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A case of a stillbirth with lethal type II osteogenesis imperfecta (OI) was reported. The fetus had skull fractures and craniocerebral injuries during pregnancy. Postmortem multi-sliced computed tomography (MSCT) and 3D-reconstruction were performed, followed by a medico-legal autopsy. The autopsic findings showed the typical features of type II OI, including a soft calvarium, deformed extremities, flexed and abducted hips, and uncommon features, such as white sclera, coxa vara, absence of several bones and organs, a cleft lip, and asymmetric ears. The radiologic images revealed such anomalies and variations as a cleft palate, mandibular dysplasia, spina bifida, costa cervicalis, and fusion of the ribs and vertebrae, which were difficult to detect during conventional autopsy. The paper investigated the classification, causative mutation, cause of death, and the differentiation of OI from child abuse, coming to a conclusion that OI knowledge can be of great importance to forensic pathologists and that the merits of postmortem MSCT should be emphasized in forensic pathologic examinations.

Objective: To establish a diagnostic model for diffuse axonal injury (DAI) by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). To screen the proteins or peptides associated with DAI for providing the biomarkers with theoretic foundation., Methods: Fifteen male Sprague-Dawley rats were randomly divided into DAI group (n = 10) and control group (n = 5). The protein or peptide expression profiles of rat brain stem were detected by MALDI-TOF-MS. ClinProTools 2.2 software was used to find specific peaks, and a diagnostic model was established by the genetic algorithm., Results: There were significant differences in 61 peaks of DAI group (P < 0.05), 9 peaks were down-regulated and 52 up-regulated. The diagnostic model was established based on 5 different peaks. The specificity and sensitivity of cross validation was 96.14% and 95.98%; while the specificity and sensitivity of blind validation showed was 73.33% and 70.00%, respectively., Conclusion: A specific and sensitive diagnostic model of DAI can be established by MALDI-TOF-MS to provide a potential value for determining DAI in forensic practice.

Karoshi remains one of the most troublesome issues in forensic identification. It is rather a social medicine than a clinical disease. Japanese scholars pioneered examining the relation between sud- den cardiac death (SCD) and chronic fatigue from long time and/or high-tension work. In the current case, a 55-year-old man, whose job was loading and carrying heavy cement bags, was found dead after 11 days of continuous hard work. His family members sued the cement factory for his death and claimed for compensation. The problem was the difficulty of identifying the causative relation without the precedent or the relevant regulations. However, the forensic problems were finally acknowledged after autopsy and calculation of labor intensity. The lawsuit was won as the first case pertaining to Karoshi in the Chinese court.

Postmortem chemistry is becoming more and more essential in routine forensic pathology and has made considerable progress over the past years. Biochemical analyses of vitreous humor, blood, urine and cerebrospinal fluid may provide important information in determining the cause of death or in elucidating forensic issues. Postmortem chemistry may be essential for the determination of cause of death when morphological methods (diabetes mellitus, alcoholic ketoacidosis and electrolytic disorders) cannot detect the pathophysiological changes involved in the death process. It can also provide many information in other forensic situations, including myocardial ischemia, sepsis, inflammation, infection, anaphylaxis and hormonal disturbances. The most recent relevant research advances on glucose metabolism, liver function, cardiac function, renal function, sepsis, inflammation, infection, anaphylaxis and hormonal aspect are hereby reviewed.

Objective: To explore the application value of multi-slice spiral computed tomography (MSCT) in traffic accidents through observing and analyzing the injury features of the accidents., Methods: Two fatal cases caused by traffic accidents were fully examined using MSCT, 3D imaging reconstruction and angiography through cardiac puncture. The features of traffic injury mechanism were analyzed through combination of MSCT and postmortem external examination., Results: In case 1, right cardiac rupture was found by MSCT and angiography through cardiac puncture. The cause of death was cardiac tamponade and right ventricular rupture due to the crush injury of chest in the traffic accident. In case 2, splenic rupture and intra-abdominal hemorrhage was found and caused by injury of left trunk by MSCT. The cause of death was hemorrhage and traumatic shock., Conclusion: MSCT could observe skeletal injury, soft tissue injury, and hematologic disorder well. The combination use of MSCT and angiography through cardiac puncture provided assistance to the diagnosis of cardiovascular system injury.

There are many deficiencies in forensic traumatic molecular markers detected by the techniques of traditional immunohistology and molecular biology, because these markers are isolated and obscure of the mechanism of interaction. The imaging mass spectrometry (IMS) is more suitable for the forensic molecular markers using function of screening, analysis and graphical representation. In this paper, the techniques and the latest research in screening and identification of typical molecular markers by IMS based on matrix-assisted laser adsorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) are reviewed. And its application values in forensic injury are discussed.

