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Journal of Forensic Medicine

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    28 February 2020, Volume 36 Issue 1 Previous Issue    Next Issue
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    2020, 36(1): 1-3.  DOI: 10.12116/j.issn.1004-5619.2020.01.001
    Abstract ( 479 )   PDF (979KB) ( 4186 )  
     
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    2020, 36(1): 4-5.  DOI: 10.12116/j.issn.1004-5619.2020.01.002
    Abstract ( 328 )   PDF (930KB) ( 3454 )  
     
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    Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 （COVID-19） （Trial Draft）
    MAO Dan-mi, ZHOU Nan, ZHENG Da, et al.
    2020, 36(1): 6-15.  DOI: 10.12116/j.issn.1004-5619.2020.01.003
    Abstract ( 567 )   PDF (1102KB) ( 3744 )  
    Autopsy is of great significance to the elucidation of the pathological changes, pathogeneses and causes of death of corona virus disease 2019 （COVID-19） and can provide theoretical basis for more scientific and accurate prevention and control of the outbreak. Based on related laws and regulations, such as the Law of the People’s Republic of China on Prevention and Control of Infectious Diseases, the clinical manifestations and epidemiological characteristics of COVID-19, and the related guidelines on the prevention and control of the outbreak, combined with the practical work of forensic pathology examination, the Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 （COVID-19） （Trial Draft） has been developed. This guide includes information on the background investigation of the cases, autopsy room requirements, personal prevention and protections, external examinations, autopsy, auxiliary examinations, and so on. This guide can be used as a reference by forensic and pathological examination institutions, as well as examination staff.
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    Review and Prospect of Pathological Features of Corona Virus Disease
    WANG Hui-jun, DU Si-hao, YUE Xia,et al.
    2020, 36(1): 16-20.  DOI: 10.12116/j.issn.1004-5619.2020.01.004
    Abstract ( 1516 )   PDF (1293KB) ( 11087 )  
    Since 2003, coronavirus has caused multiple major public health events that resulted in global epidemics, such as severe acute respiratory syndrome （SARS）, Middle East respiratory syndrome （MERS） and corona virus disease 2019 （COVID-19）. Especially since COVID-19 outbroke in Wuhan, Hubei, in December 2019, coronavirus has had a significant impact on people’s health and lives. But so far, the pathological diagnosis of COVID-19 has been relatively deficient： it is still confined to the pathological findings of punctured organs, and the majority of medical workers have poor awareness of its pathological characteristics. The COVID-19, as same as SARS and MERS, is caused by coronaviruses and can cause viral pneumonia. They have certain similarities. This article comprehensively reviews the pathological features observed in the autopsies of the aforementioned three diseases, in order to provide reference to the analysis of pathological changes of COVID-19.
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    Gross examination report of a COVID-19 death autopsy
    LIU Qian, WANG Rong-shuai, QU Guo-qiang, et al.
    2020, 36(1): 21-23.  DOI: 10.12116/j.issn.1004-5619.2020.01.005
    Abstract ( 5087 )   PDF (2523KB) ( 41434 )  
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    Determination of Electrocution Using Fourier Transform Infrared Microspectroscopy and Machine Learning Algorithm
    TUO Ya, LI Shi-ying, ZHANG Ji,et al.
    2020, 36(1): 35-40.  DOI: 10.12116/j.issn.1004-5619.2020.01.008
    Abstract ( 259 )   PDF (4561KB) ( 821 )  
    Objective To analyze the differences among electrical damage, burns and abrasions in pig skin using Fourier transform infrared microspectroscopy （FTIR-MSP） combined with machine learning algorithm, to construct three kinds of skin injury determination models and select characteristic markers of electric injuries, in order to provide a new method for skin electric mark identification. Methods Models of electrical damage, burns and abrasions in pig skin were established. Morphological changes of different injuries were examined using traditional HE staining. The FTIR-MSP was used to detect the epidermal cell spectrum. Principal component method and partial least squares method were used to analyze the injury classification. Linear discriminant and support vector machine were used to construct the classification model, and factor loading was used to select the characteristic markers. Results Compared with the control group, the epidermal cells of the electrical damage group, burn group and abrasion group showed polarization, which was more obvious in the electrical damage group and burn group. Different types of damage was distinguished by principal component and partial least squares method. Linear discriminant and support vector machine models could effectively diagnose different damages. The absorption peaks at 2 923 cm-1, 2 854 cm-1, 1 623 cm-1, and 1 535 cm-1 showed significant differences in different injury groups. The peak intensity of electrical injury’s 2 923 cm-1 absorption peak was the highest. Conclusion FTIR-MSP combined with machine learning algorithm provides a new technique to diagnose skin electrical damage and identification electrocution.
