Fatal tolperisone poisoning: autopsy and toxicology findings in three suicide cases

Tolperisone (Mydocalm) is a centrally acting muscle relaxant with few sedative side effects that is used for the treatment of chronic pain conditions. We describe three cases of suicidal tolperisone poisoning in three healthy young subjects in the years 2006, 2008 and 2009. In all cases, macroscopic and microscopic autopsy findings did not reveal the cause of death. Systematic toxicological analysis (STA) including immunological tests, screening for volatile substances and blood, urine and gastric content screening by GC-MS and HPLC-DAD demonstrated the presence of tolperisone in all cases. In addition to tolperisone, only the analgesics paracetamol (acetaminophen), ibuprofen and naproxen could be detected. The blood ethanol concentrations were all lower than 0.10 g/kg. Tolperisone was extracted by liquid-liquid extraction using n-chlorobutane as the extraction solvent. The quantification was performed by GC-NPD analysis of blood, urine and gastric content. Tolperisone concentrations of 7.0 mg/l, 14 mg/l and 19 mg/l were found in the blood of the deceased. In the absence of other autopsy findings, the deaths in these three cases were finally explained as a result of lethal tolperisone ingestion. To the best of our knowledge, these three cases are the first reported cases of suicidal tolperisone poisonings.     

THCVA-A - a new additional marker for illegal cannabis consumption

The aim of the present investigations was to find markers for differentiating between the consumption of illegal cannabis products and legal medication containing fully synthetic Δ9-tetrahydrocannabinol (Δ9-THC), e.g., Marinol capsules. Δ9-Tetrahydrocannabinolic acid A (Δ9-THCA-A) and Δ9-tetrahydrocannabivarinic acid A (Δ9-THCVA-A) were taken into consideration for analysis, because these substances are the precursors of Δ9-THC and Δ9-tetrahydrocannabivarin (Δ9-THCV) in plant material of Cannabis sativa and are not contained in medical THC formulations. Whereas Δ9-THCA-A is an already well investigated substance, there is little analytical data on Δ9-THCVA-A. The reason for the presented investigations was a case in which a man was tested positive for Δ9-THC during a routine traffic control claiming that the positive serum sample resulted from the intake of a THC medication (Marinol) and not from consuming illegal cannabis products. Sample preparation consisted of a protein precipitation with acetonitrile. Analysis was carried out on a Thermo Fisher LCQ Deca ion trap LC-MS-MS-system using electron spray ionization (ESI) in negative mode. MS(2)- and MS(3)-full scan spectra were recorded for Δ9-THCA-A and Δ9-THCVA-A starting from [M-H](-). Reference spectra were obtained by measuring a Δ9-THCA-A reference solution and an ethanolic cannabis extract for Δ9-THCVA-A as there is no reference material for this cannabinoid available on the market yet. Main transitions for Δ9-THCA-A were m/z 357→313 and 339 in the MS(2)-spectrum and m/z 313→245 and 191 in the MS(3)-spectrum. Fragmentation pattern of Δ9-THCVA-A was identical with a difference of 28 amu less for the precursor ion as well as the fragments due to a shorter alkyl side chain in the molecule (MS(2): m/z 329→285 and 311; MS(3): m/z 285→217 and 163). The two plant cannabinoids Δ9-THCA-A and Δ9-THCVA-A could be detected in the serum sample by LC-MS-MS which proved the intake of illegal cannabis products derived from plant material of C. sativa in the described case.     

Ventricular septal necrosis after blunt chest trauma

Ventricular Septal Defect (VSD) after blunt chest trauma is a very rare traumatic affection. We report here a case of blunt chest injury-related VSD and pseudoaneurysm. A 30-year old male truck driver was referred from a trauma center to our hospital seven days after a blunt chest trauma and rib fracture. The patient had severe pulmonary edema and echocardiography showed large VSD. Several mechanisms are involved in the pathogenesis of this affection including an acute compression of the heart muscle between the sternum and the spine, leading to excessive changes in the intrathoracic and most likely the intracardiac pressure after blunt chest injury. Traumatical patients with the same symptoms may be at risk of sudden death. Therefore, a high grade of suspicion is mandatory even without solid evidence of myocardial damage on the initial evaluation. In continue some hidden angles of this case was discussed. Given the prognostic implications of traumatic VSD with associated pseudoaneurysm, its detection has critical value for preventing its clinical sequelae.     

经济繁荣期哈萨克斯坦失业变动特征及原因分析

哈萨克斯坦独立后经济经历了衰退,复苏和繁荣阶段,每个阶段的失业问题对国家的影响不同。在经济繁荣期,哈萨克斯坦的失业人数和失业率持续降低。根据失业率的大小来看,江布尔州和克孜勒奥尔达州是失业现象最为严重的地区,卡拉干达州的失业率在所有地区中始终保持最低水平。根据失业人数的规模大小,哈萨克斯坦可以划分为高失业人群聚居区,低失业人群稳定区和失业人群中等规模区三类地区。从性别来看,哈萨克斯坦女性失业率高于男性,但差距在不断缩小。影响哈萨克斯坦失业水平的因素主要有经济因素、劳动就业制度因素和教育因素。     

衷心祝贺中国人民对外友好协会成立60周年

<正>黎巴嫩中国友好合作联合会("黎中友联")成立于2003年3月3日,汇集了一批黎巴嫩文化、文艺、女性、前外交官、工程师、医生、企业家和律师界精英人士。长期以来,黎中友联受到了历任中国驻黎大使的鼎力支持,成员受邀出席使馆举办的各类活动。双方合作的第一个成果是乔治·哈特姆博     

何为意思表示

本文对德国目前意思表示构成要件理论进行了全面的综述。并在此基础上,抛弃了传统意思表示理论中行为意思、表示意思和效果意思三分的意思表示内部构成要件。分别在能力上的要件、意图上的要件和实质的条件三个方面对意思表示内部构成要件进行了论述。在能力上的要件方面,认为行为意思这个概念并非适当的规范性标准;对于意思表示的归责,重要的并非是否存在行为意思,而是自由形成意思的能力。在意图上的要件方面,认为表示意识并非恰当的术语,沟通意思和参与意思才是意思表示的在意图上的构成要件。在实质的条件方面,认为不应把实质的决定自由一般性地作为意思表示的生效条件。最后认为意思表示应被理解为效力表示,即"应如此发生效力"的表示。     

快速溶剂萃取-气相色谱-质谱联用法分析血液中的农药

目的：建立生物检材血液中农药的快速溶剂萃取（accelerated solvent extraction,ASE）法。方法通过优化ASE萃取条件,考察萃取温度、时间和萃取剂对回收率的影响,提取血液中的农药进行气相色谱-质谱联用（GC/MS）法定性定量分析。结果血液中8种农药的平均回收率在70.6%~92.4%,变异系数小于5.0%,8种农药在0.5~5.0μg/mL的浓度范围内线性良好。结论该方法具有操作简便快捷、回收率高、重现性好等特点,可用于农药的提取检验。