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    Analysis of 39 Forensic Clinical Sex Identification Cases after Sex Reassignment Surgery
    Yu-jiao WU, Yue-qin ZHOU, Yi-wen SHEN, Jie-qing JIANG
    Journal of Forensic Medicine    2024, 40 (4): 365-371.   DOI: 10.12116/j.issn.1004-5619.2023.230602
    Abstract2575)   HTML    PDF(pc) (733KB)(3444)       Save

    Objective To analyze the characteristics of forensic clinical sex identification cases after sex reassignment surgery for transsexualism, discuss the main point of forensic clinical sex identification in China based on domestic and foreign sex change policies and related cases, so as to standardize relevant identification. Methods A total of 39 cases of forensic clinical sex identification were collected from Center for Forensic Science, Shanghai Medical College of Fudan University in recent years, and the ratio of sex, identification time, the location of surgery, secondary sex characteristic and other information were statistically analyzed. Results Transgender woman accounted for 97.4% of the cases, and 94.9% of the cases were operated in Thailand. All cases were identified after the sex reassignment surgery, and at least one of the secondary sex characteristics was consistent with the postoperative primary sexual characters. There were only 2 cases in which auxiliary examination was applied. Conclusion Forensic clinical sex identification should be based on the principle that the primary and secondary sex characteristics are consistent with the changed sex.

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    Journal of Forensic Medicine    2024, 40 (1): 86-87.   DOI: 10.12116/j.issn.1004-5619.2023.430102
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    Legal Theories, Disability Models and Principles of Disability Assessment
    Xu WANG
    Journal of Forensic Medicine    2023, 39 (4): 329-336.   DOI: 10.12116/j.issn.1004-5619.2023.230307
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    In the personal injury compensation system, the protection and relief of the injured people’s rights to life, rights to health, and body rights are generally based on the results of disability assessment. Over the years, with the increased number of personal injury compensation cases, the practice of disability assessment have been greatly developed, and the development of disability assessment standards tends to be mature. However, the lack of basic theories for disability assessment has seriously affected the construction and unification of standards. Starting from the tort legal system of personal injury compensation, this article systematically analyzes the legal theories of disability assessment, and holds that the loss of labor ability is the legal basis for disability assessment in China, and the essence of disability assessment should be understood as the quantitative assessment of an individual’s permanent loss of labor ability. This article combines the international disability assessment models and the primary concepts of American Medical Association’s Guides to the Evaluation of Permanent Impairment to refine the basic concepts of disability assessment in China, such as impairment, disability, handicap, disabled people and self-care ability, etc. At the same time, it sorts out the critical issues of identification time, promotion principles and compound calculation of multiple injuries in disability assessment. It is expected to be beneficial to the theory and practice of disability assessment in personal injury compensation.

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    A Bibliometric and Visual Analysis of the Current Status and Trends of Forensic Mixed Stain Research
    Qing-wei FAN, Ling LI, Hui-ling YANG, Ting-ting DENG, Dong-dong XU, Yun WANG, Bing DU, Jiang-wei YAN
    Journal of Forensic Medicine    2024, 40 (1): 20-29.   DOI: 10.12116/j.issn.1004-5619.2022.521010
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    Objective To explore the context and hotspot changes of forensic mixed stain research through bibliometric approach. Methods The literature of forensic mixed stain included in the core collection of Web of Science database from 2011 to 2022 were collected as the study object, and the annual publication number, countrie (region), institution, journal, keywords, etc. were bibliometrically and visually analyzed using the R-based Bibliometrix 1.1.6 package and VOSviewer 1.6.18 software. Results A total of 732 articles on forensic mixed stain were included from 2011 to 2022, with the annual number of articles published and the annual citation frequency showing a steady increase year by year. Among the 59 countries (regions) with the most published articles, the United States ranked first with 246 articles, followed by China with 153 articles. The literature came from 104 journals, and the total number of articles published in the top 10 journals was 633. FORENSIC SCI INT GENET ranked first with 307 articles. Visual analysis using VOSviewer software showed that keywords could be divided into four research clusters, namely the genetic marker development group (blue), the mixed stain typing analysis theory group (red), the sequencing analysis group (yellow), and the case sample research group (green). It can be divided into four development stages in terms of different time periods: early development (2011—2013), middle development (2014—2016), rapid development (2017—2020) and latest development (2021—2022). Conclusion The number of publications by domestic and foreign scholars in the study of mixed stain in forensic science is showing a relatively stable trend. Machine learning, next generation sequencing and other research have been the hottest topics that have attracted the most attention in recent years, which is expected to further develop the theory of mixed stain typing and sequencing analysis in forensic mixed stain research.

