     

芬太尼中毒死亡大白兔体内分布研究

目的建立芬太尼中毒致死的动物模型,探讨芬太尼在致死大白兔体内的分布规律。方法用6只雄性大白兔按5.4mg/kg(2LD50)经耳缘静脉推注芬太尼注射液,大白兔死后迅速解剖并提取心、肝、脾、肺、肾、脑、肌肉、睾丸、胃、心血、周围血、胆汁和尿液,用正己烷∶乙醇(20∶1)萃取,利用UPLC-MSn法检测各组织和体液中芬太尼含量,使用SPSS15.0进行方差分析,均数两两比较的SNK法进行统计分析。检验水准为α=0.05。结果实验大白兔给药后1min出现颈项强直、四肢抽搐等中毒症状,平均4.7min因呼吸抑制而死亡。死后肺内芬太尼含量最高,其次是肾和心,而尿液中含量较低。结论本实验的结果与相关案例报道基本吻合,提示肺、肾和心脏是芬太尼中毒案件鉴定的理想检材,芬太尼在致死大白兔体内的分布规律可为相关案件的鉴定提供一定的依据。