發(fā)布時(shí)間：2018-06-13 15:55

  本文選題：水尸 + 死亡時(shí)間�。� 參考：《汕頭大學(xué)》2008年碩士論文

【摘要】： 背景與目的 死亡時(shí)間( Postmortem Interval, PMI)推斷是法醫(yī)學(xué)界研究的重點(diǎn)和難點(diǎn),其對(duì)兇犯的確定、刑事案件的偵破,以及死亡醫(yī)療糾紛,甚至遺產(chǎn)繼承的仲裁等司法審判實(shí)踐有著非常重要的意義。傳統(tǒng)推斷PMI的方法已有許多研究,包括根據(jù)早期尸體現(xiàn)象、胃內(nèi)容物消化程度等多種方法推斷早期PMI;根據(jù)尸體腐敗程度、蠅蛆生長(zhǎng)規(guī)律等推斷晚期PMI。但這些方法由于影響因素多、檢測(cè)方法繁雜等問題,均存在較大的誤差。近年來,較多研究利用DNA和蛋白質(zhì)降解的分子生物學(xué)技術(shù)推斷PMI,認(rèn)為是比較準(zhǔn)確可靠的方法,但其依然受到自身和外界多重因素的影響,且操作復(fù)雜,尚處于研究階段。 PMI推斷的研究,實(shí)驗(yàn)條件的控制非常重要。本實(shí)驗(yàn)在課題組其他成員的空氣中大鼠PMI研究基礎(chǔ)上,以水中尸體為研究對(duì)象,控制溫度、空氣流通度等實(shí)驗(yàn)條件,期望探討水中尸體軟組織的生物力學(xué)性狀的時(shí)序性變化與PMI關(guān)系的規(guī)律,將法醫(yī)生物力學(xué)理論和技術(shù)引入到PMI推斷中,進(jìn)一步豐富法醫(yī)生物力學(xué)(forensic biomechanism)的研究?jī)?nèi)容和開拓PMI推斷新技術(shù)方法。同時(shí),本實(shí)驗(yàn)利用CDIA技術(shù),觀測(cè)常規(guī)HE染色的肝細(xì)胞病理圖像并進(jìn)行體視學(xué)分析與量化處理,結(jié)合水中尸體主要臟器的病理形態(tài)的系統(tǒng)觀察,期望為PMI推斷提供新思路和參考依據(jù)。 材料與方法 清潔級(jí)健康雄性SD大鼠80只,3～3.5月齡,體重250-300g,頸脫位法處死,按死后不同時(shí)間點(diǎn)隨機(jī)分為0h、6h、12h、18h、24h、30h、36h、42h、48h、60h、72h、96h、120h、144h、168h、192h共16組,每組5只。立即放置于2/3滿在GXZ型智能光照培養(yǎng)箱中25±0.5℃恒溫的自來水塑料桶,讓其自然腐敗,分別于上述時(shí)間點(diǎn)提取胸部正中皮膚1×4cm2、腹壁白線右側(cè)1cm處腹壁肌肉1×4cm2、直腸上4～10cm處結(jié)腸、胃下6～12cm處小腸進(jìn)行生物力學(xué)指標(biāo)檢測(cè),每個(gè)時(shí)間點(diǎn)5只,檢測(cè)其極限載荷、最大應(yīng)力、應(yīng)變等軟組織生物力學(xué)指標(biāo)。同時(shí)選取0h、12h、24h、36h、48h、72h腦、心、肝、腎、肺切片HE染色并進(jìn)行鏡下觀察,觀察各組織自溶腐敗的形態(tài)學(xué)變化,并對(duì)大鼠肝細(xì)胞進(jìn)行病理學(xué)圖像體視學(xué)分析和量化處理,檢測(cè)肝細(xì)胞的核面積、核漿比、核漿光密度比和核異形指數(shù),用SPSS軟件進(jìn)行統(tǒng)計(jì)學(xué)處理和分析,探討其形態(tài)時(shí)序性變化規(guī)律及其與PMI的關(guān)系。 結(jié)果 1主要臟器組織形態(tài)學(xué)改變 水中大鼠尸體經(jīng)尸僵、腐敗靜脈網(wǎng)、尸綠、腹部膨隆至塌陷約需8天。HE染色鏡下觀察,各臟器均呈現(xiàn)時(shí)序性變化。腦0-24h神經(jīng)元細(xì)胞核固縮,24-48h核擴(kuò)大至腦液化。心0-24h肌漿腫脹、肌間隙增寬,24-48h肌漿模糊、斷裂,肌細(xì)胞核明顯減少,48-72h心肌細(xì)胞核消失;肝0-24h肝細(xì)胞腫脹,24-48h肝細(xì)胞間隙變小至邊界不清,核固縮、碎裂,48-72h僅殘留少量細(xì)胞核碎片。腎0-24h近曲小管上皮細(xì)胞嗜酸性增強(qiáng),24-72h腎小管、腎小球細(xì)胞核相繼固縮、碎裂、溶解消失,96h細(xì)胞核完全消失。肺0-24h肺泡上皮細(xì)胞胞漿淡染,24-48h肺泡上皮細(xì)胞核固縮、碎裂、明顯減少,48-72h肺泡腔漿液淤積至肺組織完全破碎、結(jié)溝不清。各臟器比較,腦自溶、腐敗最快,肝、心、肺其次,腎自溶腐敗最慢。其中,腦48h即已液化無法取材切片,肝、心、肺72h組織結(jié)構(gòu)基本消失,腎組織自溶腐敗速度較慢,96h細(xì)胞核基本消失,120h組織輪廓不清。 2生物力學(xué)測(cè)試與分析結(jié)果 2.1極限載荷 各組織極限載荷均值大小排序?yàn)?皮膚(14.71N)大腸(3.96N)肌肉(3.85N)血管(1.97N)小腸(1.27N)。 