苏子降气汤辅助治疗慢性阻塞性肺疾病急性加重69例临床观察

目的 观察苏子降气汤辅助治疗慢性阻塞性肺疾病急性加重（acute exacerbation chronic obstructive pulmonary disease,AECOPD）患者的临床疗效。方法 将138例AECOPD患者随机分为试验组和对照组,每组69例。对照组给予西医常规治疗,试验组在西医常规治疗基础上给予苏子降气汤治疗。观察两组治疗前后中医证候评分、肺功能［1秒用力呼气容积（forced expiratory volume in one second,FEV1）,用力肺活量（forced vital capacity,FVC）及FEV1/FVC］、血气分析指标［动脉血氧饱和度（arterial oxygen saturation,SaO2）、动脉血氧分压（arterial PO2,PaO2）、动脉血二氧化碳分压（arterial PCO2,PaCO2）］、血清炎症因子［降钙素原（procalcitonin,PCT）、白细胞介素-38（interleukin,IL-38）及超敏C反应蛋白（hypersensitive C-reactive protein,hs-CRP）］和D-二聚体（D-Dimer,D-D）水平。结果 治疗后两组患者喘息、咳嗽、哮鸣、纳呆、咳痰及胸膈满闷评分均较治疗前显著降低（P＜0.05）;FEV1、FVC及FEV1/FVC均较治疗前显著增加（P＜0.05）;SaO2、PaO2均显著升高（P＜0.05）,PaCO2显著降低（P＜0.05）;PCT、IL-38、hs-CRP、D-D水平均较治疗前显著降低（P＜0.05）。试验组咳嗽、纳呆、咳痰及胸膈满闷评分降低程度均显著大于对照组（P＜0.05）;FEV1、FVC及FEV1/FVC升高程度显著大于对照组（P＜0.05）;PaO2升高程度和PaCO2降低程度显著大于对照组（P＜0.05）;IL-38、hs-CRP水平降低程度均显著大于对照组（P＜0.05）。试验组疗效优于对照组（P＜0.05）。结论 苏子降气汤治疗AECOPD可有效抑制PCT、IL-38、hs-CRP等炎症相关因子生成,降低D-D水平,改善患者肺功能、血气分析指标及中医证候评分。     

血瘀证血细胞参数与血液流变学指标的相关性研究

观察５６例血瘀证患者（血瘀证组）及６０例正常人（对照组）的血细胞参数：平均红细胞体积（ＭＣＶ）、红细胞体积分配宽度（ＲＤＷ－ｃｖ）、平均血小板体积（ＭＰＶ）、血小板体积分配宽度（ＰＤＷ）及全血比粘度（ＢＶ）、红细胞变形能力（ＥＤ）、血小板聚集率（ＰＡＰ）、甲皱微循环速度（ＮＭＳ）。结果血瘀证组显著差异于对照组。相关分析表明：血瘀证组前４项指标与血液流变学呈直线相关性，探讨其内在联系，提示ＭＣＶ、ＲＤＷ－ｃｖ、ＭＰＶ、ＰＤＷ增高是血瘀证形成的红细胞与血小板形态学基础因素。     

87例亲权鉴定案例分析

<正> 1987年5月至1991年3月,我室共接受亲权鉴定案87例,占我室同期总鉴定例数的44%,现将资料整理报告如下。材料与方法一、材料来源87例亲权鉴定案中,62例由湖北、湖南、河南、江西、江苏省各地、县、市及武汉地区司法机关送检,占71.3%,22例为自诉案件,占25.3%,其余3例由主管计划生育部门委托鉴定,占3.4%。     

对冻死尸体血糖变化的研究

用分光光度计对10具冻死尸体、50具非冻死尸体、50名健康体检人的血糖及5只家兔冻死前后的血糖分别进行测定,测得的数据用统计学“方差分析”方法处理,结果为健康人男、女的血糖浓度、健康人与非冻死尸体血糖的浓度差异无显著性;冻死与非冻死血糖的浓度、冻死与健康人血糖的浓度差异有高度显著性;家兔在冻前与冻死后血糖浓度的差异有高度的显著性。结论为冻死尸体血糖明显升高,可以做为法医确定冻死的佐证之一。     

In depth investigation of the capabilities and limitations of combined proteomic-MALDI MS based approach for the forensic detection of blood

For the past 7 years, Matrix Assisted Laser Desorption Ionisation Mass Spectrometry (MALDI MS) based methods have been developed and published for the forensic detection of blood in stains and fingermarks. However, in the view of adoption in an operational context, further investigation into the capabilities and limitations of this approach must be conducted. The refinement and testing of this approach must also be tailored to the requirements of the end users, enabling them to address the specific circumstances most encountered in a forensic scenario. The present study delves deeper into the assessment of the applicability of MALDI MS based strategy for the reliable and robust detection of human blood through: (i) a semi-qualitative assessment of the sensitivity of the method, (ii) a wider investigation of the compatibility of the method with the prior application of commonly used presumptive tests and (iii) assessment of the specificity of the method (when blood is present in mixture with other biofluids) and of its robustness, by assessing blood detection from a range of porous materials. The findings strengthen the evidence supporting the adoption of MALDI MS based approaches as a confirmatory test for the forensic detection of human blood in an operational context.     

