Case histories in forensic medicine

Case histories make up a great part of publications in forensic medicine, especially forensic pathology, although considered low on the hierarchy of evidence based medicine because of its inherent anecdotal nature. Meanwhile some journals exclude case histories categorically from publication. The boom of case histories in forensic medicine has not only opportunity reasons (easily [even mental] and cheap to do) but also structural reasons: due to its tasks in case work many items of forensic medicine can not be simulated experimentally for ethical reasons (violent death, traumatic injuries, sexual assault, poisonings, influence of alcohol and drugs on driving ability and legal responsibility, medical malpractice, adverse events during medical care). In these fields the role of case histories is mainly the augmentation of experience based knowledge. However, quality aspects have to be considered and case histories should be the basis for systematic or hypothesis based research.     

基于Citespace的法医临床学研究发展历程分析

目的运用Citespace软件对法医临床学相关文献绘制知识图谱、进行可视化分析,探究该学科领域研究热点和动态发展,梳理鉴定难点脉络。方法汇总CNKI收录《中国法医学杂志》《刑事技术》《法医学杂志》《中国司法鉴定》刊登的法医临床学相关论文,利用Citespace分析其关键词、研究热点、基金资助、作者、发文机构及所在地等。结果法医临床学作为法医学分支学科之一,近年来呈现的科研成果部分获基金资助,多由开设法医学专业的院校完成;随着科研理论、技术方法推陈出新,法医临床学鉴定标准、版本也得以构建、更迭、完善,鉴定体量位居法医"四大类"之首。结论作为最具中国特色的法医学分支学科,法医临床学研究着重服务司法实践、以期用成果技术反哺鉴定,实现学术、实践的交流、转化。通过Citespace知识图谱可视化分析学科发展历程,有助于回溯此间规律,提示未来研究方向,提升鉴定业务水平,为持续增强法医临床学学科影响力提供借鉴。     

国外法医临床学发展史

法医临床学是法医学的重要分支学科,正处于蓬勃发展阶段。研究法医临床学的发展史,对明确其定义和实践范畴,维护司法公正,具有重要意义。本文将从“简介、历史溯源、18世纪之后的法医临床学发展、现代法医临床学、世界法医临床学司法实践现状和结语”六个部分介绍法医临床学在国外,尤其是英国的发展历史,促进我国法医临床学的学科建设和发展。     

Origin and development of forensic medicine in the Kingdom of Saudi Arabia

The medicolegal death investigation system in the Kingdom of Saudi Arabia (KSA) is unique in the world. It is exclusively derived from Islamic judiciary based on Shari'ah law, which is the definitive Islamic law or doctrine. This law is applied on Saudi citizens as well as foreigners. This is different from other Islamic countries, which have a combination of Islamic and other judiciary systems.The forensic medicine centers in KSA are related administratively to the Ministry of Health (MOH) and its subdivisions in the different governorates. They are concerned with forensic medical examination and autopsy, as well as the clinical forensic medical examination of sexual assault cases, and those injured in civil and criminal cases. The assisting laboratories (forensic histopathology, microbiology, serology, forensic chemistry) are working independently under the funding of MOH, whereas the DNA laboratory and other departments of forensic sciences, for example, counterfeiting and forgery unit are related administratively to the Ministry of Interior represented by the Administration of Criminal Evidences. Efforts concerning crime scene investigations are shared with Administration of Criminal Evidences' crime scene investigators.Forensic medicine education in KSA developed in the past few years after the foundation of Saudi specialty certificate in forensic medicine. The certificate is a postgraduation qualification equivalent to a doctorate degree in forensic medicine and requires completion of a 4-year training program in both MOH- and Ministry of Interior-related departments, as well as passing annual evaluation and examination.This review is aimed at providing in the next decade the medicolegal centers with national forensic specialists throughout the kingdom and granting skillful headships for the next generations. Moreover, this review suggests more scientific associations with the academic universities in the various fields of forensic sciences through academic cooperation.     

