Objective To explore the clinical diagnostic and prognostic value of serum levels of Syndecan-1 and pentraxin 3(PTX-3)in patients with multiple organ dysfunction syndrome(MODS)complicated by multiple injuries.Methods A sum of 140 patients with multiple injuries admitted to Tangshan Central Hospital from January 2022 to June 2023 were collected prospectively as the research subjects,and they were divided into MODS group(n=49)and non MODS group(n=91)based on the presence or absence of concurrent MODS.According to the survival status of the patients within 28 days of admission,the MODS group was grouped into a survival group(n=21)and a death group(n=28).Enzyme linked immunosorbent assay(ELISA)was applied to measure the expression levels of Syndecan-1 and PTX-3 in serum,and the diagnostic value of serum Syndecan-1 and PTX-3 in MODS and their predictive efficacy in predicting the prognosis of patients with multiple injuries combined with MODS were analyzed using the receiver operating characteristic(ROC)curve analysis.Results The ISS score,acuse physiology and chronic health evaluation(APACHE)Ⅱ score,and serum Syndecan-1 and PTX-3 expression levels in the MODS group(24.41±5.22 scores,22.02±4.41 scores,77.76±8.25 ng/ml,34.87±4.53 pg/ml)were higher than those patients with no MODS group(18.62±4.06 scores,16.69±3.54 scores,63.98±7.52 ng/ml,25.43±3.97 pg/ml),and the differences were statistically significant(t=7.265,7.783,9.994,12.766,all P＜0.05).The AUCs of serum Syndecan-1 and PTX-3 for predicting the prognosis of patients with multiple injuries and MODS alone were 0.845 and 0.792,respectively,while the AUC of combined diagnosis of the two was 0.941,and the diagnostic value of the combination of the two for multiple injuries with MODS was superior to that of Syndecan-1 and PTX-3 separately(Z=4.029,2.681,P=0.001,0.007),while the sensitivity of the combined diagnosis of the two was significantly higher than that of conventional inflammatory indicators IL-6 and PCT diagnosis.The expression levels of Syndecan-1(85.17±9.03 ng/ml)and PTX-3(40.20±5.21 pg/ml)in the serum of patients in the death group were higher than those in the survival group(67.90±7.22 ng/ml,27.77±3.64 pg/ml),and the differences were statistically significant(t=7.201,9.345,all P＜0.05).The AUCs predicted by serum Syndecan-1 and PTX-3 alone were 0.845 and 0.792,respectively,while the AUC predicted by the combination of the two was 0.932.The combined prediction of multiple injuries with MODS was superior to Syndecan-1 and PTX-3 separately(Z=1.982,2.311,P=0.047,0.020),and it has certain predictive value for the prognosis of patients with multiple injuries combined with MODS.Conclusion The expression levels of Syndecan-1 and PTX-3 in serum are related to the occurrence of multiple injuries with MODS.The combined detection of the two has high diagnostic and prognostic value for multiple injuries with MODS.

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.

Objective T o observe the chem ical groups changing in rat kidney w ith regard to fatal hyper-therm ia by Fourier transform infrared m icrospectroscopy (FT IR-M SP ) and to provide a new m ethod to diagnose fatal hypertherm ia. Methods R ats w ere sacrificed by hypertherm ia, brainstem injury, m assive hem orrhage and asphyxiation and divided into groups. T he renal sam ples w ere dissected im m ediately af-ter death. T he data of infrared spectroscopy in glom erulus w ere m easured by FT IR-M SP. Results T he absorbances of 3 290, 3 070, 2 850, 1 540 and 1 396 cm -1 significantly increased (P<0.05),and the ratios of A1650/A3290 and A1650/A1540 significantly decreased (P<0.05) in group of hypertherm ia. Conclusion FTIR-M SP can analyze the changes of chem ical groups of kidney as an auxiliary diagnosis for discrim inating hyper-therm ia w ith other causes of death.

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.

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.