A Novel Method for Removing a Spinal Cord with Attached Cervical Ganglia from a Pediatric Decedent

A diagnosis of child abuse is dependent on a comprehensive and accurate assessment of injury in the context of a thorough investigation. However, signatures of trauma are often subtle and interpretation can be very difficult. Recently, researchers have refocused their attention from the head to the neck in search of traumatic signatures of abusive head trauma. HCIFS has developed a technique to remove the cervical spinal cord with the ganglia attached that is less destructive and more time and cost efficient than alternative methods previously published. Once removed, the dorsal nerve roots and ganglia are evaluated for the presence of hemorrhage. The authors performed a small pilot study using the novel method to evaluate 20 decedents with a history of blunt force trauma and eight without a traumatic history. Fifteen of the traumatic deaths and two of the nontraumatic deaths were found to have dorsal nerve root and/or ganglia hemorrhage.     

An Autopsy Case of Acute Massive Hematochezia Caused by Superior Mesenteric Vein Thrombosis: A First Report in Forensic Medicine

Superior mesenteric vein thrombosis (SMVT) is an uncommon cause of intestinal ischemia and massive gastrointestinal bleeding. This report describes a man with alcoholic liver cirrhosis, who died of massive hematochezia due to SMVT. A medicolegal autopsy disclosed a thrombus at the superior mesenteric vein and hemorrhagic infarction of the bowel wall, an area also within the territory of the superior mesenteric vein. Liver cirrhosis, an enlarged spleen, and esophageal varices without rupture were also observed, but ulcers and variceal bleeding were not. Other organs showed no significant findings. His blood alcohol level was 0.14% w/v. Thus, this man died from severe hematochezia associated with SMVT due to liver cirrhosis and alcohol dehydration, which can lead to coagulopathy and rapid progress of thrombus formation. This is the first report on an alternate cause for massive gastrointestinal hemorrhage with a cirrhotic patient in a forensic autopsy.     

The Institution of a Standardized Investigation Protocol for Sudden Infant Death in the Eastern Metropole,Cape Town,South Africa,,

The rate for the sudden infant death syndrome (SIDS) in Cape Town, South Africa, is estimated to be among the highest in the world (3.41/1000 live births). In several of these areas, including those of extreme poverty, only sporadic, nonstandardized infant autopsy, and death scene investigation (DSI) occurred. In this report, we detail a feasibility project comprising 18 autopsied infants with sudden and unexpected death whose causes of death were adjudicated according to the 1991 NICHD definitions (SIDS, n = 7; known cause of death, n = 7; and unclassified, n = 4). We instituted a standardized autopsy and infant DSI through a collaborative effort of local forensic pathology officers and clinical providers. The high standard of forensic investigation met international standards, identified preventable disease, and allowed for incorporation of research. We conclude that an effective infant autopsy and DSI protocol can be established in areas with both high sudden unexpected infant death, and elsewhere. (SUID)/SIDS risk and infrastructure challenges.     

硫化氢对创伤应激引起大鼠急性肝损伤的作用

目的探讨硫化氢(H_2S)在挤压大鼠后肢致急性肝损伤过程中的作用。方法将大鼠随机分为对照组、挤压组、H_2S供体硫氢化钠(Na HS)+挤压组、H_2S生成抑制剂炔丙基甘氨酸(propargylglycine,PAG)+挤压组。用标准重物挤压大鼠后肢建立急性肝损伤模型,分别于挤压结束后30、120 min处死大鼠。比色法检测血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)活性,化学法检测大鼠血浆H_2S、肝组织丙二醛(malondialdehyde,MDA)、蛋白质羰基、谷胱甘肽(glutathion,GSH)含量和H_2S生成酶胱硫醚γ-裂解酶(cystathionineγ-lyase,CSE)活性,RT-PCR半定量检测肝组织CSE m RNA的表达。结果挤压大鼠后肢可引起血清AST、ALT活性增高,肝组织MDA、蛋白质羰基含量增加及GSH含量降低,血浆H_2S含量减少,肝组织CSE活性降低、CSE m RNA表达下降。预先给予Na HS可显著减轻、而PAG明显加剧挤压后肢所致上述肝损伤改变。结论 H_2S生成减少参与介导创伤应激引起的大鼠急性肝损伤。     

大鼠血液中HbCO随吸入CO浓度和时间的变化

目的研究不同一氧化碳(carbon monoxide,CO)浓度下中毒大鼠的行为学特征、存活时间、碳氧血红蛋白(carboxyhemoglobin,HbCO)饱和度变化规律,为法医学实践中CO中毒死亡案件提供实验依据。方法将160只SD大鼠随机分为4组。自制染毒装置,使大鼠分别在CO浓度为1 250、3 750、6 250 mg/m~3及持续通入CO状态下染毒致死亡。观察不同CO浓度中毒大鼠的行为学特征,记录存活时间,采用分光光度法检测心血HbCO饱和度,并提取脑、心脏、肺、肝等器官进行组织病理学观察。结果 CO中毒大鼠的行为学特征表现为肢体瘫软、反应迟钝。随着CO浓度的升高,大鼠存活时间逐渐缩短,心血HbCO饱和度逐渐升高。在CO浓度为1 250 mg/m~3条件下,发现3例心血HbCO饱和度明显低于致死饱和度,其余各组未发现心血HbCO饱和度低于致死饱和度的情况。结论建立的不同浓度下CO中毒死亡动物模型,操作简单,重复性好,为进一步研究CO中毒及其他吸入性有毒气体的法医学研究奠定了基础。     

