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。     

大鼠死后心血中吗啡浓度变化的HPLC检测

本文采用高效液相色谱（HPLC）分析技术检测了治疗量及中毒量吗啡肌注大鼠死后心血中吗啡浓度变化．结果表明．以治疗量吗啡肌注大鼠死后96h内，心血中吗啡浓度随死后时间增加而显著升高（P<0.01），吗啡浓度水平与死后时间呈显著正相关．以中毒量吗啡肌注大鼠死后12h内，心血中吗啡浓度无明显变化．死后24h、48h及96h．随死后时间延长，心血中吗啡浓度逐渐升高（P＞0.01），其递增强度不如治疗量吗啡组大鼠的明显．本研究证实死后尸体心血吗啡浓度明显受生前剂量的影响，且死后96h内，随死后时间延长心血中吗啡浓度不断增高．本文初步探讨了死后心血吗啡浓度变化发生的可能机制．为海洛因或吗啡中毒死亡的血液检测结果评判及死因分析提供理论依据．     

大鼠死后心血吗啡浓度变化的HPLC检测

采用高效液相邑谱分析技术（HPLC）检测治疗量及中毒量吗啡肌注大鼠死后心血中吗啡浓度变化。结果表明，以治疗量吗啡肌往大鼠，在死后96h内，心血中吗啡浓度随死后时间增加而显著升高（P＜0．01），吗啡浓度水平与死后时间里显著正相关；以中毒量吗啡肌注大鼠，在死后12h内，心血吗啡浓度无明显变化；死后24h、48h及96h，随死后时间延长，心血中吗啡浓度逐渐升高（P＞0．01），其递增强度不如治疗量吗啡组大鼠的明显.本研究证实，死后尸体心血吗啡浓度明显受生前剂量的影响，且在死后96h内，随死后时间增加．心血中吗啡浓度少数不断增高。     

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。     

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。     

溶血对尸体化学检验影响的研究现状及展望

尸体化学检验作为辅助诊断死因及反映死前病理生理状态的重要辅助方法,近年来逐渐应用于法医病理学实践中.但由于死后变化、尸体冷冻保存等因素影响,死后检材受溶血干扰情况严重,对检验分析产生严重干扰.本文结合临床医学及法医学研究文献,对溶血干扰检验的机制、溶血对尸体化学检验的影响及死后溶血血液检材检验方法的研究现状进行综述,并...     

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。     

中空纤维超滤技术在死后溶血血液总IgE检测中的应用

目的探究中空纤维超滤技术对溶血样品的处理效果及超滤液中IgE浓度与溶血前血清浓度的差异。方法收集死后72 h内非冷冻尸体的尸检血样33例,每例取4 m L血液,其中1 mL离心保留血清,余3mL血液冻融3～5次致其完全溶血。将2 m L溶血样品经中空纤维超滤处理得到超滤液。应用文齐氏液-氰化高铁血红蛋白测定法检测血清、全溶血样品及其超滤液中血红蛋白浓度,电化学发光法检测血清、超滤液中总IgE。结果超滤液中血红蛋白浓度明显低于全溶血样品(P0.05)。超滤液和血清中总IgE检测值具有良好相关性(r=0.984),超滤液中IgE校正后数值与血清差异无统计学意义,且两者检测阳性率差异无统计学意义(P0.05)。结论超滤技术对全溶血样品具有良好处理效果且超滤液检测校正值贴近溶血前血清水平,可应用于冷冻尸体溶血样品总IgE检测。     

心包液检测在法医学鉴定中的应用

心包液是存在于心包腔内的一种浆液.相对于血液易受自溶和腐败等死后变化的影响、玻璃体液含量少、脑脊液易受血液污染等缺陷,心包液存在于封闭的浆膜腔内,不易受尸体死后变化的污染和影响,且容易获取,不仅是临床上重要的检测样品,在法医鉴定中也有广泛的应用前景.本文阐述了心包液的理化性质及临床应用,重点综述了心肌病变、溺死或窒息时心包液中不同生物化学检测指标的变化及其在法医病理学鉴定中的意义,并介绍了心包液在法医物证学、法医毒物分析等相关领域的应用情况.随着研究的深入,心包液在法医学领域中将发挥越来越广泛的作用.     

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,     

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.     

Blood alcohol concentrations of sudden unexpected deaths and non natural deaths.

This study reports on the relationships between the blood alcohol concentration (BAC) and the cause of death - which is of course common knowledge for forensic scientists! Our special aim was to gain unselected data for generalizing conclusions. The blood of 2465 consecutive cases (86% of all 2852 sudden unexpected and unnatural fatalities investigated at the Institute for Legal Medicine in Hamburg during the year 1989) was analysed. The BAC was evaluated according to sex, age, cause of death and place of death. In natural causes of death there were 80% cases under 0.05% BAC. Endocrine and digestive system diseases in particular were associated with positive BAC values. In unnatural death cases the BAC under 0.05% was found in 64% of the suicides, 62% of the accidents, 54% of the homicides and 51% of the drug intoxications. The drowning cases showed higher BAC's than traffic accidents. In suicides middle aged males had high BAC's.     

