Comparison of CT Values between Thrombus and Postmortem Clot Based on Cadaveric Pulmonary Angiography / 法医学杂志

OBJECTIVES@#To explore the difference in CT values between pulmonary thromboembolism and postmortem clot in postmortem CT pulmonary angiography (CTPA) to further improve the application value of virtual autopsy.@*METHODS@#Postmortem CTPA data with the definite cause of death from 2016 to 2019 were collected and divided into pulmonary thromboembolism group (n=4), postmortem clot group (n=5), and control group (n=5). CT values of pulmonary trunk and left and right pulmonary artery contents in each group were measured and analyzed statistically.@*RESULTS@#The average CT value in the pulmonary thromboembolism group and postmortem clot group were (168.4±53.8) Hu and (282.7±78.0) Hu, respectively, which were lower than those of the control group (1 193.0±82.9) Hu (P<0.05). The average CT value of the postmortem clot group was higher than that of the pulmonary thromboembolism group (P<0.05).@*CONCLUSIONS@#CT value is reliable and feasible as a relatively objective quantitative index to distinguish pulmonary thromboembolism and postmortem clot in postmortem CTPA. At the same time, it can provide a scientific basis to a certain extent for ruling out pulmonary thromboembolism deaths.

Virtual Autopsy Morphological Features of Drowning / 法医学杂志

OBJECTIVES@#To explore the application value of virtual autopsy to obtain key evidence information on drowned corpses and its application value of virtual autopsy in the diagnosis of drowning.@*METHODS@#In this study, 7 corpses were selected as the research objects. The image data of corpses were collected by computed tomography (CT) before conventional autopsy. The characteristics of corpses were observed through image reading, combined with virtual measurement indexes, and compared with 15 non-drowned corpses.@*RESULTS@#The postmortem CT of drowning showed the more fluid in respiratory tract than the non-drowning, and ground-glass opacities in the lung. The statistical volume of fluid in the sinus (maxillary sinus and sphenoid sinus) was (10.24±4.70) mL in drowning cases and (2.02±2.45) mL in non-drowning cases. The average CT value of fluid in the sinus, left atrial blood and gastric contents in drowning cases were (15.91±17.20), (52.57±9.24) and (10.33±12.81) HU, respectively, which were lower than those in non-drowning cases (P<0.05).@*CONCLUSIONS@#The comprehensive consideration of multiple characteristic image manifestations and the virtual measurement indexes are helpful to the forensic pathological diagnosis of drowning. Virtual autopsy can be used as an auxiliary method in the forensic diagnosis of drowning.

Comparison among Four Deep Learning Image Classification Algorithms in AI-based Diatom Test / 法医学杂志

OBJECTIVES@#To select four algorithms with relatively balanced complexity and accuracy among deep learning image classification algorithms for automatic diatom recognition, and to explore the most suitable classification algorithm for diatom recognition to provide data reference for automatic diatom testing research in forensic medicine.@*METHODS@#The "diatom" and "background" small sample size data set (20 000 images) of digestive fluid smear of corpse lung tissue in water were built to train, validate and test four convolutional neural network (CNN) models, including VGG16, ResNet50, InceptionV3 and Inception-ResNet-V2. The receiver operating characteristic curve (ROC) of subjects and confusion matrixes were drawn, recall rate, precision rate, specificity, accuracy rate and F1 score were calculated, and the performance of each model was systematically evaluated.@*RESULTS@#The InceptionV3 model achieved much better results than the other three models with a balanced recall rate of 89.80%, a precision rate of 92.58%. The VGG16 and Inception-ResNet-V2 had similar diatom recognition performance. Although the performance of diatom recall and precision detection could not be balanced, the recognition ability was acceptable. ResNet50 had the lowest diatom recognition performance, with a recall rate of 55.35%. In terms of feature extraction, the four models all extracted the features of diatom and background and mainly focused on diatom region as the main identification basis.@*CONCLUSIONS@#Including the Inception-dependent model, which has stronger directivity and targeting in feature extraction of diatom. The InceptionV3 achieved the best performance on diatom identification and feature extraction compared to the other three models. The InceptionV3 is more suitable for daily forensic diatom examination.

