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28 December 2013, Volume 29 Issue 6 Previous Issue    Next Issue

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Application of MSCT’s Coronary Artery Calcification Score in Evaluation of Sudden Death Caused by Coronary Artery Disease WAN LEI, YING CHONG-LIANG, LIU NING-GUO, ET AL. 2013, 29(6): 401-404.  DOI: 10.3969/j.issn.1004-5619.2013.06.001 Abstract ( 1297 )   Objective To access application value of multi-slice spiral computed tomography （MSCT） and coronary artery calcium scoring （CACS） in investigation the coronary artery disease （CAD）, and to explore the effective way of virtual autopsy to evaluate the sudden death due to CAD. Methods Nine cases of sudden cardiac death were collected to analyze MSCT before the autopsy. The quantitative analysis of the degree of coronary artery calcium was made by Agatston’s method. The CACS of all the subjects were calculated based on the diagnostic criteria for CAD, in which calcium scoring was more than 400. The results of CACS were compared with that of the autopsy. Results Only 2 cases got the high calcium scoring which were more than 400 in the 9 cases died of CAD confirmed by the autopsy. The prediction rate of CACS for CAD was only 22.2%. Pulmonary edema of different severity was found in both autopsy and MSCT. There was a higher morbidity rate in the left anterior descending of coronary artery than the other branches. Conclusion Obvious calcification of coronary artery can be detected by MSCT and calculating CACS. To detect subtle calcification needs other technologies such as postmortem angiography. Related Articles | Metrics

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Changes of Postmortem Human Blood Biochemical Indexes DENG KAI-FEI, LI SHI-YING, QIN ZHI-QIANG, ET AL 2013, 29(6): 405-408.  DOI: 10.3969/j.issn.1004-5619.2013.06.002 Abstract ( 1614 )   Objective To investigate and analyze the changes of postmortem human biochemical indexes. Methods Subclavian venous blood samples were collected from 81 cases of traffic fatalities. Thirteen blood biochemical indexes including liver function （ALT, AST, TBIL and DBIL）, renal function （UA and Cr）, cardiac function （CK, CK-MB and LDH）, electrolytes （K+, Na+ and Cl-）, and glucose （GLU） were tested by Roche cobas c311 automatic biochemical analyzer. The descriptive analysis was made by SPSS 17.0 statistical software. Results The values of ALT, AST, CK, CK-MB, LDH and K+ were higher than normal reference values with more fluctuations. The values of TBIL, DBIL, UA, Cr, Na+, Cl- and GLU were relatively stable with less fluctuations. Conclusion The postmortem human blood biochemical indexes of liver function, renal function, cardiac function, electrolytes and glucose could be affected by the factors, especially hemolysis and autolysis. The biochemical indexes, particularly enzymes, increased significantly with higher standard deviation. Related Articles | Metrics

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Applicability of Capacity of Sexual Self-defense Assessment Scale in Psychiatric Patients without Mental Retardation LIU CHAO, CAI WEI-XIONG 2013, 29(6): 414-418.  DOI: 10.3969/j.issn.1004-5619.2013.06.004 Abstract ( 1421 )   Objective To explore the applicability of Capacity of Sexual Self-defense Assessment Scale （CSSAS） in psychiatric patients without mental retardation. Methods Eighty-seven cases required for assessment of the capacity of sexual self-defense were collected and evaluated by trained professionals according to CSSAS, and the results were compared to the experts’ opinions. Results The scores of three grades of capacity of sexual self-defense （none, limited and whole） were 5.97±5.83, 32.22±10.15 and 61.60±13.02, respectively, which were statistically significant among them （P<0.01）. The correlation coefficients between items and total score were 0.59 to 0.91, the Cronbach’s α value was 0.96, the spilt half Cronbach’s α value were 0.94 and 0.91, respectively, and the relation coefficient between them was 0.94. According to the original cut off scores, the Kappa value between scale results and experts’ opinions was 0.32 （P<0.01）. By redefining the cut off scores, the Kappa value was improved to 0.84 （P<0.01）. Two factors were extracted by means of the factor analysis. The explanation rates of variance were 46.15% and 28.93%, respectively. The accuracy of retrospective cumulative square was 94.30%. Conclusion The CSSAS could be applied in the psychiatric expertise of the capacity of sexual self-defense in psychiatric patients without mental retardation; however, the cut off scores and the factor weight should be redefined. Related Articles | Metrics

