心传导系统取材及组织形态观察的实验研究

收集32例人体心脏标本，分为两组，每组16例，介绍并比较心传导系统的不同取材方法。一组采用与窦房结、房里结长轴相垂直切面取材（横切法）；另一组采用与窦房结、房室结相平行的水平切面取材（纵切法）。通过石蜡切片，HE染色后于光镜下观察其形态结构。结果显示：横切取材较易掌握，不需间断连续切片，16例心脏在显微镜下全部显示出窦房结、房室结结构；纵切面16例心脏有7例没有取中窦房结，9例没有取中房室结，操作方法较难掌握。提倡心传导系统取材采用横切法。     

婴幼儿猝死综合征心传导系统的免疫组化研究

作者应用ＰＧＰ９．５与抗Ｓ１００抗体和高压消毒蒸锅抗原复活技术对４例婴幼儿猝死综合征（ＳＩＤＳ）和３例非心源性死亡对照婴儿心传导系统的神经组织总量进行免疫组化研究。结果：在正常婴儿心传导系统，ＰＧＰ９．５与Ｓ１００阳性的神经纤维里不均匀分布，以窦房结最多，房室结次之，希氏束最少；４例ＳＩＤＳ心传导系统的神经组织分布同对照组无明显差异。     

NMDAR1在成人心脏中的分布及其法医学意义

目的 检测成人心脏中NMDAR1蛋白,观察其分布情况,并探讨法医学意义。方法以12例高坠死亡成人心脏为标本,提取左、右心室和心传导系统（窦房结、房室结、房室束及左右束支）组织作为实验组;取大脑额部组织作为阳性对照组。所取标本各两份,一份采用westernblot技术检测NMDAR1蛋白,另一份采用免疫组化染色法观察NMDAR1在成人心脏中的分布。结果两组中用westernblot均可检出NMDAR1蛋白表达,其强弱程度：脑组织最强,其次为窦房结和房室结,左右心室肌最弱;用免疫组化方法观察,结果在心脏传导系统可见NMDAR1阳性表达,而在心室肌中未见表达。结论成人心脏中存在NMDAR1,主要分布在心传导系统,NMDAR1可能在心脏电生理和病理生理中起作用。     

178例心源性猝死法医组织病理学诊断分析

目的探讨心源性猝死(SCD)的病理特点与鉴别要点。方法对四川华西法医学鉴定中心2000—2005年尸检出的178例SCD死亡案例进行回顾性分析,主要对其病因、年龄、诱因及病理改变进行分析。结果本组资料显示冠心病、心传导系统病变、心肌炎、心肌病等在SCD中占有较大比例。冠心病猝死是中老年人SCD的最主要原因,青壮年人SCD的病因以非冠心病为主。如传导系统病变、心肌炎、心肌病。在儿童的SCD中先天性心脏病、传导系统病变及心肌炎占主导地位。结论不同的病因,其病理特点不同,其病理变化是法医学鉴定的主要依据。     

第11卷中文文题索引

第１１卷中文文题索引（期：页）法医学史十九世纪血痕、精液斑等物证检验史２：８８十九世纪临床法医学的主要成就（一）３：１３８法医学教育心脏传导系统取材方法多媒体计算机辅助教学的应用研究４：１４９病理检验技术心脏传导系统的一种新型染色法２：６０心脏传导系...     

急性心肌梗死心传导系统的免疫组化实验观察

观察急性心肌梗死时心传导系统的形态学改变。取急性心肌梗死死亡者的心传导系统标本6例,运用抗纤维连接蛋白抗体、肌红蛋白抗体、血管内皮生长因子抗体进行免疫组化染色。结果发现,纤维连接蛋白染色有3例呈现强阳性,2例出现阳性,1例出现弱阳性;血管内皮生长因子染色均呈弱阳性;肌红蛋白染色呈脱失改变。提示纤维连接蛋白检测量敏感性强,稳定性好,易于观察,可作为在心肌梗死时了解心传导系统受损害的指标之一。     

