Research on the Identification Model of Medical Damage.

OBJECTIVES: To understand the perceptions of doctors, patients and forensic examiners on the current situation of medical disputes and medical damage identification in China, and to explore the medical damage identification model that is more conducive for the resolution of medical disputes. METHODS: A questionnaire was designed, and in-service clinicians, forensic examiners and inpatients in Sichuan Province and Chongqing City were randomly selected from April to November 2019. SPSS 22.0 software was used to analyze the data of various survey results. RESULTS: Compared with patients (24.92%), doctors (61.72%) believed that the current doctor-patient relationship was more tense than before; both doctors and patients were more inclined to choose voluntary consultation and people's mediation to resolve medical disputes; forensic examiners have the highest level of cognition of medical and health-related laws and regulations, followed by doctors and patients; 66.72% of doctors and 78.41% of patients believed that medical damage identification was necessary, and they were more inclined to entrust forensic identification institutions; different groups all believed that forensic examiners and doctors should participate in the identification together, 80.94% of doctors believed that the appraisal institutions should be responsible for the forensic opinion, not the appraiser. CONCLUSIONS: It is suggested that the Medical Association identification and forensic identification should learn from each other and formulate basic unified rules for the identification of medical damage. It is suggested to standardize the behavior of medical damage forensic identification institutions and appraisers, to improve their own appraisal level, actively invite clinical medical experts for consultation in identification, and promote the standardized, scientization of forensic identification.

Research Progress on Molecular Markers Related to Unexplained Sudden Cardiac Death and Its Forensic Application. / ä¸æ˜ŽåŽŸå› å¿ƒè„æ€§çŒæ­»ç›¸å ³åˆ†å­æ ‡å¿—ç‰©ç ”ç©¶è¿›å±•åŠæ³•åŒ»å­¦åº”ç”¨.

Routine pathological examination of unexplained sudden cardiac death (USCD) lacks significant morphological characteristics. In the field of forensic medicine, molecular biology methods have been used to find the cause of death by detecting genes and research related to the mechanism of sudden cardiac death has been carried out. From the molecular pathology point of view, the application of multiple levels of biomarkers to resolve the causes of USCD has already shown potential and provides an important path for forensic identification of USCD. This article reviews the latest research progress on USCD-related genes, RNA, proteins and USCD, and summarizes forensic application.

Sudden Death From Ruptured Intracranial Vascular Malformations During Mechanical Asphyxia: A Domestic Violence Case Report.

Smothering and manual strangulation are not uncommon in domestic violence against women; however, no report on the combination of mechanical asphyxia and intracranial vascular malformations has been previously published. We report a middle-aged woman who was smothered and manually strangled by her husband and subsequently died from subarachnoid hemorrhage due to ruptured intracranial vascular malformations, rather than direct mechanical asphyxiation. Smothering and manual strangulation are considered provocative conditions for rupture and contributory causes of death. In this case study, we underline the importance of meticulous autopsy in cases of mechanical asphyxia and intracranial hemorrhage. Exclusion of underlying diseases that may have caused or contributed to death is also required, despite serious asphyxiation signs and neck injuries. Postmortem angiography is a valuable complement to autopsy to detect vascular pathology, with good prospects for further development in China.

[Relationship between Body Height and Craniofacial Lines Measured by CT in Southwest Han Males].

OBJECTIVE: To establish regression model between craniofacial lines and body height by measuring craniofacial lines in Southwest Han males using CT and to accumulate data for the study of forensic anthropology. METHODS: Head CT data of 273 Han males in Southwest were collected and 7 craniofacial lines were determined. Multiplanar reconstruction and volume rendering were performed by image post-processing software and the selected lines were measured. The relationship between each measuring indicator and body height was analyzed using SPSS 21.0 software. The regression equation of body height estimation was established and 50 samples were selected again and put into the mathematics models to verify its accuracy. RESULTS: The linear regression equations of 7 lines were established (P < 0.05). The correlation coefficients of the unary linear regression equations were 0.190-0.439 and the standard errors of the estimate (SEE) were 4.597-5.023 cm. The correlation coefficients of the multiple linear regression equation were 0.494-0.524 and the SEE were 4.418-4.458 cm. The return tests showed that the highest ± 1SEE accuracy of the multiple regression equation: y = 83.959+3.589 x6+2.573 x2, were 30%; and the highest ± 2SEE accuracy of the multiple regression equation: y = 72.646+3.316 x6+1.586 x2+1.553 x4+2.211 x3, were 92%. CONCLUSION: There is significant linear correlation between 7 selected lines and the stature in this study, and the plural linear regression equation established could be applied for estimating the stature of Southwest Han males.

Characteristics of eight X-STR loci for forensic purposes in the Chinese population.

