虎地肠溶胶囊对宫颈癌放射治疗致急性肠损伤的防护作用

目的 探讨虎地肠溶胶囊对宫颈癌患者放射性肠损伤的治疗效果。方法 将54例宫颈癌患者随机分成对照组和观察组,每组27例,对照组予以同步放射治疗和化学治疗,观察组在对照组基础上加用虎地肠溶胶囊;观察两组放射性损伤发生的时间、严重程度;放射治疗前后采用磁共振小肠造影（magnetic resonance enterography, MRE）检查肠损伤程度;采用欧洲癌症研究和治疗组织的30条目生活质量问卷（The European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Count 30, EORTC QLQ C30）评估两组患者放射性治疗前后生活质量。结果 观察组放射性肠损伤出现时间较对照组显著延迟（P＜0.05）;两组放射性肠损伤分级比较,差异无统计学意义(P＞0.05);MRE检查结果显示,两组放射治疗后小肠黏膜均明显增厚（P＜0.05）,观察组肠黏膜厚度增加程度显著小于对照组（P＜0.05）。EORTC QLQ C30显示虎地肠溶胶囊能够明显改善放射治疗致急性肠损伤的宫颈癌患者的生活质量。结论 虎地肠溶胶囊可有效延缓宫颈癌患者放射治疗后放射性肠损伤的发生,改善放射治疗后肠壁的水肿状态,提高患者生活质量。     

挤压伤大鼠血清对血管内皮细胞凋亡的作用及机制探讨

目的观察挤压伤大鼠血清对血管内皮细胞凋亡的影响及可能机制。方法培养小牛主动脉内皮细胞,观察挤压伤大鼠血清对培养的血管内皮细胞凋亡及胞内钙浓度的影响,并检测血浆内皮素-1(endothelin-1,ET-1)及心钠素(atrial natriuretic peptide,ANP)的含量。结果与正常大鼠血清相比,挤压伤大鼠血清致细胞的凋亡百分数由(8.26±1.75)%降为(2.75±0.90)%,胞内钙浓度由(96.98±3.95)nmol/L增加到(118.79±3.22)nmol/L,挤压伤大鼠血浆内皮素-1和心钠素含量显著增高。结论肢体挤压伤大鼠血清可抑制血管内皮细胞的凋亡,此效应可能与内皮素-1和心钠素诱发胞内钙浓度增加有关。     

大鼠皮肤切创愈合过程中泛素的表达及其法医学意义

目的观察大鼠皮肤切创后泛素(ubiquitin)表达的变化规律。方法应用免疫组化方法,观察大鼠皮肤切创后1、3、6、12h和1、3、6、10、14d ubiquitin的表达情况,并用图像分析系统进行图像分析。结果正常对照组大鼠皮肤有低水平ubiquitin表达,切创后ubiquitin表达增加,伤后6d达峰值,伤后10d开始下降,伤后14d恢复到正常水平。结论ubiquitin可作为法医学损伤时间推断的有效指标。     

The Role of Forensic Botany in Reconstructing the Dynamics of Trauma from High Falls

The analysis of botanical traces can be supportive, especially when the crime scene investigation and autopsy do not provide sufficient information. This issue arises most commonly in fatal falls from height. We report the case of a man found dead below a hill. The body showed traumatic injuries from a fall. During the scene investigation, a sampling of botanical elements was carried out on three zones of the hill called the point of loss of balance, the point of fall, and the point of impact. The botanical elements collected on the three zones were compared with those found on the victim and an autopsy was performed. The botanical analysis clarified the phases of falling, as well as allowing us to reconstruct the dynamics and the accidental manner of death.     

Severe Cardiac Rupture by Only One Blow to the Chest in a Young Boy: An Autopsy Case

Cardiac rupture by blunt chest trauma is commonly seen after motor vehicle accidents and falls; however, it is rarely caused by a blow to the chest. We herein report an autopsy case of a high school boy who sustained severe right ventricular rupture by only one knee kick to the chest during a quarrel. He was hospitalized and developed cardiopulmonary arrest. Emergency surgery was performed, but the patient died. The autopsy revealed no external severe trauma or deformation, but the side wall of the right ventricle contained a large V‐shaped laceration. The other thoracic organs had no injuries. This case illustrates that severe cardiac rupture can occur by only one blow to the chest. Blunt cardiac injuries can occur even if no severe injuries are present on the body surface. We should consider the possibility of severe cardiac injuries regardless of the presence of external injuries.     

