Interpreting Injury Mechanisms of Blunt Force Trauma from Butterfly Fracture Formation

According to biomechanics of fracture production during blunt impact, tubular bones are subject to compressive (impact site) and tensile (opposite impact site) forces; this causes bones to break in tension before compression, producing Y-shaped fracture patterns with breakaway (butterfly) fragments. In current forensic models, the side of the bone exhibiting the breakaway fragment is designated the impact side, with initial breakage occurring opposite. Fracture production and patterning of blunt impacts to 255 sheep femora were analyzed. Contra the existing model, only 60% of complete butterfly fractures exhibited impact side breakaway fragments. Although fractures initiated on the tension, nonimpact side, butterfly fragments formed on either compression or tension sides. Using newly defined breakaway fragment shape criteria, impact side was estimated with 98% accuracy for both complete and partial butterfly fractures. Furthermore, the results suggest that the impact site is the located on one of the Y-fracture's arms, not the butterfly fragment's center, as previously modeled.     

CDK5的表达与脑损伤时间推断的相关性研究进展

细胞周期蛋白依赖激酶5(cyclin-dependent kinase 5,CDK5)是CDK家族中一类不直接调控细胞周期的蛋白。CDK5通过靶蛋白的磷酸化在神经细胞的发育、修复及退行性变等方面发挥着不可替代的作用。脑损伤是指暴力作用于头部造成的脑组织器质性损伤,由于损伤发生后机体启动应激及修复机制,脑组织中变化的多种蛋白及酶类物质可作为损伤时间判定的指标。本文就CDK5的分布、活性机制、生理作用及其脑损伤研究与其作为脑损伤标志物可能性的研究进展进行综述。     

Introduction: the measures of waves

Abstract

The aftershocks of the spring of 2011 in Japan led the nation into a paralysis of futureshock. But as the aftershocks continued and news of more radiation seeped out of the cracks in the tightly sealed industrial-political power generator, it became clear that the idea that the earthquake has brought a new reality to Japan must itself be resisted. Indeed what is now evident is that little has changed, despite renewed urgency to respond.

Although the waves of disaster in Japan unfolding from 11 March caught everyone off guard, in some significant ways Japan was already prepared. Such preparedness can be read into Japan's long history of dealing with disasters, twenty years of economic stagnation and the growing prevalence of mysticism and eschatology in pop culture in the wake of the Kobe earthquake and Aum Shinrikyō attacks on the Tokyo subway. So, rather than a rupture, an anomalous event, the series of catastrophes of the spring 2011 that appeared as if out of the blue could be narrativized in real time through social media and connected to historical and social contingencies and continuities.

Rather than mourning the passing of some Japan that may never have existed or may already have passed away some time in the early 1990s, 11 March should be the occasion for reflection on the past, action in the present and taking stock for the future. Fighting the tendency to be stunned into complacency, this special issue reflects on the past and future amid the aftershocks radiating from Fukushima and post-earthquake Japan.     

Discrimination of Falls and Blows in Blunt Head Trauma: Assessment of Predictability Through Combined Criteria*

Abstract: The discrimination of falls from homicidal blows in blunt head injuries is a common but difficult problem in both forensic anthropology and pathology. Three criteria have been previously proposed for this distinction: the hat brim line rule, side lateralization of fractures, and number of lacerations. The aim of the present study was to achieve a better distinction rate by combining those criteria and assess the predictability of these combined criteria tools. Over a 6‐year period, a total of 114 cases (92 males and 22 females) were studied: 21 cases of downstairs falls, 29 cases of falls from one’s own height, and 64 cases of head trauma by a blunt weapon. The results revealed predictability rates varying from 62.5 to 83.3% for criteria pointing towards a fall. As for combined criteria in favor of a blow, the assumption was accurate in all cases (100%).     

图片再认ERP在重型颅脑损伤后记忆障碍鉴定的应用

目的探讨图片再认事件相关电位（ERP）对重型颅脑损伤（sTBI）后记忆障碍法医学鉴定的应用价值。方法采用韦氏记忆量表（WMS—RC）和Neuroscan ERP仪,对74例健康志愿者（对照组）及需评定精神伤残等级的29例重型颅脑损伤后记忆障碍者（sTBI组）进行记忆能力和图片再认ERP检测。结果sTBI组WMS-RC各分测验量表分及记忆商数（MQ）均值均明显低于对照组（P〈0．01）;完成ERP任务的反应时、正确率明显延长和降低（P〈0．01）。对照组在靶与非靶刺激呈现后170ms和500ms左右均可记录到潜伏期无显著性差异的二个正向波（P170和P500）,但靶刺激诱发的P500波幅明显高于非靶刺激（P〈0．01）;sTBI组可记录到相似的ERP波形,但各成分的波幅、潜伏期均明显降低和延长（P〈0．01）。sTBI组P500潜伏期与WMS—RC的记图、再认、再生分测验量表分和MQ值均呈高度负相关（r=-0．73～-0．83,P〈0．01）,而与伤残等级呈明显正相关（r=0．65,P〈0．01）。结论图片再认诱发的Psoo潜伏期与WMS-RC反映的短时记忆功能及鉴定的精神伤残等级明显相关,可为sTBI后记忆障碍的伤残鉴定提供一项较客观的神经电生理依据。     

