儿童骨骼特征的组织学研究

目的研究儿童骨骼的组织学特征,为儿童骨骼残片的法医学鉴定提供科学依据。方法提取儿童四肢长骨骨片,制作骨骼的组织切片,在显微镜下观察内、外环骨板,骨单位,骨细胞的组织学结构,比较儿童骨骼与动物及成人骨骼的组织学区别。结果儿童骨骼的骨单位形态与成人相似,骨单位间存在大量的内层骨板,与动物的骨组织特征相似。结论根据骨组织学特征,可以确定儿童的骨骼残片。     

大鼠挫伤肺组织中水通道蛋白1表达变化

目的探讨水通道蛋白1（aquaproin 1,AQP1）在大鼠挫伤肺组织中的表达变化及其与肺水肿的关系。方法将SD大鼠随机分为实验组和对照组,制备肺挫伤模型,用免疫组织化学方法检测肺组织中AQP1的分布和表达变化。结果肺挫伤后1和3h肺组织出现水肿、出血,炎性细胞浸润,5h炎性反应进一步加重。AQP1表达在挫伤后1、3和5h均明显高于对照组（P〈0．01）,随着伤后时间延长,水肿加重,AQP1持续上升。正常AQP1主要分布在支气管和肺泡壁的毛细血管内皮细胞及间质细胞,挫伤后肺AQP1的表达部位未发生改变,但积分光密度值（intergrated optical density,IOD）差异有统计学意义（P〈0．01）。结论挫伤肺组织可能存在AQPs的基因表达调控失衡,导致大量水的异常跨膜转运以及在肺组织中的异常聚集,这可能是挫伤肺组织水肿形成原因之一。     

Postmortem Diagnosis of Fatal Hypothermia by Fourier Transform Infrared Spectroscopic Analysis of Edema Fluid in Formalin-Fixed,Paraffin-Embedded Lung Tissues

The goal of this study was to investigate whether pulmonary edema could become a specific diagnostic marker for fatal hypothermia using Fourier transform infrared (FTIR) spectroscopy in combination with chemometrics. The spectral profile analysis indicated that hypothermia fatalities associated with pulmonary edema fluid contained more β-sheet protein conformational structures than the control causes of death, which included sudden cardiac death, brain injury, cerebrovascular disease, mechanical asphyxiation, intoxication, and drowning. Subsequently, the results of principal component analysis (PCA) further revealed that the content of β-sheet protein conformational structures in the pulmonary edema fluid was the main discriminatory marker between fatal hypothermia and the other causes of death. Ultimately, a robust postmortem diagnostic model for fatal hypothermia using a partial least-squares discriminant analysis (PLS-DA) algorithm was constructed. Pulmonary edema fluid spectra collected from eight new forensic autopsy cases that did not participate in the construction of the diagnostic model were predicted using the model. The results showed the causes of death of all these eight cases were correctly classified. In conclusion, this preliminary study demonstrates that FTIR spectroscopy in combination with chemometrics could be a promising approach for the postmortem diagnosis of fatal hypothermia.     

Highly efficient and automated extraction of DNA from human remains using a modified EZ1 protocol

Bones and teeth often represent the only sources of DNA available for identifying human remains. DNA in bones and teeth is generally better preserved than that in soft tissues because of the presence of hard connective tissue with a high level of calcium. Because of the extensive mineralisation, the choice of an efficient DNA extraction procedure is important to minimise the sampling of a high level of minerals and to remove polymerase chain reaction (PCR) inhibitors. Some protocols are available for DNA extraction from bones and teeth as part of the Qiagen EZ1 DNA Investigator Kit using the EZ1 Advanced XL automated purification platform. To improve the efficiency of DNA extraction from skeletal remains, the present study focuses on a modification to these already available protocols. In this study, different bones and teeth collected between 1 and 50 years after death were subjected to DNA extraction using the standard EZ1 protocol, a supplementary protocol, and a modified protocol. The modified approach included a decalcification step, whereas the Qiagen protocols worked directly on non-decalcified powder. In all three procedures, 150 mg samples were used for DNA extraction. We evaluated the quantity of DNA recovered from samples, the presence of any PCR inhibitors co-extracted, the level of DNA degradation, the quality of short tandem repeat (STR) profiles, and the reproducibility of the modified procedure. When compared with the other protocols, the modified protocol resulted in the best recovery of DNA that was free of PCR inhibitors. Additionally, the STR profiles were reliable and of high quality. In our opinion, the decalcification step increases DNA recovery by softening tissues, which allows lysis solutions to act more effectively. Furthermore, the use of two lysis solutions and the variation added to the EZ1 purification step allow for DNA recovery with quality and quantity superior to those of the previously available Qiagen-based protocols. These findings may be helpful solutions to the problems commonly encountered when dealing with difficult samples, such as bones and teeth.

