血液中乙醇检测结果的法医学分析

目的对交通事故中血液中乙醇检测结果进行法医学分析。方法从检测方法、血液采集方法、采集时间、血液保存、尸体腐败、饮酒量与血液中乙醇质量浓度关系等方面进行血液中乙醇检测结果的法医学分析。结果检测方法、血液采集方法、采集时间、血液保存、尸体腐败等因素直接影响血液中乙醇检测结果。结论为保证交通执法的公正性，对血液中乙醇检测结果应当作法医学分析。     

腐败血液中乙醇的顶空气相色谱分析

目的分析血液腐败后产生的乙醇及其他物质并探讨腐败血液中乙醇的检测及计算方法。方法以正常人空白血液制作腐败血样,采用1,4-二氧六环为内标物,通过顶空气相色谱进行定性及定量分析。结果血中乙醇在0.0625～1mg/mL范围内线性关系良好（r^2=0.9996）,各质量浓度组的变异系数（CV%）〈2%,血中乙醇的最低检出限为1μg/mL（S/N≥3）。腐败血样所产生乙醇与正丙醇的比例大致为25：1。结论检验方法简便、准确。为法医毒化检验相关工作提供了依据。     

硫化氢中毒者血中硫化氢的检测及特征鉴别

目的探讨硫化氢(H2S)中毒者血中H2S的检测及特征鉴别;方法取新鲜空白血液和5℃下保存1月、1年的血液各2m L,经微波低火加热1min后,吸取顶空气体100μL进行GC/PFPD-S、GC/MS检测;取相同样本进行酸化处理后进行检测;取疑似为H2S中毒者血液直接加热后进行检测。结果新鲜血液和5℃下保存1月、1年的血液均可检出H2S成分,但保存1个月以上的血液可同时检出二硫化碳(CS2)成分;酸化处理后的血液,H2S和CS2成分检出的含量明显比未加酸化的血液高;中毒者血液中除了检出H2S成分外,还检出甲硫醚成分。结论血液样本同时检出H2S和较大量的CS2时,不宜判定为H2S中毒,提示可能为腐败所致,而同时检出H2S和较大量的甲硫醚,则可做出H2S中毒的判断。     

尸体血液中乙醇质量浓度的分析评价

血液中乙醇质量浓度是分析评价机体内乙醇水平的重要证据,由于尸体内检测到乙醇可能受死后生成、乙醇扩散等因素影响,尸体血液中乙醇质量浓度检测结果未必能反映其死亡时机体内乙醇的真实水平。鉴别尸体内乙醇是否为原始浓度是分析评价的关键。本文对乙醇在体内的分布特点、如何合理取材及死后乙醇扩散、尸体腐败产生的乙醇对乙醇质量浓度分析的影响进行了综述,并对死后乙醇质量浓度检测的分析评价策略进行了讨论。     

不同输血量对新近受血者血样PCR-STR检验的影响

异体血液或血液成分的输入是否会影响受血者血液样本STR-PCR检验的结果国内外文献鲜有报道[1-3]。本文收集了25例受血者输血前后的血液样本,用CTT系统、SilverSTRⅢ系统、3114系统进行STR复合扩增,银染检测。并对分型结果予以比较分析,试图了解输血对受血者血样STR-PCR检验的影响程度。1材料及方法1.1实验样本25例受血者输血前、后的血液样本各5ml(由志愿者提供)。以输入全血或浓缩红细胞者为收集范围;受血者输血后的血液样本在输血后24h内采集;输全血量为400～10000ml(输入浓缩红细胞者按1个单位浓红相当于200ml全血折算),输血量…     

制约与解释--生活场景对法律生命的考量

人与社会存在的固有事实与本来逻辑显示,内含秩序与正义两大终极价值的法律与人的生活场景紧密结合在一起.法律的存在也是一个过程,具有断裂的可能性.人的生活场景是由自然性的物质世界、社会性的物质世界、文化世界、关系世界构成的统一体,决定着法律的生成、运作与进化;法律也不断地解释着人的生活场景,法律的生命在解释的过程中体现出来.在此过程中,法律必须具有深厚的亲和力.     

