颅内出血患者血清IL-6、TNF-α变化在法医临床鉴定中的意义

目的探讨颅内出血患者血清IL-6、TNF-α的水平变化及在法医学的临床意义。方法采用酶联免疫吸附法(ELISA)对颅内出血患者住院后不同时间段血清IL-6、TNF-α水平进行检测,并与正常对照组的健康受试者进行比较分析。结果研究组重型与轻型患者后第1、3、5、7天血清IL-6、TNF-α水平较正常对照组明显增加,重型患者入院第5、7天的血清IL-6、TNF-α较轻型患者明显增加,差异有统计学意义(P0.05);根据患者最后结果(死亡组和存活组),发现死亡组随着时间延长,在第5、7天时IL-6、TNF-α水平显著高于存活组(P0.05)。此外,血清IL-6和TNF-α水平呈正性显著相关(r=0.721,P0.05)。结论检测颅内出血患者血清IL-6、TNF-α水平对观察其病情变化有重要意义,可作为法医学鉴定的辅助手段。     

论法医学领域的标准化方法

通过对法医学领域标准化工作存在问题的分析,结合标准化方法的演变历程,运用标准体系和综合标准化的理论和方法,指出法医学领域标准化方法应以需求导向为主,通过构建标准体系指导标准化工作的开展,填补标准缺项,完善现有标准,同时积极适应多专业协同鉴定的发展需求,推进标准综合体的建立,并不断提升制标参与度,加大宣贯,促进标准的应用。     

人隐瞒信息状态下多通道事件相关电位的研究

目的采用隐瞒信息测试(concealed informationtest,CIT)模式和多通道事件相关电位(event related potential,ERP)技术,对人类大脑在不同刺激下各脑区域活动情况和活跃程度进行对比,从神经电生理学层面揭示CIT模式隐瞒信息状态下视觉刺激人类大脑认知相关脑功能区特征。方法参考犯罪知情测试模式(GKT)的CIT模式,选用传统扑克牌,对17名被试人员进行视觉刺激,包括:靶、探测、无关和中立刺激,获得29通道ERP波。结果靶、探测和无关刺激平均按键反应时间:775ms、774ms和720ms;探测和无关刺激各通道P300峰潜伏期配对t检验,有统计学意义(P0.05)的通道有4个;探测和无关刺激各通道P300平均波幅(400~700ms)进行配对t检验,有统计学意义(P0.05)的通道有19个。结论隐瞒知晓信息是一个由多个脑功能皮质共同完成的复杂过程,与诚实反应抑制有密切关系,与额叶前部和上部皮质、前扣带回皮质(ACC)和缘上回等脑功能皮质特异相关。     

听力正常人的长潜伏期听觉诱发电位

目的探索长潜伏期听觉诱发电位(auditory long latency response,ALR)潜伏期、波幅与声刺激强度间的关系和特点,并探讨其在听阈评估中的意义。方法对46名听力正常人(92耳)进行ALR测试,予受试者从70、50、30、20至10 dB nHL 5个声刺激强度顺序诱发ALR波形,标记N_1波、P_2波,得出三个观察指标(N_1波及P_2波潜伏期、N_1-P_2波幅)的数值。分析观察三个指标的变化趋势及频率差异性。结果 46名听力正常人(92耳)ALR波形的引出率均为100%。随着声刺激的降低,ALR的N_1波、P_2波潜伏期延长,N_1-P_2波幅降低。结论在适宜的条件下,ALR是一项稳定的检测技术。ALR的N_1波、P_2波潜伏期及N_1-P_2波幅与声刺激强度间的关系对ALR应用于听阈评估中有重要作用。     

外伤性癫痫及其法医学评定进展

外伤性癫痫(post traumatic epilepsy,PTE)是指颅脑损伤后的癫痫性发作,影像学检查可见器质性病变,脑电图检查可见异常脑电波与颅脑损伤部位一致。外伤后癫痫发生率低,案例报道较少,患者易夸大病情,给法医学鉴定增加难度。本文就外伤性癫痫流行病学、发病机制、临床治疗、法医学鉴定等方面的现状进行综述。     

