Patient complaints not only reflect the shortcomings of hospital services, but also provide an opportunity for hospitals to improve quality. In July 2023, based on the theory of comprehensive quality management and from the perspective of complaint management, Shanghai General Hospital constructed and launched a " 1 (patient service quality improvement work team)+ X (Shanghai 12320 Health Hotline, various functional departments and clinical medical technology departments of the hospital)" patient service defect management system. This system established a four level organizational structure of patient service quality improvement leadership group-work team-clinical medical technology department work group-all employees. It established mechanisms for acceptance, disposal, improvement, training, evaluation, and rewards and punishments, created a comprehensive service platform, and achieved systematic improvement in patient services. By the end of 2024, the hospital had carried out nearly 200 patient service improvement projects; The daily usage of cloud customer service had exceeded 5 000 people, with an effective response rate of over 94%. In 2024, the response rate for handling work orders through various channels within 48 hours was 90%. This practice had achieved good results in improving the quality of hospital services and enhancing the patient experience, which could provide references for other hospitals to promote the management of patient service defects.

In recent years, botulinum toxin type-A (BTX-A) combined with cosmetic injections and radiofrequency lasers have been widely implemented to achieve better tissue repair. Among these therapies, platelet-rich plasma (PRP), rich in growth factors, has demonstrated notable efficacy in promoting tissue regeneration and repair. However, there is some controversy regarding the combined use of these two biomaterials in the treatment of various diseases. This review summarizes the current status of their combined application in peripheral neuropathic pain, seborrheic alopecia, and facial rejuvenation, also analyzes the advantages, interactions, and influencing factors of the combined application. Although the effectiveness and safety of PRP combined with BTX-A injection therapy in many of the above diseases are relatively high, the conclusion should still be carried out in the future multi-center, large-sample clinical studies to improve the credibility and representativeness of the results.

Objective:To investigate the relationship among iron content, volume and drainage venous oxygen saturation (SvO 2) in deep gray matter nuclei of healthy people using quantitative susceptibility mapping (QSM). Methods:The study was a cross-sectional study. A total of 126 healthy volunteers were prospectively enrolled in the community in Tianjin from June 2019 to December 2023, and 57 males and 69 females, aged 48±15 years. All healthy volunteers underwent MRI examinations to get STrategically Acquired Gradient Echo images, then it was post-processed to obtain T 1 weighted enhanced images, QSM maps and the maximum intensity projection images. In QSM maps, caudate nucleus (CN), putamen (PUT), globus pallidus (GP), thalamus (THU), subthalamic nucleus (STN), substantia nigra (SN) and red nucleus (RN) were semi-automatically segmented to calculate the iron content and volume using SPIN software. Four bilateral deep cerebral veins regions of interest, including septum pellucidum veins, thalamostriate veins, internal cerebral veins and basilar veins, were manually delineated on the maximum intensity projection images of QSM to obtain venous magnetic sensitivity. The venous magnetic sensitivity was calculated as SvO 2. To observe the age-related trend of SvO 2, iron content and volume, the partial correlation analysis was conducted. The relationships between iron content, volume and SvO 2 were explored using the partial correlation analysis. To explore the potential effects of SvO 2 between iron content and volume in deep gray matter, the mediation analysis was utilized. Results:The relationships between the SvO 2 of thalamostriate veins ( r=0.23, P=0.018), basilar veins ( r=0.27, P=0.004) and age were positive. The relationships between the SvO 2 of internal cerebral veins and the iron contents of CN ( r=?0.25, P=0.042) and PUT ( r=?0.33, P<0.001) were negative. The relationships between the SvO 2 of basilar veins and the iron contents of STN ( r=?0.25, P=0.042) and SN ( r=?0.24, P=0.045) were negative. The relationships between iron content and volume including CN ( r=0.46, P<0.001), PUT ( r=0.20, P=0.027), GP ( r=0.76, P<0.001), STN ( r=0.87, P<0.001), SN ( r=0.90, P<0.001), RN ( r=0.79, P<0.001) were positive. The mediation analysis showed that the SvO 2 of internal cerebral veins indirectly mediated the relationship between iron content and volume of CN, PUT, GP and THU. Conclusions:The process of iron deposition required the participation of oxygen in deep gray matter nuclei. Volume shows positive correlation with iron content in deep gray matter nuclei, with individual variations. The SvO 2 of internal cerebral veins mediate the relationship between iron content and volume of deep gray matter nuclei.

