Two Fatal Cases of Hidden Pneumonia in Young People*

Abstract: Acute respiratory distress syndrome (ARDS) is a severe lung disease characterized by inflammation of the lung parenchyma leading to impaired gas exchange. This condition is often lethal, usually requiring mechanical ventilation and admission to an intensive care unit. We present two fatal cases of hidden pneumonia in young people and discuss the pathophysiological mechanism of ARDS with reference to the histological pattern. A complete forensic approach by means of autopsy and histological, immunohistochemical, and microbiological, examination was carried out. In both cases the cause of death was cardio‐respiratory failure following an acute bilateral pneumonia with diffuse alveolar damage and ARDS associated with sepsis and disseminated intravascular coagulation. Our cases suggest on one side the importance of an early diagnosis to avoid unexpected death while on the other that the diagnosis of ARDS has to be confirmed on the basis of a careful postmortem examination and a complete microscopy and microbiological study.     

Death From Butane Inhalation Abuse in Teenagers: Two New Case Studies and Review of the Literature

The ready availability of butane makes butane abuse frequent. Fatalities are rare. This study presents two cases of death by butane overdose. The postmortem analyses were carried out using headspace gas chromatography–mass spectrometry. It revealed femoral blood butane concentrations of 18 and 22 mg/L, respectively, as well as specific combinations of adjuvants in each victim. In one of the victims, brain and fatty tissue also contained butane, pointing to chronic consumption. The originality of this study is to show that the identification of specific combinations of adjuvants can be helpful for identifying the brand of deodorant used. Also, sampling the skin and mucosa can help identify the method of drug delivery. The histological examination documented both the direct toxic effect of the gas on the respiratory mucosa and signs of chronic abuse. Volatile substance intoxications should be systematically considered in case of sudden death in a teenager.     

Involvement of Amphetamines in Sudden and Unexpected Death

Abstract:  In the present study, the effects of amphetamine-class drugs were examined in cases reported to the Victorian coroner from 2001 to 2005 to determine if death can occur from the use of amphetamine-class drugs alone. A total of 169 cases were reviewed where a forensic autopsy detected amphetamine(s) in the blood. Pathology, toxicology, and police reports were analyzed in all cases to ascertain the involvement of amphetamine-class drugs in these deaths. In Victoria, methamphetamine (MA) is the principal abused amphetamine-class followed by methylenedioxymethamphetamine (MDMA). There were six cases in which a cerebral hemorrhage caused death and three cases in which serotonin syndrome was established as being caused by the interaction of MDMA and moclobemide. There were 19 cases in which long-term use of amphetamines was associated with heart disease. There were three cases where amphetamine-class drugs alone were regarded as the cause of death, of which two cases exhibited high levels of MDMA and lesser amounts of MA and/or amphetamine. There were no cases in which significant natural disease was absent and death was regarded as caused by the use of MA. There was no correlation between blood concentration of drug and outcome.     

缺失信号肽和跨膜区的PRRSV GP5融合蛋白基因的表达

通过分析猪繁殖与呼吸综合征病毒(PRRSV)HH08株GP5基因序列,设计了2对引物,经PCR扩增,获得不含信号肽和跨膜功能区的GP5基因片段,长度分别为121 bp和248 bp。应用酶切位点相连构建融合基因技术,将2段基因亚克隆到原核表达载体pET-30a(+)中,获得重组表达质粒pET-GP5。将重组质粒转入大肠杆菌,经IPTG诱导后获得高效表达。免疫印迹试验证实,表达的融合蛋白能与特异性血清抗体反应,表明表达的PRRSV GP5蛋白具有良好的生物学活性。     

断奶仔猪多系统衰竭综合征淋巴结与脾损伤的病理学观察

对通过临床特征与PCR确诊为断奶仔猪多系统衰竭综合征的8例自然病例进行剖检取材,常规石蜡切片与超薄切片,HE染色及醋酸铀一柠檬酸铅染色,观察了淋巴结与脾的病理学变化.肉眼观察可见淋巴结肿大,特别是腹股沟淋巴结、肠系膜淋巴结与肺门淋巴结明显肿大;脾萎缩或中度肿大.组织学观察显示,淋巴结与脾淋巴细胞坏死,数量明显减少,网状内皮细胞增生与巨噬细胞浸润,在一些网状内皮细胞与巨噬细胞的胞浆内见嗜碱性包涵体.超微结构观察显示,淋巴结与脾淋巴细胞线粒体肿胀,内质网扩张,核浓缩,边集,甚至形成凋亡小体;在巨噬细胞与网状内皮细胞核和胞浆内均可见包涵体,包涵体为大小不等,圆形、椭圆形或不规则形的均质或颗粒状2种类型,胞浆包涵体常见于肿胀的线粒体与扩张的内质网附近.表明断奶仔猪患多系统衰竭综合征可致淋巴结与脾淋巴细胞坏死、凋亡,淋巴细胞数量减少.     

