Status quo and countermeasures of the new medical service price items management in China / 中华医院管理杂志

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.

Progress of diagnosis and treatment of upper respiratory obstruction in patients with Treacher Collins syndrome / 中国修复重建外科杂志

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.

Progress of monitoring methods and preventions of disorder of blood supplying of expanded flaps / 中国修复重建外科杂志

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.