图片再认ERP在重型颅脑损伤后记忆障碍鉴定的应用

目的探讨图片再认事件相关电位（ERP）对重型颅脑损伤（sTBI）后记忆障碍法医学鉴定的应用价值。方法采用韦氏记忆量表（WMS—RC）和Neuroscan ERP仪,对74例健康志愿者（对照组）及需评定精神伤残等级的29例重型颅脑损伤后记忆障碍者（sTBI组）进行记忆能力和图片再认ERP检测。结果sTBI组WMS-RC各分测验量表分及记忆商数（MQ）均值均明显低于对照组（P〈0．01）;完成ERP任务的反应时、正确率明显延长和降低（P〈0．01）。对照组在靶与非靶刺激呈现后170ms和500ms左右均可记录到潜伏期无显著性差异的二个正向波（P170和P500）,但靶刺激诱发的P500波幅明显高于非靶刺激（P〈0．01）;sTBI组可记录到相似的ERP波形,但各成分的波幅、潜伏期均明显降低和延长（P〈0．01）。sTBI组P500潜伏期与WMS—RC的记图、再认、再生分测验量表分和MQ值均呈高度负相关（r=-0．73～-0．83,P〈0．01）,而与伤残等级呈明显正相关（r=0．65,P〈0．01）。结论图片再认诱发的Psoo潜伏期与WMS-RC反映的短时记忆功能及鉴定的精神伤残等级明显相关,可为sTBI后记忆障碍的伤残鉴定提供一项较客观的神经电生理依据。     

Unusual suicide with a chainsaw

Described here is a case of suicide with the use of a chainsaw. A female suffering from schizophrenia committed suicide by an ingenious use of a chainsaw that resulted in the transection of her cervical spine and spinal cord. The findings of the resulting investigation are described and the mechanism of suicides with the use of a chainsaw is reviewed. A dry bone study was realized to determine the bone sections, the correlation between anatomic lesions and characteristics of chainsaw. The damage of organs and soft tissues is compared according to the kinds of chainsaw used.     

Differentiation between drug use and environmental contamination when testing for drugs in hair

Personality disorders are associated with criminality and antisocial and borderline personalities as strong predictors of violence. Nevertheless antisocial patients show more instrumental violence, while borderline patients more emotional violence. We surveilled medical records of a personality disorder facility, searching data of aggression and crimes against property among 11 patients with antisocial personality disorder and 19 borderline personality disorder. We found that there are differences regarding engagement in violence and lawbreaking according to the personality disorder: antisocial patients statistically engage more in crimes against property than the borderline patients, and more in this kind of crime than in aggression, whilst borderline patients show a tendency to engage more in episodes of aggression and physical violence than antisocial patients, and less in crimes against property. We conclude that the distinct personality leads to a distinct pattern of crimes and violence: antisocial patients are cold and get more involved in crimes requiring more detailed planning, whilst borderline patients are impulsive and engage in explosive episodes of physical violence. Further studies on the association among personality disorder, behavior pattern and violence type may be useful for both treatment and criminal profiling.     

105例儿童抽动障碍临床资料分析及中药疗效观察

目的 了解儿童抽动障碍的临床特点及中医证型分布,观察中药治疗儿童抽动障碍的临床疗效。方法 以确诊为抽动障碍的105例儿童作为研究对象,进行临床分析。在停用所有西药2周后,予自拟抽动1号方加减治疗3个月,观察疾病疗效和中医证候疗效。结果 105例儿童抽动障碍的临床表现多样化,误诊率高达57.1%,中医证型分布以肝亢风动型最多,自拟抽动1号方治疗儿童抽动障碍的总有效率达93.3%,随访1年后复发率为21.9%。结论 具有平肝熄风、镇静止痉功效的自拟抽动1号方对儿童抽动障碍有较好疗效,且无明显不良反应。     

