Objective To explore and estimate a new non-operative treatment of maxillary fracture with elastic traction for the purpose of early treatment and on-spot first aid. Methods 12 patients, who were suffer from maxillary fracture including Lefort Ⅰ, Ⅱ, Ⅲ fracture, zygomatico-maxillary complex fracture and nasomaxillary complex fracture within the past 2 or 3 weeks,were treated by closed tractive reduction with a patent craniomaxillary tractive device, a non-operative manner instead of surgical open reduction and rigid internal fixation. The devices were placed after dental splints had been ligated, and the traction force was adjusted depending on the extent of maxillary displacement and patient’s endurance. In general, the displaced maxilla could be pulled upwards, downwards, forward, leftward and rightward. For fallen maxilla, a special plate was placed on upper teeth and palate in order to push up the whole maxillary fragments. By adjusting the position of maxillary bar, the displacement could be reduction and correction. The elastic rubber loops were placed between dental splint and headframe, then the reduction of maxilla was accomplished. After reduction, external fixation such as intermaxillary fixation and craniomnetal bandage were used for maintenance. Results Tractive times of those 12 patients lasted from 2 days to 7 days, with an average of 4 days. After the non-operative trative reduction, satisfactory functional and cosmetic results were achieved with normal occlusion and facial contour in all patients. No obvious complications were found. Conclusion For fresh maxillary fracture except comminuted and impacted fracture, this new non-operative tractive treatment could be an ideal treatment rather than surgical open reduction.

Quality management covers every corner of hospital services,which upholds full-process quality management,continuous quality improvement and smooth management with patients at the center.By means of building a 3-tier quality management framework at the hospital,development of quality management criteria,appraisal indicators and documentation and use of quality management tools,quality management defects were identified from a third-party perspective.This effort has significantly improved quality of care at the hospital,and elevated the management execution and general service quality of the hospital.

Objective:To analyze the filing mechanism for cross provincial immediate reimbursement of medical insurance in China, so as to provide reference for optimizing the filing mechanism and improving the filing accessibility of insured personnel.Methods:Taking the filing policy of cross provincial immediate reimbursement of medical insurance in 2019 as the research object, on the basis of a comprehensive understanding of the national filing policy background, 90 coordinating regions in Zhejiang Province, Hubei Province and Ningxia Hui Autonomous Region were taken as survey samples to evaluate the relevant policies and extract key parameters, including filing identification methods, filing-related settlement benefits and filing ways. The parameters were compared and analyzed by using descriptive statistical methods.Results:The results of the survey showed that in terms of identity recognition methods, the provision of various supporting materials(residence permit, work certificate, etc.)was still the main way to carry out identity recognition for medical insured persons in different places.Filing-related reimbursement benefits were mainly adjusted by limiting the area of medical insurance treatment and adjusting the benefits parameters(reimbursement ratio). In terms of filing channels, 51(56.7%)sample co-ordination areas had realized at least one remote filing mode.Conclusions:The inclusiveness of filing identity verification mechanism for the floating population needs to be further improved, the filing-related treatment policies need to be further improved, and the convenience and standardization of filing channels need to be strengthened.

After recent years′ development, China′s Internet medical service and medical insurance policy system has begun to take shape, but it still needs to be further improved. By combing the connotation and mode of Internet medical services, the evolution of medical insurance payment system and the content of medical insurance payment policy in the United States, the authors put forward that China could further improve the medical insurance payment policy system of Internet medical care, strengthen the multi-point practice management of licensed doctors on the Internet, give full play to the role of commercial insurance in promoting Internet medical care, and rely on information technology means to improve the medical insurance supervision of Internet medical services, then promote the development and management of Internet medical insurance services in China.

Objective:To analyze the health development plans of the provinces in China during the " 14th Five-Year Plan" , and explore the key tasks, similarities and differences of health informatization construction in each province.Methods:Using the website of local people′s government and the official website of the provincial Health Commission, 27 copies of health development plans of various provinces during the " 14th Five-Year Plan" period were retrieved and collected from February 16 to June 5, 2022. The relevant statements of health information in the plan were extracted, content analysis was used to reveal the structural characteristics of the policy in the form of word frequency statistics, and discourse analysis was used to study the policy content.Results:The health information policies of 27 provinces during the " 14th Five-Year Plan" period could be summarized as 10 major themes, such as accelerating the construction of hierarchical diagnosis and treatment system, promoting the high-quality development of public hospitals, and deepening the reform of medical security system. The health information policy in the eastern, central and western regions was relatively clear, and there were certain differences in the construction points according to their own characteristics.Conclusions:During the " 14th Five-Year Plan" period, the policies of each province around the field of health information are well defined, and the core structure and content are similar. The distribution of key points in the eastern region is relatively balanced; the construction of health information in the central region is more prioritized and prominent; the construction of health information in the western region is focused on complementing the weak links and weaknesses.

Objective To introduce a practical high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS)method for the detection of seven growth hormone-releasing peptides (GHRPs)including GHRP-1,GHRP-2,GHRP-4,GHRP-5,GHRP-6,Hexarelin and Alexamorelin and two growth hormone secretagogues(GHS)including anamorelin and ipamorelin,and study the stability of these nine substances in the human urine.Method The urine samples were purified and extracted by a solid phase extraction procedure using Oasis(R) WCX column.The urine was first centrifuged and taken out 1 mL into a small column,cleaned by 5％ NH4OH and 20％ CH3CN respectively,eluated using the mixture of water and acetomitrile(1/3)with 2％ formic acid,blow-dried in the nitrogen at 35℃ and finally redissolved to be injected into the LC-MS/MS.Result The limits of detection were between 0.01～0.5 ng/mL accordingly.The spiked recoveries at the low concentration(1 ng/mL),medium concentration(2 ng/mL)and high concentration(10 ng/mL)ranged between 40％ and 76％.The intra-and interday precisions of the target substances at these three concentrations were all less than 15％.The indoor temperature,refrigeration condition and multigelation were observed to have significant impact on the anamorelin,GHRP-2,GHRP-4 and GHRP-5.Conclusion The method established in this study is simple,and its specificity and sensitivity meets the international standard and technical documents for laboratories set up by the Wworld Anti-Doping Agency.It has been applied in our routine work.Multigelation should be avoided in the transport,detection and long-term laboratory storage of urine samples.