Postmortem chest computed tomography for the diagnosis of drowning:a feasibility study

It may be difficult to distinguish the cause of death in drowning cases without specific findings. The aim of this study was to explore the forensic value of thoracic postmortem computed tomography (PMCT) using routine images and three-dimensional (3D) image reconstructions. The imaging data of PMCT examinations of six drowning cadavers, aged 21–54 years, were analyzed. Twelve victims of sudden death from coronary artery disease (CAD) were chosen as a control group. After 3D bilateral lung images were reconstructed using image processing software, an interactive medical image control system was used to measure and analyze parameters including lung volume, lung volume ratio, mean CT value of the whole lung, and lung CT value distribution curves. Lung volume and lung volume ratio were used to assess the shape changes of the lung. Lung CT value distribution curves showed the corresponding number of pixels of the different CT values in the lung image. Lung volume was not significantly larger in drowning cases (mean 2 958 cm³) than in controls (mean 2 342 cm³). Lung volume ratio values in the drowning group (mean 0.3156) were greater than those in the control group (mean 0.2763); (P = 0.02). There was no significant difference between the drowning and control group in the mean CT value of the whole lung. There were differences between lung CT value distribution curves in drowning victims and controls, with drowning victims showing a single peak and CAD cases showing a bimodal distribution. Thoracic PMCT is helpful for the forensic medical diagnosis of drowning. Lung volume ratio and lung CT value distribution are potential indicators to distinguish between drowning and CAD.     

Fatal Methemoglobinemia Due to Acute Inhalation of Methyl Nitrite in an Industrial Accident

Methyl nitrite is suggested to cause methemoglobinemia by generating methemoglobin, which may be lethal when the methemoglobin concentration exceeds 70%. However, intoxication with methyl nitrite is seldom reported compared with that with other nitrites. Here, we present an industrial accident involving methyl nitrite inhalation during its synthesis process that resulted in three fatalities and one survivor. The autopsy revealed conspicuous blue-gray discoloration in various parts of the body, including the skin, airway mucosa, vessels, brain, heart, and among other areas. The toxicological tests on the deceased showed methemoglobin concentrations in the blood over the lethal level and increased nitrite ion levels in the blood, gastric contents, liver, and lung tissue compared with those in control samples. The cause of death was determined to be methemoglobinemia-induced hypoxia due to methyl nitrite inhalation. This report provides evidence that in methyl nitrite intoxication, exposure duration has a significant influence on the postmortem changes and likelihood of a fatal outcome may be related to the age of the victim. More attention is required regarding the industrial hazards of this substance.     

Video Advance Directives: A Turning Point for Advance Decision-Making? A Consideration of Their Roles and Implications for Law and Practice

Questions regarding making and implementing care preferences through advance directives have become increasingly significant as the greying population grows with rising numbers of people experiencing incapacity. Currently, there is no consensus in the format for making advance directives. Recent developments highlighted the use of recording technology as an option to counter the challenges of written forms. Services offering video and audio recording available for online and offline storage are emerging in the United States. These services presumably strengthen a person’s expression of care preferences for healthcare providers in making treatment decisions compared to written advance directives. This article examines the role video advance directives play in advance decision-making and their legal and practical implications to the existing framework. An appreciation of the legal challenges presented by this development facilitates an understanding of their use in contemporary advance directives and enables appropriate recommendations for implementing safeguards in their use.

     

个人大病求助互联网服务平台行政规制研究——以水滴筹为例

个人大病网络互助是目前我国应用最为广泛的个人求助形式,一定程度上能够弥补慈善组织社会救助之不足。实践中,个人大病求助互联网服务平台暴露出诸多问题。应从确立监管主体、明确权利义务、开立专门账户、设立第三方基金会、提高准入退出门槛等方面加强对个人大病求助互联网服务平台的行政规制,以营造良好的慈善氛围。     

新时代国家凝聚力发展的新向度

新中国国家凝聚力发展经历了社会主义探索、改革开放、新时代三个阶段,迎来三次高潮。进入新时代,习近平新时代中国特色社会主义思想伸向国家凝聚力核心、保护层、基础层三个层面,使之发生深刻变革,引发国家凝聚力发展向度的新走向。不仅增强国家凝聚力核心的活力,而且引发国家凝聚力定向绽放;不仅融入国家凝聚力保护层,而且塑造国家凝聚力工程;不仅以人民为中心,而且拉近基础层。防止了核心硬化、中间层分化、基础层边缘化,增强了国家凝聚力。     

北京市保安服务行业开展工资集体协商的实践与思考

北京市保安服务业近年来发展迅速,从业人员大量增加,工资协商是工会维护保安员收入权,构建和谐劳动关系的一项重要举措。实践中需要我们了解保安服务行业职工队伍状况、开展工资协商情况、当前面临的困难和问题,并提出健全完善保安服务行业工资集体协商制度的对策建议。     

Environmental Stressors and Food Security in China

This article considers the immediate forces influencing China’s food system and food security. By immediate is meant events of the reform period, from the late 1970s to 2008. It begins by asking the question that has preoccupied specialists since the publication of Lester Brown’s Who Will Feed China? in 1995: How much arable land does China have? Is that land area sufficient to insure grain sufficiency? To insure food security? The article focuses on the human pressures on the food production environment, and then treats the effects of socioeconomic change: land, air, and water degradation. The core of the article examines six responses of the state to both perceived and actual environmental stressors: policy restricting arable land conversion, China’s one-child policy, investment in irrigation systems, the South–North Water Diversion Project, large-scale afforestation and reforestation campaigns, and the program to convert marginal agricultural lands to forests and grasslands.     

A health management research on the insured group who participate in medical insurance

Taking the insured group who participate in medical insurance as the main subject, Wendeng city carries out the health management and establishes health files for the insured. Through the free health checkup for the high-risk group, the targeted health interventions are conducted according to the physical examination results of those people, and relative health education has achieved satisfying effects. The health education in different western countries has been carried out for more than 20 years, which accumulates a wealth of experiences. However, health education in China has not yet gained sufficient attentions, and to develop the domestic health education becomes an imperative task at present.     

论先秦人文思潮及其深远影响

中华民族是一个富有人文智慧的民族,早在春秋战国之际的百家争鸣时期,就掀起了中国历史上第一次波澜壮阔的人文思潮。"人文"这个概念,最早见于《周易.贲卦.彖传》,其基本含义,指的是围绕对"人"的关爱所创造出的思想观念。在第一次人文思潮中,先秦诸子的人文创造,对我们民族的文明进步,产生过极其深远的影响。尔后,历代思想家都站在自己所处的时代高度,从不同侧面丰富和发展了先秦诸子的人文理念。今天,回顾总结我国古代的人文传统,发掘其优秀成果,对于借鉴历史、服务现实、培养社会主义新人,都有不可低估的积极意义。     

中国农业银行中间业务竞争力比较分析

本文在研究中国农业银行中间业务发展现状的基础上,通过采用比较分析法,对其结算业务、银行卡业务、担保业务、咨询顾问类业务、其他业务等5个子中间业务与同业分别进行对比,得出了其竞争力较弱的原因:网络银行建设步伐慢,国际化网络不完善;缺乏营销理念,缺少理财产品融合;业务品种较传统,缺乏精细化管理;无投资银行部,无金融控股集团;营销手段落后,综合实力较差等,并提出了一系列相应建议:深化发展网络银行,融合银行卡业务和个人理财业务;逐步完善国际化网络;加快新产品、服务的开发设计;择机成立金融控股公司;落实组织改造,积极发掘人才,培育核心竞争力等.