论道路交通事故与驾驶员血中酒精含量关系

目的探讨道路交通事故与饮酒驾车血中酒精含量关系及其法医学意义,为预防、控制道路交通事故提供重要依据。方法对2005份道路交通事故肇事驾驶员血酒精鉴定资料进行系统分析性研究。结果饮酒驾车以男性为主,女性饮酒驾车出现醉酒驾车的比例与男性无差别。市区驾驶员醉酒驾车高于郊区。驾驶员BAC<20mg/100mL肇事导致死亡的比例高于饮酒驾车肇事组(BAC20￣79mg/100ML),而BAC≥80mg/100mL则低于饮酒驾车肇事组。结论应降低饮酒驾车和醉酒驾车BAC标准,以利于减少交通事故肇事死亡率。     

利用积温和昆虫发育历期推测死亡时间的研究

目的积累尸食性蝇类虫态发育历期和积温的资料。方法采用动物尸体作诱饵,分别对自然飞到诱饵上繁殖生长的6种尸食性蝇类的虫态发育历期和积温进行观察研究。结果经过观察,取得了棕尾别麻蝇、丝光绿蝇、紫绿蝇、宽丽蝇、巨尾阿丽蝇、大头金蝇等6种尸食性蝇类的虫态发育历期和积温的基础数据。并采用倒计积温的方法推测实际案例中死者死亡时间,破案后证实推测时间与实际死亡时间一致。结论本文数据可为利用尸食性蝇类虫态育历期的积温推测死亡时间提供依据。     

Unnatural and Violent Death in Cases with High Blood Alcohol Concentration— Autopsy Study

The use of alcohol increases the risk of dying from unnatural or violent causes. The presented study explored the distribution of age, gender, cause, and circumstances of death in persons who died in an unnatural and violent manner, with a blood alcohol concentration (BAC) higher than 0.3 g/dL, and where the cause of death was not alcohol intoxication. We defined the control (0 < BAC < 0.3 g/dL) and study (BAC ≥ 0.3 g/dL) groups, as in subjects with these concentrations, there is a significant risk of gross intoxication, stupor, and death. The subjects from the study group were older, with no difference in gender distribution. Traffic accidents were the most common fatal event in both groups, followed by suicides. Other accidents (choking on food and exposure to fire) were more frequent in the study group. Compared to the control group, subjects from the study group were older persons whose deaths were mainly accidental.     

Urine/blood ratios of ethanol in deaths attributed to acute alcohol poisoning and chronic alcoholism

The concentrations of ethanol were determined in femoral venous blood (BAC) and urine (UAC) and the UAC/BAC ratios were evaluated for a large case series of forensic autopsies in which the primary cause of death was either acute alcohol poisoning (N=628) or chronic alcoholism (N=647). In alcohol poisoning deaths both UAC and BAC were higher by about 2g/l compared with chronic alcoholism deaths. In acute alcohol poisoning deaths the minimum BAC was 0.74 g/l and the distribution of UAC/BAC ratios agreed well with the shape of a Gaussian curve with mean+/-standard deviation (S.D.) and median (2.5th and 97.5th centiles) of 1.18+/-0.182 and 1.18 (0.87 and 1.53), respectively. In alcoholism deaths, when the BAC was above 0.74 g/l (N=457) the mean+/-S.D. and median (2.5th and 97.5th centiles) UAC/BAC ratios were 1.30+/-0.29 and 1.26 (0.87 and 2.1), respectively. When the BAC was below 0.74 g/l (N=190), the mean and median UAC/BAC ratios were considerably higher, being 2.24 and 1.58, respectively. BAC and UAC were highly correlated in acute alcohol poisoning deaths (r=0.84, residual S.D.=0.47 g/l) and in chronic alcoholism deaths (r=0.95, residual S.D.=0.41 g/l). For both causes of death (N=1275), the correlation between BAC and UAC was r=0.95 and the residual S.D. was 0.46 g/l. The lower UAC/BAC ratio observed in acute alcohol poisoning deaths (mean and median 1.18:1) suggests that these individuals died before absorption and distribution of ethanol in all body fluids were complete. The higher UAC/BAC ratio in chronic alcoholism (median 1.30:1) is closer to the value expected for complete absorption and distribution of ethanol in all body fluids.     

法医毒物动力学

本文作者针对法医毒理学的任务、发展趋势和面临的挑战，提出将法医毒物动力学列为法医毒理学新的分支学科，并阐述了法医毒物动力学的概念、研究目的和任务、研究对象、研究内容、研究方法、研究方向及亟待解决的问题。内容涉及毒物动力学、死后分布、动态分布、死后再分布、死后弥散、毒物分解动力学、毒物死后产生情况等。法医毒物动力学研究将解决中毒法医学鉴定中的许多问题，如尸体或活体中毒当时机体内毒物浓度的推断、死后腐败产生毒物与生前服毒的区别、生前服毒与死后染毒的鉴别、毒物进入机体时间、途径和方式的确定。     

尸体胸骨骨髓细胞核DNA含量变化及其与死后经过时间的关系

目的探讨推断腐败尸体死亡时间的新方法。方法应用计算机图像分析技术,对以改良的Feu lgen法染色,死后经过不同时间(<1~14d)的胸骨骨髓细胞核DNA含量进行观测,并对所得数据进行相关分析。结果胸骨骨髓细胞核DNA含量随死亡时间延长逐渐下降,死后2周DNA量达最低值;死后DNA降解速率与死亡时间呈直线相关。结论测定胸骨骨髓细胞核DNA含量有助于腐败尸体的死亡时间推断。     

The case of a corpse found in a fox's den--forensic and criminological aspects

Whenever foul play is suspected in a death, the forensic pathologist is required to examine the corpse where it is found. In the case described here, the unusual location of the corpse initially led investigators to suspect a crime was involved. A thorough examination of the site and the autopsy results ultimately pointed to a not-violent manner of death, although the advanced state of decomposition made it impossible to determine the exact cause of death. The fact that the victim crawled into a fox's den to die can be interpreted as a primitive reaction in a case of death due to hypothermia. Criminological aspects of the case are also discussed.