法医学论文摘要的写作特点

目的探讨法医学论文摘要特别是英文摘要的写作方法。方法对目前国内医学杂志和法医学杂志的论文摘要进行分析比较和举例说明。结果国内医学杂志采用结构式摘要的写作方法，而国外法医学杂志一般采用叙述式摘要的写作方法。结论英文摘要是国际间信息交流的桥梁，掌握英文摘要的写作方法对于法医学者来说是十分重要的。     

Current medico-legal death investigation system in China

Medico-legal death investigation in China has a long history that can be traced back to the Chhin era in the third century BC. We conducted a national study on the current medico-legal death investigation system in China. Our study showed that, at present, medico-legal death investigations in China are conducted by c. 12,000 forensic medical experts mainly within five relatively independent agencies: the police organizations, the prosecutors' offices, the departments/divisions of forensic medicine/science in medical colleges and universities, the Institute of Forensic Science in the Ministry of Justice, and the government or private forensic societies. Owing to China's large population and area, the medico-legal death investigation is largely based on the administrative divisions. There is a wide variation in the scope, extent, and quality of investigations among the agencies and at the different levels of county/district, municipal, and provincial governments. This article gives a general overview of medicolegal death investigation in modern China.     

Medical criminalistics

Medical criminalistics is an essential part of legal/forensic medicine. It includes the clinical examination of surviving victims and suspects, the inspection of the scene in suspicious deaths with subsequent performance of medico-legal autopsies, the assessment of (biological) traces and the reconstruction of criminal events under medical aspects. Just as the circumstances of life and the manifestations of crime are changing with time, there is a permanent alteration regarding the issues of medical criminalistics. Legal/forensic medicine is a university subject in most countries and therefore, research work is one of the main tasks also in medical criminalistics. In contrast to clinical medicine and basic research, some common study designs are not suitable for the special needs of medical criminalistics, whereas other types are more appropriate like epidemiological evaluations, cross-sectional studies and (retrospective) observation studies. Moreover, experimental model tests and case reports also rate high in medical criminalistics.     

Peculiar approaches to the estimation of the severity of harm to health in children with non-fatal injuries

The medico-legal estimation of non-fatal injuries in the children and adolescents is presented. The data obtained have been used to develop and substantiate the algorithm of forensic medical expertise of such injuries. Scientifically sound criteria have been proposed to be used for the purpose of expert estimation of the severity of harm to health associated with non-fatal injuries taking into consideration their clinical manifestations. The procedures of forensic medical expertise for the estimation of the harm to health have been analysed with special reference to non-fatal injuries in children and adolescents. Main attention was given to the accompanying strategic, organizational, and methodological errors. The approaches to their prevention and correction are described.     

The contribution of N.I. Pirogov to the development of forensic medicine (on the occasion of his 200th birthday anniversary)

The main facets of professor N.I. Pirogov's professional activity are outlined. Forensic medicine (in the first place its organizational and practical aspects) was an integral component of his scientific and clinical work, along with applied anatomy and surgery. Landmark publications of N.I. Pirogov are listed with special reference to those concerned with forensic medical expertise of medical malpractice cases, postmortem inspection and intravital examination procedures, wound ballistics studies, the atlas of forensic pathology, etc. The surgeon and anatomist N.I. Pirogov can be justly regarded as a founder of forensic medicine in this country.     

Forensic evaluation of sudden death due to tuberculosis

Abstract:  The emergence of drug-resistant tuberculosis (TB) poses a major threat to TB control efforts. We report a case of a 50-year-old man with pulmonary TB. The scene investigation had initially suspected for homicide; however, the result of medico-legal autopsy demonstrated natural cause of death. Statistical data suggest that the rates of national mortality by respiratory TB decreased in the last decades in Hungary; however, an increasing TB mortality was detected in the capital Budapest. Facing a new mortality trend in TB, the forensic scene investigation and determination of manner of death represent new challenges for practitioners.     

Forensic medicine and criminalistics

The supplementary designation "criminalistics" in the title of certain forensic medical institutes in the first half of this century is to be regarded as a reaction to faulty developments in our specialty, which almost led to the elimination of forensic medicine as an independent scientific discipline in the 1960s. The ability to think in terms of criminalistics and the corresponding working procedures has always been a crucial precondition for the forensic physician, since forensic medicine is the application of medical knowledge for juridical purposes. Forensic medicine originated with the appraisal of cases of violent death by doctors, i.e., reconstruction of the facts in the case. To use the term "criminalistics" in the form of a supplementary designation is thus not required. An attempt is nevertheless made to define "medical criminalistics" as a small but important component of criminalistics. They are subdivided into two phases: the first part begins at the scene of the crime or the place of discovery (local evidence). Here, the trained eye of the forensic physician is indispensable to the criminal investigation department and the prosecutor. Medical criminalistic thinking and working procedures continue at the autopsy. Here, forensic autopsy differs from that practiced by the pathologist. Without knowledge of the situation at the discovery location, the forensic physician runs the risk of not recognizing facts that are important for reconstruction and thus becoming a "destroyer of clues". The second part of medical criminalistics is the actual detection of medical clues, i.e., the investigation of medical clues with special methods, including histological and toxicological investigations.(ABSTRACT TRUNCATED AT 250 WORDS)     