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One-step Methylation Variable Position Analysis Technology in Single-tube YUE YANG-YANG, ZHAO GUI-SEN, ZHANG QIAN, ET AL. 2013, 29(6): 419-424.  DOI: 10.3969/j.issn.1004-5619.2013.06.005 Abstract ( 1606 )   Objective To develop the single-tube one-step methylation variable position （MVP） analysis technology——single-tube post-digestion PCR-melting curve analysis （PDP-MCA）. Methods Based on differentially methylated region （DMR） reported previously as the model, a set of primers with different melting temperatures of products in the two sides of MVP were designed. By using the FastDigest methylation-sensitive restriction enzyme （MSRE）, DNA digestion, multiplex amplification, MCA detection and MCA profiles were performed in a single reaction tube. Same samples （peripheral venous blood, semen, and vaginal fluid, 5 samples each type） were tested by single-tube one step MVP and traditional MSRE- PCR MCA technology. To verify the feasibility of this method, the results were compared with that of the traditional technology. The MCA/HRM profiles of different samples were analyzed and compared. Results When the melting temperature of the fragments had a differential of 2 ℃, the MCA melting peaks separated well, and MCA detection after multiplex amplification was successful. The single-tube PDP-MCA assay was developed, which integrated multiple reactions （digestion, amplification and detection） into one tube. By this method, the sample-specific profiles and data were analyzed in 2 h, which is similar to that of the traditional method. The rapid classifications of the samples were also realized. Conclusion Multiplex MVPs can be analyzed in a single closed-tube. The single-tube PDP-MCA technology is a simple, fast, and automatable method. It can be used for detection of DNA methylation variations. Related Articles | Metrics

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Determination of 33 Inorganic Elements in Human Hair by Electricity Plate Digestion and Inductively Coupled Plasma-Mass Spectrometry LUO RU-XIN, MA DONG, ZHANG SU-JING, ET AL. 2013, 29(6): 425-430.  DOI: 10.3969/j.issn.1004-5619.2013.06.006 Abstract ( 1375 )   Objective To establish the electricity plate digestion and inductively coupled plasma-mass spectrometry （ICP-MS） method for determination of 33 inorganic elements in human hair. Methods Lithium （6Li）, Germanium （72Ge）, Yttrium （89Y）, Indium （115In）, and Terbium （159Tb） were used as internal standards. The electric heating board digestion in a mixture of nitric acid and hydrogen peroxide was used as the pre-treatment of the hair. Thirty-three inorganic elements in human hair were analyzed by ICP-MS method. Results The detection limit of ICP-MS was 0.000 1 μg/g（Th）~10.9 μg/g（Ca） and the limit of quantitation was 0.000 5 μg/g（Th）~25 μg/g（Ca）. The recovery rate of this method was 86%- 113%. The RSD for the intra-day and inter-day were less than 9.2%. The method was not statistically different from microwave digestion method. Conclusion This method is highly efficient and accurate. It can be used for analysis of 33 inorganic elements in human hair. Related Articles | Metrics

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Forensic Analysis of Death Caused by Fat Embolism: A Study of 20 Autopsy Cases ZHOU LAN, MU JIAO, DONG HONG-MEI, ET AL. 2013, 29(6): 431-433.  DOI: 10.3969/j.issn.1004-5619.2013.06.007 Abstract ( 1366 )   Objective To analyze the general and forensic pathological characteristics of death due to fat embolism syndrome （FES） and to provide reference data for forensic identification. Methods Twenty autopsy cases due to FES were selected from the forensic center of a medical college from 1999 to 2012. The general and forensic pathological characteristics such as the ways and types of injuries, clinical manifestation and the pathological changes were summarized. Results Fat embolism mainly occurred after long bone fracture or a large area of soft tissue injury with the majority of cases being fat embolism of lung and occasional cases being combined embolisms of lung and brain as well. The onset of symptoms appeared shortly after the injury or surgery. Lipid droplets could be observed within small pulmonary vessels and verified by special staining. Conclusion There are particular characteristics in death due to FES in concern with types of injuries, onset of symptoms and pathological findings. In order to find out the direct evidence of FES, special staining （oil red O staining） can be used in the forensic identification. Related Articles | Metrics

