论网络色情案件侦查难点

网络色情犯罪主要是指利用互联网络以牟利为目的,制作、复制、贩卖、传播色情信息,或者虽不以牟利为直接目的,传播淫秽信息情节严重的行为,或者引诱、介绍卖淫等犯罪行为。目前我国网上扫黄行动方兴未艾,严重打击了网络犯罪行为,净化了网络环境。色情网站不会随着一次专项斗争而消失,在未来还将长期存在,如何高效地打击网络色情犯罪,快速地发现并破获网络色情犯罪是一件非常重要的课题。本文就网络色情案件的特点与规律进行分析,并针对网络色情犯罪侦查难点进行了深入的探讨。     

Post-mortem cases involving amphetamine-based drugs in The Netherlands. Comparison with driving under the influence cases

In this study we reviewed the post-mortem cases in the years 1999-2004 that were presented at the Netherlands Forensic Institute. The concentrations of amphetamine-based drugs in femoral blood from cases of suspected unnatural death were compared with concentrations in whole blood from non-fatal cases of driving under the influence (DUI cases) and with literature. Furthermore, the combinations with other drugs and/or alcohol were investigated. Amphetamine-based drugs were present in 70 post-mortem cases and 467 DUI cases. The most detected amphetamine-based drug was MDMA, followed by amphetamine. The presence of MDA could usually be explained by metabolism of MDMA. Methamphetamine and MDEA were rarely present. Frequently, the amphetamine-based drugs were taken in combination with alcohol and/or other non-amphetamine-based drugs such as cocaine or cannabinoids. The 70 post-mortem cases were divided into 38 amphetamine-based drug caused (i.e. the amphetamine-based drug directly caused or contributed to the death) and 32 amphetamine-based drug related deaths (i.e. death was not directly caused by the amphetamine-based drug). In the latter category, other (poly)drug intoxications and death by violence or drowning were the most frequent causes of death. In 30 cases, MDMA caused death directly. The range in blood concentrations of MDMA in these cases was substantial, i.e. 0.41-84 mg/L with a median concentration of 3.7 mg/L (n=30). MDMA blood concentrations in the MDMA related deaths (n=20) and in the DUI cases (n=360) varied up to 3.7 and 4.0 mg/L, respectively. Seven victims died from the direct effects of amphetamine; the blood concentration of amphetamine ranged from 0.24 to 11.3 mg/L, with a median concentration of 1.7 mg/L (n=7). The median concentrations of amphetamine in the amphetamine related deaths (n=13) and the DUI cases (n=208) were much lower, i.e. 0.28 and 0.22 mg/L, respectively. Amphetamine blood concentrations up to 6.0 and 2.3 mg/L were seen in the drug related deaths and DUI cases, respectively. The most frequently encountered amphetamine-based drugs in the investigated deaths were MDMA and amphetamine. The majority of MDMA- and amphetamine-caused deaths, i.e. 90% of these deaths, occurred with blood concentrations above 1.5 and 0.80 mg/L, respectively. MDMA and amphetamine blood concentrations in drug related deaths and DUI cases, however, overlap the range of fatal concentrations. Therefore, MDMA or amphetamine concentrations should never be used alone to establish the cause of death.     

Prosecution decisions in cases of domestic violence involving children

Increasing attention is being paid to the problem of children as the secondary victims of domestic violence. It is now well documented that children suffer as a result of domestic violence. However, it has yet to be shown how, if at all, the presence of children as direct or indirect victims influences the decision-making of the police and prosecutors in those cases of domestic violence which enter the criminal justice process. The findings of an empirical study of the Crown Prosecution Service (CPS) that shed light on this issue are discussed in this article. The research, which combined an analysis of case files with observations and discussions with prosecutors, suggests important differences between the approach of the police and CPS lawyers.     

Forensic cases involving the use of GHB in The Netherlands

In this study, forensic cases involving the use of Gamma Hydroxy Butyric acid (GHB) from the second half of 1999 through the second half of 2001 in The Netherlands (blood >5mg/l and urine >10mg/l) are described. GHB was analysed by GC-MS after lactone formation and using GHB-d6 as internal standard. The results are divided into three groups: cases of chemical submission, cases of driving under the influence and cases of unknown causes of death.GHB was found in six cases of possible chemical submission. In these cases, relatively low concentrations of GHB were found. The results show that in cases of chemical submission, urine should be analyzed, because GHB is present longer in urine than in blood. The police should collect the samples in containers that do not contain citrate as anticoagulant. Especially at low levels of GHB, the formation of GHB in these tubes hampers an interpretation of the results.GHB was found in 13 cases of driving under the influence. In contrast to the cases of chemical submission, high concentrations of GHB were found, corresponding with observations of extreme sleepiness or temporary loss of consciousness.GHB was found in 16 cases of unexplained death: the measured range of GHB concentrations in blood might correspond to effects such as drowsiness, but not to serious toxicity of GHB. In 4 of these 16 cases, the role of GHB could be excluded. In the remaining cases, the role of GHB remains unclear; more research into "background" concentrations of GHB in post-mortem material is required.The incidence of the use of GHB in The Netherlands cannot be derived from these toxicological data. As GHB is not routinely found during systematical toxicological analyses, these data may seriously underestimate the use of GHB. Therefore, information from the police to the forensic institute is essential.     