The combination use of dexamethasone and calcium gluconate can be applied to hypersensitivity. Severe hypokalemia is a usual complication of dexamethasone and calcium gluconate therapy, which occurs frequently with therapeutic use. Fatal cases, accidental and intentional, occur frequently in forensic practice. The current case report presented a 43-year-old man with diabetes mellitus with infection, to whom dexamethasone and calcium gluconate were administered in the private clinic. With the development of such clinical symptoms of severe hypokalemia as quadriplegia, he was confirmed to have severe hypokalemia through a biochemical test before dying of arrhythmia. And also it presented pathophysiologic mechanism underlying severe hypokalemia as well as suggestions for clinical practice regarding combination use of dexamethasone and calcium gluconate.

A 45-year-old male car driver died in a traffic accident of four cars rear-end collision on the highway. He was found to have died after a respiratory and cardiac arrest at the scene. No sign of skin injuries was observed from the external inspection. The autopsy was not permitted by the family members because of the local culture. Multislice computed tomography (MSCT) was applied to the current case, showing dislocation of C3-4 cervical vertebrae with II degree, C4 vertebral plate fractures, and spinal stenosis. Post-mortem MSCT confirmed the diagnosis as whiplash injuries. MSCT was verified to be effective in showing the severity of whiplash injuries, thus providing certain objective evidence for medicolegal expertise.

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.

Objective: To establish a 3D finite element model of the complete human thoracic cage, and to perform a biomechanical analysis., Methods: The multislice computed tomography (MSCT) images of human thorax were obtained and used to develop a 3D reconstruction and a finite element model of the thoracic cage by finite element modeling software. The right hypochondrium area of the model was simulated to sustain the frontal impacts by a blunt impactor with velocities of 4, 6 and 8 m/s, and the distribution of stress and strain after the impact of the model was analyzed., Results: A highly anatomically simulated finite element model of human thoracic cage was successfully developed with a fine element mean quality which was above 0.7. The biomechanical analysis showed that the thoracic cage revealed both local bending and overall deformation after the impact. Stress and strain arose from the initial impact area of the ribs, and then spread along the ribs to both sides, at last concentrated in the posterior side of the ribs and near the sternum. Impacts with velocities of 6 m/s and 8 m/s were predicted to cause rib fractures when the strain of the ribs were beyond the threshold values., Conclusion: The finite element modeling software is capable of establishing a highly simulated 3D finite element model of human thoracic cage. And the established model could be applicable to analyze stress and strain distribution of the thoracic cage under forces and to provide a new method for the forensic identification of chest injury.

Objective: To reconstruct a car-pedestrian crash accident using numerical simulation technology and explore the injury biomechanism as forensic evidence for injury identification., Methods: An integration of multi-body dynamic, finite element (FE), and classical method was applied to a car-pedestrian crash accident. The location of the collision and the details of the traffic accident were determined by vehicle trace verification and autopsy. The accident reconstruction was performed by coupling the three-dimensional car behavior from PC-CRASH with a MADYMO dummy model. The collision FE models of head and leg, developed from CT scans of human remains, were loaded with calculated dummy collision parameters. The data of the impact biomechanical responses were extracted in terms of von Mises stress, relative displacement, strain and stress fringes., Results: The accident reconstruction results were identical with the examined ones and the biomechanism of head and leg injuries, illustrated through the FE methods, were consistent with the classical injury theories., Conclusion: The numerical simulation technology is proved to be effective in identifying traffic accidents and exploring of injury biomechanism.

It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography (PMCT). This article reported a case of sudden natural death after the complaint of anterior chest pain in which coronary artery calcification (CAC) was clearly displayed using PMCT scan. The entire coronary artery system was almost reconstructed via multiplanar reformation (MPR) and volume-rendering reconstruction (VR), and the total calcium score of the coronary arteries was obtained with CaScoring automatic analysis software. The results showed that CAC was conspicuous; the total calcium score was 640.3, considerably higher than 400. The pulmonary ground-glass opacity (GGO) and small amount of fluid both in the subglottic trachea and main bronchi were also found. The imaging results confirmed those of autopsy. In addition, the results concluded that PMCT might serve as an invaluable adjunct to the classic autopsy procedure.