各組織總體均呈死后時(shí)序性下降趨勢(shì),下降速度在各時(shí)間點(diǎn)存在差異。皮膚0-18h下降迅速(直線回歸方程為YPMI=33.087-1.3121XML,r=-0.999),相鄰點(diǎn)間差異顯著(P0.01),18-36h、96-168h呈緩慢下降趨勢(shì)(YPMI=120.153-9.009XML,r=-0.965;YPMI=13.822-0.0485XML,r=-0.941),P0.05。36-96h、168-192h相鄰時(shí)間點(diǎn)差別不明顯(P0.05)。肌肉0-24h、96-168h下降趨勢(shì)明顯,其直線回歸方程分別為YPMI=42.914-4.9861XML,r=-0.989;YPMI=177.6-24.289XML,r=-0.970。24-96h為“平臺(tái)期”,168-192h比較差異不明顯(P0.05)。大腸0-36h、72-192h(YPMI=66.238-8.6983XML,r=-0.981;YPMI=225.14-41.488XML,r=-0.978)下降趨勢(shì)明顯(P0.05),36-72h為“平臺(tái)期”。小腸0-18h(YPMI=53.903-27.422XML,r=-0.968)、120-192h(YPMI=350.55-200.57XML,r=-0.986)下降趨勢(shì)明顯,18-120h為“平臺(tái)期”(P0.05)。血管全程變化趨勢(shì)不明顯。 2.2應(yīng)變 血管應(yīng)變最大為3.96,但變化趨勢(shì)不明顯。小腸最小為0.34。皮膚、肌肉、大腸、小腸總體均呈下降趨勢(shì)。 皮膚0-48h下降迅速,YPMI =88.894-77.665XSR,r=-0.962(P0.01)。48-192h為“平臺(tái)期”。肌肉0-30h下降迅速,YPMI =52.112-41.544 XSR,r=-0.970(P0.01),30-192h為“平臺(tái)期”(P0.05)。大腸0-24h下降迅速,YPMI=59.106-55.031XSR,r=-0.962。24-72h為“平臺(tái)期”,72-192h下降趨勢(shì)明顯(P0.01),YPMI=307.03-346.59 XSR,r=-0.993。小腸0-24h下降迅速,YPMI =56.758-87.079 XSR,r=-0.949(P0.01),24h-192h為”平臺(tái)期”。 3肝臟細(xì)胞病理圖像量化處理 肝細(xì)胞核面積各時(shí)間段的差異沒有統(tǒng)計(jì)學(xué)意義(P0.05)。 肝細(xì)胞核漿比呈下降趨勢(shì),其直線回歸方程為YPMI=0.3683-0.0045XRKC,r=-0.9361。其中12-24h下降速率最大,0-12h、24-72h下降速度較慢。各相鄰時(shí)間點(diǎn)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 核漿光密度比,0-36h呈逐漸上升趨勢(shì)(Y=69.751X-78.117,r=0.982),36-72h呈逐漸下降趨勢(shì)(Y=198.44-97.676X,r=-0.999),各相鄰時(shí)間點(diǎn)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 異形指數(shù)呈上升趨勢(shì)(YPMI=30.177XRKC-31.707,r=0.989),12-36h上升速度最大,其次為0-12h(P0.05),48-72h差異不明顯(P0.05)。 結(jié)論 1、水尸各器官組織形態(tài)的時(shí)序性變化與PMI之間存在明顯的相關(guān)性,其主要為自溶和腐敗的結(jié)果,與空氣中尸體比較,自溶和腐敗約晚12小時(shí),提示日常法醫(yī)病理學(xué)檢驗(yàn)時(shí),應(yīng)注意鑒別生前彌漫性病變與死后自溶腐敗性變化,還應(yīng)綜合考慮尸體腐敗環(huán)境。水尸72h內(nèi)為自溶、腐敗高峰期,應(yīng)爭(zhēng)取盡早尸檢或冷凍保存尸體。 2、水尸皮膚、肌肉、小腸和結(jié)腸各器官組織的生物力學(xué)性狀存在時(shí)序性變化規(guī)律,特別是各自均存在一段明顯的線性相關(guān)的“窗口期”和相互彌補(bǔ)性,提示軟組織生物力學(xué)指標(biāo)及其檢測(cè)方法可以作為推斷死亡時(shí)間的一種簡(jiǎn)便、客觀、量化的檢測(cè)手段。 3、病理學(xué)圖像量化分析技術(shù)檢測(cè)的常規(guī)HE組織細(xì)胞各種描述指標(biāo),可以量化地反映死后組織細(xì)胞自溶腐敗的形態(tài)學(xué)變化程度,與PMI之間存在明顯的相關(guān)性,特別是組織細(xì)胞結(jié)構(gòu)的自身比較的相對(duì)性指標(biāo),可以避免不同制片、染色效果的影響,更客觀地反應(yīng)病變情況和分級(jí)標(biāo)準(zhǔn),為量化病理學(xué)提供了新的思路。
[Abstract]:Background and Purpose


