Comparison of Medical Dispute Resolution Mechanisms in China and Abroad / 法医学杂志

Medical disputes are one of the common problems concerned by the whole world. All countries and regions have established their own medical dispute resolution mechanisms, in accordance with their own national conditions. Medical dispute identification opinions, as one of the important bases for identifying the responsibilities of both doctors and patients, play a pivotal role in the process of dispute settlement. A reasonable medical dispute resolution mechanism and standardized medical dispute identification model can help resolve disputes flexibly and reduce the conflict between doctors and patients. This paper briefly compares the medical dispute resolution mechanism and identification mode of China and several other representative countries (the United States, Britain, France, Germany, Italy, Japan, etc.), and discusses their respective characteristics and shortcomings, to bring some enlightenment to the medical dispute resolution and identification in our country.

Characteristics and Forensic Identification of Blunt Vertebral Artery Injury / 法医学杂志

Blunt vertebral artery injury occurs frequently in forensic practice. However, injuries of the vertebral artery are easily ignored or overlooked because of its relatively deep location. Through literatures review, this paper finds that the manners of blunt vertebral artery injury are varied and one or more injury mechanisms may be involved simultaneously. Patients often undergo immediate or delayed cerebral apoplexy as well as compression and injury of surrounding structures, due to direct injury or secondary aneurysm or dissection, resulting in disability or death. Diseases such as, vertebral atherosclerosis and dysplasia can increase the disability and death risk and the difficulty of forensic identification. In forensic identification, the details of the case should be considered. For cases of suspected vertebral artery injury, in addition to routine examination of intracranial segment, attention should be paid to the examination of extracranial segment. If conditions permit, angiography can be used prior to or during the autopsy to improve the identification efficiency and accuracy of opinions.

Application of Intravascular Imaging in Forensic Autopsy / 法医学杂志

With the emergence of new technologies and devices including minimally invasive catheters and rotary couplers, the application of imaging technology such as traditional ultrasound and optical coherence tomography （OCT） is gradually expanded. In recent years, intravascular ultrasound （IVUS） and OCT have become increasingly mature as coronary intravascular imaging techniques, and therefore become an important complementary means of coronary angiography. Although studies on feasibility of clinical applications of IVUS and OCT have been confirmed in the evaluation of previous cadaver studies, these techniques have been neglected in forensic autopsy. This paper reviews the application value of IVUS and OCT in forensic autopsy, especially in the adjuvant evaluation of coronary artery disease. Including the characteristics of IVUS and OCT imaging technology, the problems of coronary examination in traditional autopsy and the specific application of new intravascular imaging technology in forensic autopsy.

Current Status of Forensic Identification for Blunt Injuries of Internal Carotid Arterial System / 法医学杂志

Internal carotid arterial system is the main source of blood supply in brain. In forensic identi-fication practice, blunt injures of internal carotid arterial system usually cause complications such as throm-bus, aneurysm and arteriovenous fistula, etc. The deaths following delayed cerebral infarction or intracra-nial haemorrhage are not rare. At present, literature of deaths caused by blunt injuries of internal carotid arterial system mainly consist of case reports in China. This paper reviews related literature and case re-ports at home and abroad, and summarizes forensic medical features and identification method of the deaths caused by such injuries. The results show that blunt injures of internal carotid arterial system are related to the direct or indirect force on head and neck, which can result in exceed physiological range traction of head and neck, incision following basicranial fracture, etc. Such injuries are common in the cases as mechanical asphyxia, cervical manipulation, traffic accident and fall, etc. The artery should be examined carefully, and the relationship among injury, disease and death should be analysed correctly when no cause of infarction and hemorrhage was found in routine examination of such cases in forensic pratice. Because of the difficulty for exposing the artery completely in autopsy, angiography can be used to infer the location when necessary for improving the scientificity and reliability of the appraisal conclusion.

Distribution of Diatoms in Main Sections of Urban District Rivers with Drowning-prone in Chengdu / 法医学杂志

OBJECTIVES@#To explore the species distribution and constituent ratio of diatoms in main sections of urban district rivers where drowning occurs frequently in Chengdu.@*METHODS@#Total 39 water samples from the sampling points of 5 rivers （Jinjiang, Jinniu, Qingyang, Wuhou and Chenghua districts） in October 2014 were collected. The diatoms smear were made and the species distribution and constituent ratio of diatoms from the water samples were analyzed using biological microscope and acquisition system of digital microscope.@*RESULTS@#Total 21 species of diatoms were detected in main sections of urban district rivers in Chengdu. Significant differences in the dominant diatom species and proportions of the different rivers were observed, and there were different species existed in all sampling points of the upstream, midstream and downstream of the rivers.@*CONCLUSIONS@#The database of species map, species distribution and constituent ratio of diatoms in main sections of urban district rivers in Chengdu are preliminarily established, which has special meaning for the analysis and evaluation of falling location inference using diatoms test in case investigation.

