Sudden Death Due to Undiagnosed Rheumatic Heart Disease in a Child

We report the case of a 5‐year‐old boy who died from complications of rheumatic heart disease with atypical presentation. He was hospitalized for recent inflammatory and neurological symptoms. He was diagnosed with viral encephalitis. He died the day after he was discharged. The macroscopic autopsy findings were unremarkable. Histology revealed typical rheumatic heart disease. Neuropathology showed cerebral infarction due to an embolic event linked with the rheumatic valvulitis. The cause of death was determined as heart failure due to rheumatic heart disease secondary to an undiagnosed acute rheumatic fever. It is related to an autoimmune response to infection with group A streptococcus. It mainly affects children in developing countries. In our case, viral encephalitis was consistent with the medical history and the proper diagnosis was made on histological analysis. Forensic pathologists should consider this diagnosis facing a sudden unexpected death in childhood, even in industrialized countries.     

Inferior Vena Cava Tumor Thrombosis Secondary to Metastatic Uterine Cancer: A Rare Cause of Sudden Unexpected Death

Pulmonary tumor thromboembolus (PTTE) secondary to uterine cancer is a rare cause of sudden unexpected deaths in the elderly population. Additionally, tumor extension to the inferior vena cava (IVC) makes it rarer. No such cases have been previously reported in the forensic literature. We report this phenomenon in a previously healthy 70‐year‐old woman with no other known risk factors for the development of deep vein thrombosis. The deceased was found dead while watching television with her relatives. Autopsy examination revealed that her death was attributed to a saddle embolus lodged in the main pulmonary arteries. A uterine tumor was discovered, and microscopic examination revealed low‐grade endometrial stromal sarcoma with angiolymphatic invasion. The tumor cells were also found in the embolus and the remnant thrombosis attached to the inner wall of the IVC. This case demonstrates a sudden unexpected death caused by acute PTTE following seeding of uterine cancer into the IVC and raises awareness of such events.     

论政府机关思想政治工作的基准点

对政府官员的思想政治工作搞了几十年何以成效甚微,一个重要的原因是对政府官员本质身份的定位不准确所致.政府官员同其他千千万万不同职业和自然人一样,也属于追逐自身利益的经济人的范畴,只有把握这一基准点,才能在制度建设、道德规范和思想教育等方面取得预期成效.     

论死刑的立法限制--基于国际标准的分析

限制直至废除死刑的国际标准,已在世界范围内得到普遍认同和推广.限于我国实情,当前不能废除死刑.但应立足国际人权公约标准,严格限制我国死刑立法.死刑实体立法限制表现为科学削减死刑罪名,限缩死刑适用对象.死刑程序立法限制表现为完善面临死刑者的诉讼权利、死刑执行方式与死刑减刑制度,并增设死刑赦免制度.     

马克思死刑思想研究——兼论对中国死刑改革的启示

马克思认为,在一个文明的社会裹,死刑是残暴的、不文明的、不人道的、不公正的、无效的、没有正当根据的,从而提出了在文明社会彻底废除死刑的主张。这必将封中国的死刑改革具有重大的指导性意义。     

白血病死亡的法医学鉴定

材料和方法回顾性研究我所2003～2005年间检案实践中4例白血病死亡的法医学鉴定案件。结果4例死者生前均无明显的血液病症状,其中1例死亡前经临床确诊为急性颗粒增多型早幼粒细胞性白血病（M3）,另外3例均无血液病相应的临床资料。尸体解剖主要所见：（1）多器官（尤其是脑）白血病细胞浸润;（2）肝、脾肿大;（3）凝血功能障碍引起的出血倾向,如：皮肤紫癜、创口渗血或迁延不愈等;（4）可排除暴力死亡。结论白血病细胞脑浸润引起的脑内血肿和血液病的并发症弥漫性血管内凝血（DIC）是导致死亡的常见原因;在白血病患者突发死亡的案例中,死者生前往往缺乏典型的血液病症状,或仅有轻微的症状未引起注意;此类案件的法医学鉴定应注意收集临床资料,必须进行系统的尸体解剖检验,在有检验条件的情况下应进行骨髓细胞学病理检验。     

