饮料中γ-羟基丁酸的分析

目的建立饮料中γ-羟基丁酸(GHB)的分析方法。方法检材以GHB-d6为内标,加入酸性氯化铵饱和溶液调节pH值<4,用乙酸乙酯提取、离心后取有机层,水浴下吹干,经BSTFA衍生化后,用气相色谱/质谱联用仪测定。检材以GHB-d6为内标,经流动相稀释、离心后,吸取上清液用液相色谱-串联质谱仪测定。结果GC/MS测定饮料中GHB的检出限为0.2μg/mL,日内精密度和日间精密度小于8.54%;LC/MS/MS测定饮料中GHB的检出限为2μg/mL,日内精密度和日间精密度小于8.62%。结论饮料中GHB进行定性定量分析。方法灵敏、准确、快速,适用于法庭毒物分析中饮料中GHB的检测。     

γ-羟基丁酸在急性中毒大鼠体液和组织中的检测及分布

目的建立生物检材中γ-羟基丁酸(GHB)的检测方法,研究GHB急性中毒大鼠体内GHB的分布,为GHB中毒的鉴定提供方法和评价依据。方法用GC/MS法检测生物检材中的GHB;以1000mg/kg剂量给大鼠灌胃使其染毒,分别于1h和3h处死,测定体液和组织中GHB的含量。结果测组织中内源性GHB的线性范围是1～20μg/g,R2=0.9974;测组织中外源性GHB的线性范围为100～1500μg/g,R2=0.9958。相对回收率为98%～103%。体内内源性GHB的含量均≤10μg/mL或10μg/g。尿液中GHB含量为最高,其他依次为:胃、血液、肠、肾、肺、脾、心、肝和脑。结论所建方法准确、便捷,适用于GHB中毒的鉴定;尿液是体内检测GHB的最佳检材。     

UPLC-QTRAP同时检测8种新型策划药

目的建立一种简单、快速的超高压液相色谱-串联质谱(UPLC-MS/MS)联用法同时检测毛发样品中8种新型策划药。方法毛发样品经冷冻研磨超声后,通过Phenomenex Kinetex~?F5 100á(50mm×2.1mm,2.6μm)色谱柱进行分离,以5 mmol/L乙酸铵和甲醇为流动相,0.35mL/min流速进行梯度洗脱。在电喷雾离子源正离子(ESI+)模式下,质谱采集使用独有的多反应监测-信息依赖式采集-增强子离子扫描(MRM-IDA-EPI)模式。结果 8种新型策划药在0.1-100 ng/mL的浓度范围内线性关系良好(r≥0.9999)。检出限为1.5 ng/g,5 ng/g、50 ng/g、2500ng/g 3个添加水平的回收率在92.46%～105.70%之间。日间精密度RSD在0.39%～7.67%之间、日内精密度的RSD在0.37%～7.54%之间(n=9)。结论本方法简单快速、特异性强,可同时对毛发样品中8种新型策划药进行定性定量分析。     

气质联用法快速分析“咔哇潮饮”中γ-羟基丁酸

目的建立气质联用法快速检验"咔哇潮饮"中γ-羟基丁酸(GHB)成分的分析方法。方法以SKF525A为内标,加入盐酸调节PH4,经乙酸乙酯提取,离心后取有机层,经BSTFA衍生化后,用GC/MS方法进行定性定量分析。结果 GC/MS法测定饮料中GHB的浓度为0.125mg/m L,检出限为0.1μg/m L,日内和日间精密度小于8.24%。结论该分析方法操作便捷、实用,结果准确,适用于刑事案件中"咔哇潮饮"检材中毒品成分的快速检验。     

高效液相色谱法测定人血液、尿液中的2,4-D丁酯

目的建立检测血液、尿液中2,4-D丁酯的高效液相色谱分析方法。方法采用正己烷为样品萃取溶剂,色谱柱为Zorbax SB-Aq柱,流动相为V（甲醇）∶V（水）=60∶40。结果 2,4-D丁酯在血液和尿液中的线性范围分别为0.10～10.00μg/mL（r≥0.999 8）和0.08～8.00μg/mL（r≥0.999 5）,检测限分别为0.002 0μg/mL和0.001 8μg/mL,准确度为94.5%～104.5%,日内、日间精密度≤4.5%。结论本研究建立的血液、尿液中2,4-D丁酯的提取和HPLC检测方法,可应用于2,4-D丁酯中毒的快速检验和中毒死亡的法医学鉴定。     

