法医学中的性别鉴定

对用形态学、细胞学、性激素检测、 DNA重组技术和聚合酶链式反应（ PCR）等方法进行性别鉴定进行了概述,显示骨骼的性别鉴定以形态学方法为好;对能获得足够量基因组 DNA的人体组织,最好用 PCR检测牙釉基因。而检测性染色质因阳性率较低,检测性激素仅适用于血痕检材, DNA分子杂交技术需要复杂的仪器及放射性同位素标记的探针,这些方法目前已较少应用。     

Cerebral hypoxia and ischemia: the forensic point of view: a review

In cases with suspected brain anoxia/ischemia and hypoxia/hypoxemia a neuropathological investigation should give additional information to elucidate the cause of death and its pathophysiological mechanisms. Primary ischemic brain damage is associated with morphological and biochemical alterations. While acute ischemic neuronal injury reveals axon sparing and selective neuronal lesions due to the release of large quantities of glutamate, late neuronal death is associated with antiapoptotic growth factors, and decreased expression of microtubule-associated proteins and tubulin. On the morphological level ischemia can be detected by necrosis of neurons, proliferation of microglia, and astrocytes in vulnerable regions of the brain. In cases of permanent ischemia the so-called pale nervous cell injury is observed, in cases of partial perfusion the so-called dark nerve cell injury and apoptosis are detectable. In spite of the considerable advantages of recent research, presently there is no reliable qualitative marker to ascertain death due to acute hypoxic or ischemic events.     

Parallels between clinical and morphological characteristics in fetal and newborn asphyxia from the standpoint of forensic medicine

This paper deals with morphological methods for diagnostics of pre-, intra-, and postnatal asphyxia in newborn infants. Parallels between clinical and morphological characteristics in fatal cases resulting from this condition are described. The analysis of the voluminous literature has demonstrated the imperative necessity to broaden the scope of diagnostic morphological and pathomorphological methods for the study of newborn baby corpses in order to elucidate the causes of death or clarify whether a baby was born alive or stillborn.     

Electronic government from the legal point of view: methods

This paper analyses the working methods used by those jurists who are dedicated to the drafting of proposals for Electronic Government. As will be shown by several practical examples, the best method to perform this task—and, in general, to deal with an innovation such as Electronic Government—consists of proposing, to those interested, a detailed and careful research of the legal activities enabling and improving the reality behind this name. This should be considered as the starting point to building up coherent regulation proposals, in compliance with the fact of the Electronic Government and the rules appropriate to a democratic State.     

Earlobe creases and coronary atherosclerosis. The view from forensic pathology

In several clinical studies, the diagonal earlobe crease has been statistically related to the presence of ischemic heart disease. Only one study of a relatively small number of hospitalized patients attempts to relate the earlobe crease with amount of stenotic coronary atherosclerosis demonstrated at necropsy. We examined the relationship between the degree of coronary atherosclerosis and the presence of a diagonal earlobe crease in 800 consecutive autopsies performed for medicolegal reasons and thus including a wide spectrum of subjects. Statistical analysis by the chi 2 test demonstrated a positive correlation (p less than 0.01) between the presence of the diagonal earlobe crease and obstructive coronary atherosclerosis narrowing on at least one major coronary artery greater than 75%. We conclude that the autopsy findings support the clinical observations that the diagonal earlobe crease is a cutaneous sign of obstructive coronary atherosclerosis and that the sign should be used accordingly.     

Insight into stress-induced cardiomyopathy and sudden cardiac death due to stress. A forensic cardio-pathologist point of view

Emotional, physiological and physical stress is associated with increased rates of cerebrovascular events and sudden deaths. The pathophysiology of stress-induced cardiomyopathy is not well understood. Proposed mechanisms for catecholamine-mediated stunning in stress cardiomyopathy include epicardial vasospasm, microvascular dysfunction, hyperdynamic contractility with midventricular or outflow tract obstruction, and direct effects of catecholamines on cardiomyocytes. Studies show evidence of significant heritable influences on individual responses to adrenergic stimulation. Data from such studies may be of help for a more accurate comprehension of clinical and morphological alterations of the heart. Irrespective of the cause, patients with the classic stress-induced cardiomyopathy morphology deserve special attention because this extensive distribution of wall motion abnormalities has implications for potential associated complications. Cardiac response may be significantly coupled to genetic differences at candidate loci that encode components of catecholamine biosynthesis, storage, and metabolic pathway. Given the role of the sympathetic nervous system in responses to acute stress, it is reasonable to explore whether genetically determined alterations in catecholamine system functions contribute to acute and chronic cardiovascular disorders such as stress-induced cardiomyopathy.     

类胰蛋白酶及其法医学应用

类胰蛋白酶由肥大细胞表达,以活性形式储存在肥大细胞的脱颗粒中。作为肥大细胞及其脱颗粒的标志,类胰蛋白酶具有多种生物活性,可以促进气道的恢复,调节气道平滑肌细胞的张力和反应性,提高毛细血管的通透性,刺激新生血管的生成,进而启动和加速多种疾病的进程,并与过敏反应、羊水拴塞、注射海洛因过量、外伤致死及SIDS等有关,因而在法医学中有重要的意义。     

帽状腱膜下血肿法医学鉴定2例

案例资料　案例1 赵某，男，13岁。某医院病历记载：某年8月3日被他人揪住头发厮打，顿感头皮胀痛，继而头部发胀，急去当地诊所就诊，未见明显好转，于8月9日到我院就诊。体检：前额双侧眉弓上缘经耳朵上缘至后枕部，头顶大面积可触及波动感的血肿，深压痛，双侧血肿达后枕部粗隆。CT示：头皮下血肿。根据症状、体征及临床所见，诊断为帽状腱膜下血肿（见图1，2）。入院第二天，经耳朵上缘粗针头穿刺，抽出红色血液约160ml，并加压包扎。8月8日本室对其进行了法医学检查，检见其左额部至左颞顶部可触及15cm×5cm波动感皮下血肿，额部发际下正中至右颞顶部可触及13cm×8.5cm波动感皮下血肿，右颞部可触及9 cm×8 cm皮下血肿。