全基因组扩增技术的法医学应用价值及其结果评价

微量模板DNA的分析,一直是法医学特别关注和急需解决的难题之一,近年发展起来的一系列技术为解决这一问题提供了新的可能途径,本文即对微量模板DNA分析技术的进展和目前逐步发展的全基因组扩增技术的法医学应用价值、结果评价进行浅议。     

腰椎间盘突出症综合康复治疗初探

将80例腰椎间盘突出症患者分别用传统康复和综合康复手段进行治疗，并作疗效及治疗时间观察对照，结果表明两种方法在疗效和治疗时间上后者均优于前者。     

多层螺旋CT诊断颅底骨折及其法医学应用价值

目的 比较多层螺旋CT三种重建方法在显示颅底骨折方面的差异,探讨其在法医学鉴定中的应用价值。方法 对40例颅脑外伤后怀疑颅底骨折的伤者进行多层螺旋CT扫描,然后将容积数据输入工作站进行横断面重建、多平面重建(MPR)和三维重建,三维重建采用表面显示法(SSD)。结果 24例颅前窝骨折,其中横断面显示骨折9例,MPR显示骨折24例,SSD显示9例;3组比较有显著性差异(P<0.001)。24例颅中窝骨折,横断面显示骨折15例,MPR显示骨折24例,SSD显示骨折4例;3组比较有显著性差异(P<0.001)。横断面重建和MPR均显示颅后窝骨折3例,两者无明显差异,SSD有1例显示。结论 SSD成像直观立体地显示了骨折的形态、走行、空间位置等情况,但对细小骨折显示不佳;多层螺旋CT检查可用于颅底骨折的法医学鉴定。     

Analysis of the autopsy,toxicological, and psychiatric reports of Portugal’s first major forensic case: part III

This work presents an odd historical record obtained through more than 14 years of research regarding one of the first major European forensic cases. The presumed homicide of Mário Guilherme Augusto de Sampaio in 1890 was allegedly perpetrated by his uncle, the prestigious doctor Vicente Urbino de Freitas. This famous poisoning had international repercussions for decades, with the participation of several forensic experts that made the history of forensic sciences, namely forensic toxicology and pathology. This third work aims to collect, restore, and analyse all the forensic evidence, particularly from the autopsy, toxicological, and psychiatric forensic reports. Facts regarding the life of Vicente Urbino de Freitas during his exile in Brazil were also recovered, along with a vast and outstanding assortment of forensic medicine photographs from the 19th century.     

影响DNA检验因素的研究

人类DNA检验在为破案和诉讼提供重要甚至关键证据的同时,DNA应用的一些缺点和弊端也逐渐暴露出来。本文就人类DNA检验作为证据需要注意和解决的问题进行了综述。     

Death and injury caused by land mines in Burma

One hundred and eighty-eight Burmese refugees in Thailand were interviewed. One hundred and five of those interviewed had knowledge of a total of 313 persons who had been exposed to land mine explosions. Twenty-three of the interviewed were land mine survivors. They were all male, aged between eight and 68 years, and all except one had been injured between 1986 and 1997. Fifteen of the 23 were civilians, eight were guerilla soldiers who were injured either in battle or while deploying or disarming land mines. Those who had stepped on land mines were all crus or femur amputated and had several scars on the lower limbs, abdomen and some also on the forearms. Those who had handled a land mine had lost either fingers or hands and one also lost both eyes. This study shows that the frequency of land mine accidents in Burma has been underestimated and that the mortality is high. The study also supports the general impression that many victims are civilians.     

Evaluation of Agonal Cardiac Function for Sudden Cardiac Death in Forensic Medicine with Postmortem Brain Natriuretic Peptide (BNP) and NT-proBNP: A Meta-analysis

Sudden cardiac death (SCD) is an unexpected death caused by a sudden loss of cardiac function, which is currently a global public health problem. Evaluation of the agonal cardiac function of the deceased is a quite important task for the diagnosis of SCD in forensic medicine. Brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are currently considered as significant biomarkers for the diagnosis of heart failure in both clinical and forensic practices. To investigate the postmortem evaluation roles of postmortem BNP and NT-proBNP levels for SCD, the present study meta-analyzed eight related studies from Embase, Cochrane Library, PubMed, China Biomedical Literature Database, China National Knowledge Infrastructure, and Wanfang Data. Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of the included literature, and the meta-analysis was performed by RevMan 5.3.5 software. Postmortem NT-proBNP in pericardial fluid showed higher levels in the SCD group than that of the non-SCD group with the weighted mean difference = 3665.74, 95% confidence interval: 1812.89–5518.59, and p = 0.0001. However, postmortem levels of BNP in pericardial fluid and NT-proBNP in serum revealed no statistical difference between SCD and non-SCD subjects. The results of present meta-analysis demonstrated that postmortem NT-proBNP in the pericardial fluid could be used as an ancillary indicator for evaluation of agonal cardiac function in forensic medicine.     

Unusual Elevator-Related Deaths: A Report of Two Cases

We present two cases of elevator-related deaths that occurred in two different elevators, and deaths were caused by a similar, but unusual, mechanism. An elevator is a platform or compartment housed in a shaft for raising and lowering people or things to different levels. Elevator-related deaths and injuries are rarely reported in the literature. In most of these cases, cause of death was attributed to falls. It seems that most of the elevator accidents may be attributed to factors related to device maintenance inadequacies or even to device malfunctioning. In our cases, both elevator cars were not equipped with full-length inner doors, thus allowing both accidents to occur. Since 2014, the European Union adopted a relative directive, which imposes the need to equip all elevators with such full-length doors. The enforcement of the above-mentioned EU Directive is crucial, in order to prevent similar accidents in the future.     

新冠肺炎尸检:法医工作者面临的挑战与对策

新型冠状病毒肺炎(简称"新冠肺炎")病例于2019年12月出现,疫情在短时间内蔓延,已导致数千名患者死亡。目前我们对新冠肺炎的致病、转归、致死的病理学机制了解甚少,尽早开展新冠肺炎死亡病例的尸体检验尤为重要,这给法医工作者带来了挑战。新冠肺炎尸检应在可以维持负压的独立解剖室进行,检验人员应严格按照三级防护标准穿戴防护用具,注重环境、器械、耗材的消毒以及废液废弃物处理。解剖及检验过程应规范、谨慎,尽量减少切割操作,并避免体液流出或组织飞溅导致病毒传播。本文将就法医工作者面临新冠肺炎尸检的挑战与对策做一述评。     

等速技术检测膝关节伪装瘫痪的可靠性

目的评估等速技术对健康青年志愿者配合及伪装膝关节运动的重测可靠性。方法 30名健康青年志愿者在30°/s角速度下间隔45min执行2次向心全力配合及半力、随机力量伪装膝关节屈伸运动,对2次测试的峰力矩(peak torque,PT)值进行统计学分析。结果全力测试的相对可靠性ICC值(0.892~0.956)大于半力和随机力量的ICC值(0.246~0.481),并且全力的绝对可靠性各参数数值均小于半力和随机力量。结论在配合条件下,等速技术对健康青年膝关节PT的检测具有良好的可靠性,并高于伪装条件下的可靠性。