Objective:To analyze the non-medical technology security liability dispute litigation cases in hospitals and propose corresponding countermeasures, for references for optimizing hospital safety management.Methods:Through the China Judgments Online, non-medical technical security liability dispute litigation cases in hospitals (279 cases) nationwide from 2021 to 2023 were collected. Swiss cheese model and content analysis were employed to examine the basic case details, reasons for judgment, types of hospital liability, characteristics of suicide cases, and plaintiffs′ claims regarding.Results:The 279 cases involved 231 hospitals (excluding anonymous and duplicate hospitals) and 279 patients. Among them, there were 144 tertiary hospitals, accounting for 62.34%; The inpatient department was a high-risk area for accidents (103 times, 36.92%); The frequency of falls was the highest (182 times, 65.23%); 210 cases were ruled against the hospital, accounting for 75.27%. From the perspective of court judgment reasons, the precursor of unsafe behavior (122 cases, 58.10%) was the most common primary reason, the proportion of cases which hospital bore the main responsibility was relatively high (46 cases, 71.88%); 50 cases (23.81%) were due to safety hazards in hospital facilities caused by secondary reasons. Among the 41 cases of patient suicide, 36 cases were fatal, 18 cases occurred in general hospitals, and 24 cases were without medical fault.Conclusions:The inpatient department of the hospital was a high-risk area for accidents, and the medical side had a relatively high failure rate; The warning signs of unsafe behavior were easily overlooked, and there were more cases of suicide among patients in general hospitals. It is recommended that hospitals should enhance their safety management systems, establish collaborative tiered nursing teams involving medical and nursing staff, promote the application of artificial intelligence in refined logistical management, and implement a documentation and oversight mechanism for critical procedures.

Objective:To analyze the non-medical technology security liability dispute litigation cases in hospitals and propose corresponding countermeasures, for references for optimizing hospital safety management.Methods:Through the China Judgments Online, non-medical technical security liability dispute litigation cases in hospitals (279 cases) nationwide from 2021 to 2023 were collected. Swiss cheese model and content analysis were employed to examine the basic case details, reasons for judgment, types of hospital liability, characteristics of suicide cases, and plaintiffs′ claims regarding.Results:The 279 cases involved 231 hospitals (excluding anonymous and duplicate hospitals) and 279 patients. Among them, there were 144 tertiary hospitals, accounting for 62.34%; The inpatient department was a high-risk area for accidents (103 times, 36.92%); The frequency of falls was the highest (182 times, 65.23%); 210 cases were ruled against the hospital, accounting for 75.27%. From the perspective of court judgment reasons, the precursor of unsafe behavior (122 cases, 58.10%) was the most common primary reason, the proportion of cases which hospital bore the main responsibility was relatively high (46 cases, 71.88%); 50 cases (23.81%) were due to safety hazards in hospital facilities caused by secondary reasons. Among the 41 cases of patient suicide, 36 cases were fatal, 18 cases occurred in general hospitals, and 24 cases were without medical fault.Conclusions:The inpatient department of the hospital was a high-risk area for accidents, and the medical side had a relatively high failure rate; The warning signs of unsafe behavior were easily overlooked, and there were more cases of suicide among patients in general hospitals. It is recommended that hospitals should enhance their safety management systems, establish collaborative tiered nursing teams involving medical and nursing staff, promote the application of artificial intelligence in refined logistical management, and implement a documentation and oversight mechanism for critical procedures.

