生前伤与死后伤皮肤弹力纤维变化研究

采用Ｈａｒｔ氏弹力纤维染色对不同时间的皮肤生前伤和死后伤进行组织学观察研究，结果表明：生前伤和死后伤真皮中的弹力纤维在形态和分布上无任何区别，因此，在法医实践中依据真皮中弹力纤维形态变化区别生前伤与死后伤无诊断价值     

列车撞击伤及碾轧伤的损伤形态与成伤机制

目的总结列车撞击、碾轧伤的典型损伤形态，探讨其成伤机制。方法对103例列车撞击伤、84例列车碾轧伤案例进行回顾性分析。结果不同的致伤方式及受害者伤时状态不同，在损伤形态及成伤机制上有所差异。结论典型损伤形态可为推断致伤方式及受害者伤时状态提供依据。     

头部木质棍棒伤的法医鉴定

棍棒伤是法医检案中常见的一种损伤，由于木质棍棒取材方便，因此木质棍棒所致的损伤较多见。本文结合典型案例提出头部木质棍棒伤的特征及检验要点进行初步探讨。1案例例1：某男，30岁，被人用木棒多次打击头部致死。尸检见：左颞顶部有一处8cm×4cm斜向后上的头皮挫擦伤，面部多处软组织损伤，左侧帽状腱膜下广泛出血，左颞顶部头皮损伤，颅脑凹陷骨折，呈椭圆形，大小为9cm×4．8cm，两侧为弧状细线形骨折，中间一条骨折线较粗向左延伸至颞部，向右延伸至颅中窝，由粗渐细，相应凹陷处内板有4条呈放射状骨折线。大脑左半球表面积聚厚约0…     

桡骨远端骨折成伤方式分析1例

<正>骨折的成伤方式或者成伤机制分析在损伤程度鉴定中是必要的，甚至是不可或缺的，具有重要价值^[1]。文献有关于颅脑损伤^[2]、颅底环状骨折^[3]和肋骨骨折^[4]等致伤方式、成伤机制的报道，提示不同部位骨折成伤机制的分析对还原案件事实、判断案件性质具有直接的证据价值。本文报道一例以桡骨远端骨折的形态特征来分析成伤方式、重现致伤过程的案例，为办案机关查明事实、解决纠纷、公平公正处理案件提供了重要依据。     

附加伤的分类及法医学意义

法医检案过程中,经常会在致死性损伤（主要损伤）之外,发现其他形式的损伤。这些损伤的作用方式、形成机制、成伤的目的各有特点。笔者试着将这些损伤定义为附加伤,再按照损伤形成的时间分为生前附加伤和死后附加伤,并总结其法医学意义。     

胸部刺创与交通意外同为致死伤1例

某年冬某夜11时许,某县公安局接报称:城东公路上一人被汽车压死.尸检情况:尸长167c m,发育正常,营养一般.死者双睑紧闭,右眼睑及眼球挫伤,左眼角膜混沌,球睑结膜苍白,唇及口腔粘膜苍白.右额部有5cm×5cm头皮撕裂,创口哚开.右颧部有5cm×4.5cm 的擦伤,呈暗褐色.解剖:颅骨未见骨折.前胸第4肋间处有2cm长创口,创口明显哆开,深达胸腔,创缘整齐,创角较锐.右锁骨第1,2肋在锁骨中线处骨折,其余肋骨自腋中线处骨折 ,断端有出血.腹部有25cm×8cm擦伤,呈暗褐色.胸腔内有大量积血,心包前区有1cm长破口,内有积血,右肺挫伤撕裂,右心室壁有1cm长创口,未达心室.腹腔内有少量积血,肝脏碎裂,肠管多处挫伤.左大腿内侧、右大腿前侧分别有1.5cm、1.3cm刺创,均深达肌层. 四肢、躯干有多处片状擦伤,呈暗褐色.     

颅骨及脑并存对冲伤尸解1例

脑对冲伤在法医尸解中常见,但颅骨及脑对冲伤共存罕见,本文复习有关文献,结合尸解发现,对颅骨对冲伤的发生机制进行探讨。案例某男,于2003年9月10日被发现死在路旁,身上带有当天准备考驾照证明。为查明死因,要求进行法医病理解剖。尸体解剖发现:死者身长165cm,发育正常,营养良好。尸斑位于尸体腰背部,呈暗红色,指压不退色,尸僵分布四肢大关节。双眼上下眼睑肿胀明显,双瞳孔等大等圆,轻度混浊,左耳道血迹附着,口腔见血迹附着,双鼻孔棉花球填充。左腹股沟见10cm长灌注切口,缝合3针。左肘关节下方擦伤2cm×1.2cm、青紫大小约11cm×6cm。解剖头…     

行人被撞与客车坠车尸体损伤鉴别研究

目的探讨坠车损伤及与火车撞击损伤鉴别。方法对行人被撞23例和铁路客车坠车23例死者损伤的部位、类型进行统计分析,有两处以上损伤部位的分别累计计算,采用SPSS软件进行数据进行处理、分析。结果躯干部与身体纵轴方向一致的擦伤是铁路客车坠车区别于行人被撞主要鉴别点。手部损伤伤是铁路客车坠车区别于行人被撞主要鉴别点。下肢损伤不能作为铁路客车坠车区别于行人被撞主要鉴别点。     