X-chromosomal short tandem repeats (ChrX STRs) loci are used for forensic practice in recent years. Considering the unique heredity characteristics of ChrX, recombination and linkage disequilibrium (LD) among ChrX STR loci vary between male and female and different populations as well. However, there is a lack of data for analysis of recombination and linkage disequilibrium on ChrX STR loci in the Chinese population. In this work, a total of 303 unrelated individuals (203 males and 100 females) in the Chinese Han population were analyzed with Mentype Argus X-8 PCR amplification kit (DXS10135-DXS8378, DXS7132-DXS10074, HPRTB-DXS10101, and DXS10134-DXS7423). The recombination and linkage disequilibrium of the eight ChrX STR loci were investigated with HapMap LD plots and software ARLEQUIN 3.1. Allele frequencies of the eight loci and further population forensic genetic parameters were obtained. Our results revealed hotspots for recombination, and there was no obvious evidence for LD among the eight loci in the Chinese population. Our work implied that single locus frequencies rather than haplotype frequencies should be applied for forensic practice in the Chinese population.

[DNA-based personal identification in disaster].

The disaster is a sudden unexpected event that causes serious human injuries and deaths as well as missing persons. The main tasks of forensic DNA laboratories are to identify victim in the disaster. After reviewed the previous disasters and related studies, we proposed a new procedure of DNA identification for the use of disaster in the future, which includes preparation works, samples collection, samples storage, DNA extraction, typing, data analysis and interpretation of results. Some experiences and problems about the DNA identification are also discussed.

[Analysis of Y-chromosomal biallelic polymorphisms in Sichuan Han of Chinese population].

OBJECTIVE: To evaluate the forensic utility of Y-single nucleotide polymorphisms (SNPs) markers. METHODS: Allele-specific PCR, restriction enzyme digestion or direct PCR were performed to examine 10 different SNP loci on Y chromosome, namely M9, M15, M45, M89, M95, M122, M134, M145, M173 and P25 in 161 Chinese Han males. RESULTS: A total of 8 of the 10 SNPs are reported to be polymorphic in Chinese. The gene diversity for the loci showing polymorphism ranged from 0.988/0.012-0.752/0.248, with a power of discrimination 0.094-0.373. Loci M122 and M134 were the most polymorphic markers in Chinese Hans. Nine different haplogroups with frequencies from 1.2% to 51.6% were observed and 3 of the haplogroups-K*(x O2a, O3, P), O3*(x O3e) and O3e were found in 75.2% of Chinese Hans. CONCLUSION: A comprehensive gene diversity data of Y chromosome and haplogroups were obtained in Sichuan Han population, which will be served as the base for using these Y-SNP markers in forensic medicine and individual identification in Sichuan Hans.

[Identification of sarcosaphagous flies by analyses the sequence of 16S rDNA].

OBJECTIVE: To solve the difficulties of identification of Sarcosaphagous flies such as Lucilia sericata (Meigen) and Lucilia cuprina (Wiedemann) which could not be identified by analyzing the 278bp and 635 bp regions of the gene encoding for cytochrome oxidase subunit I and II (CO I and CO II) in mtDNA. METHODS: Specimens were collected from the corpses of rabbits on the grassland in Huhhot and Chengdu, the sequences of 551 bp region of 16S rDNA of their mtDNA were analyzed, the multiple-alignment program DNAMAN(version 4.0) and MEGA 2.1 sofeware were employed for sequence alignments neighbour-joining tree construction. RESULTS: Lucilia sericata (Meigen) and Lucilia cuprina (Wiedemann) were distinguished successfully by sequence analysis of The 551 bp region of the gene of 16S rDNA. CONCLUSION: The 551 bp region of the gene of 16S rDNA of sarcosaphagous flies can be used for identifying them on species level effectively. It is likely to be a successful compliment to identify the sarcosaphagous flies by sequence analysis of CO I and CO II in mtDNA.

Genetic polymorphisms of four STR loci on chromosome X and their forensic applications in a Chinese Han population.

OBJECTIVE: To add DXS7133, GATA198A10, DXS9896 and DXS6797 to the panel of forensically validated X chromosome markers, and apply the multiplex amplification system to a population study and forensic analysis on the Hans of Chengdu. METHODS: The PCR products were detected by the polyacrylamide gel electrophoresis and silver staining method. Hardy-Weinberg equilibrium of females was tested and every forensically interested value was calculated. RESULTS: Sequencing revealed that their common sequence motifs were tetranucleotide repeats. Population genetic data were obtained by analyzing 120 unrelated females and 100 males from Chengdu Han ethnic group. In this population, DXS7133, GATA198A10, DXS9896 and DXS6797 exhibited 6, 6, 11, 8 distinguishable alleles respectively. Chi-square test demonstrated that genotype frequencies in females did not depart from Hardy-Weinberg equilibrium. Power of discrimination for female samples for the four loci were 0.7962, 0.8021, 0.9675, and 0.9444. The parentage testing in 32 cases revealed a typical X-linked inheritance and no mutations. CONCLUSION: DXS7133, GATA198A10, DXS9896 and DXS6797, which are highly polymorphic in Chengdu Han population, are appropriate for individual identification and paternity testing involving a female child.