Studies regarding sport-related sudden cardiac death(SCD)mainly focus on competitive ath-letes;similar data are rare in the general population,especially in China.We conducted a retrospective study(from September 1998...Studies regarding sport-related sudden cardiac death(SCD)mainly focus on competitive ath-letes;similar data are rare in the general population,especially in China.We conducted a retrospective study(from September 1998 to August 2013)to investigate the aetiological distribution and epidemiological features of sport-related SCD in Southern China.Selections of cases are based on details,and two subgroups were established:one was the sport-related SCD group,and the other was the disease-free accident victims group which was matched with the sport-related SCD group in gender,age and year of death.Among the 3770 sudden-death cases,1656 cases were SCD cases.A total of 65 cases(57 males)out of 1656 SCD cases were sport-related.The age range of the 65 sport-related SCD cases was from 12 to 68 years old with a mean(35.92±14.23)years old.Only two of these cases were competitive athletes.The most common circumstances of the 65 sport-related SCD cases were heavy physical labour(46.15%)and running(30.77%).The three leading forensic diag-noses were the coronary atherosclerotic disease(CAD,28 cases),cardiomyopathy(CM,14 cases)and sudden unexplained death(7 cases).CM was the most common forensic diagno-sis in those?35 years old,while CAD was the most common one in those>35 years old.Left anterior descending in which atherosclerotic plaques was most commonly found was the principal artery branch associated with sport-related SCD.There was a statistically signifi-cant difference in the weight of hearts between the 65 sport-related SCD cases and 65 dis-eases-free accidental cases.This study highlights the need to attract public attention to sport-related SCD and to issue a prevention strategy to the public,and to make the SCD-related genetic sequencing a routine tool in both forensic pathological examination and clinic screening.展开更多
Background:Diagnosis of fatal hypothermia is challenging by autopsy approach alone.Aims and Objectives:To explore the features of fatal hypothermia on postmortem computed tomography(PMCT)and study their diagnostic val...Background:Diagnosis of fatal hypothermia is challenging by autopsy approach alone.Aims and Objectives:To explore the features of fatal hypothermia on postmortem computed tomography(PMCT)and study their diagnostic value in such cases.Materials and Methods:A retrospective study was conducted on the imaging data of three cases of low-temperature death.The study compared the images of lung tissue in the control group and used statistical tools to analyze typical changes associated with low-temperature death.The potential applications of cadaveric imaging in these cases were also discussed.Results:The typical postmortem imaging manifestations of death from hypothermia include increased volume of bilateral lung tissue,decreased density of bilateral lung tissue,and absence of pulmonary hypostasis.By comparison,it has been proven that PMCT can quickly detect typical changes in postmortem imaging of death from hypothermia.After applying PMCT,combined with the results of postmortem imaging,physical and chemical,and the environmental condition of the scene,in the absence of individual deaths because of other reasons,it can be determined that the individual died from hypothermia.Conclusions:The case of the death from hypothermia is a tough issue in forensic pathology examination.Through this review,it was found that the death from hypothermia cases have typical postmortem imaging.After combining the case,on-site investigation,and toxicology testing,we found the PMCT can solve the case of the death from hypothermia.展开更多
Background:As traditional autopsy rates decline,the importance of forensic imaging,particularly postmortem computed tomography(PMCT),grows for non-invasive cause of death determination and evidence collection in legal...Background:As traditional autopsy rates decline,the importance of forensic imaging,particularly postmortem computed tomography(PMCT),grows for non-invasive cause of death determination and evidence collection in legal investigations,with unique considerations required for frozen corpses due to the lack of systematic imaging characteristic studies.Aims and Objectives:This study aims to fill the gap in current knowledge by systematically analyzing the PMCT imaging characteristics of frozen corpses.Materials and Methods:This study utilized postmortem computed tomography(PMCT)and postmortem computed tomography angiography(PMCTA)to examine tissue changes during the freezing and thawing process in a total of 61 corpses.Results:The results demonstrated that imaging changes in the brain were most pronounced during freezing and thawing,with a clear correlation to the duration of freezing/thawing and the position of the corpses.Typical ice crystal artifacts were observed in body fluids after freezing,while thawing led to a marked increase and redistribution of internal gas.Serial angiographic studies revealed"pseudo-brain hemorrhage"in the brainstem and cerebellum in several cases due to incomplete thawing and transport.Conclusion:This study provides a comprehensive analysis of the CT imaging characteristics of frozen corpses,elucidating the imaging features during the freezing and thawing processes.展开更多