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A Retrospective Analysis of Estimating Postmortem Interval in 256 Murder Cases SUN ZHENG, ZHONG LI-HUI, SUN DONG 2013, 29(6): 434-436.  DOI: 10.3969/j.issn.1004-5619.2013.06.008 Abstract ( 1317 )   Objective To discuss the method of reducing error in estimating postmortem interval （PMI）. Methods Two hundred and fifty-six solved murder cases from 2003 January to 2013 January in Changzhou and Nanjing City were collected, The PMI of all cases was estimated by traditional method and then compared with the real PMI obtained after the cases were solved. The cases were grouped according to the PMI, the accuracy was calculated, and the reasons of suboptimal PMI were analyzed. Results The accuracies of early PMI （less than 12 h and 13-24 h） were 90% and 89%, respectively; while the accuracies of late PMI （1-7 d, 1-2 weeks, 3-4 weeks, 1-6 months, 7-12 months and 1-5 years） decreased over time, being 79%, 76%, 83%, 79%, 60% and 50%, respectively. The common reasons of estimating error included improper inference methods, water submerged body, extreme temperature, lack of objective evidence, intentionally abandoned body, and changed or destroyed scene, etc. Conclusion The multiple index data can reduce the error in estimating PMI. Related Articles | Metrics

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Disability Identification for Cases with Clinical Diagnosis of Diffuse Axonal Injury due to Traffic Accidents: A Study of 89 Cases SU QIAO-RONG, CHEN MING-MIN, ZHANG DENG-KE, ET AL. 2013, 29(6): 437-439.  DOI: 10.3969/j.issn.1004-5619.2013.06.009 Abstract ( 1507 )   Objective To study the disability identification for cases with clinical diagnosis of diffuse axonal injury （DAI） due to traffic accidents, and to explore the possible effects of DAI on identification results. Methods Five hundred and fifty-six cases of cerebral injury due to traffic accidents were collected, including 467 cases diagnosed with cerebral contusion or laceration and 89 cases diagnosed with DAI. The identification results of different groups with diagnosis of DAI diagnosis, diagnosis of DAI with cerebral contusion （laceration）, and diagnosis of cerebral contusion or laceration without DAI were compared and statistically analyzed, based on the results of CT and MRI re-review. Results The disability identification levels in DAI group （20 cases）, DAI group （69 cases） with cerebral contusion （laceration） and DAI group （467 cases） not complicated by cerebral contusion （laceration） were 7.72±1.09, 7.78±1.11, and 8.86±0.66, respectively. The disability levels of the two groups diagnosed with DAI were higher than those of the group without DAI diagnosis （P<0.05）. Conclusion Patients with DAI diagnosis might have more severe cerebral injury. In the identification process, one should pay attention to the possible missed diagnosis and misdiagnosis, and meanwhile avoid relying on those evidences provided only by CT and MRI. Related Articles | Metrics

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Genetic Polymorphisms of 19 STR Loci in Shandong Han Population ZHANG MAO-XIU, HAN SHU-YI, GAO HONG-MEI, ET AL. 2013, 29(6): 440-443,446.  DOI: 10.3969/j.issn.1004-5619.2013.06.010 Abstract ( 1738 )   Objective To investigate the genetic polymorphisms of 19 STR Loci in Shandong Han population in order to provide the genetic data for paternity testing. Methods The genotypes of 205 unrelated individuals in Shandong Han population were typed by GoldeneyeTM 20A kit to get the allele frequencies and population genetic parameters of 19 STR loci. Four kits, IdentifilerTM kit, SinoFilerTM kit, PowerPlex 16 kit, and GoldeneyeTM 20A kit, were compared with each other and used in the analysis of a special paternity test case. Results The population genetic parameters of 19 STR loci in Shandong Han Population were obtained. The cumulative discrimination power （CDP） and cumulative probability of exclusion （CPE） ranked from high to low were GoldeneyeTM 20A kit, SinoFilerTM kit, PowerPlex 16 kit and IdentifilerTM kit, respectively. As duo case, the result of the real case showed that IdentifilerTM kit had no excluding loci, and none of the SinoFilerTM kit, PowerPlex 16 kit or GoldeneyeTM 20A kit could exclude fatherhood. Conclusion Compared with IdentifilerTM kit, SinoFilerTM kit, and PowerPlex 16 kit, GoldeneyeTM 20A kit shows the higher efficiency than the others, but is not completely satisfied for duo cases. Related Articles | Metrics

