人体冠心病心肌组织cTnI免疫组织化学研究

目的 研究cTnI免疫组织化学法诊断人体急性心肌梗死的法医病理学意义.方法 应用免疫组织化学法检测人体冠心病心肌组织cTnI的变化,进行图像分析,与HE染色法进行比较.结果 人体冠心病心肌组织急性心肌梗死区域心肌细胞内cTnI免疫组化染色缺染、分布失规律性;梗死修复区域纤维间质cTnI免疫组化染色弱阳性:陈旧性心肌梗死瘢痕区域纤维间质cTnI免疫组化染色阴性.失血性休克组近心内膜心肌细胞内cTnI免疫组化染色轻度增强,并见点灶状心肌细胞内cTnI免疫组化染色缺染.结论 cTnI免疫组织化学检测可以应用于人体急性心肌梗死的诊断.     

SPECIAL NEEDS CHILDREN IN FAMILY COURT CASES

This article presents a conceptual framework for describing cases involving children with special needs that are increasingly being seen in family court. Three categories that represent the most common of such cases include (1) acute, life-threatening medical conditions; (2) chronic developmental disorders; and (3) psychological and behavioral syndromes. After detailing the nature of the disabilities in each category, perspectives from the bench are offered with specific recommendations and general strategies for effective case management. This is followed by a proposal of an innovative conceptual model—the Individualized Parenting Plan (IPP)—that organizes and integrates nine domains essential for a comprehensive parenting plan for special needs children. The article concludes with a list of sixteen strategic guidelines for servicing the families of these special needs children, in their best interests.     

双黄连粉针湿敷治疗急性湿疹临床观察

目的 观察双黄连粉针湿敷治疗急性湿疹的临床疗效。方法 将符合纳入标准的70例急性湿疹患者随机分为对照组和治疗组，每组各35例。两组患者均接受抗组胺药物治疗，口服富马酸氯马斯汀口服液；治疗组同时采用双黄连粉针湿敷治疗，对照组采用3％硼酸洗液湿敷。结果 治疗组总有效率显著优于对照组（91.43% vs 74.29%，P<0.05）。结论 双黄连粉针湿敷治疗急性湿疹，方法简便、安全，值得临床推广。     

家兔急性胰腺炎死后不同时间眼玻璃体液淀粉酶变化

目的探讨急性胰腺炎死后不同时间眼玻璃体液淀粉酶变化。方法用1%牛胆酸钠诱导家兔急性胰腺炎动物模型建立,于死后不同时间和正常对照组,观察其淀粉酶变化。结果家兔急性胰腺炎死后72h眼玻璃体液淀粉酶含量(x)与死亡时间(y)存在相关关系,并导出其二项式回归方程为y=8.7420 0.7699x-0.0083x2(R2=92.62792,F=14.89734,P=0.001)。可作为推定早期损伤时间的参考指标。结论家兔急性胰腺炎死后不同时间眼玻璃体液淀粉酶改变为法医早期死亡时间推断提供了灵敏客观的实验依据。     

冠状病毒感染性疾病尸体检验相关病原学检测回顾与展望

冠状病毒曾经给世界带来两次严重的人类间大流行,包括严重急性呼吸综合征(severe acute respiratory syndrome,SARS)和中东呼吸综合征(Middle East respiratory syndrome,MERS),2019年岁末新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)再次引发了全球性的重大公共卫生事件。由于新型冠状病毒传染性较强,相关死亡病例的解剖工作难以广泛开展。本文对既往冠状病毒感染性疾病尸体检验相关的病原学检测情况进行回顾,介绍了临床上正在开展的新型冠状病毒的检测手段,旨在为开展COVID-19尸体检验相关的病原学检测和研究提供借鉴和参考。     

