颈椎损伤的伤残等级及“三期”法医学评定——附64例分析

目的探讨交通事故致颈椎损伤后伤残等级和休息、护理、营养时限的法医学鉴定,以及颈部损伤、原有疾患与后遗症之间因果关系法医学鉴定的原则与方法。方法收集64例颈椎损伤的伤残等级鉴定案例,对相关资料/数据进行统计分析。收集交警部门反馈的涉及伤病关系案件的处理结果,了解案件双方当事人对鉴定结论的认可程度。结果随着对颈椎损伤后伤残评定案件中原发病的认识逐渐增加,相应颈椎损伤涉及伤病关系鉴定的案件也日益增多;在受理的颈椎损伤伤病关系案件中,均按照伤病关系理论进行鉴定,案件处理机关（交通警察）以及双方当事人对鉴定结论均表示满意。结论对于各种颈椎损伤进行伤残等级和“三期”鉴定的案例,由于损伤机制不同,自身原有颈椎健康程度不同,所造成的后果也不尽相同,鉴定中应考虑原有疾病对伤残等级的影响。     

论大学生精神疾病干预对策

大学生精神疾病已经成为引发校园恶性事件的重要原因,重视学生精神卫生、有效应对精神疾病,成为高校教育、管理工作尤其是危机预防与干预工作的重要内容。文章透过大学生中常见的、容易引发恶性事件的三类精神疾病,分析了其引发恶性事件的可能性,提出了相应的应对干预原则和策略。     

An Analysis of Possible Mechanisms of Unexpected Death Occurring in Hydatid Disease (Echinococcosis)

Abstract:  Most cases of hydatid disease in human populations are due to Echinococcus granulosus. The hydatid life cycle involves passage between definitive hosts such as dogs and intermediate hosts such as sheep. Humans become accidental intermediate hosts following ingestion of food or water contaminated with eggs or by contact with infected dogs. Although hydatid disease may remain asymptomatic, occasional cases of sudden and unexpected death present to autopsy. Causes of rapid clinical decline involve a wide range of mechanisms including anaphylaxis (with or without cyst rupture), cardiac outflow obstruction or conduction tract disturbance, pulmonary and cerebral embolism, pericarditis, cardiac tamponade, myocardial ischemia, pulmonary hypertension, peritonitis, hollow organ perforation, intracerebral mass effect, obstructive hydrocephalus, seizures, cerebral ischemia/infarction, and pregnancy complications. The autopsy assessment of cases therefore requires careful examination of all organ systems for characteristic cystic lesions, as multiorgan involvement is common, with integration of findings so that possible mechanisms of death can be determined. Measurement of serum tryptase and specific IgE levels should be undertaken for possible anaphylaxis.     

Identification of Prostate-Specific Antigen and Spermatozoa from a Mixture of Semen and Simulated Gastric Juice

Abstract:  The detection of prostate-specific antigen (PSA) and visualization of spermatozoa from forensic-type samples containing semen exposed to simulated gastric juice was investigated as a support for forensic practice. Samples of simulated gastric juice mixed with semen were prepared and incubated for up to 4 h at 37°C. Samples were deposited on cotton cloth and on ceramic plates and allowed to dry. The samples were examined for the presence of PSA using the Seratec^® PSA Semiquant immunochromatographic membrane test. Microscope slides were prepared, stained, and analyzed for spermatozoa. Spermatozoa were detected in all samples, and PSA was detected on neat samples and on samples from the ceramic plate after incubation for up to 4 h. PSA was not detected in the samples deposited on cotton cloth at incubation times greater than 15 min. This may serve as a support for examinations performed when vomit or vomit-stained evidence is submitted for analysis.     

Burden of Neurodegenerative Diseases in a Cohort of Medical Examiner Subjects*

Abstract: Here we report studies of the burden of neurodegenerative neuropathologies in a cohort of Medical Examiner (ME) subjects from the County of Santa Clara (California) to determine if this unique population of decedents manifested evidence of neurodegeneration that might underlie causes of death seen in an ME practice. We found that 13% of the brains from ME cases showed significant tau pathology, including 55% of those 65 years old and older and 63% of those 70 years old and older. The histochemical and immunohistochemical findings were consistent with Alzheimer’s disease (AD) in 7 subjects and frontotemporal lobar degeneration (FTLD) tauopathy type in six cases. There were no cases of Parkinson’s disease, dementia with Lewy Bodies or other neurodegenerative conditions. Our study suggests that decedents >65 years of age in an ME practice are afflicted by common causes of dementia such as AD and FTLD which could contribute wholly or in part to their causes of death.     

