Objective To study the analgesia effect and adverse reactions of epidural and subcutaneous multimodal analgesia in thoracotomy esophageal cancer resection operation .Methods Forty patients undergoing elective esophageal cancer resection op‐eration were randomly divided into the epidural and subcutaneous analgesia group (group A) and the subcutaneous analgesia group (group B) ,20 cases in each group .The group A adopted 0 .15% ropivacaine and 0 .00002% sufentanil by continuous pumping infu‐sion before and during operation for continuous analgesia ,then intravenous tramadol was given before closing chest ,tramadol and sufentanil subcutaneous patients self‐control analgesia (PCA)were used after operation for analgesia .The group B was given intra‐venous tramadol before closing chest ,then tramadol and sufentanil patient subcutaneous controlled analgesia after operation were used for analgesia .The scores of the visual analogue scale(VAS) ,comfort scale ,sedative scores ,dose of analgesics ,pressing fre‐quency and pressing frequency ratio of PCA ,vital signs and adverse reactions were assessed at different time periods .Results The VAS scores and pressing frequency of PCA at rest and movement in the group A were remarkably decreased compared with the group B ,while the comfort status score and pressing frequency ratio of PCA were obviously increased ,the differences were statisti‐cally significant(P<0 .05);the occurrence rates of adverse reactions such as the vital signs ,sedative scores ,nausea ,vomitting ,skin itch ,chest distress after operation had no statistically significant differences between the two groups .Conclusion Epidural and sub‐cutaneous multimodal analgesia is a better multimodal analgesia scheme in thoracotomy esophageal cancer resection operation .

Objective: To summarize the progress of diagnosis and treatment of upper respiratory obstruction in patients with Treacher Collins syndrome (TCS). Methods: The domestic and abroad literature about the diagnosis and treatment of upper respiratory obstruction in patients with TCS was extensively reviewed and analyzed. Results: TCS is an autosomal-dominant craniofacial developmental syndrome. It is often accompanied by midface and/or mandibular hypoplasia, soft tissue hypertrophy, and other respiratory tissue developmental abnormalities, which can lead to different degrees of upper respiratory obstruction symptoms. Respiratory obstruction in patients with TCS is affected by many factors, and the obstructive degree are different. Early detection of the causes and obstructive sites and adopted targeted treatments can relieve the symptoms of respiratory obstruction and avoid severe complications. Conclusion: Due to the low incidence of TCS, there is still a lack of high-quality research evidence to guide clinical treatment. Large-scale and prospective clinical studies are needed to provide new ideas for the treatment and prevention of upper respiratory obstruction.

Results: Handheld Doppler, digital subtraction angiography, computer tomographic angiography, magnetic resonance angiography, and fluorescein angiography can be used as reliable preoperative imaging methods in designing expanded flaps with rich blood supply. Several techniques can be used for monitoring the blood supply of expanded flaps during the early postoperative period including traditional monitoring via physical examination, monitoring via dynamic infrared thermography, near-infrared spectroscopy tissue oximeter, external and implantable Doppler, and more recently developed diffuse correlation spectroscopy. Surgical delay, bloodletting, leech therapy, hyperbaric oxygen, and so on can decrease the risk of necrosis in expanded flaps.

Objective The study was designed to comparatively analyze ultrasonic appearance,laboratory and pathological findings in autoimmune hepatitis(AIH),and their correlation.The clinical value of ultrasound in diagnosing autoimmune hepatitis was studied.Methods By retrospectively reviewing the ultrasonic images,pathological and laboratory results of 68 patients with autoimmune hepatitis admitted to the PLA 302 Hospital from 2014 to 2015,we tried to reveal the correlation between ultrasonic features and pathological and laboratory findings.Results The ultrasonic diagnosis of liver fibrosis was not statistically correlated with the features of pathological ″interface hepatitis″ and serological liver function test.But it was positively correlated with the features of pathological ″spotty necrosis″(r=0.5099,P ＜ 0.001).The ultrasonic features of ″cord-like structure″ and ″nodular change″ had statistically improved the classification of the degree of AIH fibrosis on ultrasonic diagnosis(t=3.9547,P ＜ 0.01).The ultrasonic feature of the change of ″liver size″ and ″morphology″ also have statistically improved the diagnosis of AIH fibrosis with ultrasonography(t=2.070,2.137,4.584,3.773,all P＜0.05).Conclusion Ultrasonic images could provide objective evidence in diagnosis of AIH and evaluation of fibrosis degree.

Digital medical technologies or computer aided medical procedures have greatly promoted the progress of craniomaxillofacial surgery. Digital three-dimensional reconstruction, 3D printing, digital imaging simulated surgery and osteotomy guide plate have revolutionized the treatment strategy, reduced the difficulty of treatment, and improved the accuracy and predictability of treatment outcome. Now, they have become the routine diagnosis and treatment options in craniomaxillofacial surgery. It is believed that craniomaxillofacial surgery will achieve further development with the continuous improvement of dynamic navigation and research and application of intelligent surgical robots.

Digital medical technologies or computer aided medical procedures have greatly promoted the progress of craniomaxillofacial surgery. Digital three-dimensional reconstruction, 3D printing, digital imaging simulated surgery and osteotomy guide plate have revolutionized the treatment strategy, reduced the difficulty of treatment, and improved the accuracy and predictability of treatment outcome. Now, they have become the routine diagnosis and treatment options in craniomaxillofacial surgery. It is believed that craniomaxillofacial surgery will achieve further development with the continuous improvement of dynamic navigation and research and application of intelligent surgical robots.

New medical service price items (hereinafter referred to as the new item) management is key to deepening medical service price reform.Based on the review of the policy development of the new item management and status quo of provincial-level practices, the authors sorted out the problems in the new item management as follows. Namely the new item connotation was not clearly defined, linkage with the national specifications for medical service price items was not yet well defined, the approval process was imperfect, the pricing fundamentals were weak, and the maturity term system was to be strengthened. According to such analyses, the authors proposed countermeasure recommendations for optimizing the new item management: to introduce and implement unified national specifications for medical service price item and the new item guidance as quickly as possible, to promote the linkage between the new item management and the dynamic adjustment mechanism of medical service prices, and to strengthen institutional construction of the new item management.

The symmetry of facial contours is an important reference for assessing the attractiveness of human face. Restoring facial symmetry is the main goal in the treatment of many craniofacial conditions; therefore, the accurate measurements of symmetry deviation is highly relevant when planning surgical treatment. Quantitative assessment of facial asymmetry first requires the establishment of a reliable midline or midsagittal plane (MSP). Direct anthropometry, two-dimensional photometry, cephalometric, computed tomography imaging or three-dimensional, etc. can be used for qualitative and quantitative evaluate facial asymmetry. The following review summarize the progress of quantitative method for evaluating facial asymmetry, so as to provide some references for surgeons to accurately, qualitatively and quantitatively analyze the facial contour symmetry of patients before surgery.

The symmetry of facial contours is an important reference for assessing the attractiveness of human face. Restoring facial symmetry is the main goal in the treatment of many craniofacial conditions; therefore, the accurate measurements of symmetry deviation is highly relevant when planning surgical treatment. Quantitative assessment of facial asymmetry first requires the establishment of a reliable midline or midsagittal plane (MSP). Direct anthropometry, two-dimensional photometry, cephalometric, computed tomography imaging or three-dimensional, etc. can be used for qualitative and quantitative evaluate facial asymmetry. The following review summarize the progress of quantitative method for evaluating facial asymmetry, so as to provide some references for surgeons to accurately, qualitatively and quantitatively analyze the facial contour symmetry of patients before surgery.