Determination of bromadiolone in whole blood by high-performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry

A rapid, sensitive and selective high-performance liquid chromatography tandem mass spectrometric method (HPLC/MS-MS) has been developed and validated for the determination of bromadiolone in whole blood using warfarin as an internal standard (IS). Bromadiolone was extracted from the whole blood samples by liquid-liquid extraction with ethyl acetate. Multiple-reaction monitoring (MRM) was used to detect bromadiolone and IS, using precursor --> product ion combinations at m/z 527 --> 465 and 307 --> 161, respectively. The calibration curve was linear (r2=0.998) in the concentration range of 0.5-100.0 ng/mL with a lower limit of quantification of 0.5 ng/mL in whole blood. Intra- and inter-day relative standard deviations (R.S.D.s) were less than 7.5 and 11.9%, respectively. Recoveries of bromadiolone ranged from 82.1 to 85.2%. This method is found to be determined trace bromadiolone in whole blood and can be used in the diagnosis of the poisoned human beings.     

浅谈命案现场中血迹的法医学意义

命案现场血迹既是痕迹又是物证,血迹的双重特性也充分反映出其在命案现场上的重要地位和作用。作为痕迹,它能充分反映出被害人被害时所处的状态和受伤以后的活动过程以及案犯触及血迹后的活动轨迹;作为物证,血迹是最重要的法医物证,刑事技术部门可以利用血迹的生物学特性,来确定血迹的种属、血型、性别以及DNA同一认定等。因此,研究命案现场中血迹的特点以及血迹的发现和利用具有重要的意义。     

Post-mortem cases involving amphetamine-based drugs in the Netherlands: Comparison with driving under the influence cases

In this study we reviewed the post-mortem cases in the years 1999–2004 that were presented at the Netherlands Forensic Institute. The concentrations of amphetamine-based drugs in femoral blood from cases of suspected unnatural death were compared with concentrations in whole blood from non-fatal cases of driving under the influence (DUI cases) and with literature. Furthermore, the combinations with other drugs and/or alcohol were investigated. Amphetamine-based drugs were present in 70 post-mortem cases and 467 DUI cases. The most detected amphetamine-based drug was MDMA, followed by amphetamine. The presence of MDA could usually be explained by metabolism of MDMA. Methamphetamine and MDEA were rarely present. Frequently, the amphetamine-based drugs were taken in combination with alcohol and/or other non-amphetamine-based drugs such as cocaine or cannabinoids. The 70 post-mortem cases were divided into 38 amphetamine-based drug caused (i.e. the amphetamine-based drug directly caused or contributed to the death) and 32 amphetamine-based drug related deaths (i.e. death was not directly caused by the amphetamine-based drug). In the latter category, other (poly)drug intoxications and death by violence or drowning were the most frequent causes of death.In 30 cases, MDMA caused death directly. The range in blood concentrations of MDMA in these cases was substantial, i.e. 0.41–84 mg/L with a median concentration of 3.7 mg/L (n = 30). MDMA blood concentrations in the MDMA related deaths (n = 20) and in the DUI cases (n = 360) varied up to 3.7 and 4.0 mg/L, respectively. Seven victims died from the direct effects of amphetamine; the blood concentration of amphetamine ranged from 0.24 to 11.3 mg/L, with a median concentration of 1.7 mg/L (n = 7). The median concentrations of amphetamine in the amphetamine related deaths (n = 13) and the DUI cases (n = 208) were much lower, i.e. 0.28 and 0.22 mg/L, respectively. Amphetamine blood concentrations up to 6.0 and 2.3 mg/L were seen in the drug related deaths and DUI cases, respectively. The most frequently encountered amphetamine-based drugs in the investigated deaths were MDMA and amphetamine. The majority of MDMA- and amphetamine-caused deaths, i.e. 90% of these deaths, occurred with blood concentrations above 1.5 and 0.80 mg/L, respectively. MDMA and amphetamine blood concentrations in drug related deaths and DUI cases, however, overlap the range of fatal concentrations. Therefore, MDMA or amphetamine concentrations should never be used alone to establish the cause of death.     

脑创宁对脑组织含水量和血脑屏障通透性影响

目的：考察脑创宁对闭合性脑外伤小鼠脑水肿、血脑屏障通透性的作用。方法：采用自由落体法复制闭合性脑外伤小鼠模型，测定脑组织含水量和伊思蓝含量。结果：脑创宁可明显减轻模型小鼠脑水肿程度，降低伊思蓝含量，保护血脑屏障。结论：脑创宁对闭合性脑外僵小鼠脑组织有一定的保护作用。     

消糖胶囊对2型糖尿病血糖、血脂和血液流变性影响

目的：探讨消糖胶囊（XTC）对2型糖尿病患血糖，血脂和血液流变性等的影响。方法：用XTC治疗3周后采用葡萄糖氧化酶法，酶法及细胞流变仪分别检测血糖，血脂及血液流变性，结果：治疗后其血糖，血脂及血流流变性明显改善（P＜0．05或P＜0．01），结论：XTC对血糖，血脂及血流变性的治疗作用，是改善糖尿病代谢紊乱的重要机制之一。