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    Rapid Determination of Ammonia in Biological Samples by GC-MS Derivatization Method
    YUAN Hui-ya, LIU Jun-ting, XU En-yu,et al.
    2020, 36(1): 41-44，51.  DOI: 10.12116/j.issn.1004-5619.2020.01.009
    Abstract ( 493 )   PDF (1291KB) ( 880 )  
    Objective To establish a qualitative and quantitative method to determine ammonia in biological samples by gas chromatography-mass spectrometry （GC-MS）. Methods A heptafluorobutyryl chloride derivatization method was used. GC-MS was used for determination. The effects of different pH conditions, derivatization temperature, time and different extraction solvents on the test results were investigated. The pretreatment conditions were optimized. Results This method could accurately detect the ammonia content in blood, and the limit of detection was determined to be 0.1 μg/mL. The target component showed good linearity in the range of 0.5-200.0 μg/mL （R2=0.987 7）. The relative standard deviation range of intra-day precision was 2.59%-3.88%. The relative standard deviation range of inter-day precision was 3.21%-3.76%. Conclusion The method showed good sensitivity, stability and specificity, therefore can be used for forensic toxicology analysis and clinical biochemical detection.
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    Rapid Determination of 13 Sedative Substances and Their Metabolites in Blood by LC-MS/MS
    SHI Yin-tao, WANG Hui-jun, WANG Jun-wei, et al.
    2020, 36(1): 45-51.  DOI: 10.12116/j.issn.1004-5619.2020.01.010
    Abstract ( 320 )   PDF (1445KB) ( 742 )  
    Objective To establish an analysis method for simultaneous determination of 13 sedative substances and their metabolites in blood by liquid-liquid extraction and liquid chromatography-tandem mass spectrometry （LC-MS/MS） technology and to apply the method to actual cases. Methods The samples were extracted with ethyl acetate after an internal standard was added. The extract was condensed until it was nearly dry and then its residues were dissolved with methanol, filtered through 0.22 μm filter and finally determined. The 13 sedative substances and their metabolites were separated through the C18 chromatographic column, then gradient elution was performed on them with methanol and 20 mmol/L ammonium formate （containing 0.1% formic acid） solution. After that, they were determined in the electrospray positive ion mode and quantified by internal standard method. Results The 13 sedative substances and their metabolites in blood showed good linearity in the range of 5-200 μg/L with correlation coefficients ranging from 0.990 3 to 0.999 8. The detection limits were 0.1-1.0 μg/L. Recovery rates of sedative substances were in the range of 71.2%-93.4% when solutions with concentrations of 10, 50 and 200 μg/L were added. The deviations of intra-day and inter-day relative standard deviations （RSD） were not more than 8.6%. Accuracies （bias） were within ±9.8%. Conclusion This method is rapid, simple, effective and sensitive, and can be applied to analysis of 13 sedative substances and their metabolites in blood in forensic toxicology.
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    Working Memory of Patients with Mild Cognitive Impairment due to Brain Trauma Based on fNIRS
    CHANG Fan, LI Hao-zhe, ZHANG Sheng-yu, et al.
    2020, 36(1): 52-60.  DOI: 10.12116/j.issn.1004-5619.2020.01.011
    Abstract ( 503 )   PDF (2241KB) ( 874 )  
    Objective To discuss the activation characteristics of the prefrontal cortex of people with mild cognitive impairment （MCI） due to brain trauma during working memory tasks. Methods The psychological experiment design software E-prime was used and N-back paradigm was adopted as working memory task. Functional near-infrared spectroscopy （fNIRS） was used to detect changes in cortical oxygenated hemoglobin concentrations of 22 channels within the prefrontal lobe of 24 people with MCI due to brain trauma （study group） and 27 healthy volunteers （control group） with matching gender and age. Behavioral data, such as the number of keystroke errors and reaction time, were recorded simultaneously. Independent samples t test and non-parametric test were used to compare the mean value of oxygenated hemoglobin concentration change, the number of key errors and the mean value of reaction time of the two groups in each task. Results （1） The differences in the number of errors and reaction time between the two groups in 1-back and 2-back tasks had statistical significance （P<0.05）.The main effects of task load and group were both significant （task F=14.11, P=0.001 1; group F=10.39, P=0.001 5）. （2） During the 1-back task, the differences in oxygenated hemoglobin concentration changes of the 22 channels between the two groups had no statistical significance （P>0.05）. During the 2-back task, the differences in oxygenated hemoglobin concentration changes of the two groups in channel 2, 3, 7, 9, 10, 11, 14, 15, 18, 19, 21 and 22 had statistical significance （P<0.05）. （3） In the 1-back task, the left frontal pole and dorsolateral prefrontal area in both groups were activated. In the 2-back task, the activation areas of the control group were the left frontal pole area and the left dorsolateral prefrontal area, while that of the study group almost covered most of the left and right frontal pole areas, which were scattered and the right area was activated, too. Conclusion Patients with MCI due to brain trauma have obvious working memory impairment, and during the 2-back working memory task, the activation of the prefrontal lobe decreased, but the activation range was wider.