脑血管造影在法医学尸体检验中的应用

脑血管造影作为诊断脑血管疾病的"金标准",目前已经广泛地应用于临床医疗活动中,并积累了丰富的理论和实践资料,是趋于成熟的技术方法。由于因脑血管疾病引发的法医学鉴定案件较为多见,故该技术近年开始应用于法医学,显示出在法医学实践中独特而重要的应用价值。本文对脑血管造影术在法医学中的应用价值进行综述,内容包括辅助定位血管病变或损伤部位、明确出血性质、指导尸体解剖与脑组织病理取材等,并在此基础上展望了该技术在法医学中的应用前景。     

急性心肌梗死时人心脏房室结细胞糖蛋白表达

目的观察急性心肌梗死时心传导系统糖蛋白表达。方法运用花生凝集素(PNA),对8例急性心肌梗死亡者的心传导系统标本进行亲和组化染色。结果PNA有7例呈现强阳性,1例出现弱阳性。结论房室结传导细胞在缺血时细胞膜表达PNA受体,提示急性心肌梗死时房室结细胞和工作心肌都不同程度受累,并且细胞病理改变机制可能相关或类似。     

法医学计算机辅助教学系统的应用

为了提高法医学教学质量，笔者在IBM～PC／XT微型计算机上成功地开发了计算机辅助教学软件——法医学计算机辅助教学系统（本文中简称为FMCAI），在开发和应用这个软件系统的过程中，对法医学的计算机辅助教学的方法、技术及理论作了一些探索和总结。一、系统的总体功能结构为了充分利用PC／XT计算机现有的硬件资源并取得更好的效果，将FMCAI分为通用系统和教师专用系统。二者可分别独立地使用。总体设计上采用结构化设计方法，使FM－CAI系统的每个模块可以独立地被理解、编写。测试、排错和修改。在具体程序编写上，采用高级程…     

受虐儿童眼内改变的多媒体计算机研究

本研究在传统计算机应用的基础上，综合应用多媒体计算机，视窗下多媒体创作工具等技术，结合法医学实际，研制出受虐儿童眼内改变的多媒体计算机系统。对于提高法医学工作质量，跟踪国际先进技术具有重要意义。展望多媒体计算机在法医学鉴定、法医学教育、法医学科研等方面的应用在深度和广度方面会有更大的发展。     

计算机辅助法医教学系统

本研究综合应用多媒体计算机技术，结合法医学实际，研制出法医学尸体解剖教学的计算机软件．结果表明符合形象教学的要求．具有较强的交互能力，能按学习不同层次选择有关步骤和内容．     

Possibility of the species identification using blood stains located on the material evidences and bone fragments with the method of solid phase enzyme immunoassay with "IgG general-EIA-BEST" kit and human immunoglobulin G

The authors give the comparative analysis of Russian and foreign forensic medical methods of species character identification of the blood from the stains on the material evidences and bone fragments. It is shown that for this purpose it is feasible to apply human immunoglobulin G (IgG) and solid phase enzyme immunoassay (EIA) with the kit "IgG general-EIA-BEST". In comparison with the methods used in Russia this method is more sensitive, convenient for objective registration and computer processing. The results of experiments shown that it is possible to use the kit "IgG general-EIA-BEST" in forensic medicine for the species character identification of the blood from the stains on the material evidences and bone fragments.     

网络环境下的法医学循证

法医学是当前司法鉴定中的重要组成部分,其研究内容广泛,具有高度的专业性。随着网络技术的发展、信息资源的增加以及人们法律意识的增强,法医学必然会面临许多新问题,对诉讼证据的要求标准也越来越高。鉴于此,在法医学领域应建立起循证的理念,通过循证的方式在法医学以及相关领域内寻求最合适的解决法医学实务中具体问题的证据,循证不但能够及时解决法医学领域的现行问题,其对于法医学的进步与发展也将具有重大的推动作用。本文综述了循证的基本理论及其在法医学领域的作用,以及循证的途径、方法、证据的评价,并探讨网络环境下法医学循证的应用价值。     

The history of forensic medicine in times of the Weimar republic and national socialism--an approach

German Forensic Medicine established the tasks and aims of forensic medicine during the period of the "Weimar Republic" (1919-1933). Since 1925, forensic medicine is part of the medical examination regulation. In times of the 3rd Reich (1933-1945), most of forensic pathologists were influenced by and involved in National Socialism. The special subject of forensic medicine was endangered by the absence of political neutral forensic pathologists.     