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    Pathological Changes and Cause of Death Associated with the Global Novel Coronavirus Disease (COVID-19)
    Bin YANG, Lu-yao XU, Ling-yue LI, Dong-fang QIAO, Si-hao DU, Xia YUE, Hui-jun WANG
    Journal of Forensic Medicine    2023, 39 (6): 586-595.   DOI: 10.12116/j.issn.1004-5619.2023.430703
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    The coronavirus disease 2019 (COVID-19) has been a global epidemic for more than three years, causing more than 6.9 million deaths. COVID-19 has the clinical characteristics of strong infectivity and long incubation period, and can cause multi-system damage, mainly lung damage, clinical symptoms of acute respiratory distress syndrome (ARDS) and systemic multiple organ damage. The SARS-CoV-2 virus is still constantly mutating. At present, there is no global consensus on the pathological changes of COVID-19 associated deaths and even no consensus on the criteria for determining the cause of death. The investigation of the basic pathological changes and progression of the disease is helpful to guide the clinical treatment and the development of therapeutic drugs. This paper reviews the autopsy reports and related literature published worldwide from February 2020 to June 2023, with a clear number of autopsy cases and corresponding pathological changes of vital organs as the inclusion criteria. A total of 1 111 autopsy cases from 65 papers in 18 countries are included. Pathological manifestations and causes of death are classified and statistically analyzed, common pathological changes of COVID-19 are summarized, and analytical conclusions are drawn, suggesting that COVID-19 infection can cause life-threatening pathological changes in vital organs. On the basis of different health levels of infected groups, the direct cause of death is mainly severe lung damage and secondary systemic multiple organ failure.

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    The Latest Research Progress on Cell-Free DNA and Prospects of Its Forensic Application
    Wen-jing HU, Ting-ting YANG, Ya-ya WANG, Jiang-wei YAN
    Journal of Forensic Medicine    2024, 40 (1): 70-76.   DOI: 10.12116/j.issn.1004-5619.2022.521001
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    In recent years, with the continuous progress of DNA extraction and detection technology, cell-free DNA(cfDNA)has been widely used in the life science field, and its potential application value in forensic identification is becoming more and more obvious. This paper reviews the concept, formation mechanism, and classification of cfDNA,etc., and describes the latest research progress of cfDNA in personal identification of crime scene touch DNA samples and non-invasive prenatal paternity testing (NIPPT). Meanwhile, this paper summarizes the potential application of cfDNA in injury inference, and discusses the advantages and disadvantages of common cfDNA analysis methods and techniques, and its application prospects, to provide a new idea for the wide application of cfDNA in the field of forensic science.

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    Journal of Forensic Medicine    2024, 40 (2): 205-207.   DOI: 10.12116/j.issn.1004-5619.2023.430318
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    Process of Forensic Medicine in DNA Identification of Aged Human Remains
    Lu CHEN, Zhe ZHOU, Sheng-qi WANG
    Journal of Forensic Medicine    2023, 39 (5): 478-486.   DOI: 10.12116/j.issn.1004-5619.2021.511209
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    Skeleton and teeth are important biological samples. Due to their special structure and strong ability to resist degradation, they are ideal biological materials to retain DNA under natural condition. In many cases, such as historical figure identification, aged skeleton and teeth are usually the only biological samples. However, their DNA is in a state of trace, damage and degradation to different degrees, which requires special experimental treatment to achieve identification. This paper reviews the sample selection, DNA extraction, DNA enrichment and analysis approaches based on relevant research reports in recent years, aiming to promote the further development and improvement of the aged skeleton and teeth identification system.

