眼眶骨折的影像学诊断及法医学评定

在眼眶骨折的法医学鉴定中常常出现漏诊和误诊。目前影像学技术在研究眼眶骨折的法医学特点和评价外伤的严重程度中有重要的意义。本文综述了眼眶骨折的分类、发病机制和影像学诊断的特点,对于眼眶骨折的法医学评价和鉴定有较好的帮助。     

Postmortem diagnosis of syphilitic aortitis, including serological verification on postmortem blood

304 postmortem blood samples were serologically examined for syphilis at Statens Seruminstitut. Seventy-six percent of the samples were usable and gave clear-cut results (18% positive, 34% negative and 24% borderline). Twenty-four percent were indeterminable. The blood samples originated from 304 medico-legally examined bodies, 301 of whom were autopsied. The indications for the serological examinations were suspicion of syphilitic aortitis (SA) on the basis of the macroscopical appearance of the aorta at the autopsy--or information on earlier syphilis. Ninety-seven cases of SA were verified macro- and microscopically, 53 being lethal. The serological results were positive in half of these 97 cases, negative in 15, borderline in 21 and indeterminable in 12. A little more than half of the 97 cases were known in advance in the nation-wide syphilis index at the State Serum Institute. The variegated findings in the remaining part of the material are discussed. It is concluded that serological examination of postmortem blood may be a valuable adjuvant for the pathologist for the diagnosis of SA and other syphilitic manifestations.     

警察职业心理压力分析与干预

世界各国的警察都为心理健康问题所困扰。随着我国各项改革的不断深化,公安工作的内容发生了深刻的变化,警察的各种压力越来越大。面对长期高风险、高强度、高负荷的工作,公安民警也会出现挫折感、心理障碍等问题,生活的压力、职业的竞争、人际的困惑,特别是职业的规范给他们带来更多普通人体会不到的精神与心理压力。警察心理健康问题一方面关系到警察这个群体的发展与进步,另一方面也关系到社会的安全与稳定。     

Analysis of Forensic Autopsy in 120 Cases of Medical Disputes Among Different Levels of Institutional Settings

Despite advances in medical science, the causes of death can sometimes only be determined by pathologists after a complete autopsy. Few studies have investigated the importance of forensic autopsy in medically disputed cases among different levels of institutional settings. Our study aimed to analyze forensic autopsy in 120 cases of medical disputes among five levels of institutional settings between 2001 and 2012 in Wenzhou, China. The results showed an overall concordance rate of 55%. Of the 39% of clinically missed diagnosis, cardiovascular pathology comprises 55.32%, while respiratory pathology accounts for the remaining 44. 68%. Factors that increase the likelihood of missed diagnoses were private clinics, community settings, and county hospitals. These results support that autopsy remains an important tool in establishing causes of death in medically disputed case, which may directly determine or exclude the fault of medical care and therefore in helping in resolving these cases.     

Giant Diaphragmatic Lipoma: Two Autopsy Case Reports and Review of the Literature

Lipomas are common benign tumors most frequently found within the subcutaneous areas of the body. Deep-seated lipomas are rare and tend to be larger than cutaneous ones. Lipomas are rarely seen in the thoracic cavity, and they are usually located in the mediastinum, bronchiole, and lungs. Diaphragmatic lipomas have been occasionally reported in the literature, the first being described by Clark et al. in 1886. The authors report two rare cases of giant diaphragmatic lipoma incidentally found during forensic autopsies. In the first case, a Caucasian 85-year-old woman burned to death with another passenger, after her methane-fueled car collided with another car on a highway near Terni, Umbria, Italy. In the second case, a Caucasian 45-year-old man collapsed while walking through the countryside of Perugia. In either case, a large mass in the thorax was observed. The definitive pathologic diagnosis was giant intrathoracic diaphragmatic lipoma without evidence of malignancy. The authors also review the relevant literature and discuss differential diagnoses. These case reports contribute to the establishment of the actual incidence of diaphragmatic lipomas.     

