臂丛神经主要分支损伤法医学鉴定66例分析

目的探讨臂丛神经主要分支损伤的法医学鉴定。方法取自本室2003年1月至2005年12月共66例84条臂丛神经主要分支损伤的案例进行统计分析。结果被鉴定人中男性青壮年占较大比例;锐器伤引起神经损伤居多达94%;神经损伤伴有骨折的占34%,其中50%尺神经损伤伴尺骨骨折;曾行肌电图检查的为34条神经,占40%,其中有15条临床未确诊为神经损伤。结论臂丛神经主要分支损伤的法医学鉴定,关键看影响肢体运动功能的后果,鉴定时机宜术后20天 L(神经断端远侧的长度)/R(生长速度) 90天。     

Further investigations into the speed of cerebral swelling following blunt cranial trauma

An anesthetized sheep model of traumatic brain injury (TBI) has been developed to assess early changes in intracranial pressure (ICP) following closed head injury. Immediately after TBI, a transient (<10 min) hypertensive response occurred, followed by significant and prolonged systemic hypotension. ICP demonstrated a biphasic response, being seven times baseline values of 8 ± 2 mm Hg 10 min after injury, decreasing to 25 ± 2 mm Hg by 30 min, and then increasing to values exceeding 30 mm Hg by 4 h postinjury. ICP was always significantly higher than baseline values, which combined with hypotension, reduced cerebral perfusion pressure to less than 60% of normal. This early and sustained increase in ICP after craniocerebral trauma acutely alters cerebral perfusion pressure and brain oxygenation and provides a potential pathophysiological explanation for immediate clinical manifestations in humans following significant TBI.     

Differential decomposition patterns in charred versus un-charred remains

Although researchers have examined many aspects of fire modification, the rate and pattern of decomposition in charred remains have not been studied previously. This study utilized 48 domestic pigs, divided into 24 charred (head, neck, and limbs burned to Crow-Glassman level 1 and torso to level 2) and 24 un-charred pig carcasses. Decomposition of control carcasses was scored at 50 accumulated degree days (ADD) intervals, and charred carcasses were also observed and photographed at this time. A Charred Body Scale was subsequently created, and charred carcasses were scored retrospectively for the same ADD intervals. Analysis using a mixed-effect repeated measures model indicated that, while decomposition rate was not statistically different between the two groups (p = 0.2692), the charred remains initially displayed an ostensibly more advanced pattern. Body regions displaying significant charring decomposed at a faster rate (p < 0.001), while areas with very light levels of charring decomposed at a significantly slower rate (p < 0.001).     

Decaying Mouse Volatiles Perceived by Calliphora vicina Rob.‐Desv.

Volatiles emitted by decaying human remains are in the focus of recent research. The identification of core volatiles in this field is of high importance, because cadaveric volatiles generally show high variation. In this study, the volatile profiles of five mice (Myodes glareolus) were sampled with charcoal filter tubes from their time of death until advanced decay. Eleven compounds were quantitated by means of gas chromatography–mass spectrometry. Electroantennographic experiments with female Calliphora vicina antennae led to the identification of dimethyl trisulfide, dimethyl disulfide, nonanal, hexan‐1‐ol, 1‐octen‐3‐ol, 3‐methylbutan‐1‐ol, and heptanal as electrophysiologically active compounds. When these were compared, dimethyl trisulfide (17 ng/μL) and dimethyl disulfide (11 ng/μL) were found to be emitted in higher concentrations. The roles of these compounds and nonanal as core volatiles for cadaver detection or postmortem time determination and their correlation to the stages of decay and the accumulated degree days are discussed.     

Assessing the Behavior and Needs of Veterans with Traumatic Brain Injury in Washington State Prisons: Establishing a Foundation for Policy,Practice, and Education

Abstract

A growing awareness of justice-involved veterans is revealing how little is known about this population, to what extent they have experienced a traumatic brain injury (TBI), and how this may relate to institutional behavior, participation in programs, and use of institutional resources. The current study identifies the prevalence of incarcerated veterans in Washington State who have experienced a TBI and how a TBI history may affect their prison experience and use of prison resources. The results of our study show that incarcerated veterans in Washington State with a moderate-to-severe TBI are more likely to use medical services, commit violent infractions, be placed in maximum custody (solitary confinement), and less likely to complete vocational and job skills programs. The importance of these findings to policy and practice is discussed.     

