尸检样本乙醇分析结果的解释策略

由于死后各种复杂的人为现象的存在，使得建立死后血液酒精含量（BAC）和死亡时醉酒状态之间的关系十分困难。在日常检案中必须考虑细菌污染、发酵是否引起死后乙醇再合成．死亡时胃中未被吸收的乙醇是否向周围组织以及血中扩散等问题。本文总结了关于死后乙醇分析及结果解释相关问题的研究文献，旨在为从事法医毒物学乙醇分析的同行在调查此类案件时提供良好的开端。     

血液中乙醇检测结果的法医学分析

目的对交通事故中血液中乙醇检测结果进行法医学分析。方法从检测方法、血液采集方法、采集时间、血液保存、尸体腐败、饮酒量与血液中乙醇质量浓度关系等方面进行血液中乙醇检测结果的法医学分析。结果检测方法、血液采集方法、采集时间、血液保存、尸体腐败等因素直接影响血液中乙醇检测结果。结论为保证交通执法的公正性,对血液中乙醇检测结果应当作法医学分析。     

11例毒鼠强中毒死尸检分析

近年来毒鼠强中毒死的案例在法医检案中经常遇到,已有个案报道,视系统报道11例。1资料分析本文资料选自青田县1996年1月至1998年6月检验的11例毒鼠强中毒尸检案例,其一般情况和中毒症状、尸检所见等见表1-表4。表1毒鼠强中毒发作时间（min）2讨论2,1毒鼠强特性毒鼠强又称没鼠命（Tetramine）,四二四,化学名称：四次甲基二矾四胺,其理化性质为无臭无味,白色粉末状,微溶于水,难溶于乙醇,稍溶于丙酮和氯仿,化学性质稳定。该药毒力极强,比磷化锌毒力强15倍,为氯乙酸胺毒力的1．8倍『‘］,小白鼠LDS。致死置为0．2mg／kg。毒鼠…     

607例不同年份中毒尸检资料对比分析

目的研究不同年份中毒案例的毒物种类、中毒途径、中毒方式等相关问题,为此类案例的法医学鉴定提供参考。方法对华中科技大学同济医学院法医学系（湖北同济法医学司法鉴定中心）1957—2008年鉴定的607例中毒案例尸检资料进行对比分析。结果 1999—2008年218例中毒案例中死者男性居多,30～49岁占50%,中毒以口服方式为主,意外中毒居首位,毒物种类以杀鼠剂、有毒气体、农药类位居前三位。与1983—1998年及1957—1982年的中毒尸检资料对比,不同年份间毒物种类明显变化,近年农药、氰化物中毒减少,杀鼠药、有毒气体及醇类中毒增加,毒品滥用激增。结论农药中毒是长期威胁公众健康的一类毒物,须对此提高防范意识;对联合中毒日益增多的趋势应引起关注。     

全面系统的法医学尸体检验及常见失误的防范

法医学尸体检验是法医学检案鉴定工作中的重要环节,是保证鉴定质量的基础和前提。虽然各人所做方法、步骤略有不同,每一案例又各有特殊性,但力求全面系统和规范是其基本要求。狭义的全面系统尸体检验是指尸体解剖时不仅应剖验颅、胸、腹腔这“三大腔”,还应剖验脊髓腔及其它应解剖的部位。如脊髓腔、关节腔、骨骼、眼球、周围神经和软组织等。而广义上的全面系统法医学尸体检验则应包括上述尸解和提取并保存适当、足量、可靠的检材标本这两方面。其常见的失误有:①案情不清,致尸检方案错误;②准备不足,盲目尸检;③仅作局解,片面不全;④尸解不规范,操作不标准;⑤观察不仔细,遗漏损伤或病变;⑥描述不准,记录不明,图照不清;⑦取材不适当,不能反映事实。     

例吸入性窒息死亡尸检分析

本文整理１９８１－１９９５年间的案件１６８９例，其中由于吸入性窒息死亡的４２例，经统计分析观察表明，吸入性窒息与年龄，原因，堵塞部位有一定的比例关系；亦易被其它现象所忽略。提示某些急死存在吸入窒息的可能性。     

法医尸检工作中常见的职业危害因素及预防措施

法医尸体解剖在解决民事、刑事案件中所涉及的死亡原因、死亡方式等问题中发挥重要作用,法医作为尸体检验工作的承担者,其在尸检过程中自身常面临多种危害因素,本文对法医实践中常见的职业性危害因素以及其可能危害机制进行总结分析,以期提高法医的自我保护意识并引起相关部门的重视.     