Postmortem investigation of methamphetamine(MA)abuse is an important task in forensic pathology.The present study investigated morphological changes in the astrocytes in the parietal cerebral cortex of MA abusers.Glia...Postmortem investigation of methamphetamine(MA)abuse is an important task in forensic pathology.The present study investigated morphological changes in the astrocytes in the parietal cerebral cortex of MA abusers.Glial fibrillary acidic protein immunoreactivity in the cerebral cortex was examined in forensic autopsy cases for MA-detected group and control group.Clasmatodendrotic astrocytes(including those with swollen cell bodies and disintegrating distal processes)were frequently observed in the cerebral cortex of MA abusers.Quantitative analysis using a colour image processor showed a concomitant increase in the astrocyte area and astrocyte-to-vessel area ratio(size and number of astrocytes)in the grey matter in acute MA fatality and other MA-involved cases,although the astrocyte area(size)was also increased in cases of asphyxiation.The total astrocyte area(size)in the white matter was significantly higher in MA fatalities and asphyxia than in the other groups involving MA abusers.Those indices were independent of blood MA level,age,sex,survival or postmortem time.These observations suggest the increasing number and hypertrophic changes of astrocytes in the grey matter in MA abusers can be the outcome of long-term abuse,while disintegrating distal processes may exist only in acute fatal MA intoxication.展开更多
Brugada syndrome(BrS)is an arrhythmogenic disorder which was first described in 1992.This disease is a channelopathy characterized by ST-segment elevations in the right precordial leads and is susceptible to sudden de...Brugada syndrome(BrS)is an arrhythmogenic disorder which was first described in 1992.This disease is a channelopathy characterized by ST-segment elevations in the right precordial leads and is susceptible to sudden death.BrS is a fatal disease with gender and age preferences.It occurs mainly in young male subjects with a structurally normal heart and silently progresses to sudden death with no significant symptoms.The prevalence of BrS has been reported in the ranges of 5-20 per 10000 people.The disease is more prevalent in Asia.Nowadays,numerous variations in 23 genes have been linked to BrS since the first gene SCN5A has been associated with BrS in 1998.Not only can clinical specialists apply these discoveries in risk assessment,diagnosis and personal medicine,but also forensic pathologists can make full use of these variations to conduct death cause identification.However,despite the progress in genetics,these associated genes can only account for approximately 35%of the BrS cases while the etiology of the remaining BrS cases is still unexplained.In this review,we discussed the prevalence,the genes associated with BrS and the application of molecular autopsy in forensic pathology.We also summarized the present obstacles,and provided a new insight into the genetic basis of BrS.展开更多
Diabetes mellitus(DM)is one of the most common diseases in the elderly,and among DM patients,more than 90%have type 2 DM(T2DM).The etiology of T2DM is complex and associated with risk factors such as age,genetic dispo...Diabetes mellitus(DM)is one of the most common diseases in the elderly,and among DM patients,more than 90%have type 2 DM(T2DM).The etiology of T2DM is complex and associated with risk factors such as age,genetic disposition,and diet.The genetic factors underlying T2DM are currently the focus of intense research,and it has been established that the susceptibility genes associated with T2DM vary among different populations.A recent longitudinal exome-wide association study in the Japanese population has identified GGA3 as a susceptible locus for T2DM.1 GGA3 is one of the Golgi-localized-ear-containing ARF binding proteins(GGAs)that function widely in the transport of Golgi-derived vesicles and in endocytic trafficking pathways.However,although it is widely acknowledged that the control of glucose homeostasis via endocytosis and glucose metabolism plays a vital role in T2DM,the associations between intracellular trafficking and diabetes pathogenesis have not been sufficiently established.In this study,we used a Gga3 gene knockout mouse strain to investigate the potential involvement of GGA3 in controlling blood glucose.The study was approved by the ethics committee of Jining Medical University(No.2019-JS-005).Our results indicate that the GGA3 gene might play a protective role against diabetes.展开更多
