Objective To investigate the scale of self-efficacy and the influencing factors among the elderly diabetic population in rural communities in Shanghai . Method The diabetic patients in the rural communities were involved in the study by questionnaire to analyze the patient′s self-efficacy and its influencing factors. Results The total score of self-efficacy was (77.48 ± 22.22), with the index score of 59.60%. By multiple stepwise regression analysis, the influencing factors were age, education level and annual income. Conclusions The self-efficacy of diabetic patients is at a low level. To improve their self-efficacy, we should strengthen the education to the diabetic patients with age of 40~49 or poor in education or lower in income.

In recent years, with the development of autologous fat grafting and the use of scaffolds, prepectoral breast reconstruction (PBR) has regained popularity and aroused a hot topic. Several meta-analyses have shown that PBR is safe when compared with subpectoral breast reconstruction, the standard of prosthetic breast reconstruction. There are many advantages in PBR such as mild pain and no dynamic deformity. Radiotherapy, required by up to 40% of patients, is a routine treatment for breast cancer. However, the safety and efficacy of PBR in this population are still inconclusive. Therefore, we reviewed clinical researches concerning PBR in patients who recieved radiotherapy, in order to provide reference for clinical application and future study of PBR. We analysed in the following five aspects: the influence of radiation on soft tissue and the implant, indications and contraindications, the research status of PBR in patients with radiotherapy, the influence of fat grafting on PBR in patients with radiotherapy and the limitation of the present study.

Breast augmentation using polyacrylamide hydrogel (PAHG) was widely used in China. We present the first case of delayed breast inflammation after 2019 novel coronavirus(2019-nCoV) infection in a patient who recieved breast augmentation with PAHG 20 years ago, without any other predispositions. The 45-year-old female patient complained of severe breast swelling and pain three weeks after 2019-nCoV infection. The swelling extended from the upper clavicle to the upper abdomen. Delayed inflammation reaction was diagnosed, followed by emergency surgery. During the surgery, the injected material was observed to gush out in a form of greenish and thin paste, with a foul odor. The wound had extensive diffuse oozing and hemoglobin decreased significantly. The patient was discharged one week after surgery. During a three-month follow-up, she experienced weakness and fatigue with no complications. There are still many unknown areas of the impact of 2019-nCoV on human foreign bodies and immune system, which is diverse and complex. Reporting various possible symptoms and mechanisms is conducive to improving the level of awareness and intervention of plastic surgeons.

In recent years, with the development of autologous fat grafting and the use of scaffolds, prepectoral breast reconstruction (PBR) has regained popularity and ignited a heated discussion. Several meta-analyses have shown that PBR is safe when compared with subpectoral breast reconstruction, the standard of prosthetic breast reconstruction. There are many advantages in PBR such as mild pain and no dynamic deformity. Radiotherapy, required by up to 40% of patients, is a routine treatment for breast cancer. However, the safety and efficacy of PBR in this population remain inconclusive. Therefore, we reviewed clinical researches concerning PBR in patients who received radiotherapy, with the purpose to provide reference for clinical application and future study of PBR. We analysed the following five aspects: the influence of radiation on soft tissue and the implant, indications and contraindications, the research status of PBR in patients with radiotherapy, the influence of fat grafting on PBR in patients with radiotherapy and the limitation of the present study.

Indocyanine green angiography (ICGA) is currently the only technique that can quantitatively evaluate the intraoperative perfusion, which can reduce the rate of postoperative flap necrosis. It has been widely used in the flap surgery in clinical practice, scientific research and teaching area. Being quite safety and effectiveness, it has the advantages of non-invasive, no renal toxicity and no radiation with the result which can be both qualitative and quantitative. This review also introduced the application method and application status of ICGA, summarized all application indicators reported so far, and analyzed the limitations such as the accuracy of the result and the lack of application guidelines. In general, ICGA has a great application prospect in flap surgery.

In recent years, with the development of autologous fat grafting and the use of scaffolds, prepectoral breast reconstruction (PBR) has regained popularity and aroused a hot topic. Several meta-analyses have shown that PBR is safe when compared with subpectoral breast reconstruction, the standard of prosthetic breast reconstruction. There are many advantages in PBR such as mild pain and no dynamic deformity. Radiotherapy, required by up to 40% of patients, is a routine treatment for breast cancer. However, the safety and efficacy of PBR in this population are still inconclusive. Therefore, we reviewed clinical researches concerning PBR in patients who recieved radiotherapy, in order to provide reference for clinical application and future study of PBR. We analysed in the following five aspects: the influence of radiation on soft tissue and the implant, indications and contraindications, the research status of PBR in patients with radiotherapy, the influence of fat grafting on PBR in patients with radiotherapy and the limitation of the present study.

