实验性脑死亡脑外器官变化

研究了原发性脑死亡垂体、肾上腺、胰腺、脾脏等脏器宏观、微观及超微结构的变化规律．结果如下：（1）胰腺腺泡酶原颗粒减少，胰岛细胞核固缩；（2）脾脏被膜下出血，脾窦扩张淤血；（3）肾上腺皮质及髓质细胞疏松，胞核浓缩；超微结构可见束状带细胞线粒体嵴消失，核质溶解；（4）腺垂体细胞核变小，胞质出现空泡，神经垂体胶质细胞增生，纤维组织排列紊乱，染色浅淡；（5）原发性脑死亡可以引起脑外器官包括垂体、肾上腺、胰腺、脾脏的形态结构变化，但远比脑组织本身的变化轻．     

检测浮游生物叶绿素相关基因诊断溺死的实验研究

目的评估浮游生物叶绿素相关基因检测用于溺死诊断的价值。方法将18只大白兔随机分为溺死组（n=10）、死后抛尸组（n=6）和对照组（n=2）,各组分别取心血及肺、肝、肾、脑组织,分离浮游生物并提取其DNA,用PCR技术检测叶绿素相关基因EG（EG1和EG2）及SK（SK1和SK2）。同时用硝酸消化法检验肺和肝组织中的硅藻。结果溺死组心血及肺、肝、肾、脑组织中EG1分别检出9、10、9、7和8例阳性,EG2分别检出8、10、7、5和7例阳性;死后抛尸组仅在心血和肺组织中各检出1例EG1阳性;对照组各组织均未检出EG1和EG2。SK1、SK2除在溺死组心血、肺和肾有少数检出外（≤2例）,在其他组未检出扩增产物。硝酸消化法从溺死组肺、肝组织中分别有9例及3例检出硅藻,死后抛尸组仅在1例肺组织中检出。结论浮游生物叶绿素相关基因EG用于溺死诊断的阳性检出率要高于硝酸消化法,在溺死诊断中具有较高的应用价值。     

脑死亡及其法医学意义

脑死亡及其法医学意义谷振勇，韩业兴综述脑死亡（ＢｒａｉｎＤｅａｔｈ）是１９６８年才明确提出的现代死亡概念［１］。脑死亡不仅是医学、法医学的重要课题，还涉及法律、哲学及伦理等多学科，引起世人瞩目。作者就脑死亡一些基本问题综述如下。一、脑死亡的定义脑死亡...     

脑死亡在日本的研究现状和法医学对策

随着脏器移植的开展，脑死亡（BrainDeath）的概念越来越被人们所认识。同时，脑死亡概念的提出对法医学在死亡时间、死亡性质的确定等方面也提出了新的要求。然而，目前有关临床医学中脑死亡发生的现状以及法医学对策的资料鲜有报道。本文介绍日本脑死亡研究的有关材料，以供参考。一、脑死亡的发生事日本厚生省脑死亡研究班于1984年对713所医院进行了调查。桂田菊嗣于1992年对全国Zll所急救中心和日本急救医学会会员所属的大规模医院脑外科等进行了问卷式调查［‘j。根据以上的调查结果及参考各因素，推恻日本每年的脑死亡发生例数在3，…     

脑死亡诊断标准

脑死亡诊断标准李如波，李德祥中国医科大学法医学系法医病理教研室（沈阳１１０００１）一、脑死亡的定义近年来随着心肺复苏水平的提高以及器官移植的广泛开展，提出了脑死亡的概念。脑死亡即包括脑干在内全脑机能完全地、不可逆转地停止，而不管脊髓和心脏机能是否存在...     

为脑死亡男孩立碑

2003年11月上旬,一场车祸致使10岁的湖北男孩赵新(化名)不幸脑死亡,开明的父母捐出了他的双肾,使两个生命之花正渐渐枯萎的孩子获得了新生。这起全国首次正式将脑死亡、器官捐献同时付诸实践的经典个案诠释着爱心、奉献和生命的意义,但它却是在我国《脑死亡法》、《器官移植法》均未立法的情况下进行的。正确认识脑死亡,将对推动我国的脑死亡立法有着划时代的意义。     

人体死后体内氰菊酯及其代谢产物分布检测1例

1案例资料1.1简要案情池某,女。2011年11月6日死亡,因死因不明怀疑被人投毒。提取心血未检出毒物成分,后解剖提取肾、心、子宫、肝、脑、肺等脏器,要求进行毒物分析检验。1.2毒物分析检验主要仪器与试剂美国ABI公司API2000 LCMS/MS;岛津LC-20A型高效液相色谱仪;甲氰菊酯、3-苯氧基苯甲酸（3-phenoxybenzoic acid,3-PBA）和甲     

