Objective: This study is to manufacture the templates for costal cartilage carving, by digital simulation and three-dimensional printing technology, to realize the individualization of rhinoplasty. Methods: Preoperative simulated images and 6-month postoperative images, of 10 patients were included in this study. The simulation was produced using Geomagic Studio 2013 and 3-matic Research 9.0 software, according to patients′requirements. The templates for costal cartilage carving during the operation, were designed, measured and three-dimensional printed. Statistical analyses were performed using paired t-test. Results: The dorsal length in preoperative simulation was significantly shortened, compared with postoperative [(4.73±0.11) cm vs. (4.88±0.16) cm, t=-0.465, P=0.001). The nasal tip projection in preoperative simulation is parallel with postoperative[(2.66±0.10) cm vs. (2.66±0.11) cm, t=0.068, P=0.947). The nasolabial angle in preoperative simulation is slightly greater than postoperative, yet failed to reach statistical significance (95.3±3.1 degrees vs. 94.3±3.0 degrees, t=1.936, P=0.085). Most of the patients were satisfied with both the preoperative simulation and the surgical outcomes. Conclusions With the assistance of digital simulation and three-dimensional printing technology, the expectation of rhinoplasty patients can be visualized, which is helpful to minimize the difference between surgical outcomes and the patient′s anticipation. Therefore, the digital simulation and three-dimensional printing technology should be considered, to provide individually surgical plan for this group of patients.

Objective:To study the epidemiological characteristics and mixed infection of adenovirus in acute respiratory tract infections in Shanghai from 2015 to 2019, and to provide scientific basis for the prevention and control of adenovirus.Methods:Acute respiratory tract infections were collected from 3 hospitals in Shanghai from 2015 to 2019. Relevant information was registered and respiratory specimens were sampled for detection of respiratory pathogens by multiplex PCR.Results:A total of 1 543 cases of acute respiratory tract infection were included. The positive rate of adenovirus was 2.92%(45/1 543), the positive rates of influenza like illness (ILI) and severe acute respiratory illness (SARI) were 2.74%(29/1 058) and 3.30%(16/485), respectively. The positive rate of ILI during January-May 2019 was 5.43%(7/129), higher than that in the same period of 2015- 2018 (0.52%-4.48%) (Fisher’s exact test value=8.92, P=0.036). The incidence of adenovirus-positive cases was mainly distributed in the first and second quarters, accounting for 62.22% (28/45). The difference of the incidence of adenovirus-positive cases in each quarter was significant ( χ2= 12.52, P=0.006). The positive rate in the second quarter was highest (6.03%), which was higher than that in other quarters (1.89%-2.93%). There were significant differences among different age groups ( χ2=16.94, P=0.001), and the positive rate decreased with age ( χ2=10.16, P=0.001). The positive rate of 13-19 years old group (9.43%) was higher than that of other age groups (1.48%-4.81%). The positive rate of student group (12.07%) was higher than that of other occupations (2.61%). The difference was systematic ( χ2=11.53, P=0.001). Mixed infection accounted for 31.11% (14/45) of 45 adenovirus positive cases. The mixed infection rates of ILI and SARI were 34.48% (10/29) and 25.00% (4/16), respectively. Among 14 cases of mixed infection, the main mixed infection pathogens of adenovirus were influenza A virus and coronavirus. Conclusion:Adenovirus surveillance should be further strengthened in adolescents with a focus on students and other key groups in the second quarter.