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    Journal of Forensic Medicine    2024, 40 (6): 525-532.   DOI: 10.12116/j.issn.1004-5619.2024.340605
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    Journal of Forensic Medicine    2023, 39 (4): 337-342.   DOI: 10.12116/j.issn.1004-5619.2023.230310
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    Screening of Genes Co-Associated with Sudden Infant Death Syndrome and Infectious Sudden Death in Infancy and Bioinformatics Analysis of Their Regulatory Networks
    Yu-xin SUN, Xiao-juan GONG, Xiu-li HAO, Yu-xin TIAN, Yi-ming CHEN, Bao ZHANG, Chun-xia YAN
    Journal of Forensic Medicine    2023, 39 (5): 433-440.   DOI: 10.12116/j.issn.1004-5619.2022.420803
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    Objective The common differentially expressed mRNAs in brain, heart and liver tissues of deceased sudden infant death syndrome (SIDS) and infectious sudden death in infancy (ISDI) confirmed by autopsy was screened by bioinformatics to explore the common molecular markers and pathogenesis of SIDS and ISDI. Methods The datasets of GSE70422 and GSE136992 were downloaded, the limma of R software was used to screen differentially expressed mRNA in different tissue samples of SIDS and ISDI decedents for overlapping analysis. The clusterProfiler of R software was used to conduct gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The protein-protein interaction (PPI) network was constructed by STRING database, while the hub gene was screened by cytoHubba plug-in. Results Compared with the control group, there were 19 significant differentially expressed genes in the tissue samples of SIDS and ISDI decedents, among which 16 in the heart tissue and 3 in the liver tissue, and the astrotactin 1 (ASTN1) gene expression difference in the heart tissue was most significant. The PPI network identified Ras homolog family member A (RHOA), integrin subunit alpha 1 (ITGA1), and H2B clustered histone 5 (H2BC5) were hub genes. The analysis of GO and KEGG showed that differentially expressed genes were enriched in the molecular pathways of actin cytoskeleton regulation, focal adhesion and response to mycophenolic acid. Conclusion ASTN1, RHOA and ITGA1 may participate in the development of SIDS and ISDI. The enrichment of differentially expressed genes in immune and inflammatory pathways suggests a common molecular regulatory mechanism between SIDS and ISDI. These findings are expected to provide new biomarkers for molecular anatomy and forensic identification of SIDS and ISDI.

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    Urine Metabolites Changes in Acute Myocardial Infarction Rats via Metabolomic Analysis
    Nian-nian CHEN, Jiao-fang YU, Peng WU, Li LUO, Ya-qin BAI, Li-kai WANG, Xiao-qian LI, Zhan-peng LI, Cai-rong GAO, Xiang-jie GUO
    Journal of Forensic Medicine    2024, 40 (3): 227-236.   DOI: 10.12116/j.issn.1004-5619.2023.431108
    Abstract866)   HTML    PDF(pc) (3989KB)(2253)       Save

    Objective To screen biomarkers for forensic identification of acute myocardial infarction (AMI) by non-targeted metabolomic studies on changes of urine metabolites in rats with AMI. Methods The rat models of the sham surgery group, AMI group and hyperlipidemia + acute myocardial infarction (HAMI) group were established. Ultra-high performance liquid chromatography-mass spectrometry (UPLC-MS) was used to analyze the changes of urine metabolic spectrometry in AMI rats. Principal component analysis, partial least squares-discriminant analysis, and orthogonal partial least squares-discriminant analysis were used to screen differential metabolites. The MetaboAnalyst database was used to analyze the metabolic pathway enrichment and access the predictive ability of differential metabolites. Results A total of 40 and 61 differential metabolites associated with AMI and HAMI were screened, respectively. Among them, 22 metabolites were common in both rat models. These small metabolites were mainly concentrated in the niacin and nicotinamide metabolic pathways. Within the 95% confidence interval, the area under the curve (AUC) values of receiver operator characteristic curve for N8-acetylspermidine, 3-methylhistamine, and thymine were greater than 0.95. Conclusion N8-acetylspermidine, 3-methylhistamine, and thymine can be used as potential biomarkers for AMI diagnosis, and abnormal metabolism in niacin and nicotinamide may be the main causes of AMI. This study can provide reference for the mechanism and causes of AMI identification.

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    UPLC-MS/MS Method for Detection of Etomidate and Its Metabolite Etomidate Acid Quantity in Blood
    Xing HAN, Xin LIU, Ming-luo DU, Ruo-lun XU, Jia-rong LI, Chao LIU, Wei-guo LIU
    Journal of Forensic Medicine    2023, 39 (6): 564-570.   DOI: 10.12116/j.issn.1004-5619.2023.330901
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    Objective To establish a method for the simultaneous quantitative analysis of etomidate and its metabolite etomidate acid in blood, and to discuss its application value in actual cases. Methods Acetonitrile precipitate protein method was used, and C18 column was selected. Gradient elution was performed with acetonitrile and 5 mmol/L ammonium acetate within 6 min. Electrospray ionization source in positive ion mode was used. The internal standard etomidate acid-d5 was obtained by etomidate-d5 alkaline hydrolysis reaction. Ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used for quantitative analysis. The methodological verification was conducted. Results Etomidate and etomidate acid in blood showed good linear relationship in the quantitative linear range (r>0.999), with the lower limit of quantification was 2.5 ng/mL and 7.5 ng/mL, respectively. The accuracy, precision, recovery rate, and matrix effect of the method met the professional verification standards. The practical application results showed that etomidate and etomidate acid could be detected in the blood of the abusers, and their mass concentrations ranged from 17.24 to 379.93 ng/mL. Conclusion The method established in this study can simultaneously quantify etomidate and etomidate acid in blood, which is simple and convenient to operate with accuracy. It can meet the detection needs of actual cases and provide technical support for law enforcement to crack down on etomidate abuse.

