1.Journey and Significance of Quality Control in Medical Safety for China's Plastic Surgery and Aesthetic Medicine Professions
Jiaojie ZHENG ; Mingzi ZHANG ; Loubin SI ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1233-1237
Medical quality and safety are essential safeguards for the harmonious society in China, directly affecting people's sense of security and happiness. Continuously improving medical quality and ensuring medical safety are fundamental and essential to implementing the strategies of the Party Central Committee and the State Council, and promoting the construction of a healthy China. In recent years, with the rapid development of China's economy and the people's increasing emphasis on their own health and safety, China's plastic surgery industry has achieved significant progress and yielded outstanding results. However, along with the rapid growth of the industry, medical quality issues and safety accidents have occurred frequently, attracting widespread attention from all sectors of society. This article briefly outlines the history of quality management and quality control for medical quality and safety in China's plastic surgery specialty. It explores the development of quality management from its origin to medical quality management, as well as the responsibilities and contributions of the National Plastic Surgery Quality Control Center in improving industry standards and ensuring patient safety. It aims to provide support for the standardized management of the plastic surgery industry in the future, so as to promote its healthy and sustainable development.
2.Construction of Medical Quality Control Indicators System for Chinese Plastic and Aesthetic Major
Mingzi ZHANG ; Loubin SI ; Jiuzuo HUANG ; Nanze YU ; Jiaojie ZHENG ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1318-1324
To construct a quality control indicators system for Chinese plastic and aesthetic major and lay foundation for medical quality control. National Quality Control Center of Plastic and Aesthetic Major established a working group in February 2023. Guided by the "structure-process-outcome" theory, the working group formulated medical quality control indicators for Plastic and Aesthetic major by learning from relevant indicators of other majors, reviewing literature, discussing in meetings, and combining opinions from quality control experts. The quality control indicators system was finally established by Delphi expert consultation. Delphi survey was 100% of 2 rounds. The authorities of 2 rounds of expert consultation were 0.854 and 0.857. The harmonious coefficients were 0.387 of primary indicators and 0.425 of secondary indicators( The quality control indicators system established in this study for Plastic and Aesthetic major in China has a certain degree of scientificity and rationality, which offers reference for medical quality control of Plastic and Aesthetic major in China. However, this system should be improved and ameliorated in practical application.
3.Data Development Trend of Public/Private Medical Institutions in Chinese Plastic and Aesthetic Major
Mingzi ZHANG ; Loubin SI ; Jiaojie ZHENG ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1325-1333
To compare and understand the trends in quality control data changes in public and private medical institutions specializing in plastic and aesthetic major in China over the past three years. The national quality control center of plastic and aesthetic major formulated quality control indicators, collected indicator data through the National Clinical Improvement System, conducted feedback verification on the data, organized and summarized the final data, and convened expert committees to analyze the data change trends. In the past three years, the number of both public and private medical institutions specializing in plastic and aesthetic major has shown an upward trend. The number of doctors increased significantly in 2022, with over 90% of doctors in public institutions (about 70% in private institutions) receiving higher education. In recent years, the proportion of doctors from other specialties engaging in plastic and aesthetic activities has increased. The proportion of inpatients seeking aesthetic treatments has also increased. Among outpatient patients, the proportion of injection procedures was relatively low. About one-third of private medical institutions have not yet adopted an electronic medical record system. Data feedback is the cornerstone of medical quality control in Chinese plastic and aesthetic major. Existing data indicates that the related industry is developing steadily, but there is still room for improvement in terms of some indicator data. However, due to the limited data from private medical institutions, it is still necessary to encourage them to improve their reporting enthusiasm in order to conduct a more comprehensive assessment in the future.
4.Qualitative and quantitative diagnosis of benign and malignant adnexal masses by transvaginal contrast-enhanced ultrasonography
Jiajia WANG ; Caicha YU ; Mingzi HU
Chinese Journal of Primary Medicine and Pharmacy 2024;31(3):333-337
Objective:To evaluate the qualitative and quantitative diagnostic value of transvaginal contrast-enhanced ultrasonography for benign and malignant adnexal masses.Methods:Forty-nine patients with adnexal masses detected by routine ultrasound examination at Wenzhou People's Hospital from January 2021 to December 2022 were included in this study. Initially, transvaginal two-dimensional ultrasound, two-dimensional ultrasound integrated with color Doppler, and contrast-enhanced ultrasonography were used to accurately classify the masses as benign or malignant. Using postoperative pathology as the gold standard, the qualitative diagnostic accuracy of various detection methods was compared. Subsequently, the receiver operating characteristic curve analysis was performed to assess the quantitative diagnostic accuracy of transvaginal contrast-enhanced ultrasonography-related parameters in distinguishing between benign and malignant adnexal masses.Results:Among the 49 patients, 10 were diagnosed with malignant tumors. The diagnostic accuracy of contrast-enhanced ultrasonography was 93.88% (46/49), with a sensitivity of 90.00% (9/10), a specificity of 94.87% (37/39), a positive predictive value of 81.82% (9/11), and a negative predictive value of 97.37% (37/38). The results of the diagnostic difference assessment (McNemar test) revealed that there was no significant difference between two-dimensional ultrasound ( χ2 = 0.37, P = 0.546), two-dimensional ultrasound combined with color Doppler ( χ2 = 0.17, P = 0.683), and contrast-enhanced ultrasonography ( χ2 = 0.00, P = 1.000), and the gold standard test results. The consistency assessment (Kappa test) revealed that the diagnostic results of contrast-enhanced ultrasonography exhibited the highest concordance with the gold standard, with a Kappa value of 0.82 ( P < 0.001). Furthermore, the receiver operating characteristic curve analysis indicated that the initial increase time, peak intensity, and mean transit time in contrast-enhanced ultrasonography demonstrated high quantitative diagnostic accuracy. The areas under the curve were 0.83, 0.82, and 0.84, respectively, and the diagnostic cutoff values were 17.30 s, 21.65 dB, and 92.60 seconds, respectively. Conclusion:Contrast-enhanced ultrasonography exhibits diagnostic value in the differential diagnosis of benign and malignant adnexal masses, both qualitatively and quantitatively. This method can provide valuable insights for further treatment.
