“事实自己说明”在英美医疗过失诉讼中的应用——兼与我国医疗侵权的举证责任分配相比较

在英美过失侵权中,通过“事实自己说明”原则的适用,推断出被告具有过失,举证责任转移至被告。在医疗过失案件中,“事实自己说明”适用于不需要专家证据,“一般人通过常识即可推断出被告具有过失”的情形。在我国医疗侵权诉讼中,实行的是双重推定。比较“事实自己说明”与双重推定,我国的双重推定违背了侵权法的预防与补偿功能。导致防御性医疗的出现,不利于医患关系的和谐。建议修改我国的双重推定制度,仅对于不需要鉴定即可推断被告有过失的简单情形,才可实行过失推定。     

新药专利保护期限国际化法律冲突研究

在新药专利保护的国际化进程中 ,各国基于本国的国家利益以及归属该国的新药专利持有者或使用者的利益 ,对新药专利保护期限提出了不同的要求 ,使新药专利保护期限的国际化法律冲突日益明显化。文章针对此情况 ,从各国的期待利益出发 ,结合新药专利本身的特殊性及实现各国利益的次序性 ,运用经济学理论和价值分析方法 ,对国际化进程中的新药专利保护期限冲突法律解决机制作初步设计 ,并对该种机制的合理性作简要地论述     

棕尾别麻蝇的季节分布及虫态变化与死亡时间的研究

目的提供法医学死亡时间鉴定的准确性.方法在海拔1115.2～¨20.8m处每月投放一次诱饵,一天观察两次并详细记录,对嗜尸蝇类季节分布进行1年的调查研究.发现棕尾别麻蝇只在8、9、10三个月份繁殖后代而且虫态变化历期也出现明显差异.特别是10月份幼虫进入蛹期后发育历期持续到次年4月份才羽化出蝇,整个发育历期长达半年之久.结果这种有季节性分布的蝇类及特定季节发育历期延长的特点,对法医学推断死亡时间及对其它嗜尸蝇类的研究均有参考价值.     

全面系统的法医学尸体检验及常见失误的防范

法医学尸体检验是法医学检案鉴定工作中的重要环节,是保证鉴定质量的基础和前提。虽然各人所做方法、步骤略有不同,每一案例又各有特殊性,但力求全面系统和规范是其基本要求。狭义的全面系统尸体检验是指尸体解剖时不仅应剖验颅、胸、腹腔这“三大腔”,还应剖验脊髓腔及其它应解剖的部位。如脊髓腔、关节腔、骨骼、眼球、周围神经和软组织等。而广义上的全面系统法医学尸体检验则应包括上述尸解和提取并保存适当、足量、可靠的检材标本这两方面。其常见的失误有:①案情不清,致尸检方案错误;②准备不足,盲目尸检;③仅作局解,片面不全;④尸解不规范,操作不标准;⑤观察不仔细,遗漏损伤或病变;⑥描述不准,记录不明,图照不清;⑦取材不适当,不能反映事实。     

Age-at-death estimation based on the study of frontosphenoidal sutures

Determination of age at the time of death based on the observation of cranial sutures has led to numerous studies with sometimes contradictory results. The initial hypothesis being that suture closure is part of an age-related physiological process, the conflicting results have been interpreted by various authors as secondary to the choice of sutures, under the co-existing influence of pathological factors or genetic factors, or even independent of age. Despite these differences, macroscopic methods remain much used in anthropology and in forensic medicine. In our work, we evaluated the value of the degree of closure of the frontosphenoidal suture in estimating age at death of mature subjects, with the secondary objective of establishing a linear regression which could be used in routine practice. The study concerned bone specimens from individuals whose age, sex and medical history were known. Macroscopic observation was carried out on the ectocranial and endocranial sides according to four stages of closure previously defined. 290 sutures were taken from a population of whom two-thirds were men. The method can be repeated and reproduced and the regression established shows the confidence range for average error to be +/-1.5 years. While this result is of interest in terms of precision in prediction for a group of people, the prediction range is too great (+/-23 years) to be applicable to a single individual as part of a forensic procedure.     

Comparison of ethyl glucuronide in hair with phosphatidylethanol in whole blood as post-mortem markers of alcohol abuse

Ethyl glucuronide (EtG) is a direct metabolite of ethanol and has been used as a marker of alcohol abuse in both urine and hair. This study investigated the value of EtG testing in post-mortem hair for diagnostic improvement of alcohol abuse in forensic medicine. Material from 70 consecutive medico-legal autopsies was collected in accordance with the recommendations on ethics by the Swedish National Board of Forensic Medicine. A method for determination of EtG in hair samples was developed using ultra performance liquid chromatography/electrospray tandem mass spectrometry (UPLC/ESI-MS/MS; LOQ, 2.5 pg/mg). The result of the EtG analysis was compared with the findings of phosphatidylethanol (PEth) in femoral whole blood, as measured by high performance liquid chromatography with an evaporative light-scattering detector (HPLC-ELSD; LOQ, 0.22 micromol/l). Evaluation of liver histology and anamnestic evidence of alcohol abuse of the deceased were taken in consideration for the interpretation. Measurable levels of EtG were present in 49 of the 70 autopsy cases whereas PEth was present in 36. Thirty-nine cases had EtG levels above the cutoff limit (> or = 30 pg/mg) compared with 29 for PEth (> or = 0.7 micromol/l). Fifteen cases had EtG as exclusive indicator for alcohol abuse compared with four cases for PEth. These findings suggest that measurements of EtG in hair may provide improved diagnostic information on alcohol abuse, due to a long retrospective time-window for detection and stability of EtG in hair in the decaying cadaver. However, an EtG level below the cutoff does not completely exclude previous alcohol abuse.     

经脉脏腑与脑相关研究是中西医理论结合的突破口

近年来虽然一直在强调中西医结合,如何结合却是困扰广大医务工作者和科研工作者的难题.经脉脏腑与脑相关体现了作为整体的人的功能调控途径.在神经科学高度发展的今天,用医学科学语言阐释传统中国医学,经脉脏腑与脑相关研究无疑将会起到积极的促进作用.经脉脏腑相关不仅是经络理论研究的核心,更可能是中西医理论结合的突破口.     

不同听力水平听性稳态反应阈值与纯音测听阈值比较

目的探讨不同频率下不同听力水平的听性稳态反应（auditory steady-state responses,ASSR）阈值与纯音测听（pure tone audiometry,PTA）阈值的关系。方法对听力正常的志愿者及不同听力水平的感音神经性聋的志愿者共86例（172耳）,分别行PTA及500、1000、2000和4000Hz的ASSR,得出PTA阈值及ASSR阈值（单频刺激）。比较不同频率（500、1000、2000、4000Hz）下不同听力水平组（≤20、21～39、40～59、60～79、≥80dB）的ASSR阈值与PTA阈值之间的关系。结果各频率的ASSR阈值与PTA阈值均具有良好的相关性。但各频率下不同听力水平校正后的校正值均高于PTA阈值。结论应用ASSR阈值进行听阈级评估时需要进行校正,ASSR检测技术可以用于听力障碍法医学鉴定听阈级评估。     

创道的超声检测及法医学意义

陈旧性创道长度的测定是法医学鉴定中的难点,长期以来没有得到应有的重视。随着高频二维超声和彩色多普勒成像技术的运用,目前已可以准确地定量创道的长度。通过两例损伤程度鉴定案例,并结合超声图像,说明超声检测在损伤程度鉴定中有重要的价值,可以为损伤程度的鉴定提供有价值的科学证据。