颈动脉钝性损伤法医学研究进展

颈动脉钝性损伤的发生率虽低,但死亡率高,易发生于交通事故、扼勒、缢吊、颈部直接外力作用和高坠等案例中。颈动脉钝性损伤有5种基础成伤机制：颈部直接外力作用,颈部过度伸展和旋转,颅底骨折碎片切割,口腔内扁桃体窝处直接外力作用,头胸部复合伤造成颈动脉被牵拉。国外相关研究文献和个案报道较多,而国内未见系统研究,不多的个案报道中,也有错误鉴定案例。本文对颈动脉钝性损伤的致伤方式、解剖学和生物学基础、成伤机制和法医学鉴定注意事项进行综述,希望能引起国内法医技术人员的重视,并为相关研究和应用提供参考。     

颅骨及脑对冲伤并存尸解1例

脑对冲伤在法医尸解中常见 ,但颅骨及脑对冲伤共存罕见。本文复习有关文献 ,结合尸解发现 ,对颅骨在冲击伤的发生机制进行探讨。案　例某男 ,于 2 0 0 3年 9月 10日被发现死在路旁 ,身上带有当天准备考驾照证明。为查明死因 ,要求进行法医病理解剖。尸体解剖发现 :死者身长 16 5cm ,发育正常 ,营养良好。尸斑位于尸体腰背部 ,呈暗红色 ,指压不退色 ,尸僵分布四肢大关节。双眼上下眼睑肿胀明显 ,双瞳孔等大等圆 ,轻度混浊 ,左耳道血迹附着 ,口腔见血迹附着 ,双鼻孔棉花球填充。左腹股沟见 10cm长灌注切口 ,缝合 3针。左肘关节下方擦伤 2cm× …     

Forensic medical examination of abrasions in the study of mummified tissues in experiment

Morphological and biophysical characteristics of abrasions and intact skin were studied during the process of their mummification at temperatures from 40 to 70 degrees C. The time after which the injuries become undetectable because color of the skin and injuries coincides, was determined. Changes in configuration and area of abrasions while drying are described. The rate of mummification and duration of the latter were established by dielectric indices of abrasions and skin at 10 cm wave length.     

480例活体损伤的法医学鉴定分析

目的分析活体损伤的特征,探讨其损伤类型与损伤程度的关系,以及法医学鉴定的有关问题。方法随机抽取1998-2001年间活体损伤的鉴定资料,对伤者的损伤及其法医学鉴定进行回顾性分析。结果男性伤者居多;多发伤高于任何单一部位损伤;致伤方式以钝器致伤为主;重伤以颅内血肿和腹腔脏器破裂最多,轻伤以四肢骨折居首。结论损伤程度与损伤部位及类型有一定的关系。     

玻璃刺创形态学特点的初步研究

目的研究玻璃刺创的形态学特点。方法分别用3个厚度为0．31cm带尖状突起的啤酒瓶残端及3块厚度为0．29cm有尖的普通窗玻璃碎片按设定的不同方向刺击带皮猪肉组织,重复此过程3次,形成198例创口,观察、编号、拍照、测量各创口。结果198例创口的整体形态可分为5种类型,即“工”型、“”型、“”型、“上”型与“一”型,各型在不同刺击方向的分布上存在差异,其中前4种为主要类型,共约占总数的93％,其共同点为在损伤的中部出现了一段与损伤整体走向垂直的创口,啤酒瓶残端所致垂直创口的长度为0．31±0．Olcm（x±s）,窗玻璃碎片所致垂直创口的长度为0．29±0．Olcm（x±s）。结论损伤中部有与损伤整体走向垂直的短创口是玻璃刺创中易出现的一种形态学特点,垂直创的长度与致伤玻璃的厚度具有一致性。     

Preclinical Assessment of Safety and Efficacy of Fluorescent Dye for Detecting Dermal Injuries (the injuries were both abrasions and incision) in a Murine Model

Objective documentation of tears and abrasions to the external genitalia after sexual assault is an important part of the forensic examination. A 1% aqueous solution of toluidine blue (TB) dye is often used to highlight injury, but the dye can be difficult to see on dark skin. We evaluated a fluorescent dye for detecting injuries on all skin colors in a relevant preclinical murine model. We compared the ability of trained, blinded observers to detect unstained wounds and wounds stained with 1% fluorescein sodium (FL) and with TB. We also evaluated the cutaneous wound healing response after application of both dyes. The no‐dye group had significantly fewer (p < 0.05) true‐positive identifications compared to all the dye groups. No differences in effectiveness were detected between dye treatments. All groups exhibited statistically similar healing rates. These findings support the evaluation of fluorescein sodium in a future clinical study with human subjects.     

