加减薯蓣丸抑制单磷酸腺苷活化蛋白激酶活性对慢性脑灌注不足大鼠的神经保护研究

目的 检测慢性脑灌注不足大鼠海马组织单磷酸腺苷活化蛋白激酶（adenosine monophosphate-activated protein kinase, AMPK）水平的变化,探讨加减薯蓣丸对海马神经细胞损伤的影响及其作用机制。方法 采用改良双侧颈总动脉阻断法复制慢性脑灌注不足模型,应用尼氏染色检测神经细胞损伤情况,应用Western blot法检测海马区AMPK及p-AMPK表达水平。结果 与正常组比较,模型组大鼠海马CA1区的尼氏染色较浅,神经锥体细胞数减少,海马组织p-AMPK表达水平明显升高（P<0.05）;与模型组比较,中药组与西药组大鼠海马CA1区的尼氏染色加深,锥体细胞数量增加,p-AMPK表达水平明显下降（P<0.05）;中药组与西药组大鼠海马CA1区AMPK和p-AMPK表达水平比较,差异均无统计学意义（P>0.05）。结论 大鼠慢性脑灌注不足损伤后,AMPK过度激活,出现海马神经细胞损伤,加减薯蓣丸可抑制海马区AMPK的激活,减轻海马神经损伤。     

Myocardial hypertrophy induces carotid body hyperplasia

The carotid bodies tend to enlarge after long-standing cardiopulmonary disease. Our objective was to investigate whether cardiac hypertrophy is associated with carotid body hyperplasia. Fifteen autopsy cases with combined left and right ventricular hypertrophy were examined and compared with two control groups (16 cases). The study involved a meticulous dissection of carotid bifurcations, thin serial sections, and morphometric analysis of carotid body volume and cell types (progenitor, dark, light, and sustentacular). There was a significant increase in sustentacular cells in all individuals with cardiac hypertrophy, which was not drug-induced, and accompanied by a similar increase in carotid body volume. Dark or light cell accumulation was detected focally and only in three instances. It appears that the generalized sustentacular cell hyperplasia is the result of long-standing hypoxia, while a superimposed focal prominence of dark or light cells may be proliferative or metaplastic in nature and attributed to short-term hypoxia.     

Evaluation of maxillary sinus dimensions in gender determination using helical CT scanning

Gender determination is an important step in identification in forensic medicine. CT measurements of maxillary sinuses may be useful to support gender identification. This study was undertaken to study the accuracy and reliability of maxillary sinus dimensions measurement in gender classification through the use of reconstructed helical CT images. Eighty-eight patients (43 men and 45 women) with age range from 20 to 49 years were selected in this study. The width, length, and height of the maxillary sinuses in addition to the total distance across both sinuses were measured. Data were subjected to discriminant analysis for gender using multiple regression analysis. Maxillary sinus height was the best discriminant parameter that could be used to study sexual dimorphism with an overall accuracy of 71.6%. Using multivariate analysis, 74.4% of male sinuses and 73.3% of female sinuses were sexed correctly. The overall percentage for sexing maxillary sinuses correctly was 73.9%. It can be concluded that reconstructed CT image can provide valuable measurements for maxillary sinuses and could be used for sexing when other methods of sexing are not conclusive.     

Personal Identification Using the Frontal Sinus*

Abstract: The frontal sinuses are known to be unique to each individual; however, no one has tested the independence of the frontal sinus traits to see if probability analysis through trait combination is a viable method of identifying an individual using the frontal sinuses. This research examines the feasibility of probability trait combination, based on criteria recommended in the literature, and examines two other methods of identification using the frontal sinuses: discrete trait combinations and superimposition pattern matching. This research finds that most sinus traits are dependent upon one another and thus cannot be used in probability combinations. When looking at traits that are independent, this research finds that metric methods are too fraught with potential errors to be useful. Discrete trait combinations do not have a high enough discriminating power to be useful. Only superimposition pattern matching is an effective method of identifying an individual using the frontal sinuses.     

The Reliability of Visually Comparing Small Frontal Sinuses*

Abstract: Several studies have investigated frontal sinus comparison for personal identification. One study addressed the statistical reliability of correct identification using automated digital methods and resulted in a 96% accuracy rate. Missed matches with the digital methods generally involved small, less featured sinuses. This study investigates the hypothesis that human examiners may be able to more accurately identify correct matches than digital methods, even when the comparisons involve small frontal sinuses. Participants were provided two sets of 28 radiographs and were instructed to identify matching radiographs and list the radiographs that did not have a corresponding match. Overall, error rates were low, with correct associations identified at a rate of 0.983. No incorrect associations (“false positives”) were made. Correct association rates were highest among participants “experienced” examining radiographs. Results support previous assertions that frontal sinus radiographs are a reliable means of personal identification even when the frontal sinuses are small.     