65例道路交通事故死亡案例骨盆骨折特征的法医学分析

目的分析道路交通事故死亡案例中骨盆骨折的特点及成伤机制。方法收集65例发生骨盆骨折的道路交通事故死亡案例,对骨盆骨折的部位、特点、成伤机制等情况进行统计学分析。结果 65例骨盆骨折案例中,骶髂关节脱位38例,且多合并耻骨联合分离或耻骨骨折;耻骨、坐骨、髋臼骨折主要以线性骨折为主,骶尾骨骨折以粉碎性骨折多见;合并盆腔软组织损伤54例,盆腔器官损伤8例,腹腔器官损伤44例。骨盆环损伤类型中,分离型32例,占49.23%;其次是压缩型,占26.15%;垂直型最少,仅1例,占1.54%。结论细致、全面地检验尸体,确定骨盆骨折类型,有助于分析成伤机制。     

不同温度下大鼠脑组织RNA降解与早期PMI的相关性

目的探讨大鼠脑组织8种RNA指标,在不同温度下的表达水平与早期死亡时间(PMI)的相关性。方法将222只SD大鼠随机分为对照组(死后0 h)和4个实验组,实验组断颈处死后分别置于5℃、15℃、25℃和35℃的环境中,于死后1~24 h内9个时间点提取脑组织RNA,利用实时荧光定量PCR技术检测8种RNA指标(β-actin、GAPDH、RPS29、18S rRNA、5S rRNA、U6 snRNA、miRNA-9及mi RNA-125b)的表达水平,ge Norm软件选取合适内参,SPSS软件对内参标准化RNA指标进行回归分析,R软件构建推断PMI的数学模型,另选6只已知PMI的SD大鼠予以验证。结果 5S rRNA、miR-9和mi R-125b表达稳定,可作为内参指标。β-actin和GAPDH具有良好的时序性降解规律,在24 h内随PMI延长不断降解。R软件拟合得ΔCt值随PMI和温度变化的数学模型可用以推断PMI。运用β-actin和GAPDH验证模型的平均误差率分别为14.1%和22.2%。结论β-actin和GAPDH表达水平与PMI和环境温度相关性良好。本研究建立的数学模型可为温度变化条件下的早期PMI推断提供参考。     

小鼠皮肤损伤愈合过程中PI3K/Akt通路的作用

目的探讨小鼠皮肤损伤愈合过程中损伤区磷脂酰肌醇-3-激酶(phosphatidylinositol-3-kinase,PI3K)、磷酸化磷脂酰肌醇-3-激酶(phospho-PI3K,p-PI3K)、蛋白激酶B(protein kinase B,PKB,又称Akt)和磷酸化蛋白激酶B(phospho-Akt,p-Akt)的表达及其随时间的变化规律。方法应用免疫组织化学染色、Western印迹法和real-time PCR技术检测小鼠皮肤损伤不同时间段PI3K、Akt、p-PI3K及p-Akt的变化情况。结果免疫组织化学染色显示,皮肤损伤后,PI3K、p-Akt阳性染色出现在单核细胞和成纤维细胞,峰值出现在组织修复期。Western印迹法显示,各个时间段均有PI3K、p-PI3K、Akt、p-Akt的阳性条带,其中p-PI3K、p-Akt表达的峰值出现在炎症期和增生期,PI3K、Akt表达的高峰出现在组织重建期。real-time PCR结果显示,PI3K m RNA的峰值出现在炎症期和组织重建期,Akt m RNA的峰值出现在组织重建期。结论在皮肤损伤愈合过程中,PI3K、Akt、p-PI3K及p-Akt的表达变化呈现不同的规律性并有较好的时间依赖性,PI3K/Akt通路的表达规律可以用于法医学损伤时间推断。     

溺死大鼠肺组织AQP-1、AQP-4的表达

目的观测生前溺死与死后抛入河水中大鼠肺组织水通道蛋白-1(aquaporin-1,AQP-1)、AQP-4的表达变化。方法将30只健康雄性Wistar大鼠随机分为河水溺死组、抛尸入水组及脱颈致死组。HE染色观察各组大鼠肺组织形态学变化,实时荧光定量PCR法检测各组大鼠肺组织AQP-1、AQP-4 m RNA的表达,免疫组织化学、Western印迹法检测其蛋白表达。结果免疫组织化学法和Western印迹法检测河水溺死组AQP-1蛋白的表达高于抛尸入水组和脱颈致死组(P0.05)。免疫组织化学法显示河水溺死组AQP-4蛋白的表达高于抛尸入水组和脱颈致死组(P0.05),而Western印迹法未检测出三者的差别(P0.05)。河水溺死组大鼠肺组织的AQP-1、AQP-4 m RNA表达高于抛尸入水组(P0.05)。结论河水溺死组的大鼠在急性肺损伤时肺组织AQP-1、AQP-4 mRNA及蛋白表达增高可能对生前溺死与死后抛尸的鉴别有一定意义。     

根据双刃刺器刺创口推断刺器宽度

解决根据皮肤创口推断刺器宽度的问题。实验在自愿捐献的12具男性尸体的胸部,用不同宽度和厚度的双刃匕首致创221个。应用法医学、解剖学及数理统计的理论和技术对创口形成机理、影响因素及其与刺器宽度的相关关系进行分析,得出了以下结论：刺器厚度与创口长度无明显相关,刺器宽度与创口长相关,创口回缩程度与创口方向及刺器宽度相关。并建立了两个最优回归方程,提出了一个根据皮肤双刃利器创口推断刺器宽度的方法。