血液乙醇同源化合物分析及其法医学意义

酒精饮料申除含多量乙醇外,还含有微量甲醇、杂醇等乙醇同源化合物,且具有和乙醇类似的代谢及药代动力学特征,均参与肝ADH代谢,并与乙醇存在条件性竞争抑制。利用其代谢特性,在某些复杂醉酒驾车案件的法医学调查中,可根据血液中乙醇同源化合物的定量检测结果,结合对应血液乙醇质量浓度,帮助核实或推算饮酒者申诉的饮酒时间的真实性。     

法医尸检中应注意的几种现象

尸体是法医学研究的重要对象。尸体检验是法医鉴定工作的一个重要组成部分，通常尸体检验可以明确死因和致死方式，推断死亡时间和致伤物体，为刑事、民事诉讼和非正常死亡案件的审理提供医学证据。我国伟大的法医学家宋慈在《洗冤集录》序言中述：“狱事莫重于大辟，大辟莫重于初情，初情莫重于检验。”充分阐明了慎重全面检验的重要性。所以，尸体检验要求全面、仔细，稍有疏忽就可能酿成不可弥补的损失。但目前有些尸体检验工作不仔细、不规范，致鉴定结论不能令人信服。造成当事人上访，要求复检和重新鉴定，给审理工作带来不少麻烦和非…     

血液样本乙醇来源鉴定1例

<正>1案例资料1.1简要案情死者黄某桂,女,60岁。于2023年9月8日下午4时许,在辖区偏远乡村道路骑电动自行车过程中发生车祸,致颅脑损伤而当场死亡。为查明肇事双方是否存在酒驾,公安机关提取肇事双方血液样本并委托司法鉴定机构进行乙醇检测,检测结果提示死者涉嫌醉酒驾驶。由于死者家属对检测结果的乙醇来源提出质疑,要求进行重新鉴定并分析乙醇来源。     

Interpreting results of ethanol analysis in postmortem specimens: a review of the literature

We searched the scientific literature for articles dealing with postmortem aspects of ethanol and problems associated with making a correct interpretation of the results. A person's blood-alcohol concentration (BAC) and state of inebriation at the time of death is not always easy to establish owing to various postmortem artifacts. The possibility of alcohol being produced in the body after death, e.g. via microbial contamination and fermentation is a recurring issue in routine casework. If ethanol remains unabsorbed in the stomach at the time of death, this raises the possibility of continued local diffusion into surrounding tissues and central blood after death. Skull trauma often renders a person unconscious for several hours before death, during which time the BAC continues to decrease owing to metabolism in the liver. Under these circumstances blood from an intracerebral or subdural clot is a useful specimen for determination of ethanol. Bodies recovered from water are particular problematic to deal with owing to possible dilution of body fluids, decomposition, and enhanced risk of microbial synthesis of ethanol. The relationship between blood and urine-ethanol concentrations has been extensively investigated in autopsy specimens and the urine/blood concentration ratio might give a clue about the stage of alcohol absorption and distribution at the time of death. Owing to extensive abdominal trauma in aviation disasters (e.g. rupture of the viscera), interpretation of BAC in autopsy specimens from the pilot and crew is highly contentious and great care is needed to reach valid conclusions. Vitreous humor is strongly recommended as a body fluid for determination of ethanol in postmortem toxicology to help establish whether the deceased had consumed ethanol before death. Less common autopsy specimens submitted for analysis include bile, bone marrow, brain, testicle, muscle tissue, liver, synovial and cerebrospinal fluids. Some investigators recommend measuring the water content of autopsy blood and if necessary correcting the concentration of ethanol to a mean value of 80% w/w, which corresponds to fresh whole blood. Alcoholics often die at home with zero or low BAC and nothing more remarkable at autopsy than a fatty liver. Increasing evidence suggests that such deaths might be caused by a pronounced ketoacidosis. Recent research has focused on developing various biochemical tests or markers of postmortem synthesis of ethanol. These include the urinary metabolites of serotonin and non-oxidative metabolites of ethanol, such as ethyl glucuronide, phosphatidylethanol and fatty acid ethyl esters. This literature review will hopefully be a good starting point for those who are contemplating a fresh investigation into some aspect of postmortem alcohol analysis and toxicology.     

利用人体标本进行死亡时间推断的研究现状

死亡时间(PMI)推断具有重要的法医学意义,但尚无可以应用在实践领域的PMI推断方法。本文从PMI推断的实践应用角度出发,从脏器、骨骼、骨骼肌、牙齿、牙龈以及大体观、毛发、皮肤和血液等角度,对利用人体标本进行死亡时间推断的研究现状进行了综述。希望对我国开展人体标本的PMI推断实践研究提供借鉴。     

Evaluation of postmortem biochemical markers: Completeness of data and assessment of implication in the field