Sudden Death Due To Acute Cocaine Toxicity—Excited Delirium in a Body Packer

Excited delirium denotes a life-threatening medical condition characterized by the acute onset of agitated and violent behavior that often results in a sudden and unexplained death. Cocaine-induced excited delirium refers to fatal cocaine intoxication with the following symptoms occurring sequentially: hyperthermia, delirium with agitation, respiratory arrest, and death. We present a case of cocaine-induced excited delirium in a cocaine “body packer” or a “mule”, specifically an individual who attempts to smuggle cocaine within the body. Investigators at the scene initially suspected homicide due to the victim's sharp and blunt force injuries. Three rubber packets containing cocaine were removed from the victim's rectum. Blood toxicological analysis revealed an alcohol concentration of 0.016 g/100 and cocaine >1 mg/L. The forensic pathologist should consider cocaine-induced excited delirium when an individual exhibits aggressive behavior, unexpected strength, and resistance to pain who dies suddenly. Further analysis should be performed during the scene investigation and autopsy for evidence of body packing.     

兔急性心肌缺血脱氢酶电镜—细胞化学变化的动态观察

为了研究急性心肌缺血脱氢酶变化的规律性，本文应用电镜酶细胞化学技术，通过结扎５０只家兔冠状动脉左前降支，观察心肌缺血后０．２５、０．５、１、１．５、２、４、６、１２、２４、３６、７２小时ＳＤＨ和ＬＤＨ的变化。结果显示：心肌缺血０．５小时后，ＳＤＨ和ＬＤＨ活性开始下降。同时伴有致密体的形成和超微结构的改变。随着缺血时间的延长，酶活性下降更加明显，最后消失。     

Undiagnosed, untreated acute promyelocytic leukemia presenting as a suspicious sudden death

Acute promyelocytic leukemia (APL) is a subtype of acute myelogenous leukemia frequently associated with clotting abnormalities and severe hemorrhagic diathesis. The disease is associated with a high incidence of early fatal hemorrhage. We report the sudden death of a 40-year-old male without significant medical history in which foul play had been initially suspected. A thorough postmortem investigation performed on the decedent lead to the diagnosis of APL. Cause of death was a cerebellar hematoma. Underlying APL should be considered in the differential diagnosis when unexplained bleeding is encountered in a decedent. This case emphasizes the value of routinely collecting bone marrow during an autopsy to enable accurate testing and diagnosis.     

大鼠急性早期心肌梗死细胞膜PNA受体表达

探测急性心肌缺血早期细胞膜PNA受体的表达特点。应用免疫组化法(S-P法)对32只SD大鼠急性心肌缺血早期不同时间心肌细胞膜凝集素受体的表达进行研究。结果发现:心肌缺血15min时,心肌局部可出现PNA染色阳性,且随着缺血时间的延长,其阳性表达面积明显增加;缺血2h;其表达水平达到高峰,呈弥漫性染色阳性,明显高于对照组;2h后,心肌缺血区域PNA受体的表达开始出现下降趋势。实验结果稳定,敏感性强,可为心肌缺血早期诊断提供客观的依据。     

Repeat Coronary Artery Dissection in Pregnancy: A Case Report and Review of the Literature

Non‐atherosclerotic spontaneous coronary artery dissection (NA‐SCAD) is a rare cause of morbidity and mortality with a propensity for young, healthy, and often peripartum women. NA‐SCAD etiology is poorly understood, with possible hormonal and hereditary mechanisms. Current treatment strategies range from conservative management (often showing resolution on angiographic follow‐up) to invasive angiographic procedures. Rarely, NA‐SCAD has recurred in another coronary artery, ranging hours to years later. We report NA‐SCAD of the right coronary artery (RCA) in a 30‐year old, 3‐month postpartum female with an additional autopsy finding of remote myocardial infarction (MI) in the left anterior descending (LAD) coronary artery territory. The remote MI is consistent with prior NA‐SCAD of the LAD and, given the medical history, may have occurred in the peripartum period of the decedent first pregnancy 3 years earlier. As such, to the best of our knowledge, this may represent the first reported case of NA‐SCAD recurrence in a subsequent pregnancy.