《损伤程度》与《致残分级》关于脊柱四肢评定条款的比较

本文对《人体损伤程度鉴定标准》和《人体损伤致残程度分级》有关脊柱四肢评定方面的条款进行比较研究。从结构破坏、功能障碍、结构破坏合并功能障碍等方面分析两者的异同,为损伤程度和致残程度评定提供借鉴。     

CBS在脑挫伤后损伤时间推断中的作用

目的观察胱硫醚β合成酶(cystathionineβ-synthase,CBS)在脑挫伤后皮质中不同时段的表达变化。方法利用改良的自由落体装置建立小鼠脑挫伤模型,通过Western印记法和免疫组织化学方法检测不同时间点(1 h、6 h、12 h、1 d、2 d、3 d、7 d)损伤区周围皮质CBS的表达变化。结果 Western印迹法显示,CBS在脑损伤后皮质中的表达下调,在损伤3 d时降到最低,于损伤7 d恢复到正常水平。免疫组织化学结果显示,CBS在正常皮质中有表达,损伤后表达逐渐减弱,损伤3 d后阳性表达明显减少,7 d恢复到正常水平。结论 CBS有望成为法医学推断脑挫伤后损伤经过时间的参考指标。     

浅谈变频调速技术及防雷

变频调速技术是20世纪90年代涌现出来的一种新的交流调速技术,现广泛应用于国民经济和人民生活的各个领域,文中阐述了变频调速技术的原理及防雷问题。     

Complex suicide: an unusual case with six methods applied

Complex suicides (CSs) are committed by using more than one method. They account for 1.5-5% of all suicides. We present a case of CSs of a 44-year-old man, found dead in the vicinity of his car, in a deserted frozen field. Police investigation excluded homicide, and no medical data confirmed mental illnesses. Autopsy revealed wrist cuts, neck cuts, acid burns in the GI tract, multiple stab wounds to the head by a screwdriver, and several uncertain signs of hypothermia. Toxicology analysis (gas chromatography-mass spectrometry) confirmed ingestion of insecticide. We concluded that stab wounds to the head were the cause of death, while external hemorrhage and hypothermia were contributing factors. This is the first case of CSs reviewed in the literature where six suicide methods were applied. This particular case is interesting because the victim used a screwdriver as a tool for inflicting stab wounds to the head, which is a rare suicidal method.     

Fatal suicidal crossbow injury--the ability to act

We report a case of a 58-year-old man who committed suicide using a modern crossbow. The victim shot himself in the chest with a conical field-tip arrow from close proximity. We first presumed that this was a case of homicide committed with a firearm. We were, however, subsequently proved wrong. The reasons for the primary statement were as follows: the external morphology of the entrance wound being typical of a firearm discharged from long distance; the perforation found on the victim's clothing; the absence of the firearm at the place of death; the absence of the arrow in the wound. All of these reasons forced us initially to conclude that the case was one of homicide. In the reported case, the man, after having been shot with an arrow, was further able to act, even though the abdominal aorta and liver were seriously injured. While the arrow was in the wound, the injuries may not have led to massive bleeding because of incomplete tamponade of the defects by the arrow shaft. Pulling the arrow out of the victim's wound track initiated massive bleeding. Despite all these injuries, the man was capable of pulling the bow string again and reloading the crossbow with the arrow used in the first attempt. This case demonstrates that forensic investigations into crossbow injuries can be very difficult, especially when the bolt has been removed from the body.     

原发性脑干损伤神经元凋亡及caspase3的表达

目的观察原发性脑干损伤（PBSI）致死者脑干神经元凋亡及caspase3的表达情况,探讨其法医学意义。方法选择法医学检案中30例确定为原发性脑干损伤致死者脑干,按伤后不同存活时间（t≤5min、5min〈t≤15min、15min〈t≤1h、1h〈t≤24h）分为4组,以5例非脑干损伤死亡者脑干为对照组;分别运用常规HE、免疫组化和TUNEL染色检测中脑、桥脑及延脑重要核团内神经元凋亡及caspase3的表达情况。结果原发性脑干损伤后15min～24h出现明显神经元细胞凋亡（23.2%～35.9%）和caspase3阳性表达（28%～54%）,并呈现随损伤时间进行性增加的趋势,与对照组有显著性差异（P〈0.01）。结论原发性脑干损伤早期即出现神经元凋亡及caspase3表达增加,并随损伤时间的延长呈进行性增加,可据此辅助诊断原发性脑干损伤死亡。     