Traumatic Brain Injury among Indiana State Prisoners

Research on traumatic brain injury among inmates has focused on comparing the rate of traumatic brain injury among offenders to the general population, but also how best to screen for traumatic brain injury among this population. This study administered the short version of the Ohio State University Traumatic Brain Injury Identification Method to all male inmates admitted into Indiana state prisons were screened for a month (N = 831). Results indicate that 35.7% of the inmates reported experiencing a traumatic brain injury during their lifetime and that these inmates were more likely to have a psychiatric disorder and a prior period of incarceration than those without. Logistic regression analysis finds that a traumatic brain injury predicts the likelihood of prior incarceration net of age, race, education, and psychiatric disorder. This study suggests that brief instruments can be successfully implemented into prison screenings to help divert inmates into needed treatment.     

A Preliminary Examination of Differential Decomposition Patterns in Mass Graves

Five pairs of mass graves, each containing carcasses of 21 rabbits, were used to examine differential decomposition at four locations within the burial: surface, deep, mid‐outer, and core. Every 100 accumulated degree days (ADD), a pair of graves was exhumed, and total body score (TBS) and internal carcass temperature of each rabbit were recorded. Decomposition did not differ for core‐ and deep‐positioned carcasses (p = 0.13); differences were significant (p < 0.001) for all other location comparisons. Decomposition occurred fastest in shallow carcasses, followed by mid‐outer carcasses; deep and core carcasses decomposed slowest and at rates not significantly different from one another. Adipocere formation was minimal and confined to deep carcasses. Carcass location within the mass grave significantly influenced internal carcass temperature (p < 0.001); a mean internal temperature difference of ca. 1°C existed between deep and shallow carcasses (30 cm apart). Effects of mass compactness and oxygenation require further investigation.     

Do bone elasticity and postmortem interval affect forensic fractographic analyses?

Forensic fractographic features of bone reliably establish crack propagation in perimortem injuries. We investigated if similar fracture surface features characterize postmortem fractures. Experimentally induced peri- and postmortem fractures were used to assess if fractographic features vary as bone elasticity decreases during the postmortem interval (PMI). Thirty-seven unembalmed, defleshed human femoral shafts from males and females aged 33–81 years were fractured at varying PMIs with a drop test frame using a three-point bending setup and recorded with a high-speed camera. Vital statistics, cause of death, PMI length, temperature, humidity, collagen percentage, water loss, fracture energy, and fractography scores were recorded for each sample. Results showed that fractographic features associated with perimortem fractures were expressed in PMIs up to 40,600 accumulated degree hours (ADH), or 60 warm weather days. Hackle was the most consistently expressed feature, occurring in all fractures regardless of ADH. The most variable characteristics were wake features (78.4%) and arrest ridges (70.3%). Collagen percentage did not correlate strongly with ADH (r = −0.04, p = 0.81); however, there was a strong significant correlation between ADH and water loss (r = 0.74, p < 0.001). Multinomial logistic regression showed no association between fractographic feature expression and ADH or collagen percentage. In conclusion, forensic fractographic features reliably determine initiation and directionality of crack propagation in experimentally induced PMIs up to 40,600 ADH, demonstrating the utility of this method into the recent postmortem interval. This expression of reliable fractographic features throughout the early PMI intimates these characteristics may not be useful standalone features for discerning peri- versus postmortem fractures.     

Financial Development,Entrepreneurship and Urban-rural Inequality

Based on the panel data of prefecture-level city over 2000—2012, this article shows that financial development can reduce urban-rural inequality through entrepreneurship. Furthermore, the above relationship is related to the degree of marketization. Among the three major regions of China, it is the most remarkable in the east area where degree of marketization is the highest, the least remarkable in the western area where degree of marketization is the lowest.     

GFAP和VEGF在创伤性脑损伤中表达的研究进展

创伤性脑损伤是世界上导致死亡及残疾的主要原因之一。检测对中枢神经系统损伤有高度特异性和敏感性的生物标志物,可以在一定程度上反映损伤情况。胶质纤维酸性蛋白与血管内皮生长因子均可作为颅脑损伤的生物学标记物,其表达变化规律、峰值出现时间,与创伤性脑损伤的严重程度及损伤时间的推断密切相关,对于法医病理学具有重大意义。该文对胶质纤维酸性蛋白与血管内皮生长因子的分子生物学特性及其在创伤性脑损伤中的表达进行综述。