The endoplasmic reticulum is an important organelle responsible for the synthesis,folding and processing of proteins.When the endoplasmic reticulum protein folding ability is affect-ed,internal unfolded proteins or misfolded proteins accumulate in the endoplasmic reticulum accumulation,leading to endoplasmic reticulum structural dysfunction resulting in endoplasmic reticu-lum stress.Autophagy is the process by which cells selectively remove stress endoplasmic reticulum and error proteins.Under stress,the endoplasmic reticulum can maintain normal physiolog-ical functions through unfolded protein responses and autophagy.Postmenopausal osteoporosis is mainly due to an imbalance be-tween bone resorption by osteoclasts and bone formation by oste-oblasts.Endoplasmic reticulum stress and autophagy both modu-late bone cells status with consequences for bone homeostasis.This article provides a review of the progress of research on en-doplasmic reticulum stress and autophagy interaction in the path-ogenesis of postmenopausal osteoporosis.

Patient complaints not only reflect the shortcomings of hospital services, but also provide an opportunity for hospitals to improve quality. In July 2023, based on the theory of comprehensive quality management and from the perspective of complaint management, Shanghai General Hospital constructed and launched a " 1 (patient service quality improvement work team)+ X (Shanghai 12320 Health Hotline, various functional departments and clinical medical technology departments of the hospital)" patient service defect management system. This system established a four level organizational structure of patient service quality improvement leadership group-work team-clinical medical technology department work group-all employees. It established mechanisms for acceptance, disposal, improvement, training, evaluation, and rewards and punishments, created a comprehensive service platform, and achieved systematic improvement in patient services. By the end of 2024, the hospital had carried out nearly 200 patient service improvement projects; The daily usage of cloud customer service had exceeded 5 000 people, with an effective response rate of over 94%. In 2024, the response rate for handling work orders through various channels within 48 hours was 90%. This practice had achieved good results in improving the quality of hospital services and enhancing the patient experience, which could provide references for other hospitals to promote the management of patient service defects.

The endoplasmic reticulum is an important organelle responsible for the synthesis,folding and processing of proteins.When the endoplasmic reticulum protein folding ability is affect-ed,internal unfolded proteins or misfolded proteins accumulate in the endoplasmic reticulum accumulation,leading to endoplasmic reticulum structural dysfunction resulting in endoplasmic reticu-lum stress.Autophagy is the process by which cells selectively remove stress endoplasmic reticulum and error proteins.Under stress,the endoplasmic reticulum can maintain normal physiolog-ical functions through unfolded protein responses and autophagy.Postmenopausal osteoporosis is mainly due to an imbalance be-tween bone resorption by osteoclasts and bone formation by oste-oblasts.Endoplasmic reticulum stress and autophagy both modu-late bone cells status with consequences for bone homeostasis.This article provides a review of the progress of research on en-doplasmic reticulum stress and autophagy interaction in the path-ogenesis of postmenopausal osteoporosis.