两地区医疗纠纷法医学尸检鉴定质量的比较研究

目的研究影响涉及医疗纠纷法医学尸检鉴定质量差异的原因。方法两个具有代表性的法医学尸检鉴定机构所涉及医疗纠纷的相关案例,进行字2检验、t检验等统计学研究。结果通过字2检验发现,在设定的10个指标中,有7个指标存在显著性差异,提示两鉴定单位在“涉及医疗纠纷的法医学尸检鉴定”中检验手段和标准、规范性等均存在极大的差异。结论通过研究,提示法医学鉴定人素质、尸检的标准化和规范化、尸检检材的提取标准化、死因或疾病的诊断标准、会诊制度及法医学鉴定书的书写规范化等是法医学尸检鉴定质量控制和管理的重要环节。     

Methamphetamine-related fatalities in forensic autopsy during 5 years in the southern half of Osaka city and surrounding areas

To outline the recent features of methamphetamine-related fatalities from the medico-legal point of view, a retrospective investigation of forensic autopsy cases involving methamphetamine during a 5-year period (1994-1998) in the southern half of Osaka city and surrounding areas (about 1.57 million population) was undertaken. Among 646 autopsy cases, methamphetamine was detected in 15 victims (nine males, six females; 16-71 years of age; most frequently in males in their thirties). Primary scenes of fatal events were concentrated in the middle of the city. About half of them were transferred from emergency medical centers (survival time, up to 30 h). The cause and manner of death were: methamphetamine poisoning (n=4), homicide (n=4), accidental falls and aspiration from drug abuse (n=4), fire death (n=1), myocardial infarction (n=1), and cerebral hemorrhage (n=1) under drug influence. Usually injection scars and fresh puncture sites were found. Blood methamphetamine concentrations were 2.29-17.05 micromol/dl in the fatal poisoning, 0. 44-3.80 micromol/dl in deaths from other extrinsic causes (trauma), and 1.35-2.17 micromol/dl in cardio- and cerebrovascular strokes. Common complications were cardiomyopathy, cerebral perivasculitis and liver cirrhosis/interstitial hepatitis. Fatal and nonfatal methamphetamine poisonings are separately dealt with by the administrative medical examiner's office and in emergency medical centers. Tightly cooperative approaches of clinical and medico-legal experts are required for the effective social and medical management of drug abuse.     

Forensic medical identification of death due to poisoning of tetrodotoxin in puffer fish

One case died of poisoning of tetrodotoxin in dry fugu fillet was reported. Through the detailed forensic examination for this lethal case, many questions about forensic medical identification of death due to poisoning of tetrodotoxin was discussed and its medico-legal significance was also discussed. In particular, emphasis was placed on the details of a case, extraction of TTX in specimen, quantitative detection of TTX, purplish mouth and nails, dilatation of stomach and intestines, excluding other causes and combining animal experiment in order to get definite forensic medical identification.     

Teaching post-mortem external examination in undergraduate medical education--the formal and the informal curriculum

In undergraduate medical education, the training of post-mortem external examination on dead bodies might evoke strong emotional reactions in medical students that could counteract the intended learning goals. We evaluated student perception of a forensic medicine course, their perceived learning outcome (via self-assessment) and possible tutor-dependent influences on the overall evaluation of the course by a questionnaire-based survey among 150 medical students in Hamburg, Germany. The majority of students identified post-mortem external examination as an important learning objective in undergraduate medical education and did not feel that the dignity of the deceased was offended by the course procedures. After the course, more than 70% of the students felt able to perform an external examination and to fill in a death certificate. Respectful behavior of course tutors towards the deceased entailed better overall course ratings by students (p<0.001). Our findings highlight the importance of factors such as clearly defined learning goals and course standardization (formal curriculum) as well as tutor behavior (informal curriculum) in undergraduate education in forensic medicine. Furthermore, we suggest embedding teaching in forensic medicine in longitudinal curricula on death and dying and on the health consequences of interpersonal violence.     

Forensic-medical assessment of terroristic chemical attacks

By potential damage, chemical terroristic attacks are much more dangerous than terroristic bombing. To fight chemical terrorism it is necessary to create the system of medical-environmental defense of the population. In line with emergency medicine, forensic medical service is a very important element of the antiterroristic defense. The activity of forensic-medical experts in the field of terroristic chemical attack is analysed.     

