利用中国汉族成人股骨上端CR片特征判定年龄

目的探讨中国汉族成人股骨上端CR片的特征随年龄变化的规律,以推断年龄。方法 277例中国汉族成人骨盆正位CR片,其中男性139例,年龄范围18-83岁,女性138例,年龄范围18-85岁,选取股骨上端的股骨头、股骨颈、大转子内的骨小梁及股骨上端髓腔高度四项指标,观察不同年龄各指标的变化进行统计分析。结果成人股骨头、股骨颈骨小梁变化和股骨上端髓腔高度是影响45岁以下年龄变化的重要因素,股骨大转子影响较小。四项指标对45岁以上年龄组均是影响年龄变化的重要因素。利用以上指标建立的回归方程能很好的反映成人股骨上端的增龄性变化,预测骨龄较为准确。结论利用成人股骨头、股骨颈、股骨大转子内骨小梁的改变及股骨上端髓腔高度变化可推断年龄。     

血府逐瘀汤辅助治疗重症闭合性胸外伤临床观察

目的 观察血府逐瘀汤辅助治疗重症闭合性胸外伤的疗效。方法 将60例重症闭合性胸外伤患者随机分为治疗组和对照组，每组30例。对照组在西医常规对症治疗的基础上进行纤维气管镜肺泡灌洗，治疗组在对照组疗法的基础上加服血府逐瘀汤。采用视觉模拟量表(visual analogue scale，VAS)评价患者的胸痛程度，通过检测外周血白细胞(white blood cell, WBC)及血清C-反应蛋白(C-reactive protein, CRP)水平评价炎症程度，采用血气分析评价肺通气和换气功能。结果 治疗组患者治疗后VAS评分降低程度显著大于对照组（P<0.05）。治疗组患者住院时间较对照组明显缩短（P<0.05）。治疗第3、7、12天末，治疗组患者血pH值、动脉血氧分压、血氧饱和度均显著高于对照组（P<0.05），动脉血二氧化碳分压、外周血WBC计数、血清CRP水平均显著低于对照组（P<0.05）。治疗组临床疗效明显优于对照组（P<0.05）。结论 血府逐瘀汤能提高重症闭合性胸外伤患者肺泡的通透性，改善肺组织的通气及换气功能，降低炎症反应。     

利用中国汉族成年人胸部正位CR片影像学特征判定年龄

目的建立利用胸部正位CR片影像学变化判定年龄的方程,并评价其法医学意义。方法收集381例汉族成年人胸部正位CR片样本,其中男性208例,女性173例。选取胸部右侧第一肋胸骨端、左侧第一肋胸骨端、右侧第五肋胸骨端、左侧锁骨骨小梁和左侧锁骨松质骨网眼5项特征性指标,对351例样本进行描述评分,运用SPSS 19.0软件进行多元线性回归模型条件的基本论证,建立回归方程。并使用30例样本对方程的准确性进行盲测。结果本文所选取的5项胸部正位CR片特征性指标与年龄的关系可以使用线性回归模型(P0.05);建立了1组全指标回归方程和2组分组逐步回归方程,全指标回归方程估计值的标准误男性和女性分别为2.83岁和3.41岁,低年龄组(18~35岁)男性和女性分别为2.47岁和2.79岁,高年龄组(36~50岁)男性和女性分别为2.39岁和2.55岁;随机选取30例样本的盲测结果,误差在3岁以内的,全指标回归方程男性和女性分别为80.0%和73.3%,分组回归方程男性和女性分别为86.7%和80.0%。结论利用胸部正位CR片影像学特征变化可判定年龄。     

Causes and Mechanisms of Death in Fatal Water Buffalo Attacks

Deaths due to buffalo attack have not been well described. A 72‐year‐old man was trampled by a water buffalo (Bubalus bubalis) while attempting to move the animal within an enclosed area at an abattoir. At autopsy, there were numerous injuries involving the chest, head, neck, and left upper arm. Blunt force injury had resulted in multiple rib fractures with a flail chest and fracture/dislocation of the mid‐cervical vertebrae caused either by physical crushing by the animal against the walls of the enclosure or by stomping. There was also evidence of crush asphyxia with bilateral conjunctival hemorrhages and petechial hemorrhages. In addition, there was a deep degloving injury of the upper left arm compatible with goring by one of the buffalo horns. While large animal attacks may result in death from multiple injuries, careful dissection and examination of specific injuries at autopsy may clarify the complex interaction of lethal mechanisms.     