Objective:To investigate the relationship among iron content, volume and drainage venous oxygen saturation (SvO 2) in deep gray matter nuclei of healthy people using quantitative susceptibility mapping (QSM). Methods:The study was a cross-sectional study. A total of 126 healthy volunteers were prospectively enrolled in the community in Tianjin from June 2019 to December 2023, and 57 males and 69 females, aged 48±15 years. All healthy volunteers underwent MRI examinations to get STrategically Acquired Gradient Echo images, then it was post-processed to obtain T 1 weighted enhanced images, QSM maps and the maximum intensity projection images. In QSM maps, caudate nucleus (CN), putamen (PUT), globus pallidus (GP), thalamus (THU), subthalamic nucleus (STN), substantia nigra (SN) and red nucleus (RN) were semi-automatically segmented to calculate the iron content and volume using SPIN software. Four bilateral deep cerebral veins regions of interest, including septum pellucidum veins, thalamostriate veins, internal cerebral veins and basilar veins, were manually delineated on the maximum intensity projection images of QSM to obtain venous magnetic sensitivity. The venous magnetic sensitivity was calculated as SvO 2. To observe the age-related trend of SvO 2, iron content and volume, the partial correlation analysis was conducted. The relationships between iron content, volume and SvO 2 were explored using the partial correlation analysis. To explore the potential effects of SvO 2 between iron content and volume in deep gray matter, the mediation analysis was utilized. Results:The relationships between the SvO 2 of thalamostriate veins ( r=0.23, P=0.018), basilar veins ( r=0.27, P=0.004) and age were positive. The relationships between the SvO 2 of internal cerebral veins and the iron contents of CN ( r=?0.25, P=0.042) and PUT ( r=?0.33, P<0.001) were negative. The relationships between the SvO 2 of basilar veins and the iron contents of STN ( r=?0.25, P=0.042) and SN ( r=?0.24, P=0.045) were negative. The relationships between iron content and volume including CN ( r=0.46, P<0.001), PUT ( r=0.20, P=0.027), GP ( r=0.76, P<0.001), STN ( r=0.87, P<0.001), SN ( r=0.90, P<0.001), RN ( r=0.79, P<0.001) were positive. The mediation analysis showed that the SvO 2 of internal cerebral veins indirectly mediated the relationship between iron content and volume of CN, PUT, GP and THU. Conclusions:The process of iron deposition required the participation of oxygen in deep gray matter nuclei. Volume shows positive correlation with iron content in deep gray matter nuclei, with individual variations. The SvO 2 of internal cerebral veins mediate the relationship between iron content and volume of deep gray matter nuclei.

In recent years, botulinum toxin type-A (BTX-A) combined with cosmetic injections and radiofrequency lasers have been widely implemented to achieve better tissue repair. Among these therapies, platelet-rich plasma (PRP), rich in growth factors, has demonstrated notable efficacy in promoting tissue regeneration and repair. However, there is some controversy regarding the combined use of these two biomaterials in the treatment of various diseases. This review summarizes the current status of their combined application in peripheral neuropathic pain, seborrheic alopecia, and facial rejuvenation, also analyzes the advantages, interactions, and influencing factors of the combined application. Although the effectiveness and safety of PRP combined with BTX-A injection therapy in many of the above diseases are relatively high, the conclusion should still be carried out in the future multi-center, large-sample clinical studies to improve the credibility and representativeness of the results.

