From "Criminal on Death Row" to "Acquittal of Charge"——A showcase of China's human rights protection in the administration of justice

In Januaury 1996, a case of murder shocked the seat of Qiaojia County in Yunnan Province. Eight years later, in February 2004, the county town was again astir with the news that the alleged murderer Sun Wangang returned home after being acquitted of the murder charge.

Arrhythmogenic right ventricular cardiomyopathy: From genetics to diagnostic and therapeutic challenges

Arrhythmogenic right ventricular cardiomyopathy(ARVC) is a genetic disease characterized by myocyte loss and fibro-fatty tissue replacement. Diagnosis of ARVC remains a clinical challenge mainly at its early stages and in patients with minimal echocardiographic right ventricular(RV) abnormalities. ARVC shares some common features with other cardiac diseases, such as RV outflow ventricular tachycardia, Brugada syndrome, and myocarditis, due to arrhythmic expressivity and biventricular involvement. The identification of ARVC can be often challenging, because of the heterogeneous clinical presentation, highly variable intra- and inter-family expressivity and incomplete penetrance. This genotypephenotype "plasticity" is largely unexplained. A familial history of ARVC is present in 30% to 50% of cases, and the disease is considered a genetic cardiomyopathy, usually inherited in an autosomal dominant pattern with variable penetrance and expressivity; in addition, autosomal recessive forms have been reported(Naxos disease and Carvajal syndrome). Diagnosis of ARVC relays on a scoring system, with major or minorcriteria on the Revised Task Force Criteria. Implantable cardioverter defibrillators(ICDs) are increasingly utilized in patients with ARVC who have survived sudden death(SD)(secondary prevention). However, there are few data available to help identifying ARVC patients in whom the prophylactic implantation of an ICD is truly warranted. Prevention of SD is the primary goal of management. Pharmacologic treatment of arrhythmias, catheter ablation of ventricular tachycardia, and ICD are the mainstay of treatment of ARVC.

Human Rights Jurisprudence in Hospice Care——Thoughts on the Concept and Boundary of “Death with Dignity”

Death with dignity is the embodiment of the dignity of human life in the context of end-of-life medical care.However,in the development of its concept,it has been alienated into a single way of death and is often confused with the concept of euthanasia.It is therefore a theoretical and practical necessity to re-expand the connotations of death with dignity Death with dignity is the subjective value of dignity reflected in the context of dying.It takes equality,freedom,and virtue as the core,and uses the right to life as its external support.It is projected onto the medical context and incorporates the patient’s right to informed consent.Subject to public interest,legal paternalism,and the principles of public order and good customs,the boundary of the right to death with dignity should be between active treatment and natural death,and active euthanasia in the form of giving up the right to life should not be included in the right to death with dignity.

Prison Management Works Hard to Bring Human Rights under Good Protection

EDITOR＇S NOTE： Human rights protection in prisons is an important part of China＇s National Human Rights Action Plan and the human rights conditions in prisons constitute an important hallmark of the human rights protection level of the country. In order to get to know more about human rights protection in this special area, this reporter paid a visit to the No. 4 Prison in Henan Province, central China.

Arrhythmogenic ventricular cardiomyopathy:A paradigm shift from right to biventricular disease

