微波消解-扫描电镜联用检测脏器内硅藻

目的介绍一种微波消解-扫描电镜联用检测脏器内硅藻的新方法。方法大白兔30只,随机分为生前溺死组（n=15）和死后溺尸组（n=15）。提取兔肺、肝、肾、股骨骨髓和现场珠江水样,采用建立的微波消解-扫描电镜联用法检测脏器组织和水样中的硅藻,并与硝酸乙醇消解-扫描电镜联用的方法进行比较。结果生前溺死组的兔肺、肝、肾、股骨骨髓组织中大多数观测到与现场珠江水样一致的硅藻,微波消解-扫描电镜联用法检测脏器内硅藻的平均含量分别为：2505.2个/2g肺,18.7个/10g肝,6.5个/10g肾,6.3个/0.5g骨髓;肺与肝、肾、骨髓检出硅藻的阳性比例为86.7%,脏器硅藻检出含量和硅藻检验阳性比例均明显高于硝酸乙醇消解-扫描电镜联用法所测值。死后溺尸组的兔脏器组织均未观测到硅藻。结论微波消解-扫描电镜联用法检测脏器内硅藻,高效、安全、环保,硅藻检验灵敏度高,降低了劳动强度,提高了定性定量分析准确度,且能有效避免污染,在法医学溺死鉴定中具有良好的应用价值。     

Application of Postmortem 3D‐CT Facial Reconstruction for Personal Identification*

Abstract: Postmortem computed tomography (CT) images can show internal findings related to the cause of death, and it can be a useful method for forensic diagnosis. In this study, we scanned a ready‐made box by helical CT on 2‐mm slices in a mobile CT scanner and measured each side of the box to assess whether reconstructed images are useful for superimposition. The mean difference between the actual measurements and the measurements on the three‐dimensional (3D) reconstructed images (3D‐CT images) is 0.9 mm; we regarded it as having no effect on reconstruction for the superimposition method. Furthermore, we could get 3D‐CT images of the skull, which were consistent with the actual skull, indicating that CT images can be applied to superimposition for identification. This study suggested that postmortem CT images can be applied as superimpositions for unidentified cases, and thinner slices or cone beam CT can be a more precise tool.     

Analysis of Forensic Autopsy in 120 Cases of Medical Disputes Among Different Levels of Institutional Settings

Despite advances in medical science, the causes of death can sometimes only be determined by pathologists after a complete autopsy. Few studies have investigated the importance of forensic autopsy in medically disputed cases among different levels of institutional settings. Our study aimed to analyze forensic autopsy in 120 cases of medical disputes among five levels of institutional settings between 2001 and 2012 in Wenzhou, China. The results showed an overall concordance rate of 55%. Of the 39% of clinically missed diagnosis, cardiovascular pathology comprises 55.32%, while respiratory pathology accounts for the remaining 44. 68%. Factors that increase the likelihood of missed diagnoses were private clinics, community settings, and county hospitals. These results support that autopsy remains an important tool in establishing causes of death in medically disputed case, which may directly determine or exclude the fault of medical care and therefore in helping in resolving these cases.     

眼眶骨折的影像学诊断及法医学评定

在眼眶骨折的法医学鉴定中常常出现漏诊和误诊。目前影像学技术在研究眼眶骨折的法医学特点和评价外伤的严重程度中有重要的意义。本文综述了眼眶骨折的分类、发病机制和影像学诊断的特点,对于眼眶骨折的法医学评价和鉴定有较好的帮助。     

二分髌骨影像学征象及其法医学意义

二分髌骨较罕见,系因青春期二个或多个髌骨骨化中心(化骨核)未融合而形成,临床误诊为骨折的屡有报道。为提高对二分髌骨影像征象的认识,避免法医学鉴定失误,现分析行法医学鉴定的3例二分髌骨资料并结合文献,阐述其形成原因、组织学变化、影像学征象及临床症状体征。3例被鉴定人均为成年,因膝关节外伤后出现膝部疼痛,曾被医疗单位诊断为髌骨骨折,委托损伤鉴定2例,伤残评定1例。依据Saupe’s分型法,其中Ⅲ型2例,Ⅱ型加Ⅲ型1例。在法医学鉴定实践中,熟知二分髌骨影像学征象并与髌骨骨折鉴别,可确保鉴定结论的客观、准确。     