5.Journey and Significance of Quality Control in Medical Safety for China's Plastic Surgery and Aesthetic Medicine Professions
Jiaojie ZHENG ; Mingzi ZHANG ; Loubin SI ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1233-1237
Medical quality and safety are essential safeguards for the harmonious society in China, directly affecting people's sense of security and happiness. Continuously improving medical quality and ensuring medical safety are fundamental and essential to implementing the strategies of the Party Central Committee and the State Council, and promoting the construction of a healthy China. In recent years, with the rapid development of China's economy and the people's increasing emphasis on their own health and safety, China's plastic surgery industry has achieved significant progress and yielded outstanding results. However, along with the rapid growth of the industry, medical quality issues and safety accidents have occurred frequently, attracting widespread attention from all sectors of society. This article briefly outlines the history of quality management and quality control for medical quality and safety in China's plastic surgery specialty. It explores the development of quality management from its origin to medical quality management, as well as the responsibilities and contributions of the National Plastic Surgery Quality Control Center in improving industry standards and ensuring patient safety. It aims to provide support for the standardized management of the plastic surgery industry in the future, so as to promote its healthy and sustainable development.
6.Construction of Medical Quality Control Indicators System for Chinese Plastic and Aesthetic Major
Mingzi ZHANG ; Loubin SI ; Jiuzuo HUANG ; Nanze YU ; Jiaojie ZHENG ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1318-1324
To construct a quality control indicators system for Chinese plastic and aesthetic major and lay foundation for medical quality control. National Quality Control Center of Plastic and Aesthetic Major established a working group in February 2023. Guided by the "structure-process-outcome" theory, the working group formulated medical quality control indicators for Plastic and Aesthetic major by learning from relevant indicators of other majors, reviewing literature, discussing in meetings, and combining opinions from quality control experts. The quality control indicators system was finally established by Delphi expert consultation. Delphi survey was 100% of 2 rounds. The authorities of 2 rounds of expert consultation were 0.854 and 0.857. The harmonious coefficients were 0.387 of primary indicators and 0.425 of secondary indicators( The quality control indicators system established in this study for Plastic and Aesthetic major in China has a certain degree of scientificity and rationality, which offers reference for medical quality control of Plastic and Aesthetic major in China. However, this system should be improved and ameliorated in practical application.
7.Data Development Trend of Public/Private Medical Institutions in Chinese Plastic and Aesthetic Major
Mingzi ZHANG ; Loubin SI ; Jiaojie ZHENG ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1325-1333
To compare and understand the trends in quality control data changes in public and private medical institutions specializing in plastic and aesthetic major in China over the past three years. The national quality control center of plastic and aesthetic major formulated quality control indicators, collected indicator data through the National Clinical Improvement System, conducted feedback verification on the data, organized and summarized the final data, and convened expert committees to analyze the data change trends. In the past three years, the number of both public and private medical institutions specializing in plastic and aesthetic major has shown an upward trend. The number of doctors increased significantly in 2022, with over 90% of doctors in public institutions (about 70% in private institutions) receiving higher education. In recent years, the proportion of doctors from other specialties engaging in plastic and aesthetic activities has increased. The proportion of inpatients seeking aesthetic treatments has also increased. Among outpatient patients, the proportion of injection procedures was relatively low. About one-third of private medical institutions have not yet adopted an electronic medical record system. Data feedback is the cornerstone of medical quality control in Chinese plastic and aesthetic major. Existing data indicates that the related industry is developing steadily, but there is still room for improvement in terms of some indicator data. However, due to the limited data from private medical institutions, it is still necessary to encourage them to improve their reporting enthusiasm in order to conduct a more comprehensive assessment in the future.