Objective:To explore the clinical outcome and applicability of the comb flap technique and stepwise design concept in plastic aesthetic and reconstructive surgery.Methods:The clinical data of patients who underwent plastic aesthetic and reconstructive surgery with the comb flap technique in Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2018 to December 2022 were retrospectively analyzed. The application of the comb flap technique follows the concept of stepwise design, that was, preoperative and intraoperative design and adjustment were carried out step by step and in sequence, and the design was combined with the surgical procedure. Its main operations included: an incision was designed along the edge of the target area, the tissue flap was widely separated at the base of the target area. The tissue flap was cut in sequence perpendicular to the cutting edge and temporarily sutured and fixed, the edge was cut and fixed. During the operation, the tension of the incision and the local appearance could be adjusted. The incisal edge was finely sutured, and the temporary suture was finally removed. The healing of surgical incision and complications were observed after the operation, and the facial recovery and surgical effect were followed up.Results:Six patients were enrolled, including 3 males and 3 females, aged from 2 to 58 years. One patient underwent upper eyelid tightening and lower eyelid blepharoplasty through subeyebrow incision. One patient underwent middle and lower face rhytidectomy. One patient underwent thick lip thinning and right facial liposuction. One patient underwent facial congenital melanocytic nevi resection. One patient underwent eyebrow congenital melanocytic nevus resection. One patient underwent facial flap repair. All patients had primary healing of incision, and no surgery-related complications occurred. All patients were followed up for 3 to 18 months, and all patients were satisfied with the surgical effect.Conclusion:The application of comb flap technique and stepwise design concept in plastic aesthetic and reconstructive surgery can delicately adjust the alignment of the incision margin, make the tension evenly distributed, and reduce the risk of scar formation and deformity after the operation. It has a wide range of clinical applications and good applicability.

Objective:To explore the clinical outcome and applicability of the comb flap technique and stepwise design concept in plastic aesthetic and reconstructive surgery.Methods:The clinical data of patients who underwent plastic aesthetic and reconstructive surgery with the comb flap technique in Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2018 to December 2022 were retrospectively analyzed. The application of the comb flap technique follows the concept of stepwise design, that was, preoperative and intraoperative design and adjustment were carried out step by step and in sequence, and the design was combined with the surgical procedure. Its main operations included: an incision was designed along the edge of the target area, the tissue flap was widely separated at the base of the target area. The tissue flap was cut in sequence perpendicular to the cutting edge and temporarily sutured and fixed, the edge was cut and fixed. During the operation, the tension of the incision and the local appearance could be adjusted. The incisal edge was finely sutured, and the temporary suture was finally removed. The healing of surgical incision and complications were observed after the operation, and the facial recovery and surgical effect were followed up.Results:Six patients were enrolled, including 3 males and 3 females, aged from 2 to 58 years. One patient underwent upper eyelid tightening and lower eyelid blepharoplasty through subeyebrow incision. One patient underwent middle and lower face rhytidectomy. One patient underwent thick lip thinning and right facial liposuction. One patient underwent facial congenital melanocytic nevi resection. One patient underwent eyebrow congenital melanocytic nevus resection. One patient underwent facial flap repair. All patients had primary healing of incision, and no surgery-related complications occurred. All patients were followed up for 3 to 18 months, and all patients were satisfied with the surgical effect.Conclusion:The application of comb flap technique and stepwise design concept in plastic aesthetic and reconstructive surgery can delicately adjust the alignment of the incision margin, make the tension evenly distributed, and reduce the risk of scar formation and deformity after the operation. It has a wide range of clinical applications and good applicability.

Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with unclear etiology and limited treatment options. The median survival time for IPF patients is approximately 2-3 years and there is no effective intervention to treat IPF other than lung transplantation. As important components of lung tissue, endothelial cells (ECs) are associated with pulmonary diseases. However, the role of endothelial dysfunction in pulmonary fibrosis (PF) is incompletely understood. Sphingosine-1-phosphate receptor 1 (S1PR1) is a G protein-coupled receptor highly expressed in lung ECs. Its expression is markedly reduced in patients with IPF. Herein, we generated an endothelial-conditional S1pr1 knockout mouse model which exhibited inflammation and fibrosis with or without bleomycin (BLM) challenge. Selective activation of S1PR1 with an S1PR1 agonist, IMMH002, exerted a potent therapeutic effect in mice with bleomycin-induced fibrosis by protecting the integrity of the endothelial barrier. These results suggest that S1PR1 might be a promising drug target for IPF therapy.

