ABSTRACT
On the basis of retaining the technical identification system of medical negligence, the Medical Association Identification Rules of Medical Damage mainly provides technical services for various types of conciliation work about doctor-patient dispute. Its identification work is still influenced by the thinking of medical negligence technical identification and has certain administrative color. Guidance for Judicial Expertise of Medical Malpractice is mainly reflected that the trial of civil cases and pre-trial mediation of courts need service. Its procedures and evidence review are strictly required by the litigation rules and has the characteristics of public legal services provided as a third-party neutral institution. Technical identification of medical damage, whether organized by the Medical Association or the forensic identification institutions, is carried out under the background of the current Regulations on the Prevention and Treatment of Medical Disputes and the Civil Code of the People's Republic of China; both have a corresponding positive role in regulating the medical damage identification activities, and have also laid a certain foundation for the establishment of a unified identification system in the future in China. To understand the different characteristics of the medical damage identification rules issued by the Chinese Medical Association and the Ministry of Justice, and to improve the understanding of the standardization of the forensic identification of medical damage, a comparative study was conducted on Medical Association Identification Rules of Medical Damage and Guidance for Judicial Expertise of Medical Malpractice from seven aspects: Concept and legal status, entrust of identification, identification acceptance, identification procedures, identification presentation meeting, theory of medical malpractice evaluation, consequences and causality of medical damage. The subject of evaluation, the function of evidence review, the role of consulting experts, the technical standard system of malpractice evaluation and other contents were emphatically analyzed.
Subject(s)
Humans , China , Forensic Medicine , MalpracticeABSTRACT
From January 15 to March 3, 2020, seven editions of the guidelines for the diagnosis and treatment of COVID-19 have been issued successively by the National Health Commission of the People's Republic of China, and the guidelines' name was changed from Guidelines for Diagnosis and Treatment of Novel Coronavirus Pneumonia to Diagnosis and Treatment for COVID-19. It optimized and perfected the etiology, clinical manifestations and types, diagnostic procedures and specific treatment measures of the disease, so that the clinical management of the cases was more scientific. In the revision process of guidelines for diagnosis and treatment, forensic medicine experts have also made some positive suggestions on clinical diagnosis and treatment. Especially regarding the pathological changes of COVID-19, they have repeatedly called for rapid autopsy at different levels. With the support, understanding and cooperation of all parties, pathological examination of more than ten cases of the remains were carried out, which made an important contribution to the understanding of the clinical characteristics and pathological characteristics of the disease and the improvement of treatment plans.
Subject(s)
Humans , COVID-19 , China , Clinical Protocols , Forensic Medicine , SARS-CoV-2ABSTRACT
<p><b>OBJECTIVE</b>This study aimed to investigate the genetic background of mitochondrial genes in young patients with Coronary heart disease (CHD) to provide a foundation for the early prevention of young patients with CHD.</p><p><b>METHODS</b>115 cases of young (⋜ 45 years) CHD Chinese Han patients (case group), 100 cases of older (> 45 years) Chinese Han CHD patients (experimental group) hospitalized and 100 cases of healthy people through physical examination (control group) at the General Hospital of PLA between January 2014 and December 2015 were selected. General information, clinical assessment, pedigree analysis, and mitochondrial full sequence scanning were performed. The pedigrees of one patient harbouring the C5263T mutation were recruited. Mitochondrial functional analysis including cellular reactive oxygen species (ROS) levels and mitochondrial membrane potential (MMP) were performed on pedigrees with the C5263T mutation (mutation group) and without the mutation (non-mutation group).</p><p><b>RESULTS</b>The differences in biochemical tests (P > 0.05) between the case group and experimental group were not significant. The C5263T single-nucleotide mutation of the mitochondrial ND2 gene was observed in 2 young CHD patients in the case group. The premature CHD of these 2 patients followed a pattern of maternal inheritance. The mutation group (I1, II2) had higher ROS levels (4750.82 ± 1045.55 vs. 3888.58 ± 487.60, P = 0.022) and lower MMP levels (P = 0.045) than the non-mutation group (II1, III1, III2).</p><p><b>CONCLUSION</b>We speculated that the mitochondrial C5263T mutation might be associated with the occurrence CHD in Chinese Han young people.</p>