Fatal penetrating abdominal injury by a metallic projectile

Penetrating abdominal injury is often a life-threatening condition, which is mainly associated with inflicted injuries. Fatal self-inflicted sharp force abdominal injuries too have been reported in the literature. Inadvertent penetrating abdominal injuries are a rarity and are caused by sharp objects of low-velocity and often nonmissile-type. A 27-year-old male factory worker was brought dead to the emergency department with an alleged history of sustaining abdominal injury by a sharp metal projectile while working on a metal cutting grinder. Autopsy observations were consistent with the history of inadvertent penetrating injury. Our case reports a fatal missile-type inadvertent sharp force trauma over the abdomen with intestinal perforation, a relatively uncommon scenario in occupational/workplace settings. The present case report describes the significance of the death scene visit and corroborating the medical findings with investigating agencies. This case further emphasizes on the need for adopting proper safety measures at the workplace.     

眼部损伤程度鉴定意见一致性的影响因素分析

目的分析眼部损伤程度重新鉴定意见不一致的原因,为此类鉴定提供借鉴。方法选取法大法庭科学技术鉴定研究所2016~2019年受理的108例眼部损伤程度重新鉴定案例进行回顾性分析。结果鉴定时机的选择、鉴定材料的利用、检验方法的采用、损伤的论证、标准条款的理解等问题是重新鉴定与原鉴定意见不一致的常见原因。结论针对上述原因,应从科学把握鉴定时机、充分利用送检材料、提高鉴定人的专业技能以及建立统一判定标准等方面来实现眼部损伤程度鉴定的规范化、准确性。     

脑震荡后综合征伤残评定研究进展

由于症状表现的主观性以及当前客观检查方法所能提供证据的匮乏,加之赔偿伴生的症状伪装和夸大等问题,脑震荡后综合征患者的伤残评定鉴定意见一致性不高。在人体损伤赔偿纠纷中,脑震荡后综合征患者的伤残评定成为法医精神病鉴定的争议点和难题。通过对脑震荡及相关术语变化、脑震荡后综合征的发生率、症状表现及诊断标准、脑震荡后综合征客观评价技术以及伤残评定的现状及未来发展方向进行综述,以期提高对脑震荡、脑震荡后综合征的认识,提高鉴定意见的一致性。     

高频超声检查在周围神经损伤鉴定中的应用价值

目的探讨高频超声检查在周围神经损伤鉴定中应用的价值。方法收集38例锐器伤、钝挫伤、骨折及撞击造成的单侧肢体外伤病例,应用东芝Aplio 500型彩色多普勒超声诊断仪进行高频超声检查,将其特征性表现与30例正常周围神经的高频超声图表现进行对比分析。结果经高频超声检查,确诊38例周围神经损伤中发生于颈部5例、下肢5例,上肢27例(肘部以上3例、以下24例)。损伤类型包括卡压性损伤8例、创伤性神经瘤28例、神经完全断裂2例。特征性表现为:卡压性损伤神经受压处变细,近端神经节段性增粗;创伤性神经瘤与神经干相连的梭形增粗段,增粗段神经外膜的线性强回声中断,内部回声紊乱;神经完全断裂表现为神经外膜强回声线与神经纤维低回声束完全中断,断端两侧均呈梭形瘤样改变。结论高频超声能够明确周围神经损伤类型及发生节段,可为法医学人体损伤程度鉴定提供有价值的参考依据。     

因工患传染病职工工伤认定研究 ——基于对《工伤保险条例》中“事故伤害”的法释义学分析

对于所患传染病种类非属于《职业病分类和目录》的职工,由于法律未有明文规定,实务中就是否认定工伤问题存在争议,导致相关职工难以获得工伤保险的救济。《工伤保险条例》保障因工作遭受事故伤害或者患职业病的职工。而职业病由《职业病分类和目录》法定列举,法律解释空间极小;事故伤害为不确定的法律概念,存在相当的法律解释空间。法院对患传染病职工工伤认定纠纷案件的裁判,呈现出将职工患传染病纳入遭受事故伤害的思考路径。研究通过贯彻宪法规范和价值,结合工伤保险的目的与工伤认定的本质,并为了法律概念的统一使用和行政法律规范之间的冲突解决,运用法释义学的方法,强化论证了传染病可被纳入事故伤害的解释范畴,从而化解因工患传染病职工认定工伤无法可依的困境。     

