书写能力的结构

目的提出人的书写能力由基础因子构成的假说。方法根据因子说,不同字的笔顺可能相关。以反犬旁、山字为目标字,收集799份有效实验样本,分性别检验实验样本中2个目标字的笔顺是否相关。结果统计检验表明反犬旁笔顺与山字笔顺相关（p〈0.01）,用一个笔顺在另一个笔顺出现的条件下的出现率与它的出现率之比测定它们相关性的大小,最高的比值为3.65。结论证实了人的书写能力由基础因子构成的假说,这个假说可以作为笔迹比较的理论基础。     

芪丹通脉片对健康犬冠状动脉血流量及阻力影响

目的：观察复方中药制剂芪丹通脉片对健康犬心脏冠状动脉血流量及阻力的影响，方法：分离犬的冠状动物左旋支及主动脉根部，放置电磁流量计探头，测定不同药物在给药前后不同时刻碱诉冠状动脉血流量，计算冠状动脉阻力。结果：芪丹通脉片高剂量（生药2g/kg)能明显增加冠状动脉血流量，减少冠状动脉阻力，结论：芪丹通脉片能够增加冠状动脉血流量，调整和改善心肌供血，为缺血性心脏病的治疗提供了实验论据。     

光谱成像检验法在朱墨时序鉴定中的应用

光敏印文色料与签字笔书写色料交叉重叠后,因互溶渗透不易形成层状结构而使判定朱墨时序的难度较大。光谱成像检验法是通过比较交叉点、纯印文色料、纯墨迹色料处的反射曲线位置来判定交叉时序关系。     

门字框笔顺的判断方法

通过实验研究门字框笔顺判断的科学方法，收集155份实验笔迹样本，由书写人报告样本字中门字框的笔顺。分析门字框的笔迹形态与规范笔顺、通用笔顺的关系，发现点笔搭配位置，竖笔和点笔的收笔动向可以作为判断笔顺的可靠依据，根据点笔位置、竖笔和点笔收笔动向的规律，得出了门字框规范笔顺和通用笔顺的判断规则。     

Contribution of Antemortem Computed Tomography Findings to Cause of Death Determination: An Unusual Fatal Stroke

In the case reported here, the antemortem computed tomography scan (CT scan) was essential in the forensic investigation. A 32‐year‐old man was found fully awake with a facial abrasion, after what seemed to be a car accident. He lost consciousness suddenly one hour after initial management. Successive CT scan showed a facial fracture and a metallic foreign body in the carotid canal associated with an occlusion/dissection of the left internal carotid, a pseudoaneurysm, and a carotid‐cavernous fistula. The victim died from a stroke. Autopsy confirmed that the facial abrasion was a gunshot entrance wound, the metallic foreign body being a projectile. Intracranial vascular injuries linked with gunshot wounds are most of the time isolated and due to pelet embolism. The observed vascular injury association has never been described in the existing literature. The CT scan provided a better understanding of the chronology of events that led to death.     

Diagnosis of Hemorrhagic Stroke in an Exhumed Brain After Three Years of Burial in a Deep Grave

Abstract: We present the forensic neuropathologic analysis of an exhumed decomposed brain following long‐term interment in a 50‐year‐old white woman, who had been buried for 34 months. Next of kin authorized exhumation of the body for an autopsy to determine the cause of death. The embalmed body was anatomically intact and revealed decompositional changes with mold colonies. Internal viscera showed intact histomorphology. The brain revealed diffuse congestive swelling and extracellular edema with dissecting parenchymal hemorrhage and hematoma originating from the left putamen and thalamus and extending to the left lateral ventricle. Excitotoxic neuronal injury as well as penumbric parenchymal changes was noted. Cause of death was determined to be a hypertensive cerebral parenchymal hemorrhage. This case and our previously reported case are sentinel cases, which should encourage and guide the forensic neuropathologic work‐up and investigation of causes of death in spite of long‐term burial in deep graves.     

灸刺督脉治疗气虚血瘀型缺血性脑卒中临床观察

目的 观察评价灸刺督脉疗法治疗气虚血瘀型缺血性脑卒中的临床疗效。方法 将气虚血瘀型缺血性脑卒中患者41例，随机分为对照组（20例）和治疗组（21例）。两组均予以基础病管理，对照组采用脑卒中气虚血瘀型常规针刺治疗，取穴为顶颞前后斜线、极泉、尺泽、内关、委中、足三里、三阴交、气海、血海；治疗组在常规针刺治疗基础上加用灸刺督脉疗法，取通督七穴（水沟、神庭、百会、风府、大椎、命门、腰阳关），其中百会艾灸，大椎刺络，其余腧穴予以针刺治疗。治疗周期为14 d。疗程结束后以美国国立卫生研究院卒中量表（National Institute of Health stoke scale，NIHSS）及改良Rankin量表（modified Rankin scale，MRS）评分结果评价两组的临床疗效。结果 两组患者治疗后NIHSS及MRS评分均较治疗前显著降低（P<0.05），治疗组NIHSS及MRS评分差值与对照组比较，差异均有统计学意义（P<0.05）。两组临床疗效分布比较，差异有统计学意义（P<0.05）。结论 灸刺督脉疗法治疗气虚血瘀型缺血性脑卒中临床疗效确切，优于常规针刺治疗。     

