Application of IMA and H-FABP in Forensic Diagnosis of Sudden Cardiac Death / 法医学杂志

Acute myocardial ischemia is the most common cause of sudden cardiac death.The diagnosis of early myocardial ischemia is a hot point in forensic medicine,which is also an early and important part for a prevention against myocardial infarction.This paper conducts a comprehensive discussion of the structure,function,clinical value and forensic medicine application prospect of ischemia modified albumin (IMA) and heart-type fatty acid binding protein (H-FABP),aiming to determine whether the two proteins can be used as biochemical detection indicators of early myocardial ischemia for the diagnosis of sudden cardiac death in forensic medicine.

Forensic Analysis of 6 Cases of Sudden Death due to Hyperthyroid Heart Disease / 法医学杂志

Objective To analyse the cases of sudden death due to hyperthyroid heart disease,and explore the general information of deaths and the forensic pathological characteristics to provide reference evidence for forensic identification of such cases.Methods Six cases of sudden death due to hyperthyroid heart disease between 2001 and 2016 were selected from School of Forensic Medicine,China Medical University.The general information (gender and age),clinical manifestations,medical history,anatomical and histopathological findings,biochemical parameters and cause of death were analysed retrospectively.Results Most of the 6 patients had definite history of hyperthyroidism,and they all showed certain degrees of symptoms of cardiovascular disease;had obvious incentive factors of death;histopathological examination of thyroid conformed to the performances of diffuse toxic goiter;with increase of cardiac weight,dilatation of cardiac chambers,myocardial hypertrophy and focal necrosis;postmortem biochemical analyses of pericardial fluid could be used as an additional method for diagnostic of sudden death due to hyperthyroid heart disease.Conclusion The identification of death due to hyperthyroid heart disease should be based on the clinical history and the results of autopsy,histopathological examination,postmortem toxicology tests.The postmortem biochemical detection of thyroid and cardiac function should be performed if necessary.

Application of Ischemia Modified Albumin for Acute Ischemic Heart Disease in Forensic Science / 法医学杂志

Objective To explore the application value and forensic significance of ischemia modified albumin (IMA) in pericardial fluid to diagnose sudden cardiac death.Methods IMA level in pericardial fluid was detected in acute ischemic heart disease group (n=36),acute myocardial infarction group (n=6),cardiomyopathy group (n=4) and control group (n=15) by albumin cobalt binding method.The levels of IMA were compared among these groups.The best cut-off IMA value was estimated and the sensitivity and specificity of acute myocardial ischemia group was distinguished from control group by receiver operating characteristics (ROC) curve.Results The IMA level in acute ischemic heart disease group was significantly higher than that of control group (P＜0.05).Compared with acute myocardial infarction group and cardiomyopathy group,the IMA level in acute ischemic heart disease group had no significant difference (P＜0.05).The cut-off value for the identification of acute myocardial ischemia which obtained by ROC analysis was 40.65U/mL.And the sensitivity and specificity for distinguishing acute ischemia cardiac disease was 60.0％ and 80.5％,respectively.Conclusion The IMA value in pericardial fluid can be a reference marker for the diagnosis of acute myocardial ischemia,which also can provide objective basis for the forensic identification of sudden cardiac death.

Correlation analysis on plasma D-dimer level with deep venous thrombosis after spinal surgery / 中国骨伤

<p><b>OBJECTIVE</b>To analyze the relation of plasma D-dimer levels and incidence of deep venous thrombosis after spinal surgery.</p><p><b>METHODS</b>The clinical data of 63 patients underwent spinal surgery from October 2009 to October 2010 were retrospective analyzed. There were 40 males and 23 females with an average age of 48 years old(21 to 76) in operation. Operation levels of 15 cases were in cervical vertebrae, 4 cases were in thoracic vertebrae,and 44 cases were in lumbar vertebrae. Thirty patients with spinal fracture were caused by trauma and 33 patients without trauma, 11 patients combined with nerve injury. The patients were divided into two groups according to plasma D-dimer levels, more than or equal to 500 microg/L was D-dimer positive group and less than 500 microg/L was D-dimer negative group. Venous blood of all patients early morning with empty stomach were testd on admission, and at 2 h, 1 d, 2 d, 3 d, 4 d, 6 d, 8 d, 10 d, 15 d after operation,respectively.</p><p><b>RESULTS</b>There was no statistically significant differences in sex, operative segments, implants, operative posture, age, bleed volume, body weight, peroperative D-dimer levels between two groups. After operation, plasma D-dimer of 19 patients were more than or equal to 500 microg/L, with persistent or progressive increasing. Two cases occurred deep venous thrombosis in D-dimer positive group, they respectively were found at 3 days and 8 days after operation. Both of them underwent posterior decompression and internal fixation. However,no deep venous thrombosis was found in D-dimer negative group.</p><p><b>CONCLUSION</b>Postoperative D-dimer assay can effective predict deep venous thrombosis occurrence. D-dimer level more than or equal to 500 microg/L will be considered as a risk factor for deep venous thrombosis after spinal surgery.</p>