人体死亡后血液中生化指标的变化

目的测定人体死亡后血液中生化指标的变化并进行分析。方法收集81例交通事故死亡后尸体锁骨下静脉血样,并采用罗氏cobasc311全自动生化分析仪检测血液中肝功能（ALT、AST、TBIL、DBIL）、肾功能（UA、Cr）、心功能（CK、CK—MB、LDH）、电解质（K＋、Na＋、Cl-）以及葡萄糖（GLU）13项生化指标的变化,采用SPSS17．0统计学软件进行描述性分析。结果生化指标中ALT、AST、CK、CK—MB、LDH、D数值较活体正常参考值高、波动幅度较大。TBIL、DBIL、UA、Cr、Na＋、Cl-、GLU数值相对稳定、波动幅度较小。结论人体死亡后血液生化指标中肝功能、肾功能、心功能、电解质以及葡萄糖等指标易受溶血、自溶等因素影响,表现为生化指标升高明显,尤以酶类为著,且标准差较大。     

血液中氯胺酮的GC／MS／MS分析

目的建立血液中氯胺酮的定性分析方法;方法采用串联质谱法分析;结果选择氯胺酮的特征离子m/z180为母离子,CID电压为0.5v进行MS/MS分析;结论此检验方法能有效的消除来自人体血液的干扰物质,方法快速、灵敏、准确。     

人体内乙醇含量检测的影响因素分析

人体内乙醇含量检测不仅是法医鉴定工作中常规检测项目,也是交通肇事案件最终的仲裁依据,其检测结果直接影响着受检人员的责任判罚。本文根据乙醇的毒理特征及在人体内的代谢过程,就不同检材、送检时效性、尸体腐败、血液检品中不同成分和保存方式、以及检测结果的不确定度等对乙醇含量检测结果的影响进行分析,以利于对受检者是否饮酒及其程度做出科学、公正的判定。     

让被污染的生命之河重新纯净

如果说浩大江河以及它的密如蛛网的分支构成了大自然、动植物和人类生命源泉的话,那么在每个生物体和人体内流淌的鲜红的血液就构成了生物体和人的生命之河。 血液之所以成为生命之河,那是它供给人生存的基础。血液首先供给人的是氧气,这是由染红了生命之河的红细胞来完成的。血液供给人体第二大重要物质是能量和水,这就是糖、蛋白质、脂肪。人吃进的所有食物和水都必须吸收入血,然后再输送到全身各组织器官。血液给予人的第三大重要物质就是防御卫士。遍布血液中的各类白细胞和免疫球蛋白、细胞因子是保护人体免受各种病菌袭击的有效防御力量。有了血液的这些基本功能,人和生物体才能生存,人的各种生理功能才能完成,人的思维火花和创造力才能迸发,人类才能繁衍     

Ethanol production by Candida albicans in postmortem human blood samples: effects of blood glucose level and dilution

We present two cases in which the ethanol concentration in blood samples taken after death continued to increase in the absence of any remarkable increase in n-propanol concentration. Species of bacteria and yeasts, including Candida albicans were isolated from these samples. We then examined whether C. albicans, the most common yeast in the general environment, was able to produce ethanol in human blood stored at room temperature. Ethanol production increased as the glucose concentration increased, indicating that C. albicans produced ethanol from the glucose. Our results also suggested that C. albicans produced ethanol more easily in blood diluted by intravenous infusions that included glucose than in undiluted blood. These findings are useful for the evaluation of postmortem ethanol production in subjects whose blood has been diluted by infusions with glucose. Furthermore, there was no quantitative relationship between the amount of n-propanol detected and the amount of ethanol production: n-propanol appears to be an unreliable index of putrefaction and postmortem ethanol production by C. albicans. It is possible for the blood ethanol level to be high and n-propanol not to be detected, even if the subject has not been drinking alcohol. We reconfirmed the necessity of immediately adding sodium fluoride to samples for ethanol analysis to prevent postmortem ethanol production.     