盐酸曲马多在大鼠体内的分布特点

目的观察盐酸曲马多在大鼠体内的分布及其特点。方法大鼠以3倍和6倍LD50228mg/kg剂量盐酸曲马多灌胃染毒致死,取材,薄层色谱法检测其心、肺、肝、脾、肾、大脑和血内盐酸曲马多的浓度。结果3倍LD50剂量组大鼠肾、肺、血、肝、大脑、脾和心组织盐酸曲马多的浓度分别为112±15、59±17、53±31、32±19.7、22±11.5、20±20、16.7±8.3μg/g或μg/ml;6倍LD50剂量组大鼠血、肺、肝、心、肾、大脑和脾中盐酸曲马多的浓度分别为107.6±7.2、26.3±20、11.7±6.6、11.2±7.2、10.3±3.6、6.38±0.2、6.1±0.3μg/g或μg/ml。结论3倍LD50剂量组大鼠,肾、肺、血内盐酸曲马多浓度最高;6倍LD50剂量组大鼠血、肺、肝中盐酸曲马多的浓度最高。盐酸曲马多中毒时,血、肝、肺和肾可以作为法医毒物分析的检材。     

HPLC法测定百草枯急性中毒大鼠的体内分布

目的 应用高效液相色谱法对口服百草枯急性中毒大鼠体内分布进行测定。方法以200mg／kg剂量百草枯给予Wister大鼠灌胃,4h后脱臼处死,解剖取脑、心、肝、脾、肺、肾、胃、盲肠、肌肉等组织,应用固相萃取法提取,液相色谱法测定各器官组织中百草枯含量。结果各组织经检验,均检出百草枯;组织间百草枯含量（μg／g）相差明显,其中最高为胃（231．47±129．10）,其次为盲肠（87．08±39．86）、肺（22．73±10．20）,最低为心（2．01±0．36）。结论百草枯口服给药后组织分布较为广泛,除胃、肠外各脏器中以肺浓度最高。     

甲胺磷在犬体内的死后分布

目的建立甲胺磷的犬灌胃染毒致死模型,观察甲胺磷在犬体内的死后分布规律。方法犬经8倍LD50（7.4mg/kg）剂量甲胺磷灌胃后,观察其中毒症状,死亡后即刻解剖,分别取心、肝、脾、肺、肾、脑、右上肢肌、右下肢肌、胸肌、胃组织、心血、胆汁、玻璃体液和尿液,GC/MS和GC法检测其中甲胺磷含量。结果犬8倍LD50甲胺磷灌胃染毒后20min内出现中毒症状（,53.3±14.1）min死亡。各组织脏器及体液中甲胺磷含量由高到低分别为胃（99.84±0.87）μg/g、脾（46.87±28.67）μg/g、肝（43.82±22.74）μg/g、肾（43.79±29.04）μg/g、心血（35.36±13.98）μg/mL、肺（35.25±18.59）μg/g、尿34.81μg/mL、胸肌（19.23±17.18）μg/g、右上肢（16.92±8.98）μg/g、心（15.09±6.11）μg/g、右下肢（12.83±7.63）μg/g、脑（10.91±4.13）μg/g、胆汁（6.75±1.45）μg/mL、玻璃体液（6.22±4.97）μg/mL。结论甲胺磷在犬体内死后分布不均,胃、脾、肝、肾、心血、肺、尿检材中含量较高,可作为疑似甲胺磷中毒毒物分析的检材。     

溴敌隆及其代谢物-苄叉丙酮在犬体内的死后分布

目的研究溴敌隆及其代谢物-苄叉丙酮在中毒致死犬体内死后分布规律,为溴敌隆中毒检材的采取提供实验依据。方法分别经口给予犬2倍和4倍LD_(50)溴敌隆,待其死亡后迅速解剖取材,气相色谱-质谱联用法测定心血、外周血、尿、胆汁、心、肝、脾、肺、肾、脑、左下肢肌、膀胱、胃、胃内容、胰等脏器和体液中溴敌隆和代谢物-苄叉丙酮的含量。结果犬经2倍和4倍LD_(50)溴敌隆灌胃染毒后3d开始出现出血症状,(178.40±20.94)h后死亡。溴敌隆和代谢物-苄叉丙酮在各组织脏器及体液中的死后分布为:溴敌隆2LD_(50)组溴敌隆:胆汁尿、肝、心、肾心血、外周血、脾、肺等;苄叉丙酮:胆汁、尿、心血、外周血、肺、胃内容中含量高于其他脏器。溴敌隆4LD_(50)组溴敌隆:胆汁、尿肝、外周血心血、胃内容物等脏器。苄叉丙酮:胆汁、尿、肺浓度高于其他脏器。结论溴敌隆及其代谢物-苄叉丙酮在中毒致死犬体内死后分布不均匀,溴敌隆在胆汁、尿、肝脏、心血和外周血含量较高,代谢物-苄叉丙酮在胆汁、尿、肺较高。胆汁、尿、肝脏、心血、外周血可作为疑似溴敌隆中毒毒物分析的检材。     

