仵作研究评述

仵作这一角色在中国历史上的地位比较特殊。早期工作主要为往返于民间丧葬和衙门招募之间,检尸验伤逐渐成为他们的专业与职责;直至清代,仵作才正式成为衙门的吏役。随着对法医学研究的深入,仵作逐渐引起学界的重视,上个世纪法医学界试图重现中国法医学史,仵作在此领域中的重要性日益受到关注,诸多学人从官方规制的角度构建并完善了法医学中的仵作话语结构,更是对仵作向近代法医的转变给予了极大的关注。然囿于史料的缺失,完整的仵作研究情况仍不可尽知。本文拟对近年来一系列仵作研究成果进行综论,并提出推进仵作研究的若干思考。     

肩袖损伤法医学鉴定研究进展

肩袖损伤是一种临床常见的肩关节病,成因复杂且症状有时不甚明显,缺乏特征性表现,容易被漏诊及误诊。在法医学鉴定中,时常遇到肩袖损伤的案例,判定该类案例是创伤所致、自身疾病抑或属于伤病共同作用导致是目前摆在法医鉴定人面前的难点问题。但因找不到客观的鉴别指标,容易使鉴定工作进入盲区,也时常引起当事人对鉴定意见的质疑,甚至长期的上访缠诉,引发社会的不稳定。基于此,从肩袖解剖结构、损伤机制、临床表现、鉴别诊断及法医学鉴定等方面展开论述,有助于为此类案件的鉴定提供参考。     

家兔死后离体血液ATP含量变化与放置时间的关系

目的探讨恒温(25℃)条件下家兔死后离体血液ATP含量变化与放置时间的关系。方法健康家兔8只,空气栓塞处死后即刻取右心室血液,置于25℃恒温水浴槽中,每4h应用ATP荧光快速检测仪检测血液ATP含量,所得数据应用SPSS17.0统计学软件进行方差检验及回归分析。结果恒温(25℃)环境下,家兔死后离体血液的ATP含量,在8h内从死后即刻的2.46×10-12mol/L升至3.09×10-12mol/L,8h之后则随PMI的延长而下降,直至56h,56～72h ATP含量在0.13×10-12mol/L时趋于稳定。以Log[ATP]为因变量(y),离体放置时间为自变量(x),对死后0～56h的数据进行回归曲线分析,建立了3个推断离体时间方程,即y=-0.019x-11.359(R2=0.763)、y=0.001x2+0.016x-11.666(R2=0.962)和y=-1.281×10-5x3-0.007x-11.576(R2=0.980),其中三元回归方程的系数为0.980,曲线拟合度最好。结论家兔离体血液ATP含量变化与放置时间呈现一定的规律性,有望应用于死亡时间推断。     

The Black body and the Jewish body: a comparison of medical images

Hödl attempts to show how deeply the medical views of Blacks and Jews were embedded in racial theories in the nineteenth and early twentieth centuries. Concepts of racial distinctiveness formed the framework that purportedly explained a specific liability of African Americans and Jews to various ailments. In particular, he compares the prevailing perception of the susceptibility of Jews and Blacks to tuberculosis in the United States from the 1840s to the early twentieth century, and shows that physicians advanced widely differing explanations for the proclivity to this disease, explanations that fall into three distinct periods. Within the same time span, however, there is continuity in the concepts of the 'sick Negro' and the 'healthy Jew'. The aetiologies were largely dependent on stereotypes of the bodily constructs of Jews and Blacks. Hödl thereby demonstrates the interdependence of racism and medicine.     

The relationship between alcohol elimination rate and increasing blood alcohol concentration--calculated from two consecutive blood specimens