Comamonas testosteroni meningitis in a homeless man

We report a case of meningitis caused by Comamonas testosteroni in a 54-year-old, alcoholic, homeless man. He, as a pedestrian, was struck by a car and suffered multiple fractures of the facial bones including the left frontal sinus. Over the course of 2-week hospitalization, he was clinically diagnosed with multiple cerebral and cerebellar infarcts resulting in altered mental status. He was pronounced dead 15 days after the injury. At the time of autopsy, diffuse purulent meningitis was found on gross examination. A swab culture of the brain surface was positive for C. Testosteroni, a saprophytic organism commonly found in soil and water. This is the first reported case of fatal meningitis caused by this micro-organism.     

Histological examination of carotid artery tissue in cases of ligature strangulation and hanging

Violence against the neck can result in a range of macromorphological and micromorphological findings. However, the forensic relevance of the carotid sinus in cases of violence against the neck remains controversial. In this follow-up study of 22 cases of suicidal and accidental strangulations, carotid bifurcations were examined histologically for morphological changes implying direct trauma, including haemorrhage and immunohistochemical expression of heat-shock proteins 27, 60, and 70 and aquaporin-3. These cases were compared with a control group (82 cases) without neck compression or head trauma and with variable causes of death. No relevant histopathological findings implying direct trauma of the carotid bifurcation were found. No cases showed positive aquaporin-3 staining and only five cases showed positive heat-shock protein-27 staining, all of which were hangings. Without massive trauma of the carotid bifurcation, histological alterations cannot be expected. Without signs of rapid death, findings of acute circulatory failure, macromorphological and micromorphological findings of neck compression, and reliable markers indicating relevant impact on the carotid bifurcation the diagnosis of a lethal reflex cannot be verified.

Key points

• Among 22 cases of strangulation causing death, there were 16 cases of hanging and 6 cases of ligature strangulation
• Few cases showed small haemorrhages located predominantly in the surrounding fat and connective tissues; however, the haemorrhages did not have any effects on the tissues
• Neck compression had minimal effects on heat shock protein 27 expression in carotid artery tissue
• Aquaporin-3 staining suggested it is not a useful marker for relevant neck pressure, or that there had not been any relevant neck impact
• Our findings suggested no direct evidence for reflex cardiac death resulting from a brief force against the neck

     

窦房结中央动脉狭窄与心源性猝死

近年来国内外学者相继报道由单纯窦房结中央动脉狭窄引起的猝死。本文就窦房结中央动脉的解剖、组织学特点、病变特点进行综述,探讨窦房结动脉狭窄引起猝死的机制,以期为相关法医病理学死因鉴定提供理论基础。     

用于法医学同一认定的额窦CT编码

目的 使用头颅CT图像重建冠状位鼻骨切面研究额窦观测指标,以编制特异的识别编码.方法 通过距离数值量和形态学描述对额窦CT图像进行分析.额窦同一认定识别编码为:右侧额窦部分隔数,形态一额窦中间隔位置,形态一左侧额窦部分隔数,形态;右侧额窦上缘弓形弯曲数(右侧最高峰位置,最低峰位置)-左侧额窦上缘弓形弯曲数(左侧最高峰位...     

额窦数字X线影像分型与同一认定指标的筛选

目的 从法医学同一认定的视角探究柯氏位额窦计算机X线摄影(computer radiography,CR)的形态学分类,并结合识别指标的数字编码,构建X线影像同一认定体系.方法 收集 400例四川汉族成年人额窦标准柯氏位CR片.以两侧眼眶上缘均相切的直线与额窦的位置关系对额窦形态学特征进行分型研究,并对额窦识别指标进行数字编码.结果 提出额窦CR片影像学特征6类分型,筛选出额窦不对称性、最大额窦面积的侧别、同侧额窦面积与眼眶面积比、额窦上缘弓形弯曲数、额窦部分分隔位置、额窦中间隔位置等8项识别指标.结论 提出了先作分型鉴别,再用所选取的8项指标对额窦形态进行识别编码的柯氏位额窦CR片影像同一认定的新思路.