轻型颅脑损伤电生理研究及其在临床法医学上的应用

本文对60例轻型颅脑损伤（MHI）患者的ABR、LEDVEP及其中40例BEAM的变化进行了研究。结果表明：ABR异常主要表现为Ⅰ－Ⅲ峰间潜伏期的延长；LEDVEP异常表现为N70潜伏期的延长，并可伴有N70－P100波幅的降低；BEAM异常以α1频带的平均功率增高为特征，且θ／α2功率比的增高可提示幕上损伤的存在。同时，根据电生理追踪检测的结果，首次提出了轻型颅脑损伤脑功能损害程度分级的标准，为此类损伤伤害程度的法医学鉴定提供了客观依据。     

Artifacts Caused by Leaf-Cutting Ants of the Genus Atta (Hymenoptera: Formicidae): Postmortem Bite Injuries and the Tearing of Clothes

Ants are one of the first insects to find an exposed cadaver and can be present during all stages of decomposition. Although these organisms are not commonly used in postmortem interval estimates, they are to be taken into account on criminal investigations involving human corpses, since they can leave bite marks that can be mistaken for antemortem or perimortem injuries, which could be misleading when ascertaining the occurrence of abuse or physical altercation during a crime. A few studies report the action of ants on human cadavers and even though leaf-cutting ants of the genus Atta are frequently encountered in succession studies that use animal carcasses, there are no records of these fungus-growing species on human corpses. Atta is a genus restricted to the New World, ranging from northern Argentina to southern United States and acts as one of the most conspicuous neotropical herbivores. In this study, we report three cases of violent death that illustrate the impact of ants, especially those of the genus Atta, in a forensic setting. We compare the patterns displayed by postmortem bite injuries caused by leaf-cutter ants and other common species with less robust mandibles. We also present the capability of Atta ants to create artifacts by cutting victim’s clothes in a crime scene, contributing to the knowledge of ant-mediated confounding factors in crime scene investigation.     

Homer蛋白的研究进展及法医学应用

Homer蛋白由Homer 1~3基因编码,属于新发现的突触后密度蛋白家族成员,其所有剪切变异体可分为长、短两种亚型,在调控兴奋性突触的结构和功能及细胞内信号转导中发挥关键作用。作为即早基因表达产物的短亚型Homer la,在癫痫、高频刺激及发育过程中可通过海马或皮层神经元的兴奋性突触活动,快速短暂地诱导其表达增加。大鼠弥漫性脑损伤后可诱导大脑皮层神经元Homer la表达动态上调。本文简述其结构、分布、功能、研究进展、存在问题及其在法医学上的应用。     

HSP70表达与脑挫伤经过时间的关系

目的观察大鼠脑挫伤后不同时间内HSP70蛋白表达的变化关系,探讨其与脑损伤时间的关系。方法应用免疫组织化学染色观察自由落体撞击大鼠脑挫伤后HSP70蛋白在伤后不同时间(0.5h、6h、12h、24h、3d、7d、14d、28d)表达情况。结果0.5h伤侧皮质挫伤灶周围HSP70阳性细胞表达开始增强,12h达高峰,24h降至较低,3d又再次升高,以后逐渐下降,28d恢复至正常对照组水平。结论HSP70免疫组化染色可以作为法医学推断早期脑损伤时间的敏感性指标之一;HSP70可作为判断脑损伤是否存在及区分生前和死后脑损伤的重要标志。     

经脉脏腑与脑相关研究是中西医理论结合的突破口

近年来虽然一直在强调中西医结合,如何结合却是困扰广大医务工作者和科研工作者的难题.经脉脏腑与脑相关体现了作为整体的人的功能调控途径.在神经科学高度发展的今天,用医学科学语言阐释传统中国医学,经脉脏腑与脑相关研究无疑将会起到积极的促进作用.经脉脏腑相关不仅是经络理论研究的核心,更可能是中西医理论结合的突破口.     

ApoE的研究进展及其在脑外伤发生中的意义

载脂蛋白E(ApoE)是血浆中主要的载脂蛋白之一,参与机体的脂质代谢及调节胆固醇平衡,其基因多态性与多种疾病相关,在神经系统的正常生长和损伤后的修复过程起重要作用。近来发现其免疫反应性与脑损伤时间有一定规律性,可望将其作为法医检案中判定脑损伤时间的客观指标。     

87例大脑及脑干挫伤HSP70变化的研究

目的探讨人大脑及脑干挫伤后神经细胞HSP70变化与损伤时间的关系及大脑与脑干HSP70变化的差异。方法对87例闭合性颅脑损伤死亡脑挫伤组织进行病理学及HSP70免疫组织化学染色,结果进行图像分析。结果脑挫伤24h后.HSP70阳性神经细胞最多见,且免疫反应性最强,随后逐渐下降,14d组及30d组HSP70表达与对照组类似。脑挫伤部位可见较多HSP70阳性的淀粉样小体。图像分析显示大脑与脑干HSP70阳性细胞3个参数(A、IOD及AOD)之间呈高度显著正相关或显著正相关,由高至低排列为:A>IOD>AOD。结论神经细胞HSP70免疫组化染色结合图像分析技术作为推断脑挫伤经过时间的参考,大脑与脑干挫伤后神经细胞HSP70变化规律基本一致,但脑挫伤灶周围淀粉样小体形成的意义有待于进一步研究。     

85例成人闭合性脑挫伤组织病理学研究

目的研究大脑及脑干脑挫伤后组织病理学变化及与损伤时间的关系,并比较大脑与脑干损伤之间有无差异。方法对85例闭合性颅脑损伤死亡的脑挫伤组织进行病理学GFAP、HSP70、NF200免疫组织化学染色。结果脑损伤早期出现的胞浆嗜酸性肿胀胶质细胞(ECSG)是脑损伤后一种早期应激性反应,挫伤部位淀粉样小体(CA)的增多及噬神经细胞现象也可在脑挫伤后早期形成,而脑干挫伤ECSG发生率高于大脑。中性粒细胞浸润、泡沫细胞及胶质瘢痕形成有一定时序性。结论ECSG在判断生前脑挫伤及推断脑挫伤时间中有重要的参考价值。在ECSG较多的部位,泡沫细胞及CA也较多,三者之间可能存在联系,并提出CA是脑挫伤后反应性产物之一,可用于推断脑损伤时间。     

The Injustice of a Felony Conviction for Offenders Under Age Twenty‐One: A New Option for the Courts to Save Our Youths’ Futures

When the Criminal Justice System adjudicates an individual felony offender, it complicates many aspects of that individual's life; from applying for colleges, and jobs to attempting to become contributing member of society. In New York, to prevent seven‐ to sixteen‐year‐old youth who commit felony offenses from becoming felony offenders, the courts prosecute them as juvenile delinquents or juvenile offenders. In the United States, individuals under the age of twenty‐one cannot purchase alcohol or tobacco and cannot get married without parental consent, but they can be charged with a felony. Before and even after reaching the age of twenty‐one, individuals are still in need of guidance, support, education, employment, and stability as brain development is still ongoing. To help protect those who have not reached the age of twenty‐one, states should implement Senior Youthful Offender Hearings as proposed in this Note. This hearing is a two‐part hearing: (1) determine if an individual should be considered eligible for the protections under the current Youthful Offender Laws and (2) determine sentencing and alternatives to incarceration, focused on steering Senior Youthful Offenders on the right path.