Research Progress of Automatic Diatom Test by Artificial Intelligence / 法医学杂志

Diatom test is the main laboratory test method in the diagnosis of drowning in forensic medicine. It plays an important role in differentiating the antemortem drowning from the postmortem drowning and inferring drowning site. Artificial intelligence (AI) automatic diatom test is a technological innovation in forensic drowning diagnosis which is based on morphological characteristics of diatom, the application of AI algorithm to automatic identification and classification of diatom in tissues and organs. This paper discusses the morphological diatom test methods and reviews the research progress of automatic diatom recognition and classification involving AI algorithms. AI deep learning algorithm can assist diatom testing to obtain objective, accurate, and efficient qualitative and quantitative analysis results, which is expected to become a new direction of diatom testing research in the drowning of forensic medicine in the future.

Sharing the WHO guideline on control and elimination of human schistosomiasis to achieve the goal of schistosomiasis elimination in China / 中国血吸虫病防治杂志

Currently, the national schistosomiasis control program of China is moving from transmission interruption to elimination, and there are multiple challenges during the stage moving towards the progression of schistosomiasis elimination, including a high difficulty in shrinking snail-infested areas, unstable achievements for infectious source control, imperfect surveillance system and a reduction in schistosomiasis control and administration. Based on the core suggestions proposed in the 2022 WHO guideline on control and elimination of human schistosomiasis, recommendations on schistosomiasis surveillance system building, development of novel diagnostics, adjustment of the schistosomiasis control strategy and maintaining and improvements of the schistosomiasis control capability are proposed for the national schistosomiasis control program of China in the new era according to the actual status of schistosomiasis control in China. Formulation of the national schistosomiasis control strategy and goal from One Health perspective, verification of transmission interruption and elimination of schistosomiasis, precision implementation of schistosomiasis control interventions with adaptations to local circumstances, development and application of highly sensitive and specific diagnostics are recommended for elimination of schistosomiasis in China. In addition, the implementation of the 2022 WHO guideline on control and elimination of human schistosomiasis may guide the elimination of schistosomiasis in China.

Conversion of serum anti-Schistosoma japonicum antibodies detected by immunological tests following treatment with praziquantel: a meta-analysis / 中国血吸虫病防治杂志

Objective To evaluate the conversion of serum antibodies against Schistosoma japonicum in humans and livestock detected by immunological tests following treatment with praziquantel. Methods The studies pertaining to serological tests of schistosomiasis japonica published from 1991 to 2020 were retrieved in electronic databases, including Chinese National Knowledge Infrastructure, WanFang Data, PubMed and ScienceDirect. Data were extracted from included studies. The publication bias was assessed with funnel plots using the software RevMan version 5.3, and the conversion of antibodies against S. japonicum was evaluated through meta-analysis. Results A total of 40 publications were included in the final meta-analysis, consisting of 33 Chinese publications and 7 English publications, and all immunological tests were performed with indirect hemagglutination test (IHA) and enzyme-linked immunosorbent assay (ELISA). Pooled analysis showed that the negative rates of serum anti-S. japonicum antibody were 45.36% [95% confidential interval (CI): (43.96%, 46.76%)] and 20.83% [95% CI: (19.69%, 21.97%)] detected by ELISA and IHA within 6 months post praziquantel treatment, 62.95% [95% CI: (61.59%, 64.31%)] and 55.61% [95% CI: (54.21%, 57.01%)] within 6 to 12 months after treatment and 85.92% [95% CI: (84.94%, 86.90%)] and 86.90% [95% CI: (85.95%, 87.85%)] over 12 months after treatment, respectively. Conclusions The negative rate of the serum anti-S. japonicum antibody by IHA and ELISA increased with the time of post-treatment with praziquantel. The overall negative rates of anti-S. japonicum antibody detected by IHA and ELISA are low within 12 months post praziquantel treatment. However, a high negative rate of anti-S. japonicum antibody is detected if there is no new contact with infested water after 12 months of praziquantel treatment.