Headspace/solid-phase microextraction/gas chromatography-mass spectrometry: a screening technique for the recovery and identification of volatile organic compounds (VOC's) in postmortem blood and viscera samples.

This paper describes the application of Headspace/Solid-Phase Microextraction/Gas Chromatography-Mass Spectrometry (HS/SPME/GC-MS) to the recovery and identification of volatile organic compounds in blood and viscera samples from deceased persons. The technique is used as a screening procedure to rapidly obtain information relating to toxicological investigations. The technique is suitable for the detection of volatiles (of wide boiling range) including butane, halothane, toluene, xylenes, and petrol residues in blood and viscera (lung, brain, and body fat).     

曲马多在家兔体内的死后分布研究

目的研究曲马多在中毒家兔体内死后分布规律,为曲马多中毒检材采取提供实验依据。方法家兔经口给予10倍LD50曲马多,待家兔死亡后迅速解剖取样,气相色谱／质谱联用和气相色谱-FTD法测定其体液、脏器、大脑及右上肢和右下肢肌肉中曲马多的含量,比较其变化规律。结果血液和肝脏中曲马多的最低检出限分别为0．05μg/mL和0．05μg/g,提取回收率为97．60％±0．65％～103．10％±1．24％。曲马多在家兔体内的死后分布为：肾〉胃〉肝〉脾〉肺〉脑〉心〉上肢肌肉〉下肢肌肉〉〉体液（尿〉胆汁、心血〉玻璃体液）。结论大剂量曲马多中毒致死后在体内分布不均匀,组织中曲马多含量明显高于心血、胆汁等体液。     

Forensic chemical testing of cadaveric material for acetonitrile

Gas chromatographic conditions for qualitative and quantitative evaluation of acetonitrile in biological material were determined, including those for reactive gas chromatography. Absolute and relative time of acetonitrile and concomitant substances retention in three columns of different polarity was determined. Study of the time of acetonitrile retention in biological material showed that acetonitrile concentration in the blood virtually did not change in cadaveric material stored in a hermetically closed flask for 2 weeks at 20 +/- 3 degrees C, while its concentration in the stomach decreased by 10-15%. Distribution of acetonitrile in human viscera in lethal poisoning was studied; the agent was evenly distributed in the gastric wall, intestine, liver, and kidney, while its concentrations in the lung and brain were 2-3 times higher. Forensic chemical expert analyses of the blood, urine, and viscera from corpses of humans dead from lethal acetonitrile poisoning showed that lethal concentration in the blood was 28.3-57.0 mg and in the urine 23.2-40.6 mg/100 ml.     

毒鼠强中毒实质性器官组织超微病理变化研究

目的观察不同浓度毒鼠强中毒大鼠实质性器官的超微病理变化。方法采用灌胃方法使大鼠毒鼠强染毒,制作大鼠中毒模型,并以健康大鼠灌服生理盐水为对照,提取大鼠的脑皮质、脑干桥脑部、心、肝、脾、肾等实质性器官,进行超微病理观察。结果不同浓度的毒鼠强可对心肌细胞、脑神经细胞、神经纤维和肝细胞造成一定损伤,而对肾、脾组织细胞损伤不明显。脑皮质神经元细胞结构模糊,内质网轻度扩张,线粒体扩张水肿,且无明显的剂量-反应关系;脑干桥脑部可见多处弥散性软化灶,神经细胞核溶解,神经纤维细胞有坏死,血管内皮细胞肿胀,血管周围有间隙出现,脑干损伤有明显的剂量-反应关系;心肌细胞表现为不同程度的心肌细胞坏死、线粒体弥漫性崩解或肿胀、肌丝断裂溶解、肌溶灶普遍存在等变化,并呈现出明显的剂量-效应关系;肝细胞表现弥漫性肿胀,细胞模糊,肝窦狭小,内皮细胞肿胀,结构模糊不清,细胞质内线粒体明显肿胀,糖原含量减少,与中毒剂量和时间均呈明显相关性。结论脑、心、肝可能为其毒性作用的主要靶器官或靶组织。     