致伤方式推断在道路交通事故再现研究及责任认定中的作用

本文从法医学的角度,论述了道路交通事故致伤方式推断的方法、特点以及与涉案人员交通行为方式鉴定、死因分析的相关性,强调了致伤方式推断在事故重建及涉案人员责任认定中的重要性。并以3起真实的道路交通事故为例,阐述了致伤方式推断分析的过程,进一步结合碰撞软件对事故进行计算机仿真研究,再现过程表明致伤方式推断的正确性,初步验证了从致伤方式推断入手分析涉案人员交通行为方式、死亡原因的可行性;同时指出对于致伤方式不明确的道路交通事故,可通过事故遗留的制动轨迹、速度等进行计算机模拟研究,对于致伤方式推断具有一定的参考价值。     

Forensic medicine and criminalistics

The supplementary designation "criminalistics" in the title of certain forensic medical institutes in the first half of this century is to be regarded as a reaction to faulty developments in our specialty, which almost led to the elimination of forensic medicine as an independent scientific discipline in the 1960s. The ability to think in terms of criminalistics and the corresponding working procedures has always been a crucial precondition for the forensic physician, since forensic medicine is the application of medical knowledge for juridical purposes. Forensic medicine originated with the appraisal of cases of violent death by doctors, i.e., reconstruction of the facts in the case. To use the term "criminalistics" in the form of a supplementary designation is thus not required. An attempt is nevertheless made to define "medical criminalistics" as a small but important component of criminalistics. They are subdivided into two phases: the first part begins at the scene of the crime or the place of discovery (local evidence). Here, the trained eye of the forensic physician is indispensable to the criminal investigation department and the prosecutor. Medical criminalistic thinking and working procedures continue at the autopsy. Here, forensic autopsy differs from that practiced by the pathologist. Without knowledge of the situation at the discovery location, the forensic physician runs the risk of not recognizing facts that are important for reconstruction and thus becoming a "destroyer of clues". The second part of medical criminalistics is the actual detection of medical clues, i.e., the investigation of medical clues with special methods, including histological and toxicological investigations.(ABSTRACT TRUNCATED AT 250 WORDS)     

A new examination program for forensic assessment: performance of computers in medicine

Computerizing of medicine is expected to increase very rapidly in the next few years. This will bear new questions for forensic judgement. We report a case and our expert opinion concerning the use of a very simple computer program at a private hospital to obtain comments on laboratory findings. Furthermore we discuss questions we consider to be of importance for forensic judgement in this field.     

The forensic expert witness--an issue of competency

Scientists submitting expert opinions within the legal system are expected to be knowledgeable in the forensic aspects of their particular science, as well as to be ethical and unbiased. Scientists are seldom able to decline a request to provide an expert opinion in their field, even when their forensic expertise is minimal. The competence of scientists providing expert opinions in forensic cases is reviewed here. Three examples of the perils of uninformed "expertise" in forensic biology, medicine and anthropology are presented.     

国外法医临床学发展史

法医临床学是法医学的重要分支学科,正处于蓬勃发展阶段。研究法医临床学的发展史,对明确其定义和实践范畴,维护司法公正,具有重要意义。本文将从“简介、历史溯源、18世纪之后的法医临床学发展、现代法医临床学、世界法医临床学司法实践现状和结语”六个部分介绍法医临床学在国外,尤其是英国的发展历史,促进我国法医临床学的学科建设和发展。