OBJECTIVETo correct the minor breast ptosis with minimal breast scar.

METHODS32 cases with minor breast ptosis were corrected by subfascia breast augmentation with periareolar incision and anatomic mammary implant.

RESULTBreast ptosis was completely or mostly corrected in all the patitents with periareola scar, avoiding the vertical breast scar. Except for short-time effusion in 2 cases, no other complication happened.

CONCLUSIONSSubfascia breast augmentation with periareolar incision and anatomic mammary implant can effectively correct minor breast ptosis with minimal breast scar and less complication.

Adult ; Breast Implantation ; methods ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Nipples ; surgery

Objective To introduce the technical key points and clinical efficacy of dual plane breast augmentation under endoscope through a transaxillary incision.Methods By analyzing the 89 surgical cases,we have summarized the key points of the pre-operative design,surgical skills and postoperative management.Results All patients had no uncontrolled bleeding during operation and loss of nipple and areola sensation.71 patients got 6-12 months follow-up,showing that only one case presented with unilateral capsular contraction,and the others had satisfied results.Conclusions Blunt dissection can reduce the risks of uncontrolled bleeding on the inner side of the pocket and the damage of the nerves on the lateral side of the dissecting pocket.The lower inner part,lower part and lower lateral part are the areas that could be sharply dissected by electrocautery under endoscope to achieve the dual plane Ⅰ.The drainage and bandage are necessary after the operation.

Objective:To investigate the wear resistance of four low-shrinkage commercial composite resins and two traditional composite resins in vitro and discuss the relative influencing factors, and to illustrate the inner relationship of the wear resistance of resins and material composition.Methods:Four low-shrinkage commercial composite resins including CLEARFIL MAJESTY Posterior(CMP), Filtek LS(LS), Admira(AD), Kalore(KA) and two traditional composite resins including Filtek Z350XT (Z350), Solitaire2(S2) were chosen.The bar-shaped specimens were fabricated and mounted in a UMT-2 wear testing machine and abraded with the two-body media (distilled water) with a Si3N4 ball as antagonist.The maximum wear depth was determined after 14 400 cycles.The friction coefficient was determined during the test.The worn surfaces were examined with SEM.Results:CMP showed the lowest maximum wear depth and KA presented the highest maximum wear depth.The maximum wear depth ranked as follows: CMP

Medical insurance fund is the foundation for the healthy operation of the medical insurance system, which is related to the well-being of the people and social stability. Medical institutions, as important entities in the implementation of medical insurance policies and the use of medical insurance funds, should continuously improve and optimize their self-management, and strengthen the prevention and control of clean risks in the use of medical insurance funds. This is not only a necessary response measure in the context of strict supervision of national medical insurance funds, but also an inevitable choice for hospitals under the trend of high-quality development. This article took a certain hospital as an example to illustrate the practice of sorting out the relevant authority directory for the use of medical insurance funds, analyze the integrity risk points of doctors, patients, and medical insurance reimbursement auditors; And introduced the practice of using a clean risk prevention and control grid to strengthen the hospital′s medical insurance fund, including improving the medical insurance management system, cultivating a sustainable culture of integrity, optimizing process design, improving information system construction, and improving medical insurance service modes, so as to provide reference for other medical institutions.

Objective To compare the efficacy between autologous fat and hyaluronic acid in filling nasolabial grooves.Methods Sixty patients who wanted improvement of nasolabial grooves were involved in the study.They were randomly and equally classified into two groups:autologous fat injection group and hyaluronic acid injection group.Photographs were taken before,half a year,and one year after injection.The nasolabial grooves were also graded before,half a year,and one year after injection.The grade improvement was obtained after postoperative grade minus preoperative grade.If the grade improvement was more than 1 grade,the treatment was regarded as effective to evaluate the outcome between the two methods.Results The results of the two groups were tested by SPSS 13.0 software.The effects of the two methods were not significantly different after half a year of filling (P＞0.05).The difference was significant one year after filling (P＜0.05).In autologous fat injection,the patients had a long and magnificant swelling and redness around the nasolabial grooves;on the contrary,the patients who underwent hyaluronic acid had slight and short-time local reaction like swelling and redness.No other serious complications were found in both the groups.Conclusions The effects of the autologous fat and the hyaluronic acid are equal after half a year of filling.The autologous fat has a longer effect in one year.Both methods are safe and effective.Surgeons can select the method accordingly.

As suggested by regulatory feedbacks from relevant national regulatory agencies on the use of medical insurance funds, noticeable problems were found in the compliance and rationality of medical service charges among Chinese hospitals. Based on the practice of hospital management, the authors summarized common problems of various medical service charge management as reported by the management authorities at all levels. These problems referred to name-replaceable charges and affiliated charges, splitting charges, repeated charges, and multiple(false) charges. On this basis, the paper analyzed such hospital management risks incurred as regulatory penalties, fee disputes and medical disputes, as well as their internal and external causes. In the end, the paper put forward countermeasures and suggestions for reference by hospitals in their management of medical service charges.

Objective To investigate the clinical efficacy of immunotherapy in stroke.Methods CNKI,VIP,Wanfang Data,CBM,the Cochrane Library,Embase,PubMed,and Web of Science databases were searched for random-ized controlled trials on immunotherapy for stroke published from 2000 to 2022,and RevMan5.3 and Stata14 were used for quality assessment and network meta-analysis.Results A total of 11 articles with 2 742 patients were included.The meta-analysis showed that compared with the placebo control group,the immune drug intervention group had no significant influence on modified Rankin Scale(mRS)score(P=0.45)and Barthel index(P=0.33)on day 90.The network meta-analysis showed that compared with the placebo group,there was a tendency of increase in the proportion of patients with an mRS score of 0-1 in the groups of GSK249320(OR=1.33,95%CI 0.48?3.67,P>0.05),Abciximab(OR=1.20,95%CI 0.69?2.07,P>0.05),and Cyclosporine(OR=1.07,95%CI 0.39?2.95,P>0.05),and there was a tendency of increase in Barthel index in the groups of IL-1Ra(OR=1.22,95%CI 0.75?1.96,P>0.05)and Abciximab(OR=2.75,95%CI 0.36?20.96,P>0.05).The largest surface under the cumulative ranking curve(SUCRA)of mRS score was ob-served for GSK249320,followed by Abciximab,Cyclosporine,Placebo,IL-1Ra,Natalizumab,and Enlimomab,and the largest SUCRA of Barthel index was observed for IL-1Ra,followed by Abciximab,Placebo,and Natalizumab.Conclusion Compared with placebo,immunotherapy does not show a better efficacy in the treatment of stroke,which may be associated with the inadequate understanding of the spatiotemporal dynamics and individualized characteristics of stroke immunity and a lack of systematic and comprehensive immunotherapy regimens.