Deaths involving buprenorphine: a compendium of French cases

Buprenorphine at high dosage became available in France in 1996, as a substitution treatment for heroin addicts. Since this date, numerous deaths were attributed to this drug. This paper reports two original series of 39 and 78 fatalities involving buprenorphine observed at the Institute of Legal Medicine of Strasbourg and at 13 other French forensic centers, respectively. The files were recorded from January 1996-May 2000. The first 20 fatalities that were previously published were excluded from this epidemiological study. From these 117 subjects, 96 were male (82%). Buprenorphine and its primary metabolite norbuprenophine were assayed in post-mortem blood by HPLC/MS (n=11 labs) or by GC/MS (n=3 labs). Blood levels for buprenorphine ranged from 0.5 to 51.0ng/ml (mean 10.2ng/ml) and 0.1 to 76ng/ml (mean 12.6ng/ml) in Strasbourg and the other centers, respectively. Blood levels for norbuprenorphine ranged from 0.2 to 47.1ng/ml (mean 8.2ng/ml) and <0.1 to 65ng/ml (mean 10.6ng/ml) in Strasbourg and the other centers, respectively. The mean values appear to be within the therapeutic range. Buprenorphine was identified in 24 of the 26 hair samples assayed in Strasbourg, at concentrations ranging from 10 to 1080pg/mg. Intravenous injection of crushed tablets, a concomitant intake of psychotropics (especially benzodiazepines and neuroleptics) and the high dosage of the buprenorphine formulation available in France appear as the major risk factors for such fatalities. In addition, two suicide-related deaths were also observed, with blood buprenorphine concentrations at 144 and 3276ng/ml.     

Two fatal cases involving concurrent use of methamphetamine and morphine

We report on two cases of simultaneous administration of methamphetamine (MAP) and morphine (MOR) with hyperthermia. The blood levels of MAP and MOR were toxic and putatively lethal, respectively, although hyperthermia is a known cause of intoxication due to MAP rather than MOR. In Japan, MAP is the most predominant cause of drug intoxication. The presented cases suggest that MOR may exert synergistic effect on hyperthermia due to the MAP intoxication, together with experimental findings.     

Post-mortem cases involving amphetamine-based drugs in the Netherlands: Comparison with driving under the influence cases

In this study we reviewed the post-mortem cases in the years 1999–2004 that were presented at the Netherlands Forensic Institute. The concentrations of amphetamine-based drugs in femoral blood from cases of suspected unnatural death were compared with concentrations in whole blood from non-fatal cases of driving under the influence (DUI cases) and with literature. Furthermore, the combinations with other drugs and/or alcohol were investigated. Amphetamine-based drugs were present in 70 post-mortem cases and 467 DUI cases. The most detected amphetamine-based drug was MDMA, followed by amphetamine. The presence of MDA could usually be explained by metabolism of MDMA. Methamphetamine and MDEA were rarely present. Frequently, the amphetamine-based drugs were taken in combination with alcohol and/or other non-amphetamine-based drugs such as cocaine or cannabinoids. The 70 post-mortem cases were divided into 38 amphetamine-based drug caused (i.e. the amphetamine-based drug directly caused or contributed to the death) and 32 amphetamine-based drug related deaths (i.e. death was not directly caused by the amphetamine-based drug). In the latter category, other (poly)drug intoxications and death by violence or drowning were the most frequent causes of death.In 30 cases, MDMA caused death directly. The range in blood concentrations of MDMA in these cases was substantial, i.e. 0.41–84 mg/L with a median concentration of 3.7 mg/L (n = 30). MDMA blood concentrations in the MDMA related deaths (n = 20) and in the DUI cases (n = 360) varied up to 3.7 and 4.0 mg/L, respectively. Seven victims died from the direct effects of amphetamine; the blood concentration of amphetamine ranged from 0.24 to 11.3 mg/L, with a median concentration of 1.7 mg/L (n = 7). The median concentrations of amphetamine in the amphetamine related deaths (n = 13) and the DUI cases (n = 208) were much lower, i.e. 0.28 and 0.22 mg/L, respectively. Amphetamine blood concentrations up to 6.0 and 2.3 mg/L were seen in the drug related deaths and DUI cases, respectively. The most frequently encountered amphetamine-based drugs in the investigated deaths were MDMA and amphetamine. The majority of MDMA- and amphetamine-caused deaths, i.e. 90% of these deaths, occurred with blood concentrations above 1.5 and 0.80 mg/L, respectively. MDMA and amphetamine blood concentrations in drug related deaths and DUI cases, however, overlap the range of fatal concentrations. Therefore, MDMA or amphetamine concentrations should never be used alone to establish the cause of death.     

