婴儿猝死综合征的法医学鉴定

近20多年来,婴儿猝死综合征(sudden infant death syndrome,SIDS)一直是西方发达国家医学界尤其是法医学和儿科学领域研究的热点。目前,随着对SIDS广泛而深入的研究,对其病因、发病特点、危险因素以及致病机制等都有了更明确的认识。虽说近年来SIDS的发病率已有明显下降,在欧美洲、澳洲等发达国家,SIDS仍然是导致1个月到1岁婴儿死亡的首要原因。在亚洲国家和地区,尤其是发展中国家SIDS的报道很少见。本文通过总结文献并结合美国马里兰州近20年(1990—2006)来对SIDS的调查研究资料,介绍SIDS的发展历史、研究现状和新的发展趋势,并对SIDS法医学鉴定程序及鉴定要素进行讨论。

美国马里兰州涉及电击枪死亡案例分析

目的研究美国马里兰州涉及电子武器(电击枪)死亡案件的特点,探讨其法医学鉴定要点。方法收集2004—2009年美国马里兰州法医局鉴定的涉及电击枪死亡案件13例,案件均经详细的现场调查,尸体进行系统解剖,并进行全面的毒(药)物检测及组织病理学检验。从一般情况、电击枪类型及接触方式、毒物检测结果、死亡方式、死亡原因等方面进行分析。结果死者多为男性,且多见于精神障碍患者突然急性发作,死前有服用药物或毒品情况,死亡原因系多种因素共同所致。结论涉及电击枪案件死者的死亡原因多为多种因素共同作用所致,死亡机制有待进一步研究,全面的现场调查及规范的尸体解剖程序对于此类案件的法医学鉴定至关重要。

网络离不开容错技术

局域网是实现资源共享的一种方便且有效的方法,已成为多数企业信息基础设备不可分割的一部分。今天人们已不再仅仅满足于网络能够运行。还要求网络能够按照人们的需要运行。这样网络容错技术就成为一个很重要的课题。网络容错不是每个网络都必不可少的。

Resource availability and plant diversity explain patterns of invasion of an exotic grass

Aims in this study,we examine two common invasion biology hypotheses-biotic resistance and fluctuating resource availability-to explain the patterns of invasion of an invasive grass,Microstegium vimineum.Methods We used 13-year-old deer exclosures in great smoky mountains National Park,USA,to examine how chronic disturbance by deer browsing affects available resources,plant diversity,and invasion in an understory plant community.using two replicate 1 m2 plots in each deer browsed and unbrowsed area,we recorded each plant species present,the abundance per species,and the fractional per-cent cover of vegetation by the cover classes:herbaceous,woody,and graminoid.For each sample plot,we also estimated overstory canopy cover,soil moisture,total soil carbon and nitrogen,and soil pH as a measure of abiotic differences between plots.Important Findings We found that plant community composition between chronically browsed and unbrowsed plots differed markedly.Plant diversity was 40%lower in browsed than in unbrowsed plots.at our sites,diver-sity explained 48%and woody plant cover 35%of the variation in M.vimineum abundance.in addition,we found 3.3 times less M.vimineum in the unbrowsed plots due to higher woody plant cover and plant diversity than in the browsed plots.a parsimonious explanation of these results indicate that disturbances such as herbivory may elicit multiple conditions,namely releasing available resources such as open space,light,and decreasing plant diversity,which may facilitate the proliferation of an invasive species.Finally,by testing two different hypotheses,this study addresses more recent calls to incorporate multiple hypotheses into research attempting to explain plant invasion.

Systemic air embolism complicating upper gastrointestinal endoscopy:a case report with post-mortem CT scan findings and review of literature

Endoscopy of the gastrointestinal and biliary tract is a common procedure and is routinely performed for therapeutic and diagnostic purposes.Perforation,bleeding and infection are some of the more common reported side effects.Air embolism on the other hand,is a rare complication of gastrointestinal endoscopy.We report a 77-year-old African-American female with a history of pancreatic cancer,which was resected with a Whipple procedure.As part of diagnostic and therapeutic procedure,an endoscopic retrograde cholangiopancreatography was planned several months after the surgery.The patient’s heart rate suddenly slowed to 40 bpm during the procedure and she became cyanotic and difficult to oxygenate after the endoscope was introduced and CO2 gas was insufflated.A forensic autopsy was performed with post-mortem computed tomography(PMCT)and revealed extensive systemic air embolism.The detailed PMCT and autopsy findings are presented and current literature is reviewed.

Characteristics of Suicides Caused by Drug Overdose in the State of Maryland

Suicidal drug overdose is a major public health issue.In the United States,every year more than 33,000 people commit suicides.Our study focused on the characteristics of suicide victims in the state of Maryland.Material and methods:This study was a retrospective review of autopsy cases of all suicide deaths caused by drug(s)or drug(s)with alcohol intoxication investigated by the OCME in Maryland over a 7-year period from January 2004 to December 2011.All deaths investigated by the OCME that require autopsy examination are subject to comprehensive toxicology testing for drugs and alcohol.The screen tests were performed using gas chromatography(GC)and radioimmunoassay techniques.All detected drugs and/or metabolites were confirmed using GC-mass spectrometry(GC-MS).Results:From 2004 to 2011,434 deaths were certified as suicide.Of the 434 suicidal overdose deaths,84%were white,11%were African-American,and about 5%were either Hispanic or Asian.The male and female ratio was almost equal.Their ages ranged 15-82 years.Of the 434 suicidal drug overdose deaths,277 victims(63.8%)consumed a single drug type and 157(36.2%)consumed more than one type of drug.Of the 277 single-drug overdose cases,71.1%suicides were due to prescription drugs,23.5%due to over-the-counter drugs,and 5.4%due to street/recreational drugs.Among single-type prescription drugs,analgesic(N=76),antidepressant(N=45),and neuroleptic(N=35)classes were the three leading type of drugs used in suicidal deaths.Oxycodone,morphine,quetiapine,and amitriptyline were the most common prescription drugs in suicidal overdose.Diphenhydramine was the leading over-the-counter drug.Of the 157 victims who consumed more than one drug,combined prescription drugs were present in 54.1%,mixed prescription and overthe-counter drugs in 29.3%,and prescription drugs/over-the-counter drugs and street drugs in 16.6%of cases.Of the multiple-drug overdose suicides,66.2%cases involved antidepressants.Discussion:Suicide is found in every age,racial,and ethnic group.In the USA,poisoning is thethird-leading method of suicide,following firearm injuries and hanging/strangulation.Our study indicates that prescription drugs,such as those in the opioid analgesic,neuroleptic,and antidepressant class(e.g.,oxycodone,morphine,quetiapine,amitriptyline,doxepin,and citalopram),are of special concern in the context of suicidal overdose deaths in the state of Maryland.Therefore,addressing the problems of intentional drug overdose in our society is worthy of public attention.