人体冠心病心肌组织cTnI免疫组织化学研究

目的 研究cTnI免疫组织化学法诊断人体急性心肌梗死的法医病理学意义.方法 应用免疫组织化学法检测人体冠心病心肌组织cTnI的变化,进行图像分析,与HE染色法进行比较.结果 人体冠心病心肌组织急性心肌梗死区域心肌细胞内cTnI免疫组化染色缺染、分布失规律性;梗死修复区域纤维间质cTnI免疫组化染色弱阳性:陈旧性心肌梗死瘢痕区域纤维间质cTnI免疫组化染色阴性.失血性休克组近心内膜心肌细胞内cTnI免疫组化染色轻度增强,并见点灶状心肌细胞内cTnI免疫组化染色缺染.结论 cTnI免疫组织化学检测可以应用于人体急性心肌梗死的诊断.     

SPECIAL NEEDS CHILDREN IN FAMILY COURT CASES

This article presents a conceptual framework for describing cases involving children with special needs that are increasingly being seen in family court. Three categories that represent the most common of such cases include (1) acute, life-threatening medical conditions; (2) chronic developmental disorders; and (3) psychological and behavioral syndromes. After detailing the nature of the disabilities in each category, perspectives from the bench are offered with specific recommendations and general strategies for effective case management. This is followed by a proposal of an innovative conceptual model—the Individualized Parenting Plan (IPP)—that organizes and integrates nine domains essential for a comprehensive parenting plan for special needs children. The article concludes with a list of sixteen strategic guidelines for servicing the families of these special needs children, in their best interests.     

冠状病毒感染性疾病尸体检验相关病原学检测回顾与展望

冠状病毒曾经给世界带来两次严重的人类间大流行,包括严重急性呼吸综合征(severe acute re?spiratory syndrome,SARS)和中东呼吸综合征(Middle East respiratory syndrome,MERS),2019年岁末新型冠状病毒肺炎(coronavirus disease 2...     

家兔急性胰腺炎死后不同时间眼玻璃体液淀粉酶变化

目的探讨急性胰腺炎死后不同时间眼玻璃体液淀粉酶变化。方法用1%牛胆酸钠诱导家兔急性胰腺炎动物模型建立,于死后不同时间和正常对照组,观察其淀粉酶变化。结果家兔急性胰腺炎死后72h眼玻璃体液淀粉酶含量(x)与死亡时间(y)存在相关关系,并导出其二项式回归方程为y=8.7420 0.7699x-0.0083x2(R2=92.62792,F=14.89734,P=0.001)。可作为推定早期损伤时间的参考指标。结论家兔急性胰腺炎死后不同时间眼玻璃体液淀粉酶改变为法医早期死亡时间推断提供了灵敏客观的实验依据。     

兔急性心肌缺血脱氢酶电镜—细胞化学变化的动态观察

为了研究急性心肌缺血脱氢酶变化的规律性，本文应用电镜酶细胞化学技术，通过结扎５０只家兔冠状动脉左前降支，观察心肌缺血后０．２５、０．５、１、１．５、２、４、６、１２、２４、３６、７２小时ＳＤＨ和ＬＤＨ的变化。结果显示：心肌缺血０．５小时后，ＳＤＨ和ＬＤＨ活性开始下降。同时伴有致密体的形成和超微结构的改变。随着缺血时间的延长，酶活性下降更加明显，最后消失。     

Undiagnosed, untreated acute promyelocytic leukemia presenting as a suspicious sudden death

Acute promyelocytic leukemia (APL) is a subtype of acute myelogenous leukemia frequently associated with clotting abnormalities and severe hemorrhagic diathesis. The disease is associated with a high incidence of early fatal hemorrhage. We report the sudden death of a 40-year-old male without significant medical history in which foul play had been initially suspected. A thorough postmortem investigation performed on the decedent lead to the diagnosis of APL. Cause of death was a cerebellar hematoma. Underlying APL should be considered in the differential diagnosis when unexplained bleeding is encountered in a decedent. This case emphasizes the value of routinely collecting bone marrow during an autopsy to enable accurate testing and diagnosis.     