Pulmonary fat embolism (PFE) and pulmonary thromboembolism (PTE) are common post-operative complications of orthopedic surgical procedures, but are reported less often following maxillofacial plastic surgical procedures, especially with respect to PFE. Thrombi, or together with fat emboli in pulmonary vessels can induce hemorrhagic infarction and cause death. Herein this report introduced a death due to pulmonary hemorrhagic infarction following maxillofacial plastic surgery. The female patient underwent several osteotomies of the mandible, zygomas and autologous bone grafting within a single operation. The operative time was longer than normal and no preventive strategies for pulmonary embolism were implemented. The patient died 20 days after hospital discharge. The autopsy confirmed pulmonary hemorrhagic infarction. The fat emboli and thrombi were also noted in the pulmonary vessels, which were thought to have resulted from the maxillofacial osteotomy. Suggestions were offered to forensic pathologists that risk factors of PFE and PTE, such as the type and length of surgery, the surgical sites, and the preventive strategies, should be considered when handling deaths after maxillofacial operations.

Objective: To observe the postmortem degradation process in rat myocardium and skeletal muscle using Fourier transform infrared (FTIR) spectroscopy and to provide a new method for estimating postmortem interval (PMI)., Methods: Left ventricle and skeletal muscles of rats dying of mechanical asphyxiated were sampled at different PMIs. The changes of different chemical functional group in the myocardium and skeletal muscle samples were measured by FTIR spectroscopy. The different absorbance (A) ratios of peaks were calculated and the curve estimation analysis between absorbance ratios (x) and PMI (y) were performed to establish six mathematical models., Results: FTIR spectral absorption peak of rat myocardium and skeletal muscle showed three changes: increase, decrease and stable. The cubic model function showed the strongest correlation coefficient. The A1080/A1396 ratio of skeletal muscle showed the strongest correlation coefficient (r = 0.832) with more accurate determination of PMI., Conclusion: FYIR spectroscopy can be potentially used as an effective method for estimating PMI in forensic practice using myocardium and skeletal muscle.

Objective: To investigate the feasibility of creating an effective femoral finite element model from medical images of CT scan with Mimics software, and to provide a good model for femoral fracture biomechanics., Methods: CT images of femur were obtained from 16-slice spiral CT, which were subsequently imported into Mimics software according to DICOM standard. The 3D femoral finite element model was developed, meshed and assigned with material properties. The feasibility of the model was tested and validated with LS-DYNA in different modes including vertical load of 1 000 N, 3-points bending and side impacts., Results: Five hundred twenty-one scanning images were available and reconstructed to create a femoral finite element model consisting of 17 879 nodes and 106 834 tetrahedron elements. The average stress on the femoral neck nodes under vertical load was (3.209 7 +/- 1.373 5) MPa. Strain-deflection curve in 3-points bending test was consistent with Kennedy's study results. The results of the side impact test were in accordance with the forensic anatomical findings., Conclusion: The established model should be applicable to femoral collision biomechanics studies.

Objective: To establish a human 3D finite element skull model, and to explore its value in biomechanics analysis., Methods: The cadaveric head was scanned and then 3D skull model was created using Mimics software based on 2D CT axial images. The 3D skull model was optimized by preprocessor along with creation of the surface and volume meshes. The stress changes, after the head was struck by an object or the head hit the ground directly, were analyzed using ANSYS software., Results: The original 3D skull model showed a large number of triangles with a poor quality and high similarity with the real head, while the optimized model showed high quality surface and volume meshes with a small number of triangles comparatively. The model could show the local and global stress changes effectively., Conclusion: The human 3D skull model can be established using MSCT and Mimics software and provides a good finite element model for biomechanics analysis. This model may also provide a base for the study of head stress changes following different forces.

FEM combined with modern computer technology is a mathematical method for stress analysis. It has gradually become a significant experimental tool to explore the functions of biomechanically simulated human body structure and mechanism of craniocerebral injuries. This paper reviewed the features and biomechanical materials of the FEM human head models, materials assignment and their applications in blunt injury, fall, traffic accident. It also explore their merits and values in forensic head injury cases.

Objective: To develop a novel three dimensional finite element(FE) model of the human pelvis and investigate the biomechanics of the pelvic injury and explore the applications of FE approach in forensic medicine., Methods: The FE model of pelvis including bilateral iliac bones, sacrum, bilateral femurs, joint cartilages and ligaments was developed with Mimics 13.1 based on the CT images. The CT value of material properties were assigned. A static pressure of 600 N was applied at the upper surface of the sacrum endplate downwards along the vertical axis of sacral bone to validate the model. To simulate the side impacts, the lateral forces of 1, 2, 3, 4 and 5 kN were applied to the trochanter surface of right femur, respectively. The von Mises stress contours, displacement contours and stress distribution curves were subsequently calculated., Results: An integrated FE model of pelvis including the joint cartilages and ligaments was successfully established. The model geometry coincided well with the CT images. The stress distributions of pelvis in erect position mainly located near the sacroiliac joints and the greater sciatic notches. Stress concentration was found on the superior and inferior pubis ramus, hip and sacroiliac joints on both sides under side impacts., Conclusion: The established FE model has accurate and reliable biomechanical features. The FE model can be used to simulate injury and provide intuitive and accurate evidence for medicolegal expertise.