In the past 10 years,medical malpractice litigations have become a serious public health and social issues in China.This study aims to evaluate the medical malpractice litigations in Beijing.A retrospective study was ...In the past 10 years,medical malpractice litigations have become a serious public health and social issues in China.This study aims to evaluate the medical malpractice litigations in Beijing.A retrospective study was conducted using the database from the Key Laboratory of Evidence Science(KLES)at China University of Political Science and Law(CUPL)to demonstrate the extent and characteristics of the alleged medical malpractice cases and the conclusions of forensic evaluation from 2002 to 2011 in Beijing.A total of 1515 alleged medical malpractice cases were investigated by forensic medical experts at KLES‑CUPL during the study period.Of the 1515 cases,45.2%were male patients and 54.8%were female patients.The age of the patients ranged from newborn to 90 years,with average age of 44 years.The alleged medical malpractice cases involved 11.3%of newborns.From 2002 to 2006,the average number of medical malpractice litigations was 123 cases per year,while from 2007 to 2011,the average number of medical malpractice litigations was 180 per year,a 46%increase.Of the 1515 cases,588(38.8%)litigations were due to the patients’death.Clinical departments involved in claims most often were obstetrics(18.9%),followed by orthopedics(15.1%)and general surgery(11.5%).Medical error was found in 945(62.4%)cases.Of the 945 confirmed medical malpractice cases,the top medical misadventures were diagnostic errors(36.5%),improper performance of procedures(36.4%),and medication error(12.6%).Although tertiary hospitals were more likely to be sued than the secondary and primary hospitals(63.6%vs.36.4%),there was no significant difference between tertiary and secondary hospitals in the percentage of confirmed malpractice cases(62.3%vs.59.4%).The primary hospitals had the highest confirmed malpractice cases(73.2%).展开更多
The purpose of the study was to delineate the epidemiological characteristics of electrocution deaths in Maryland,identify any potential risks,and address preventive measures.A retrospective review of all the deaths d...The purpose of the study was to delineate the epidemiological characteristics of electrocution deaths in Maryland,identify any potential risks,and address preventive measures.A retrospective review of all the deaths due to electrocution was conducted at the Office of the Chief Medical Examiner in the State of Maryland from 2005 to 2015.During the 11-year period,a total of 55 electrocution deaths were identified from the autopsy cases at the statewide medical examiner system.More males died of electrocution than females with its ratio of(M:F)=9:l.Of the 55 cases,67.3%were White,18.2%were African-American,12.7%were Hispanic,and 1.8%were other races.The age of the victims ranged from 4 to 83 years with mean age of 40 years.>96%deaths due to accidents and 3.4%were suicide.The majority of deaths(70.9%)were caused by high-voltage circuits.Approximately 64%of fatalities were work-related accidents.The study indicated that electrocution deaths frequently affected young male workers who were in contact with a high-voltage currents while on the job.The detailed death scene investiRation and autopsy findings are presented.The potential hazards of electricity must continue to be addressed in public safety campaigns to prevent such deaths.Strategies should ensure safe work environments for any contact with electric currents.展开更多
基金This work was supported by the National Natural Science Foundation of China [grant number 81430046].
文摘Studies regarding sport-related sudden cardiac death(SCD)mainly focus on competitive ath-letes;similar data are rare in the general population,especially in China.We conducted a retrospective study(from September 1998 to August 2013)to investigate the aetiological distribution and epidemiological features of sport-related SCD in Southern China.Selections of cases are based on details,and two subgroups were established:one was the sport-related SCD group,and the other was the disease-free accident victims group which was matched with the sport-related SCD group in gender,age and year of death.Among the 3770 sudden-death cases,1656 cases were SCD cases.A total of 65 cases(57 males)out of 1656 SCD cases were sport-related.The age range of the 65 sport-related SCD cases was from 12 to 68 years old with a mean(35.92±14.23)years old.Only two of these cases were competitive athletes.The most common circumstances of the 65 sport-related SCD cases were heavy physical labour(46.15%)and running(30.77%).The three leading forensic diag-noses were the coronary atherosclerotic disease(CAD,28 cases),cardiomyopathy(CM,14 cases)and sudden unexplained death(7 cases).CM was the most common forensic diagno-sis in those?35 years old,while CAD was the most common one in those>35 years old.Left anterior descending in which atherosclerotic plaques was most commonly found was the principal artery branch associated with sport-related SCD.There was a statistically signifi-cant difference in the weight of hearts between the 65 sport-related SCD cases and 65 dis-eases-free accidental cases.This study highlights the need to attract public attention to sport-related SCD and to issue a prevention strategy to the public,and to make the SCD-related genetic sequencing a routine tool in both forensic pathological examination and clinic screening.
