Forensic Analysis of Sudden Death Associated with Sexual Activity / 法医学杂志

OBJECTIVES@#To analyze the characteristics of sudden death associated with sexual activity to provide recommendations for forensic identification.@*METHODS@#A retrospective analysis was conducted on autopsy cases accepted by Forensic Identification Center of Huazhong University of Science and Technology from 1998 to 2018, and a total of 15 cases of sudden death associated with sexual activity were screened out. The general information, case data and pathological changes of 15 cases were collected to find the relationship between sexual activity and sudden death.@*RESULTS@#The ratio of male to female was 1.5∶1. The average age of males was 50.1 years and that of females was 35.0 years. Coronary artery diseases and brain diseases accounted for most of the cases (12/15). Sexual partners were associated with locations of deaths and body dumping behaviors.@*CONCLUSIONS@#Sudden death associated with sexual activity, although rare, may occur in people over 30 years old with pre-existing heart or brain diseases, which should be paid attention to in forensic practice.

Advances in Neuropathologic Research of Hypoglycemic Brain Damage Caused by Insulin Overdose / 法医学杂志

The number of death from insulin overdose, including accidental poisoning, suicide and homicide, is increasing these years. The forensic diagnosis of death from insulin overdose is a tough task. Glucose is the main energy source of the brain. Therefore, hypoglycemic brain damage is considered to be the main reason of death from insulin overdose. Recently, research of hypoglycemic brain damage caused by insulin overdose is gradually being paid attention in the field of forensic medicine. This paper summarizes the neuropathologic changes, pathophysiologic process and potential neural molecular markers of hypoglycemic brain damage caused by insulin overdose in terms of forensic neuropathology, providing reference for the research and practice in forensic medicine related fields.

Trial of Chloroquines in the Treatment of COVID-19 and Its Research Progress in Forensic Toxicology / 法医学杂志

Chloroquines are the long-established prescription drug, which are often used clinically to treat malaria and connective tissue diseases. Since December 2019, corona virus disease 2019 （COVID-19） outbreaks caused by 2019 novel coronavirus （2019-nCoV） has occurred in China and many countries around the world. Due to the lack of drugs against COVID-19, the disease spreads rapidly and the mortality rate is relatively high. Therefore, specific drugs against 2019-nCoV need to be quickly screened. The antimalarial drug chloroquine phosphate which has already been approved is confirmed to have an anti-2019-nCoV effect and has been included in diagnostic and therapeutic guidelines. However, awareness of the risk of chloroquine phosphate causing acute poisoning or even death should be strengthened. The current dosage recommended in clinical treatment is larger than that in previous treatment of malaria and the period of treatment is longer. Many provinces have required close clinical monitoring of adverse reactions. This paper reviews the pharmacological effects, poisoning and toxicological mechanisms, in vivo metabolism and distribution, and forensic issues of chloroquine drugs, in order to provide help to forensic practice and clinical work.

Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 （COVID-19） （Trial Draft） / 法医学杂志

Autopsy is of great significance to the elucidation of the pathological changes, pathogeneses and causes of death of corona virus disease 2019 （COVID-19） and can provide theoretical basis for more scientific and accurate prevention and control of the outbreak. Based on related laws and regulations, such as the Law of the People's Republic of China on Prevention and Control of Infectious Diseases, the clinical manifestations and epidemiological characteristics of COVID-19, and the related guidelines on the prevention and control of the outbreak, combined with the practical work of forensic pathology examination, the Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 （COVID-19） （Trial Draft） has been developed. This guide includes information on the background investigation of the cases, autopsy room requirements, personal prevention and protections, external examinations, autopsy, auxiliary examinations, and so on. This guide can be used as a reference by forensic and pathological examination institutions, as well as examination staff.

Analysis of 4 Cases of Electrocution due to Direct Current Electronic Hunter / 法医学杂志

Objective To summarize the characteristics of cases of electrocution due to direct current （DC） electronic hunter, and to provide references for forensic identification. Methods Four cases of electrocution due to DC electronic hunter were collected. Statistical analysis was carried out from the perspective of the scene and electric marks distribution, damage characteristics and histopathological changes. Results All the 4 cases of electrocution were accidental events. There were multiple electric marks, most of which were located in the lower limbs with serious damage. Some strip type electric marks were visible. Conclusion The distribution, morphological characteristics and severity of the electric marks caused by DC electronic hunter are different from those of the ordinary low-voltage alternating current damage. It is alerting that there would be actions of destroying the scene and abandoning the corpse in such cases.