Relationship between the increase of fibrous and fatty in atrioventricular node and narrowing of the atrioventricular node artery / 法医学杂志

OBJECTIVE@#To explore relationship between increase of fibrous and fatty in atrioventricular node (AVN) and narrowing of the AVN artery. To analyze the cause of pathological fibrosis and fatty infiltration in AVN.@*METHODS@#One hundred and nineteen cases of sudden cardiac death determined by autopsy were selected and the histological sections were examined with Image-pro plus software to calculate the AVN area, AVN artery inside-diameter, AVN artery lumen area(LA) , AVN artery perimeter area(PA), fibrous area and fatty area. All cases were divided into two groups: narrowing of artery group and normal control group. The changes of the PA/LA value and the fibrous and fatty contents were evaluated.@*RESULTS@#The PA/LA value is the highest in 21-40 age group. The difference of the fatty contents and total interstitial tissue was statistical significance in the two groups under 40 years of age.@*CONCLUSION@#There is some relationship between the narrowing of the AVN artery and the increase of interstitial contents in AVN.

Traffic accidents associated with emotional stress after divorce / 法医学杂志

In recent years, the traffic accidents increased gradually, especially those caused by the drivers daily emotional abnormality and in which the drivers were liable. This article reviewed the traffic accidents caused by divorced driver's emotional abnormality, illustrated the features of those accidents from the gender, age, occupation and mileage of drivers. It was considered that the major cause of those accidents was excessive drinking due to drivers' emotional stress. Suggestions about preventing the traffic accidents caused by emotional abnormality were put forward so as to make the corresponding rules and finally decrease the emotional abnormality traffic accidents.

A forensic pathological study of eighty-two cases of adrenal hemorrhage / 法医学杂志

OBJECTIVE@#To analyze the relationship between adrenal hemorrhage and the cause of death, age and gender.@*METHODS@#Eighty-two cases of adrenal hemorrhage were statistically analyzed.@*RESULTS@#Adrenal hemorrhage occurred mostly in cases of sudden death, infection, trauma and asphyxia. Male had more chance than female to have adrenal hemorrhage. Adrenal hemorrhage caused by sudden death, trauma and poisoning was more frequently seen in young adults, whereas adrenal hemorrhage in children as well as in fetus and newborns was often caused by infection as well as sudden death and asphyxia respectively. Adrenal hemorrhage caused by sudden death and asphyxia was mainly located in medulla, while the infection usually induced hemorrhage in cortex. Adrenal hemorrhage caused by trauma showed an equal opportunity in either the cortex or medulla.@*CONCLUSION@#Our data indicate that adrenal hemorrhage might provide some clues in searching for the cause of death.

The application of cerebral angiography in the forensic postmortem examination / 法医学杂志

As a "Gold Standard" in clinical diagnosis of cerebrovascular disease, cerebral angiography also plays an important role in forensic postmortem examination. The key roles of identifying the site of cerebrovascular disease and the cause of death as well as providing guidance for autopsy and postmortem sampling and the broad future application of cerebral angiography in forensic practice are reviewed.

The prospect of application of toxicogenetics/pharmcogenetics theory and methods in forensic practice / 法医学杂志

Individual response to drugs, toxicants, environmental chemicals and allergens varies with genotype. Some respond well to these substances without significant consequences, while others may respond strongly with severe consequences and even death. Toxicogenetics and toxicogenomics as well as pharmacogenetics explain the genetic basis for the variations of individual response to toxicants by sequencing the human genome and large-scale identification of genome polymorphism. The new disciplines will provide a new route for forensic specialists to determine the cause of death.

Retinal examination with ophthalmic endoscopy in forensic autopsy / 法医学杂志

Autopsy by forensic pathologist is a main mean currently to determine the cause of sudden unexpected death. Retinal examination is important but seldom performed during a forensic autopsy for various reasons. The value of retina examination has not been recognized. With invention of ophthalmic endoscopy and its subsequent application in postmortem retina examination, it has proved to be useful adjunct to determine the cause of death and to estimate the postmortem interval.

The application of radiological imaging in the forensic pathology about cervical part / 法医学杂志

Multislice spiral computed tomography (MSCT) and magnetic resonance imaging (MRI) are useful to analyze cervical injury. Especially in injury of skeleton and soft tissue, it has equal value with conventional autopsy. Even they can reparation some shortcoming consisted in the cervical part autopsy. In some difficult postmortem examination of decomposed, charred or highly infectious cadavers and in some religion country, they should be a useful alternative way to examine injury in cervical part of cadaver such as mechanical asphyxia, whiplash injury, vertebra injury, or vascular injury.

The clinical forensic medicine identification on pseudoseizures after head trauma / 法医学杂志

Two pseudoseizures after head trauma are reported. We summarize the clinical manifestation of pseudoseizures, and identify difference of pseudoseizures and Seizures after head trauma. The forensic identification of pseudoseizures after head trauma should base on the extend and position of cerebral trauma, sequelae focus in cerebral, and the clinical manifestation.

Experimental study of restiffening of the rigor mortis / 法医学杂志

OBJECTIVE@#To observe changes of the length of sarcomere of rat when restiffening.@*METHODS@#We measured the length of sarcomere of quadriceps in 40 rats in different condition by scanning electron microscope.@*RESULTS@#The length of sarcomere of rigor mortis without destroy is obviously shorter than that of restiffening.@*CONCLUSION@#The length of sarcomere is negatively correlative to the intensity of rigor mortis. Measuring the length of sarcomere can determine the intensity of rigor mortis and provide evidence for estimation of time since death.