法医学研究中的伦理审查建设

法医学研究伦理审查既是法医学研究管理工作的内容,也是法医学研究的对象,本文针对法医学研究中的伦理审查问题,论述开展伦理审查的必要性,并对法医学研究伦理审查委员会建设指导原则进行探讨,呼吁开展伦理审查建设。     

HLA基因多态性及其法医学应用

人类白细胞抗原(Human Leukocyte Antigen,HLA)基因复合物定位于人类第6号染色体短臂上,是人类最复杂的显性多态遗传系统,基因型可达108种之多,是理想的人类遗传标记,已广泛应用于法医学亲子鉴定和个体识别。本文就其基因多态性的研究进展和在法医学中的应用作一综述。     

体视学技术在医学影像学中的应用及其法医学价值

基于Cavalieri原理的体视学技术经常运用在组织学和病理学的研究中,但是现在,这种技术已经被运用于医学影像学(如CT、MRI、ECT、超声等)的测量。体视学的方法提供了一个非侵入性的、精确的、无偏的、简单的和快速的测量方法。所以该方法在医学影像学的形态计量学的测量中有临床使用价值。而影像资料的定量测量结果则有助于法医学实践。     

Clinical forensic medicine and its main fields of activity from the foundation of the German Society of Legal Medicine until today

The fields mainly covered by clinical forensic medicine are subject to time-related changes which are described on the basis of the German literature of the 20th century. Some fields of forensic sexual medicine (diagnosis of virginity, proof of criminal abortion, potentia coeundi, potentia generandi, potentia concipiendi) have become less important in the daily work of medicolegal institutes, whereas victims of rape and sexual abuse continue to form a major part of the forensic examination material in the German-speaking countries. The evaluation of suspected physical child abuse has grown in importance since the 60s, and it is essentially the merit of Elisabeth Trube-Becker that this problem is now dealt with also in scientific medicine. More recently, medicolegal experts are increasingly confronted with further groups of persons: victims of domestic violence, abused/neglected seniors, refugees from countries where torture is used. A new special field, which established itself only in the 90s, is the estimation of age with regard to the criminal responsibility of suspects who have no identity papers or pretend to have none. A phenomenon frequently observed in the last two decades is the non-accidental self-infliction of injuries. Whereas in the first half of the 20th century the motive for self-mutilation was typically to evade military service, this category of injury was later mainly seen in the context of insurance fraud; more recently most forensically relevant self-inflicted injuries refer to simulated offenses (fictitious sexual offenses and robbery, attacks allegedly having a political background). One of the traditional fields of clinical forensic medicine continues to be the evaluation of victims and suspects following bodily harm and attempted homicides. In the field of civil law medicolegal experts are particularly often concerned with controversial consequences of traffic accidents (e.g. alleged whiplash injuries after rear-end collisions at low velocities).     

心肌桥的研究现状及法医学意义

心肌桥是一种少见的解剖学异常,可引起猝死,近年来已成为临床和法医工作者的一个研究热点。本文依据文献资料从心肌桥的发生率、解剖学特征、病理生理变化、临床表现及法医学意义等方面进行综述。     

溺死法医学鉴定的研究新进展

综述了近年来在硅藻检验、水中浮游生物叶绿素（A）检测、血液化学和组织化学检验等方面的最新文献报道,并对各种溺死检验方法的优缺点进行了评价：在硅藻检验中,硝酸乙醇法、破机罐法及微波消解法,可缩短检验时间,提高办案效率;酶消化法及PCR法硅藻检出率高,适用于可疑水样中硅藻密度低等情况。早期器官组织中浮游生物叶绿素（A）、血液和组织中其他生化指标,可作为鉴定溺死的重要参考。微量元素锶检测可用于鉴定海水中溺死。另外,硅藻及其他浮游生物遗传多态性片断PCR,可望成为新的、灵敏的溺死检测方法。     

MVR-PCR及其法医学的应用

小卫星可变重复单位作图(MinisatelliteVariantRepeatmapping,MVRmapping)是近十年发展起来的一项DNA分析技术。本综述对该技术的分子学基础、发展过程及其在法医学的应用作了系统的阐述。认为该技术在个人识别与亲子鉴定方面发挥着为其它DNA分析技术所不可替代的作用,正在成为法医学生物检材检验的重要手段之一。     