化学显色法快速筛选饮料及尿液中γ-羟基丁酸和γ-丁内酯

目的建立化学显色法快速筛选饮料及尿液中γ-羟基丁酸(GHB)及其前体γ-丁内酯(GBL)的方法。方法在酸性条件下GHB转化为GBL,GBL和盐酸羟胺在碱性条件下生成γ-羟基丁酰羟胺,γ-羟基丁酰羟胺在酸性条件下和三氯化铁反应,生成紫红色的络合物。结果饮料中GHB最低检出浓度为0.5～2mg/mL,低于常见滥用质量浓度。该方法也可以用于尿液分析,最低检出质量浓度为0.5mg/mL。考察了常见有机溶剂和麻醉镇静药物的干扰。结论该方法简单、安全、快速,为临床和法庭科学实验室快速筛选GHB和GBL提供了便利。     

全血中苯骈二氮杂类药物的胶束电动色谱法分析

目的建立用固相萃取胶束电动毛细管色谱法测定人体全血中苯骈二氮杂艹卓类药物的方法。方法全血以Oasis小柱提取,以克仑特罗为内标,采用未涂层毛细管(75μmID×50.2cm,有效分离长度为40cm),缓冲液为30mmol/LSDS→15mmol/L硼砂→15mmol/L磷酸盐(pH8.2)→18%甲醇。进样条件:压力进样0.5psi×10s,分离电压为25kV,柱温25℃,检测波长为230nm。结果本法分离效率高,9种苯骈二氮杂艹卓类药物的最低检测浓度为5～50ng/ml;血药浓度的线性范围为0.02～1.6μg/ml,日内、日间精密度<12%。结论本法简便、高效、可靠。     

固相萃取毛细管区带电泳法测定全血中甲基苯丙胺

目的建立全血中甲基苯丙胺的固相萃取毛细管区带电泳法检验方法。方法血液采用OasisHLB固相萃取小柱直接萃取,BeckmanP/ACEMDQ毛细管电泳仪区带法分析。结果回归方程y=0.0083x-0.0164,线性范围5～75μg/mL(r=0.994),日内精密度RSD=2.22%,日间精密度RSD=5.31%,盐酸甲基苯丙胺质量浓度为25.0μg/mL的全血相对回收率(91.63±2.5)%。电泳分离良好,空白无干扰。结论本方法操作简便,适用于全血中甲基苯丙胺的检验。     

尿液中γ-羟基丁酸及其前体物质的检测和应用

目的建立尿液中γ-羟基丁酸(gamma-hydroxybutyric acid,GHB)及其前体物质1,4-丁二醇(1,4-butanediol,1,4-BD)和γ-丁内酯(gamma-butyrolactone,GBL)的液相色谱-串联质谱法(LC-MS/MS),为相关案件提供依据。方法以GHB-d6、MOR-d3为内标,尿样经甲醇沉淀蛋白后通过液相色谱分离,电喷雾离子源进行离子化,多反应监测模式对各化合物进行检测。结果 GHB及其前体物质1,4-BD、GBL的检出限分别为0.1、0.1和2μg/m L,准确度为87.6%~98.1%,日内及日间精密度均小于15%,基质效应大于80%。结论所建立的分析方法灵敏度高、简便快速、专属性强、可靠性高,可为司法鉴定实践中涉及GHB的案件提供技术支持和基础数据。     

LC-MS/MS法测定全血中新型安眠药的研究

目的建立血液中检测新型安眠药的方法。方法取血液样品过ABN小柱,用甲醇洗脱,洗脱液供LC-MS/MS分析。色谱条件:色谱柱为:kinetex 2.6μC18(50m×3.0mm,2.6μm),以乙腈和水(10 mmol/L甲酸铵)溶液为流动相进行梯度洗脱,进样量为5μL。质谱条件:离子源为ESI源;监测方式为正离子多离子反应监测(MRM);扫描范围分别为全扫描。结果唑吡坦、扎来普隆和氟硝西泮的线性范围为1～500ng/mL,佐匹克隆、氯硝西泮和diclaepam的线性范围为5～500ng/mL,7-氨基氯硝西泮和尼美西泮的线性范围为1～250ng/mL,地洛西泮和氯甲西泮的线性范围为5～250ng/mL;日内精密度和日间精密度均≤15%(n=5);回收率范围为53.6-101.3%;基质效应范围为63.64-118.0%。结论该方法专属性强、灵敏度高、简单快速可用于新型安眠药的检测。     

