Objective To analyze the cases of anaphylactic death cases and explore the standards of judi-cial expertise of anaphylactic death for providing evidence for judicial expertise. Methods Fifty-nine cas-es death due to allergic reaction in Shanghai were collected. And details of medical history, clinical manifestation of anaphylactic reaction and postm ortem exam ination findings were review ed for all cases. Results In the 59 cases, there were 58 cases died from drug allergy, including 77.6% of them were an-tibiotics. The rates of treating in standard hospital and illegal clinic were 37.3% and 61.0%, respectively. The allergic sym ptom s were dyspnea and facial cyanosis. The time from contacting allergens to death ranged from 1 m in to 3 d. The concentration of total serum IgE ranged from 50 to 576.92 IU/m L . The results of clinical manifestation and pathological anatomy had obviously changes. Conclusion B ased on the exclusion of all other cause of death and synthetically analysis of details of cases, medical history, clinical manifestation and anatomy, the conclusion of anaphylactic death can reached. The details of cas-es including clinical history, exposure to allergens, and clinical manifestation play an im portant role in diagnosis of anaphylactic death.

Karoshi rem ains one of the m ost troublesom e issues in forensic identification. It is rather a social m edicine than a clinical disease. Japanese scholars pioneered exam ining the relation betw een sud-den cardiac death (SCD ) and chronic fatigue from long tim e and/or high-tension work. In the current case, a 55-year-old m an, w hose job w as loading and carrying heavy cem ent bags, w as found dead after 11 days of continuous hard work. H is fam ily m em bers sued the cem ent factory for his death and claim ed for com pensation.The problemw as the difficulty of identifying the causative relation w ithout the precedent or the relevant regulations. H ow ever, the forensic problems were finally acknow ledged after autopsy and calculation of labor intensity.The law suit w as w on as the first case pertaining to Karoshi in the Chinese court.

BACKGROUND:Discectomy and pedicle fixation fusion are golden standard to repair lumbar degenerative disease, but the treatment would induce other complications such as degeneration of adjacent segments or severer pre-existing spinal degeneration. For the problem of lumbar fusion and fixation, lumbar elastic fixation has recently been a hot focus. ＜br> OBJECTIVE:To evaluate the short-term effectiveness of dynamic lumbar pedicle fixation in repair of lumbar spinal stenosis and lumbar disc herniation. ＜br> METHODS:From December 2010 to December 2012, 62 cases of lumbar spinal stenosis and lumbar disc herniation treated with lumbar dynamic system were included. The involved segments included:5 cases at L 3/4 , 20 cases at L 4/5 , 20 cases at L 5 S 1 , 6 cases at double segment L 3/4 and L 4/5, 8 cases at double segment L 4/5 , L 5 S 1 , 3 cases at L 3/4 and L 5 S 1 . There were 34 males and 28 females with an average age of 50.8 years (range 32 to 72 years). According to different fixation systems, they were assigned to three groups:general dynamic lumbar fixation system in 17 cases, K-Rod posterior dynamic stabilization system in 28 cases, and Dynesys system in 17 cases. The fol ow-up time was from 24 to 48 months. Evaluation indexes included visual analogue scale, Oswestry disability index, imaging analysis and excellent and good rate of curative effects. ＜br> RESULTS AND CONCLUSION:Compared with before treatment, visual analogue scale score and Oswestry disability index were significantly improved at 6 months after treatment and final fol ow-up (P＜0.01). No apparent changes were detected in the length of inserted segments and adjacent segments before treatment and during final fol ow-up. There were no significant differences in the excellent and good rate in each group after treatment (P>0.05). These data indicated that the lumbar dynamic system was an effective option for lumbar disc herniation and spinal stenosis. Although there are some differences in the structure of three kinds of flexible fixation, no obvious difference in early therapeutic effects was detected. Long-term effects deserve further investigations.

Matrix-assisted laser desorption/ionization tim e-of-flight im aging m ass spectrom etry (MALDI-TOF-IMS ) has been a classical technique for studying proteom ics in present and a tool for analyzing the distribution of proteins and sm all m olecules w ithin biological tissue sections. MALDI-TOF-IMS can analyze m ultiple unknow n com pounds in biological tissue sections sim ultaneously through a single m ea-surem ent w hich can obtain m olecule im aging of the tissue w hile m aintaining the integrity of cellular and m olecules in tissue. In recent years, im aging m ass spectrom etry technique develops relatively quickly in all biom edical dom ain. T his paper based on the relevant data and review s the present developing level of MALDI-TOF-IMS, the principle of im aging m ass spectrom etry, m ethology and the prospect in foren-sic pathology.

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.

Postm ortem chem istry is becom ing m ore and m ore essential in routine forensic pathology and has m ade considerable progress over the past years. B iochem ical analyses of vitreous hum or, blood, urine and cerebrospinal fluid m ay provide im portant inform ation in determ ining the cause of death or in elucidating forensic issues. Postm ortem chem istry m ay be essential for the determ ination of cause of death w hen m orphological m ethods (diabetes m ellitus, alcoholic ketoacidosis and electrolytic disorders) cannot detect the pathophysiological changes involved in the death process. It can also provide m any in-form ation in other forensic situations, including m yocardial ischem ia, sepsis, inflam m ation, infection, ana-phylaxis and horm onal disturbances. T he m ost recent relevant research advances on glucose m etabolism , liver function, cardiac function, renal function, sepsis, inflam m ation, infection, anaphylaxis and horm onal aspect are hereby review ed.

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 tam-ponade 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 in-jury, 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.