Determined to Die! Ability to Act Following Multiple Self‐inflicted Gunshot Wounds to the Head. The Cook County Office of Medical Examiner Experience (2005–2012) and Review of Literature

Cases of multiple (considered 2+) self‐inflicted gunshot wounds are a rarity and require careful examination of the scene of occurrence; thorough consideration of the decedent's psychiatric, medical, and social histories; and accurate postmortem documentation of the gunshot wounds. We present a series of four cases of multiple self‐inflicted gunshot wounds to the head from the Cook County Medical Examiner's Office between 2005 and 2012 including the first case report of suicide involving eight gunshot wounds to the head. In addition, a review of the literature concerning multiple self‐inflicted gunshot wounds to the head is performed. The majority of reported cases document two gunshot entrance wound defects. Temporal regions are the most common affected regions (especially the right and left temples). Determining the capability to act following a gunshot wound to the head is necessary in crime scene reconstruction and in differentiation between homicide and suicide.     

Relative Expression of Indicators for Wound Age Estimation in Forensic Pathology

Objective In order to understand which kind of function genes play an important role for estimating wound age, the variation of difference genes' mRNA expression were compared after injury.Methods The mRNA expression levels of seven candidate genes(ICAM-1, NF-κB, MX2, MT1, MT2,s TnI, and Cox6c) were analyzed in contused rat skeletal muscle at different time points using real-time fluorescent quantitative PCR(RT-qP CR). The raw Ct values were normalized relative to that of RPL32 mRNA, and converted to standard Ct values. At each time point after injury, the standard deviations(SD) of the standard Ct values were calculated by SPSS. Results The expression trends of the seven genes were all found to be related to wound age, but there were lower variation coefficients and greater reliability of s TnI and Cox6c when compared with other genes. Conclusion The genes encoding structural proteins or proteins that perform basic functions can be suitable for wound age estimation.     

大鼠双后肢挤压伤后肺、肝细胞的凋亡

目的研究大鼠双后肢挤压伤后肺、肝细胞的凋亡过程,探讨挤压伤损伤机制。方法建立大鼠双后肢挤压伤模型,采用TUNEL法对大鼠肺、肝细胞凋亡进行检测,免疫组织化学法检测凋亡相关蛋白Bax、Bcl-2、caspase-3的表达。结果与对照组相比,损伤组大鼠双后肢局部肌肉组织明显损伤,肺、肝细胞凋亡明显增多(P0.05),凋亡相关蛋白Bax上调、Bcl-2下调、caspase-3被激活(P0.05)。结论大鼠双后肢挤压伤后引起肺、肝细胞凋亡明显增多,可能是损伤释放的相关因子介导了细胞凋亡的发生。     

上海市道路交通事故受伤人员伤残分析

目的分析道路交通事故伤残的特征,为制定和修改伤残鉴定标准和相关法规提供参考。方法对上海市因道路交通事故受伤,2005年经法医评定构成伤残的案例资料进行回顾性分析。结果伤残部位以肢体最多（53.3%）,其次为头部（23.3%）,脊柱（9.7%）,胸部（5.8%）和腹部（4.4%）。2005年上海市交通事故年累积致残率为414.8/10万,男性（505.7/10万）高于女性（318.7/10万）,以35～59岁的致残率最高（538.2/10万）,60岁以上致残率呈现下降趋势（30.2/10万）。伤残者中交通方式以非机动车最多,其次为行人。结论2005年上海市道路交通伤致残率青壮年（35～59岁）最高,对社会经济和劳动力损失大。     

大鼠皮肤损伤纤维蛋白形成能力荧光法定量研究

本文报告采用荧光分光光度法检测损伤皮肤纤维蛋白形成能力,以探讨生前伤与死后伤的区别及不同存活时间的生前损伤之间的关系。实验结果证明,生前1min至3h的损伤皮肤纤维蛋白形成能力逐渐升高,生前30min损伤与死后伤的形成能力相比有显著差异,形成能力的检出率与死后放置时间长短和温度有关,而与该部位有无尸斑无关。     

Advantage of affinity histochemistry combined with histology to investigate death causes: indications from sample cases

Mast cell histochemistry has been proposed in addition to classic histological methods to estimate the course of traumatic events before and after death. We have addressed the utility of this approach on nine victims of different types of trauma. Sections of wounded skin were stained with hematoxylin and eosin and with fluorescent avidin to tag mast cells. Mast cell numbers were evaluated by both direct and digitalized counts. Intact skin was used as control. The results on mast cells implemented the findings upon hematoxylin and eosin stain and helped to put the wounds and death in chronological sequence. Digitalized morphometry allowed to reduce intra- and inter-observer variation. We conclude that combined histological and histochemical analyses can be of practical use in forensic pathology, that a preliminary setting of the reference values is needed for each laboratory, and that image analysis can be of help for the quantification of the results.     