Fatal exsanguination following complete transection of femoral vessels due to angle grinder injury in an industrial accident

Angle grinders are one of the most dangerous and frequently used tools in industrial settings. Angle grinder injuries range from superficial cuts to deep penetrating injuries with underlying fracture-dislocation and vascular trauma. The injuries caused by angle grinders mostly involve the head, face, or upper limbs, while the lower limb is an unusual site. The high-speed rotating disc of the angle grinders does not respect anatomical boundaries or structures; therefore, the injuries caused may be disfiguring, permanently incapacitating, or even fatal. We report a fatal case of an angle grinder injury to the lower limb. The victim sustained a sharp cut over the left thigh while woodworking in an industrial setup. The rotating disc of an angle grinder had transected the skin, subcutaneous fat and muscles, and both the femoral vessels of the left side, which led to fatal exsanguination within 10 min of the incident.     

过劳相关案件的法律分析 —— 以中国裁判文书网相关案例为对象

本文通过因过劳致病、致死相关案件的检索与溯源,基于基本信息的统计结果对案件案由、性质、受害人情况、法院判决等进行的实证研究,发现劳动者难以证明过度劳动与死亡之间的因果关系,以及工伤认定受到"48小时内"死亡的约束,是民法和行政法对过劳的认定标准和法律救济面对的困境。建议尽快完成对过劳认定的医学支撑、明确立法价值取向、进一步完善相关法律规定。     

碎米蕨叶马先蒿对小鼠肝肾和血液指标的影响

为探讨碎米蕨叶马先蒿对动物机体的损害程度,以评价其安全性,本试验将采自新疆巴音布鲁克草原的碎米蕨叶马先蒿粉碎,自制含15%和30%的碎米蕨叶马先蒿草粉鼠粮,饲喂小鼠三个月以上,随机抽取小鼠血液进行生化指标天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、总蛋白(TP)、白蛋白(ALB)、总胆固醇(TC)、尿素(BUN)、肌酐CRE的测定和血常规红细胞(RBC)、白细胞(WBC)、平均红细胞血红蛋白含量(MCH)、血红蛋白(HGB)、红细胞压积(HCT)、平均红细胞血红蛋白浓度(MCHC)、淋巴细胞绝对值(LYMPH#)、淋巴细胞(LYMPH)百分数、中性粒细胞(NEUT)比率和单核细胞(MONO)比率的测定。生化指标结果显示,高剂量组碎米蕨叶马先蒿对小鼠肝脏可能造成轻微损害,对小鼠肾脏可能造成损害;血液学检测结果显示,在试验第28天时WBC、LYMPH百分数、LYMPH#高剂量组极显著高于对照组(P<0.01),NEUT比率和MONO比率显著低于对照组(P<0.05)。在血液学检测整个试验期间,各测定指标都在不断波动,试验后期均趋于动态平衡。上述结果表明,30%碎米蕨叶马先蒿草粉鼠粮对小鼠肝脏可造成轻微损伤、对肾脏造成损伤,但不影响造血系统。     

Contribution of Antemortem Computed Tomography Findings to Cause of Death Determination: An Unusual Fatal Stroke

In the case reported here, the antemortem computed tomography scan (CT scan) was essential in the forensic investigation. A 32‐year‐old man was found fully awake with a facial abrasion, after what seemed to be a car accident. He lost consciousness suddenly one hour after initial management. Successive CT scan showed a facial fracture and a metallic foreign body in the carotid canal associated with an occlusion/dissection of the left internal carotid, a pseudoaneurysm, and a carotid‐cavernous fistula. The victim died from a stroke. Autopsy confirmed that the facial abrasion was a gunshot entrance wound, the metallic foreign body being a projectile. Intracranial vascular injuries linked with gunshot wounds are most of the time isolated and due to pelet embolism. The observed vascular injury association has never been described in the existing literature. The CT scan provided a better understanding of the chronology of events that led to death.