Adult ; Aneurysm, Dissecting ; diagnosis ; etiology ; Computed Tomography Angiography ; methods ; Conservative Treatment ; methods ; Coronary Angiography ; methods ; Coronary Vessels ; diagnostic imaging ; pathology ; Electrocardiography ; methods ; Heart Injuries ; complications ; Humans ; Magnetic Resonance Imaging, Cine ; methods ; Male ; Multimodal Imaging ; methods ; Myocardial Infarction ; diagnosis ; etiology ; therapy ; Treatment Outcome ; Wounds, Nonpenetrating ; complications

Commotio cordis （CC） is the acute death caused by the cardiac rhythm disorder after a sudden blunt external force to the precordium of a healthy person without previous heart disease. As one type of violent heart damage, CC is rare with relatively small external force and sudden death, therefore causing disputes. This paper reviews the epidemiology, mechanisms and the key points in forensic identification of CC, discusses the identification and antidiastole of CC, myocardial contusion, sudden cardiac death and death from inhibition, and provides assistance to forensic pathologists to identify such causes of death.
Commotio Cordis/epidemiology* ; Death, Sudden, Cardiac ; Forensic Pathology ; Heart ; Humans ; Wounds, Nonpenetrating

OBJECTIVES: To explore the differences in the repair process of skin and skeletal muscle after contusion caused by blunt force attack with different heights. METHODS: Three degrees of contusion were performed on SD rats' right hind limbs by a designed free-dropping device falling from 15, 30 and 50 cm heights, which as a main consideration factor for degree of injury. The repair process of skin and skeletal muscle at 6 h, 24 h, 3 d, 7 d and 13 d after contusion were observed using routine histological methods. RESULTS: Hematoma within skin and/or muscle was found in the rats' hind limbs after contusion with three different heights. The repair processes were similar at 24 h after contusion. However, with the increase of height, the display degree was more obvious. At 3 d after contusion, the RBC of the hemorrhagic region would be decomposed and elapsed in 15 cm contusion group, but for 30 cm contusion group, it delayed to 7 d. At 13 d after contusion, the similar result was found in 15 cm and 30 cm contusion groups, in contrast, the 50 cm contusion group was still in the proliferative phase. CONCLUSIONS With the increase of height, the occurring rate of hematoma within skin and muscle at the same time increases, and the more serious histological appearance after contusion, including inflammation and proliferation, the longer healing process are observed. According to the results of present study and considering forensic application, the contusion model with 50 cm height （2.58 J/cm²） is recommended as the experimental animal model for the future study of wound age estimation on contusion.
Animals ; Contusions/pathology* ; Hindlimb ; Muscle, Skeletal/pathology* ; Rats ; Rats, Sprague-Dawley ; Skin/pathology* ; Wounds, Nonpenetrating

Adolescent ; Humans ; Iliac Artery ; anatomy & histology ; pathology ; Male ; Pelvis ; injuries ; Peripheral Vascular Diseases ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating ; diagnosis ; diagnostic imaging

OBJECTIVE: To establish a feasible evaluation index and method to identify composition of remaining metal particles on ferrochrome kitchen knife. METHODS: The small samples of remaining metal particles were rubbed from the knives using filter paper. The composition of remaining metal particles was detected by scanning electron microscopy and energy dispersive X-ray spectrometer (SEM-EDX) and GSR particle analysis function, using mathematical methods to calculate the ratio (relative amount) of Fe and Cr in remaining metal particles. RESULTS: The ratio (relative amount) of Fe and Cr of remaining metal particles had significant differences among most ferrochrome kitchen knives (P < 0.05). CONCLUSION Using GSR particle analysis function to quantitatively detect the ratio (relative amount) of Fe and Cr of remaining metal particles on ferrochrome kitchen knife, which can establish the feasible evaluation method to estimate such injury tool.
China ; Chromium/isolation & purification* ; Forensic Medicine/methods* ; Iron/isolation & purification* ; Metals/chemistry* ; Microscopy, Electron, Scanning/methods* ; Spectrometry, X-Ray Emission/methods* ; Wounds, Nonpenetrating/pathology*

The incidence and importance of tricuspid valve regurgitation after a blunt chest injury has risen with the increase in the number of automobile accidents and steering wheel traumas. This kind of injury has been reported more frequently in the last decade because of the better diagnostic procedures and understanding of the pathology. However, tricuspid valve regurgitation following a blunt chest injury can still be easily missed because most patients do not show symptoms at the time of the trauma. A 55-year-old male patient presented himself at our facility after suffering a chest injury from an automobile accident. His transthoracic echocardiography (TTE) revealed severe tricuspid valve regurgitation due to the prolapse of his anterior valve leaflet. We report a case of asymptomatic tricuspid regurgitation that developed after a blunt chest injury.
Automobiles ; Chordae Tendineae* ; Echocardiography ; Humans ; Incidence ; Male ; Middle Aged ; Pathology ; Prolapse ; Rupture* ; Thoracic Injuries* ; Thorax* ; Tricuspid Valve Insufficiency* ; Wounds, Nonpenetrating