Analysis of Influencing Factors of Single Camera Photogrammetry in Forensic Three-Dimensional Reconstruction / 法医学杂志

Objective To evaluate the influence of factors such as the selection of equipment, focal length and the selection of reconstruction quality in the reconstruction software on the reconstruction results of single camera photogrammetry and provide reference for the forensic application of single camera photogrammetry. Methods The 19 skulls were measured by traditional measurement method and single camera photogrammetry. The differences between the two measurement methods and within the group with same equipment but different focal length were analyzed. One skull and one corpse were selected as the research objects. According to the reconstruction quality selection conditions in the photogrammetric software, the experimental group was divided into five grades. The model reconstructed by optical scanner was defined as reference model, while the model reconstructed by single camera photogrammetry was defined as test model. The test model was aligned with the reference model, 3D deviation analysis was carried out and the mean error and root mean square （RMS） values were calculated. Results The differences between EOS 7D zoom group and traditional measurement, and within the group with same equipment had statistical significance （P<0.05）. The mean error value and minimum RMS value of the skull reconstructed by single camera photogrammetry and the three-dimensional model of the corpse existed in the medium quality group, and the trend was basically the same. Conclusion The equipment and focal length has no obvious influence on the results of single camera photogrammetry. Lower reconstruction quality can easily cause distortion, while higher reconstruction quality can easily generate noise, so medium quality is preferred.

Application of Artificial Intelligence Automatic Diatom Identification System in Practical Cases / 法医学杂志

Objective To discuss the application of artificial intelligence automatic diatom identification system in practical cases, to provide reference for quantitative diatom analysis using the system and to validate the deep learning model incorporated into the system. Methods Organs from 10 corpses in water were collected and digested with diatom nitric acid; then the smears were digitally scanned using a digital slide scanner and the diatoms were tested qualitatively and quantitatively by artificial intelligence automatic diatom identification system. Results The area under the curve （AUC） of the receiver operator characteristic （ROC） curve of the deep learning model incorporated into the artificial intelligence automatic diatom identification system, reached 98.22% and the precision of diatom identification reached 92.45%. Conclusion The artificial intelligence automatic diatom identification system is able to automatically identify diatoms, and can be used as an auxiliary tool in diatom testing in practical cases, to provide reference to drowning diagnosis.

Quantitative analysis of gene expression in Pomacea canaliculata infected with Angiostrongylus cantonensis and α - tubulin gene expression in various tissues / 中国血吸虫病防治杂志

Objective To investigate the expression of some genes in Pomacea canaliculata infected with Angiostrongylus cantonensis, so as to provide insight into the preliminary understanding of the interactions between Angiostrongylus cantonensis and its intermediate host Pomacea canaliculata. Methods P. canaliculata was fed with rat faces containing the first-stage larvae of A. cantonensis. Three to five P. canaliculata was sampled 1, 10 days and 20 days after feeding, and the hemolymph, hepatopancreas, kidney, intestinal tract, head-foot and gill tissues were collected, while uninfected P. canaliculata served as controls. Total RNA was extracted from various tissues of P. canaliculata at different time points post-infection, and transcribed reversely into cDNA. Based on previous transcriptome sequencing results, 10 genes associated with immune defense, signal transduction, cell growth and metabolism, stress response were selected, and the gene expression was determined in the hemolymph tissues of P. canaliculata 1, 10 days and 20 days post-infection with A. cantonensis using real-time fluorescent quantitative PCR assay, and the α-tubulin gene expression was quantified in the hepatopancreas, kidney, head-foot, intestinal tract and gill tissues of P. canaliculata infected with A. cantonensis. Results Higher CELA1 gene expression was detected in the infection group than in the control group 1 (t = 12.32, P < 0.05), 10 days (t = 23.51, P < 0.05) and 20 days post-infection (t = 34.92, P < 0.05), and the CELA1 expression increased with the time of infection. The GST gene expression was (7.26 ± 1.80) times higher in the infection group than in the control group 1 day post-infection, and was significantly lower in the infection group than in the control group 10 days (t = 23.89, P < 0.05) and 20 days post-infection (t = 19.83, P < 0.05). Higher ferritin gene expression was found in the infection group than in the control group 10 days post-infection (t = 32.76, P < 0.05), and higher CRT gene expression was seen in the infection group than in the control group 1 (t = 7.23, P < 0.05), 10 days (t = 5.78, P < 0.05) and 20 days post-infection (t = 6.32, P < 0.05). In addition, the greatest α-tubulin gene expression was observed in the the hepatopancreatic tissues of P. canaliculata (F = 17.58, P < 0.05), and the α-tubulin gene expression altered in various tissues of P. canaliculata post-infection with A. cantonensis, with the most remarkable reduction of α - tubulin gene expression seen in the hepatopancreatic tissues (P < 0.05). Conclusions Following A. cantonensis infection in P. canaliculata, the expression of multiple genes is altered, and the expression of α-tubulin gene is inhibited in multiple tissues. The findings provide a basis for the further elucidation of the interactions between P. canaliculata and A. cantonensis.