Objective: To study the application value of multi-slice computed tomography (MSCT) and 3D reconstruction in biomechanical analysis of traffic accidents in forensic medicine., Methods: Based on a real case, the tomoscan images were obtained from a corpse by MSCT scanning. The 3D images were reconstructed. The biomechanic process of injury manners of impacting, rolling and crushing in traffic accidents was analyzed together with autopsy, vehicle inspection, etc. The MSCT results were compared with the autopsy results., Results: Some characters in situ including the part of fracture on different site that suffered by force from different directions, trends of fracture line, and status of smash inner bones were obtained trough MSCT and 3D reconstruction. Some details like fracture were even better than those from autopsy., Conclusion: MSCT and 3D reconstruction have some advantages such as in situ reconstruction, easily controlled image and fully conserved evidence. It may be a supplementary method and have a directive function for the biomechanical analysis of traffic accidents.

Since first application of computed tomography (CT) in postmortem examination in 1990, investigators have been discussing the value and advantage of CT in full-body examination in cadaver. CT examination before autopsy is able to provide not only the informations to guide the autopsy, but also the significant findings to analysis the causes of death, which may be not fount in autopsy. This review focuses on the value of CT in analysis of the death causes, injury manners, and personal identifications in postmortem examination as well as its development in the field of forensic medicine. It is our belief that CT in combination with other newly developed technologies will make more contribution to forensic medicine in the future.

Objective: To explore the application of imaging techniques in determining the death cause and injury manner., Methods: One case due to high fall was fully examined using multi-slice spiral computed tomography (MSCT), 3-D imaging creation and magnetic resonance imaging (MRI). The systemic and detailed autopsy was subsequently performed to compare with the results from imaging studies. The advantages and disadvantages of autopsy and imaging studies were then analyzed., Results: Most of the important information such as trauma, fracture and hemorrhage could be obtained by imaging techniques. Furthermore, imaging methods can predict injuries in internal body before autopsy and be minimal or non-invasive to the cadaver. However, the imaging techniques probably also can not find some details in comparison to autopsy in forensic practice and need to improve in their future application., Conclusion: Application of imaging techniques can be used as the guidance and complimentary for the forensic autopsy in the identification of injury manner. In addition, the application can even be used to replace autopsy in some special circumstances.

Objective: To reconstruct the collision process of traffic accident and the injury mode of the victim by computer simulation technology in forensic assessment of traffic accident., Methods: Forty actual accidents were reconstructed by stimulation software and high performance computer based on analysis of the trace evidences at the scene, damage of the vehicles and injury of the victims, with 2 cases discussed in details., Results: The reconstruction correlated very well in 28 cases, well in 9 cases, and suboptimal in 3 cases with the above parameters. Accurate reconstruction of the accident would be helpful for assessment of the injury mechanism of the victims., Conclusion: Reconstruction of the collision process of traffic accident and the injury mechanism of the victim by computer simulation is useful in traffic accident assessment.

Objective: Using computer simulation to analyze the effects of speed, type of automobile and impacted position on crash-course and injuries of pedestrians in automobile vs. pedestrian accidents., Methods: Automobiles (bus, minibus, car and truck) and pedestrian models were constructed with multi-body dynamics computing method. The crashes were simulated at different impact speeds (20, 30, 40, 50 and 60 km/h) and different positions (front, lateral and rear of pedestrians). Crash-courses and their biomechanical responses were studied., Results: If the type of automobile and impact position were the same, the crash-courses were similar (impact speed < or = 60 km/h). There were some characteristics in the head acceleration, upper neck axial force and leg axial force., Conclusion: Multi-body dynamics computer simulation of crash can be applied to analyze crash-course and injuries (head, neck and leg) of pedestrians.