Immunohistochemical detection of CCR2 and CX3CR1 in sepsis-induced lung injury

Sepsis is a systemic inflammatory disease with high mortality. In the present study, we immunohistochemically examined CCR2 and CX3CR1 expression in sepsis-induced lung injury, and discussed its availability for the postmortem diagnosis of sepsis. Lung samples were obtained from different lung lobes of nine sepsis and eight control cases with postmortem intervals between 12 and 48 h. Immunohistochemically, mononuclear cells recruited into the lungs expressed CCR2 and CX3CR1 in both sepsis and non-septic groups. In double-color immunofluorescence analysis, CCR2- or CX3CR1-positive cells could be identified as CD68-positive macrophages. Moreover, most of CD68-positive macrophages expressed both CCR2 and CX3CR1. Morphometrically, the average of CCR2- and CX3CR1-positive macrophages was significantly increased in sepsis group, compared with control group (sepsis vs. control: 41.6 ± 1.3% vs. 8.0 ± 0.4% in CCR2; 36.2 ± 1.3% vs. 9.2 ± 0.4% in CX3CR1). These observations implied that CCR2- or CX3CR1-positive macrophages were recruited into the lungs under several pathological conditions. In particular, their recruitment might be more evident in sepsis. Moreover, from the forensic aspects, immunohistochemical detection of CCR2 and CX3CR1 expression in the lungs can be considered as valuable diagnostic tools for the postmortem diagnosis of sepsis.     

论罪犯心理矫治中感情势能的消解对策

罪犯感情势能的形成和积累,给罪犯带来各种各样的情感困扰,使罪犯产生心理问题,不仅对罪犯自身的服刑改造产生影响作用,而且对罪犯的身心健康也有着极大的影响作用。因此,防止罪犯感情势能在罪犯体内形成和积累,让罪犯学会及时宣泄自己的不良情绪,使心理恢复平衡,把握宣泄不良情绪、情感的方法,有效地、科学地把消极情感"零存整取"地排解出去,是保持罪犯身心健康的有效手段。     

刺激性毒物西阿尔（CR）的检验

目的简要介绍刺激性毒物西阿尔的物理、化学性质及检验方法;方法使用直接提取法对常见检材进行提取,使用TLC、GC/MS方法对其进行定性分析,以西阿尔在不同展开系统下的Rf值和特征质谱图作为定性依据;结果可快速准确的对西阿尔进行定性分析;结论该方法简便,易行,准确,可靠,可用于案件检验。     

胸部损伤死因鉴定审查在诉讼中的应用

人身伤害案件被害人的死因鉴定,轻则涉及被告人的量刑,重则事关案件的定性。而司法实践中,经常遇到一些刑事被害人的死因鉴定意见是建立在推断的基础之上,且其推断不具有排他性,经不起推敲,往往直接影响到案件的定性与处理。针对这一问题,结合司法案例进行分析,以期提升死因鉴定的证明力和法医学鉴定意见的公信力。     

中国汉族成人肱骨近端CR片特征与年龄的相关性

目的探讨中国汉族成人肱骨近端CR片的特征随年龄变化的规律,以推断年龄。方法 210例中国汉族成人肩关节CR片,其中男性124例,年龄范围18~83周岁,女性86例,年龄范围18~60周岁,选取与年龄变化关系密切的肱骨骨髓腔高度、肱骨近端骨骺骨小梁变化、肱骨大结节内骨小梁变化、锁骨骨髓腔肩峰侧骨小梁变化4项指标,观察不同年龄各指标的变化进行统计分析。结果四项指标均是影响年龄变化的重要因素。肱骨近端骨骺骨小梁变化、锁骨骨髓腔肩峰侧骨小梁变化对年龄的预测影响较大,肱骨骨髓腔高度、肱骨大结节内骨小梁变化稍小。利用以上指标建立的回归方程能很好的反映成人肱骨的增龄性变化,预测骨龄较为准确。结论利用成人肱骨骨髓腔高度、肱骨近端骨骺骨小梁变化、肱骨大结节内骨小梁变化、锁骨骨髓腔肩峰侧骨小梁变化可推断年龄。     

Death Due to Coronary Artery Insufficiency Following Blunt Trauma to the Chest

There have been numerous reports of sudden cardiac death following blunt trauma to the chest, but there is lack of such references in forensic literature. It is the court of law which makes decision about trauma precipitating natural events. The forensic pathologist is scientifically trained in the medical field and would be in a better position to give clear picture about the victim's general status at the time of death, exact nature and severity of the illness he is suffering from if any. He can also assess the nature and severity of injuries sustained, and thus, his opinion as to the possible role played by the traumatic event in bringing about the death is valuable. This paper will discuss the mechanism of cardiac injury or possible cardiac injury and sudden death of an apparently healthy 36‐year‐old male following blunt chest trauma sustained during alleged assault by his neighbor.