Advance of Forensic Research in Insulin Poisoning / 法医学杂志

Insulin as a common clinical hypoglycemic agent can effectively control serves to lower the concentration of blood glucose. However, insulin overdose can lead to death. In the whole fatal cases of insulin overdose, medical accident is the most common, followed by suicide. Though insulin homicide is extremely rare, it deserves great attention. Though there are some researches about insulin poisoning on forensic toxicology and pathology, it is still a difficult task in forensic practice. In this paper, the mechanism of death, pathological changes, detection methods and diagnose criteria of insulin overdose will be discussed in the view of forensic toxicology and pathology. We hope that this paper could enhance relative knowledges of insulin poisoning for medical examiners.

Magnetic resonance diffusion tensor imaging for diagnosis of pyramidal tract damage in rats / 法医学杂志

OBJECTIVE@#To explore the applicability of magnetic resonance diffusion tensor imaging (DTI) for diagnosis of pyramidal tract damage in rats.@*METHODS@#Marmarou's model was set up, followed by DTI scanning at 3, 12, 24 and 72 h post trauma to acquire the dispersion parameter of bilateral pyramidal tracts. Moreover, axonal varicosities per square millimeter and the percentage of positive area of axons demonstrated by beta-amyloid precursor protein (beta-APP) immunostaining were obtained, as well as the mean density and sum density of neurofilament (NF) 68 immunostaining.@*RESULTS@#Axial diffusivity (AD), fraction anisotropy (FA) and relative anisotropy (RA) in the pyramidal tract were significantly and continuously reduced and reached to the bottom at 72h post trauma (P < 0.05) in accord with the gradient of axonal damage verified by beta-APP and NF68 immunostaining. Furthermore, the changes of AD, FA and RA showed a significant negative correlation with the beta-APP immunohistochemical results.@*CONCLUSION@#DTI has important value for early diagnosis in pyramidal tract damage.

Advance in animal models of traumatic brain injury / 法医学杂志

Traumatic brain injury (TBI) is a highly complex multi-factorial disorder. Animal models of TBI are used to elucidate primary and secondary injury mechanisms and pathophysiological changes and to provide the diagnostic and therapeutical basis for TBI. The choices of animal models depend upon the research objectives. However, various animal models have limitations. The models only can duplicate the pivotal injury mechanisms or a certain important pathophysiological course. The characteristics of human TBI can not fully be reflected by using these models. In the review, animal models of traumatic brain injury are classified as dynamic direct brain injury, indirect dynamic brain injury and combined neuro-traumatic models. Several common models are described for consideration.

Study on electrical current mark with environmental scanning electron microscopy and energy dispersive X-ray microanalyser / 法医学杂志

OBJECTIVE@#To provide objective proof on diagnosis of electrical current mark in electrocution, the environmental scanning electron microscopy and energy dispersive X-ray microanalyser (ESEM-EDX) were adopted to study the microscopic morphological characteristics and elemental composition of electrical current mark.@*METHODS@#Morphological characteristics of electrical current marks, the elemental composition and morphology of metal particles were studied with ESEM-EDX.@*RESULTS@#The electroporation and metal melted beads could be found in the electrical current marks and skin around them. The metal melted beads mainly composed of common metal such as iron, copper, aluminum and some uncommon metal including gold, titanium and barium.@*CONCLUSION@#ESEM-EDX can be applied in forensic diagnosis of electrocution.

Recent progress in epilepsy in neuropathology / 法医学杂志

Epilepsy is a common cerebral disease, and may cause sudden death. Although electric activity study of epileptic brain had been emphasized in the past, the neuropathological study of epilepsy has become a main focus in clinical and forensic medicine recently. This article reviews the recent progress in neuropathology of epilepsy including developmental disorder, abnormal tumoral proliferation, hippocampal sclerosis, dual pathological alteration, and mossy fiber sprouting. Its significance in forensic medicine, particularly for the diagnosis of sudden unexpected death in epilepsy, is discussed.

Application of immunofluorescence and sandwich ELISA with double-antibodies in detection of human rabies / 法医学杂志

OBJECTIVE@#To explore the application of immunofluorescence and sandwich ELISA with double-antibodies in detection of human rabies.@*METHODS@#The cerebrum, cerebellum, brainstem, and hippocampus of four patients died of rabies identified by clinical diagnosis were collected and kept in freezer at -70 degrees C or in formaldehyde solution separately. The rat brain tissue infected by CVS strain of rabies virus was used as a positive control and the brain tissue of a patient died of acute pancreatitis was used as a negative control.@*RESULTS@#Rabies virus was detected in the tissues kept in freezer at -70 degrees C and the positive control but was not detected in the tissues kept in formaldehyde solution and the negative control.@*CONCLUSION@#Immunofluorescence and Sandwich ELISA with double-antibodies could be used in detection of human rabies. The samples should be kept in deep frozen temperature condition instead of in formaldehyde solution.