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    Retrospective Analysis of 73 Hanging and Ligature Strangulation Cases#br#
    PI Zhi-yun, XING Yu-ming, CHENG Bao-wen
    2020, 36(1): 61-65.  DOI: 10.12116/j.issn.1004-5619.2020.01.012
    Abstract ( 2147 )   PDF (1271KB) ( 1783 )  
    Objective To retrospectively analyze 40 cases of hanging and 33 cases of ligature strangulation in Kunming, to explore the neck injury characteristics and similarities and differences of related asphyxia signs of corpses in hanging and ligature strangulation cases, in order to provide reference for forensic identification. Methods Statistics of hanging and ligature strangulation cases accepted by Kunming Municipal Public Security Bureau from 2000 to 2017 were collected. Data including the gender, age, injury tool, neck injury and related asphyxia signs of the deceased in hanging and ligature strangulation cases were statistically tested by SPSS 23.0. Results There were more males in hanging cases than females. However, there were more females than males in ligature strangulation cases. In hanging cases, suicide was common, while homicide was rare. In ligature strangulation cases, homicide was common, while suicide or accidental death was rare. The average age of the deceased in hanging cases were older than those in ligature strangulation cases. The ligature mark in hanging was usually above the thyroid cartilage. The ligature mark in ligature strangulation was usually at the same level of the thyroid cartilage. The most common vital reactions were exfoliation and subcutaneous hemorrhage at the ligature mark, common among the deceased in hanging cases. Hyoid fracture rate of the deceased in ligature strangulation cases was more common than those in hanging cases. Conclusion The gender, age distribution, position of ligature mark, detection rate of vital reactions at the ligature mark and hyoid fracture rate of the deceased can help distinguish hanging from ligature strangulation.
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    Forensic Analysis of 41 Traumatic Tooth Fracture Cases
    LIU Min, WANG Wei
    2020, 36(1): 66-68.  DOI: 10.12116/j.issn.1004-5619.2020.01.013
    Abstract ( 529 )   PDF (1218KB) ( 945 )  
    Objective To discuss the types, number and diagnostic methods of traumatic tooth fracture in order to provide reference for forensic clinical identification. Methods The 41 cases accepted by Judicial Appraisal Center of Gansu University of Political Science and Law from January 2015 to December 2017, were analyzed by descriptive statistics according to information such as the basic situation, injury manner, type and number of tooth fracture, diagnostic method and expert opinion. Results The 41 cases included 31 males and 10 females. Tooth fracture occurred mainly on the maxillary anterior teeth. The main injury manner of traumatic tooth fracture was collision injury. CT scan improved the accuracy of diagnosis. Conclusion There are gender differences in tooth fracture cases. The part of fracture is related to tooth anatomical characteristics. CT scan can be a priority in tooth fracture diagnosis. Forensic analysis of traumatic tooth fracture should comprehensively consider the types and number of tooth fracture, and define the relationship between tooth fracture and the injury.
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    Analysis of Driver-Passenger Relationship and Restoration of Accident Process Based on 3D Laser Scanning Technology
    ZHANG Xue, LI Sheng-dong, YU Yan-geng,et al.
    2020, 36(1): 69-71，76.  DOI: 10.12116/j.issn.1004-5619.2020.01.014
    Abstract ( 261 )   PDF (2846KB) ( 743 )  
    Objective To discuss the application of 3D laser scanner and computer technology in restoration of the accident scene and reconstruction of the accident process, as well as identification of the driver-passenger relationship. Methods The scene of a traffic accident, the accident vehicle and the vehicle of the same type as accident vehicle were scanned using 3D laser scanner. The accident scene, traces and accident vehicle were integrated using computer technology to restore the accident scene, and the accident process was reconstructed and analyzed by combining the characteristics of the body injuries. Results By restoring the accident scene and reconstructing the accident process with 3D laser scanner, it was determined that Wu was in the driving seat at the time of the accident. Conclusion It is more objective and scientific to use 3D laser scanning technology to restore the accident scene, reconstruct the accident process and analyze the moving track of the driver and passengers in the vehicle. It will help to improve the accuracy of forensic identification of road traffic accidents.