Cultural histories of kumiss: tuberculosis,heritage and national health in post-Soviet Kazakhstan

In the nineteenth century, European doctors began to credit kumiss (fermented mare’s milk) for the apparent absence of tuberculosis among the nomads of the Eurasian steppe. As European and American medical journals published articles on the ‘kumiss cure’ and Russian doctors opened kumiss sanatoria, praise for the drink’s curative powers was wound together with romanticized images of the nomadic pastoralists whose creation it was. In Soviet and now in post-Soviet Kazakhstan, kumiss came to hold the double status of medicine and of national heritage. Yet if in the nineteenth century, the steppe was notable for the absence of tuberculosis, in the late twentieth century, it is notable for its presence: Kazakhstan, like many post-Soviet countries, is currently the site of an epidemic of drug-resistant tuberculosis. Discussions of the epidemic now tangle together concerns over the physical health of the population with concern over the cultural health of the body politic.     

北京市城镇医药卫生体制改革研究报告

现行医药卫生体制存在卫生资源不合理,医疗费用增长过快,公立医疗机构缺乏活力,卫生资源利用效率不高,药品监管工作亟待加强等问题,针对以上问题,本提出了我市城镇医药卫生体制改革的主要内容与原则建议。     

The Evolution of the Theoretical Foundations of Punctuated Equilibrium Theory in Public Policy

Punctuated equilibrium theory in public policy replicated from biological punctuated equilibrium theory has concluded that public policies alternate between stasis and punctuation. However, recent research on Pacific Northwest forest policy, U.S. state tobacco policy, and U.S federal auto efficiency policy have found no punctuations despite an attempt to do so. What is the efficacy of using biological punctuated equilibrium theory to also explain punctuated equilibrium in public policy? Significant differences exist between biological and public policy punctuated equilibrium theory including time frames for change, what constitutes outside disturbances of equilibrium, venues of punctuated equilibrium, levels of analysis for change, and patterns of change. Most policy research on punctuation has focused on the “tone” of media coverage related to change. Some recent studies concluding no punctuation occurred have focused on government action or inaction. Proving strong inference in scientific research requires a clear and viable syllogism linked to appropriate methodology. Both of these crucial elements are now in question in punctuated equilibrium research in public policy.     

法医牙科学研究进展CSCD

法医牙科学是法医学与口腔医学的交叉学科,通过科学地收集、检测、评价牙科证据而为司法实践提供有法律效力的证明资料。本文从年龄推断,性别推断,种族、职业及生活习惯推断,个体识别,家庭暴力或虐待行为判定等方面对法医牙科学的应用现状进行综述,并对其未来应用进行展望,希望对法医牙科学体系进行不断的补充和完善,使其在法医学甚至司法实践中更好地发挥作用。     

Participation in welfare legislation—A poverty-aware paradigm

Public participation, responsive regulation, and other policy formulations are intended to draw governments down from their ivory towers and into engagement with the people. However, they paint at best, a hazy picture of who “the people” are. This superficial representation is felt, among other collectives, by people living in poverty, who not only face hunger, often accompanied by poorer health and lower life expectancy, but whose social exclusion typically goes unrecognized by the authorities. The legal framing of poverty—and, as a result, states' policy approaches to its alleviation—focuses on the material core, representing a very thin conceptualization that fails to address the social dimension. Furthermore, practical avenues for incorporating citizens' views into lawmaking—which might enrich understanding—are lacking when it comes to people in poverty. Combined with a blatantly hegemonic stance, the resulting ignorance around poverty and “the poor” generates welfare laws that are woefully out of touch with reality, and legislative thinking that perpetuates, rather than alleviates, poverty. This paper seeks to make a twofold contribution: (i) to demonstrate this situation with a deep empirical inquiry into the legislative process of one legal provision within the Israeli welfare law regime, juxtaposed against qualitative field-research findings and (ii) to introduce the inventive and groundbreaking “poverty-aware” paradigm, constructed in social-work discourse, to illuminate and explain the empirical findings and point to potential procedural–institutional reform, to pave the way for poverty-aware legislation.