Forensic Pathological Analysis of Maternal Death Cases / 昆明医科大学学报

Objective This study aimed to investigate the characteristics of maternal death cases, the cause of maternal death and the cause of medical dispute,and recommended the relative prevention measures. Methods We retrospectively analyzed 35 cases of maternal death identified in the College of Forensic Medicine in Kunming Medical University from January 2002 to December 2012. Results In 35 maternal death cases: (1) Most maternal deaths are over 30 years old (14 cases, 40%), followed by 17 to 19 years old (6 cases, 17.1%) . And most maternal deaths came from countryside (25 cases,71.4%) . (2) 26 cases maternal deaths happened during the perinatal period (68.5%) . (3) 26 cases happened in county hospitals, township hospitals and informal medical organizations (74.3%) . 5 maternal deaths happened on the way to the hospital or at home (14.3%) . (4) 17 cases died of obstetric hemorrhagic shock (48.6%), 11 cases died of amniotic fluid embolism (31.4%), 2 cases died of amniotic fluid embolism and obstetric hemorrhagic shock (5.7%) . (5) 30 cases of medical disputes were caused by maternal death. Among them, the clinical diagnosis was not consistent with the pathological diagnosis in 20 cases (The misdiagnosis rate was 66.7%) . (6) The causes of medical dispute:clinical diagnosis was unknown in 11 cases (36.7%),11 cases were suspected that rescue was not timely or improper (36.7%),and 8 cases were suspected of misdiagnosis (26.6%) . Conclusion Obstetric hemorrhage and pulmonary amniotic fluid embolism were the main reasons of the maternal death. The incidence of maternal death and medical disputes could be reduced by improving the ability of obstetric staff,and strengthening the diagnosis and treatment about obstetric hemorrhage and pulmonary amniotic fluid embolism. At the same time, women should improve their self-care awareness, reduce early marriage and early pregnancy,and enhance the consciousness of hospital treat and cure.

Forensic Analysis of 9 Cases with Enterovirus 71 Infection / 昆明医科大学学报

Objective To investigate the forensic characteristics of death cases of EV71 through retrospective analysis of 9 death forensic cases of Enterovirus 71 (EV71) . Methods Nine cases of EV71 death cases were collected,and the population characteristics, histopathological change,toxicology,pathology and causes of death of these cases were discussed. Results All 9 patients had fever, cough, emesis, and were treated as influenza or hand-foot and mouth disease (HFMD) in local hospitals, the condition was still deteriorating and finally died. The 9 autopsy cases were diagnosed as brain stem encephalitis and death in forensic diagnose. Conclusion The HFMD disease caused by EV71 infection progresses rapidly often leads to medical disputes, the patient's family and hospital's opinions on the causes of death in patients are often different,identifying the cause of death is conducive to resolve the disputes.

Forensic Analysis of 27 Death Cases of Acute Interstitial Pneumonia / 昆明医科大学学报

Objective To investigate the forensic characteristics of death cases of Acute Interstitial Pneumonia (AIP), so as to provide references for forensic assessment of AIP. Methods The data of 27 AIP death cases were retrospectively analyzed. The data included the population characteristics, toxicology, pathology and causes of death. Results All 27 patients had clinical symptoms including fever, cough and chest tightness, 25 patiens of them were treated as upper respiratory tract infection in local hospital, and finally died of deteriorating condition. The forensic diagnosis after autopsy showed the 27 cases were died of respiratory failure caused by AIP. Conclusion AIP is a disease with rapid progression and often leads to medical disputes,the patient's families often have different opinion on the death cause of patients with the hospital,so forensic identification of the cause of death is conducive to resolve the disputes.

Morphine-induced changes of adenylate and guanylate cyclase in locus ceruleus, periaqueductal gray, and substantia nigra in rats.

OBJECTIVES: To observe the changes of adenylate cyclase (AC) and guanylate cyclase (GC) in the cerebral regions including the locus ceruleus, periaqueductal gray, and substantia nigra in rats that were physiologically dependent on morphine. We also investigated the relationship of enzymatic changes in these cerebral regions to the mechanism of morphine dependence. METHODS: A morphine-dependent rat model was established and withdrawal symptoms evaluated. Enzyme histochemistry was used to detect the variations of AC and GC in cerebral regions. RESULTS: Compared to controls, AC and GC significantly increased in morphine-dependent groups. Comparisons of four different morphine-dependent groups also showed AC and GC significantly differed at weeks 1, 2, 4, and 8. CONCLUSIONS: Results found that the content of AC and GC increased in these cerebral regions in rats that demonstrated morphine dependence and appeared to be closely linked to increases in AC and GC activity.

The Top-quality Course Construction in Forensic Pathology and Its Relevant Problems / 昆明医科大学学报

The top-quality course construction,in comprehensive medical university,is very important for the undergraduate teaching evaluation. The paper discussed the top-quality course construction in forensic pathology and the relevant issues in medical college course teaching,such as the status of the course,characteristic in school-running and enforcement measures,which aimed to improve cognition and enhance teaching quality and teaching level.