文摘Background:Diagnosis of fatal hypothermia is challenging by autopsy approach alone.Aims and Objectives:To explore the features of fatal hypothermia on postmortem computed tomography(PMCT)and study their diagnostic value in such cases.Materials and Methods:A retrospective study was conducted on the imaging data of three cases of low-temperature death.The study compared the images of lung tissue in the control group and used statistical tools to analyze typical changes associated with low-temperature death.The potential applications of cadaveric imaging in these cases were also discussed.Results:The typical postmortem imaging manifestations of death from hypothermia include increased volume of bilateral lung tissue,decreased density of bilateral lung tissue,and absence of pulmonary hypostasis.By comparison,it has been proven that PMCT can quickly detect typical changes in postmortem imaging of death from hypothermia.After applying PMCT,combined with the results of postmortem imaging,physical and chemical,and the environmental condition of the scene,in the absence of individual deaths because of other reasons,it can be determined that the individual died from hypothermia.Conclusions:The case of the death from hypothermia is a tough issue in forensic pathology examination.Through this review,it was found that the death from hypothermia cases have typical postmortem imaging.After combining the case,on-site investigation,and toxicology testing,we found the PMCT can solve the case of the death from hypothermia.
文摘Background:As traditional autopsy rates decline,the importance of forensic imaging,particularly postmortem computed tomography(PMCT),grows for non-invasive cause of death determination and evidence collection in legal investigations,with unique considerations required for frozen corpses due to the lack of systematic imaging characteristic studies.Aims and Objectives:This study aims to fill the gap in current knowledge by systematically analyzing the PMCT imaging characteristics of frozen corpses.Materials and Methods:This study utilized postmortem computed tomography(PMCT)and postmortem computed tomography angiography(PMCTA)to examine tissue changes during the freezing and thawing process in a total of 61 corpses.Results:The results demonstrated that imaging changes in the brain were most pronounced during freezing and thawing,with a clear correlation to the duration of freezing/thawing and the position of the corpses.Typical ice crystal artifacts were observed in body fluids after freezing,while thawing led to a marked increase and redistribution of internal gas.Serial angiographic studies revealed"pseudo-brain hemorrhage"in the brainstem and cerebellum in several cases due to incomplete thawing and transport.Conclusion:This study provides a comprehensive analysis of the CT imaging characteristics of frozen corpses,elucidating the imaging features during the freezing and thawing processes.
基金funded by Natural Science Foundation of Guangdong Province[Grant Number 2015A030313110]Shanghai Key Lab of Forensic Medicine[Grant Number KF1503].
文摘Postmortem investigation of methamphetamine(MA)abuse is an important task in forensic pathology.The present study investigated morphological changes in the astrocytes in the parietal cerebral cortex of MA abusers.Glial fibrillary acidic protein immunoreactivity in the cerebral cortex was examined in forensic autopsy cases for MA-detected group and control group.Clasmatodendrotic astrocytes(including those with swollen cell bodies and disintegrating distal processes)were frequently observed in the cerebral cortex of MA abusers.Quantitative analysis using a colour image processor showed a concomitant increase in the astrocyte area and astrocyte-to-vessel area ratio(size and number of astrocytes)in the grey matter in acute MA fatality and other MA-involved cases,although the astrocyte area(size)was also increased in cases of asphyxiation.The total astrocyte area(size)in the white matter was significantly higher in MA fatalities and asphyxia than in the other groups involving MA abusers.Those indices were independent of blood MA level,age,sex,survival or postmortem time.These observations suggest the increasing number and hypertrophic changes of astrocytes in the grey matter in MA abusers can be the outcome of long-term abuse,while disintegrating distal processes may exist only in acute fatal MA intoxication.
基金supported by the National Natural Science Foundation of China[grant number 81430046].
文摘Brugada syndrome(BrS)is an arrhythmogenic disorder which was first described in 1992.This disease is a channelopathy characterized by ST-segment elevations in the right precordial leads and is susceptible to sudden death.BrS is a fatal disease with gender and age preferences.It occurs mainly in young male subjects with a structurally normal heart and silently progresses to sudden death with no significant symptoms.The prevalence of BrS has been reported in the ranges of 5-20 per 10000 people.The disease is more prevalent in Asia.Nowadays,numerous variations in 23 genes have been linked to BrS since the first gene SCN5A has been associated with BrS in 1998.Not only can clinical specialists apply these discoveries in risk assessment,diagnosis and personal medicine,but also forensic pathologists can make full use of these variations to conduct death cause identification.However,despite the progress in genetics,these associated genes can only account for approximately 35%of the BrS cases while the etiology of the remaining BrS cases is still unexplained.In this review,we discussed the prevalence,the genes associated with BrS and the application of molecular autopsy in forensic pathology.We also summarized the present obstacles,and provided a new insight into the genetic basis of BrS.