Manual and Automated Cardiopulmonary Resuscitation (CPR): A Comparison of Associated Injury Patterns,

The purpose of this study was to identify and compare patterns of trauma associated with AutoPulse^® CPR and manual CPR. Finalized autopsy records from 175 decedents brought to the Harris County Institute of Forensic Sciences were reviewed, 87 received manual‐only CPR, and 88 received AutoPulse^® CPR (in combination with manual CPR as per standard protocol). The characteristic pattern observed in manual‐only CPR use included a high frequency of anterior rib fractures, sternal fractures, and midline chest abrasions along the sternum. The characteristic pattern observed in AutoPulse^® CPR use included a high frequency of posterior rib fractures, skin abrasions located along the anterolateral chest and shoulder, vertebral fractures, and a few cases of visceral injuries including liver lacerations, splenic lacerations, and hemoperitoneum. Knowledge of the AutoPulse^® CPR injury pattern can help forensic pathologists differentiate therapeutic from inflicted injuries and therefore avoid an erroneous assessment of cause and manner of death.     

不同部位颅脑摔跌伤的特征分析68例

目的探讨不同受力部位颅脑摔跌伤后损伤程度和特征差异。方法收集摔跌所致颅脑损伤68例,根据案情、受伤过程、临床体征、CT影像资料将受伤部位分为颅前部、颅侧部、颅后部;损伤类型分为颅骨骨折、硬脑膜外血肿、硬脑膜下血肿和脑挫裂伤;损伤数量分为单一和多发伤;颅骨骨折分为受力点骨折和非受力点骨折;脑挫裂伤分为冲击伤、对冲伤等。运用非参数统计χ2检验比较其频数分布。结果不同摔跌部位颅骨骨折和颅脑损伤程度存在明显差异(P0.05),颅后部摔跌颅骨骨折远离受力点多见,多发伤为主,而颅前部、颅侧部受力点骨折多见,单处损伤多见;颅后部、颅侧部摔跌后脑挫裂伤发生率高,以对冲部位多见,颅前部摔跌后脑挫裂伤发生率低,冲击伤亦多见。结论摔跌部位不同颅脑损伤程度和特征存在差异,CT检查资料有助于损伤机制推断。     

几种眼外伤鉴定时机的研究

目的分析几种眼外伤的伤后视力稳定时间,研究最早且合适的鉴定时机。方法将145件案例160个伤眼按损伤类型分成5组,研究几种眼外伤后视力水平、眼外伤类型与视力稳定时间的关系。结果不同的眼外伤,其视力稳定时间有较大差异,且视力水平的高低与视力稳定时间也有明显的相关性。结论眼外伤最早的合适鉴定时机既与眼外伤的类型有关,也与伤后视力水平有关;应灵活掌握鉴定时机,以适应司法机关的需要。     

The skin as a repository and masker of evidence

The role of the skin as a repository and masker of evidence is evaluated. Skin examination and testing are very important in the (a) identification of victims and suspects (for example, by fingerprints, lip prints, and fingernail marks), (b) recognition of patterns and shape of injurious energy impacts (for instance, recognition of type of injury and particular weapon), and (c) recovery of embedded evidence (for example, glass, wood, powder, explosives, and paint). It is also important to realize that the skin may conceal evidence by masking significant and/or lethal internal injuries.     

车外人员撞击伤特点分析

目的以真实案例为基础,研究汽车碰撞事故中,不同机动车车型、不同交通方式等因素造成车外人员撞击伤的特征。方法选取上海地区发生的汽车与车外人员碰撞事故案例200例,通过对事故中的人、车等检验对比,分析车外人员撞击伤的特点。结果车外人员撞击伤主要出现在下肢,其次为胸部和头部;行人（含推车人）撞击伤出现频次与骑车人（含自行车或摩托车后座乘员）无明显差异;小轿车和小客车事故中撞击伤多见于下肢,大客车多见于胸部;车外人员被撞击后发生抛甩频率随车速的加大而增高,且通过车体痕迹检验,人体与车辆挡风玻璃发生（二次）撞击伤匹配程度最高。结论分析汽车与车外人员碰撞事故人体撞击伤特点,对于交通伤法医学鉴定及深化交通伤机制研究具有参考价值。     

Characterization and Comparison of Injuries Caused by Accidental and Non‐accidental Blunt Force Trauma in Dogs and Cats

Motor vehicle accidents (MVA) are often difficult to distinguish from non‐accidental injury (NAI). This retrospective case–control study compared animals with known MVA trauma against those with known NAI. Medical records of 426 dogs and cats treated after MVA and 50 after NAI were evaluated. Injuries significantly associated with MVA were pelvic fractures, pneumothorax, pulmonary contusion, abrasions, and degloving wounds. Injuries associated with NAI were fractures of the skull, teeth, vertebrae, and ribs, scleral hemorrhage, damage to claws, and evidence of older fractures. Odds ratios are reported for these injuries. MVA rib fractures were found to occur in clusters on one side of the body, with cranial ribs more likely to fracture, while NAI rib fractures were found to occur bilaterally with no cranial–caudal pattern. Establishing evidence‐based patterns of injury may help clinicians differentiate causes of trauma and may aid in the documentation and prosecution of animal abuse.