Throughout the years an increase has been observed in research output on biochemical markers for determining the postmortem interval (PMI). However, to date, a complete overview is missing on the results of postmortem biochemical markers (PBM's) for PMI estimation. In this paper, literature was reviewed in order to identify the knowledge lacunae of PBM research from a practical point of view. A three-step approach was undertaken in order to achieve the set goal. Literature was collected, the PBM's were evaluated for completeness by means of a scorings index based on set criteria, and PBM's were subsequently evaluated in light of the Daubert & Frye criteria for scientific evidence in court. Seven PBM's were found to be well investigated, from which potassium had the highest completion score. However, none of these PBM's could be qualified as suitable for court evidence. Further, this study revealed that the majority of PBM's (94%) is not well investigated. Consequently, these PBM's did not meet Daubert & Frye criteria. In order to improve the assessment for use of PBM's as evidence in court regarding PMI estimation, PBM's should be investigated more thoroughly and data should be made readily available.     

脑组织与其相关分析推断死亡时间的研究进展

推断死后间隔时间(postmortem interval,PMI)一直是法医学鉴定中需要解决的重要问题之一.可用于推断PMI的尸体检材有很多种,脑组织因其独特的解剖学位置与生理功能,是推断PMI的重要检材之一.本文从三个方面将根据脑组织推断PMI的方法进行综述,包括了通过脑组织的温度、形态特点等尸体现象推断PMI;通过...     

The distribution of ethanol in postmortem blood specimens.

Ethanol was determined by gas chromatography in a variety of tissues and body fluids secured at autopsy in 61 cases. The specimens tested included right and left heart blood, femoral blood, pericardial fluid, cerebrospinal fluid, vitreous humor, urine, stomach contents, and brain. Statistical analysis of the cases revealed no significant differences among the various blood sites tested. However, the variations in blood ethanol concentrations among the various sampling sites within each case were as follows: 40 cases showed differences of less than 25%; 16 cases revealed variability between 25% and 50%, 4 cases had differences exceeding 50%. In one case, satisfactory blood analyses could not be accomplished. The larger variances occurred especially in those instances in which stomach alcohol concentration was 0.50% or greater. In one case, the variability amongst the different blood sites exceeded 400% (femoral blood--0.043%, right atrium--0.070%, root of aorta--0.156%); the brain was 0.050%, and the stomach contents was 1.2%. For all 61 cases, variances in blood alcohol content among the different sampling sites in a single cadaver ranged from 1.8 to 428%.     

人脾脏细胞核DNA含量与死亡时间关系的图像分析

目的研究人脾脏细胞DNA含量改变与死亡时间的关系。方法选取36例已知死亡时间的人体脾脏,在死后5～36h内逐时进行细胞学涂片、Feulgen Vans染色观察,并用图像分析系统,测定脾脏细胞核积分光密度、平均灰度等灰度参数,所得数据用SPSS软件分析。结果在5～36h内平均光密度、积分光密度、平均灰度均值均与死亡时间显著性相关,并得出对应的回归方程,其中平均光密度、积分光密度随死亡时间的延长而逐渐减小、平均灰度逐渐增大。结论人脾脏细胞核DNA含量改变呈现一定规律,与死亡时间明显相关。     

大鼠死后不同时间肌肉酶组织化学观察

目的　为了研究死后不同时间酶组织化学改变和死亡时间的关系。方法　用ＨＥ、ＰＴＡＨ 和酶组织化学染色法,对死后大鼠尸僵形成时肌肉的横纹和酶活性改变进行观察。结果　发现死后２ ～４ｈ 横纹模糊,６ｈ 后变清楚,可持续至２４ｈ 。琥珀酸脱氢酶（ＳＤＨ） 和辅酶Ⅰ黄递酶（ＮＡＤＨＤ） 变化较小,至死后２４ｈ,两种肌纤维的酶活性均较强;细胞色素氧化酶（ＣＣＯ） 活性下降较明显,至死后２４ｈ ,Ⅱ型纤维的酶活性几乎完全消失。结论　肌纤维结构的变化以及酶活性的变化可以用作推测死后经过时间     

氯氮平在家兔体内死后再分布规律研究

目的阐明死后48h内家兔体内氯氮平再分布规律,为相关法医鉴定工作提供借鉴。方法取家兔15只,随机分为5组,以氯氮平灌胃,分别于死后0、6、12、24、48h取心血、外周静脉血、尿液、肝组织检测氯氮平浓度。结果家兔死亡后心血、外周静脉血、肝脏氯氮平浓度不断升高,尿液氯氮平浓度不断降低;死后早期浓度变化率大于晚期浓度变化率。死后48h心血、外周静脉血、肝脏、尿液氯氮平浓度分别为死后0h各检材氯氮平浓度的418%、193%、154%和29%。结论死亡一段时间后,提取生物检材,检测出的氯氮平浓度并不能准确反映刚死时的实际浓度。