Trend of bone development of adolescent at 14 years old / 法医学杂志

OBJECTIVE@#To describe characteristic of hand-wrist bone development in adolescents of 14 years old in China, and to estimate trend of bone development of them.@*METHODS@#A total of 109 adolescents of 14 years was selected as subjects (males: 53, females: 56). X-rays examination of their left hand-wrist bone were performed and analyzed. The development characteristics of each position in accordance with Gu's mapping of skeletal age were compared with Gu's results and ours.@*RESULTS@#Compared with Gu's, osteoepiphysis of distal radius, the first metacarpal bone, the fourth proximal phalanx were more advanced in boys, osteoepiphysis of distal radius, the second-fifth metacarpal bones, the first-fifth proximal phalanxs, and the second-fifth middle phalanxs were more advanced in girls.@*CONCLUSION@#The results suggested that a forward trend of 14 years old adolescents bone development currently exists in our country, especially in girls. As an important age of criminal responsibility, this forward trend of development of bones among adolescents currently should be kept in mind when estimating bone age of criminals.

Development of hand-wrist bones of 14 year-old adolescents. II. Standard of bony age for girls / 法医学杂志

OBJECTIVE@#To study the current development of hand-wrist bones of adolescents in China, and establish special forensic bony age standard for estimating 14 years of criminal responsible age in female adolescents.@*METHODS@#One hundred and ten healthy girls aged from 13 years and 9 months to 14 years and 3 months in Lengshuijiang district of Hunan province were enrolled in this study. X-ray films of their left hand-wrists were taken dorsaventrally, and 15 sites on the wrist x-ray films were examined and measured under standard condition. The development grade was confirmed by maximal percentage to establish a method to estimate the bony age, which was then checked by single blind method.@*RESULTS@#Development grade of the radius, the middle third phalanx and the fourth phalanx was partially closed (> 2/3), and the rest was wholly-closed with existence of the epiphyseal line. The development grade of the middle third phalanx and fourth phalanx was different between the younger group (< 14 years, partially closed, > 2/3) and the older group (> 14 years, mostly closed with existence of only epiphyseal line). The cross diameter of the osteoepiphysises were wider than that of all the diaphysises. The confirmed accuracy (in 30 girls) was 83.3%.@*CONCLUSION@#Our study seemes to be feasible in establishing the estimation standard for bony age determination. The standard established by developmental metaphysis and authropometry may be particularly helpful in forensic practice for estimation of accurate criminal responsible age in adolescents.

Study on development of hand-wrist bone in 14 year-old adolescents I: bone age standard for boys / 法医学杂志

OBJECTIVE@#To study the bone development in adolescents in China, and establish forensic skeletal age standard for estimation of the criminal responsible age in 14 years old male adolescents.@*METHODS@#One hundred and three healthy boys aged from 13 years and 9 months to 14 years and 3 months in Lengshuijiang, Hunan, China were enrolled in this study. X-ray films of their left hand-wrist were taken dorsaventrally, and 15 selected sites on the wrist X-ray films were examined and measured under standard condition. The development grade was confirmed by maximum percentage to establish a method to estimate the bone age, which was then checked by single blind method.@*RESULTS@#Development grade of the first metacarpal bone and the first phalanx IV was partially closed (less than 1/3), but the rest was non-closed. The cross diameters of all the osteoepiphysis were wider than that of all the diaphysis. The development grade of the fourth metacarpal bone and the fifth metacarpal bone as well as the adjacent third phalanx were different in both younger age group (<14 years, mostly non-closed) and the older age group (>14 years, mostly closed). The confirmed accuracy (in 30 boys) was 80%.@*CONCLUSION@#Our study seems to be feasible in establishing the estimation standard for skeletal age determination using developmental metaphysis and anthropometry. The standard may be particularly helpful in forensic practice for estimation of accurate criminal responsible age in adolescents.

Adverse drug events and its forensic medical identification / 法医学杂志

OBJECTIVE@#To investigate the basic principles and important rules of forensic identification of adverse drug events and to accumulate basic data and to provide references for forensic identification of similar cases.@*METHODS@#Thirty-three cases of adverse drug events in our forensic identification files were retrospectively reviewed, analyzed, and summarized.@*RESULTS@#There were 27 live and 6 dead victims included in this study. Our study showed a gradually increasing numbers of adverse drug cases in forensic identification year by year with a slight female predominance (20/33 cases, 60.6%). Of the 33 victims, nearly two-thirds (21/33, 63.6%) were due to hospital errors including only one case of drug overdose (1/21, 4.8%), whereas the rest were not related to the hospital errors. Eight cases (8/33, 24.2%) were caused by illegal medical practitioners due to improper use of medication.@*CONCLUSION@#Investigators need to pay more attention to the characteristics and complexities of adverse drug events on a case by case basis encountered in increasing numbers of more and more such forensic identification.

Accuracy of age estimation in 14-year-old females by two skeletal age standards / 法医学杂志

OBJECTIVE@#To study the accurate of Li Guozhen's Percent Numeration and the Development Standard of Chinese Wrist Bone CHN Numeration of age estimation in 14-year-old females.@*METHODS@#Fifty-one 14-year-old females from three middle schools in Loudi City in Hunan were selected randomly, whose left wrists were photographed with X-rays under the same condition. Skeletal age was estimated following the two numerations. The two skeletal ages were compared with each other and with chronological age.@*RESULTS@#The skeletal age from Percent Numeration and CHN Numeration have no significance difference, P > 0.05. And the skeletal ages of the two Numerations have no significance difference either, P > 0.05.@*CONCLUSION@#The Percent Numeration and the CHN Numeration are still suited for age estimation in 14-year-old females.

"The severe degree of negligence" and its application in the settle of medical malpractice / 法医学杂志

OBJECTIVE@#To found the quantifiable index of "The severe degree of negligence" in describing the general severity degree of medical malpractice or medical dispute.@*METHODS@#"The severe degree of negligence" can be calculated by the way of multiplying the coefficient of medical malpractice's grade by the coefficient of responsibility degree.@*RESULTS@#There are 15 grades of "The severe degree of negligence" through calculation, from the severest degree of 1 to the lightest degree of 20.@*CONCLUSION@#"The severe degree of negligence" can give an order of severe degree to different grade and different responsibility of medical malpractice. According to this order, the operation of medical malpractice and medical dispute settle will be easier and more rationality.