Determination of Herbicides Paraquat,Glyphosate, and Aminomethylphosphonic Acid in Marijuana Samples by Capillary Electrophoresis

In this work, two methods were developed to determine herbicides paraquat, glyphosate, and aminomethylphosphonic acid (AMPA) in marijuana samples by capillary electrophoresis. For paraquat analysis, sample was extracted with aqueous acetic acid solution and analyzed by capillary zone electrophoresis with direct UV detection. The running electrolyte was 50 mmol/L phosphate buffer (pH 2.50). For glyphosate and AMPA, indirect UV/VIS detection was used, as these substances do not present chromophoric groups. Samples were extracted with 5 mmol/L hydrochloric acid. The running electrolyte was 10 mmol/L gallic acid, 6 mmol/L TRIS, and 0.1 mmol/L CTAB (pH = 4.7). The methods presented good linearity, precision, accuracy, and recovery. Paraquat was detected in 12 samples (n = 130), ranging from 0.01 to 25.1 mg/g. Three samples were positive for glyphosate (0.15–0.75 mg/g), and one sample presented AMPA as well. Experimental studies are suggested to evaluate the risks of these concentrations to marijuana user.     

玻璃体液化学成分的检测及其意义

采用日立7170A型全自动生化分析仪，对42例死后3小时内尸体玻璃体液中20种成分进行检测。其均值为：0．754mmol／L（钙）、0．783mmol／L（镁）、0．776mmol／L（无机磷）、3．35mmol／L（葡萄糖）、4．03mmol／L（尿素）、43．27μmol／L（肌酐）、0．016mmol／L（尿酸）、0．029mmol／L（总胆固醇）、0．015mmol／L（甘油三酯）、0．031μmol／L（总胆红素）、1．249／L（球蛋白）、0.609／L（白蛋白）、31.68u／L（谷草转氨酶）、1．39u/L（谷雨转氨酶）、5．15u/L（碱性磷酸酶）、0．83u／L（γ-谷氨酸转酞酶）、64．15u／L（磷酸肌酸激酶）、8.68u／L（乳酸脱氢酶）、7.12u／L（α-羟丁酸脱氢酶）；同时在Easylyteplus仪器用离子选择电极法测定钠均值为138．44mmol／L，钾5．05mmol／L和氯120．7mmol／L。为建立玻璃体液中化学成分正常值提供参考数据。     

Basal Vacuolization in Renal Tubular Epithelial Cells at Autopsy and Their Relation to Ketoacidosis

Basal vacuolization of renal tubular epithelial cells is a useful postmortem marker for ketoacidosis. To investigate its incidence and relationship to the severity of ketoacidosis, 158 autopsy cases with elevated β‐hydroxybutyrate (>1 mmol/L) over a 7‐year‐period were retrospectively reviewed. Sixty‐eight cases (43%) exhibited basal vacuolizations (vitreous β‐hydroxybutyrate: 1.16–29.35 mmol/L, mean 10.28 mmol/L), and 90 cases (57%) did not (vitreous β‐hydroxybutyrate: 1.03–13.7 mmol/L, mean 2.84 mmol/L). Quantitative analysis revealed on average a fourfold elevation in β‐hydroxybutyrate in cases with basal vacuolizations compared to those without; 10.3% of cases with β‐hydroxybutyrate concentrations between 1.01 and 2.00 mmol/L had basal vacuolizations, and this incidence increased to 33.3% with concentrations between 4.01 and 6.00 mmol/L. A marked increase in incidence to >70% was observed with concentrations >6.00 mmol/L, and basal vacuoles were invariably present (100%) with concentrations >14.01 mmol/L. This study demonstrates that basal vacuolizations are a sensitive marker for significant ketoacidosis and reaffirms its use as an indicator for likely cases of fatal ketoacidosis at autopsy.     

How Useful is Basal Renal Tubular Epithelial Cell Vacuolization as a Marker for Significant Hyperglycemia at Autopsy?

