大鼠机械性脑干损伤早期延脑网状结构的超微病理研究

目的　探讨脑干损伤早期延脑网状结构的超微病理变化。方法　将实验大鼠分为创伤组和对照组,透射电镜观察大鼠机械性脑干损伤早期（１０ｍｉｎ,０ ．５ｈ,１ｈ ,３ｈ） 延脑网状结构的超微病理变化。结果　脑干损伤１０ｍｉｎ 即可见神经微丝（ｎｅｕｒｏｆｉｌａｍｅｎｔ, ＮＦ） 排列紊乱、疏密不均,ＮＦ 臂的缺失,髓鞘层面分离,轴膜内皱,与髓鞘间形成空隙,微血管周围基质密度降低以及线粒体肿胀等超微病变。脑干伤后存活时间延长,上述病变更为显著。本文就上述超微病变的形成机制及病理学意义进行了探讨。结论　脑干机械性损伤能够明显引起延脑网状结构的超微病理学变化,并增加个体快速死亡和免疫组化染色的易感性     

重伤家兔体内Cu及代谢酶变化与MOF及死亡关系

目的探讨兔重伤后机体内铜（Cu）含量及其代谢酶铜锌超氧化物歧化酶（Cu/Zn-SOD）、细胞色素c氧化酶（CCO）活性变化与继发性多器官衰竭（MOF）及死亡的关系。方法参照国际通用的创伤程度量化评分标准（ISS）,建立致MOF的家兔重伤模型,检测伤后不同时段血清及组织Cu含量与Cu/Zn-SOD和CCO的活性,分析其变化规律与继发MOF及死亡的关系。结果①重伤组家兔（包括死亡组家兔）血清Cu含量在伤后12h显著下降,36h后逐步回复;脑、心、肺组织中Cu含量伤后下降,肝脏组织Cu含量于伤后12h显著升高,36h后回落。伤后死亡组家兔脑、心、肺、肝Cu含量均较对照组降低,其中脑、肝组织Cu含量下降显著。②重伤组家兔血清Cu/Zn-SOD活性伤后12h下降3,6h之后呈升高的趋势,肝脏组织中的Cu/Zn-SOD活性伤后持续显著升高。③重伤后家兔（包括死亡组家兔）大脑皮质、心、肝CCO活性变化不明显,但脑干组织CCO活性显著升高。伤后死亡组家兔脑、心、肺、肝等器官的大体及组织学呈MOF改变。结论严重创伤可引发兔血清和组织Cu水平及Cu/Zn-SOD、CCO活性变化,这些变化可能与继发多器官衰竭和死亡相关。     

脑干损伤后神经轴突和髓鞘变化的免疫组织化学研究

探讨脑干损伤后神经轴突和髓鞘的病理学改变及其意义。用免疫组织化学显示神经丝蛋白和髓鞘碱性蛋白 ,观察人体脑干组织中的神经轴突及髓鞘在损伤后的病理学改变。在脑干损伤组 ,神经轴突在伤后 0 5h即有不规则肿胀及断裂 ,神经髓鞘在伤后 19～ 2 2h有明显曲折、不完全剥脱及节段性消失 ;而在正常脑干组 ,神经轴突和髓鞘均无明显病理改变。脑干组织中的神经轴突和髓鞘在损伤后将发生改变 ,并可用于脑干损伤的死后诊断     

Role of alcoholization in pathogenesis of morphological changes in substance abusers

Morphological manifestations of combined intoxication with ethanol and narcotics are described. Special attention is paid to changes in the liver which were studied both qualitatively and quantitatively. Specific features in the pathological processes concomitant with combined intoxication are described; high incidence and expression of morphological markers of alcoholism in subjects abusing both ethanol and narcotics in comparison with "pure" alcoholics were determined. These features can be used in forensic medical and pathological (autopsy) diagnosis of chronic narcotic intoxication and its combination with alcoholism.     

猫脑震荡与脑损伤的实验性研究

了解轻型颅脑损伤和脑震荡的脑组织病理形态学及生理功能的变化情况。以流体液压冲击法及胶锤打击的方式 ,分别造成闭合性脑外伤及脑震荡的动物模型。结果显示 :较大的钝性外力可造成脑组织明显的病理形态学改变和脑电、心电等生理功能的持续性改变 ,即脑损伤 ;较小的钝力则只能造成动物意识的一过性丧失 ( 3 0min以内 )及脑电、心电的可复性变化 ,脑组织光镜下病理形态学改变不明显。区别脑震荡与轻型脑损伤应以有无明显的病理形态学改变为“界” ,以脑电、心电、意识障碍等改变是否可复为“度”来划分脑震荡与脑损伤     