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    Application of Virtual Anatomy Technology in Postmortem Examination of Medical Dispute Cases
    JIN Xin, ZHAO Jian-xin, YAO Yi, et al.
    2020, 36(1): 72-76.  DOI: 10.12116/j.issn.1004-5619.2020.01.015
    Abstract ( 335 )   PDF (1421KB) ( 857 )  
    Objective To discuss the application value of CT scanning technology in cause of death determination of medical dispute cases. Methods From July 2017 to December 2018, postmortem CT imaging data of 12 medical dispute cases were collected. CT imaging diagnosis results and anatomy findings as well as differences between antemortem and postmortem CT diagnosis were compared. The advantages and disadvantages of CT routine tests of the cadavers in terms of the diagnosis of disease and damage were analyzed. Results The comparison between CT imaging diagnosis and anatomical findings showed that CT scans had advantages in the diagnosis of disease and damage with large differences in density changes, such as atelectasis, pneumonia, calcification, fracture and hemorrhage, etc. The comparison of CT diagnosis in antemortem and postmortem examination showed that the cadavers of medical dispute cases were well preserved and that postmortem CT scan was meaningful for the diagnosis of antemortem diseases. Conclusion Virtual anatomy technology has a relatively high application value in postmortem examination of medical dispute cases. It can provide effective information for the appraisers before the autopsy and can also provide a reference for cause of death analysis when the anatomy cannot be performed.
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    New Opportunities and Challenges for Forensic Medicine in the Era of Artificial Intelligence Technology#br#
    FANG Ya-ting, LAN Qiong, XIE Tong,et al.
    2020, 36(1): 77-85.  DOI: 10.12116/j.issn.1004-5619.2020.01.016
    Abstract ( 2292 )   PDF (1303KB) ( 3264 )  
    Traditional forensic identification relies on forensic experts to manually extract information and provide identification opinions based on medicine, biology and other fields of knowledge combined with personal work experience, which is not only time-consuming and require great effort, but also affected by subjective factors that are difficult to overcome. In the era of big data, the booming development of artificial intelligence brings new ideas to forensic medicine. In recent years, forensic researchers at home and abroad have conducted many studies based on artificial intelligence technology, such as face recognition, age and gender identification, DNA analysis, postmortem interval estimation, injury and cause of death identification, showing the feasibility and advantages of using artificial intelligence technology to solve forensic identification problems. As a new means of technology that has adapted to the development of the times, artificial intelligence has brought new vitality to forensic medicine, but at the same time also some new challenges. How to deal with these challenges scientifically and form a new mode of ‘artificial intelligence plus forensic medicine’ with artificial intelligence and forensic medicine developing collaboratively is a new direction for the development of forensic medicine in the era of big data.
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    Big Data and Artificial Intelligence： New Insight into the Estimation of Postmortem Interval
    ZOU Yi, ZHUANG Chong, FANG Qi,et al.
    2020, 36(1): 86-90.  DOI: 10.12116/j.issn.1004-5619.2020.01.017
    Abstract ( 598 )   PDF (1332KB) ( 1234 )  
    The estimation of postmortem interval （PMI） is a core issue in forensic practice. A large amount of time-dependent data can be produced in the decomposition process of a body, however, such multidimensional data cannot be comprehensively and effectively analyzed and utilized by any existing conventional PMI estimation method. As a rapidly developing information technology, artificial intelligence （AI） has significant advantages in big data processing, due to it’s comprehensiveness, efficiency and automation. Some scholars have already applied it to researches on the estimation of PMI, showing it’s significant advantages in terms of accuracy and development prospect. This article reviews the significance, mode and progress of application of AI in PMI estimation and provides some suggestions and prospects for future study.
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    Research Progress and Prospect of Machine Learning in Bone Age Assessment
    PENG Li-qin, WAN Lei, WANG Mao-wen,et al.