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    Retrospective Analysis of Death Cases of Oral Diphenidol Hydrochloride Poisoning
    Yu YANG, Fan-zhang LEI, Yu-you DONG, Jian-long MA, Qi-qiang SHI, Xue-song YE
    Journal of Forensic Medicine    2023, 39 (4): 393-398.   DOI: 10.12116/j.issn.1004-5619.2022.420401
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    Objective To explore the characteristics of postmortem examination, chemical examination and scene investigation of deaths caused by oral diphenidol hydrochloride poisoning, and so as to provide a reference for proper settlement and prevention of such deaths. Methods The data of 22 deaths caused by oral diphenidol hydrochloride poisoning in a city from January 2018 to August 2020 were collected, including case details, scene investigations, autopsies, chemical examinations and digital evidence. Thirty-one cases of deaths caused by oral diphenidol hydrochloride poisoning reported in previous literature were also collected. Results In the 53 oral diphenidol hydrochloride poisoning death cases, 50 cases were suicide, 2 cases were accidental, while 1 case was undetermined. Fifty-two cases were found in the medical records or crime scene investigation reports with doses ranging from 775 mg to 12 500 mg, and 23 deceased were detected with postmortem blood concentrations ranging from 2.71 mg/L to 83.1 mg/L. Clinical symptoms were recorded in 6 patients, including conscious disturbance and convulsion. Among the 45 cases which were performed with external examination, 23 cases autopsied. Conclusion Most of the deceased of oral diphenidol hydrochloride poisoning were suicide. No significant correlation was found between dose and blood concentration through the retrospective analysis of cases.

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    Establishment and Application of TaqMan qPCR Detection Method for Human DNA Contamination in DNA Laboratory
    Gao-fang SHEN, Yong-song ZHOU, Jian-qiu ZHANG, Shi-you JI, Ying-feng WU, Hao SHANG, Bo-feng ZHU
    Journal of Forensic Medicine    2025, 41 (1): 66-73.   DOI: 10.12116/j.issn.1004-5619.2023.531004
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    Objective To establish a highly sensitive and specific method for detecting human DNA based on real time quantitative PCR (qPCR) technique for the rapid detection of potential DNA contamination sources in DNA laboratories. Methods Primers and probes were designed with Primer ExpressTM software using the reference sequence of human 18S rRNA gene as a template, and the optimal prime-probe combination was screened by matrix method. The PCR products of the target sequence of human 18S rRNA gene were used to construct the plasmid, and a plasmid standard was used to draw the standard curve of the qPCR system. According to the Minimum Information for Publication of Quantitative Real-time PCR Experiments (MIQE) guidelines, the specificity, sensitivity, repeatability and application effect of the qPCR system were evaluated. Results The sensitivity of the qPCR system established in this study was 5.3×10-5 ng/μL, which showed good specificity for human DNA samples. The correlation coefficient of the qPCR system was -0.999, and amplification efficiency was 100%. Both the intra-batch and inter-batch variation coefficients were less than 2%. Conclusion The established human DNA detection method based on qPCR technique has good specificity, high sensitivity, and robust stability. It can be used for rapid detection of DNA contamination and daily monitoring of the accumulated human DNA in the laboratory environment.

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    Modeling Methods and Influencing Factors for Age Estimation Based on DNA Methylation
    Yi-hang HUANG, Wei-bo LIANG, Hui JIAN, Sheng-qiu QU
    Journal of Forensic Medicine    2023, 39 (6): 601-607.   DOI: 10.12116/j.issn.1004-5619.2023.530106
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    Age estimation based on tissues or body fluids is an important task in forensic science. The changes of DNA methylation status with age have certain rules, which can be used to estimate the age of the individuals. Therefore, it is of great significance to discover specific DNA methylation sites and develop new age estimation models. At present, statistical models for age estimation have been developed based on the rule that DNA methylation status changes with age. The commonly used models include multiple linear regression model, multiple quantile regression model, support vector machine model, artificial neural network model, random forest model, etc. In addition, there are many factors that affect the level of DNA methylation, such as the tissue specificity of methylation. This paper reviews these modeling methods and influencing factors for age estimation based on DNA methylation, with a view to provide reference for the establishment of age estimation models.