The aim of this study was to evaluate the roles of interleukin (IL)-17A in risk stratification and prognosis of patients with sepsis-associated acute kidney injury (SAKI). Methods: We enrolled 146 sepsis patients (84 non-SAKI and 62 SAKI patients) admitted to the emergency department from November 2020 to November 2021. Patients with SAKI were differentiated based on the severity of acute kidney injury. All clinical parameters were evaluated upon admission before administering antibiotic treatment. Inflammatory cytokines were assessed using flow cytometry and the Pylon 3D automated immunoassay system (ET Healthcare). In addition, a receiver operating characteristic (ROC) curve was utilized to determine the prognostic values of IL-17A in SAKI. Results: The levels of creatinine, IL-2, IL-4, IL-6, IL-17A, tumor necrosis factor alpha, C-reactive protein, and procalcitonin (PCT) were significantly higher in the SAKI group than in the non-SAKI group (p < 0.05). The level of IL-17A revealed significant differences among stages 1, 2, and 3 in SAKI patients (p < 0.05). The mean levels of PCT, IL-4, and IL-17A were significantly higher in the non-survival group than in the survival group in SAKI patients (p < 0.05). In addition, the area under the ROC curve of IL-17A was 0.811. Moreover, the IL-17A cutoff for differentiating survivors from non-survivors was 4.7 pg/mL, of which the sensitivity and specificity were 77.4% and 71.0%, respectively. Conclusion: Elevated levels of IL-17A could predict that SAKI patients are significantly prone to worsening kidney injury with higher mortality. The usefulness of IL-17A in treating SAKI requires further research.

This article reports a pedigree with two previously deceased neonates. Both neonates did not experience asphyxia but passed away on their 5th and 13th day of life. The chromosomal analysis of the parents' karyotype revealed no abnormalities. Clinical manifestations of the two deceased cases and relevant medical records were recollected. Whole exome sequencing was conducted on the stem blood sample of Neonate 2, revealing a c.729_730insTT homozygous mutation (p.D244Lfs*39) in the methylmalonyl-CoA mutase gene (NM_000255). It was confirmed that Neonate 2 was affected with methylmalonic acidemia. Amniocentesis was performed at 20 +3 weeks in the current pregnancy. Sanger sequencing of amniotic fluid indicated that the fetus carried the same gene mutation as Neonate 2. Consequently, the fetus was expected to be a patient with methylmalonic acidemia and to exhibit the same phenotype as Neonate 2. Termination of pregnancy, therefore, was selected at 24 weeks of gestation.

Thanks to the development of computer science, display technology and tracking technology in recent years, virtual reality and augmented reality catch more and more people’s eyes. At the same time, this new technology has been applied to many different industries, and it has huge practical value and broad prospect in healthcare, especially in plastic surgery. In this article we review the basic concept of virtual reality and augmented reality and introduce their practical applications in plastic surgery (preoperative planning, intraoperative guiding and surgical training), providing an outlook for further development in this field.

Thanks to the development of computer science, display technology and tracking technology in recent years, virtual reality and augmented reality catch more and more people’s eyes. At the same time, this new technology has been applied to many different industries, and it has huge practical value and broad prospect in healthcare, especially in plastic surgery. In this article we review the basic concept of virtual reality and augmented reality and introduce their practical applications in plastic surgery (preoperative planning, intraoperative guiding and surgical training), providing an outlook for further development in this field.

Autophagy is a critical cellular homeostatic mechanism, and its dysfunction is linked to invasive breast carcinoma (BRCA). Recently, several omics methods have been applied to explore autophagic regulators in BRCA; however, more reliable and robust approaches for identifying crucial regulators and druggable targets remain to be discovered. Thus, we report here the results of multi-omics approaches to identify potential autophagic regulators in BRCA, including gene expression (EXP), DNA methylation (MET) and copy number alterations (CNAs) from The Cancer Genome Atlas (TCGA). Newly identified candidate genes, such as