冠状动脉肌桥与心源性猝死

冠状动脉肌桥也称冠脉肌桥或心肌桥,是一种先天性冠状动脉分布走行的发育畸形,为冠状动脉某一段或其分支的某一段走行于心外膜下的心肌层内。这种先天性冠状动脉分布走行的发育畸形可以引起猝死,在尸体解剖中也较为常见。本文对冠脉肌桥的形态学特点、临床影像学与心电图改变、猝死机制以及法医学鉴定中需要注意的问题等方面进行了阐述。     

正交试验设计辅助Pc-Crash实现事故再现分析

目的利用Pc-Crash实现事故再现分析时,探索由参数敏感性分析方法确定那些对仿真结果有显著影响的参数,通过对这些参数进行合理处理尝试提高仿真结果的精度。方法引入基于正交试验设计的参数敏感性分析方法。结果将此方法应用到Pc-Crash优化计算器内参数敏感性分析的实践中,获得了对碰撞后车辆运行轨迹有影响显著的参数。通过对一实际碰撞试验的再现研究,验证了敏感性分析所得结论在指导优化参数选取方面的有效性。结论研究表明借助正交试验设计辅助Pc-Crash实现事故再现分析具有实用价值。     

道路交通事故精神伤残评定相关问题

近年来,道路交通事故频繁发生,造成严重的人身伤害。许多颅脑损伤患者伤后常出现明显的行为或认知缺陷,创伤性脑损伤患者精神障碍的患病率明显增高,精神伤残的评定日益增多。但同时,关于精神伤残评定的争议也日益激烈。首先介绍国内外精神伤残的相关概念,然后分析道路交通事故精神伤残评定标准存在的不足和缺陷,重点分析道路交通事故中精神伤残程度的影响因素,并介绍精神伤残评定中的检查方法,最后提出解决精神伤残评定分歧的思路。     

医疗意外损害赔偿中的国家责任

现代科技发展使大量新的技术和产品在医疗诊治中广泛运用,各种潜在的危险因素致使医疗意外损害发生的机率大幅上升,在不可归结于医师和患者等方面的原因而造成对患者合法权益损害的情况下,同样要得到相应利益的补偿才合乎社会的公平和正义。故社会必须建立一种能合理而迅速地分配责任风险、消化损害的国家补偿机制,以实现对被害人的权益保障。     

Manifestations and Medicolegal Significance of Loeys–Dietz Syndrome

Loeys–Dietz syndrome is a recently described autosomal dominant disorder with underlying vasculopathy characterized by aortic and other vascular aneurysmal dissection/rupture. A 61‐year‐old man is reported who died suddenly and unexpectedly and at autopsy was found to have a ruptured abdominal aortic aneurysm. Additional findings included dolichostenomelia, high‐arched palate, and pectus excavatum. There was a strong family history of Loeys–Dietz syndrome, although the decedent had never been tested. Death was, therefore, due to a ruptured abdominal aortic aneurysm in a case of probable Loeys–Dietz syndrome. Although Loeys–Dietz syndrome shares common characteristics with Marfan and other connective tissue syndromes, it is a distinct entity with a much more aggressive clinical course. Lethal events may not occur until later adult life; however, the identification of the syndrome and differentiation from other connective tissue disorders at autopsy is important so that genetic investigation of close relatives can be undertaken with prophylactic surgical treatment if necessary.     

A Novel Pixel‐Based Method to Estimate the Instantaneous Velocity of a Vehicle from CCTV Images

In traffic forensic identifications, it was usually unfavorable that estimated velocities of questioned vehicles derived from frame‐based methods eventually turned out to be close to but a bit less than speed limits. In this paper, a novel pixel‐based method was presented to estimate vehicles’ relatively instantaneous velocities. First, two adjacent pixels’ actual distance was acquired from the closed‐circuit television (CCTV) images. Then, the instantaneous average velocity within this one frame interval time (FIT) was calculated out. The frame‐based method and its evaluating result were also introduced in this paper. The results showed that the velocity estimated by this new pixel‐based method was higher than which derived from the frame‐based method. Employing this presented novel method in these cases, it could be more accurately identified whether or not the vehicles had exceeded the speed limits, and then the responsibilities could be consequently assigned impartially.     

论医疗事故罪中“严重损害就诊人身体健康”之认定

认定医疗事故罪"严重损害就诊人身体健康"的具体内涵应遵循医学依据而非刑法学依据,同时应把握"二维"标准首先,是<条例>和新<标准>中的一级乙等和二、三级医疗事故;其次,事故参与度必须在50%以上(不含50%).     

车祸致颅脑外伤儿童的智力特点分析

目的探讨颅脑外伤的儿童智力特点。方法对43例因车祸导致颅脑外伤儿童和50名正常儿童的韦氏智力测验结果进行比较。结果车祸致颅脑外伤儿童的智力水平普遍下降,其总智商、言语智商和操作智商均显著低于正常对照组,弥漫性颅脑损伤对智力的损伤最大。结论颅脑外伤儿童智力水平普遍下降,弥漫性颅脑损伤对智商的损伤最大。     

12例静脉输液过程中猝死的死因分析

从2002—2004年,在我们司法鉴定中心共解剖208例尸检病例,其中死于静脉输液过程中的有12例,占总数的5.8%。其中,有8例发生于医疗条件较差的农村诊所。这些死亡事故的主要原因为忽视静脉输液的适应证和禁忌证。尸检资料显示,9例猝死原因直接或间接与静脉输液有关。其余3例则死于其原先疾病,不过死亡时间与静脉输液时间偶然巧合而已。