Arrhythmogenic ventricular cardiomyopathy(AVC) isgenerally referred to as arrhythmogenic right ventricu-lar(RV) cardiomyopathy/dysplasia and constitutesan inherited cardiomyopathy.Affected patients maysuccumb to sudden cardiac death(SCD),ventriculartachyarrhythmias(VTA) and heart failure.Geneticstudies have identified causative mutations in genesencoding proteins of the intercalated disk that lead toreduced myocardial electro-mechanical stability.Theterm arrhythmogenic RV cardiomyopathy is somewhatmisleading as biventricular involvement or isolated leftventricular(LV) involvement may be present and thus abroader term such as AVC should be preferred.The di-agnosis is established on a point score basis accordingto the revised 2010 task force criteria utilizing imagingmodalities,demonstrating fibrous replacement throughbiopsy,electrocardiographic abnormalities,ventricu-lar arrhythmias and a positive family history includingidentification of genetic mutations.Although severarisk factors for SCD such as previous cardiac arrest,syncope,documented VTA,severe RV/LV dysfunctionand young age at manifestation have been identified,risk stratification still needs improvement,especially inasymptomatic family members.Particularly,the roleof genetic testing and environmental factors has to befurther elucidated.Therapeutic interventions include re-striction from physical exercise,beta-blockers,sotalol,amiodarone,implantable cardioverter-defibrillators andcatheter ablation.Life-long follow-up is warranted insymptomatic patients,but also asymptomatic carriersof pathogenic mutations.

老年人对善终认知质性研究的Meta整合

目的系统评价和整合老年人对善终认知的质性研究,为医护人员实施符合老年人意愿的善终关怀服务提供参考。方法计算机检索中英文数据库从建库至2023年11月收录的关于老年人对善终或优逝认识与了解的质性研究。运用JBI循证卫生保健中心质性研究质量评价标准对纳入文献质量进行评价。采用汇集性整合方法进行结果整合。结果共纳入11篇文献,提炼出37个研究结果,归纳成8个新的类别,综合成3个整合结果:躯体层面(避免成为负担、保持独立自理,放弃无效救治、希望无痛离世,体面离世、缩短濒死过程);精神层面(朋友支持、家人陪伴,寻找精神慰藉、传承优良品质,克服负面情绪、自然平静死亡);社会层面(奉献社会、珍爱生命,完成人生使命、妥善处理后事)。结论老年人在晚年渴望能够实现善终,家庭成员和医护人员是该过程顺利实施的关键人员,建议医护人员全面了解老年人对善终的认知及理解,帮助其实现善终。

Consideration of the Necessity of Prophylactic Bypass Grafting for Anomalous Origin of the Right Coronary Artery—Based on a Case with Concomitant Left Main Trunk Disease Resuscitated from Cardiopulmonary Arrest

Anomalous origin of the right coronary artery is a rare congenital anomaly, but is associated with sudden death. Originating from the opposite sinus of Valsalva, an interarterial?course and an intramural course are especially considered as the risk factor for fatal cardiac events. Surgical indication remains controversial because many patients are asymptomatic. A 52-year-old man with anomalous origin of the right coronary artery with an interarterial?course concomitant with the left main trunk disease was resuscitated from cardiopulmonary arrest. It was likely to be attributed to the left main trunk disease, but anatomical structure of the right coronary artery suggests its possible involvement. Prophylactic bypass grafting for the right coronary artery was performed using saphenous vein graft without ligating native vessel to prevent future cardiac events, as well as revascularization of the left main trunk disease. All grafts were patent in one-year follow-up coronary angiography. Any cardiac event has not occurred.

Severe Trauma of Uterus and the Right Limb during a Road Accident at the Department of Obstetrics and Gynecology of the Teaching Hospital Souro Sanou of Bobo-Dioulasso: A Case Report and Review of Literature

The authors reported a case of trauma with uterus rupture at 35 weeks gestation with fetal death in uterus with a trauma of the right limb injuries during a serious road accident. Aim: the aim is to show the increasing of road accident with the motorized tricycle and their many risks for pregnant woman. Case Presentation: our patient was thrown from the back cargo of a motorized tricycle (three-wheeled vehicle) after a collision with a truck in a rural area from 150 km to Bobo-Dioulasso. She sustained a closed abdominal injury and a severe right lower limb open injury. At admission in our department in the Teaching Hospital, she was conscious, shocked with hemodynamic instability, including low blood pressure (75/52 mmHg), rapid heart rate (140 pulses per minute), rapid breath rate (40 per minute), and cold extremities. Abdominal examination was painful with uterine hypertonia, 28 cm height uterus, and no fetal heart heartbeat. A laparotomy in urgency revealed a rupture of the uterus fundus with a dead fetus. A conservative surgical treatment was performed. An open trauma to the right limb was managed by the orthopedists with a good outcome. Conclusion: Accident trauma during pregnancy is becoming more and more frequent with the increase in means of transport in urban and inter urban areas. The transport ways of the pregnant woman must take into account her safety and that of the fetus.

