伤后因医疗因素导致死亡8例分析

在法医检案中,因创伤致死的案例较多.而其中由于伤者伤后即送医院抢救,在医疗因素的参与下而导致死亡的例数有增多态势,而由此产生的嫌疑人过多承担法律责任的问题,在法医检案中应引起充分的重视.现将笔者在工作中遇到的8例报道如下.     

拳击头部致急死3例分析

当拳击头部时,由于拳头属较圆滑的钝物,加上头皮头发的覆盖衬垫作用,即使颅内已产生重度损伤,而头皮不伴有裂伤和颅骨骨折征。法医工作者在检案中应引起重视。 笔者在检案中曾遇到3例头部被拳击,报导如下: 案例1 死者某男,57岁,于1987年4月8日与邻里吵架时被对方拳击头部,后倒地昏迷,送医院抢救,当天下午死亡。尸检时发现左侧额颞部有—4.1cm×3.5cm的头皮下血肿,而未见头皮裂伤和骨折。而延髓腹侧实质内有散在性出血,大小脑蛛网膜下腔呈广泛性出血,以左侧尤甚。侧脑室及第四脑室内见有少量血块。法医病理诊断:1.左额颞部头皮下血肿;2.原发性脑干出血伴蛛网膜下腔广泛性出血。     

迟发性外伤性脑干出血死亡1例

在法医检案中轻微外伤致脑干出血、血肿形成而死亡的案例较为少见。本文报道1例迟发性外伤性脑干出血死亡案并对其死因进行分析。1案例1.1案情某男，35岁，农民，某日因纠纷被人用手电筒（三节电池型）打击头部致头皮挫裂创，当即送医院治疗。受伤当时神志清，伤后除有头痛、头晕外无其它不良反应，亦未检查出其它神经系统阳性体征，遂于两天后出院，回家休息，继续观察、治疗。四天后因头痛、头晕不缓解，行颅脑CT检查未见异常。之后，一直因头痛、头晕未中断治疗，此间能进行一般体力活动。14天后大便时突然发生昏迷，急送医院抢救，入院…     

腹部暴力致肺、脑血管破裂死亡分析1例

腹部暴力致伤分为开放性和闭合性损伤，这在日常检案中并不少见，其中闭合性损伤中的尸表无明显改变而腹内脏器破裂对法医检案有一定难度，伴肺、脑损伤者更是少见，笔者在检案中遇到一例，报告如下：１案例资料某男，８２岁，农民，１９９８年４月因纠纷被人用脚踏腹部后坐在地上，即刻起来因便意上厕所时，右半身瘫痪，继而昏迷，送医院抢救无效死亡，受伤至死亡共约半小时。尸体检验：老年男性尸体，发育正常，清瘦。尸斑位于背腰部，指压退色。尸僵存在于全身大关节处；已部分缓解。头皮无损伤，颅骨无骨折。角膜轻度混浊瞳孔等大等圆，…     

外伤性硬膜下积液死亡1例

外伤性硬膜下积液死亡１例叶松青（福建省清流县公安局；清流３６５３００）头部受较轻微外伤后，大量脑脊液积聚在硬脑膜下间隙，继发脑水肿、脑疝死亡的案例，在法医检案中颇为少见。笔者在法医检案实践中遇见一例，报告如下：１案例某男，７１岁，１９９３年９月１５日...     

两例拳击致爆裂性眼眶骨折的报告

<正> 案例报告爆裂性眼眶骨折(blowout fracture ofthe orbit)指眶缘无骨折或错位,而眶壁骨折片向远离眼球方向位移的骨折。爆裂性眼眶骨折在法医检案中相对较少见,国内胡景和(1990)曾报告一例眼眶内侧壁骨折,眼球内陷的案例。笔者在法医检案中遇到二例,现报告如下。例1.严某,男,29岁。1992年1月2日因挤公共汽车时与他人发生纠纷,左眼被拳击。眼部检查:左眼睑水肿,眶周淤斑,球结膜下小片状出血;左眼视力0.1,矫正     

殴斗中食物返流致吸入性窒息死亡机制初探(附3例报告)

在法医检案中,食物返流所致的吸入性窒息,常发生在意识丧失的情况下,如醉酒、一氧化碳中毒、癫癎、脑震荡等。在殴斗中颈、胸、腹等部位受外力作用引起反射性呕吐致吸入性窒息死亡的案例比较少见。笔者在实际检案中曾遇到3例,现报告如下:     

男性个体Amelogenin基因座Y片段缺失1例

在法医物证检案中,男性个体Amelogenin基因座Y片段未检出的案例时有报道。笔者在检案中遇到1例,现报道如下。     

外伤性腔隙性脑梗死的法医学鉴定

损伤与神经系统疾病因果关系的鉴定一直是法医学的难点,但在法医检案实践中,颅脑损伤在全身各部位损伤中所占的比例却是最高的,特别是在检案中经常会碰到医院作出“外伤性腔隙性脑梗死”的诊断,这就需要引起我们的重视。颅脑外伤主要引起颅内血肿、脑挫裂伤及弥漫性脑损伤。外伤性脑梗死近年来国内外文献已有报道[1-2],单纯发生于外伤后基底节-内囊区的腔隙性脑梗死发病率极低且报道甚少,据报道,临床上占颅脑损伤的1.4%。本文结合案例就其在法医临床学鉴定方面进行分析和讨论。1案例资料1.1由某医学院提供确诊为“外伤性腔隙性脑梗死”12例…     