Morphometric approaches to diagnosing the time of death

A new method has been used to evaluate the time of death. The relationship between the degree of autolysis of cadaveric viscera and time of death has been studied by histomorphometrical methods. The study was carried out on histological preparations of the lungs, heart, liver, spleen, and kidneys from 20 corpses of humans dead from craniocerebral injuries. Based on the results, tables were created for evaluating the time of death even at remote periods after death, when the results of other methods are unreliable.     

Fatal accidents with compressed air diving equipment (author's transl)]

The post-mortem findings of 4 sport divers involved in accidents showed air embolism of the heart as well as 2 subcutaneous emphysemas of shoulder and neck. The lungs were distended and the viscera were hyperaemic. The pleura showed petechiae and small patchy hemorrhages. In microscopic examination foci of alveolar hemorrhages of the lungs and, occasionally, muscosal rupture of small branches of the bronchial tree and of the bronchioli could be determined. The most likely causes for the accidents are discussed and special attention is given to panicking under water.     

Fatal intoxication with labetalol (Trandate)

The dead body of a 44-year-old woman, previously known for depression and alcoholism, has been discovered at her place of residence by her husband. A forensic autopsy has been carried out. The results indicated unspecific histological lesions (alveolar oedema, liver steatosis and interstitial nephritis) but did not reveal any apparent cause of death. Several boxes of medicines have been found near the body, justifying a toxicological analysis. This has been performed on peripheral blood and urine samples using liquid chromatography with diode array and mass spectrometric detections, in conjunction with gas chromatography coupled with mass spectrometry. Ethanol has been found (1.24 g/L in blood, 2.63 g/L in urine and 1.33 g/kg in gastric content), as well as therapeutic concentrations of meprobamate (14.1mg/L) and low concentrations of nordazepam (0.12 mg/L) in blood. On the other hand, particularly high levels of labetalol, a widely used beta-blocker, have been found both in blood (1.7 mg/L) and urine (20.2mg/L), which led us to measure labetalol levels in available viscera samples (liver, heart, kidney, and lung) and gastric content. Measured concentrations were 14.2 microg/g, 7.8 microg/g, 5.4 microg/g, 5.2 microg/g and 31.1 microg/g, respectively. We describe here the first report of a fatal intoxication attributed to labetalol that is linked to its acute toxicity, with tissue distribution of this beta-blocker.     

Histopathological Profile In Fatal Yellow Phosphorous Poisoning

Yellow phosphorous (YP) is the toxic form of elemental phosphorous and the chief constituent of firecrackers and rodenticides. In India, the rodenticide paste is frequently used for the suicidal purpose. This study is an autopsy‐based observational study which describes the histopathological features of heart, lungs, liver, and kidney of fatal cases of YP poisoning. The most common autopsy features in the viscera were congestion and petechial hemorrhage. The liver histopathology findings were microvesicular steatosis (68%), hepatic necrosis (62%), macrovesicular steatosis (50%), inflammatory cells (46%), sinusoidal congestion (40%), cholestasis (32%), and toxic hepatitis (18%). Hepatic necrosis ranged from being focal to centrizonal in distribution. Congestion was the most common feature observed in the lungs and the kidney. This is the largest autopsy‐based study on YP poisoning till date. The histopathological features of liver were consistent with YP poisoning whereas the findings of heart, lungs, and kidney were nonspecific in nature.     

大鼠死后组织细胞DNA含量变化与死亡时间的相关性研究

目的应用流式细胞术研究大鼠死后组织细胞DNA含量变化与死亡时间的相关性。方法SD大鼠断颈处死后于不同时间段取心、肝、脾、肾器官组织,经胰蛋白酶消化等处理后制成单细胞悬液,应用流式细胞术,在620nm波长处检测各组不同器官组织细胞DNA含量,观察其变化规律。结果大鼠各器官组织细胞DNA含量随死亡时间延长均呈下降趋势。其中以脾组织细胞DNA含量变化趋势与死亡时间最具相关性,肝、肾次之,而心最差;死后48h,各器官组织细胞仅存微量完整的细胞核DNA。结论机体死亡后,各器官组织细胞核DNA含量随死亡时间的延长逐渐减少,具有一定的变化规律,可应用组织细胞DNA含量变化来推断死亡时间。