Strengthening the development and application of molecular diagnostic techniques to facilitate precision schistosomiasis control in China / 中国血吸虫病防治杂志

Oncomelania hupensis is the only intermediate host of Schistosoma japonicum, and S. japonicum-infected Oncomelania snail is one of the major risk factor of schistosomiasis transmission. Therefore, the detection of S. japonicum-infected Oncomelania snails plays a vital role in the national schistosomiasis control programmes of China. Recently, a florescent recombinaseaided amplification (RAA) assay, developed by Jiangsu Institute of Parasitic Diseases, has shown rapid, sensitive and simple to detect S. japonicum-infected Oncomelania snails, which deserves expanded experiments.

Strengthening the development and application of molecular diagnostic techniques to facilitate precision schistosomiasis control in China / 中国血吸虫病防治杂志

Oncomelania hupensis is the only intermediate host of Schistosoma japonicum, and S. japonicum-infected Oncomelania snail is one of the major risk factor of schistosomiasis transmission. Therefore, the detection of S. japonicum-infected Oncomelania snails plays a vital role in the national schistosomiasis control programmes of China. Recently, a florescent recombinaseaided amplification (RAA) assay, developed by Jiangsu Institute of Parasitic Diseases, has shown rapid, sensitive and simple to detect S. japonicum-infected Oncomelania snails, which deserves expanded experiments.

Quantitative analysis of gene expression in Pomacea canaliculata infected with Angiostrongylus cantonensis and α - tubulin gene expression in various tissues / 中国血吸虫病防治杂志

Objective To investigate the expression of some genes in Pomacea canaliculata infected with Angiostrongylus cantonensis, so as to provide insight into the preliminary understanding of the interactions between Angiostrongylus cantonensis and its intermediate host Pomacea canaliculata. Methods P. canaliculata was fed with rat faces containing the first-stage larvae of A. cantonensis. Three to five P. canaliculata was sampled 1, 10 days and 20 days after feeding, and the hemolymph, hepatopancreas, kidney, intestinal tract, head-foot and gill tissues were collected, while uninfected P. canaliculata served as controls. Total RNA was extracted from various tissues of P. canaliculata at different time points post-infection, and transcribed reversely into cDNA. Based on previous transcriptome sequencing results, 10 genes associated with immune defense, signal transduction, cell growth and metabolism, stress response were selected, and the gene expression was determined in the hemolymph tissues of P. canaliculata 1, 10 days and 20 days post-infection with A. cantonensis using real-time fluorescent quantitative PCR assay, and the α-tubulin gene expression was quantified in the hepatopancreas, kidney, head-foot, intestinal tract and gill tissues of P. canaliculata infected with A. cantonensis. Results Higher CELA1 gene expression was detected in the infection group than in the control group 1 (t = 12.32, P < 0.05), 10 days (t = 23.51, P < 0.05) and 20 days post-infection (t = 34.92, P < 0.05), and the CELA1 expression increased with the time of infection. The GST gene expression was (7.26 ± 1.80) times higher in the infection group than in the control group 1 day post-infection, and was significantly lower in the infection group than in the control group 10 days (t = 23.89, P < 0.05) and 20 days post-infection (t = 19.83, P < 0.05). Higher ferritin gene expression was found in the infection group than in the control group 10 days post-infection (t = 32.76, P < 0.05), and higher CRT gene expression was seen in the infection group than in the control group 1 (t = 7.23, P < 0.05), 10 days (t = 5.78, P < 0.05) and 20 days post-infection (t = 6.32, P < 0.05). In addition, the greatest α-tubulin gene expression was observed in the the hepatopancreatic tissues of P. canaliculata (F = 17.58, P < 0.05), and the α-tubulin gene expression altered in various tissues of P. canaliculata post-infection with A. cantonensis, with the most remarkable reduction of α - tubulin gene expression seen in the hepatopancreatic tissues (P < 0.05). Conclusions Following A. cantonensis infection in P. canaliculata, the expression of multiple genes is altered, and the expression of α-tubulin gene is inhibited in multiple tissues. The findings provide a basis for the further elucidation of the interactions between P. canaliculata and A. cantonensis.