A 38-year-old woman developed diffusely distributed opacities with crystalline materials in the laser in situ keratomileusis (LASIK) interface of her eye after she was scratched by a sprig during mountain climbing. No sign of flap displacement was noted. Despite two days of topical and systemic antibiotics therapy, the corneal infiltration with interface opacities persisted. The following day, the distribution of the crystalline materials had rotated in a counterclockwise direction. Flap lifting and foreign body removal using sufficient irrigation were performed. One month after surgery, the patient's postoperative uncorrected visual acuity was 0.8 with cleared interface. No signs of epithelial ingrowth or flap striae were noted. Mild traumatic corneal scratching without flap displacement may threaten the integrity of the LASIK interface. If foreign bodies are suspected to be the cause of inflammation, early flap lifting with irrigation is imperative for successful treatment.
Adult ; Cornea/*injuries/pathology/surgery ; Eye Injuries/*complications/diagnosis/surgery ; Female ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ/*methods ; Myopia/surgery ; *Surgical Flaps ; Surgical Wound Dehiscence/diagnosis/*etiology/surgery ; Wounds, Nonpenetrating/*complications/diagnosis/surgery

OBJECTIVE: To establish a new method to estimate injury-tool by analyzing the components of left metal particles from hammers impact on pig skin and filter paper using scanning electron microscope and energy dispersive X-ray spectrometer (SEM-EDX). METHODS: The pig skin and filter paper were stricken by two steel hammers. The left metal particles were examined by SEM-EDX and the results were statistically analyzed by SPSS 13.0. RESULTS: The characteristics of left particles showed stable by several impacts using one steel hammer. The left particles showed no statistical difference for impact on pig skin and filter paper. The left particles displayed a statistical difference using two hammer with different components. CONCLUSION SEM-EDX can be used to detect the left metal particles from the steel hammer and can provide a method for estimating injury-tool.
Animals ; Forensic Medicine/methods* ; Iron/analysis* ; Manganese/analysis* ; Metals/chemistry* ; Microscopy, Electron, Scanning/methods* ; Models, Animal ; Skin/injuries* ; Spectrometry, X-Ray Emission/methods* ; Swine ; Wounds, Nonpenetrating/pathology*

OBJECTIVE: To explore MSCT optimal examination time for patients with unconspicuous rib fracture. METHODS: Sixty-three patients with thoracic trauma from January 2009 to June 2011 were collected. They were examined by MSCT in the first week after trauma and re-examined during eighth weeks after trauma. The number of rib which had been found fractured in the first examination was compared to that in re-examinations. RESULTS: Patients with fine rib fracture often have different diagnostic results at different examination time after trauma. There was statistical difference between the number in the first week and the third week to the fifth week. CONCLUSION MSCT could show the pathophysiological changes of rib fracture objectively in the stage between the third week and the fifth week after trauma, which is optimal examination time for the fine rib fracture.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography ; Pleura/pathology* ; Radiography, Thoracic/methods* ; Rib Fractures/physiopathology* ; Thoracic Injuries/physiopathology* ; Time Factors ; Wounds, Nonpenetrating/physiopathology* ; Young Adult

OBJECTIVETo investigate the effects of penehyclidine hydrochloride on apoptosis of lung tissue cells and its mechanism in acute lung injury following blunt chest trauma in rats.

METHODSSprague Dawley (SD) rats (n equal to 54) weighing (250+/-5) g were divided equally and randomly into three groups: normal control group (C group, n equal to 18), trauma model group (T group, n equal to 18) and penehyclidine hydrochloride treatment group (P group, n equal to 18). Each group was further divided into three subgroups according to the time points of 3, 12 and 24 hours after experiment (at each time point, n equal to 6 for each subgroup). Rats of P group were intraperitoneally injected with penehyclidine hydrochloride for 2 mg/kg immediately after blunt chest trauma and rats in its 24 hours subgroup were once again injected with penehyclidine hydrochloride in the same dose 12 hours after injury. Lung tissue samples were collected at every time point and cell apoptosis in lung tissues were measured by TUNEL. Apoptotic index (AI) was calculated, expressions of bax and bcl-2 were detected by immunohistochemical staining of SABC, and lung tissue sections were taken for light and electron microscopic observation.

RESULTSAs compared with C group, at every time point, AI and expressions of bax and bcl-2 in T group were higher (P less than 0.05), and the ratio of bcl-2/bax markedly decreased (P less than 0.05), especially in the 24 hours subgroup. The ratio in T group (0.468+/-0.007) was lower than that in C group (1.382+/-0.058, t equal to 12.5, P less than 0.01). Lung tissue injuries were significant under a light microscope, and the number of apoptotic cells increased obviously under a transmission electron microscope. As compared with T group at the same phase, AI and expression of bax decreased in P group (P less than 0.05 and P less than 0.01), while the expression of bcl-2 increased significantly (P less than 0.01), and the ratio of bcl-2/bax markedly increased (P less than 0.05), especially in the 24 hours subgroup. The ratio in P group (1.012+/-0.070) was much higher than that in T group (0.468+/-0.007, t equal to 8.3, P less than 0.01). The injury of lung tissues was relieved, and apoptosis of cells decreased obviously under a transmission electron microscopic observation.

CONCLUSIONSApoptosis and expressions of bax and bcl-2 in lung tissues might be involved in the pathogenesis of lung injury induced by blunt chest trauma. Penehyclidine hydrochloride can alleviate lung injuries by inhibiting apoptosis of lung tissue cells, during which effects of penehyclidine hydrochloride on regulating expressions of bax and bcl-2 may play an important role.

Acute Lung Injury ; drug therapy ; metabolism ; pathology ; Animals ; Apoptosis ; drug effects ; Lung ; pathology ; Male ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Quinuclidines ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Thoracic Injuries ; complications ; Wounds, Nonpenetrating ; complications ; bcl-2-Associated X Protein ; analysis