ICF脑卒中核心分类组合功能的图形建模研究

目的依据《国际功能、残疾和健康分类(ICF)》脑卒中核心组合,探讨脑卒中相关功能类目之间的关系,绘制ICF脑卒中核心分类组合的功能地形图,为脑卒中的伤残评定提供科学理论依据。方法收集106例脑卒中被鉴定人样本,采用"最小的绝对缩减和变量选择算子",研究脑卒中ICF核心组合功能的59项类目变量之间的条件依存关系,并用图形建模分析类目之间的内在联系,绘制功能地形图。结果 59项类目之间的相互联系构成了功能地形图,b340、b735、b175和b152因关联性较高而居于地形图的中心位置。结论脑卒中功能地形图可以揭示ICF功能类目之间复杂的关系结构及关联程度。可以为应用ICF进行脑卒中的伤残评定提供科学理论依据。     

基于EPO介导的JAK2/STAT5信号通路研究百会、大椎刺络促缺血性脑卒中后血管新生的调控机制

目的 基于促红细胞生成素（erythropoietin,EPO）介导的JAK2/STAT5信号通路探讨百会、大椎刺络促缺血性脑卒中后血管新生的调控机制。方法 选取健康SD雄性大鼠150只,随机分为正常对照组、假手术组、模型对照组、刺络治疗组、刺络+EPO拮抗组,每组30只;正常对照组不进行手术,假手术组仅分离血管而不插线栓,模型对照组、刺络治疗组、刺络+EPO拮抗组采用改良的Zea-Longa法制备大脑中动脉局灶性脑缺血再灌注模型（middle cerebral artery occlusion/reperfusion model,MCAO/R）大鼠。模型制备后刺络治疗组、刺络+EPO拮抗组采用“百会”“大椎”穴刺络进行干预,刺络+EPO拮抗组在针刺前将脂质体-siEPO2复合物按5 mg/kg剂量对大鼠进行腹腔注射,使之进入合成EPO的靶细胞,在细胞内引起针对EPO的RNA干扰效应。采用苏木精-伊红染色观察各组大鼠脑皮质病理形态,RT-PCR法检测各组大鼠脑皮质中EPO、血管内皮生长因子（vascular endothelial growth factor,VEGF） mRNA表达水平,Western Blot法检测各组大鼠脑皮质中P-JAK2、P-STAT5、VEGF蛋白表达水平。结果 与正常对照组比较,模型对照组及刺络+EPO拮抗组大鼠脑皮质病理损伤严重;与模型对照组比较,刺络治疗组大鼠脑皮质病理损伤明显改善。与正常对照组比较,模型对照组大鼠脑皮质中EPO、VEGF mRNA表达水平显著升高（P＜0.05）,P-JAK2、P-STAT5、VEGF蛋白表达水平显著升高（P＜0.05）,刺络治疗会进一步增强这种趋势;与刺络治疗组比较,刺络+EPO拮抗组大鼠脑皮质中EPO、VEGF mRNA表达水平降低（P＜0.05）,P-JAK2、P-STAT5、VEGF蛋白表达水平降低（P＜0.05）。结论 通过百会、大椎刺络能上调MCAO/R模型大鼠EPO的表达水平,激活JAK2/STAT5信号通路,促进下游VEGF的表达而促进缺血性脑卒中后血管的新生。     

Psychostimulant Use and Fatal Stroke in Young Adults

Psychostimulant use is associated with increased stroke risk. To determine the proportion of psychostimulant users among fatal strokes in young adults (15–44 years), all cases were retrieved from the National Coronial Information System (1/1/2009–31/12/2016). A total of 279 cases were identified: hemorrhagic (259), ischemic (8), thrombotic (8), and mycotic (4). Fifty (17.9%) were identified as psychostimulant users. Psychostimulants in blood were detected in 37/45 where toxicology was available, predominantly methamphetamine (32/45). Hemorrhagic strokes in the psychostimulant group were more likely to be intraparenchymal (OR 2.33). Psychostimulant users were less likely to be obese (OR 0.31), but more likely to have a history of tobacco use (OR 2.64). No psychostimulant user had a previous stroke history, was gravid/postpartum, or diagnosed with cerebral vasculitis or endocarditis. The work illustrates the substantial role of psychostimulant use in fatal strokes among young adults. In cases of hemorrhagic stroke among young adults, psychostimulant use should be considered.