Objective Blepharoplasty is a typical complex structural system, which involves many factors and the interaction among them. Therefore, it is the basis of controlling the occurrence of medical complications in blepharoplasty to clarify the hierarchical relationship of various risk factors and find out the key risk factors. Methods On the basis of identifying the risk factors for quality management of blepharoplasty by means of literature research, questionnaire survey and expert interview, the risk factor model of blepharoplasty quality management were analyzed and constructed. The relationship between the risk factors and the degree of influence on the risk factors was studied using Decision‐Making Trialand Evaluation Laboratory and Interpretative Structural Modeling Method, and the hierarchical structure model of the risk factors for blepharoplasty quality management was obtained. Results Six levels of risk factors in quality management of blepharoplasty were identified and classified, and the causal attributes among risk factors were determined. Six key risk factors in quality management of double eyelid surgery were determined according to centrality, and finally the above risk factors were divided into three categories: direct cause, excessive cause, and essential cause. Conclusions This study realizes the comprehensive risk factor analysis of the complex system of quality management of blepharoplasty, which can provide reference for plastic surgeons to make safety decisions of blepharoplasty.

Background Douyin APP is the short video APP with the largest number of users in China. Objective This study aimed to evaluate the quality and reliability of short videos about cosmetic surgery on Douyin. Methods In August 2022, we retrieved and screened 300 short videos related to cosmetic surgery from Douyin, extracted basic video information, encoded the content and identified the video source. The quality and reliability of short video information were evaluated using the DISCERN instrument. Results A total of 168 short videos of cosmetic surgery were included in the survey, and the video sources included personal accounts and institutional accounts. Overall, the total proportion of institutional accounts (47/168, 27.98%) is significantly less than that of personal accounts (121/168, 72.02%); nonhealth professionals received the most praises, comments and even collections and reposts, while for‐profit academic organizations or institutions received the least. The DISCERN scores of 168 short videos of cosmetic surgery were 3.74–4.58 (average 4.22). Content reliability ( p = .04) and overall short video quality ( p = .02) are significantly different, but short videos published from different sources have no significant difference in treatment selection ( p = .052). Conclusion The overall information quality and reliability of short videos about cosmetic surgery on Douyin are satisfactory in China. Patient or Public Contribution The participants were involved in developing research questions, study design, management and conduct, interpretation of evidence and dissemination.

Until now there has been no definitive anatomical study of the boundary between hepatic subsegments IVa and IVb. In this study, we used a multicolor segmental corrosion cast technique and a multicolor segmental technique on plastinated slices, in combination with helical CT three-dimensional (3D) reconstruction on 15 donated fresh isolated human liver specimens. The corrosion cast technique was carried out on eight of these specimens, and the remaining seven livers were used to make horizontal plastinated slices. Examination of these specimens and observation of 20 additional liver corrosion cast specimens showed that all boundaries between hepatic segments were complex, undulating scissures rather than simple, flat planes. We also found that there was an obvious boundary between subsegments IVa and IVb, such that subsegment IVa laid posterosuperior to subsegment IVb. A tributary of a hepatic vein passed through the boundary between subsegments IVa and IVb, and could serve as an anatomical landmark of this boundary.

Background: The glandular fluid secreted by apocrine sweat glands is decomposed by parasitic bacteria on the skin surface and releases a bad smell called axillary osmidrosis.Objective: To evaluate the effect of power-assisted rotary cutter with negative pressure suction through small incision for axillary osmidrosis.Methods: From January 2017 to January 2022, 647 patients with axillary osmidrosis underwent power-assisted rotary cutter with negative pressure suction through small incision surgery to treat for axillary osmidrosis. The operation time (min), intraoperative bleeding (ml) and recovery time (days) were counted. Three months after operation, the amount of underarm sweat, the disappearance of underarm hair, the incidence of operation, the effective rate of operation, and the satisfaction of operation results were evaluated by questionnaire.Results: There were no postoperative complications except five cases of mild axillary pigmentation after 3 months. All patients evaluated good odor elimination. No patient was rated as average or poor. No recurrence. Conclusion:Power-assisted rotary cutter with negative pressure suction through small incision is an effective and ideal surgical method to reduce the complications and recurrence of axillary osmidrosis.

Background: Vemurafenib is a selective BRAF inhibitor with significant early effects in melanoma, but resistance will develop with the duration of treatment. Therefore, overcoming vemurafenib resistance can effectively improve the survival rate of melanoma. The transcriptional activity of TCF4 is necessary to maintain the malignant phenotype of cancer cells. However, the effect of TCF4 on melanoma sensitivity to vemurafenib and the underlying mechanism is unclear. Methods: Vemurafenib-resistant A375 (A375/Vem) and SK-Mel-28 (SK-Mel-28/Vem) cells were constructed by administering increasing concentrations of vemurafenib, and the expression of TCF4 was examined in parent and vemurafenib-resistant cells. TCF4 loss-function cells models were established in A375/Vem and SK-Mel-28/Vem cells, respectively. Cell survival, clone formation, and cell apoptosis were assessed. The downstream target gene of TCF4 was verified by chromatin immunoprecipitation. Finally, the effect of TCF4 on melanoma cells glycolysis was investigated and were performed. Results: TCF4 expression was increased in vemurafenib-resistant melanoma cells, and knocking down TCF4 could promote the sensitivity of melanoma cells to vemurafenib. Mechanism investigation revealed that TCF4 could interact with GLUT3 and silencing TCF4 could inhibit GLUT3 expression. In addition, overexpression of GLUT3 reversed the growth and glycolysis of tumor cells that were inhibited by TCF4 knockdown. Conclusion: Our study demonstrates that TCF4 downregulation sensitizes melanoma cells to vemurafenib through inhibiting GLUT3-mediated glycolysis. These findings support TCF4 as an oncogene and provide new mechanism by which TCF4 confers chemotherapy resistance in melanoma.