驾驶模拟器用于驾驶员安全教育的研究

本文简要介绍了我国交通事故和驾驶员安全教育现状以及驾驶模拟器用于驾驶员安全教育的前提条件,提出了驾驶模拟器用于驾驶员安全教育的虚拟道路交通视景系统的组成及设计方法,分析了驾驶员安全教育的虚拟道路交通视景特征及驾驶模拟器用于安全教育的可行性。     

围产期母婴医疗纠纷尸检49例分析

围产期母婴死亡所致的医疗纠纷在医疗纠纷的法医学鉴定中占有相当大一部分比例。本文从死者性别年龄、涉及医院、尸检结果、医疗行为过错情况等方面统计分析了49例围产期母婴死亡的医疗纠纷尸检案例,揭示了围产期母婴的常见死亡原因、医疗因素在其中的作用以及医疗纠纷的发生原因等,希望能对该类医疗纠纷的法医学鉴定、医疗纠纷的正确处理和防范提供帮助。     

人体器官肺的体积、密度检测及其医学和法医学意义

目的积累不同种族人体器官组织体积和密度的基本数据。为病理学和法医学尸检提供简便、可靠的诊断方法。方法应用电子智能化体积-密度仪,同步检测正常人及各种疾病死者肺的质量、体积、密度。结果获得正常肺和不同程度弥漫性肺水肿病变器官体积和组织密度;在2例医源性循环超负荷和水中毒案件的法医病理学鉴定中,用肺密度值证实了常规病理组织学形态不典型的严重低渗性肺水肿。结论大体检测器官密度对尸体解剖的综合病理诊断具有一定的辅助意义。     

Reduction of postmortem angiography-induced tissue edema by using polyethylene glycol as a contrast agent dissolver

Postmortem investigation is increasingly supported by computed tomography (CT) and magnetic resonance imaging, in which postmortem minimal invasive angiography has become important. The newly introduced approach using an aqueous contrast agent solution provided excellent vessel visualization but was suspected to possibly cause tissue edema artifacts in histological investigations. The aim of this study was to investigate on a porcine heart model whether it is possible to influence the contrast agent distribution within the soft tissue by changing its viscosity by dissolving the contrast agent in polyethylene glycol (PEG) as a matrix medium. High-resolution CT scans after injection showed that viscosities above c. 15 mPa s (65% PEG) prevented a contrast agent distribution within the capillary bed of the left ventricular myocardium. Thereby, the precondition of edema artifacts could be reduced. Its minimal invasive application on human corpses needs to be further adapted as the flow resistance is expected to differ between different tissues.     

论“虚拟财产”

虚拟财产是在网络环境下以电子数据为载体的财产,是个人财产的一种特殊形式,它具有传统财产的法律属性.法律对虚拟财产的保护有利于现代财产制度的完善和健全,从而促进社会的稳定和发展.     

心外科手术后死亡医疗纠纷尸检分析

目的从尸检角度讨论心外科手术后死亡的死因及诊疗缺陷。方法按临床诊断、手术类型、死亡时间、死亡特点、尸检特点、纠纷特点、诊疗缺陷等方面,比较所选案例的临床、尸检资料特点。结果心瓣膜置换手术4例,冠心病冠脉搭桥手术1例,先心病大动脉转位手术1例。心肌梗死2例,心肌广泛损伤1例。心内膜感染2例,多器官功能衰竭1例。家属怀疑诊疗不当6例。诊疗缺陷主要为手术适应证、手术时机,手术器材的选用,手术操作,术后病情观察、处理不及时,对病情严重程度、手术风险及预后的告知不充分。结论尸检不仅能查明死因,还可帮助评价手术质量、术后处理的诊疗质量,对解决纠纷具有重要的辅助作用。     

The association between body mass index and pulmonary thromboembolism in an autopsy population