Objective: To study the characteristics and biomechanical mechanism of riding injuries involving bicycles collided by motor vehicles., Methods: The real traffic accident cases of bicycles collided by motor vehicles, including the information of scenes, bicycles, motor vehicles, rider wounds and traffic directions, were collected. Retrospective method was used to study these riding injuries. In addition, typical cases were selected to simulate traffic accident courses with computer simulation software, and the dynamic data like acceleration, force, moment were cxtracted to compare with those in the real cases., Results: There were no difference of occurring frequency between cases with or without riding injuries, as well as between one-side-collision and front- or back-collision. The riding injuries seemed less in accidents involving large-scale vehicles. The frequency of riding injuries increased with vehicle speed. The wound location was low on collision side and high on opposite., Conclusion: Analysis of riding injury characteristic in traffic accidents and their biomechanical mechanism would be helpful for estimation of traffic manner.

Objective: This study aimed at computer simulation of reconstruction of vehicle-bicyclist traffic accidents and investigation of the injury characteristics., Methods: To use the model established by high performance computer and PC-Crash software to study the bicyclists and vehicles and to reconstruct the accident., Results: The model of computer simulation response perfectly reconstructed phases of the traffic collision and explained the mechanisms of the injuries of the bicyclists, which correlated with details found in forensic investigation., Conclusion: Computer simulation is feasible for forensic analysis on the injury mechanism of bicyclists in traffic related accidents.

This study analyzed injuries of motorcycle occupants and the trace evidence of motor vehicles in 3 cases of motorcycle accidents. Due to differences in positions, postures, and responses, the driver and passenger showed their unique injury patterns and characteristics, which could be verified by analysis of trace evidence of the vehicles. It provided some common features from these cases and could be useful to determine the responsible parties and to determine who was the driver.

Objective: To evaluate the validation of the test strip of colloidal gold-labeled anti-Fibronectin EIIIA(Fn-EIIIA) Splicing Variant for estimating the time of injury., Methods: After skin tissues with variant injury times were collected from corpses, the test strip were used to detect the expression of Fn-EIIIA and its tested results were valued; The arisen autolysis which may influence the results of test were also observed by rats models., Results: In no-injured skins, no Fn-EIIIA were detected by the strip, while in all the injured skins it was detected successfully as soon as injured after 1h and it showed more obvious results with the elongating of injured time; No changes made by autolysis were found in our studied time ranges., Conclusion: The test strip which used in this study showed to be a sensitive and steady method for estimating the time of injury in forensic science.

Objective: To develop the test Paper of gold-labelled antibody against fibronectin EIIIR A splicing variant, which can be available in forensic wound interval estimation., Methods: Two sensitive antibodies were compared with enzyme link immunoabsorband assay (ELISA). After colloid gold labeled, the effects of the two antibodies were tested by methods of Dot immunogold filtration assay and gold immunochromatography assay, respectively. The test paper was finally appraised by applied in experimental skin injury in rats., Results: On the test paper, detected line appeared in three hours wound age group, and then the darkness of positive staining became darker with injury time prolonging, while control normal skin cannot found to be positive staining., Conclusion: The gold-labeled test paper can be useful in estimation of wounding interval in forensic science.

Objective: To observe the means of fibronectin(FN) alternative splicing and the expression of EIIIA-FN variant in rat skin after bruise, for the sake of providing some help for forensic estimation of wound interval., Methods: Total RNA was isolated from wounded skin, and reverse transcription polymerase chain reaction was conducted to amplify target segments., Results: Detectable EIIIA+(526 bp) segments, lacked in normal organize, was amplified at 1 h after experimental wound, and the levels were increased within 24 h., Conclusion: The alternative splicing EIIIA-fibronectin variant would be a satisfied criterion for research of skin injury.

Objective: To observe pathological changes and apoptosis in mouse brain, hart, liver and kidney after tetramine poisoning, and to provide some references for forensic identification., Methods: An experimental model of mouse tetramine poisoning was found, and the technology of apoptosis detection was used. The staining results were analyzed by computer image analysis competitive system., Results: (1) Quantities of apoptosis in brain, hart, liver and kidney in chronic poisoning groups are many more than in acute poisoning groups. As in same organs, Quantities of apoptosis are different after different poisoning time. In addition, the peak-time of apoptosis is not same in different organs. (2) Poison analysis showed that, all organic samples from acute poisoning groups were positive, while that from chronic poisoning groups are negative., Conclusion: Chronic tetramine poisoning can not be detective by clinic or poison analysis while can be found changes in apoptosis, which indicate that small amount and chronic poisoning still affects the body.

Objective: To estimate the effort between antisense RNA probe and random primed DNA probe., Methods: The in situ hybridization was conducted on parafin section from wounding model of rat skin., Results: Although both probes appeared positive staining, RNA probes was superior to DNA probes in terms of depth of staining and background., Conclusion: RNA probe showed more satisfactorily on ISH.