Preservation of Human Rights as the Basis and Objective of a Modern State Governance System

A good state governance system, which features democracy, scientific decision-making, efficiency, civility and rule of law, is indispensable for realizing the Chinese Dream. As both the foundation and the objective of a good governance system, human rights protection should be integrated in all the processes of building a modern governance system. Adherence to public law in administration should be guaranteed in this connection.

China's Criminal Law Reform from the Perspective of the International Covenant on Civil and Political Rights

The International Covenant on Civil and Political Rights reflects the world’s perception of human rights, and is of vital importance in the field of international human rights. The Covenant has been signed by Chinese government. Although not ratified yet, it will definitely have an impact on the reform of China’s Criminal Law. Therefore, it is necessary to further change our notion of the criminal law system by defining the boundary between public power and civil rights and developing the view of human rights protection. In terms of the specific system, it is necessary to further reduce the number of crimes punishable by the death penalty and limit the application of the death sentence, improve China’s Criminal Procedural Law to protect the fundamental rights of suspects and defendants in terms of compulsory measures, investigation means and judicial form, and add some charges like enslavement and illegal human experimentation, which are criminalized around the world, so as to be in line with the requirements of international human rights protection.

Implications of Human Rights in China's Death Penalty Policy and its Manifestations

China’s policy of preserving the death penalty but controlling the death penalty strictly reflects the core value of striking a balance between the protection of human rights and the maintenance of social order. China has achieved remarkable results in strictly restricting the application of the death penalty in recent years, as reflected by the gradual reduction in the number of crimes punishable by death. To further promote human rights protection, China should gradually reform its death penalty policy by moving toward the goal of completely abolishing when the time is right, which requires continuous efforts at different levels across various stages.

International Cooperation and Human Rights Protection in the Fight against the COVID-19 Pandemic

The protection of human rights through international cooperation has a long history.Core human rights conventions,regional human rights treaties and other human rights instruments have continuously developed the meaning and scope of international human rights cooperation.The modern risk-laden society with a high degree of complexity and uncertainty has changed the world pattern,which calls for the building of a community with a shared future for human beings with cooperation as the starting point.Under the constant threat of the novel coronavirus,we must continue to deepen the concept of a community with a shared future for human beings,adhere to a“human rights-oriented”approach,and pay particular attention to the current supply and distribution of the COVID-19 vaccine as an important global public good.Only through solidarity and cooperation can mankind finally win the battle against this pandemic and protect human rights.

恶性肿瘤患者对善终认知的Meta整合

目的系统整合恶性肿瘤患者对善终认知的质性研究,为开展高质量的肿瘤临终护理,提高恶性肿瘤患者死亡质量提供依据。方法计算机检索相关文献数据库,检索有关恶性肿瘤患者对善终认知的质性研究。使用2016版JBI循证卫生保健中心质性研究质量评价标准对文献进行方法学质量评价,采用汇集性Meta整合法对结果进行整合。结果共纳入16篇文献,提炼出62个研究结果,归纳成11个新的类别,综合成4个整合结果:了解恶性肿瘤诊断及治疗信息并参与临终治疗决策;保持积极心态并为死亡做准备,实现舒适、体面的死亡;不成为家人的负担,并完成对家人的嘱托;得到家庭、宗教、医护团队和社会的支持。结论临终关怀医护人员应尊重恶性肿瘤患者的知情权并帮助患者参与临终治疗决策,通过高质量的临终护理和多学科协作的临终关怀模式满足患者身、心、社、灵的需求,帮助患者实现善终。