脑损伤患者听觉P300电位特点

目的探讨听觉P300电位对脑损伤患者认知功能障碍程度法医学评价的应用价值。方法对正常人和脑损伤患者,分别在主动（踩踏板）与被动任务状态下进行听觉P300测试。结果正常人主动任务状态P300电位中的N2、P3波波幅较被动状态高,潜伏期无明显延长,N1、P2波幅Cz点高于Pz点。脑损伤组被动任务状态下N2、P3波波幅较正常人被动状态下高．且潜伏期延长。脑损伤组主动任务状态P300电位中的N2、P3波波幅较被动状态高,且潜伏期延长。注意障碍患者P3波潜伏期改变最明显。结论任务类型主要影响N2、P3波幅。被动反应中的N2、P3潜伏期可作为评价脑损伤患者认知功能的指标。     

Caspase3和iNOS在人挫伤脑组织中的时序性表达

目的研究人脑挫伤后不同时间半胱氨酸天冬氨酸蛋白酶3（caspase3）和诱导型一氧化氮合酶（inducible nitric oxide synthase,iNOS）表达的变化,为法医实践中脑损伤时间的推断提供依据。方法选择30例因颅脑损伤死亡案例为损伤组,5例非颅脑损伤急死的案例为对照组,应用免疫组织化学和图像分析技术,分别于死亡后2h、4～8h、10～14h、1～2d、3～5d及8～11d检测脑组织标本中caspase3和iNOS的变化规律。结果经统计学分析：（1）caspase3阳性细胞表达在伤后2h以内组开始升高,与对照组相比差异有统计学意义（P〈0.05）,1～2d组表达强度增高,3～5d组仍见高表达（P〈0.05）,以后逐渐下降。（2）iNOS阳性细胞表达在2h以内组与对照组比较差异无统计学意义（P〉0.05）,伤后4～8h开始升高（P〈0.05）,1～2d组表达强度最高,以后逐渐下降,伤后8～11d仍有弱表达（P〈0.05）。结论caspase3和iNOS的表达可能成为实际检案中脑损伤时间推断的有效依据。     

近视眼底改变与功能相关性的研究及其法医学意义

目的研究近视眼底改变与视觉功能的关系;研究近视者轻度眼部钝挫伤后眼底改变与视觉功能的关系。对象与方法选取不同程度的近视志愿者104人/170眼及眼部轻度钝挫伤的近视者56人/112眼分别作为实验组和眼外伤组,按眼底变化分为0至4级,并测定弧盘比值,分别检测其屈光度、矫正视力及静态视野。结果在实验组和眼外伤组中,眼底改变、包括弧盘比值均与近视屈光程度、矫正视力、静态视野平均缺失敏感度相关。结论运用眼底分级可以估计受检眼的视觉功能,弧盘比值可以作为有效的补充手段;轻度眼部钝挫伤的近视者若仅见视觉功能降低,而未检见明显的眼球结构损伤性改变,则不能简单地按照伤后检见的视觉功能水平作为法医学鉴定的依据。     

Suicide by blasting caps: a case study of rare cranial trauma

Suicide is a deliberate act of ending one's life. Suicide by use of any explosive device, when not involved in a terrorist act, is quite rare in occurrence when compared with other methods routinely utilized. In this paper, we present to the medicolegal community a case of an adult male who committed suicide with blasting caps and the subsequent extensive damage to the cranial hard tissue. Although the cause and manner of death were relatively straightforward, consultation with forensic anthropologists was requested for an anthropological trauma assessment of the highly fragmented skull. After the skull was cleaned and reconstructed, the analysis revealed similarities between blasting cap trauma to the head and high velocity gunshot trauma to the head. Therefore, in a case where some evidence may have been removed or destroyed, forensic analysis involving trauma of this magnitude could result in a misinterpretation of the true mechanism responsible for the osseous damage. In this case, cooperation among the law enforcement agency, coroner's investigators, the forensic pathologist, and forensic anthropologists provided a comprehensive death case analysis.     

道路交通伤患者的智力和记忆研究

目的　研究道路交通伤对患者的智力和记忆的影响。　方法　采用韦氏成人智力量表中国版(WAIS -RC)和韦氏记忆测验量表 (WMS)对 178例患者进行研究。　结果　发现 178例患者的平均智商为71.8± 17.8。言语智商 78.3大于操作智商 67.9(t=13 ,p <0 .0 0 1)。 3 4 .8%的患者智商低于正常 ,4 5 .5 %处于边缘状态。患者的平均记忆商为 5 7.9± 11.7。 5 9.6%的记忆商低于 5 1,84 .3 %的患者记忆商低于正常。　结论　伴有颅脑损伤的道路交通伤患者多有程度不同的智力和记忆损害。