法医毒理学的结果解释（下）

法医毒理学的主要任务是从生物检材中分析毒（药）物,并且推断毒（药）物浓度对死亡或行为能力的作用程度,结果解释是法医毒理学的最终目的。现代法医毒理学主要包括死后法医毒理学、滥用药物筛查和行为能力影响三个方面,由此探讨在进行结果解释时的诸多影响因素。进行法医毒理学的结果解释时应非常慎重,充分了解案情和调查结果,全面考虑毒（药）物的毒性、生物检材、药代动力学、体内再分布、药物交叉反应等多种因素,才能对案件作出较为准确的结果解释。     

新型毒品的犯罪模式

本文运用犯罪学的基础理论,全面分析了新型毒品的犯罪行为模式、犯罪学定性和犯罪行为发展趋势,区分了其与传统毒品犯罪的异同,揭示了其对禁毒工作形成的新挑战。     

Trends and pattern of drug abuse deaths in Maryland teenagers

The Office of the Chief Medical Examiner of Maryland recorded a total of 149 drug abuse deaths of teenagers aged 13-19 years between 1991 and 2006. Of these deaths, 96 (64.4%) were caused by the use of narcotic drugs only, 29 (19.5%) by both narcotics and cocaine, four (2.7%) by both narcotics and methylenedioxymethamphetamine, six (4.0%) by cocaine only, and 14 (9.4%) by volatile substances (e.g., butane, Freon, nitrous oxide, and propane). The annual death rate from drug abuse for teenagers increased from 1.4 deaths per 100,000 population in 1991 to 2.7 deaths per 100,000 population in 2006 (chi-square test for time trend, p<0.01). The increase in teenager drug abuse deaths occurred in 1999 and since has remained at a higher rate. Further analysis revealed that the increase in drug abuse deaths was attributable to a large degree to narcotic drugs, particularly heroin/morphine and methadone, and was confined to teenagers residing in the suburban and rural areas.     

Phencyclidine: a 5-year retrospective review from the New York City Medical Examiner's Office

We report here a 5-year retrospective review of autopsy cases from the New York City Medical Examiner's Office that demonstrated phencyclidine (PCP) in the blood. There were a total of 138 cases. There were 52 deaths because of mixed drug intoxication: the blood PCP concentrations in these cases ranged from <1 to 598 ng/mL. There were 80 violent deaths in which PCP was quantified in the blood but was unrelated to the cause of death. There were five nonviolent deaths in which PCP exclusively was detected. In four of these, there were preexisting medical conditions that could also have contributed to death. In these, the highest PCP concentration was 361.3 ng/mL, a concentration lower than seven of the individuals in our violent death category. This suggests that lower concentrations may be fatal with comorbid conditions.     

新型毒品2C-B的研究进展

2C-B是一种新型的毒品,它具有兴奋和致幻的双重精神作用。作为滥用品始于上世纪80年代的欧美地区,近年来,在一些亚洲国家和地区包括我国开始出现其滥用的情况,并有逐渐增多的趋势。本文就2C-B的合成方法、药毒理作用、代谢等方面进行综述。     

Psychosocial Complications of Crohn's Disease and Cause of Death

Patients who suffer from Crohn's disease are prone not only to the complications of a relapsing, unpredictable disease, but also to feelings of stigmatization; depression; and increased risk of suicidal ideation, suicide, or drug and alcohol abuse. Cases performed at the Jackson County Medical Examiner's Office from 2008 to 2010 were reviewed. Autopsy findings, investigator reports, toxicology results, medical records, and interviews with survivors were analyzed. Twelve cases of Crohn's disease were recovered. In 10 of these cases, inflammatory bowel disease was not the cause of death. Instead, psychosocial consequences of the disease had significant implications in the deaths. The mean age of decedents was 45 years, with a female predominance. In eight cases, the decedents lived alone. Five patients had issues of acute or chronic drug or alcohol use. Five patients committed suicide. These cases underscore the role of psychosocial factors that can contribute significantly to the cause of death in patients with Crohn's disease.     

Phenibut screening and quantification with liquid chromatography–tandem mass spectrometry and its application to driving cases

An analytical strategy for identification by an LC–MS/MS multitarget screening method and a suitable LC–MS/MS based quantification were developed for the psychotropic drug phenibut. The samples analyzed were collected during traffic control and were associated with driving under the influence of drugs. A positive sample for phenibut was identified in a single case of driving under the influence. The quantification revealed a drug concentration of 1.9 μg/mL. An interaction with blood alcohol (BAC = 0.10%) was discussed as the explanation of the way of driving and deficit manifestations observed (swaying, nystagmus, quivering of the eyelid, and reddened eyes). According to the available information, the quantified phenibut concentration could be explained by an intake of four tablets (self-reported) during the day containing 250 mg of the drug. Chromatography was performed with a Luna 5 μm C18 (2) 100 A, 150 mm × 2 mm analytical column, and a buffer system consisted of 10 mM ammonium acetate and 0.1% acetic acid (v/v) included in mobile phases marked as A (H₂O/methanol = 95/5, v/v) and B (H₂O/methanol = 3/97, v/v). An effective limit of detection (LOD = 0.002 μg/mL) could be achieved for the multitarget screening method. The quantification of phenibut was performed on a second LC–MS/MS system with LOD/LOQ values of 0.22/0.40 μg/mL. Since phenibut quantification data are rare, the presented information can be used with caution for evaluation of positive cases in the future.     

Exploration of the Concept and Path of Chinese Mutual Aid Therapeutic Community from View of the Social Rehabilitation

The experiment on the drug rehabilitation community in China started at the end of 20th century from the transplantation of the US “Daytop Mode” in Yunnan Province. With the increasingly relapse rate of drug users and the deepen development of government purchases services, many places like Shenzhen have put forward the concept of “No-drug Community”, aiming to explore the indigenous experience on community treatment. After reviewing the history of community drug control work, taking Shenzhen as an example, this paper explores the concept and path of the Chinese Mutual Aid Therapeutic Community from the view of social rehabilitation. It finds that external supporting system needs to be constructed during the course of rehabilitation. Meanwhile, by stimulating the changing motivation, strengthening cognition behaviors, rebuilding supportive family relationship on the individual level, as well as providing the support from peers, colleagues, and self-organization and positive culture on the environmental level, social workers can help drug users from exclusion to rehabilitation.     

毒品走私案件取证中存在的问题及对策

在对毒品走私案件的现场勘查取证和侦办中,存在的一些问题,直接导致了该案件被退回补充侦查或未被批准逮捕,甚至检察院不起诉或法院不予认定的情况,降低了案件承办部门的办案效率,增大了侦查资源的投入,进而影响对毒品走私犯罪的打击力度。本文对毒品走私犯罪案件取证中存在的问题进行探讨,并从办案实际出发提出相应对策,以期在打击毒品走私犯罪的取证工作中起到一定的借鉴作用。