Confusing aspects of arrhythmogenic right ventricular dysplasia: Current clinical view

Arrhythmogenic right ventricular dysplasia is an inherited fatal cardiomyopathy causing fat and connective tissue infiltration of right ventricle. In advanced disease, it may also involve left ventricle. Heart failure, arrhythmias and sudden death are main clinical components. Many different genetic mutations can cause this cardiomyopathy. All mutations lead to the formation of the disease are not yet defined. Basis of pathogenetic event is corruption of physical connection as well as the electrical conduction between cardiomyocytes due to these genetic reasons. Genetical inheritance is frequently autosomal dominant but incomplete. Because of the many different phenotypes, there may be great heterogenity of clinical manifestations in same family. Diagnostic criteria are renovated lately. Current cardiac imaging techniques for the diagnosis is gradually progressing. A combination of several tests should be used for diagnosis. Early and accurate diagnosis will save lives and improve the patient’s quality of life. In this paper, after mentioning the features and diagnosis of ARVD, differential diagnosis of ARVD from other diseases which may cause fatty infiltration of heart, arrhythmias and sudden death will be focused.

Arrhythmogenic Ventricular Dysplasia/Cardiomyopathy: Insights from the Rationale of Disease Nomenclature and Clinical Perspectives

“Arrhythmogenic right ventricular dysplasia” (ARVD), a heart muscle disorder characterized by the presence of fibro-fatty tissue and ventricular electrical vulnerability related to sudden death, was first described in 1977 by a French team. Since then, other terms such as “arrhythmogenic right ventricular cardiomyopathy” (ARVC), “arrhythmogenic cardiomyopathy” (AC), “left-dominant arrhythmogenic cardiomyopathy” (LDAC), and “arrhythmogenic left ventricular dysplasia” (ALVD) have been introduced. These changes in nomenclature of the same disease entity are based on different explanations of pathomorphologic patterns. The dysplasia theory claims cardiac growth “maldevelopment” whereas the cardiomyopathy has been seen as an atrophy from acquired injury (myocyte death) and repair (fibrofatty replacement). The other area of divergent opinion is with regards to involvement of both ventricles rather than being an isolated right ventricular anomaly that may result in increased likelihood of diagnosing the concealed form manifesting with pre-dominant left ventricular arrhythmias. Multiple line of evidences support common disease path-ways: Presence of fibro-fatty and superimposed myocarditis, desmosome mutations and malfunc-tion. These compelling data regarding the heart growth, and pathological, clinical, phenotype/ genotype correlates have advanced our understanding of arrhythmogenic ventricular dysplasia/ cardiomyopathy and increased the diagnostic accuracy as well as providing an avenue for future development of new mechanism-based therapies.

Two Unusual Cases of Sudden Death in Children

We report two unusual cases of sudden unexpected death in children. Histopathologic examination showed intimal fibroplasias, a variant of fibromuscular dysplasia of the right coronary artery associated in both cases with fatty infiltration of the right ventricular myocardium. The significance of this particular combination of two lesions known to induce a sudden death in young people is discussed.

A Cool Hand on My Feverish Forehead： An Even Better Samaritan and the Ethics of Abortion

The debate concerning abortion abounds in miraculous narratives. Judith Jarvis Thomson has contrived the most celebrated set among related ones, to wit the ＂violinist analogy,＂ the ＂Good Samaritan＂ narrative, and the ＂Henry Fonda＂ allegory, by virtue of which, she intends, on the one hand, to argue that women＇s right to autonomy outweighs the alleged fetus＇s right to life, and on the other, to prove that no positive moral duties can be derived towards other persons alone from the fact that a moral agent is ascribed certain rights. What this short paper endeavors to prove is that Thomson＇s argumentation by analogy is a weak one, since neither the number nor the relevance of similarities invoked is adequate or satisfactory, while crucial parameters concerning the morality of abortion are being totally overlooked.