大鼠急性早期心肌梗死细胞膜PNA受体表达

探测急性心肌缺血早期细胞膜PNA受体的表达特点。应用免疫组化法(S-P法)对32只SD大鼠急性心肌缺血早期不同时间心肌细胞膜凝集素受体的表达进行研究。结果发现:心肌缺血15min时,心肌局部可出现PNA染色阳性,且随着缺血时间的延长,其阳性表达面积明显增加;缺血2h;其表达水平达到高峰,呈弥漫性染色阳性,明显高于对照组;2h后,心肌缺血区域PNA受体的表达开始出现下降趋势。实验结果稳定,敏感性强,可为心肌缺血早期诊断提供客观的依据。     

Repeat Coronary Artery Dissection in Pregnancy: A Case Report and Review of the Literature

Non‐atherosclerotic spontaneous coronary artery dissection (NA‐SCAD) is a rare cause of morbidity and mortality with a propensity for young, healthy, and often peripartum women. NA‐SCAD etiology is poorly understood, with possible hormonal and hereditary mechanisms. Current treatment strategies range from conservative management (often showing resolution on angiographic follow‐up) to invasive angiographic procedures. Rarely, NA‐SCAD has recurred in another coronary artery, ranging hours to years later. We report NA‐SCAD of the right coronary artery (RCA) in a 30‐year old, 3‐month postpartum female with an additional autopsy finding of remote myocardial infarction (MI) in the left anterior descending (LAD) coronary artery territory. The remote MI is consistent with prior NA‐SCAD of the LAD and, given the medical history, may have occurred in the peripartum period of the decedent first pregnancy 3 years earlier. As such, to the best of our knowledge, this may represent the first reported case of NA‐SCAD recurrence in a subsequent pregnancy.     

急性犬瘟热伴发寄生性肠炎的病理形态学观察

为从病理学方面调查急性犬瘟热与寄生性肠炎的关系,通过免疫组织化学、苏木精伊红和过碘酸雪夫氏染色等方法,对12例急性犬瘟热伴发腹泻的病例进行了病理组织学研究。结果表明,6例腹泻主要是由球虫引起的,2例由隐孢子虫所致。犬球虫主要存在于病犬的空肠和回肠黏膜的上皮细胞内,在脱落的肠上皮细胞和被破坏的肠绒毛所形成的黏液内,也能检出大量的球虫。最常见的球虫形态为滋养体和裂殖体,滋养体多位于上皮细胞内或细胞间,断面呈不整圆形,核位于中央,被苏木精深染,原生质淡染呈细网状,质膜明显;裂殖体多呈不整圆形,内有香蕉状的裂殖子,位于变性的肠上皮细胞内,含有较多的糖原颗粒,用过碘酸雪夫氏染色时呈红色。隐孢子虫主要位于肠上皮细胞和肠腺上皮细胞的纹状缘,引起微绒毛破坏和细胞脱落。用抗犬瘟热病毒核衣壳蛋白单抗染色检查,小肠黏膜上皮细胞、隐窝的腺上皮细胞、浸润在肠黏膜固有层的淋巴细胞、巨噬细胞和集合淋巴结的树突状细胞均呈强阳性反应。据此认为急性犬瘟热的寄生性腹泻是在犬瘟热病毒引起肠黏膜抵抗力降低的基础上发生的。     

Diagnostic dilemma of sudden deaths due to acute hemorrhagic pancreatitis

Sudden death due to acute pancreatitis has been rarely determined. A review of 3305 autopsies performed between 1991 and 2001 at the Council of Forensic Medicine found 12 cases (0.36%) with sudden death due to acute hemorrhagic pancreatitis without symptoms. A history of chronic alcohol ingestion was obtained from family in four cases (33%), and no stones were found in the bile ducts or in the gall bladders. During the autopsies, hemorrhage and edema were localized on the head of the pancreas in three cases and the whole pancreas in nine cases. The most common extrapancreatic pathology was found in the lung including pulmonary edema, alveolar hemorrhage, pleural effusion, and pulmonary congestion. There was no correlation between pulmonary and pancreatic damage. It is suggested that the forensic pathologists who are dealing with sudden unexpected death must not ignore the examination of pancreatic and extrapancreatic regions to avoid missing acute pancreatitis.