在“非典”防治中国际传染病监控体系的缺陷与改进

"非典"的全球蔓延使一些外国和国际组织的公共健康官员批评中国政府在应对"非典"爆发上的保密性作法与不合作姿态,这就提出了我国政府的作为(或不作为)是否要承担国家责任的问题.实际上,现行国际传染病监控体系的内在缺陷是引起国际社会与我国政府上述争端的深层原因.文章拟就国际传染病监控体系的缺陷作以简要论述,并就改进措施提出一些建议.     

Adult Hirschsprung's disease diagnosed during forensic autopsy

We report a case of fatal Hirschsprung's disease (HD) discovered at autopsy. A 20-year-old man collapsed at home. Emergency medical personnel found him in cardiac arrest and all resuscitative efforts failed. He had a past history of chronic constipation since infancy. Forensic autopsy revealed a megacolon full of gas and stools. Microscopic examination showed absence of ganglion cells in a short segment of the rectum and enterocolitis in the left and transverse colon. HD is rarely described in adults. In many cases, patients complained of constipation since infancy but the affection remained misdiagnosed. The relative good tolerance of the disease is usually due to a short aganglionic bowel segment. Enterocolitis is a frequent and severe complication of HD in children but is rarely described in adults. This case suggests the importance of HD diagnosis in childhood in order to avoid fatal complications with forensic consequences.     

杆状病毒表达的猪传染性胃肠炎病毒钉状糖蛋白在其血清学诊断上的应用

利用从猪传染性胃肠炎病毒（ＴＧＥＶ）Ｍｉｌｅｒ株（Ｍ５Ｃ）克隆建立的一株重组杆状病毒（Ｒ２－２）表达的重组ＴＧＥＶ钉状糖蛋白（Ｓ），建立了一种阻断酶联免疫吸附试验（ＥＬＩＳＡ）来检测猪群抗ＴＧＥＶ抗体。试验表明，用重组病毒Ｒ２－２接种ｓｆ９细胞（ｓｐｏｄｏｐｔｅｒａｆｒｕｇｉｐｅｒｄａ）所表达的重组蛋白量在接种后第７２ｈ达到最高值；该重组蛋白能与抗ＴＧＥＶＳ蛋白Ａ位点的单克隆抗体特异性结合。用阻断ＥＬＩＳＡ检测６８份来自无ＴＧＥＶ感染或ＴＧＥＶ（Ｐｕｒｄｕｅｌ５）免疫的仔猪或母猪血清，结果与ＴＧＥＶ蚀斑减数试验完全相符，灵敏度和特异性均为１００％。同时检测来自ＴＧＥＶ试验免疫猪、美国部分地区猪群、我国进口猪以及我国国内猪群血清６２７份，阳性检出率分别为８２．６１％、６１．６２％、５８．３３％和２９．１０％；用中和试验（微量中和试验或病毒蚀斑减数试验）检测的ＴＧＥ血清抗体阳性率分别为８０．８７％、５９．６０％、５６．１１％和３０．６０％，两种方法对抗ＴＧＥＶ抗体的检出率没有显著差异。     

分泌抗人类血型-H抗原单克隆抗体杂交瘤细胞株建立及初步应用

应用杂交瘤技术,建立了两株分泌抗 H 的单克隆抗体细胞株 H_(2-6)H_8和 B_(2-5)D_9。经体外培养半年以上,生物学性状稳定。两株细胞分泌的抗体属 IgM 类,特异性识别 H 型物质,与几种常见动物的红细胞无交叉反应。培养上清液和腹水的抗体效价最高分别达1024倍和1.28×10~5倍,可用在中和试验、免疫斑点法中,在实际办案中应用理想。     

舒心益脉胶囊对冠状动脉病变的影响及临床观察

目的：观察舒心益脉胶囊对冠状动脉病变的影响及临床疗效。方法：86例冠病患，随机分为舒心益脉胶囊组（治疗组）46例，地奥心血录组（对照组）40例，平均治疗14个月后重复冠状动脉造影，采用计算机定量测定系统评价冠状动脉病变狭窄程度的变化，同时随访患听临床情况。结果：治疗组用药后冠状动脉病变的进展、再狭窄及不稳定性心绞痛的发生率均明显低于对照组（P＜0．05），而病变的减轻、稳定有病情的稳定均明显于对照组（P＜0．05）。治疗组、对照组总有效率分别为84．5％、60．0％（P＜0．05）。结论：长期服用舒心益脉胶囊显降低冠状动脉病变进展，并显减少心脏事件和不稳定性心绞痛发生，明显改善临床症状。