In China,two administrative regulations and judicial interpretations related to forensic examinations of medical damage were issued from March 2017 to June 2018.In chronological order,they were interpretation of the s...In China,two administrative regulations and judicial interpretations related to forensic examinations of medical damage were issued from March 2017 to June 2018.In chronological order,they were interpretation of the supreme people’s court on several questions concerning the application of law in the trial of disputes over liability for medical damage and regulations on the prevention and handling of medical disputes.Those two laws,especially the regulation,have had a fundamental impact on the pattern of forensic examinations on medical damage.This paper systematically reviews the current status and existing problems with forensic examinations on medical damage following implementation of the law of tort liability;it discusses new concepts of procedures,institutional arrangements,and the selection of examiners for forensic examinations on medical damage.We believe that through the regulation,the dualistic confrontation status of forensic examinations on medical damage will gradually change toward integration.We consider that forensic examinations of medical damage will face three challenges in the future:(1)enhancing the establishment of standards;(2)undertaking theoretical research into forensic examinations onmedical damage;and(3)promoting the development ofinterdisciplinary identification specialistsmajoring in both medicine and law.Only in this way will it be possible to rectify the current dilemma with forensic examinations on medical damage in China.展开更多
A novel approach employs the principles of medical image analysis using Wavelet Transform (WT) and Difference Peak Signal-to-Noise Ratio (ΔPSNR). Both techniques are combined as a function of different decomposing le...A novel approach employs the principles of medical image analysis using Wavelet Transform (WT) and Difference Peak Signal-to-Noise Ratio (ΔPSNR). Both techniques are combined as a function of different decomposing levels of wavelets and various image search through and slicing levels, which is implemented under MATLAB environment. In this new approach, the structural change due to damage in the component or the presence of foreign bodies appearing in an image taken for a specific structure is uncovered with its extent determined after applying the search through algorithm. Such alteration of the composite structure, which could be masked by the presence of noise, is accounted for using combined WT and PSNR. Effect of Artifacts and Blurring caused by different wavelet types is investigated before choosing an appropriate wavelet, namely Sym8. This new approach, which also reduces the required layers of search within an image, produces a pattern matrix per damaged area and is an excellent way in tracing and modeling damage in structures with ability to predict effects of further damage on components and further application to artificial limbs that could suffer damage and affect users mobility.展开更多
Objective： The 8.12 Tianjin Port Explosion in 2015 caused heavy casualties. Pingjin Hospital, an affiliated college hospital in Tianjin, China participated in the rescue activities. This study aims to analyze the eme...Objective： The 8.12 Tianjin Port Explosion in 2015 caused heavy casualties. Pingjin Hospital, an affiliated college hospital in Tianjin, China participated in the rescue activities. This study aims to analyze the emergency medical response to this event and share experience with trauma physicians to optimize the use of medical resource and reduce mortality of critical patients. Methods： As a trauma centre at the accident city, our hospital treated 298 patients. We retrospectively analyzed the data of emergency medical response, including injury triage, injury type, ICU patient flow, and medical resource use. Results： There were totally 165 deaths, 8 missing, and 797 non-fatal injuries in this explosion. Our hospital treated 298 casualties in two surges of medical demand. The first one appeared at 1 h after explosion when 147 wounded were received and the second one at 4 h when 31 seriously injured pa- tients were received, among whom 29 were transferred from Tianjin Emergency Center which was responsible for the scene injury triage. After reexamination and triage, only 11 cases were defined as critical ill patients, The over-triage rate reached as high as 62.07%. Seventeen patients underwent surgery and 17 patients were admitted to the intensive care unit, Conclusions： The present pre-hospital system is incomplete and may induce two surges of medical de- mand. The first one has a much larger number of casualties than predicted but the injury level is mild; while the second one has less wounded but almost all of them are critical patients. The over-triage rate is high. The hospital emergency response can be improved by an effective re-triage and implementation of a hosoital-wide damage control.展开更多
基金This study was funded by the Humanities and Social Sciences Planning Project of Ministry of Education(No.18YJA820018,No.10YJA820105)Open Research Project of Shanghai Key Laboratory of on-site Material Evidence(2017XCWZK19).
文摘In China,two administrative regulations and judicial interpretations related to forensic examinations of medical damage were issued from March 2017 to June 2018.In chronological order,they were interpretation of the supreme people’s court on several questions concerning the application of law in the trial of disputes over liability for medical damage and regulations on the prevention and handling of medical disputes.Those two laws,especially the regulation,have had a fundamental impact on the pattern of forensic examinations on medical damage.This paper systematically reviews the current status and existing problems with forensic examinations on medical damage following implementation of the law of tort liability;it discusses new concepts of procedures,institutional arrangements,and the selection of examiners for forensic examinations on medical damage.We believe that through the regulation,the dualistic confrontation status of forensic examinations on medical damage will gradually change toward integration.We consider that forensic examinations of medical damage will face three challenges in the future:(1)enhancing the establishment of standards;(2)undertaking theoretical research into forensic examinations onmedical damage;and(3)promoting the development ofinterdisciplinary identification specialistsmajoring in both medicine and law.Only in this way will it be possible to rectify the current dilemma with forensic examinations on medical damage in China.
文摘A novel approach employs the principles of medical image analysis using Wavelet Transform (WT) and Difference Peak Signal-to-Noise Ratio (ΔPSNR). Both techniques are combined as a function of different decomposing levels of wavelets and various image search through and slicing levels, which is implemented under MATLAB environment. In this new approach, the structural change due to damage in the component or the presence of foreign bodies appearing in an image taken for a specific structure is uncovered with its extent determined after applying the search through algorithm. Such alteration of the composite structure, which could be masked by the presence of noise, is accounted for using combined WT and PSNR. Effect of Artifacts and Blurring caused by different wavelet types is investigated before choosing an appropriate wavelet, namely Sym8. This new approach, which also reduces the required layers of search within an image, produces a pattern matrix per damaged area and is an excellent way in tracing and modeling damage in structures with ability to predict effects of further damage on components and further application to artificial limbs that could suffer damage and affect users mobility.
文摘Objective： The 8.12 Tianjin Port Explosion in 2015 caused heavy casualties. Pingjin Hospital, an affiliated college hospital in Tianjin, China participated in the rescue activities. This study aims to analyze the emergency medical response to this event and share experience with trauma physicians to optimize the use of medical resource and reduce mortality of critical patients. Methods： As a trauma centre at the accident city, our hospital treated 298 patients. We retrospectively analyzed the data of emergency medical response, including injury triage, injury type, ICU patient flow, and medical resource use. Results： There were totally 165 deaths, 8 missing, and 797 non-fatal injuries in this explosion. Our hospital treated 298 casualties in two surges of medical demand. The first one appeared at 1 h after explosion when 147 wounded were received and the second one at 4 h when 31 seriously injured pa- tients were received, among whom 29 were transferred from Tianjin Emergency Center which was responsible for the scene injury triage. After reexamination and triage, only 11 cases were defined as critical ill patients, The over-triage rate reached as high as 62.07%. Seventeen patients underwent surgery and 17 patients were admitted to the intensive care unit, Conclusions： The present pre-hospital system is incomplete and may induce two surges of medical de- mand. The first one has a much larger number of casualties than predicted but the injury level is mild; while the second one has less wounded but almost all of them are critical patients. The over-triage rate is high. The hospital emergency response can be improved by an effective re-triage and implementation of a hosoital-wide damage control.