    2020, 36(1): 91-98.  DOI: 10.12116/j.issn.1004-5619.2020.01.018
    Abstract ( 463 )   PDF (1283KB) ( 1298 )  
    Bone age assessment has always been one of the key issues and difficulties in forensic science. With the gradual development of machine learning in many industries, it has been widely introduced to imageology, genomics, oncology, pathology, surgery and other medical research fields in recent years. The reason why the above research fields can be closely combined with machine learning, is because the research subjects of the above branches of medicine belong to the computer vision category. Machine learning provides unique advantages for computer vision research and has made breakthroughs in medical image recognition. Based on the advantages of machine learning in image recognition, it was combined with bone age assessment research, in order to construct a recognition model suitable for forensic skeletal images. This paper reviews the research progress in bone age assessment made by scholars at home and abroad using machine learning technology in recent years.
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    Advances in Neuropathologic Research of Hypoglycemic Brain Damage Caused by Insulin Overdose
    TONG Fang, YANG Yi, LIANG Yue, et al.
    2020, 36(1): 99-103.  DOI: 10.12116/j.issn.1004-5619.2020.01.019
    Abstract ( 454 )   PDF (1243KB) ( 938 )  
    The number of death from insulin overdose, including accidental poisoning, suicide and homicide, is increasing these years. The forensic diagnosis of death from insulin overdose is a tough task. Glucose is the main energy source of the brain. Therefore, hypoglycemic brain damage is considered to be the main reason of death from insulin overdose. Recently, research of hypoglycemic brain damage caused by insulin overdose is gradually being paid attention in the field of forensic medicine. This paper summarizes the neuropathologic changes, pathophysiologic process and potential neural molecular markers of hypoglycemic brain damage caused by insulin overdose in terms of forensic neuropathology, providing reference for the research and practice in forensic medicine related fields.
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    Forensic Significance of Skin Injury and Fracture Caused by Child Abuse
    CAO Zhe, HOU Xiao-ning, AN Zhi-yuan, et al.
    2020, 36(1): 104-108.  DOI: 10.12116/j.issn.1004-5619.2020.01.020
    Abstract ( 496 )   PDF (1207KB) ( 1105 )  
    In recent years, cases of child abuse that result in injuries and death have occurred from time to time in China, and there may be more undetected child abuse cases. However, many pediatricians and forensic doctors lack professional knowledge and formal training in detecting child abuse, which leads to the missed diagnosis, misdiagnosis and misidentification of many cases of child abuse. This paper reviews a large number of relevant domestic and foreign literatures, combined with practical work experience and China’s national conditions, preliminarily summarizes the main points of clinical diagnosis and forensic identification of child abuse cases, in order to provide some help for early detection, accurate identification of child abuse cases and timely and effective treatment and protection for abused children.
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    Research Progress on Human Age Estimation Based on DNA Methylation
    WANG Zhong-hua, LI Shu-jin
    2020, 36(1): 109-114，119.  DOI: 10.12116/j.issn.1004-5619.2020.01.021
    Abstract ( 668 )   PDF (1232KB) ( 1094 )  
    In forensic science practice, age is an important individual information, and one of the indicators to be considered first to depict features of the suspect. Recently, DNA methylation has become a research hotspot in age estimation because of its hig accuracy and stability. New progress has been made in specificity of DNA methylation sites, age estimation in multiple tissues, DNA methylation age estimation of minors, sensitivity of age estimation, forensic practical applications, etc. At the same time, several studies also established more accurate statistical modeling methods, eliminated differences between different detection platforms, found appropriate number of sites in models and analyzed the influence of environment and diseases. This review summarizes these to provide references.
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    Research Progress on the Molecular Mechanisms of Toxicology of Ethanol-Aconitine Induced Arrhythmia
    PAN Mei-chen, ZHOU Xiao-wei, LIU Yan,et al.
    2020, 36(1): 115-119.  DOI: 10.12116/j.issn.1004-5619.2020.01.022
    Abstract ( 472 )   PDF (1556KB) ( 929 )  
    Aconitum is one of the most widely used Chinese herbal medicines, and aconitine is the major toxic component in it. Aconitine can induce a variety of arrhythmias, resulting in death. Acute ethanol consumption causes arrhythmia as well. Poisoning cases caused by aconitum medicinal liquor are frequently encountered in the practice of forensic medicine. The molecular mechanisms of myocardial toxicity of these two drugs have much in common, and both of them affect the sodium channel, calcium channel and potassium channel of myocardial cell membrane and so on. This paper analyzes and discusses the possible co-effects of ethanol-aconitine on cardiomyocyte channel proteins, by reviewing researches on the mechanism of cardiotoxicity of ethanol and aconitine in recent years, in order to provide ideas and references for the research on the molecular mechanism of arrhythmia caused by combined poisoning.
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