ObjectiveTo understand patients’ cognition of third-party mediation model for medical disputes, analyze the factors influencing the trust of patients on third-party mediation, and propose recommendations for building third-party mediation mechanisms. MethodsFrom November 2013 to April 2014, we referred past literature to design a relevant questionnaire on the cognition of third-party mediation for medical disputes. Patients who had reached the end of the treatment were surveyed by random cluster sampling. The raw data were put into the computer for statistical analysis by SPSS 18.0. ResultsAfter giving out 500 questionnaires, we acquired 486 effective questionnaires. The result showed that 61.52% of the patients knew of third-party mediation; 55.35% of the patients considered that thirdparty mediation should be set in and supervised by the court or judicial administrative department; if the mediation failed, 57.41% of the patients chose to resolve the dispute through legal channels, and 67.90% of the patients tended to confirm the force of mediation conclusion by arbitration; 70.58% of the patients considered that mediators should have professional background of medicine and law; 73.05% of the patients tended to take conclusions of forensic identification as the basis for mediation; 64.81% of the patients were biased to take Tort Liability Act as the basis for determining the compensation; 53.70% of the patients believed that financial allocations could solve the fund problems of third-party mediation, while 38.48% of the patients thought the funds should be provided by insurance companies; 91.15% of the patients thought the medical institutions should purchase medical liability insurance, and 54.32% of the patients thought insurance companies should not intervene the process of meditation. Conclusions Government should provide financial allocations to ensure the funds of third-party mediation. Besides, medical insurance should be brought in as a supplement. Medical institutions should purchase medical liability insurance to solve problems caused by medical disputes. Third-party mediation should be set in and supervised by the court or the judicial administrative department. Mediators should have professional background of medicine and law. Conclusions of forensic identification should be the basis for third-party mediation.
Objective To explore the causal relationship between DNA copy number and the risk of Alzheimer disease (AD) using Mendelian randomization (MR) methods, as well as to investigate the potential mediating effects of immune cells. Methods The data related to 731 immune cell types, DNA copy number and AD from the Genome-Wide Association Study database were collected. A bidirectional MR analysis was conducted to explore the causal relationship between DNA copy number and AD, primarily using the inverse-variance weighted method and MR-Egger method. Additionally, a two-step mediation analysis was performed to identify potential mediating immune cells. Results A total of 134 single-nucleotide polymorphisms were included for bidirectional MR analysis. The MR methods results showed a negative causal relationship between DNA copy number and the risk of AD (P<0.05), while the reverse analysis showed no statistical significance. Sensitivity analysis confirmed the robustness of these results. The mediation analysis indicated that the immune cell phenotype (HVEM on CD45RA-CD4+) partially mediated the causal relationship between DNA copy numbers and the risk of AD, with a mediation effect proportion of 4.6%. Conclusion An increase in DNA copy numbers may reduce the risk of AD, and immune cells partially mediate this causal relationship.