Comparison between computed tomography (CT) and autopsy findings in cases of abdominal injury and disease

We report 10 autopsy cases involving fatal pathological changes in abdominal organs, for which findings of computed tomography (CT) on admission or after death were compared with autopsy findings. Two of the cases were death due to natural causes and eight were death due to traffic accidents. From the findings at autopsy, the causes of death were considered to be rupture of an aortic aneurysm in one case, gastrointestinal bleeding due to gastric cancer in one case, retroperitoneal bleeding in two cases, laceration of the liver in three cases, and traumatic rupture of the small intestine in three cases. CT findings revealed ascites or retroperitoneal bleeding in eight cases. However, in the cases of small-intestinal rupture, CT findings on admission revealed no free air. Therefore, ascites on CT should be regarded as a useful indicator of blunt abdominal trauma. Hepatic portal venous gas, known to be a post-mortem change, was significantly evident on post-mortem CT in cases of traumatic liver or intestinal injury, and was also seen in cases where the period between the accident and CT examination was long.     

Comparative characteristics of hydration distribution in various structures of the brain in the deceased of a severe cerebrocranial trauma

Hydration in the brain structures was analysed in 34 victims who had died of a severe craniocerebral trauma with pathological processes (hematoma, foci of brain crushing) of different location. Some of the patients had undergone open operations on the brain. Mosaic distribution of water was revealed in various structures of the brain where normohydration and dehydration occurred more often than hyperhydration.     

Histomorphological features of gunshot injuries to the calvarian bone in nephrogenic osteopathy

This histological study of calvarian bones with the injuries inflicted by a shot from an Osa traumatic non-lethal pistol revealed nephrogenic osteopathy in the preceding period. The pathologically altered bone tissue was damaged by a relatively mild tangential traumatic impact. It is concluded that the possibility of such pathological changes should be taken into consideration in the forensic medical expertise of any trauma including gunshot injuries.     

大鼠脑损伤分级自由落体打击模型的建立

目的建立一个控制性与重复性好,并可分级的脑损伤动物模型。方法根据自由落体原理,使击锤从不同的高度下落,造成轻、中、重不同程度的大鼠脑损伤,肉眼、光镜观察损伤的程度。结果肉眼、光镜观察下出现可分级的病理学改变。轻度损伤组病理改变局限于大鼠大脑皮质浅层,中度损伤组病理改变可见于大脑皮质及深部白质内的基底核、海马、胼胝体、丘脑,重度损伤组病理改变除中度损伤累及部位外,还累及脑干。挫伤灶周围神经元变性、坏死范围和程度随损伤程度的加重而增大。各组内每只动物所受损伤程度一致。结论该模型制作出常见的闭合性颅脑加速伤损伤,致伤程度较一致,重复性好,可分级,是脑损伤实验研究较合适的动物模型。     

Virtopsy,a new imaging horizon in forensic pathology: virtual autopsy by postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI)--a feasibility study

Using postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI), 40 forensic cases were examined and findings were verified by subsequent autopsy. Results were classified as follows: (I) cause of death, (II) relevant traumatological and pathological findings, (III) vital reactions, (IV) reconstruction of injuries, (V) visualization. In these 40 forensic cases, 47 partly combined causes of death were diagnosed at autopsy, 26 (55%) causes of death were found independently using only radiological image data. Radiology was superior to autopsy in revealing certain cases of cranial, skeletal, or tissue trauma. Some forensic vital reactions were diagnosed equally well or better using MSCT/MRI. Radiological imaging techniques are particularly beneficial for reconstruction and visualization of forensic cases, including the opportunity to use the data for expert witness reports, teaching, quality control, and telemedical consultation. These preliminary results, based on the concept of "virtopsy," are promising enough to introduce and evaluate these radiological techniques in forensic medicine.     

Weather-induced changes in cannabinoid content of hair

Authentic hair samples from Cannabis users and a drug free hair sample which was separately spiked with tetrahydrocannabinol (THC), cannabidiol (CBD) or cannabinol (CBN) were exposed outside as well as to natural sunlight at prevailing and elevated humidity in quartz glass tubes during 8 weeks. In addition, authentic and spiked hair samples were exposed to xenon arc radiation in a light exposure cabinet for 24 hours. Stability of THC, CBD and CBN in authentic samples differed from that of the spiked hair. The radiation experiment revealed that CBN could not be measured in hair which had been spiked with THC. Under all conditions chosen the concentrations of THC, CBD and CBN decreased. At high humidity the concentrations declined more rapidly. In both authentic and spiked samples THC was most unstable compared to CBD and CBN. Therefore, in hair analysis determination of CBD and CBN seems promising to detect Cannabis exposure even under unfavorable conditions.     