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Statistics Analysis of Tri-allelic Patterns in STR loci LIU YING, REN HE 2013, 29(6): 444-446.  DOI: 10.3969/j.issn.1004-5619.2013.06.011 Abstract ( 1551 )   Objective To investigate the statistical method of tri-allelic patterns of STR loci. Methods The DNAs of venous blood and blood stain samples from 8 846 unrelated individuals were extracted using magnetic bead method, and STR genotypes were determined by multiplex fluorescent amplification and capillary electrophoresis and analyzed using GeneMapper ID v3.2 software. The genotype frequency and allele frequency of trizonal were determined by direct counting and formula, respectively, in order to deduce the formula of trizonal in paternity test and individual recognition. Results Of the 8 846 individuals, four tri-alleles and three tri-genotypes were detected. The multiplying of allele frequency and actual rate showed significantly statistical difference. The formula of trizonal in paternity test and individual recognition was successfully deduced. Conclusion The frequency of the two alleles inherited as a whole in the population could be calculated by multiplying the frequencies of each allele in the tri-allelic patterns. Related Articles | Metrics

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Biological Characteristics of Calliphoridae and Its Application in Forensic Medicine ZHAO BO, WEN CHAN, QI LI-LI, ET AL. 2013, 29(6): 447-450.  DOI: 10.3969/j.issn.1004-5619.2013.06.012 Abstract ( 1507 )   Diptera Calliphoridae is the first major kind of flies that appears on the decomposed corpses. In forensic entomology, according to the living characteristics of Calliphoridae flies, we could accurately estimate postmortem interval （PMI） in a murder or unidentified case and could provide useful clues to solve the case. This paper introduces the characteristics of the biology and morphology of Diptera Calliphoridae, and reviews the combined application of forensic entomology, molecular biology, mathematical morphology and toxicology. Related Articles | Metrics

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Progress on Suxamethonium Chloride Analysis JIANG MING-ZHE, CHENG XIANG-WEI, CHU JIAN-XIN 2013, 29(6): 451-453.  DOI: 10.3969/j.issn.1004-5619.2013.06.013 Abstract ( 1343 )   Suxamethonium chloride is a depolarizing muscle relaxant used in general anesthesia. In overdose, it causes adverse reactions such as bradycardia, arrhythmia, cardiac arrest, and death. The article reviews the progress on testing methods of suxamethonium chloride such as infrared spectroscopy, chemical color reaction, chemical titration, enzyme electrode, chromatography and mass spectrometry. Related Articles | Metrics

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Forensic Evidence-based Medicine in Computer Communication Networks QIU YUN-LIANG, PENG MING-QI 2013, 29(6): 454-457.  DOI: 10.3969/j.issn.1004-5619.2013.06.014 Abstract ( 1364 )   As an important component of judicial expertise, forensic science is broad and highly specialized. With development of network technology, increasement of information resources, and improvement of people’s legal consciousness, forensic scientists encounter many new problems, and have been required to meet higher evidentiary standards in litigation. In view of this, evidence-based concept should be established in forensic medicine. We should find the most suitable method in forensic science field and other related area to solve specific problems in the evidence-based mode. Evidence-based practice can solve the problems in legal medical field, and it will play a great role in promoting the progress and development of forensic science. This article reviews the basic theory of evidence-based medicine and its effect, way, method, and evaluation in the forensic medicine in order to discuss the application value of forensic evidence-based medicine in computer communication networks. Related Articles | Metrics