Basal vacuolization of renal tubular epithelial cells (so-called Armanni-Ebstein phenomenon) has been attributed to hyperglycemia causing accumulation of cytoplasmic glycogen. Review of 34 autopsy cases with significant hyperglycemia (vitreous glucose ≥ 15 mmol/L/270 mg/dL) was undertaken to determine whether there was any significant association between the degree of hyperglycemia and the severity of this morphological change (graded as 0, 1+, 2+, and 3+). No association was demonstrated. Review of the subgroup of 14 cases with terminal hyperglycemia without ketoacidosis was then undertaken to assess the effect of hyperglycemia in isolation on renal tubular epithelial cells. Vitreous glucose levels in these 14 cases ranged from 17 to 49.7 mmol/L (306-894.6 mg/dL) with a mean of 26.25 mmol/L (472.5 mg/dL) and β-hydroxybutyrate levels ranged from 0.02 to 2.55 mmol/L (0.36-45.9 mg/dL) with a mean 0.79 mmol/L (14.22 mg/dL). Not one of the latter cases displayed basal vacuolization. No relationship between basal vacuolization of renal tubular epithelial cells at autopsy and terminal hyperglycemia could, therefore, be demonstrated.     

Utility of Postmortem Vitreous Beta-Hydroxybutyrate Testing for Distinguishing Sudden from Prolonged Deaths and for Diagnosing Ketoacidosis

A retrospective, cross-sectional analysis of vitreous beta-hydroxybutyrate (BHB) on 967 forensic cases over a two-year period was conducted. Cases were sorted into six categories of death: (i) sudden traumatic/non-natural (ST), (ii) sudden natural (SN), (iii) prolonged traumatic/non-natural (PT), (iv) prolonged natural (PN), (v) diabetic ketoacidosis (DKA), and (vi) alcoholic ketoacidosis (AKA). The mean BHB for all cases was 1.67 mmol/L (17.4 mg/dL; range: 0.11–18.02 mmol/L). The numbers of DKA, AKA, PN, PT, SN, and ST deaths were 21, 5, 155, 258, 275, and 253, respectively. Their mean vitreous BHBs were as follows: 11.04 mmol/L (DKA), 8.88 mmol/L (AKA), 1.56 mmol/L (PN), 1.55 mmol/L (PT), 1.26 mmol/L (SN), and 1.38 mmol/L (ST). There was a statistically significant difference between the mean BHBs of the PN and SN death groups (p < 0.001), as well as between those of the PT and ST death groups (p = 0.004). Given the overlapping ranges seen between the prolonged and sudden death groups, the identified differences did not hold clinical significance. In addition, we sought to determine a threshold value for vitreous BHB to definitely diagnose cases of ketoacidosis. BHB threshold concentrations between 2.5 and 5 mmol/L produced sensitivities >92% and specificities >96%. A receiver operator characteristic curve found 3.43 mmol/L to be the optimal cutoff value, demonstrating a specificity of 98.3% and a sensitivity of 96.2%.     

Armanni–Ebstein Lesions in Terminal Hyperglycemia

Armanni–Ebstein lesions (AEL) occur in deaths related to uncontrolled diabetes mellitus. To investigate the relationship between AEL and terminal hyperglycemia, we retrospectively reviewed 71 cases with vitreous glucose levels ≥11.1 mmol/L; 27 (38%) cases had AEL (vitreous glucose 14.0–77.3 mmol/L); and 44 cases (62%) did not (vitreous glucose 11.1–91.9 mmol/L). There was no significant difference (p = 0.271) in vitreous glucose levels between the cases with AEL (mean 39.2, SD 16.7 mmol/L) and those without (mean 34.2, SD 19.8 mmol/L). Similarly, there was no difference in the degree of dehydration, renal failure, or osmolality. However, there was a significantly higher level of β‐hydroxybutyrate among the cases with AEL compared to those without (p = 0.007), suggesting that ketoacidosis may facilitate the development of AEL. Given the possible synergistic role of β‐hydroxybutyrate, the correlation between AEL and terminal hyperglycemia in animal studies may not be applicable to humans. AEL may also possibly occur with sublethal elevations in glucose.     