Progress of research on association between schistosomiasis and single nucleotide polymorphisms / 中国血吸虫病防治杂志

Single nucleotide polymorphisms (SNP) has been regarded as a new genetic marker due to its rich dynamics and relatively stable heredity. SNP can express the relationship between genes and diseases to seek disease-linked genes particularly. A number of domestic and international studies have demonstrated that the formation of schistosomiasis egg granuloma is closely linked to HLA-Ⅱ related antigen. By detecting alleles loci of HLA-Ⅱ gene, researchers can identify the gene or haplotype that is associated with the susceptibility and progression of schistosomiasis. The detected candidate genes can serve useful therapeutic and preventative purposes by providing new technical methods to defeat schistosomiasis. In-depth study on SNP is beneficial to evaluate schistosomiasis inclination clinically, as well as to promote early diagnosis and preventive treatment.

Progress of research on association between schistosomiasis and single nucleotide polymorphisms / 中国血吸虫病防治杂志

Single nucleotide polymorphisms (SNP) has been regarded as a new genetic marker due to its rich dynamics and relatively stable heredity. SNP can express the relationship between genes and diseases to seek disease-linked genes particularly. A number of domestic and international studies have demonstrated that the formation of schistosomiasis egg granuloma is closely linked to HLA-Ⅱ related antigen. By detecting alleles loci of HLA-Ⅱ gene, researchers can identify the gene or haplotype that is associated with the susceptibility and progression of schistosomiasis. The detected candidate genes can serve useful therapeutic and preventative purposes by providing new technical methods to defeat schistosomiasis. In-depth study on SNP is beneficial to evaluate schistosomiasis inclination clinically, as well as to promote early diagnosis and preventive treatment.

Diagnostic Value of Postmortem CT Angiography in Coronary Atherosclerosis / 法医学杂志

OBJECTIVES@#To explore the application value of postmortem computed tomography （CT） angiography on diagnosis of coronary atherosclerotic stenosis degree.@*METHODS@#Based on the previous experimental results, the postmortem CT angiography device of human isolated heart was improved. Different coronary atherosclerotic stenosis degree of sudden death cases was selected. Before the cardiac anatomy, hearts were removed out completely and CT angiography was performed immediately. The CT angiography results were compared with histopathological findings. Meanwhile, the advantages and disadvantages of the angiography device before and after improvement were compared.@*RESULTS@#The improved angiography device of isolated heart could get better imaging results. The postmortem CT angiography results had high consistency with the histopathological findings on diagnosis of coronary atherosclerotic stenosis degree. And the coronary artery lesions could be revealed more objectively and vividly by 3D reconstruction technology. However, CT angiography could only be used to examine the pathological changes of blood vessels, which might have some limitations on the diagnosis of cause of death.@*CONCLUSIONS@#Postmortem CT angiography can be used as an additional method for the conventional autopsy in the cases of coronary atherosclerosis.