The EROI of agriculture and its use by the Via Campesina

Via Campesina supports peasant and small farmer agriculture both in the South and in the North. Its basic doctrine is that of ‘food sovereignty’. It is a movement that defends an ‘ecological neo-Narodnism’. Among the analytical tools used by this international peasant movement is the comparison between the energy efficiency of traditional small farm agriculture and modern industrial agriculture. This article briefly recalls the history of agricultural energetics, and then looks at the use of the concept of EROI (energy return on energy input) by Via Campesina when it claims that ‘industrial agriculture is no longer a producer of energy but a consumer of energy’, and that ‘peasant agriculture cools down the Earth’. The absence in Marxism of a tradition of analysis of energy flows is also reviewed here, since it is of interest in order to bring together the classic economic concept of decreasing returns with the more recent notion of a declining EROI. The article also draws on work analysing how environmental activists use concepts from ecological economics, while at the same time ‘activist knowledge’ contributes to ecological economics in a two-way communication between activism and science.     

细胞凋亡参与脑心综合征心肌损伤及针刺干预作用

目的 观察心肌细胞凋亡在脑心综合征(cerebral-cardiac syndrome,CCS)发病中的作用机制及针刺的干预作用。方法 从60只健康SD大鼠中随机选择10只作为伪手术组,其余50只用于CCS模型复制,从模型复制成功的大鼠中随机选取30只,分成模型组、针刺组和非经非穴组,每组10只。采用胶原酶加肝素联合注射大鼠尾状核方法复制CCS模型,伪手术组向大鼠尾状核注入等量生理盐水。模型复制后72 h处死动物,分别采用苏木精-伊红（hematoxylin-eosin,HE）染色、脱氧核糖核苷酸末端转移酶介导的缺口末端标记法(terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling,TUNEL)和免疫组织化学法检测心肌组织病理变化、细胞凋亡及半胱氨酸天冬氨酸蛋白酶3(Caspase 3)的表达。结果 HE染色示伪手术组心肌结构正常,模型组心肌细胞变性、坏死,大量平滑肌断裂;TUNEL及免疫组织化学染色提示模型组出现较多凋亡细胞,Caspase 3大量表达,针刺组TUNEL染色阳性细胞和Caspase 3阳性细胞均较模型组和非经非穴组显著减少(P<0.01)。结论 心肌细胞凋亡参与了CCS大鼠心肌损伤,其机制可能与上调凋亡蛋白酶Caspase 3表达有关,而针刺可拮抗CCS大鼠心肌组织细胞凋亡。     

闭合复位中空螺钉内固定结合中药内服治疗股骨颈骨折36例

目的 观察闭合复位中空螺钉内固定结合中药内服治疗股骨颈骨折的临床疗效。方法 将72例患者随机分为对照组、治疗组,每组各36例,两组均行中空加压螺钉内固定,治疗组依据辨证分期同时予中药内服,对照组常规预防处理。结果 治疗组总优良率显著优于对照组(94.44% vs 72.22%,P<0.05);两组术后1、3、6个月Harris评分比较,差异均有统计学意义(P<0.01)。结论 闭合复位中空螺钉内固定结合中药内服治疗股骨颈骨折临床疗效显著,值得临床推广应用。     

300例先兆流产中医证候调查分析

目的 对先兆流产患者的中医证候进行调查分析。方法 查阅分析300份先兆流产病历,统计并分析其中医证型与病因、年龄、孕周的关系。结果 先兆流产的中医证型以肾虚型频率最高;不明原因所致先兆流产者以血热型为主,其他因素所致者则以肾虚型为主;肾虚类证型的平均发病年龄显著高于非肾虚类证型的平均发病年龄;孕4~9周是先兆流产的高发病期,且以肾虚型最多见。结论 肾虚是先兆流产的基本环节,在肾虚类证型中以肾虚型最多见,在非肾虚类证型中以血热型最多见;中医证型分布与发病原因、妊娠年龄及妊娠周数有一定的相关性。     

慢传输型便秘中医证型与血管活性肠肽和P物质关系

目的 探究慢传输型便秘（slowtransitconstipation,STC）中医证型与血管活性肠肽（vasoactiveintestinalpeptide,VIP）、P物质（substanceP,SP）的关系,为中医辨证客观化寻找证据。 方法 纳入肠道实热证、肠道气滞证、肺脾气虚证、脾肾阳虚证、津亏血少证STC患者各15例,另随机选取15例健康人作为对照组。应用酶联免疫吸附双抗体夹心法检测血清VIP、SP水平。结果 STC患者血清VIP和SP水平显著高于对照组（P<0.05,或P<0.01）;STC虚证患者血清VIP和SP水平显著高于STC实证患者（P<0.01）; 3种虚证（肺脾气虚证、脾肾阳虚证、津亏血少证）患者血清VIP及SP水平比较,以及2种实证（肠道实热证、肠道气滞证）患者血清VIP水平比较,差异均无统计学意义（P>0.05）; 肠道气滞证患者血清SP水平显著低于肠道实热证（P<0.05）。结论 血清VIP、SP水平与STC中医证型有关,有利于鉴别STC虚证和实证。