基于Meta人种学的生命末期家庭照顾体验理论模型的研究

目的系统整合中国家庭在患者生命末期的照顾体验,明确家庭照顾体验的核心元素,尝试构建诠释中国家庭照顾生命末期患者现象的理论模型。方法系统检索6个英文数据库和5个中文数据库中发表在2021年12月之前的描述中国家庭在患者生命末期的照顾体验的质性研究或混合型研究。采用Meta人种学方法对纳入的16篇文献进行整合。结果整合形成了8个核心元素,即爱与责任、临终意识、伴行、告别、五味杂陈、生活改变、个人成长和需求。其中7个核心元素的GRADE-CERQual整合质量评价的可信度为低至中度,1个核心元素的可信度为高度。论证整合显示,患者优逝是中国家庭照顾者临终照顾的最终目标。结论中国家庭对临终患者的照顾体验过程是动态的,对患者的爱和责任是中国家庭照顾者坚持的动力,家庭照顾者会因患者获得优逝而感到欣慰。

左、右半结肠癌PD-L1表达、MSI状态、KRAS突变及临床病理特征的差异

目的:探讨左半结肠癌、右半结肠癌程序性死亡因子配体1(programmed death-ligand 1,PD-L1)表达、微卫星不稳定性(microsatellite instability,MSI)、Kirsten大鼠肉瘤病毒癌基因同源物(Kirsten rat sarcoma viral oncogene homolog,KRAS)基因突变以及临床病理特征的差异。方法:收集2021年1月至12月郑州大学附属肿瘤医院临床病理中心723例结直肠癌患者的临床病理与分子检测资料进行回顾性分析;采用聚合酶链反应(polymerase chain reaction,PCR)法检测MSI、KRAS基因突变,免疫组织化学法评估PD-L1蛋白表达。结果:在723例结直肠癌中,左半结肠癌521例,右半结肠癌202例。相较于左半结肠癌,右半结肠癌具有女性多发、浸润深度更深、分化更差的特点(均P<0.05);同时,右半结肠癌MSI发生率显著高于左半结肠癌(P<0.001),且PD-L1的联合阳性分数也显著高于左半结肠癌(P=0.022)。此外,左、右半结肠癌在年龄、淋巴转移、脉管癌栓、神经侵犯和KRAS基因突变等方面差异均无统计学意义(均P>0.05)。结论:左半结肠癌、右半结肠癌的临床病理特征、MSI状态及PD-L1表达均存在显著差异,提示左、右半结肠癌可能是两种不同的肿瘤。

The Whaling in the Antarctic Case, Applying the International Convention for the Regulation of Whaling as a Self-contained Regime

The Whaling in the Antarctic Case (Australia v. Japan: New Zealand intervening) decided by the International Court of Justice (hereinafter "ICJ" or "the Court") on 31 March 2014 dealt with the interpretation of specific provisions of the 1946 International Convention for the Regulation of Whaling (ICRW), in particular Article VIII.1, and its complementary instruments, i.e., the Schedule and the Annexes of the International Whaling Commission Scientific Committee. The decision of the Court was a remarkable good one. However, its rigorous reasoning focused almost exclusively on the required purpose of "scientific research" of the JARPA II Programme1 permits as set out in the ICRW, approaching the convention as an autonomous self-contained regime which leaves aside other additional grounds. Nonetheless, it would be beneficial for further jurisdictional developments to strengthen the scope of the ICWR system with the applicable provisions of the United Nations Convention on the Law of the Sea (UNCLOS) and other treaties and institutions impinging on whales and whaling, e.g., CITES, Bonn Convention, Antarctic Treaty System, among others. The query remains concerning the unexplored sources of international law ruling Antarctic spaces and species which are absent in the judgment of the Court but may allow an evolutive interpretation of the ICRW.