单核苷酸多态性及其在法医学中的应用前景

单核苷酸多态性是人类基因组中最常见、分布最广泛的DNA多态性类型。随着人类基因组计划的迅猛发展,已有越来越多的单核苷酸多态性位点被发现,使其可以广泛应用于人类遗传性和遗传相关性疾病的诊断、群体遗传学的研究、药物的开发及应用等方面,同样在法医学也具有广阔的应用前景。本文综合介绍了单核苷酸多态性的一般特性及法医学应用前景,包括其应用的可行性、存在的问题及高通量自动化的检测方法。     

色觉电生理学研究进展及其法医学应用价值

色觉是视觉功能的重要组成部分。目前色觉的检查主要依靠主观检查方法,研究和探索色觉客观检查方法具有重要的临床意义和法医学价值。随着现代科学技术的日益进步,视觉电生理学检查方法已逐渐成为色觉临床诊断与研究的重要手段。视网膜电图（electroretinogram,ERG）可以对不同的锥细胞及色觉异常进行区分,不同颜色刺激所产生的视觉诱发电位（visual evoked potential,VEP）也有不同的形态特征。通过对不同视觉电生理学检测方法,尤其是视网膜电图、闪光诱发电位、图形诱发电位等在色觉研究方面的新进展等文献的复习表明,色觉电生理研究技术将为网膜功能、脑功能的法医临床学评定提供重要手段。     

挤压综合征的法医学研究进展

目前挤压综合症(CrushSyndrome)的法医学鉴定一直没有全面、系统、量化的标准,其相关研究成为法医损伤学的热点。为此本文对挤压综合症的概念、病理生理学机制、重要器官的损伤以及相关症状的关系等问题进行了简要的综述。为挤压综合症的研究提供一些思路。     

MicroRNA在心血管疾病方面的研究现状及应用前景

MicroRNA(miRNA或mi R)是一类21~25nt大小的高度保守的内源性单链非编码RNA,在生物体内广泛存在。近年来,在临床研究中与心血管疾病相关的mi RNA不断得以证实,但其在法医学鉴定方面的研究尚未有报道。本文就mi RNA的研究进展及其在心血管疾病中的应用,以及在心源性猝死法医学鉴定中的应用前景进行综述。     

论法医学领域的标准化方法

通过对法医学领域标准化工作存在问题的分析,结合标准化方法的演变历程,运用标准体系和综合标准化的理论和方法,指出法医学领域标准化方法应以需求导向为主,通过构建标准体系指导标准化工作的开展,填补标准缺项,完善现有标准,同时积极适应多专业协同鉴定的发展需求,推进标准综合体的建立,并不断提升制标参与度,加大宣贯,促进标准的应用。     

陈垣的早期著作及其法医学贡献

陈垣,我国当代著名国学大师,史学家,教育家,在宗教史、元史、考据学、校勘学等方面成绩卓著。他早年学医及执教期间发表不少医药卫生及医学史的研究论文,被誉为中国医学史研究的奠基人之一。在法医学方面,他于1908-1909年在《医学卫生报》发表《洗冤录略史》《吉省新设检验吏》《奏设检验吏已咨行到粤》《美医剖验交涉命案》等文章,呼吁建立现代法医学检验制度,其中《洗冤录略史》是对我国法医学史研究有一定影响力的早期著作,因此,陈垣应被视为我国法医学史研究的早期学者之一。     

Clinical forensic medicine

This article discusses the merits of participation by medical examiners in the area of clinical forensic medicine. The present connotation that we deal after the fact should be abandoned with enhanced involvement in assisting the living. The paper focuses on a broad range of categories where forensic scientists by virtue of their training and experience could be most helpful in the application of medical knowledge to the solution of questions of law.     

肋软骨分析检验技术在法医学中的应用

传统法医人类学对肋软骨的分析检验仅限于形态学检验.近年来,法医影像学以及分子遗传学的发展丰富了人类肋软骨的分析检验技术,并且已经能够运用于法医学实践中.本文从肋软骨的组织学特性入手,综述了近年来肋软骨在法医人类学性别判定、年龄推断等方面的研究进展,以期为同行提供借鉴和参考.