In recent years , many researches have been made on the methods of estimating PMI by means of molecular biology techniques such as early corpse phenomenon , gastric contents digestion degree and so on .


Based on the study of PMI , it is very important for the control of the experimental conditions . In this experiment , based on the study of the PMI in the air of the other members of the study group , it is expected to study the temporal variation of the biomechanical properties of the soft tissue in the water and the law of PMI , and further enrich the research content of the forensic biomechanics theory and the technique . At the same time , the present experiment uses the CDIA technique to observe the pathological image of liver cells stained by conventional HE and the systematic observation of the pathological morphology of the main organs of the corpse in water .


Materials and Methods


The rats were randomly divided into 2 / 3 hours , 12 h , 18 h , 24 h , 30 h , 36 h , 42 h , 48 h , 60 h , 72 h , 42 h , 48 h , 60 h , 72 h , 96 h , 120 h , 48 h , 48 h , 72 h , 96 h , 120 h , 48 h , 48 h , 72 h , 24 h , 48 h , 60 h , 72 h , 96 h , 120 h , 48 h , 48 h , 72 h , 24 h , 48 h , 48 h , 72 h , 96 h , 120 h , 48 h , 48 h , 72 h . SPSS software was used for statistical processing and analysis , and the regularity of its morphology and its relationship with PMI were discussed .