The Reconstruction of the Dynamic of a Murder Using 3D Motion Capture and 3D Model Buildings: The Investigation of a Dubious Forensic Case

Photographic surveying is fundamental to crime scene investigation. It is performed using 2D images; however, this method is limited because it does not offer a detailed view. We present a 3D (three‐dimensional) experimental model that has clarified unsolved aspects of a homicide. A woman was found dead in her home. Considering the large number of injuries on the victim, signs of the use of two weapons, and the absence of traces of the killer/s, several hypotheses about the dynamics and the number of offenders were made. The forensic surveys suggested that a single offender had used two weapons at the same time, but this hypothesis was considered to be impossible by investigators. Our 3D model allowed us to experimentally reproduce the murder and compare various dynamics. The model was used as evidence in Court to prove the hypothesis of a single killer and demonstrate that no other people were involved.     

A Ballistics Examination of Firearm Injuries Involving Breast Implants

This ballistics study examines whether saline breast implants can decrease tissue penetration in firearm injuries. We hypothesize that the fluid column within a saline breast implant can alter bullet velocity and/or bullet pattern of mushrooming. The two experimental groups included saline implants with 7.4 cm projection and a no implant group. The experimental design allowed the bullet to pass‐through an implant and into ballistics gel (n = 10) or into ballistics gel without passage through an implant (n = 11). Shots that passed through an implant had 20.6% decreased penetration distance when compared to shots that did not pass‐through an implant; this difference was statistically significant (31.9 cm vs. 40.2 cm, p < 0.001). Implant group bullets mushroomed prior to gel entry, but the no implant group mushroomed within the gel. Bullet passage through a saline breast implant results in direct bullet velocity reduction and earlier bullet mushrooming; this causes significantly decreased ballistics gel penetration.     

Injuries of the Head from Backface Deformation of Ballistic Protective Helmets Under Ballistic Impact

Modern ballistic helmets defeat penetrating bullets by energy transfer from the projectile to the helmet, producing helmet deformation. This deformation may cause severe injuries without completely perforating the helmet, termed “behind armor blunt trauma” (BABT). As helmets become lighter, the likelihood of larger helmet backface deformation under ballistic impact increases. To characterize the potential for BABT, seven postmortem human head/neck specimens wearing a ballistic protective helmet were exposed to nonperforating impact, using a 9 mm, full metal jacket, 124 grain bullet with velocities of 400–460 m/s. An increasing trend of injury severity was observed, ranging from simple linear fractures to combinations of linear and depressed fractures. Overall, the ability to identify skull fractures resulting from BABT can be used in forensic investigations. Our results demonstrate a high risk of skull fracture due to BABT and necessitate the prevention of BABT as a design factor in future generations of protective gear.     

A Biomechanical Evaluation of Skull–Brain Surrogates to Blunt High‐Rate Impacts to Postmortem Human Subjects

The field of forensic injury biomechanics is an emerging field. Biomechanically validated tools may assist interdisciplinary teams of investigators in assessing mechanisms of blunt head trauma resulting in skull fractures. The objective of this study is to assess the biofidelity of spherical, frangible skull–brain (SB) surrogates. Blunt impacts were conducted at 20 m/s, using an instrumented 103 g rigid impactor, to the temporo‐parietal region of four defleshed cephalic postmortem human subjects (PMHS). Force–deformation response, fracture tolerance, and fracture patterns were recorded for comparison to spherical skull–brain surrogates. Three brain substitutes were assessed: 10% gelatin, lead shot with Styrofoam and water. Force–deformation response of the skull–brain surrogates was similar to defleshed PMHS up to the point of fracture; however, none of the surrogates fractured at tolerance levels comparable to the PMHS. Fracture patterns of the skull–brain surrogates were linear and radiating, while PMHS fractures were all depressed, comminuted.     

Chemical Analysis in the Corpus Callosum Following Traumatic Axonal Injury using Fourier Transform Infrared Microspectroscopy: A Pilot Study

Evaluating traumatic axonal injury remains challenging in clinical and forensic sciences as its identification is difficult using routine diagnostic methods. This study used Fourier transform infrared microspectroscopy to detect TAI within the corpus callosum in an animal model. Protein conformational analysis revealed significantly increased β-sheet and β-turn contents paralleled by a decrease in α-helix content at 24 h postinjury, while the antiparallel β-sheet content was decreased at 12 h postinjury. Compared with the control group, the lipid/protein ratio was significantly reduced in all of the injured groups. At 24 h postinjury, there were increases in the olefinic=CH and CH₃ group of lipids accompanied by the decreased CH₂ group, but the results at 12 and 72 h were contrary to that at 24 h. Our study showed that FTIRM could differentiate injured from normal white matter at different time points following TBI via examination of these infrared spectral parameters.