大鼠闭合性脑损伤后MAP-2的时序性表达

目的探讨大鼠闭合性颅脑损伤后脑组织微管相关蛋门－2（MAP－2）表达变化规律。方法建立大鼠闭合性颅脯挫伤模型,64只Wistar大鼠随机分为损伤后0．5h、6h、12h、ld、3d、7d、14d7个损伤组及对照组,每组8只。应用免疫组化和蛋h印记Western blot法及图像分析技术,检测脑挫伤后各设定时间点挫伤脯组织中MAP－2的变化。结果免疫纽化染色显示：对照组大鼠脑组织中可见MAP－2阳性表达;实验组伤后0．5h,挫伤灶及周同MAP－2阳性表达下降,伤后6h阳性表达降至最低,伤后12h,阳性表达逐渐增多,伤后14d,仍保持较高水平;蛋白印记结果与免疫组化结果一致。统计学分析显爪：MAP－2的表达各损伤组与对照组比较,差异均有统计学意义（P〈0．05）,伤后12h、3d及14d与上…组比较,差异有统计学意义（P〈0．05）。结论大鼠脑挫伤后14d内,MAP－2存脑组织挫伤灶及其周同呈现先减少后逐渐增多的表达变化,可作为推断脑挫伤经过时间的参考指标之一。     

MAP-2在大鼠脑损伤后表达变化的时间规律性研究

目的探讨MAP-2在大鼠脑损伤后表达变化的时间规律性。方法以355.09kPa冲击应力致大鼠局灶性脑损伤后,在不同时间应用原位杂交、免疫组化、免疫组化双染色技术检测MAP-2 mRNA和蛋白表达情况。结果 MAP-2mRNA在对照组及假手术组均有表达,伤后30 min表达增强,伤后2d,达到峰值,并维持高水平表达至伤后7d。MAP-2蛋白在对照组及假手术组均有表达,伤后3h开始呈下降趋势,伤后1d,达到最低值,伤后2d起,表达逐渐恢复,伤后15d,恢复至对照组水平。结论脑损伤后MAP-2 mRNA及蛋白表达具有时间规律,可用于法医学推断脑损伤形成时间。     

闭合性脑损伤后血清和海马的蛋白质表达

目的 研究大鼠脑损伤后血清和海马中蛋白质表达的差异.方法 用雄性SD大鼠制造脑损伤模型,应用弱阳离子交换(WCX2)芯片和铜离子结合(IMAC-Cu)芯片结合表面增强激光解析电离飞行时间质谱技术,分析大鼠闭合性脑损伤后不同时间血清和海马中蛋白质表达谱的变化.结果 WCX2芯片在血清和海马样本中分别捕获436个和364个...     

外伤性癫痫法医学评定100例分析

目的探讨颅脑外伤后癫痫的法医学评定要点,提出外伤性癫痫的法医学评定依据。方法对100例颅脑损伤后癫痫患者门诊及住院病历,结合临床脑电图（EEG）结果、CT片、MRI片等影像学资料,进行了回顾性分析。结果依据GBl8667-2002《道路交通事故受伤人员伤残评定》标准有关颅脑损伤后癫痫发作类型、发作频率的相关条款规定,Ⅲ级伤残8人,Ⅴ级伤残10人,Ⅶ级伤残22人,Ⅸ级伤残40人,Ⅹ级伤残20人。误工期限、营养期限和护理期限评定结论时间长短差异较大,具有个体化特征。结论外伤后癫痫常继发于严重的颅脑损伤,其发作特点决定于颅脑外伤的部位和程度,外伤性癫痫法医学鉴定必须以外伤史及既往史为基础,结合电生理及影像学检查,综合癫痫发作类型、频率及药物控制情况作出正确的伤残等级及误工期限、护理期限、营养期限的鉴定结论。