Postmortem production of ethanol and n-propanol in the brain of drowned persons

We examined endogenous ethanol and n-propanol levels in the brain in 29 drowning cases in which ethanol consumption was excluded. Based on the stage of putrefaction of the brain, our cases were classified into 4 groups: pulpified brain (PB, n = 11), softened brain (SB, n = 6), discolored brain (DB, n = 2), and normal brain (NB, n = 10). The endogenous ethanol and n-propanol levels (mg/g), respectively, in the brains from these groups were 1.06 +/- 0.401 and 0.076 +/- 0.032 in PB, 0.195 +/- 0.136 and 0.012 +/- 0.009 in SB, and 0.053 +/- 0.032 and 0.001 +/- 0.001 in DB. Ethanol and n-propanol were not detected in NB. The concentration ratios of ethanol to n-propanol were 16.2 +/- 7.1 in specimens with ethanol levels > or = 0.50 mg/g (n = 10), and 17.6 +/- 13.5 in specimens with ethanol levels of 0.10 to 0.49 mg/g (n = 9). Drinking may strongly be suspected when (1) ethanol concentration in the brain is > or = 0.50 mg/g and cerebral ethanol to n-propanol ratio is > or = 40; and (2) the concentration of ethanol is 0.10 to 0.49 mg/g and the ethanol to n-propanol ratio is > or = 60.     

Evaluation of breath alcohol instruments I. In vitro experiments with Alcolmeter Pocket Model

An Alcolmeter Pocket Model breath alcohol device, based on an electrochemical (fuel cell) oxidation principle for ethanol analysis, has been evaluated under in vitro conditions. The result of a test is displayed on an analogue meter within 20 – 30 seconds after sampling; replicate tests may be made within 3 – 5 minutes. The electrochemical detector used was found to respond to acetaldehyde, methanol, isopropanol and n-propanol vapours besides ethanol, but it was insensitive to acetone vapour. The Alcolmeter response with a 0 – 2.0 mg/ml scale was linearly related to ethanol vapour concentration up to 1.0 mg/ml blood alcohol equivalent concentration; above this level the response was curvilinear, the Alcolmeter reading being too low. The standard deviation of an ethanol vapour determination in vitro was ±0.0175 mg/ml at a mean concentration of 0.902 mg/ml. The accuracy of the device expressed as percent recovery at 0.50, 1.0 and 1.4 mg/ml blood alcohol concentrations was 96.8%, 98.3%, and 88.3%, respectively. When the Alcolmeter was calibrated at 0.50 mg/ml and used occasionally each day over an 18-day period, the drop in initial calibration was 0.01 mg/ml per week.     

Assessment of the Role Played by N‐propanol Found in Postmortem Blood in the Discrimination Between Antemortem Consumption and Postmortem Formation of Ethanol Using Rats

This study disproves the reliability of n‐propanol as a biomarker to establish whether the ethanol found in postmortem blood is derived from antemortem ingestion or postmortem putrefactive processes. Two groups of rats were given ethanol or normal saline solution, respectively, and sacrificed 1.5 h later. After putrefaction, blood and, in a few cases, urine samples from the rats were analyzed for ethanol and n‐propanol by head‐space gas chromatography equipped with flame ionization detection. Although the concentration ratios of ethanol/n‐propanol in the postmortem blood collected from the bodies without prior alcohol consumption were expected to be <20 (as per limited case reports and previous in vitro studies), in samples from several rats that were on saline solution, this ratio was found to exceed 20. In conclusion, the concentration ratio of ethanol/n‐propanol in postmortem blood does not allow for the discernment between antemortem ingestion and the postmortem synthesis of ethanol.     

