X线数字图像法推断前臂骨折形成时间

目的利用X线数字图像法推断前臂骨折形成的时间。方法收集70例前臂骨折患者随访的620张X线数字图像,根据X线检查骨折愈合评判标准列表,将骨折愈合过程分为5级,利用Photoshop的图像处理和测量功能,对不同年龄组、不同治疗方式的患者骨折愈合过程相关放射学标志进行观察和测量,运用SPSS11.5软件对各级愈合时间进行分析。结果年龄和手术与否分别是影响骨折愈合的独立因素,根据不同年龄、不同治疗方式可以得到各级愈合时间列表。以愈合Ⅲ级的出现时间为例,青年组采用石膏固定治疗的,平均时间为12.2周,采用手术治疗的,需要18周,而少年组采用石膏固定治疗的,则只需5.8周。结论根据骨折愈合过程中X线数字图像指标,对患者进行分组观察,可提高推断骨折形成时间的准确度。     

大鼠尺神经损伤平面与修复时间对神经传导速度的影响

目的观察尺神经损伤修复后功能恢复情况,用于确定鉴定时间。方法 52只大鼠分别按肘部和腕部分组制作尺神经损伤模型,并按伤后即刻、1、3、6月时间组分别进行修复,饲养3月后检测尺神经运动传导速度（MCV）。所得数据采用SPSS 11.5统计软件包进行统计学分析,组间比较采用配对t检验、单因素方差分析和两组独立样本的t检验。结果大鼠各实验组修复侧尺神经MCV与正常组相比,明显下降,有显著性差异,且尺神经损伤后的修复时间越晚,MCV越慢,各组间差异有统计学意义;相同修复时间、不同损伤平面（肘部和腕部）实验组修复侧之间MCV变化无统计学意义。结论大鼠尺神经损伤后的MCV变化,与伤后距离修复时间的长短呈负相关,与损伤平面无明显关系。以此可选择最佳鉴定时间。     

弥漫性轴索损伤的研究进展

弥漫性轴索损伤（diffuse axonal injury,DAI）以脑白质轴索弥漫性损伤为主要特征,迄今其形成机制尚未完全阐明,不同学科诊断标准迥异,是法医学和神经科学亟待解决的难题。磁共振弥散张量成像（diffusion tensor imaging,DTI）通过检测弥散参数及纤维束成像（fibre tracking,FT）可准确地反映轴索损伤部位及损伤程度,具有广泛的法医学应用前景。本文综述DAI发生机制及诊断方法的研究进展,尤其DTI技术在DAI诊断中的应用。     

免疫组织化学法检测HO-1在人挫伤脑组织中的表达

目的研究人脑挫伤后不同时间血红素加氧酶-1(heme oxygenase-1,HO-1)表达的变化,为法医学脑损伤时间的推断提供依据。方法选择24例因颅脑损伤死亡案例为损伤组,4例非颅脑损伤死亡的案例为对照组,应用免疫组织化学和图像分析技术,分别于脑损伤后存活时间3h、6～9h、12～24h、36h～3d、5～8d及17～20d检测脑组织标本中HO-1随时间的变化规律。结果经统计学分析,HO-1阳性细胞表达在伤后3h以内组开始升高,12～24h组表达强度最高,36h～3d组仍见高表达,以后逐渐下降。各组组间及与对照组相比差异有统计学意义(P<0.05)。结论 HO-1的表达可能成为实际检案中脑损伤时间推断的诊断指标。     

创伤性脑损伤后生物分子标志物的研究进展

创伤性脑损伤(traumatic brain injury,TBI)是指机械性外力作用于头部时发生的损伤,导致一个或者多个病变,如颅内损伤、神经病学或者神经心理学改变、意识障碍或者死亡。TBI可因直接打击、缺血缺氧性脑损伤、炎性介质、细胞因子及氧自由基等机制诱发神经元死亡。TBI发生发展过程中产生了大量生物分子标志物,深入研究TBI后生物分子标志物的变化及其规律,对法医学鉴定及临床治疗都有重大意义。本文结合相关文献概述了TBI相关生物分子标志物的研究进展,为寻找更精确的与TBI诊断相关的生物分子标志物提供参考依据。     

Classification of Porcine Cranial Fracture Patterns Using a Fracture Printing Interface,,

Distinguishing between accidental and abusive head trauma in children can be difficult, as there is a lack of baseline data for pediatric cranial fracture patterns. A porcine head model has recently been developed and utilized in a series of studies to investigate the effects of impact energy level, surface type, and constraint condition on cranial fracture patterns. In the current study, an automated pattern recognition method, or a fracture printing interface (FPI), was developed to classify cranial fracture patterns that were associated with different impact scenarios documented in previous experiments. The FPI accurately predicted the energy level when the impact surface type was rigid. Additionally, the FPI was exceedingly successful in determining fractures caused by skulls being dropped with a high‐level energy (97% accuracy). The FPI, currently developed on the porcine data, may in the future be transformed to the task of cranial fracture pattern classification for human infant skulls.     

Evaluation of Non‐Natural Deaths among Veterans: New Mexico Medical Examiner‐Investigated Deaths, 2002–2011

While it is recognized that veterans have increased rates of depression, post‐traumatic stress disorder (PTSD), suicide, and substance use disorders, rates of homicide and unintentional injury deaths in veterans have been minimally investigated. We evaluated all non‐natural deaths in New Mexico veterans between 2002 and 2011 in comparison with non‐natural deaths among non‐veterans. We reviewed all decedents in New Mexico with a history of military service and investigated by the medical examiner, excluding natural deaths and deaths due to fall from standing height. The most common manner of death was unintentional injury (62%), most of these deaths due to motor vehicle accidents (29%) followed by unintentional overdose (26%). Suicide rates among veterans were consistently higher than the general population. The most common mechanism of suicide in men was gunshot wound (72%), and intentional overdose in women (49%). Services are needed for veterans that are tailored to all ages and both sexes.     

Reasons for Lack of Consensus in Forensic Pathologist Interpretation of Photographs of Patterns of Injury of the Skin,

In a previous study, a survey‐based analysis of pathologist diagnoses of patterned injury in which participants were asked makes diagnoses from photographs in the absence of history or context. The level of consensus was low. A follow‐up survey was created to ask those who responded to the first survey why they answered as they did or why they were unsure of their answers. The most common reason for lack of consensus was that the lesion was nonspecific. Responses invoking ambiguity were more common than those that indicated a confident difference in diagnosis. There were differences between demographic groups, with age and experience being most prominent. These findings suggest that differences in image interpretation do not generally reflect firm differences in diagnosis as much as differing ways of dealing with ambiguity in the absence of history and context. A third survey will study the effect of the addition of contextual information.     

有限元方法在颈椎挥鞭样损伤分析中的应用

有限元方法（finite element method,FEM）是一种有效的应力计算分析方法,已逐渐被应用于人体结构生物力学功能研究。本文综述了颈椎有限元模型的构建、发展、材料属性赋值以及验证,并阐述了国内外研究者利用 FEM 在颈椎挥鞭样损伤成伤机制和生物力学响应分析等方面取得的研究成果。     

大鼠吸入性乙酸酐中毒的病理观察

为了观察吸入乙酸酐后机体的病理变化，在染毒柜中让大鼠吸入乙酸酐，然后在光镜下观察其吸入性损伤。结果显示：（1）急性肺水肿；（2）小支气管、细支气管粘膜凝固性坏死，炎症细胞浸润；（3）小支气管早期痉挛，后期扩张。表明引起这些损伤是由于乙酸酐对粘膜的刺激和腐蚀作用。