The coronavirus disease 2019 (COVID-19) has been a global epidemic for more than three years, causing more than 6.9 million deaths. COVID-19 has the clinical characteristics of strong infectivity and long incubation period, and can cause multi-system damage, mainly lung damage, clinical symptoms of acute respiratory distress syndrome (ARDS) and systemic multiple organ damage. The SARS-CoV-2 virus is still constantly mutating. At present, there is no global consensus on the pathological changes of COVID-19 associated deaths and even no consensus on the criteria for determining the cause of death. The investigation of the basic pathological changes and progression of the disease is helpful to guide the clinical treatment and the development of therapeutic drugs. This paper reviews the autopsy reports and related literature published worldwide from February 2020 to June 2023, with a clear number of autopsy cases and corresponding pathological changes of vital organs as the inclusion criteria. A total of 1 111 autopsy cases from 65 papers in 18 countries are included. Pathological manifestations and causes of death are classified and statistically analyzed, common pathological changes of COVID-19 are summarized, and analytical conclusions are drawn, suggesting that COVID-19 infection can cause life-threatening pathological changes in vital organs. On the basis of different health levels of infected groups, the direct cause of death is mainly severe lung damage and secondary systemic multiple organ failure.
新型冠状病毒感染（coronavirus disease 2019，COVID-19）已在全球流行超过3年，造成690多万人死亡。COVID-19具有强传染性和长潜伏期的临床特点，能造成以肺损伤为主的多系统损伤，临床出现急性呼吸窘迫综合征以及全身多器官损伤症状，其病毒SARS-CoV-2仍在不断变异。目前全球对COVID-19相关死亡的病理改变乃至于死因判断标准并未达成共识，调查该疾病的基本病变和病变进展，有助于指导临床治疗以及治疗药物的研制。本文综述了全球2020年2月至2023年6月发表的COVID-19尸体检验报告及相关文献，以有明确的尸体检验案例数量以及对应的重要器官病理学改变为纳入标准，共纳入来自18个国家65篇论文的1 111例尸体检验案例，对病理表现和死因进行归类和统计学分析，归纳和总结了COVID-19的共性病理变化，并提出分析结论，认为COVID-19感染能引起全身重要器官发生危及生命的病理改变，在感染群体健康水平各异的基础上，死亡案例的直接死因主要为严重的肺部损伤及其继发的全身多器官功能衰竭。.

OBJECTIVE: To explore the characteristics of postmortem examination, chemical examination and scene investigation of deaths caused by oral diphenidol hydrochloride poisoning, and so as to provide a reference for proper settlement and prevention of such deaths.
METHODS: The data of 22 deaths caused by oral diphenidol hydrochloride poisoning in a city from January 2018 to August 2020 were collected, including case details, scene investigations, autopsies, chemical examinations and digital evidence. Thirty-one cases of deaths caused by oral diphenidol hydrochloride poisoning reported in previous literature were also collected.
RESULTS: In the 53 oral diphenidol hydrochloride poisoning death cases, 50 cases were suicide, 2 cases were accidental, while 1 case was undetermined. Fifty-two cases were found in the medical records or crime scene investigation reports with doses ranging from 775 mg to 12 500 mg, and 23 deceased were detected with postmortem blood concentrations ranging from 2.71 mg/L to 83.1 mg/L. Clinical symptoms were recorded in 6 patients, including conscious disturbance and convulsion. Among the 45 cases which were performed with external examination, 23 cases autopsied.
CONCLUSIONS: Most of the deceased of oral diphenidol hydrochloride poisoning were suicide. No significant correlation was found between dose and blood concentration through the retrospective analysis of cases.
目的: 探讨口服盐酸地芬尼多中毒死亡案例的尸体检验、理化检验和现场勘验特点，为相关案（事）件的处置和预防提供参考。方法: 收集某市2018年1月—2020年8月发生的22例口服盐酸地芬尼多中毒死亡案例的案情、现场勘验、尸体检验、理化检验、电子物证等资料，结合既往文献报道的31例口服盐酸地芬尼多中毒死亡案例进行分析。结果: 53例口服盐酸地芬尼多中毒死亡案例中，50例为自杀，2例为意外，1例性质不详。52例在病历记录或现场勘验记录中找到服药剂量，范围为775~12 500 mg。有服药剂量的52例中，23例经死后药物浓度检测，血药质量浓度范围为2.71~83.1 mg/L。记录有临床症状的6例，表现为意识障碍、抽搐。经尸表检查的45例中，有23例进行了尸体解剖。结论: 口服盐酸地芬尼多中毒死者多数为自杀。通过多个案例的回顾性分析，尚未发现服药剂量与血药浓度之间具有相关性。.

Congenital diaphragmatic hernia (CDH) is associated with high mortality rates and significant pulmonary morbidities. The objective of this study was to delineate the histopathological features observed in necropsies of CDH patients and correlate these with their clinical manifestations.
We retrospectively reviewed the postmortem findings and corresponding clinical characteristics in eight CDH cases from 2017 to July 2022.
The median survival time was 46 (8-624) hours. Autopsy reports showed that diffuse alveolar damage (congestion and hemorrhage) and hyaline membrane formation were the primary pathological lung changes observed. Notably, despite significant reduction in lung volume, the lung development appeared normal in 50% of the cases, while lobulated deformities were present in three (37.5%) cases. All patients displayed a large patent ductus arteriosus (PDA) and a patent foramen ovale, resulting in increased right ventricle (RV) volume, and myocardial fibers appeared slightly congested and swollen. The pulmonary vessels indicated thickening of the arterial media and adventitia. Lung hypoplasia and diffuse lung damage resulted in impaired gas exchange, while PDA and pulmonary hypertension led to RV failure, subsequent organ dysfunction and ultimately death.
Patients with CDH typically succumb to cardiopulmonary failure, a condition driven by a complex interplay of pathophysiological factors. This complexity accounts for the unpredictable response to currently available vasodilators and ventilation therapies.

OBJECTIVE: To retrospectively analyze homicide cases of death after injection and provide reference for forensic identification.
METHODS: Six homicide cases of death after injection which were investigated by the Criminal Investigation Team of Shanghai Public Security Bureau were collected and analyzed, including case situation, scene investigation, autopsy and other materials.
RESULTS: The 6 cases were premeditated crimes, 5 cases took place in private spaces, and 5 cases involved the victims approached by suspects\' decoy. There were no obvious abnormalities at the scene of the 6 cases. In 6 cases, the victim\'s body surface injury was mild or no, lividity color was abnormal, and the needlestick injury showed different manifestations from conventional medical measures.
CONCLUSIONS: Death after injection is a highly concealed crime and easy to be ignored. For the suspected injection injury found in autopsy, it is necessary to carefully examine, identify and analyze, be alert to the situation of injecting poison (drug) and do a good job in evidence fixation and material extraction.
目的: 回顾性分析注射后死亡的他杀案件，为法医学鉴定提供参考。方法: 收集上海市公安局刑事侦查总队侦破的6例注射后死亡的他杀案件，整理分析案件情况、现场勘验、尸体检验等材料。结果: 6例案件均为有预谋的犯罪，5例案件的嫌疑人在私密的空间作案，5例采用诱骗方式接近受害者。6例案件现场无明显异常。6例案件的受害者体表损伤轻微或者无，尸斑颜色异常，针眼样损伤与常规医疗措施的表现不同。结论: 注射后死亡案件为一种高度隐蔽性犯罪案件，极易被忽略。对尸体检验发现的疑似注射针眼样损伤，应认真检验、鉴别、分析，警惕有无注射毒（药）物的情形，做好证据固定、检材提取等工作。.