Postmortem findings in 22 victims due to two grain silo explosions in France

In 1982 and 1997 there were explosions of barley-containing silos in France, one in Metz (1982) and the other in Blaye (1997). There were a total of 25 victims, including 23 fatalities (12 in Metz and 11 in Blaye). In each case there was one survivor. This report is a retrospective study of 22 victims (11 at each site); all of them had multiple lesions due to the explosion and the immediate aftermath. The lesions demonstrated direct involvement of the blast effect associated with silo destruction, the heat from the explosion, the effects of toxic gases and asphyxia. The forensic pathologist is an important member of the emergency response team. This team has the responsibility for initially assessing the damage and for identifying the victims. The role of the forensic pathologist is therefore essential and they should be included in emergency planning to facilitate the initial assessment, shorten the time taken to identify the victims and improve safety procedures. Although dust explosions in agro-business plants are occurring more frequently, postmortem data are rare.     

Suspicious circumstances on discovery of the cadaver

The authors report on three autopsy cases in which the findings at the death scene gave rise to the suspect of non-natural, in two cases even violent causes of death. The medico-legal and criminalistic investigations led to surprising results: Death was due to acute intoxication with narcotics, supposed delirium tremens and a suicide attempt in the presence of bronchopneumonia. External force was ruled out in all three fatalities by cooperative work of police investigators and forensic medicine.     

Human rights abuses and the medical profession

Allegations of torture are on the increase and the medico-legal and ethical problems can no longer be ignored by the medical profession. While jurists fail to give effective legal guidelines as to what amounts to 'torture', reports indicate that doctors are often engaged in activities which are difficult to reconcile with any conception of medical ethics. There is a clear need for the medical profession to re-evaluate their involvement in circumstances that are a direct antithesis of their professional occupation. The skills of doctors with forensic expertise allow detection of human rights abuses and thereby its potential reduction. There is scope for the reduction torture or ill-treatment, if the profession maintain high standards of medical practice and ethics.     

Forensic evaluation of occupational marks in establishing identity—A case report

The livings have responsibilities for the dead; and in particular, civilized societies recognize the need for identity both during life and at death, particularly in circumstances when an unknown body is summoned for medico-legal autopsy. There are numerous tools for identification of an unknown body which includes visual identification, fingerprints, medical prostheses, odontological techniques, DNA fingerprints and to include in the list is the occupational marks over the body sustained during the course of his or her profession. The medico-legal investigators should possess comprehensive knowledge of such occupational marks, which aid in identification. We are highlighting a case of rare entity, where a forensic evaluation of occupational marks was done to establish the identity of an unknown elderly male, who committed suicide by ligature hanging.     

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。     

一例药物过敏性休克死亡的医疗问题鉴定分析

目的探讨药物（低分子右旋糖酐）过敏性休克医疗纠纷案件的法医学鉴定思路及关键点，从而为审判提供划分侵权责任及医疗赔偿的科学依据。方法详细报道一例低分子右旋糖酐药物过敏性休克死亡的两级医疗事故鉴定，法医学鉴定及二次不同的法院判决结果的医疗纠纷案例。结果两级医疗事故鉴定均认为该例属医疗意外，不属医疗事故，一审判决驳回起诉。法医学鉴定认为在对该例的抢救过程中确存在不当之处；患者确因药物（低右）过敏性休克死亡，未发现院方有违反医疗常规的行为，对该例的治疗方案属非必要治疗措施。在抢救过程中，肾上腺素没有作为首选用药，肾上腺素应用不及时，药量不充足。因抢救地点的限制致使抢救质量不好。据此，二审判决被告院方对患者方予以赔偿。结论药物过敏性休克的法医学鉴定应注重：①全面审查所提供的详细医疗材料，分析整个医疗过程的临床变化特点；②全面尸检；③进行药品检验、毒物分析；④排除疾病及其它死因；⑤进行确证死因的检验。在此基础上分析确定死因及医疗过程是否存在问题，如存在医疗不当之处，分析此种医疗不当在患者的死亡中的关系比例，并适当表述鉴定意见。     

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.     

A Comparison of Coronary Artery Stenosis Estimates Made by Forensic Pathologists and Medical Students

Previous studies suggest cardiovascular pathologists are less accurate than noncardiovascular pathologists (e.g., clinical pathologists) in estimating the degree of coronary artery stenosis. To further investigate the effect of training on accurate estimation of coronary artery stenosis, we designed a study to compare the accuracy of estimates made by forensic pathologists versus medical students. Six forensic pathologists and twelve medical students each independently examined 24 images of coronary artery cross sections and gave an estimate of the degree of stenosis. When comparing all 24 images, the forensic pathologists had a median difference between the estimated percentage of stenosis and actual percentage of stenosis of −12.380 and the medical students had a median difference of −16.50 (p-value of 0.08542). In estimating the percentage of stenosis, training in forensic pathology does not guarantee significantly improved accuracy compared with medical students. Our study showed no consistent statistically significant difference between estimates given by forensic pathologists and by medical students.