Chemical identification and optimization of the 4-aminophenol colorimetric test for the differentiation between hemp-type and marijuana-type cannabis plant samples

The 4- Aminophenol (4-AP) colorimetric test is a fast, easy-to-use, and cost-effective presumptive assay of cannabis plant material producing different chromophores with THC-rich cannabis (blue color) and with CBD-rich cannabis (pink color). The main drawback of the 4-AP test is a brief observation window where the color rapidly changes to black, limiting the utility of the test. We now report for the first time, the identification of the product chromophores between 4-AP and CBD/THC as well as propose an explanation and a solution for the color degradation of the chromophores. The identification of the chromophores is provided by spectroscopic (UV–Vis), chromatography, and mass spectrometry (TLC and LC-QToF-MS). Oxidation of excess 4-AP (Reagent A) in the presence of NaOH (Reagent B) produces the black color observed for the previously reported 4-AP tests and reported in the literature. The adjustment of reactants concentrations and volumes of 4-AP:THC/CBD to a 1:1 ratio significantly reduces the black oxidation by-product and increases the observation window up to 2 h instead of the previously reported 5–10 min. For the first time, mass spectrometry and chromatography confirmed that the reaction of THC and CBD with 4-AP produced chromophores with m/z (M + H) = 420, consistent with proposed indophenol structures. The TLC method developed confirmed the separation between CBD and THC chromophores. The specificity of the test is also reported, showing false positive results for the presence of THC (blue color) for samples of thyme and oregano. LDA and SIMCA models showed that the optimized 4-AP procedure performs better than the previously reported 4-AP color test.     

Cyberbullying Victimization and Depression in Adolescents: The Mediating Role of Body Image and Cognitive Schemas in a One-year Prospective Study

Cyberbullying, the harassment of others via new technologies, is a growing phenomenon with important consequences for its victims. Despite the growing interest in this new form of violence, only a few longitudinal studies have analyzed the relationship between cyberbullying victimization and psychological problems, such as depression, in adolescents. Furthermore, the mechanisms through which cyberbullying victimization contributes to the development of depressive symptoms remain almost unexplored. The current study assesses whether cyberbullying victimization predicts the increase in depressive symptoms over time and the role of body image and cognitive schemas in the association between cyberbullying victimization and depression. We hypothesized that victims of cyberbullying would develop a negative body image, the belief that others would hurt them and that they were defective to some degree, and that, as a consequence of these cognitions, they would increase their symptoms of depression. A sample of 1015 adolescents (mean age?=?15.43, SD?=?1.09) completed measures of depressive symptoms at three waves (T1, T2, and T3) spaced 6 months apart, measures of body image and cognitive schemas at T1 and T2, and measures of CB victimization at T1. Findings indicated that CB victimization at T1 predicted a worsening of body image and cognitive schemas of mistrust and defectiveness at T2, and those changes in cognitions predicted in turn an increase in depressive symptoms from T2 to T3. Gender differences were also examined. The model was very similar for boys and girls. However, changes in body image acted as a mediator between CB victimization and depression only in girls. Therefore, this study contributes to clarifying the cognitive mechanisms involved in the development of depression among victims of CB. These findings suggest that intervention programs with victims of CB should address the cognitions that are relevant for the development of depression.     

小鼠皮肤切创愈合过程中Ⅱ型大麻素受体的表达

目的观察皮肤切创愈合过程中CB2R表达变化的时问规律性。方法 健康小鼠50只,随机分为10组,建立皮肤切创模型,应用免疫组织化学技术及Westernbloting方法检测切创后不同时间段小鼠背部正中皮肤CB2R的表达。结果免疫组织化学结果显示,对照组CB2R表达于表皮、毛囊、皮脂腺、皮肌层、血管平滑肌、神经纤维外膜及神经纤维束束膜;伤后6h损伤区及周边区多核粒细胞少量表达CB2R,12～24h以单个核细胞阳性表达为主,3d以单个核细胞和梭形成纤维细胞表达为主,5～14d以梭形成纤维细胞为主。CB2R阳性细胞率于0h～3d逐渐升高,5d达最高峰,随后逐渐下降。经Westernblotting检测显示,对照及各个损伤时间段都有CB2R阳性条带,其中5d为CB2R表达高峰。结论小鼠皮肤切创愈合过程中,CB2R于损伤区及周边区多核粒细胞、单个核细胞、梭形成纤维细胞中表达,并具有规律性,提示CB2R可能参与皮肤损伤愈合,并可用于皮肤损伤时间的推断。     