鼻骨骨折影像学检查方法与法医学鉴定

本文从影像学检查方法的不同,重点对鼻骨骨折的影像学特点进行论述,比较了各种影像学检查方法的优劣。在法医学鉴定中,应根据实际情况,选择更优质的影像学检查,注意与正常的解剖变异相区别,并提出根据鼻骨骨折的影像分型进行法医学伤情鉴定的依据。     

一起麻鸡鸡痘病毒与巴氏杆菌混合感染病例的诊断

为了对2011年10月长春市某鸡场的150多只60日龄麻鸡发生急性死亡,病死鸡在临床上出现食欲不振、精神委靡,鸡冠以及背部皮肤有结节状痘疹以及排黄绿色稀粪等临床症状的疾病进行确诊,通过细菌学检查、病毒分离鉴定、动物回归试验以及病理组织学观察等方法从病原学和病理学角度进行了系统的分析。病死鸡肝触片可见有典型的两极浓染的短杆菌;应用鸡痘病毒4b核心蛋白基因特异性引物的扩增结果为阳性;将痘疹病料处理上清液经尿囊绒毛膜途径接种9日龄SPF鸡胚,接种后第7天可见尿囊膜上形成有灰白色突起的痘斑;皮肤痘疹研磨处理上清液经电镜负染观察可见典型的痘病毒粒子。病理组织学观察结果表明,局部肝细胞发生变性、坏死,并伴有多量的异嗜性粒细胞浸润。根据上述实验室检测结果并结合临床症状进行综合分析,确诊该起病例为鸡痘病毒与巴氏杆菌混合感染所致。     

三种抗原对家畜日本血吸虫病诊断价值的比较

以日本血吸虫基因重组抗原LHD-Sj23/pGEX、可溶性虫卵抗原(soluble egg antigen,SEA)及SEA经Sephadex G-200柱层析分离后得到的第一峰SEA1作为诊断抗原,应用ELISA检测人工感染日本血吸虫绵羊血清及自然感染日本血吸虫水牛血清。结果显示,三种抗原用于检测人工感染日本血吸虫绵羊血清的阳性符合率分别为88.79%、98.15%、100%,阴性符合率均为100%;自然感染日本血吸虫水牛血清的阳性符合率分别为80%、80%、84%,阴性符合率分别为88.9%、93.3%、91.1%;三种抗原与伊氏锥虫病牛血清无交叉反应;检测感染日本血吸虫不同时间绵羊血清,发现感染6周后均被检出针对这三种抗原的特异性抗体,且SEA及SEA1在感染4周后即可检出特异性抗体。三种抗原的诊断效果差异不显著。     

Postmortem diagnosis of syphilitic aortitis, including serological verification on postmortem blood

304 postmortem blood samples were serologically examined for syphilis at Statens Seruminstitut. Seventy-six percent of the samples were usable and gave clear-cut results (18% positive, 34% negative and 24% borderline). Twenty-four percent were indeterminable. The blood samples originated from 304 medico-legally examined bodies, 301 of whom were autopsied. The indications for the serological examinations were suspicion of syphilitic aortitis (SA) on the basis of the macroscopical appearance of the aorta at the autopsy--or information on earlier syphilis. Ninety-seven cases of SA were verified macro- and microscopically, 53 being lethal. The serological results were positive in half of these 97 cases, negative in 15, borderline in 21 and indeterminable in 12. A little more than half of the 97 cases were known in advance in the nation-wide syphilis index at the State Serum Institute. The variegated findings in the remaining part of the material are discussed. It is concluded that serological examination of postmortem blood may be a valuable adjuvant for the pathologist for the diagnosis of SA and other syphilitic manifestations.     

警察职业心理压力分析与干预

世界各国的警察都为心理健康问题所困扰。随着我国各项改革的不断深化,公安工作的内容发生了深刻的变化,警察的各种压力越来越大。面对长期高风险、高强度、高负荷的工作,公安民警也会出现挫折感、心理障碍等问题,生活的压力、职业的竞争、人际的困惑,特别是职业的规范给他们带来更多普通人体会不到的精神与心理压力。警察心理健康问题一方面关系到警察这个群体的发展与进步,另一方面也关系到社会的安全与稳定。