Comparison of Postmortem MSCT and Autopsy Findings in Traffic Accident Victims / 法医学杂志

OBJECTIVE@#To explore the application value of postmortem multi-slice spiral computed tomography (MSCT) by observing and analyzing the injury features in the traffic accident victims.@*METHODS@#Ten traffic accident victims were scanned with whole body MSCT. The systemic autopsy was subsequently performed to compare with the results of MSCT. The advantages and disadvantages of autopsy and MSCT for obtaining the information of traffic accident injuries were then analyzed.@*RESULTS@#MSCT could reveal 3D shape of fractures clearly and detect air accumulation in different positions of the body, which showed the obvious advantages compared with autopsy. However, the resolution of MSCT was limited compared to the detection of organ and soft tissue injuries.@*CONCLUSION@#A combination of MSCT and autopsy is the best way for determining the manner and the cause of death in traffic fatality victims.

Determination of a Newborn with Lethal Type II Osteogenesis Imperfecta and Other Anomalies Using Autopsy and Postmortem MSCT--A Case Report / 法医学杂志

A case of a stillbirth with lethal type II osteogenesis imperfecta (OI) was reported. The fetus had skull fractures and craniocerebral injuries during pregnancy. Postmortem multi-sliced computed tomography (MSCT) and 3D-reconstruction were performed, followed by a medico-legal autopsy. The autopsic findings showed the typical features of type II OI, including a soft calvarium, deformed extremities, flexed and abducted hips, and uncommon features, such as white sclera, coxa vara, absence of several bones and organs, a cleft lip, and asymmetric ears. The radiologic images revealed such anomalies and variations as a cleft palate, mandibular dysplasia, spina bifida, costa cervicalis, and fusion of the ribs and vertebrae, which were difficult to detect during conventional autopsy. The paper investigated the classification, causative mutation, cause of death, and the differentiation of OI from child abuse, coming to a conclusion that OI knowledge can be of great importance to forensic pathologists and that the merits of postmortem MSCT should be emphasized in forensic pathologic examinations.

Progress on Diatom Test in Drowning Cases / 法医学杂志

In drowning cases, it is difficult to judge whether the deceased died from drowning or throwing into the water after killed or identificate the cause of death of the decomposed corps in forensic practices. The diatom test is still considered as the important assistant evidence in drowning cases. This paper reviews research progress on technologies in recent years of forensic diatom test, and the application value of the new developing approach in the field of forensic medicine.

Research Advances in Postmortem Chemistry / 法医学杂志

Postmortem chemistry is becoming more and more essential in routine forensic pathology and has made considerable progress over the past years. Biochemical analyses of vitreous humor, blood, urine and cerebrospinal fluid may provide important information in determining the cause of death or in elucidating forensic issues. Postmortem chemistry may be essential for the determination of cause of death when morphological methods (diabetes mellitus, alcoholic ketoacidosis and electrolytic disorders) cannot detect the pathophysiological changes involved in the death process. It can also provide many information in other forensic situations, including myocardial ischemia, sepsis, inflammation, infection, anaphylaxis and hormonal disturbances. The most recent relevant research advances on glucose metabolism, liver function, cardiac function, renal function, sepsis, inflammation, infection, anaphylaxis and hormonal aspect are hereby reviewed.

Fourier Transform Infrared Microspectroscopy of Rat Kidney with Regard to Fa- tal Hyperthermia / 法医学杂志

OBJECTIVE@#To observe the chemical groups changing in rat kidney with regard to fatal hyperthermia by Fourier transform infrared microspectroscopy (FTIR-MSP) and to provide a new method to diagnose fatal hyperthermia.@*METHODS@#Rats were sacrificed by hyperthermia, brainstem injury, massive hemorrhage and asphyxiation and divided into groups. The renal samples were dissected immediately after death. The data of infrared spectroscopy in glomerulus were measured by FTIR-MSP.@*RESULTS@#The absorbances of 3290, 3070, 2850, 1540 and 1396 cm(-1) significantly increased (P < 0.05), and the ratios of Al650/A3290 and A1650/A1540 significantly decreased (P < 0.05) in group of hyperthermia.@*CONCLUSION@#FTIR-MSP can analyze the changes of chemical groups of kidney as an auxiliary diagnosis for discriminating hyperthermia with other causes of death.