全国农村医疗救助现状、问题与对策

医疗救助属于社会救助的范畴,医疗救助对象是符合条件的五保户、特困户和其他贫困群众。各地民政部门通过农村医疗救助基线调查发现,在农村2542万（其中,五保户570万,特困户1972万）“不救不活”的特殊困难人口中,因病致贫、因残致贫的比例平均为49．8％。在因病、因残致贫人员中,得大病人数,其比例为3％至15％左右。目前,全国有1501个县开展了农村医疗救助工作,初步形成了比较系统的农村医疗救助制度框架,形成了不同的农村医疗救助模式。针对目前农村医疗救助工作中存在的主要问题,今后农村医疗救助应逐步形成在推进中规范,在规范中推进的良性机制。     

220例鼓膜穿孔性质分析

通过对 220例鼓膜穿孔鉴定的回顾,得出外伤鼓膜穿孔与炎性鼓膜穿孔在性别、年龄、耳别、穿孔形状、部位、大小、听力丧失程度、愈合时间、穿孔原因以及附着物上均具有显著性或极显著性差异 ,且这种差异与其穿孔机制有很大相关性;在比较分析基础上还提出了两种穿孔的鉴别要点,这对于临床法医检案具有较好的参考价值。     

非法行医罪的刑事政策分析

非法行医罪属于典型的法定犯罪,应在罪刑法定的前提下,合理划分刑法和行政法不同的规制范围,并坚持处罚上的轻刑化原则;在对非法行医犯罪化的过程中,应以法益侵害为基准,从非法行医行为是否严重侵害了国家医疗卫生管理秩序和公众生命健康权益这一实质标准去把握;对非法行医行为的刑法规制应坚持谦抑原则,尽管目前本罪非犯罪化的条件尚不具备,但非刑罚化措施应广泛适用.     

社会转型与农村医疗卫生

随着我国进入社会转型加速期,农村医疗卫生的宏观环境发生了重大变化,农民对健康越来越重视,健康观念对农民生活的影响也越来越大.农村疾病模式也正向慢性病模式转变,农民面临双重疾病负担.农民求医难、看病贵问题仍然没有得到很好解决,新农村建设中必须大力加强农村医疗卫生建设.     

输血后艾滋病的司法鉴定

本文综述了近年来输血后艾滋病病毒感染、艾滋病发病情况及其影响因素,强调了按照国家法律,法规,严格控制血液制品进口,采血部门严格筛查,供血单位规范生产,用血医院严把指征,以及受血病人知情理解是避免输血后艾滋病病毒感染和艾滋病法律纠纷的关键。阐述了输血后艾滋病病毒感染及艾滋病发病的司法鉴定工作要点。     

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.     

Medium‐Chain Acyl‐CoA Dehydrogenase Deficiency in Adulthood: A Potential Diagnosis in a Patient with Mental Status Changes Suspected of Drug Toxicity

Medium‐chain acyl‐CoA dehydrogenase (MCAD) deficiency is a rare but important component of the differential diagnosis for adults with a history of premortem mental status changes and the postmortem finding of hepatic steatosis. This case report describes a 30‐year‐old white man who, following a period of nausea and vomiting, was admitted to the hospital with sudden mental status deterioration followed rapidly by clinical deterioration and death. Treating physicians in this case suspected acute illicit drug toxicity with synthetic cathinones based on social history. Clinicians and medical examiners should be aware that the presentation, signs, and symptoms described may indicate an underlying inborn error of metabolism such as MCAD deficiency and take action accordingly.     

Human Cutaneous Myiasis by the Australian Sheep Blowfly,Lucilia cuprina (Diptera: Calliphoridae), in Oklahoma

This case report describes an incident of myiasis in Oklahoma City, Oklahoma. Paramedics treated a 53‐year‐old man in the field when he suffered cardiac arrest. He was intubated by the paramedics and transported to an emergency room, where he received two stents and a balloon pump. He was found to have a GCS of three and remained in the hospital for 7 days before passing away. After his death, the breathing tube was removed, revealing the presence of several maggots. On closer inspection, the dipteran larvae were found in both the oral and nasal cavities. Four of these larvae were reared to adulthood and identified as Lucilia cuprina (Weidemann) (Diptera: Calliphoridae), commonly known as the Australian sheep blowfly, by the Biology Department of the University of Oklahoma. Based on the fly's life cycle and rate of development, the infestation is suspected to be hospital acquired.     

城市“两不靠”老年群体养老保障问题研究——以福州市为例

"两不靠"指靠不上享受退休金,又不符合低保条件,依靠自己年轻时积蓄或子女提供经济支持养老的老年人群体。本文围绕这一群体社会保障的现状进行讨论,提出解决思路:养老保障拟制订一次性缴款设立个人养老账户,通过政府补贴方式发给养老金;医疗保障拟单列管理,提高补贴额、放宽门诊报销范围。通过以上办法解决两不靠群体的社会保障问题,使他们共享改革开放成果。     

非法行医罪若干问题探讨

非法行医罪是我国1997年新刑法第三百三十六条第一款设定的新罪名。由于新设罪名的不周延,导致在对于非法行医造成病人死亡或者严重损害就诊人身体健康等理论上存在很大分歧,争议颇大。对于非法行医罪的结果加重犯应着重考虑非法行医与结果之间的直接因果关系,被害人的承诺不应成为阻却非法行医的事由,我国内地非法行医的共犯问题较为常见,而网络空间的医疗行为也有可能被认定为非法行医。