In the period 1991-2005, a blood-alcohol concentration (BAC) analysis was carried out at the Institute of forensic medicine in Novi Sad including 2023 two consecutive blood specimens using the Headspace Gas Chromatography method. Cases with no alcohol concentration values, as well as cases where blood samples were taken within 1 h after the criminal act, were not taken into consideration. Following this rule, 1198 cases were considered in this study and all samples were grouped in 29 ranges of BAC1 of delta(BAC) = 0.1 g/kg, starting from 0.1-0.19 g/kg to 2.9-2.99 g/kg of absolute alcohol. Gathered results and elimination curve differ from the zero-order model of elimination proposed by Widmark and point to an elimination process similar to a well-known Michaelis-Menten elimination kinetics model and its variants. Results reported in this study show dependence of alcohol elimination rate (beta-slope) and BAC value. The analysis of beta60-slope versus BAC shows that a correlation between beta60 (y) and BAC (x) has a logarithmic trend line. The value of alcohol elimination rate shows a slight increment with increase of BAC alcohol, with the mean value of beta60 = 0.221 +/- 0.075 g/kg. Differences in values of beta60 among consecutive intervals of delta(BAC) = 0.1 g/kg are not significant (p>0.05). When obtained samples were grouped into ranges of 0.5 g/kg each in these intervals beta60 had the following values by range: 0.1-0.49 g/kg = 0.139 g/kg +/- 0.035; 0.5-0.99 g/kg = 0.184 g/kg +/- 0.043; 1-1.49 g/kg = 0.213 g/kg +/- 0.052; 1.5-1.99 g/kg = 0.239 g/kg +/- 0.058; 2-2.49 g/kg = 0.265 g/kg +/- 0.073; 2.5-2.99 g/kg = 0.306 g/kg +/- 0.096. Differences in values of beta slope among consecutive intervals of delta(BAC) = 0.5 g/kg are significant (p<0.01). The elimination curve in the BAC interval 0.5-2.5 g/kg has a linear trend, while beta-slope (y)/BAC (x) correlation is given as beta60 = 0.15 g/kg + (0.05 g/kg x BAC). Retrograde calculation of the blood alcohol concentration in tempore criminis (BAC(tc)) based on the determined alcohol concentration in the blood specimen (BAC(t)) shows a statistically significant difference between BAC(tc) calculated using a standard zero-order model versus corrected methodology. The higher the BAC(t) and the longer the calculation time, the greater and statistically more significant (p<0.01) is the difference between the calculated values of BAC(tc).     

螺旋CT三维重建在肋骨骨折法医临床鉴定中的应用

目的探讨螺旋CT三维重建评价肋骨骨折在法医临床中应用价值。方法收集肋骨骨折35例,分别采用X线摄片、CT扫描及螺旋CT三维重建检查。结论35例检查都取得清晰的立体图像,且可以消除周围组织结构,单独观察肋骨骨折情况。结果:螺旋CT三维重建在肋骨骨折的诊断、法医临床学中有较高的价值。     

药物遗传学在法医学中的应用前景

人类因为基因的差异而表现出对某种药物、毒物、外界有害的化学物质、过敏原作出不同的反应.这种遗传背景的差异使一些人可以快速地清除这些物质,而另一些人却因此产生严重的不良反应.甚至死亡.药物遗传学和药物基因组学,通过对人类基因组测序和大规模基因组多态性的鉴别研究,诠释了个体遗传差异与对药物毒物不同反应之间的关系,这为该类案件的法医学鉴定提供了新的理论基础和研究手段.     

新冠疾病对法医学鉴定的影响和挑战

新冠疾病疫情之下,法医学鉴定活动不可能停止,法医学鉴定的对象可能为COVID-19。开展鉴定的法医人员面临很大的感染风险,因此法医鉴定机构和法医鉴定人应当提高感染风险认识,加强防控措施,提升防控应对能力,遵守法律及伦理规范,加强与临床有关问题研究。     

裁判医学在湘雅的起源与发展(英文)

裁判医学在中国的起源可追溯到19世纪20年代,并在此后得到了迅速发展。本文以湘雅医学院裁判医学的学科发展历史为主线,阐述了裁判医学的演进,包括科学理论基础、法律制度和政策支持三个方面。本文旨在探求裁判医学在湘雅医学院的发展历程,呈现中国近现代法医学的缩影,并为中国法医学发展提供历史参照。     

1 003例中医体质类型流行病学调查分析

目的:初步了解安徽省自然人群的中医体质类型分布状况。方法:采用标准化的9种中医体质量表对1 003例自然人群实施横断面现状调查。结果:平和质561例,单纯偏颇体质247例,兼夹偏颇体质195例。8种偏颇体质总的分布状况是,气虚质最多(235例,单纯气虚质与兼夹体质中气虚质例数之和,下同),其次为湿热质(128例)、气郁质(122例)、痰湿质(80例);阳虚质(71例)、阴虚质(52例)和瘀血质(42例)最少,阴虚质与瘀血质主要出现在兼夹体质中。结论:9种体质在人群中的分布存在一定的差异性,兼夹体质在人群中占有一定的比例。