Key points

• Bones and teeth often represent the only sources of DNA for identifying human remains.
• The choice of an efficient DNA extraction procedure is important for maximizing DNA recovery and removing PCR inhibitors.
• This study focuses on modifications to the previously available Qiagen-based protocols.
• The modified protocol enabled the best recovery of DNA, and both quality and quantity were superior to those of the previously available Qiagen-based protocols.
• The STR profiles obtained from samples extracted using the modified protocol were reliable and of high quality.

     

补肾填精法对兔骨折后不同时相骨髓间充质干细胞成骨分化的影响

目的 观察补肾填精中药对兔骨折后不同时点骨髓间充质干细胞(bone marrow mesenchymal stem cells,BMSCs)分化为成骨细胞的影响。方法 将20只白兔随机分成4组,即正常对照组、骨折模型组、中药治疗组、西药治疗组。分离培养骨折端BMSCs,取P3代BMSCs并向成骨细胞诱导分化,分别采用碱性磷酸酶（alkaline phosphatase, ALP）试剂盒、骨钙素（osteocalcin, OCN）试剂盒检测ALP活性、OCN水平。结果 随着用药时间的延长,各骨折组ALP活性和OCN水平均逐渐增强。在骨折后第14、21天,中药治疗组ALP活性、OCN水平均高于其他3组。结论 补肾填精法可促进兔骨折后不同时点BMSCs向成骨细胞分化。     

“矫筋正骨法”针刀治疗膝骨关节炎临床疗效观察

目的 观察“矫筋正骨法”针刀治疗膝骨关节炎（knee osteoarthritis,KOA）的临床疗效和对步态的影响。方法 纳入KOA患者65例,采用随机数字表法随机分为针刀组和对照组。其中针刀组32例,行“矫筋正骨法”针刀治疗;对照组33例,行常规针刺治疗,分别于治疗前后采用视觉模拟量表（visual analogue scale,VAS）评分、美国特种外科医院（Hospital for Special Surgery,HSS）膝关节评分及步态分析的方法进行疗效评估。结果 与治疗前比较,治疗后两组VAS显著降低（P<0.05）,HSS评分中的疼痛、功能、活动度评分和总分均显著升高（P<0.05）,治疗后针刀组屈曲畸形评分也较治疗前显著升高（P<0.05）,治疗后针刀组和对照组步频、步速、步长均显著改善（P<0.05）;与对照组比较,针刀组治疗后VAS显著降低（P<0.05）,HSS评分中疼痛、功能、活动度评分和总分均显著升高（P<0.05）,步频显著改善（P<0.05）;两组患者综合疗效比较,针刀组显著优于对照组（P<0.05）。结论 “矫筋正骨法”针刀可以显著减轻KOA患者的疼痛症状,并且可以使患者的关节功能、活动度以及步频同步得到改善,体现了KOA治疗中“筋骨并重、标本兼治”的思想。     

六味地黄汤通过树突状细胞Notch信号通路调节T细胞分化干预自身免疫性脑脊髓炎

目的 通过观察树突状细胞(dendritic cells,DCs)Notch信号通路对CD4+T细胞分化的影响,探究六味地黄汤干预实验性自身免疫性脑脊髓炎(experimental autoimmune encephalomyeli-tis,EAE)的机制.方法 采用主动免疫法诱导2D2小鼠EAE模型,采用磁珠分选收集...     