电针“神门”穴对创伤后应激障碍小鼠行为学参数和前额叶皮质FKBP5表达的影响

目的 观察电针“神门”穴对创伤应激后障碍（post-traumatic stress disorder,PTSD）小鼠焦虑样行为及前额叶皮质FK506结合蛋白5（FK506-binding protein 5,FKBP5）表达的影响。方法 将C57小鼠随机分为正常组、模型组、电针组,每组6只。模型组和电针组小鼠采用单一延长应激加电刺激法复制PTSD小鼠模型。电针组小鼠每日针刺“神门”穴15 min,每日1次,连续14 d。利用旷场实验、高架十字迷宫实验检测小鼠行为学参数。采用实时荧光定量PCR法检测小鼠前额叶皮质FKBP5 mRNA表达水平,采用Western blot法检测小鼠前额叶皮质FKBP5表达水平。结果 旷场实验中,电针可明显提高模型小鼠中央区域停留时间、跨格次数（P＜0.05）;高架十字迷宫实验中,电针可明显增加模型小鼠开臂时间、开臂次数、开臂时间比、开臂次数比（P＜0.05）。模型组小鼠前额叶皮质FKBP5及其mRNA表达水平较正常组明显升高（P＜0.05）;电针组小鼠前额叶皮质FKBP5及其mRNA表达水平较模型组显著降低（P＜0.05）。结论 电针能明显改善PTSD小鼠焦虑样行为,其作用机制可能与增加PTSD小鼠前额叶皮质FKBP5的表达水平有关。     

反社会人格障碍者犯罪的特点

反社会人格障碍是以行为不符合社会规范为主要特点,犯罪倾向极其明显,是极易导致犯罪的变态人格之一,本文对反社会人格障碍者犯罪在认识、情感、意志的特点进行理论阐述,为预防打击反社会人格障碍犯罪提供理论依据     

A Cross-Cultural Assessment of Posttrauma Reactions Among Malaysian and US Women Reporting Partner Abuse

Information on partner abuse in women from non-Western cultures and resulting psychological morbidity are scant. The present study examined these issues among women who experienced partner violence and sought refuge at a domestic violence shelter in Malaysia. These women completed a semi-structured interview and standardized measures to assess posttrauma morbidity. Responses by Malaysian shelter residents were compared with a sample of US women who also reported partner violence. The majority of women in both samples reported severe levels of distress and met criteria for posttraumatic stress disorder (PTSD). These findings suggest that psychological problems that women face after partner abuse may be similar in many respects, despite political, geographical, or cultural differences.     

头部创伤后精神障碍的司法鉴定(附34例分析)

目的研究头部创伤和精神障碍的关系及其伤情评定等相关问题。方法34例头部创伤1年后出现精神障碍的鉴定案例，分为车祸组与殴伤组，对两组有关数据进行卡方检验。结果车祸组出现明显昏迷者及具有明确神经系统体征者显著多于殴伤组，殴伤者出现痴呆样表现者多于车祸组，两组出现精神病性症状、社会功能严重缺陷或丧失的例数没有显著差异。结论头部创伤严重程度和精神障碍的严重程度及后果不成比例，在伤情评定时对精神功能缺陷及丧失这一重要因素应充分加以考虑。     

Narcotics use,property crime,and dealing: Structural dynamics across the addiction career

Structural-equation modeling is used to test causal relationships between narcotics addiction and the associated cost-support activities of property crime and drug dealing across four critical periods of the addiction career. It is argued that structural-equation methodology yields greater insight into the causal dynamics of such activities than the typical methodologies of comparing means and proportions. Using structural coefficients of longitudinal models to infer causal relationships and stability, it is found that (1) dealing is often a predictor of future narcotics involvement; (2) narcotics use, property crime, and dealing are mutually interrelated during periods of elevated narcotics use and are not related during periods of reduced narcotics use; (3) dealing appears to be the most stable of the three variables, although narcotics use and property crime show appreciable stability as well; and (4) property crime and dealing appear to be inversely related to a moderate extent. The relevance of these findings to the understanding of the economic behavior of addicts during the initiation and cessation of addiction, relapse, and maturing out is discussed.