颅脑损伤血浆降钙素基因相关肽含量变化及法医学意义

目的研究颅脑损伤患者血浆中降钙素基因相关肽（CGRP）水平变化,观察其与颅脑损伤之间的关系并探讨其在颅脑损伤中的作用。方法40例脑外伤患者,其中轻中型（GCS评分9～15分）、重型（GCS评分3～8分）各20例。采用酶联免疫法测定患者伤后第1、3、5、7d及25例体检健康的志愿者血浆中CGRP水平。结果颅脑损伤患者与正常对照组比较血浆中CGRP水平明显增高,除轻中度组第7d外,均有显著性差异（P〈0．05）;且重度组在3d内高于轻中度组,有显著性差异（P〈0．05）。结论颅脑损伤者CGRP水平增高,且因病情加重会进一步升高,但随时间的延长有下降趋势。     

颅脑损伤后心内膜下出血的病理及心电图改变

研究颅脑损伤后心内膜下出血的病理改变及其法医学意义。利用68例颅脑损伤的尸检和临床病历资料,以及相应心内膜下出血的心脏标本,以病理组织学方法观察心肌损害,分析心电图异常图形。结果显示：早期主要为左心室内膜下新鲜出血,浅层心肌出血,心肌散在灶状变性、横纹消失等心肌缺血性改变。晚期主要为以多形核白细胞为主的浸润,成纤维细胞增多,早期心肌瘢痕形成等心肌梗死样改变。21倒心电图异常以窦性心动过速和ST-T改变为主,严重的出现心律紊乱和房室传导阻滞。研究颅脑损伤后心内膜下出血的病理改变和心电图异常,在法医学实际检验鉴定和临床救治方面有重要的应用价值。     

Potency of delta 9-THC and other cannabinoids in cannabis in England in 2005: implications for psychoactivity and pharmacology

Gas chromatography was used to study the cannabinoid content ("potency") of illicit cannabis seized by police in England in 2004/5. Of the four hundred and fifty two samples, indoor-grown unpollinated female cannabis ("sinsemilla") was the most frequent form, followed by resin (hashish) and imported outdoor-grown herbal cannabis (marijuana). The content of the psychoactive cannabinoid delta 9-tetrahydrocannabinol (THC) varied widely. The median THC content of herbal cannabis and resin was 2.1% and 3.5%, respectively. The median 13.9% THC content of sinsemilla was significantly higher than that recorded in the UK in 1996/8. In sinsemilla and imported herbal cannabis, the content of the antipsychotic cannabinoid cannabidiol (CBD) was extremely low. In resin, however, the average CBD content exceeded that of THC, and the relative proportions of the two cannabinoids varied widely between samples. The increases in average THC content and relative popularity of sinsemilla cannabis, combined with the absence of the anti-psychotic cannabinoid CBD, suggest that the current trends in cannabis use pose an increasing risk to those users susceptible to the harmful psychological effects associated with high doses of THC.     

钝力性心脏外伤38例尸检病理学研究

本文研究表明钝力作为原始致伤因素作用于胸部通过压、拉、剪切、旋转等可引起钝力性心脏外伤包括心脏震荡、心脏挫裂伤、心脏玻裂、心脏断离等原发性心脏外伤和继发性乃至迟发性心脏外伤，诸如外伤性心脏炎、冠脉血管炎、血栓形成、外伤性心肌梗塞、外伤性冠状动脉瘤、外伤性室壁瘤、迟发性外伤性心脏破裂等。致命性的心脏震荡，除急性冠循环障碍和心失常外，还可有心脏传导系统和神经组织损伤，尤其心肌肌膜爆裂（ｓａｒｃｏｌｅｍｍａｂｕｒｓｔ）及相应的原纤维膨出畸形变可以作为心脏震荡性外伤的形态学指证。外伤性心肌梗塞和迟发性外伤性心脏破裂以突然发生在外伤后的一定间隔期为特征，应予特殊注意．     

Forensic and medical aspects of lethality from thromboembolytic complications of trauma,diseases and certain pathological conditions

A total of 743 lethal outcomes of thromboembolytic complications of trauma, diseases and certain pathological conditions as observed in 1999-2001 and in the three quarters of 2002 were studied. The undertaken analysis confirmed two factors provoking the pathological thrombosis, i.e. 1. Pathological changes observed in the surface vascular wall preconditioned by mechanical damages, atherosclerotic process and aging; and 2. A slower blood flow due to an impaired blood circulation, a forced positioning and to hypodynamics. While deciding on a possibility of a direct cause-effect relation between past traumas, surgeries, poisonings and death of thromboembolism of the pulmonary arteries (TEPA), such relation can be mentioned only on rare occasions. It is more often the case that an indirect, mediated relationship is found, when TERA evolves due to an unfavorable combination of risk factors, i.e. a forced immobility, changing coagulated blood system, impaired blood vessels etc.