Objective:To investigate the effect of inferior epigastric artery perforator flap transplantation in repairing traumatic soft tissue defects of lower limbs.Methods:A retrospective case series study was conducted to analyze the clinical data of 34 patients with traumatic soft tissue defects of lower limbs admitted to Chongqing Great Wall Hospital from January 2019 to May 2021, including 31 males and 3 females; aged 12-65 years [(38.5±5.6)years]. There were 8 patients with defects on the calf and 26 on the ankle. All wounds were found with exposed tendons, muscles and/or bones. The area of soft tissue defects ranged from 10 cm×6 cm to 40 cm×11 cm. All patients were repaired with inferior epigastric artery perforator flap. The wound healing, flap survival and recovery were observed. The visual analogue scale (VAS) and American Orthopedic Foot and ankle Society (AOFAS) ankle-hindfoot score were used to evaluate pain and ankle function before operation and at 3 days, 7 days, 14 days, 1 month, 3 months, 6 months and 12 months after operation. The complications were observed.Results:All patients were followed up for 12-36 months [(19.5±5.3)months]. All wounds were healed by stage I, showing the healing time of 14-24 days [(17.6±2.8)days]. All flaps survived with good color, soft texture and satisfactory appearance, with no obvious swelling. All flaps produced protective sensation. The VAS was (4.3±0.8)points, (3.3±0.7)points, (1.4±0.5)points, (1.2±0.3)points, (0.8±0.2)points and (0.4±0.1)points at 7 days, 14 days, 1 month, 3 months, 6 months and 12 months after operation, decreased gradually from preoperative (7.4±1.3)points (all P<0.05). The AOFAS ankle-hindfoot score was (35.6±3.1)points, (42.6±3.6)points, (50.3±4.3)points, (56.2±5.6)points, (60.3±6.8)points and (65.3±9.0)points at 7 days, 14 days, 1 month, 3 months, 6 months and 12 months after operation, increased from preoperative (22.4±2.5)points (all P<0.05). The ankle function was excellent in 25 patients, good in 5 and fair in 4 at 12 months after operation, with an excellent and good rate of 88.2%. Venous crisis occurred in 3 patients after operation, and the flaps survived completely after venous reanastomosis or venous bridging. Conclusion:For traumatic soft tissue defects of lower limbs, inferior epigastric artery perforator flap transplantation has advantages of enhanced survival of flaps, satisfactory appearance, attenuated pain, good functional recovery and few complications.

Objective:To analyze the association of pre-pregnancy body mass index (BMI) and gestational weight gain with macrosomia.Methods:In this retrospective cohort study, data of all puerperae and newborns in the Obstetrics Center of Peking Union Medical College Hospital from July 2020 to June 2021 were collected, including basic maternal information, pregnancy complications and neonatal conditions. A total of 2 422 pregnant women with full-term singleton live birth and their newborns were included in the analysis. The incidence of macrosomia (≥4 000 g) was calculated according to the birth weight of the newborns. Logistic regression and heat map were used to analyze the associations of pre-pregnancy BMI and gestational weight gain with macrosomia.Results:The incidence of macrosomia was 4.00% (97/2 422) in full-term singleton live birth newborns. Pre-pregnancy body weight, pre-pregnancy BMI, pre-pregnancy overweight/obesity rate, pre-delivery body weight, total weight gain during pregnancy, mean weekly weight gain during pregnancy, the proportion of excessive weight gain during pregnancy, duration of pregnancy, and the proportion of primiparity and education level of junior college or below were all significantly higher in the puerperae of the macrosomia group than those in the non-macrosomia group [(63.87±8.27) vs (58.14±7.86) kg, (23.33±2.97) vs (21.60±2.72) kg/m2, 35.1% vs 17.3%, (77.48±9.11) vs (70.02±8.79) kg, (13.61±4.56) vs (11.88±4.40) kg, (0.34±0.11) vs (0.30±0.11) kg, 58.8% vs 31.1%, (280.47±7.79) vs (276.14±7.83) d, 34.1% vs 23.7%, 18.6% vs 7.5%] (all P<0.05). Pre-pregnancy BMI ( OR=1.227, 95% CI: 1.145-1.314), mean weekly weight gain during the whole pregnancy ( OR=33.453, 95% CI: 5.172-217.947), duration of pregnancy ( OR=1.083, 95% CI: 1.055-1.112), primiparity ( OR=1.969, 95% CI: 1.232-3.101) and education level of junior college or below ( OR=2.525, 95% CI: 1.325-4.668) were all positively associated with occurrence of macrosomia (all P<0.05). The incidence of macrosomia increased with the pre-pregnancy body mass index and mean weekly weight gain during the whole pregnancy. Conclusions:High pre-pregnancy BMI and mean weekly weight gain during the whole pregnancy are associated with the increased risk of macrosomia. Appropriate weight management during pregnancy may help to reduce the incidence of adverse pregnancy outcomes.