8.Kaixinsan alleviates adriamycin-induced depression-like behaviors in mice by reducing ferroptosis in the prefrontal cortex
Mingzi OUYANG ; Jiaqi CUI ; Hui WANG ; Zheng LIANG ; Dajin PI ; Liguo CHEN ; Qianjun CHEN ; Yingchao WU
Journal of Southern Medical University 2024;44(8):1441-1449
Objective To investigate the effect of Kaixinsan(KXS,a traditional Chinese medicine formula)for alleviating adriamycin-induced depression-like behaviors in mice bearing breast cancer xenografts and explore the pharmacological mechanism.Methods Forty female BALB/c mice were randomized equally into control group,model group,and low-and high-dose KXS treatment groups,and in the latter 3 groups,mouse models bearing orthotopic breast cancer 4T1 cell xenografts were established and treated with adriamycin along with saline or KXS via gavage.Depression-like behaviors of the mice were assessed using open field test and elevated plus-maze test,and the changes in serum levels of depression-related factors were examined.RNA-seq analysis and transmission electron microscopy were used and ferroptosis-related factors were detected to explore the mechanisms of adriamycin-induced depression and the therapeutic mechanism of KXS.The results were verified in SH-SY5Y cells using ferroptosis inhibitor Fer-1 as the positive control.Results KXS significantly alleviated depression-like behaviors and depression-related serological changes induced by adriamycin in the mouse models.RNA-seq results suggested that KXS alleviated chemotherapy-induced depression by regulating oxidative stress,lipid metabolism and iron ion binding in the prefrontal cortex.Pathological analysis and detection of ferroptosis-related factors showed that KXS significantly reduced ferroptosis in the prefrontal cortex of adriamycin-treated mice.In SH-SY5Y cells,both KXS-medicated serum and the ferroptosis inhibitor were capable of attenuating adriamycin-induced cell ferroptosis.Conclusion KXS alleviates adriamycin-induced depression-like behaviors in mice by reducing ferroptosis in the prefrontal cortex of breast cancer-bearing mice.
9.Comparison of suction blister transplantation and noncultured autologous suspension of epidermal cells in treatment of stable vitiligo in the face and neck region
Yong TAO ; Zhifei LIU ; Mingzi ZHANG ; Xiaohan HU ; Nanze YU ; Fei LONG ; Zenan XIA ; Lan MO ; Xiaojun WANG
Chinese Journal of Medical Aesthetics and Cosmetology 2024;30(3):208-212
Objective:To evaluate the differences and aesthetic meaning of stable vitiligo treatment in the face and neck region using suction blister transplantation or noncultured autologous suspension of epidermal cells.Methods:Sixty-four stable vitiligo patients (25 males and 39 females with age ranges from 10 to 46 years, average 25 years) in the face and neck region were randomly divided into two groups (32 patients in each group): one group received suction blister transplantation, while other group received noncultured autologous suspension of epidermal cells. Patients′treatment effectiveness, pigmentation and piecing deformity were evaluated in postoperative 3 months and 6 months.Results:In the postoperative 3 months and 6 months, the effectiveness of suction blister transplantation group was 68.75% (22/32) and 90.63% (29/32), respectively, while the effectiveness of noncultured autologous suspension of epidermal cells group was 59.37% (19/32) and 87.50% (28/32), respectively, in which no significant differences were found between two groups ( P>0.05). No obvious pigmentation and piecing deformity were found in noncultured autologous suspension of epidermal cells group, which were much better than the suction blister transplantation group in postoperative 3 months and 6 months. Conclusions:Both suction blister transplantation and noncultured autologous suspension of epidermal cells could bring good treatment effectiveness for patients of stable vitiligo in the face and neck region. Compared with suction blister transplantation, noncultured autologous suspension of epidermal cells could offer better aesthetic appearance.
10.Screening process of breast implant associated-anaplastic large cell lymphoma in symptomatic patients with textured breast implants
Wenchao ZHANG ; Jiangmiao XIE ; Zenan XIA ; Mingzi ZHANG ; Xiao LONG ; Xiaojun WANG ; Ang ZENG
Chinese Journal of Medical Aesthetics and Cosmetology 2024;30(4):354-358
Objective:To summarize the clinical diagnosis and treatment process of breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) in symptomatic patients with textured breast implants in Peking Union Medical College Hospital in order to provide reference for the management of such patients in China.Methods:From January 2019 to September 2021, 23 symptomatic patients with textured breast implants were admitted to the Peking Union Medical College Hospital, aged 29-52 years, with an average of 36.2 years. All patients agreed to remove the prosthesis by surgery, and accepted cytology, flow cytometry, and immunohistochemical examination of the fluid around the implants and capsule tissue before or during the operation to complete the BIA-ALCL screening process.Results:All 23 patients presented with unilateral periprosthetic fluid accumulation, with fluid volume ranging from 20 to 130 ml, of which 7 cases were combined with periprosthetic contracture. No tumor cells were found in the pathological findings of effusion and the capsule tissue, and the BIA-ALCL pathologic screening results (CD 30 and ALK) were all negative. No bleeding, infection, wound dehiscence and other complications occurred after the operation.Conclusions:A personalized clinical process should be developed for symptomatic patients with textured breast implants. Attention should be paid to imaging and pathological examinations.

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