Measurement of chemical analytes in vitreous humor: stability and precision studies

The analytic accuracy and precision for measurement of chemical analytes in vitreous humor (VH) are critical if results are to be used in forensic pathology. The purpose of our study was to demonstrate the stability and the reproducibility of VH sodium, potassium, chloride, glucose, urea nitrogen, acetone, and beta-hydroxybutyrate in specimens obtained from both eyes in medical examiner cases. We also compared with calculated VH osmolalities. Small but significant increases were observed in VH electrolyte concentrations in specimens refrigerated 6-12 months: sodium pre 144 mmol/L, post 151 mmol/L; potassium pre 12.0 mmol/L, post 12.8 mmol/L; chloride pre 121 mmol/L, post 123 mmol/L. No differences were observed between eyes, and within-day precision for all electrolyte measurements were excellent, (<1%). Frozen specimens showed significantly higher measured (439 mOsmol/kg) as compared with calculated osmolality (305 mOsmol/kg), with 1% within-day precision and no significance between eye variation for glucose and urea nitrogen. In 20 of 24 medical cases selected for possible ketoacidosis, measurement of beta-hydroxybutyrate concentrations appears to be a promising diagnostic biomarker for confirming suspected ketosis in medical examiner cases by means of VH analysis.     

Renal Tubular Epithelial Vacuoles—A Marker for Both Hyperlipidemia and Ketoacidosis at Autopsy

Review of 15 cases of nephrotic syndrome found that eight had significant hyperlipidemia with serum cholesterol levels ranging between 10.59 and 18.60 mmol/L (mean 12.88) and serum triglyceride levels between 2.30 and 9.92 mmol/L (mean 4.58); all of these cases displayed basal lipid vacuolization. Seven of the 15 study cases had normal–mild hyperlipidemia with serum cholesterol levels ranging between 4.71 and 7.54 mmol/L (mean 6.02) and serum triglyceride levels between 0.65 and 4.1 mmol/L (mean 1.57). Six of the seven cases had basal lipid vacuoles (86%). Of these, five cases were hyperlipidemic and one case had borderline hyperlipidemia with a serum cholesterol level of 4.71 mmol/L. Although hyperlipidemia was associated with renal tubular epithelial vacuolization, the vacuoles appeared morphologically different to those found in ketoacidosis. This study has shown that while hyperlipidemia in isolation may result in basal lipid vacuolization within renal tubular epithelial cells, the phenotype differs from that observed in ketoacidosis.     

A Case of Fatal Dehydration During Police Custody

In the forensic literature, fatal dehydration predominantly concerns young children or incapacitated elderly persons. The postmortem diagnosis of fatal dehydration can be challenging to confirm, especially if the preceding circumstances are unknown. Here presented is a case of a 23‐year‐old man who died while held in an isolation cell during police custody for 18 days. Autopsy findings were unspecific, but vitreous fluid analysis showed 192 mmol/L sodium, 179 mmol/L chloride, 16 mmol/L potassium, 352 μmol/L (3.98 mg/dL) creatinine, and 81 mmol/L (226.9 mg/dL) urea nitrogen. Based on the findings and circumstances, the cause of death was determined as severe dehydration and manner of death accident. This case illustrates the importance of performing postmortem biochemistry.     

Fatality from olanzapine induced hyperglycemia

A case history of a 31-year-old male schizophrenic patient is presented. The man was treated with olanzapine for three weeks before he died. After one week on a 10 mg daily dose of olanzapine, his fasting blood glucose was elevated to 11.3 mmol/L (203 mg/dL). In order to treat more aggressively his psychosis, the olanzapine dose was raised to 20 mg daily resulting in his fasting blood glucose climbing to 15.8 mmol/l (284 mg/dL). On the days preceding his death, he became progressively weaker, and developed polydipsia with polyuria. He had no personal or family history of diabetes mellitus and he was on no other medication at the time of his death. Postmortem blood, vitreous humor, and urine glucose concentrations were 53 mmol/L (954 mg/dL), 49 mmol/L (882 mg/dL), and 329 mmol/L (5922 mg/dL), respectively. Drug screen on urine and blood indicated only a small amount or olanzapine and no alcohols. Peripheral blood olanzapine concentration was within therapeutic limits, 45 ng/mL. Analysis of vitreous humor and urine revealed severe dehydration with small amounts of ketones. Death was attributed to hyperosmolar nonketotic diabetic coma, and olanzapine was felt most likely to be the cause. Another atypical neuroleptic, clozapine, has also been associated with the development and exacerbation of diabetes mellitus or diabetic ketoacidosis. We recommend including vitreous glucose and beta-hydroxybutyrate analysis as part of postmortem toxicology work up when the drug screen reveals the presence of either olanzapine or clozapine.