Objective: To explore the relationship between selenium and the risk for oral cancer. Methods: We performed a case-control study in 325 cases of newly diagnosed primary oral cancer from the First Affiliated Hospital of Fujian Medical University and 650 controls from the same hospital and community. Unconditional logistic regression and stratification analyses were used to explore the association between selenium and oral cancer. Adjusted OR and corresponding 95%CI were calculated. The analyses on multiple interactions between selenium and smoking or drinking status, and fruit or fish intake frequencies were conducted. Results: The level of serum selenium was 112.42 (80.98-145.06) μg/L in the case group, which was lower than 164.85 (144.44-188.53) μg/L in control group, the difference was statistical significant (P<0.01). There was a negative correlation between serum selenium level and the risk for oral cancer regardless of smoking and drinking status, and fruits and fish intake frequencies (P<0.05). There were multiple interactions between serum selenium level and smoking or drinking status, and fruit and fish intakes. Conclusions The high level of serum selenium is a protective factor for the incidence of oral cancer, and serum selenium has multiple interactions with smoking or drinking status, and fruit and fish intakes. Therefore, reducing tobacco use and alcohol consumption and increasing the intakes of fruit and fish can reduce the risk for oral cancer to some extent.

Objective: To explore the association of TBX5 polymorphisms and environmental exposure index with susceptibility to oral cancer. Methods: A case-control study was conducted to collect 300 oral cancer patients hospitalized in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University from September 2010 to December 2016. A total of 445 non-tumor patients were selected as the control group. Questionnaires were used to collect the information of all subjects and 5 ml peripheral blood was collected to detect single nucleotide polymorphisms (SNPs) of the rs10492336 locus of TBX5 gene. According to the environmental exposure index score, subjects were divided into two groups, low risk group (0-2.31) and high risk group (2.32-11.76). To analyze the association of TBX5 gene rs10492336 SNPs, environmental exposure index and oral cancer and its interactions. Results: The age of all subjects in the case group and control group were (56.19±13.10) years and (54.56±12.48) years old. Compared with CC genotype, the OR (95%CI) values of the co-dominant genetic model AC genotype and the dominant genetic model AC+AA genotype were 0.69 (0.49-0.98) and 0.70 (0.51-0.97), respectively. Compared with the low risk group, the OR (95%CI) risk of oral cancer in the high risk group was 3.72 (2.55-5.43). The results of gene-environment interaction analysis showed that compared with the group with CC genotype and high risk of environmental exposure index, the OR (95%CI) value of oral cancer in the group with AC+AA genotype and low risk of environmental exposure index was 0.18(0.10-0.31). Furthermore there was a multiplicative interaction between rs10492336 SNPs and environmental exposure index (β=-0.405, P<0.001). Conclusion This study suggests that the TBX5 gene rs10492336 SNPs and environmental exposure index were associated with oral cancer. And there was a multiplication interaction between rs10492336 SNPs and environmental exposure index.