尿中地西泮及其代谢物的气相色谱电子捕获检测法分析

目的　建立尿中地西泮及其代谢物替马西泮、去甲西泮和奥沙西泮的GC/ECD分析方法。方法　尿样经β 葡萄糖醛酸酶水解后 ,用有机溶剂提取 ,再以N ,O 双三甲硅烷基三氟乙酰胺进行衍生化 ,衍生物用GC/ECD法分析。结果　检材中分析物的回收率 70 %以上 ,检出限 5ng/ml以下。结论　本法可进行口服地西泮 10mg人体 48h内尿液中地西泮代谢物的分析。     

用双色荧光原位杂交技术鉴定血痕性别

目的 探讨荧光原位杂交技术在血痕性别鉴定中应用及其价值。方法对20例新鲜人血及20例1-2年人血痕的X、Y染色体采用双色荧光探针进行原位杂交分析。结果 人新鲜血,男性X、Y信号检出的完整率为98.8％,其中Y信号的检出率为100％,女性X、X信号检出的完整率为96.5％;1-2年人血痕,男性X、Y信号检出的完整率为88％,其中Y信号的检出率为90％,女性X、X信号检出的完整率为80％;40例血液(痕)性别检测的符合率为100％。结论双色荧光原位杂交技术可以鉴定血痕性别。     

氟乙酸五氟苄基酯的气相色谱分析

目的 对氟乙酸根阴离子的衍生物-氟乙酸五氟苄基酯(PFB-MFA)进行了气相色谱分析，以满足氟乙酰胺类鼠药化验工作的需要。方法 使用GC／ECD、GC／MS Scan、GC／MS SIM对该化合物的标准溶液进行了分析，得到了各种分析方法的校正曲线及检测限。结果 三种方法测定PFB-MFA的线性范围分别为GC／ECD 0.01～0.1ng／μl、GC／MS SCAN 1～100ng／μl、GC／MS SIM 5×10~(-3)～1ng／μl。三种方法对氟乙酸根阴离子的检测限分别为：GC／ECD1.31×10~(-4)ng／μl、GC／MS SCAN 0.13ng／μl、GC／MS SIM 1.76×10~(-4)ng／μl。结论 氟乙酸根阴离子的衍生物氟乙酸五氟苄基酯在GC／ECD及GC／MS上具有一定的线性范围，有非常高的灵敏度，可用于法庭科学的定性定量分析。     

人脾淋巴细胞核DNA含量及形态学参数的变化规律

目的 探讨人体死亡后脾淋巴细胞核DNA含量及形态学参数的变化规律。方法 选取具有明确死亡时间的人体尸体材料,离体脾脏置于室内(19～24℃),在40h内每3～7h取材1次,做成细胞悬液,经RNA酶水解等处理,PI染色,流式细胞仪测定细胞核中含不完整DNA的细胞数,获得M1值。结果 随着死亡时间的延长,M1值逐渐增大,与死亡时间具有明显的相关性,其相关系数为0.9826。在21h,M1值达21.146％,其后M1值的增大出现加速的趋势,在40h达56.965％,并仍有增大的趋势。结论 人体脾脏淋巴细胞核DNA的降解情况(M1值)与死亡时间具有明显的相关性,延长取材时间,积累标本,建立数据库,将为死亡时间的推断提供较为精确的方法。     

Engagement processes in model programs for community reentry from prison for people with serious mental illness

Linking prisoners with mental illness with treatment following release is critical to preventing recidivism, but little research exists to inform efforts to engage them effectively. This presentation compares the engagement process in two model programs, each representing an evidence-based practice for mental health which has been adapted to the context of prison reentry. One model, Forensic Assertive Community Treatment (FACT), emphasizes a long-term wrap-around approach that seeks to maximize continuity of care by concentrating all services within one interdisciplinary team; the other, Critical Time Intervention (CTI), is a time-limited intervention that promotes linkages to outside services and bolsters natural support systems. To compare engagement practices, we analyze data from two qualitative studies, each conducted in a newly developed treatment program serving prisoners with mental illness being discharged from prisons to urban communities. Findings show that the working relationship in reentry services exhibits unique features and is furthered in both programs by the use of practitioner strategies of engagement, including tangible assistance, methods of interacting with consumers, and encouragement of service use via third parties such as families and parole officers. Nevertheless, each program exhibited distinct cultures and rituals of reentry that were associated with fundamental differences in philosophy and differences in resources available to each program.     

Predictors of length of stay in forensic psychiatry: The influence of perceived risk of violence

This study describes the prevalence of adverse events and length of stay in forensic psychiatric patients with and without a restriction order. Detailed clinical and administrative information from medical records and written court decisions was gathered retrospectively from admission until discharge for a Swedish population-based, consecutive cohort of forensic psychiatric patients (n = 125). The median length of stay for the whole cohort was 951 days, but patients with a restriction order stayed in hospital almost five times as long as patients without. Restriction orders were related to convictions for violent crime, but not for any other differences in demographic or clinical variables. The majority of the patients (60%) were involved in adverse events (violence, threats, substance abuse, or absconding) at some time during their treatment. Patients with restriction orders were overrepresented in violent and threat events. Previous contact with child and adolescence psychiatric services, current violent index crime, psychotic disorders, a history of substance, and absconding during treatment predicted longer length of stay. Being a parent, high current Global Assessment of Functioning scores, and mood disorders were all significantly related to earlier discharge. In a stepwise Cox regression analysis current violent index crime and absconding remained risk factors for a longer hospital stay, while a diagnosis of mood disorder was significantly related to a shorter length of stay.     

浅议医事技术纷争的鉴定

医疗事故技术鉴定被运用于诉讼活动就是司法鉴定,它与法医类司法鉴定,是不同类别的鉴定,适用范围不同。作为《侵权责任法》专列的一类特殊侵权类型,其技术鉴定的名称,以“医疗损害责任技术鉴定,为妥。目前委托医学会进行医疗损害责任技术鉴定具有充分的法律依据。医疗纠纷争议中最为关键的“诊疗行为的过错”及“过错与损害后果之间的因果关系”这两个问题,正是法医病理鉴定、法医临床鉴定所无权涉及的内容。     

小鼠皮肤切创愈合过程中caspase-9、-3表达的研究

目的研究caspase-9、-3在小鼠皮肤切创愈合过程中的表达及其变化规律。方法在小鼠背部正中制作皮肤全层切创模型,应用免疫组化染色技术观察切创及切创周边区内caspase-9、-3的表达情况,以无切创的小鼠皮肤作为对照。结果对照组中caspase-9、-3表达于表皮层,毛囊及皮脂腺。伤后3h损伤区及损伤周边区中可见少量多核粒细胞表达caspase-9、-3,6~24h,部分浸润的多核粒细胞和单核细胞caspase-9、-3阳性,此后caspase-9、-3阳性细胞逐渐以单核细胞和成纤维细胞为主。伤后caspase-9、-3阳性细胞率逐渐升高并在3d达到高峰,此后逐渐下降,至14d最低。结论caspase-9、-3可能引发正常小鼠皮肤表皮、毛囊和皮脂腺细胞的凋亡并参与正常皮肤细胞的自我更新;在小鼠皮肤切创愈合过程中,caspase-9、-3在多核粒细胞、单核细胞及成纤维细胞中表达,其时序性变化规律可望用于皮肤切创损伤时间的判定。     

法医昆虫学的发展与主要成就

本文介绍了国内外法医昆虫学的发展历史和取得的主要成就，并对其今后的发展趋势进行了探讨。