From the perspective of law-and-economics, this paper analyzed the characteristics between medical workplace and other workplace in terms of public safety liability, risk identifiability and preventability. Then it went on to explore the costs structure incurred by medical violence, namely personal costs of victims, public safety cost, risk prevention cost and service supply cost. A law-and-economics optimal penalty model is then developed based on the benchmark of crime of violence free of social cost, and by incorporating the social cost of medical violence. And it is found that an upward deflection of the crime cost curve sharply drives up the optimal penalty corresponding to various levels of violence, and lowers the threshold violence constituting criminal offence, thus balancing the social costs borne by the public for medical violence.

Traditional mindset in anti-medical violence legislation tends to divert the responsibility to prevent medical violence to the party of the lowest costs, a design of obvious loopholes in reducing medical violence occurrence. By combining the legal liability and penalty adjustment to counter medical violence crimes, the US, Australia and South Korea are trying to match the private cost of victims and its social cost with the punishment of crime law. In this sense, China should highlight the nature of public safety of medical service, zero tolerance report and optimal punishment to medical violence crimes. This approach can take place of the existing incentive mechanism featuring violent conflicts, being conducive to building a safe and harmonious doctor-patient relationship.

Objective:To evaluate the effect of imatinib on growth impairment in children with chronic myeloid leukemia (CML-CP) in the chronic phase.Methods:From July 2018 to July 2019, questionnaires were distributed to CML children aged <18 years at the time of diagnosis who were receiving imatinib for at least 3 months or to their parents in China. The height-for-age standard deviation score (HtSDS) and the difference of standard deviation integral (△HtSDS) were used to explore the change in height with imatinib therapy.Results:The data of 238 respondents were included; 138 (58.0% ) respondents were men. The median age at the first diagnosis of CML was 11.0 years (range, 1.4-17.9 years) , and 93 (39.0% ) respondents were at the prepuberty stage. At the time of completing the questionnaires, the median age was 15.0 years (range, 2.0-34.0 years) . The median duration of imatinib therapy was 28 months (range, 3-213 months) . Among all the respondents, the mean HtSDS when completing the questionnaires (-0.063±1.361) was significantly lower than that at the time of starting imatinib treatment (0.391±1.244) ( P<0.001) . Total 71.0% respondents showed growth impairment that was more common in those starting imatinib therapy at prepubertal age than in those starting at pubertal age. Multivariate analysis showed that younger at the start of imatinib therapy ( P<0.001) and longer duration of imatinib therapy ( P<0.001) were significantly associated with severe growth impairment on imatinib therapy. Conclusions:Imatinib induced growth impairment in children with CML-CP. Younger the age of initiation and longer the duration of imatinib therapy, more obvious the effect of imatinib on growth impairment.