Abstract: To evaluate the association between obesity and pulmonary thromboembolism (PTE) in a forensic context, 160 autopsy cases of fatal PTE were compared with age‐ and gender‐matched controls. The mean age of cases was 66 years (range 26–98 years; M/F 74:86). The mean body mass index (BMI) of cases with PTE was 30.88 (range 14.95–79.51), which was significantly higher than in the controls (mean BMI = 25.33; range 12.49–61.84) (p < 0.0001). Comparing the group with PTE with controls showed that five (3.1%) compared to 20 (12.5%) were underweight, 39 (24.4%) compared to 67 (41.88%) were of normal weight, 49 (30.63%) compared to 43 (26.88%) were overweight, 43 (26.88%) compared to 24 (15%) were obese, and 24 (15.0%) compared to six (3.75%) were morbidly obese. In each category of above‐normal BMIs, there were significantly greater numbers in the groups with PTE: overweight (p < 0.01), obese (p < 0.001), and morbidly obese (p < 0.0001).     

Pathologic evaluation of the cervical spine following surgical and chiropractic interventions

When patients die after chiropractic or surgical interventions of the cervical spine, pathologists tasked with the autopsy are frequently overwhelmed by the complicated anatomy, laborious dissections, complex operative procedures and surgical hardware, and the necessity to differentiate artifacts from trauma and disease. However, abundant data can be obtained from careful evaluation of the cervical spine in situ; extensive postmortem diagnostic imaging procedures; detailed dissections of the removed, formalin-fixed and decalcified spine; and histology. This study presents a regimented, stepwise approach to the evaluation of the cervical spine in these difficult cases, promotes uniform assessment, facilitates diagnoses, and supports the accumulation of otherwise hard-to-come-by reference material that can be of value in future cases. The resultant detailed autopsy findings may prove useful in the medico-legal death investigation process. Autopsy findings may also be of great value to health care providers involved in quality assurance processes.     

Animal-related fatalities--part II: characteristic autopsy findings and variable causes of death associated with envenomation, poisoning, anaphylaxis, asphyxiation, and sepsis

In addition to blunt and sharp trauma, animal-related fatalities may result from envenomation, poisoning, anaphylaxis, asphyxiation, and sepsis. Although the majority of envenomation deaths are caused by hornets, bees, and wasps, the mechanism of death is most often anaphylaxis. Envenomation resulting from the injection of a poison or toxin into a victim occurs with snakes, spiders, and scorpions on land. Marine animal envenomation may result from stings and bites from jellyfish, octopus, stonefish, cone fish, stingrays, and sea snakes. At autopsy, the findings may be extremely subtle, and so a history of exposure is required. Poisoning may also occur from ingesting certain fish, with three main forms of neurotoxin poisoning involving ciguatera, tetrodotoxin ingestion, and paralytic shellfish poisoning. Asphyxiation may follow upper airway occlusion or neck/chest compression by animals, and sepsis may follow bites. Autopsy analysis of cases requires extensive toxinological, toxicological, and biochemical analyses of body fluids.     

Influenza A/H1N1 (2009) Infection as a Cause of Unexpected Out‐of‐Hospital Death in the Young*

Abstract: In March 2009, a new strain of influenza A/H1N1 virus was identified in Mexico, responsible for a pandemic. Worldwide, more than 13,500 patients died, most often from acute respiratory distress syndrome. Because sudden death cases were rare, involving mostly young apparently healthy persons, influenza A/H1N1 (2009)‐related deaths may be misdiagnosed, which can raise medico‐legal issues. Case history: we report on an unexpected out‐of‐hospital death involving a young male with no past medical history and no vaccination. Fever was his only symptom. Laboratory tests: histology showed patchy necrotic foci with mononuclear inflammation in the lungs. The heart was histologically normal, but virological analyses using molecular biology on frozen myocardial samples showed high virus load. In conclusion, this case report shows that influenza A/H1N1 (2009) virus can be a cause of sudden cardiac death in the young and demonstrates the importance of quantitative virological analyses for the diagnosis of myocarditis.