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    Research Progress on Microbial Community Succession in the Postmortem Interval Estimation
    Qing-qing XIANG, Li-fang CHEN, Qin SU, Yu-kun DU, Pei-yan LIANG, Xiao-dong KANG, He SHI, Qu-yi XU, Jian ZHAO, Chao LIU, Xiao-hui CHEN
    Journal of Forensic Medicine    2023, 39 (4): 399-405.   DOI: 10.12116/j.issn.1004-5619.2022.420606
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    The postmortem interval (PMI) estimation is a key and difficult point in the practice of forensic medicine, and forensic scientists at home and abroad have been searching for objective, quantifiable and accurate methods of PMI estimation. With the development and combination of high-throughput sequencing technology and artificial intelligence technology, the establishment of PMI model based on the succession of the microbial community on corpses has become a research focus in the field of forensic medicine. This paper reviews the technical methods, research applications and influencing factors of microbial community in PMI estimation explored by using high-throughput sequencing technology, to provide a reference for the related research on the use of microbial community to estimate PMI.

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    Journal of Forensic Medicine    2023, 39 (6): 626-627.   DOI: 10.12116/j.issn.1004-5619.2023.430602
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    Structure Confirmation of Three New Psychoactive Substances and Qualitative Identification of Unknown Substances
    Zong-yang NIE, Wei HU, Ling-yu LI, Qing-bo ZHANG, Xin HUANG, Bo LI
    Journal of Forensic Medicine    2024, 40 (4): 340-351.   DOI: 10.12116/j.issn.1004-5619.2023.330101
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    Objective To establish the structural confirmation methods of three suspected new psychoactive substances (NPSs), and explore a more general qualitative testing method. Methods Infrared absorption spectroscopy (IR), gas chromatography-mass spectrometry (GC-MS), 1H-nuclear magnetic resonance spectroscopy (1H-NMR), 13C-nuclear magnetic resonance spectroscopy (13C-NMR), 19F-nuclear magnetic resonance spectroscopy (19F-NMR) and other techniques were used to identify the composition and structure of 5 samples containing suspected NPS submitted by public security bureaus. Results NPSs were found in the above 5 samples, and 3 were confirmed as NPS included in the newly listed controlled substances on July 1, 2024, namely 2-(methylamino)-2-(2-methylphenyl)cyclohexan-1-one (2-MDCK), 2-(ethylamino)-2-(2-fluorophenyl)cyclohexan-l-one (2-FXE), 1-(3,4-methylenedioxyphenyl)-2-(dimethylamino)pentan-1-one (dipentylone), respectively. The first two substances were phencyclidine NPS, and the third substance was synthetic cathinone NPS. Conclusion This study systematically summarizes the distinguishing features of the infrared absorption spectrometry, nuclear magnetic resonance spectroscopy and mass spectrometry of three NPSs, which can provide a reference for the qualitative identification of unknown substances.

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    Objective Assessment of Visual Field Defects Caused by Optic Chiasm and Its Posterior Visual Pathway Injury
    Jian XIANG, Xu WANG, Li-li YU, Kang-jia JIN, Ying-kai YANG
    Journal of Forensic Medicine    2023, 39 (4): 350-359.   DOI: 10.12116/j.issn.1004-5619.2023.230309
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    Objective To investigate the characteristics and objective assessment method of visual field defects caused by optic chiasm and its posterior visual pathway injury. Methods Typical cases of visual field defects caused by injuries to the optic chiasm, optic tracts, optic radiations, and visual cortex were selected. Visual field examinations, visual evoked potential (VEP) and multifocal visual evolved potential (mfVEP) measurements, craniocerebral CT/MRI, and retinal optical coherence tomography (OCT) were performed, respectively, and the aforementioned visual electrophysiological and neuroimaging indicators were analyzed comprehensively. Results The electrophysiological manifestations of visual field defects caused by optic chiasm injuries were bitemporal hemianopsia mfVEP abnormalities. The visual field defects caused by optic tract, optic radiation, and visual cortex injuries were all manifested homonymous hemianopsia mfVEP abnormalities contralateral to the lesion. Mild relative afferent pupil disorder (RAPD) and characteristic optic nerve atrophy were observed in hemianopsia patients with optic tract injuries, but not in patients with optic radiation or visual cortex injuries. Neuroimaging could provide morphological evidence of damages to the optic chiasm and its posterior visual pathway. Conclusion Visual field defects caused by optic chiasm, optic tract, optic radiation, and visual cortex injuries have their respective characteristics. The combined application of mfVEP and static visual field measurements, in combination with neuroimaging, can maximize the assessment of the location and degree of visual pathway damage, providing an effective scheme for the identification of such injuries.

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