损伤后医疗因素与死因关系的探讨

进行尸体检验，常遇到遭受伤害或事故后，经医院抢救无效死亡的案例，这些案件的死因分析中，是否应考虑医疗因素，怎样评定它所占的比例，当前法医学界及刑法中尚无明确的规定，笔者就检案中遇到的较为典型的几例试作分析。例1，某男，35岁、1991年5月10日被人刺伤腹部，肠管外溢，送附近医院治疗。医生检查伤者外溢的肠管有一处破裂口，予以缝合、清洗后回纳腹中。1周后伤者死亡。尸检发现肠管上还有另一处刺破口未缝合。死因为弥漫性腹膜炎，感染性休克。例2，某男，28岁。1997年11月15日被人刺伤颈部，送医院抢救。医生予以扩创、止血，…     

An assessment for attitudes consistent with sexual offending for use with offenders with intellectual disabilities

Background . Over the past 10 years, the focus of assessment and treatment for sex offenders has changed from the assessment of skills and deviant sexual preferences to the assessment and treatment of cognitions that might be considered to encourage or justify inappropriate sexual behaviour. There have been a few assessment measures of deviant sexual cognitions developed for adults in mainstream sex offender populations but none in less able populations. The present study describes an assessment questionnaire consisting of 7 scales for cognitions associated with rape, voyeurism, exhibitionism, dating abuse, stalking, homosexual assault and offences against children, designed to be used by sex offenders with intellectual disabilities. Method . Four groups of subjects were employed in this study – sex offenders, non‐sexual offenders, non‐offenders all with mild intellectual disabilities or borderline intelligence and a further group of normal men. All subjects completed the questionnaire and 86 subjects provided reliability data. Results . Each item was subjected to 3 tests of reliability. Retained items were required to achieve an item‐to‐total correlation of at least 0.4. Of the 7 scales, 5 achieved an internal consistency coefficient of 0.8 or greater. All scales successfully discriminated between groups even when the normal controls were eliminated because their scores were so low. Conclusions . It is possible to develop scales to assess cognitions related to types of offences which discriminate between sex offenders and other groups with intellectual disabilities. The final scales have robust statistical properties and can be used for clinical and research purposes. Some caution was noted in the use of attitudinal assessments for sex offenders.     

合并自杀的杀人行为研究（附40例分析）

探索合并自杀的杀人行为的犯罪学特征、发生机理,为责任能力的评定提供依据,并提出进一步研究方向. 方法 采用回顾性研究方法 ,3名研究人员从1997年1月～2001年10月的鉴定案例中挑出符合研究条件的案例,进行统计学分析,并结合国内外相关文献进行讨论. 结果符合条件者共40例 ,男性被鉴定人较多(28名),平均年龄33.55岁,主要年龄段30～40岁,妄想和情绪低落等症状具有明显的作用,精神分裂症和无精神病在疾病诊断中占有显著地位. 结论 合并自杀的杀人行为具有一定的特征,应引起司法精神病学的关注,并展开更深入的研究.     

Suicide with chloroquine combined with maprotiline and trimipramine]

Report on suicide with chloroquine in combination with maprotiline and trimipramine. Chloroquine and his metabolite monodesethylchloroquine could be determined in organs and body fluids. The highest organ-concentrations of chloroquine were found in liver and kidney. The survival time and dose are discussed.     

Using the cognitive interview with adults with mild learning disabilities

Abstract

Forty-seven adults with mild learning disabilities (mild intellectual disabilities) attending day-centres and thirty-eight adults from the general population viewed a videorecording of an accident. A day later the participants were interviewed using either a cognitive interview (CI) or a structured interview (SI, a control interview). Compared with their counterparts with learning disabilities, adults from the general population recalled more correct information and made fewer confabulations about persons and objects. Nevertheless, the type of interview had an impact. For both groups, the CI was more effective than the SI in enhancing recall although, for the ‘learning disabilities’ group, the CI also produced a disproportionate increase in the reporting of person confabulations. All the same, the accuracy ratios were similar across interview types (80% for the CI and 82% for the SI). It is suggested that the CI could be helpful in assisting people with learning disabilities to provide information about events they have seen.     

民粹主义司法

民粹主义正在席卷我国司法领域并形成了史上罕见的民粹主义司法现象.民粹主义司法的主要表现形式是利用现代网络平台如微博等实施舆论审判.在民粹主义司法形成过程中,社会精英扮演了重要角色.司法在我国是政府展开社会治理的机构之一,如此之司法职能定位决定了满足民粹主义诉求不可避免地成为司法的一项基本政策.民粹主义司法在谋求案件裁判实质公正的同时表达着对现行法律体制的愤懑与期待等多种民粹主义私货.无核心价值观的民粹主义犹如毒树,民粹主义司法堪称毒树之果,它导致程序公正的应然司法观在我国的确立和巩固阻碍重重.消除民粹主义司法现象需要法院、政府、社会精英和大众传媒的共同努力.