对纤维蛋白诊断生前伤的评价——45例枪弹创组织的MSB染色和扫描电镜对比观察

生活反应是诊断生前伤的主要根据.近二十年来,法医病理学在研究生前伤和死后伤的诊断中,采用了多种新兴技术,如扫描电镜技术、酶组织化学技术、酶标技术、电泳技术等,促使生前伤的诊断水平有明显提高.伤后存活1小时死亡者,大部分皆可获得明确诊断;立即死亡或在濒死期形成的损伤,由于生活反应甚微,或受腐败等     

Sharp Force Injury Fatalities: A Retrospective Study (1982–2012) in Brescia (Italy)

A retrospective study was carried out on postmortem examination data of 131 sharp force‐related casualties recorded by the Brescia Institute of Forensic Medicine between 1982 and 2012. The objective was to identify relevant parameters that may be used to distinguish the manner of deaths between homicide, suicide, and accident. The following variables were considered: manner of death; demographic data; scene; type of sharp object; location and numbers of wounds; the presence of hesitation marks/defense wounds; toxicological findings; psychiatric history. There were 92 homicides, 28 suicides, and 11 accidents. Most victims were male, with an average age of 43. Injuries in isolation were present in 9.8% of homicides, in 35.7% of suicides, and in 54.5% of accidents. Most injuries involved the left anterior chest in homicides and the forearms in suicides. This study underlines the importance of a meticulous postmortem examination of injuries on the body and their relationship with other results from the death scene investigation.     

A Molecular Method to Correlate Bloodstains with Wound Site for Crime Scene Reconstruction

Bloodstain pattern analysis to determine the wound‐of‐origin of bloodstains is problematic with nonspecific patterns. In this proof‐of‐concept study, the authors examined a molecular approach to correlate bloodstains with injuries using the rat as a model. Specifically, investigations were conducted on the rat brain marker, rno‐miR‐124‐3p, with the QIAGEN miScript System and real‐time PCR analysis. Rno‐miR‐124‐3p was detected in brain homogenates diluted 100,000 times; in 3‐week‐old, room temperature stored, simulated brain–blood stains; and in bloodstains from head gunshot wounds collected with swabs and subsequently frozen for 9–18 months; however, rno‐miR‐124‐3p was not detected in whole blood. Proof‐of‐principle was demonstrated by the ability to distinguish bloodstains from a gunshot wound to the head versus bloodstains from a gunshot wound to the chest, by the testing of otherwise identical bloodstains from the two patterns for the presence of the marker. The results suggest a viable approach to a longstanding problem in casework.     

大鼠骨骼肌损伤后PMN、MNC及FBC百分率与损伤时间关系

目的：研究大鼠骨骼肌机械性损伤后不同时间点多形核白细胞（polymorphonuclear leucocytes , PMN）、单个核细胞（mononuclear cells,MNC）及成纤维样细胞（fibroblastic cells,FBC）百分率的变化。方法建立大鼠骨骼肌机械性损伤动物模型,随机分为伤后6h、12h、1d、3d、7d、10d、14d及正常对照组。应用HE染色法和图像分析检测大鼠骨骼肌损伤后不同时间点PMN、MNC及FBC百分率。结果伤后6~12 h,损伤区内可见PMN和MNC浸润,PMN百分率达到峰值;伤后1 d,损伤区内主要以MNC浸润为主,MNC百分率达到峰值,而PMN百分率开始下降;伤后3~7 d,FBC百分率开始逐渐增加,PMN和MNC百分率则逐渐下降;伤后10~14 d,FBC百分率达到峰值。结论大鼠骨骼肌损伤区内PMN、MNC及FBC百分率呈时间规律性变化,有望成为骨骼肌损伤时间推断的参考指标。