生血方拮抗奥沙利铂联合替吉奥方案致晚期胃癌骨髓抑制的临床观察

目的 观察自拟生血方治疗脾肾两虚型晚期胃癌行奥沙利铂联合替吉奥方案化学治疗致骨髓抑制的疗效和安全性。方法 将60例中医辨证为脾肾两虚型晚期胃癌患者随机分成对照组和观察组,每组30例。对照组予以奥沙利铂联合替吉奥方案化学治疗,观察组在对照组基础上加用自拟生血方汤剂口服及粉剂加工后外敷穴位联合治疗。观察两组患者首次骨髓抑制发生时间、骨髓抑制持续时间、0~3周骨髓抑制等级变化,采用卡氏功能状态量表（Karnofskys performance scale,KPS）、中医证候积分评价患者生活质量,观察两组患者的无进展生存期（progression- free survival, PFS）。结果 与对照组比较,观察组患者首次出现白细胞、血红蛋白、血小板下降的时间明显延长（P＜0.05）,白细胞、血红蛋白、血小板抑制持续时间明显缩短（P＜0.05）。两组患者不同时点白细胞、血红蛋白、血小板抑制等级比较,差异有统计学意义（P＜0.05）,两组患者化学治疗第21天与化学治疗第1天白细胞抑制等级变化比较,差异有统计学意义（P＜0.05）。与治疗前比较,对照组患者治疗后KPS评分显著降低（P＜0.05）。两组患者治疗前后KPS评分差值比较,差异有统计学意义（P＜0.05）。与治疗前比较,观察组患者中医证候积分显著下降（P＜0.05）,观察组中医证候积分下降程度明显大于对照组（P＜0.05）。观察组患者PFS为10个月,较对照组PFS（6个月）明显延长。结论 自拟生血方治疗晚期脾肾两虚型胃癌奥沙利铂联合替吉奥方案化学治疗所致骨髓抑制,能延迟首次骨髓抑制发生时间并缩短持续时间,降低白细胞骨髓抑制等级,在一定程度上改善晚期胃癌患者临床症状及生活质量。     

李业甫筋骨并举整脊法治疗颈性眩晕临床疗效观察

目的 观察李业甫筋骨并举整脊法治疗颈性眩晕的临床疗效.方法 将80例颈性眩晕患者按照随机数字表法分为对照组和观察组,每组40例.对照组患者采用常规推拿治疗,观察组患者采用常规推拿结合李业甫筋骨并举整脊法治疗.比较两组患者临床疗效,治疗前后颈性眩晕症状与功能评分、眩晕残障程度评定量表(dizziness handicap inventory,DHI)评分及椎-基底动脉血流速度.结果 两组患者临床疗效比较,差异有统计学意义(P<0.05),观察组的治疗效果优于对照组.两组治疗后颈性眩晕症状与功能评分均显著升高,DHI评分均显著降低(P<0.05),且观察组改善程度显著优于对照组(P<0.05).两组治疗后左侧椎动脉、右侧椎动脉、基底动脉平均血流速度均有所增加(P<0.05),且观察组改善程度优于对照组(P<0.05).结论 李业甫筋骨并举整脊法可以有效调节椎-基底动脉血流速度以减轻患者的眩晕症状.     

新鲜鼻骨骨折CT诊断指标探讨

法医鉴定工作中,需要明确判断鼻骨骨折为新鲜形成,方可作为人体损伤鉴定的依据.通过案例追踪复查与已知陈旧鼻骨骨折对照及临床表现等方法,依据骨折断端锐利、骨折部位粘膜肿胀、软组织内有小片状低密度影等CT影像表现,结合伤后鼻面部肿胀、鼻出血、鼻腔通气不畅等临床表现作为新鲜鼻骨骨折的影像诊断指标.工作中,须重视鼻骨骨折新旧伤的...