基金supported by the National Natural Science Foundation of China(No.31701247 to XL)the Supporting Fund for Teacher's Research of Jining Medical University(China)(No.JYFC2019JS001 to XZ).
文摘Diabetes mellitus(DM)is one of the most common diseases in the elderly,and among DM patients,more than 90%have type 2 DM(T2DM).The etiology of T2DM is complex and associated with risk factors such as age,genetic disposition,and diet.The genetic factors underlying T2DM are currently the focus of intense research,and it has been established that the susceptibility genes associated with T2DM vary among different populations.A recent longitudinal exome-wide association study in the Japanese population has identified GGA3 as a susceptible locus for T2DM.1 GGA3 is one of the Golgi-localized-ear-containing ARF binding proteins(GGAs)that function widely in the transport of Golgi-derived vesicles and in endocytic trafficking pathways.However,although it is widely acknowledged that the control of glucose homeostasis via endocytosis and glucose metabolism plays a vital role in T2DM,the associations between intracellular trafficking and diabetes pathogenesis have not been sufficiently established.In this study,we used a Gga3 gene knockout mouse strain to investigate the potential involvement of GGA3 in controlling blood glucose.The study was approved by the ethics committee of Jining Medical University(No.2019-JS-005).Our results indicate that the GGA3 gene might play a protective role against diabetes.
基金supported by the fund for Training Programmers Foundation for the Beijing Talents(2013D002023000002)Beijing Planning Project of Philosophy and Social Science(13FXC032)Project of Young teachers’academic innovation team by CUPL(2016CXTD05 and 2014CXTD04).
文摘In the past 10 years,medical malpractice litigations have become a serious public health and social issues in China.This study aims to evaluate the medical malpractice litigations in Beijing.A retrospective study was conducted using the database from the Key Laboratory of Evidence Science(KLES)at China University of Political Science and Law(CUPL)to demonstrate the extent and characteristics of the alleged medical malpractice cases and the conclusions of forensic evaluation from 2002 to 2011 in Beijing.A total of 1515 alleged medical malpractice cases were investigated by forensic medical experts at KLES‑CUPL during the study period.Of the 1515 cases,45.2%were male patients and 54.8%were female patients.The age of the patients ranged from newborn to 90 years,with average age of 44 years.The alleged medical malpractice cases involved 11.3%of newborns.From 2002 to 2006,the average number of medical malpractice litigations was 123 cases per year,while from 2007 to 2011,the average number of medical malpractice litigations was 180 per year,a 46%increase.Of the 1515 cases,588(38.8%)litigations were due to the patients’death.Clinical departments involved in claims most often were obstetrics(18.9%),followed by orthopedics(15.1%)and general surgery(11.5%).Medical error was found in 945(62.4%)cases.Of the 945 confirmed medical malpractice cases,the top medical misadventures were diagnostic errors(36.5%),improper performance of procedures(36.4%),and medication error(12.6%).Although tertiary hospitals were more likely to be sued than the secondary and primary hospitals(63.6%vs.36.4%),there was no significant difference between tertiary and secondary hospitals in the percentage of confirmed malpractice cases(62.3%vs.59.4%).The primary hospitals had the highest confirmed malpractice cases(73.2%).
文摘The purpose of the study was to delineate the epidemiological characteristics of electrocution deaths in Maryland,identify any potential risks,and address preventive measures.A retrospective review of all the deaths due to electrocution was conducted at the Office of the Chief Medical Examiner in the State of Maryland from 2005 to 2015.During the 11-year period,a total of 55 electrocution deaths were identified from the autopsy cases at the statewide medical examiner system.More males died of electrocution than females with its ratio of(M:F)=9:l.Of the 55 cases,67.3%were White,18.2%were African-American,12.7%were Hispanic,and 1.8%were other races.The age of the victims ranged from 4 to 83 years with mean age of 40 years.>96%deaths due to accidents and 3.4%were suicide.The majority of deaths(70.9%)were caused by high-voltage circuits.Approximately 64%of fatalities were work-related accidents.The study indicated that electrocution deaths frequently affected young male workers who were in contact with a high-voltage currents while on the job.The detailed death scene investiRation and autopsy findings are presented.The potential hazards of electricity must continue to be addressed in public safety campaigns to prevent such deaths.Strategies should ensure safe work environments for any contact with electric currents.