Results


1 . Morphological changes of major organs of organs


The results showed that after 24 - 48 h , the nuclei of the alveolar epithelial cells disappeared . The results showed that the nuclei of the cells of 0 - 24 h after 24 - 48 h could not be removed . The results showed that the nuclei of liver , heart , and lung had disappeared after 24 - 48 h .


2 biomechanical testing and analysis results


2.1 Ultimate Load


The mean size of the limit load of each tissue was ordered as : skin ( 14.71N ) large intestine ( 3.96N ) muscle ( 3.85N ) blood vessel ( 1.97N ) small intestine ( 1.27N ) .


There was no significant difference between the two adjacent time points ( P0.05 ) . The descending trend of YPMI = 42.914 - 4.9861XML , r = - 0.989 ; YPMI = 177.6 - 24.289XML , r = - 0.970 . 24 - 96h , r = - 0.978 ;


2.2 Strain


The maximum blood vessel strain was 3.96 , but the trend was not obvious . The small intestine had a minimum of 0.34 . Skin , muscle , large intestine and small intestine showed a decreasing trend .


The decrease of 0 - 30h decreased rapidly , YPMI = 52.112 - 41.544 XSR , r = - 0.970 ( P0.01 ) , 30 - 192h as " plateau phase " ( P0.05 ) . The descending trend of intestine 0 - 24h was rapid , YPMI = 59.106 - 55.079 XSR , r = - 0.993 . Small intestine decreased rapidly from 0 - 24h , YPMI = - 0.949 ( P0.01 ) , 24h - 192h was " plateau phase " .


Quantitative treatment of pathological image of liver cells


There was no significant difference in the area of liver cell nuclear area ( P0.05 ) .


The linear regression equation was YPMI = 0.3683 - 0.0045XrKC , r = - 0.9361 . The descending rate of 12 - 24h was the highest , and the rate of decline was slower between 0 - 12h and 24 - 72h .


The optical density ratio of nuclear plasm was 0 - 36h ( Y = 69.751X - 78.117 , r = 0.982 ) and 36 - 72h ( Y = 198.44 - 97.676X , r = - 0.999 ) .


The trend of abnormal index was ( YPMI = 30.177XrKC - 31.707 , r = 0.989 ) , the rate of rising of 12 - 36h was the biggest , followed by 0 - 12h ( P0.05 ) , the difference between 48 - 72h was not obvious ( P0.05 ) .


Conclusion


1 . There is a significant correlation between the temporal variation of tissue morphology and PMI , which is mainly the result of autolysis and corruption . When compared with the corpse in the air , self - dissolution and corruption are about 12 hours later , it is suggested that in the course of routine forensic pathology examination , it should be paid to the identification of the corrupt environment of the corpse before and after death .


2 . The biomechanical properties of the tissues of the skin , muscle , the small intestine and the colon of the water bodies are regularly changed , especially the " window period " and the mutual compensation of the obvious linear correlation , suggesting that the biomechanical indexes of soft tissues and their detection methods can be used as a simple , objective and quantitative detection means for estimating the dead time .


3 . Various description indexes of conventional HE tissue cells detected by pathological image quantitative analysis technique can quantitatively reflect the morphological change degree of self - dissolution and corruption of tissue cells after death , and have obvious correlation with PMI , especially the relative indexes of tissue cell structure ' s own comparison , so as to avoid the influence of different tabs and staining effect , more objectively reflect the pathological condition and grading standard , and provide a new idea for quantitative pathology .
【學(xué)位授予單位】：汕頭大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2008
【分類號(hào)】：D919.1

【引證文獻(xiàn)】

相關(guān)期刊論文 前1條

1 閆換芳;張繼宗;楊超朋;王福磊;;根據(jù)肝臟死后改變推斷死亡時(shí)間的研究進(jìn)展[J];刑事技術(shù);2011年05期

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本文編號(hào)：2014564