芪参护心方治疗冠心病经皮冠状动脉介入治疗术后气虚血瘀型心绞痛30例

目的 评价芪参护心方联合西药常规治疗冠心病经皮冠状动脉介入（percutaneous coronary intervention,PCI）术后气虚血瘀型心绞痛的临床疗效。方法 选取成功施行冠心病PCI术后气虚血瘀型心绞痛患者60例,随机分为对照组和研究组各30例。对照组采用阿司匹林、氯吡格雷、他汀等西药常规治疗,研究组在对照组的基础上加用芪参护心方治疗。治疗1个月后评价两组患者临床疗效、中医证候疗效及血脂变化情况。结果 研究组临床疗效、中医证候疗效均显著优于对照组（P<0.05）;治疗后两组总胆固醇、三酰甘油、低密度脂蛋白胆固醇水平均较治疗前显著下降(P<0.05),其中研究组治疗前后低密度脂蛋白胆固醇差值显著大于对照组(P<0.05)。结论 芪参护心方联合西药常规干预治疗冠心病PCI术后气虚血瘀型心绞痛有较好疗效,可明显改善心绞痛症状,减少心绞痛发生率,提高患者生活质量。     

The impact of fentanyl on DUIDs and traffic fatalities: Blood and oral fluid data

Fentanyl has emerged as the most prolific drug in the ongoing opioid epidemic and has greatly impacted traffic safety in recent years. This study aimed to evaluate fentanyl prevalence and concentrations in blood and oral fluid in driving under the influence of drugs (DUID) cases in three different regions (i.e., Alabama, Orange County, CA, and Houston, TX) from 2017 to 2022. Furthermore, traffic fatalities were evaluated for Alabama and Orange County, CA. Fentanyl positivity in DUID and traffic fatalities increased for most years in this study. In Alabama, the prevalence of fentanyl DUID cases increased 4-fold in 2022 compared to 2017. Orange County's increase from 2017 to 2022 was 14-fold. In Houston, the increase was approximately 2-fold from 2019 to 2022. The greatest increase for all laboratories coincided with the start of the COVID-19 pandemic. In 2022, the median fentanyl DUID blood concentrations were 4.7, 11, and 4.7 ng/mL in Alabama, Orange County, and Houston, respectively. Most fentanyl cases were polydrug cases (≥90%). Methamphetamine, THC, and alprazolam were the most frequently detected drugs in combination with fentanyl. Alabama has collected oral fluid and blood in DUID cases since 2018. The detection of fentanyl in oral fluid was comparable to blood. However, 59% and 8.7% of fentanyl-positive cases had concentrations of >20 ng/mL in oral fluid and blood, respectively. Therefore, oral fluid as an alternative or supplemental specimen to blood is an attractive approach for fentanyl in DUID cases. This study contributes to understanding recent fentanyl trends and their impact on traffic safety.     

Internal validation of reduced PCR reaction volume of the Qiagen Investigator® Argus X-12 QS Kit from blood samples on FTA cards

The onus of proof in criminal cases is beyond any reasonable doubt, and the issue on the lack of complete internal validation data can be manipulated when it comes to justifying the validity and reliability of the X-chromosomal short tandem repeats analysis for court representation. Therefore, this research evaluated the efficiency of the optimized 60% reduced volumes for polymerase chain reaction (PCR) amplification using the Qiagen Investigator® Argus X-12 QS Kit, as well as the capillary electrophoresis (CE) sample preparation for blood samples on Flinder's Technology Associates (FTA) cards. Good-quality DNA profile (3000–12,000 RFU) from the purified blood sample on FTA card (1.2 mm) were obtained using the optimized PCR (10.0 μL of PCR reaction volume and 21 cycles) and CE (9.0 μL Hi-Di™ Formamide and 0.3 μL DNA Size Standard 550 [BTO] and 27 s injection time) conditions. The analytical and stochastic thresholds were 100 and 200 RFU, respectively. Hence, the internal validation data supported the use of the optimized 60% reduced PCR amplification reaction volume of the Qiagen Investigator® Argus X-12 QS Kit as well as the CE sample preparation for producing reliable DNA profiles that comply with the quality assurance standards for forensic DNA testing laboratories, while optimizing the analytical cost.     

血府逐瘀汤治疗原发性肝癌TACE术后气滞血瘀型疼痛30例

目的 观察血府逐瘀汤治疗原发性肝癌经导管动脉化疗栓塞（transcatheter arteriachemoembolization, TACE）术后气滞血瘀型疼痛的临床疗效。 方法 将60例原发性肝癌TACE术后气滞血瘀型疼痛患者随机分为治疗组和对照组,每组30例。治疗组给予血府逐瘀汤口服,对照组予以中药汤剂安慰剂口服。治疗前后比较两组患者疼痛数字分级评分（numerical rating scale, NRS）及Karnofsky功能状态评分（karnofsky performance status, KPS）的变化。 结果 治疗后两组NRS评分均显著下降,治疗组治疗前后NRS评分差值显著大于对照组（P＜0.05）。治疗后对照组KPS评分显著降低,而治疗组显著升高,两组治疗前后差值比较,差异具有统计学意义（P＜0.05）。治疗组NRS及KPS评分改善情况均显著优于对照组（P＜0.05）。 结论 血府逐瘀汤能有效减轻原发性肝癌TACE术后气滞血瘀型疼痛,提高患者生活质量。     

