Comparison of Medical Dispute Resolution Mechanisms in China and Abroad.

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.

Sudden Death From Ruptured Intracranial Vascular Malformations During Mechanical Asphyxia: A Domestic Violence Case Report.

Smothering and manual strangulation are not uncommon in domestic violence against women; however, no report on the combination of mechanical asphyxia and intracranial vascular malformations has been previously published. We report a middle-aged woman who was smothered and manually strangled by her husband and subsequently died from subarachnoid hemorrhage due to ruptured intracranial vascular malformations, rather than direct mechanical asphyxiation. Smothering and manual strangulation are considered provocative conditions for rupture and contributory causes of death. In this case study, we underline the importance of meticulous autopsy in cases of mechanical asphyxia and intracranial hemorrhage. Exclusion of underlying diseases that may have caused or contributed to death is also required, despite serious asphyxiation signs and neck injuries. Postmortem angiography is a valuable complement to autopsy to detect vascular pathology, with good prospects for further development in China.

[Relationship between the increase of fibrous and fatty in atrioventricular node and narrowing of the atrioventricular node artery].

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].

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].

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].

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.

[Retinal examination with ophthalmic endoscopy in forensic autopsy].

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 prospect of application of toxicogenetics/pharmcogenetics theory and methods in forensic practice].

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.

[The role of urotensin II in airway remodeling of asthma].

OBJECTIVE: To observe the change of urotensin II (U-II) expression in airways of rat asthmatic models, and of patients with asthma, and therefore to investigate the role of U-II in the pathogenesis of asthma and airway remodeling. METHODS: Twenty Wistar rats were divided into a control group (10 rats) and an asthmatic group (10 rats). The animal model of asthma was established by ovalbumin intraperitoneal injection and aerosolization. The internal perimeter of bronchi (Pi), bronchial wall area (WA) and the area of bronchial smooth muscle (WAm) were measured by a computerized image analyzer, and the WA/Pi and WAm/Pi were calculated to express airway remodeling. Autopsy lung tissues from 5 patients with asthma and 5 normal human controls died of car accident were collected, stained with hematoxylin and eosin stain, and the streptavidin peroxidase method. The expression level of U-II and the percentage of positive U-II cell in the airways of rats and patients with asthma were measured. RESULTS: Rats exposed to ovalbumin developed asthma and airway remodeling: the WA/Pi and WAm/Pi [(24.1 +/- 2.4) microm(2)/microm, (5.3 +/- 1.9) microm(2)/microm] were increased, as compared with the normal group [(16.5 +/- 1.7) microm(2)/microm, (3.8 +/- 1.2) microm(2)/microm], the difference being significant (t = 3.892, 3.785, all P < 0.01). The expression level of U-II in asthmatic rats was 2.46 +/- 0.15, while in the control group was 1.26 +/- 0.11, the difference being significant (t = 6.236, P < 0.01). There was a positive correlation between the level of U-II and WAm/Pi (r = 0.712, P < 0.01). The percentage of positive U-II cells in the asthmatic rats was (82 +/- 8)%, while in the control rats was (22 +/- 8)%, the difference being significant (t = 19.102, P < 0.01). The expression level of U-II in patients with asthma was 2.61 +/- 0.19, while in the control group was 1.36 +/- 0.12, the difference being significant (t = 7.374, P < 0.01). The percentage of positive U-II cells in patients with asthma was (75 +/- 9)%, while in the controls was (27 +/- 7)%, the difference being significant (t = 16.236, P < 0.01). CONCLUSION: The expression of U-II is increased in airways of rat asthmatic models and of patients with asthma. It may play an important role in the pathogenesis of asthma and airway remodeling.

[The clinical forensic medicine identification on pseudoseizures after head trauma].

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.

[The application of radiological imaging in the forensic pathology about cervical part].

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.