Breast augmentation using polyacrylamide hydrogel (PAHG) was widely used in China. We present the first case of delayed breast inflammation after 2019 novel coronavirus(2019-nCoV) infection in a patient who recieved breast augmentation with PAHG 20 years ago, without any other predispositions. The 45-year-old female patient complained of severe breast swelling and pain three weeks after 2019-nCoV infection. The swelling extended from the upper clavicle to the upper abdomen. Delayed inflammation reaction was diagnosed, followed by emergency surgery. During the surgery, the injected material was observed to gush out in a form of greenish and thin paste, with a foul odor. The wound had extensive diffuse oozing and hemoglobin decreased significantly. The patient was discharged one week after surgery. During a three-month follow-up, she experienced weakness and fatigue with no complications. There are still many unknown areas of the impact of 2019-nCoV on human foreign bodies and immune system, which is diverse and complex. Reporting various possible symptoms and mechanisms is conducive to improving the level of awareness and intervention of plastic surgeons.

In recent years, with the development of autologous fat grafting and the use of scaffolds, prepectoral breast reconstruction (PBR) has regained popularity and ignited a heated discussion. Several meta-analyses have shown that PBR is safe when compared with subpectoral breast reconstruction, the standard of prosthetic breast reconstruction. There are many advantages in PBR such as mild pain and no dynamic deformity. Radiotherapy, required by up to 40% of patients, is a routine treatment for breast cancer. However, the safety and efficacy of PBR in this population remain inconclusive. Therefore, we reviewed clinical researches concerning PBR in patients who received radiotherapy, with the purpose to provide reference for clinical application and future study of PBR. We analysed the following five aspects: the influence of radiation on soft tissue and the implant, indications and contraindications, the research status of PBR in patients with radiotherapy, the influence of fat grafting on PBR in patients with radiotherapy and the limitation of the present study.

Indocyanine green angiography (ICGA) is currently the only technique that can quantitatively evaluate the intraoperative perfusion, which can reduce the rate of postoperative flap necrosis. It has been widely used in the flap surgery in clinical practice, scientific research and teaching area. Being quite safety and effectiveness, it has the advantages of non-invasive, no renal toxicity and no radiation with the result which can be both qualitative and quantitative. This review also introduced the application method and application status of ICGA, summarized all application indicators reported so far, and analyzed the limitations such as the accuracy of the result and the lack of application guidelines. In general, ICGA has a great application prospect in flap surgery.

Objective:To explore the safety and efficacy of prophylactic superdrainage using superficial inferior epigastric vein (SIEV) in delayed single-pedicled deep inferior epigastric perforator (DIEP) flap breast reconstruction.Methods:The clinical data of all patients who underwent single-pedicle DIEP flap delayed breast reconstruction in Department of Comprehensive Breast Plasty Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from May 2018 to August 2022 were retrospectively analyzed. According to whether SIEV-internal thoracic vein anastomosis was performed, they were divided into superdrainaged group and non-superdrainaged group. The diameter of SIEV and the time required for anastomosis were recorded. The total operation time, flap ischemia time, hospital stay, the rates of flap diffuse congestion, overall complications and second operation were compared between the two groups. The relative risks of flap diffuse congestion, complications and second operation were calculated. SPSS 24.0 software was used for data analysis. Measurement data was expressed as Mean±SD, independent sample t test was used for analysis. Counting data was expressed as %, and χ2 test was used for analysis. P<0.05 was considered statistically significant. Results:A total of 45 patients were included, including 26 patients in the non-superdrainaged group and 19 patients in the superdrainaged group. The total operation time was (7.7±1.9) h and (8.4±1.5) h, the flap ischemia time was (89.5±10.4) min and (92.6±12.3) min, and the hospital stay was (6.6±1.8) d and (6.6±2.0) d, respectively. There were no significant differences ( P>0.05). In the superdrainaged group, the diameter of SIEV was (2.5±0.3) mm, and manual suture was used. The time required for anastomosis of one SIEV was (12.2±2.3) min. The rates of diffuse congestion, recipient site complications, donor site complications and second operation were 7.7%(2/26), 15.4%(4/26), 7.7%(2/26) and 15.4%(4/26) in the non-superdrainaged group, and 0(0/19), 5.3%(1/19), 10.5%(2/19) and 5.3%(1/19) in the superdrainaged group, respectively. There were no significant differences between the two groups ( P>0.05). The relative risks were 3.7, 2.9, 0.7 and 2.9, respectively. Conclusion:Prophylactic superdrainage using SIEV is safe and effective. It can minimize the potential rate of diffuse venous congestion and secondary surgery, and not at the expense of increased flap ischemia time and abdominal complications in the meanwhile.