热休克蛋白70对大鼠脑干损伤诊断的免疫组织化学研究

为了解脑干在受到创伤后作为降解异常蛋白的分子伴侣（molecularchaperones）之一的热休克蛋白70（heatshockprotein70HSP70）在中枢神经系统的表达情况，用免疫组化法对Wistar大鼠脑干针刺损伤模型的HSP70在损伤前及损伤后1、3、6、12、24小时的中枢神经各区的表达数量、分布变化进行检测。在针刺后1小时脑组织HE染色尚无明显特异性改变的情况下，大脑及小脑内HSP7免疫活性阳性的血管内皮细胞、神经胶质细胞显著增加，在损伤灶局部周围出现HSP7I免疫活性阳性神经元细胞增多，伤后3小时该处HSP7阳性神经元数量显著多于伤前及同一时间点的其它处脑组织，伤后24小时HSP7阳性细胞依然广泛存在。脑干的外伤性损伤可导致脑组织的蛋白质结构发生改变，脑干局部HSP70阳性神经元数量增多可作为脑干损伤定位诊断的依据。     

怀疑原发性脑干损伤早期死亡脑干纤维联结蛋白的免疫组化研究

在本研究的１３个案例中，怀疑原发性脑干伤死亡的５例，明确死因的８例，其中严重闭合性颅脑损伤２例；缢死１例，失血性休克１例，电击２例，海洛因中毒２例。用ＬＳＡＢ法对１３例脑干的中脑、脑桥、延髓各部ＦＮ进行检测。结果显示５例怀疑为原发性脑干伤、２例严重颅脑损伤、２例海洛因中毒死者的脑千部位的神经元内均可见ＦＮ的异常沉积，其它各例未见ＦＮ的异常沉积。结果表明；ＬＳＡＢ－ＦＮ法是诊断原发性脑干伤早期死亡灵敏但非特异的形态学指标。     

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.     

Fatal Penetrating Injuries Sustained by High-pressure Water Jet Unit

The high-pressure water jet unit is a generator of frequent burst of water jets. The water jet reaches very high speeds and is able to cause wounds similar to those of high-velocity projectiles. In the presented case, unusual fatal injuries sustained by water jet are presented. Operating with the unit, an untrained worker accidentally activated a high-pressure water jet unit, and the extremely high pressure of water liberated the jet unit from his hand and whirled it around him. A jet stream of water ran across his body and caused fatal penetrating injuries in the femoral region. The edges of the wound were mainly sharp with contusion rings on the skin beyond the edges. Exploring the inside of the canals during the autopsy, the left femoral artery and vein were found to be completely transected. The resemblance to a firearm entry wound and the severity of the internal injury make it a noteworthy entity.     

43例手舟骨骨折成伤机制的法医学分析

目的分析手舟骨骨折成伤机制的法医学鉴定要点,为法医学鉴定实践提供参考。方法选取2007—2011年在中国刑事警察学院物证鉴定中心鉴定后已结案的手舟骨骨折成伤机制鉴定案件共43例,对手舟骨骨折初诊漏、误诊情况,骨折分型,伴发损伤,成伤机制分歧点等方面进行分析。结果手舟骨骨折初诊漏、误诊率高,以腰部骨折最多见,成伤机制分歧主要集中于系外力直接打击还是倒地摔跌间接作用所致。结论手舟骨骨折多为跌倒时手掌着地致腕关节过度背伸所致。     

Permanent Ocular Injury Following Paintball Pellet Hit: A Medicolegal Case

Paintball is a ubiquitous recreation, with severe and occasionally irreversible injuries. In this study, a rare medicolegal case of paintball‐related closed globe blunt ocular injury was described. An 18‐year‐old boy who was hit in his right eye by a paintball pellet presented with severe eye pain and blurred vision. Ophthalmologic examinations showed lid edema, conjunctival hyperemia, conjunctival laceration, subconjunctival hemorrhage, corneal edema, anterior vitreous hemorrhage, congested sclera, commotio retinae, vitreous hemorrhage, retinal hemorrhage, macular edema, and macular hole. After maximum medical improvement, the patient who sustained incurable maculopathy and decreased visual acuity was referred to the legal medicine center for appraisal of the impairment. AMA Guides was used to assess the impairment of the functional vision. Despite his monocular visual defect, the patient was rated in the range of mild vision loss namely AMA class 1 with 22 percentage visual system impairment.     

Preclinical Assessment of Safety and Efficacy of Fluorescent Dye for Detecting Dermal Injuries (the injuries were both abrasions and incision) in a Murine Model

Objective documentation of tears and abrasions to the external genitalia after sexual assault is an important part of the forensic examination. A 1% aqueous solution of toluidine blue (TB) dye is often used to highlight injury, but the dye can be difficult to see on dark skin. We evaluated a fluorescent dye for detecting injuries on all skin colors in a relevant preclinical murine model. We compared the ability of trained, blinded observers to detect unstained wounds and wounds stained with 1% fluorescein sodium (FL) and with TB. We also evaluated the cutaneous wound healing response after application of both dyes. The no‐dye group had significantly fewer (p < 0.05) true‐positive identifications compared to all the dye groups. No differences in effectiveness were detected between dye treatments. All groups exhibited statistically similar healing rates. These findings support the evaluation of fluorescein sodium in a future clinical study with human subjects.     

Jumping Together: A Fatal Suicide Pact

In suicide pact, two or more victims mutually agree and execute to end their lives together by predetermined method, preferably by hanging, drowning, gunshot, or poisoning. The victims are usually spouses, lovers, or friends, and the reasons behind such steps are various. In this reported suicide pact, husband–wife duo jumped from the terrace of a 12‐meter‐high building with their wrist bound to each other. Although they jumped together, the injury patterns were completely different. The man landed on head sustaining mainly craniocerebral injuries, and the wife landed on feet sustaining long bone injuries. They left a suicide note pointing out sudden demise of their only child as the reason for the suicide, and it was signed by both of them. Jumping from a height in suicide pact has not been reported in the scientific literature yet.