人身侵权损害与死亡赔偿的制度理性

现代社会不断发生各种事故造成大量的人身及财产损害,针对这种现象构建良性的法律调整机制给人类智慧带来极大的挑战。我国目前正处于通过创制和健全相关民事立法——侵权责任法来积极应对各种事故导致人身与财产损害的关键时期。通过梳理我国现行人身侵权损害赔偿制度中分散多元多层级立法的大致脉络,提出生命的双重价值观命题以理性关照“同命同价”与“同命不同价”的热议,思考如何使侵权死亡赔偿范围及标准更趋于正当合理等问题,为完善我国相关立法略尽绵薄之力。     

Diagnostic value of post-mortem examination of the cardiac conduction system

Introduction (Aim)

Sudden unexplained death (SUD) is a common problem in forensic pathology. In many of these cases, the autopsy findings, toxicological examinations and patient history are inconclusive. Many studies suggest that in such cases, the cardiac conduction system (CCS) should be histologically examined. We decided to determine the diagnostic value of histological examination of the CCS.

Methods

We reviewed autopsy files from the period 2005–2007 and selected those cases in which the CCS had been sampled. These were divided into two groups, the first comprising cases with an obvious cardiac pathology (e.g. severe coronary disease, myocardial infarction, significant myocardial hypertrophy/dilatation, valvular disease, etc.) and the second comprising cases without obvious cardiac pathology (i.e. fatal injuries, intoxications and deaths unexplainable by routine procedures). The CCS was sampled according to a detailed protocol and examined under a light microscope. On the basis of the findings of histological examination of CCS, we formed subgroups of the aforementioned main groups.

Results

We analyzed 118 cases, of which 83 were males and 35 females. In 57% of cases, autopsy revealed gross pathological abnormalities of the heart. In 10 (15%) of them, examination of the CCS showed significant pathological changes (narrowing of the nodal artery and its branches, moderate to severe interstitial fibrosis, calcifications in the central fibrous body impinging upon CCS). In some, especially those with no acute findings, CCS disease can be considered to have been the cause of fatal arrhythmias. In 43% of cases, autopsy revealed no gross abnormalities of the heart, while histological examination of the CCS disclosed significant pathological changes in 4 (8%). Among them, CCS disease was regarded as the cause of death in one case and as a possible cause in another case.

Conclusion

As with other similar studies, our study showed that examination of the CCS can provide valuable information on the cause of death. We therefore consider that examination of the CCS should be performed in all SUD cases, especially those in which the cause of death cannot be established by routine procedures. Although we had only 1 confirmed cause of death linked to CCS disease and one possible, we had 14 cases with significant pathological CCS changes. This leads us to the conclusion that post-mortem examination of the CCS is of diagnostic value.     

商业贿赂犯罪刑法适用疑难问题探析

具有市场价格且受贿人实际取得价值的礼券应当计入商业贿赂犯罪数额;将免费旅游界定为商业贿赂,并非意味着与免费旅游相关的费用一概认定为商业贿赂数额;应将以金钱为背景、体现贿赂犯罪权钱关系的性贿赂认定为商业贿赂。受贿人在接受行贿人财物后提供了违反法律、法规、规章、政策、行业规范规定的帮助,但行贿人没有提出要求的,不能认定为“谋取不正当利益”。复数实行犯情况下以主犯的罪名确定将共犯认定为受贿罪还是非国家工作人员受贿罪,具有合理性,但在特殊情况下应根据共犯理论与有利于被告人原则进行调适。     

伦理责任抑或法律责任——对公司社会责任制度的重新审视

公司社会责任问题是一个涉及众多学科领域的具有综合性、交叉性的概念。虽然在我国《公司法》中已明确规定公司应当承担社会责任,但对公司社会责任的概念界定无论在理论上还是在实践中都一直存在争议。事实上公司社会责任有伦理意义上的社会责任和法律意义上的社会责任之别。前者可被称为道德化的社会责任或广义社会责任,后者则可称为法律化的社会责任即狭义的社会责任。通过分析道德化社会责任在伦理基础上和经济效益上与公司法基本理念的冲突,可以得出具有实际操作性的公司社会责任概念应采狭义的即法律化的社会责任概念。只有在关涉公共利益时才需要适用公司社会责任原则来考量公司和社会公共利益之间的平衡。