Medicolegal studies on alcohol detected in dead bodies — alcohol levels in skeletal muscle

An experiment was carried out on rats to determine whether or not a skeletal muscle sample was suitable for the determination of ethanol concentration in a carcass. Gas chromatography was used to estimate the ethanol and n-propanol concentrations in the femoral muscle and intracardial blood. The ethanol concentration of each sample was corrected according to the moisture ratio of circulating blood, viz., 78.5%.The ethanol concentration ratio of blood to muscle was 1.03 two hours after ethanol administration. When the carcasses of rats pre-treated with ethanol were stored at 15 °C and 25 °C, respectively, the ethanol concentrations in muscle and blood increased with time. At all times the concentration was higher in blood than in muscle, and also higher in samples collected from the carcass stored at 25 °C than at 15 °C.When the control carcass was stored in the same manner, the postmortem production of ethanol was noticed in both blood and muscle. As in the experimental rats, the control rats exhibited a higher blood ethanol than muscle ethanol level. Again, the ethanol concentration was higher in samples collected from the carcass stored at 25 °C than at 15 °C. The ratio of ethanol to n-propanol was less than 20:1 in blood and less than 10.1 in muscle.These results suggest that skeletal muscle may be a suitable tissue for the postmortem detection of ethanol.     

Relationship between the concentration of ethanol and methanol in blood samples from Swedish drinking drivers

Headspace gas chromatography was used to determine the concentration of ethanol and methanol in blood samples from 519 individuals suspected of drinking and driving in Sweden where the legal alcohol limit is 0.50 mg/g in whole blood (11 mmol/l). The concentration of ethanol in blood ranged from 0.01 to 3.52 mg/g with a mean of 1.83 +/- 0.82 mg/g (+/- S.D.). The frequency distribution was symmetrical about the mean but deviated from normality. A plot of the same data on normal probability paper indicated that it might be composed of two subpopulations (bimodal). The concentration of methanol in the same blood specimens ranged from 1 to 23 mg/l with a mean of 7.3 +/- 3.6 mg/l (+/- S.D.) and this distribution was markedly skew (+). The concentration of ethanol (x) and methanol (y) were positively correlated (r = 0.47, P less than 0.001) and implies that 22% (r2) of the variance in blood-methanol can be attributed to its linear regression on blood-ethanol. The regression equation was y = 3.6 + 2.1 x and the standard error estimate was 0.32 mg/l. This large scatter precludes making reliable estimates of blood-methanol concentration from measurements of blood-ethanol concentration and the regression equation. But higher blood-methanol concentrations are definitely associated with higher blood-ethanol in this sample of Swedish drinking drivers. Frequent exposure to methanol and its toxic products of metabolism, formaldehyde and formic acid, might constitute an additional health risk associated with heavy drinking in predisposed individuals. The determination of methanol in blood of drinking drivers in addition to ethanol could indicate long-standing ethanol intoxication and therefore potential problem drinkers or alcoholics.     

探究尸体血样中乙醇、乙基葡萄糖醛酸苷和硫酸乙酯的产生

目的探索尸体血样保存过程中乙醇的产生情况及乙基葡萄糖醛酸苷(EtG)和硫酸乙酯(EtS)的产生可能。方法对照组为7例阳性静脉血,而实验组则为7例阴性尸体血。每例血样分成3份并保存在室温(18~22℃),4℃及-20℃等3种不同的条件下,在保存天数为0、2、3、5、7、9、11、13、15、17、19、21等时间点取样。使用顶空气相色谱法(HS-GC)检测乙醇,采用固相萃取提取EtG和EtS,使用高效液相色谱-三重四级杆质谱(LCMS/MS)法检测EtG和EtS。结果保存期间,对照组各血样中的乙醇、EtG和EtS浓度均呈下降趋势;实验组中1、2、4、5、6、7号血样的室温及4℃的样本在保存第2~3天时检出乙醇,而7号-20℃的样本在第6天检出乙醇。其中,6号室温血样的乙醇峰值浓度为64.27mg/100mL。各血样中均未检出EtG,EtS。结论室温及4℃保存的尸体血可产生乙醇且产生速度较快,反复冻融可导致-20℃保存的尸体血产生乙醇,乙醇峰值浓度可超过法定酒驾标准,但实验组血样中均无EtG和EtS产生。因此,尸体血中的EtG,EtS可以作为乙醇生前入体的特异性标志物,区分乙醇生前入体和腐败产生乙醇的依据。实际工作中,乙醇原体检测的酒精认定应注意血样保存和运输条件造成的影响。为了避免假阳性结果,涉及死亡的案件进行酒精认定时有必要辅以EtG和EtS的检测。