Improving Luminol Blood Detection in Forensics

The aim of this study was to develop chemical improvements to the original Weber protocol, in order to increase the intensity and time length of light emission and to eliminate false‐positive reactions. The intensity and duration of light were measured on serial blood dilutions using a plate reader chemiluminometer. Blood stains of various concentrations were impregnated in pure cellulose, dried, and luminol solution was added with/without the potential enhancers. An in silico study was also conducted, aiming to demonstrate the enhancing mechanism of hemoglobin denaturation using 8 M urea. The luminol blood detection test revealed important improvements after urea pretreatment or in the presence of monochloro‐triazinyl‐β‐cyclodextrin. This approach also eliminated the false‐positive reaction from sodium hypochlorite. These improvements could provide a higher sensitivity under particular circumstances such as old or washed blood stains, leading to a better localization for further DNA typing and higher quality photographic analysis.     

藏族习惯法中的赔命价刍议

藏族是一个有着悠久历史和灿烂文化的民族,在长期的历史发展中,形成了独有的民族心理素质、民族情感、风俗习惯、政教合一的政治制度和自成体系的习惯法规。这些政治、经济和文化等方面的特征,随着民主改革和社会的进步而逐渐被削弱。但旧习惯法中的赔命价仍直接或间接地影响着国家法律的贯彻执行,产生了一系列执法活动中的矛盾和冲突。这就要求司法人员在执法过程中,采取一些特殊的政策和规定,以便妥善解决与藏族习惯法中的赔命价现象有关的特殊问题。     

A Comparison of Four Presumptive Tests for the Detection of Blood on Dark Materials

Detection of blood on dark materials is difficult for crime scene examiners so presumptive tests are used to assist. This study compared the ability of luminol, leuko crystal violet, tetramethylbenzidine, and Combur Test®E to detect whole, diluted blood (1:100) and a key‐shaped blood transfer stain (1:10), on dark cotton sheeting, tea towel, socks, synthetic carpet, and car mats. Powdered bleach was used to evaluate specificity of the blood detection tests. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall misclassification rate (OMR) assessed the quality of the blood tests. Luminol was the preferred test for diluted blood having the highest sensitivity (79%–96%), NPV (66%–93%), and the lowest OMR (3%–15%). Luminol was also found to be most efficient with a testing time on 25 items of 2 h 50 min compared with up to 8 h. Overall, luminol was the most effective method, also providing information on bloodstain patterns.     

A Fatal Case of Poisoning with Fentanyl Transdermal Patches in Japan

Fentanyl transdermal patches have been used to treat cancer‐ and noncancer‐related chronic pain. However, its inappropriate or illegal application may cause fatal poisoning. We herein present the case of a Japanese woman in her 40s who was found dead with seven 25‐μg/h fentanyl transdermal patches on her body. We established a detailed toxicological analysis procedure to quantify fentanyl, and its metabolite norfentanyl, and other drugs (acetaminophen, allylisopropylacetylurea, celecoxib, estazolam, promethazine, and sertraline) in human whole blood by ultra‐high‐performance liquid chromatography–tandem mass spectrometry. The measured fentanyl and norfentanyl concentrations in the femoral and cardiac blood were 0.051 and 0.072 μg/mL and 0.033 and 0.076 μg/mL, respectively. The decedent's fentanyl concentrations were consistent with previously reported postmortem blood levels for fatal cases of poisoning by fentanyl transdermal patches. Based on the decedent's case history, autopsy findings, and toxicological analyses, the cause of death was identified as intoxication with transdermal fentanyl.     

HPLC-MS/MS法快速检测人体血液中的夹竹桃毒素

目的采用高效液相色谱-串联质谱法(HPLC-MS/MS)检测人体血液中夹竹桃苷、夹竹桃苷乙。方法采用乙腈沉淀蛋白法处理血液,HPLC-MS/MS法检测,采用MRM记录方式,保留时间和定性离子对定性,标准曲线法定量。结果夹竹桃苷、夹竹桃苷乙的检测限均在0.5ng/m L,线性范围在1ng/m L~1mg/m L,回收率为75.2%~95.7%。结论本方法操作简便,灵敏度高,可应用于中毒案件中人体血液中两种夹竹桃毒素(夹竹桃苷和夹竹桃苷乙)的快速检测。     

超高效液相色谱-四级杆飞行时间串联质谱快速分析复方守宫散化学成分及血中移行成分

目的 采用超高效液相色谱-四级杆飞行时间质谱(ultra-performance liquid chromatogra-phy/quadrupole time-of-flight-tandem mass spectrometry,UPLC-Q-TOF/MS)对复方守宫散中化学成分及其血中移行成分进行定性分析,为该制剂的...