Agreement between ratings from self-rating scales and assessments by treatment staff concerning a group of adolescent males who have sexually offended

Abstract

Despite problems of validity, self-report measurements are used in clinical practice and research. The aim here was to compare self-ratings by adolescent males who had sexually offended with assessments of the same adolescents made by professionals. Results of two self-report questionnaires were compared with staff estimates. It was assumed that observability of behaviour, social desirability of the adolescents' responses, intellectual difficulties and the presence of neuropsychiatric problems would affect the level of agreement between participant and professional responses. Agreement between staff estimates and self-ratings was generally low. However, some results supported the assumptions: i.e. higher levels of agreement on observable behaviour, higher levels of agreement for adolescents scoring low on social desirability and, most obviously, lower levels of agreement for boys with neuropsychiatric diagnoses. Discrepancies between what adolescents say about themselves through self-ratings and how professionals perceive them cause problems in assessments that rely on self-rating measurements.     

对一起职业病鉴定否定原诊断结论案例的分析

通过对一起经职业病鉴定后否定原诊断结论案例的分析,探讨如何正确运用和进一步完善职业病诊断与鉴定方面的法律、法规和标准,保护劳动者生命健康权益。     

Incidental findings and future testing methodologies: potential application of the ACMG 2013 recommendations

Reactions to the first clinical recommendations for the return of incidental findings (IFs) from genomic sequencing published by the American College of Medical Genetics and Genomics (ACMG) were polarized and resolute. Exploring the three main points of controversy: mandatory testing, testing children for adult conditions, and selection of conditions to be reported on, illuminates concerns for and conservation of bioethical principles—specifically, autonomy and non-directiveness. With the historical context of genetic testing in mind, this article studies the potential application of the ACMG recommendations to embryonic testing in the form of preimplantation genetic diagnosis. Theoretical extension of the current recommendations assists in the identification of bioethical dilemmas and possible societal impacts. The recommendations make a statement on the importance of diagnosis and intervention for specific genetic conditions, setting a precedent for disease classification and patient autonomy. In the extreme, the clinical application of such recommendations prenatally may result in discarded embryos, and less societal tolerance of specific conditions. Skilled professionals, such as genetic counselors, researchers, and lawmakers must work together to maintain patient autonomy, providing care in the best interest of each patient.     

WHEN PARENTS CAN CHOOSE TO HAVE THE “PERFECT” CHILD: WHY FERTILITY CLINICS SHOULD BE REQUIRED TO REPORT PREIMPLANTATION GENETIC DIAGNOSIS DATA

Preimplantation Genetic Diagnosis (PGD) is a procedure used to screen embryos for certain genetic conditions before implantation via in vitro fertilization (IVF) so the desired embryos can be chosen for implantation. The procedure was originally used to prevent the birth of children with deadly genetic disorders, but it is now used for more controversial reasons, such as to select for sex. Limited information is available regarding how PGD is used in the United States and there are many ethical concerns surrounding the practice of PGD, most notably that it could lead to the creation of designer babies and eugenic practices. This Note proposes amending a federal act to require fertility clinics to report PGD data through an existing web‐based system. This data can then be used by policymakers to federally regulate PGD practices.     

暴力犯罪死刑适用的量刑情节研究——基于死刑判例的实证考察

暴力犯罪是严重的犯罪行为,是死刑研究的典型样本。在＂保留死刑,严格控制死刑＂和＂宽严相济＂的刑事政策下,司法实践如何运用量刑情节来限制暴力犯罪死刑适用就成为重要课题。通过对暴力犯罪死刑判例的分析,总结出司法实践常见的几种量刑情节。根据这些量刑情节对暴力犯罪死刑适用的影响程度,将量刑情节分为三个量刑等级的情节,即将量刑情节等级化。根据三个量刑等级的情节,运用不同的处理方式来解决量刑情节竞合与冲突的问题,能够有效的从量刑情节方面来限制暴力犯罪的死刑适用。