患者死亡医疗纠纷司法鉴定24例分析

目的探讨涉及患者死亡医疗纠纷的过错成因,分析其司法鉴定的切入点。方法收集了涉及患者死亡且多次鉴定的医疗纠纷案例24例,从一般情况、科室分布、责任程度划分以及差错分析等方面进行了总结和分析。结果此类案例在技术方面存在患者自身疾病隐匿、接诊部门处理过程简单、科室之间配合不力、紧急情况下措施不果断等问题。此外,告知义务的履行、转诊时机把握以及常备抢救设施的维护等管理方面漏洞也是医疗纠纷的多发环节。结论本文可为进行此类医疗纠纷的司法鉴定提供帮助,也为避免纠纷的发生提供参考。     

臂丛神经主要分支损伤法医学鉴定66例分析

目的探讨臂丛神经主要分支损伤的法医学鉴定。方法取自本室2003年1月至2005年12月共66例84条臂丛神经主要分支损伤的案例进行统计分析。结果被鉴定人中男性青壮年占较大比例;锐器伤引起神经损伤居多达94%;神经损伤伴有骨折的占34%,其中50%尺神经损伤伴尺骨骨折;曾行肌电图检查的为34条神经,占40%,其中有15条临床未确诊为神经损伤。结论臂丛神经主要分支损伤的法医学鉴定,关键看影响肢体运动功能的后果,鉴定时机宜术后20天 L(神经断端远侧的长度)/R(生长速度) 90天。     

Accidental deaths involving derringer handguns: a report of three cases

Accidental deaths due to discharge of dropped handguns have been previously reported. In this report, the authors review the history and design of the derringer handgun and describe three cases of accidental death due to discharge of derringer-type handguns. In two of these cases, the gun was dropped, resulting in a fatal discharge. The design of the derringer and the absence of a safety feature are cited as underlying factors. If the alleged weapon can be obtained, testing may demonstrate that discharge could occur if the gun were dropped.     

基层医疗机构护患纠纷25例分析

护患纠纷是指在临床诊疗过程中主要由护理人员与患者及其家属发生的各种矛盾，是医患纠纷中的一种重要形式和特殊类型。此类纠纷常不引起人们的重视，国内文献分析报道也较少。笔者收集本县医疗机构给予患方赔（补）偿的护患纠纷25例，对其中存在的护理过失和护理缺陷及其原因进行了统计分析，并讨论相关防范措施。     

基层医疗机构护患纠纷25例分析

护患纠纷是指在临床诊疗过程中主要由护理人员与患者及其家属发生的各种矛盾,是医患纠纷中的一种重要形式和特殊类型。[1]此类纠纷常不引起人们的重视,国内文献分析报道也较少。笔者收集本县医疗机构给予患方赔(补)偿的护患纠纷25例,对其中存在的护理过失和护理缺陷及其原因进行了统计分析,并讨论相关防范措施。资料和结果笔者收集了本县1998年1月——2004年3月发生的护患纠纷中医疗机构给予患方赔(补)偿的案例共25例。一、一般情况25例赔(补)偿的护患纠纷中,发生纠纷的医疗机构等级分别为二级医院13例(52.00%),一级医院4例(16.00%),卫生所2…     

社会功能评价在精神发育迟滞患者性侵害案中的应用

目的探讨社会功能水平在精神发育迟滞患者性自我防卫能力评定中的作用。方法对性侵害案中125例符合CCMD-3精神发育迟滞诊断标准的性受害者采用自编法医精神病学鉴定案例登记表收集一般资料,使用韦氏智力测试量表(WAIS-RC)、成人智残评定量表和功能大体量表(GAF)进行评定。结果不同等级的性自我防卫能力的患者在职业、婚姻、文化程度、性知识及生育史等方面有显著差异。成人智残评定量表、大体功能评定量表(GAF)、智商(IQ)和鉴定诊断的一致性(Kappa值)分为0.710、0.661、0.494,三者和性自我防卫能力的一致率分为0.538、0.472、0.316。结论不能仅用智商来确定精神发育迟滞患者的性自我防卫能力的水平,应充分重视社会功能在性自我防卫能力评定中的作用。