Changes of cyclin D1 expression following human brain contusion / 法医学杂志

OBJECTIVE@#To study the relationships of Cyclin D1 expression with the posttraumatic intervals (PTI) following the cerebra, brainstem or cerebella contusion in human.@*METHODS@#88 cases of brain contusions of the closed head injury were investigated with pathological and Cyclin D1 immunohistochemistry methods. The results were analyzed by image analysis technique (IAT).@*RESULTS@#The immunoreactivity of Cyclin D1 was almost disappeared in the core cells of the brain contusion. Cyclin D1-positive cells started to increase in the boundary of the brain contusion in the 1h group. Cyclin D1-positive cells were increased significantly in the 3 h-30 d groups and maintained at a high level in the boundary of the brain contusion of those groups. It is suggested that the Cyclin D1-positive cells were primarily origin from microglia and other glia. A few neurons expressed Cyclin D1.@*CONCLUSION@#Cyclin D1 can express in several kinds of brain cells following the contusion, especially in the glia cells. Cyclin D1-positive cells were increased obviously and rapidly after injury, so it could be used as a reference marker for early stage brain injury.

Relationship between expression of nestin in experimental brain contusion and injury time / 法医学杂志

OBJECTIVE@#To observe the alteration of nestin intervals in the experimental traumatic brain injury and investigate its relation to the injury intervals.@*METHODS@#The rat brain contusion was conducted by falling impact injury. After various survival interval (0.5, 6, 12 h and 1, 3, 7, 14, 28 d), immunohistochemical SP method was used for observing the expression of nestin in the cortex, hippocampal dentate gyrus and the corpus callosum on injury side.@*RESULTS@#Expression of nestin positive cells increased at 0.5 h and reached the maximum level in 7 d after brain contusion, then the expression decreased gradually. The intensity of nestin staining in the the cortex and the hippocampal dentate gyrus decreased to normal on 28 d. As to the corpus callosum of injury side it remained weak on 28 d.@*CONCLUSION@#The changes of nestin immunohistochemical staining can be used as an index for forensic estimation of early injury time.

Analysis and consider of technical identification for 32 cases medical tangle in medical association / 法医学杂志

OBJECTIVE@#To analyze cause of medical accidents and actuality of technical identification in medical tangle.@*METHODS@#32 cases (17 death, 15 survive) of medical tangle by technical identification (according to sex, age, mostly diseases, sequel) and identified results (whether or not mistake, cause and effect connection, duty degree) have been studied.@*RESULTS@#13 cases of 32 medical accidents have been determined.19 cases have been attributed to no medical accidents. Causes of medical accidents were most due to negligence of sense of duty.@*CONCLUSION@#The incidence rate of medical accidents can be decreased by strengthen colligated stuff of medical affairs personnal. We suggest that our state bring out more perfect legislation of autopsy in order to gain positive effect of technical identification in medical tangle. The medical mistake among grade of medical accidents should be added so that justice of identification could be improved.

The expression of COX-1 and COX-2 following brain injuries / 法医学杂志

Cyclooxygenase (COX) is the obligate, rate-limiting enzyme for the conversion of arachidonic acid into prostaglandins, which mediate mitogenesis, apoptosis, angiogenesis, blood flow, secondary injury, and inflammation. COX is consist of 2 subtypes: COX-1 and COX-2. In recent years, there are a number of lines of evidence that COX-1 and COX-2 play a important in role brain injuries.

A primary study on the ARP-SRP gene expression profiling of brain injury by cDNA microarray / 法医学杂志

OBJECTIVE@#To screen the differential expression of apoptosis-related protein and stress response protein(APR-SRP) genes after human brain injury by cDNA microrarray.@*METHODS@#The total RNAs were isolated from normal and injured brain tissues of a car-accident victim, and were purified to obtain mRNAs by Oligotex. Both mRNAs from the tissues of the injured and the normal tissue were reversely transcribed to cDNAs with the incorporation of fluorescent dUTP to prepare the hybridization probes. The probes from normal tissue was labeled with Cy3-dUTP, that from the injured tissue with Cy5-dUTP. The mixed probes were hybridized to the BioDoor Chip ARP-SRP-1.0S, a cDNA microarray which contains 77 apoptosis related protein genes and 23 stress protein related genes. After high-stringent washing, the cDNA microarray was scanned for the fluorescent signals and showed differences between two tissues.@*RESULTS@#Among the 100 target genes, Only CLN2 gene (Homo sapiens lysosomal pepstatin insensitive protease gene) showed distinct deference in expression level between the brain injury and normal tissues.@*CONCLUSION@#cDNA microarray analysis indicated that CLN2 gene, which is correlated to a fatal childhood neurodegenerative disease, might be related to the brain injury. The expression level of CLN2 gene was significantly decreased in brain injured tissue in comparison to normal tissue. Further analysis of this gene will be helpful to understand the molecular mechanism of brain injury and utilization in forensic medicine.