教科文组织104程序及其改进

教科文组织104程序是由公约和建议书委员会负责审查教科文组织职权范围内关于案件和问题的来文的非司法程序。由于"问题"的政治敏感性,至今委员会从未作出过确认存在"问题"的决定。104程序可分为预备、审议来文、通过决定草案和报告以及决定实施四个阶段。通过对已公布的三组数据的对比,适用104程序审查的来文呈现出三个趋势:来文数量逐渐下降,来文质量提高,已解决的来文的比例显著提高且许多来文最终取得了令人满意的结果。104程序的主要特点是:以教科文组织执行局的一项决定为依据、强制性、个案性、非对抗性和严格的保密性。发达国家与发展中国家在改进104程序的多数问题上分歧严重,双方只有加强对话、相互妥协、缩小歧见、早日达成共识,才能使之更加完善,更加充分地发挥作用。     

Age Estimation in Living Adults using 3D Volume Rendered CT Images of the Sternal Plastron and Lower Chest

Age estimation is commonly of interest in a judicial context. In adults, it is less documented than in children. The aim of this study was to evaluate age estimation in adults using CT images of the sternal plastron with volume rendering technique (VRT). The evaluation criteria are derived from known methods used for age estimation and are applicable in living or dead subjects. The VRT images of 456 patients were analyzed. Two radiologists performed age estimation independently from an anterior view of the plastron. Interobserver agreement and correlation coefficients between each reader's classification and real age were calculated. The interobserver agreement was 0.86, and the correlation coefficients between readers classifications and real age classes were 0.60 and 0.65. Spearman correlation coefficients were, respectively, 0.89, 0.67, and 0.71. Analysis of the plastron using VRT allows age estimation in vivo quickly and with results similar than methods such as Iscan, Suchey–Brooks, and radiographs used to estimate the age of death.     

A Large‐Sample Test of a Semi‐Automated Clavicle Search Engine to Assist Skeletal Identification by Radiograph Comparison

In 2014, a morphometric capability to search chest radiograph databases by quantified clavicle shape was published to assist skeletal identification. Here, we extend the validation tests conducted by increasing the search universe 18‐fold, from 409 to 7361 individuals to determine whether there is any associated decrease in performance under these more challenging circumstances. The number of trials and analysts were also increased, respectively, from 17 to 30 skeletons, and two to four examiners. Elliptical Fourier analysis was conducted on clavicles from each skeleton by each analyst (shadowgrams trimmed from scratch in every instance) and compared to the search universe. Correctly matching individuals were found in shortlists of 10% of the sample 70% of the time. This rate is similar to, although slightly lower than, rates previously found for much smaller samples (80%). Accuracy and reliability are thereby maintained, even when the comparison system is challenged by much larger search universes.     

Sickle Cell Trait Mimicking Multiple Inflicted Injuries in a 5-Year-Old Boy

Abstract:  Sickle cell disease (SCD) and sickle cell trait (SCT) can be associated with sudden unexpected death in the pediatric population, usually due to pulmonary complications occurring within the acute chest syndrome (ACS). Musculoskeletal complications can occur and are classically limited to bone infarcts. The occurrence of bone pathology centered upon the epiphyseal growth plate in SCD/SCT is extremely rare, and multiple such injuries in a single patient have not been previously reported. Herein, we describe a case of sudden unexpected death in a 5-year-old child with undiagnosed SCT due to the ACS, with widespread epiphyseal and periosteal bone lesions mimicking multiple inflicted injuries at autopsy. This case highlights the importance of clinicopathological correlation and is the first to describe SCT pathology as a mimic of nonaccidental injury.     

延黄消心痛胶囊治疗心血瘀阻型冠心病心绞痛48例

目的 评价延黄消心痛胶囊治疗心血瘀阻型冠心病心绞痛的临床疗效及其安全性。方法 采用随机、双盲、安慰剂平行对照的研究方法，将48例患者随机分为试验组24例和对照组24例，分别给予延黄消心痛胶囊及模拟剂。比较两组的心绞痛疗效、中医证候疗效、心电图疗效及Duke运动平板评分。结果 试验组在降低心绞痛发作次数和Duke运动评分，提高心绞痛疗效、中医证候疗效方面显著优于对照组（P<0.05，或P<0.01）；两组心电图疗效比较，差异无统计学意义（P＞0.05）。结论 延黄消心痛胶囊临床使用安全，治疗心血瘀阻型冠心病心绞痛疗效确切。