Objective To observe the therapeutic efficacy and mechanism of Gushi Zaizao Pills for steroid-induced osteonecrosis of the femoral head(SONFH).Methods Male SD rats were randomly divided into normal group,model group,Xianling Gubao Capsules group and Gushi Zaizao Pills group.Except for the normal group,the rats in all other groups were replicated the SONFH model.After successful modeling,the continuous drug administration was carried out for six weeks.The thymus and spleen of the rats were taken to calculate the immune organ indices,the contents of interleukin 1β(IL-1β)and tumor necrosis factor α(TNF-α)in rat synovial fluid were detected by enzyme-linked immunosorbent assay(ELISA),the percentage of empty lacunae and area ratio of trabecular bone was detected by hematoxylin-eosin(HE)staining,and the femoral head parameters[reduction of bone volume fraction(BV/TV),trabecular number(Tb.N),trabecular thickness(Tb.Th)and trabecular separation(Tb.Sp)]were analyzed by Micro-CT,and bone strength of femoral head was detected by small animal bone strength tester.Results Compared with the normal group,the spleen and thymus indicators were significantly decreased in the model group,the levels of IL-1β and TNF-α in rat synovial fluid were significantly increased,the percentage of empty lacunae was increased,the area ratio of trabecular bone was decreased,the BV/TV,Tb.N and Tb.Th were decreased,the Tb.Sp was increased,the bone strength of femoral head was significantly decreased,the differences being all statistically significant(P＜0.05 or P＜0.01).Compared with the model group,the spleen and thymus indicators were significantly increased in Xianling Gubao Capsules group and Gushi Zaizao Pills group,the levels of IL-1β and TNF-α in rat synovial fluid were decreased,the percentage of empty lacunae was significantly decreased,the area ratio of trabecular bone was significantly increased,the BV/TV,Tb.N and Tb.Th were increased,the Tb.Sp was decreased,and the bone strength of femoral head was significantly increased,the differences being all statistically significant(P＜0.05 or P＜0.01).Conclusion Gushi Zaizao Pills can effectively prevent the further development of SONFH by regulating cellular immunity and reducing the secretion of inflammatory factors,thereby reducing the pathological damage of the femoral head and enhancing the bone strength.

Objective:To investigate the influencing factors for total number, total volume, and total iron burden of cerebral microbleeds (CMBs) and the relationship between CMBs with cognitive impairment in end-stage renal disease (ESRD) using semi-automatic quantitative susceptibility mapping (QSM).Methods:The study was a cross-sectional study. Clinical and imaging data of 46 ESRD patients with≥1 CMBs who attended Tianjin First Central Hospital from November 2018 to August 2022 were retrospectively analyzed. There were 26 males and 20 females, aged 42-75 years. All patients underwent susceptibility-weighted imaging (SWI) scanning, then SWI data was post-processed to obtain QSM. The semi-automatic dynamic programming algorithm was used to get the volume and mean susceptibility value of each CMB by sketching the boundary of CMBs. The CMBs iron load total volume were calculated. Stepwise linear regression analysis was used to explore independent influencing factors for the number, total volume, and total iron burden of CMBs in ESRD patients. Partial correlation analysis was used to explore the relationship between CMBs and cognitive impairment with the other signs of cerebral small vessel diseases as covariates.Results:In patients with ESRD, CMBs were located in the frontal lobe in 19 cases, parietal lobe in 9 cases, temporal lobe in 19 cases, occipital lobe in 14 cases, basal ganglia in 27 cases, dorsal thalamus in 15 cases, centrum semiovale in 14 cases, cerebellum in 14 cases, and brainstem in 13 cases. C-reactive protein levels (95% CI 101.81-157.85, r=0.96, P=0.001) and creatinine levels (95% CI 5.32-29.61, r=0.71, P=0.010) were influencing factors for the total iron burden of CMBs. C-reactive protein levels (95% CI 0.72-1.15, r=0.99, P=0.001) and creatinine levels (95% CI 0.03-0.22, r=0.89, P=0.014) were influencing factors for the total volume of CMBs. C-reactive protein levels (95% CI 0.10-0.12, r=0.96, P=0.001) and alkaline phosphatase levels (95% CI 0.16-0.38, r=0.59, P=0.001) were influencing factors for the number of CMBs. The total volume ( r=-0.61, P=0.009) and total iron burden ( r=-0.71, P=0.002) of CMBs in the frontal lobe were negatively correlated with cognitive function. However, although the number of CMBs in the frontal lobe was negatively correlated with cognitive function, the statistics analysis was insignificant ( r=-0.53, P=0.063). Conclusions:C-reactive protein and creatinine are influencing factors for CMBs′ total volume and total iron burden; C-reactive protein levels and alkaline phosphatase are influencing factors for the number of CMBs. The total iron burden and total volume of CMBs in the frontal lobe may be the biomarkers of cognitive impairment in patients with end-stage renal disease.