Objective:To explore the clinical effects of anterolateral femoral or anteromedial femoral perforator flaps in repairing skin and soft tissue defects after resection of cutaneous squamous cell carcinoma (CSCC).Methods:This study was a retrospective observational study. From July 2015 to July 2022, 21 patients with CSCC were treated in the Department of Burns and Plastic Surgery of Guizhou Provincial People's Hospital, including 15 males and 6 females, aged from 27 to 74 years. The area of skin and soft tissue defects after extended resection of CSCC was 7.5 cm×4.0 cm to 23.0 cm×8.5 cm. The wounds in 18 patients were repaired with anterolateral femoral perforator flaps; variations of perforating branch of the descending branch of lateral circumflex femoral artery were observed in 3 patients during the operation, and the wounds were repaired with anteromedial femoral perforator flaps. The flap areas were 8.0 cm×5.0 cm to 25.0 cm×10.0 cm. The wounds in the donor areas were sutured directly in 19 patients, and the wounds in the donor areas were repaired with thin and medium-thickness skin grafts in the contralateral thigh in 2 patients. The postoperative survival of flaps and the occurrence of vascular crisis were observed. The length of operation and the hospitalization day were recorded. The recurrence of tumor, the appearances of the donor and recipient areas of flaps, the function of the flap donor area were followed up. At the last follow-up, the satisfaction degree of patients for the curative effects was evaluated.Results:The flaps survived in 20 patients, while the vascular crisis occurred in 1 patient within 48 hours after operation, and the flap survived after immediate emergency operation. The length of operation was 4 to 5 hours, and the hospitalization day was 15 to 38 days. The patients were followed up for 1 to 6 years after operation, there was no local tumor recurrence, the color and texture of the flaps were with no obvious differences to those of the surrounding tissue, and the elasticity and appearance were good. The skin grafts in the flap donor areas of 2 patients survived well with local pigmentation. There was only linear scar in the flap donor areas of all patients, and there were no significant effects on sensory and motor functions. At the last follow-up, fifteen patients were satisfied with the curative effect, and 6 patients were generally satisfied with the curative effect.Conclusions:For skin and soft tissue defects after CSCC resection, the anterolateral femoral perforator flaps can be used preferentially. In the case of variation of the perforating branch of descending branch of the lateral circumflex femoral artery, the anteromedial femoral perforator flap is selected. The areas of the two flaps are large and can be adjusted according to the amount of defect tissue, thus accurately and effectively repairing skin and soft tissue defects after CSCC resection. The postoperative appearance and function are good.

Objective: The purpose is to investigate the validity of a surgical technique that utilizes autologous costal cartilage grafts in primary rhinoplasty for female patients. Methods: From July 2015 to July 2017, 137 cases received primary rhinoplasty with various types of grafts originated from autologous costal cartilage to correct the unpleasant nasal appearances including low dorsum, poorly defined nasal tip and wide alar base. Results: With 6 to 36 months follow-up, six patients(4.3%) exhibited noticeable changes in nasal contour due to graft warping. Revision surgeries were commenced to correct those minor deformities, resulting in satisfactory outcome.All other cases presented significant improvements of the nasal appearance. Conclusions Autologous costal cartilage is a good source for primary rhinoplasty cases.

Objective:To explore the method of constructing nasal cartilage scaffold with fine refinement.Methods:From 2010 to 2018, 212 patients with nasal reconstruction were admitted to the Center of Rhinoplasty and Reconstructive Surgery Hospital of Chinese Academy of Medical Sciences.Results:The stent structure of all patients was composed of nasal dorsal graft, nasal alar support graft, nasal columella support graft, shield graft, lateral nasal cartilage support graft, hat graft, etc.Conclusions:The reconstructed nose presents a more delicate appearance after the later modification compared with the traditional simple l-shaped cartilage stent, and the patient satisfaction is high.

Objective:To analyze the changes in the epidemiological characteristics of scarlet fever cases in Shanghai City before and after the outbreak of coronavirus disease 2019 (COVID-19), and to provide a reference for scientific prevention and control of scarlet fever.Methods:The information of scarlet fever reported cases in Shanghai City from January 2016 to June 2021 in the information system of Chinese Disease Prevention and Control was collected, and the differences in time trend, regional distribution, age and gender distribution of cases before and after the outbreak of COVID-19 in Shanghai City were analyzed by descriptive epidemiologic method.Results:The incidence rate of scarlet fever reported in 2016-2019 was (0.22-4.02)/100 000 in each month, with a median of 1.13/100 000. During January 2020 (the outbreak began in Shanghai City) and June 2021, the incidence rate of scarlet fever was (0.01-1.64)/100 000, with a median of 0.14/100 000, which was 12.39% of that before the outbreak of COVID-19. During February and June 2020, the monthly reported incidence rate of scarlet fever was (0.18-0.58)/100 000, showing an upward trend compared with the same period in 2020 ((0.01-0.05)/100 000). From 2016 to 2019, the annual reported incidence rate of each district was (0.55-65.48)/100 000, with a median of 9.57/100 000; while in 2020, the annual reported incidence rate of each district was (0.29-9.85)/100 000, with a median of 2.18/100 000, which was 22.78% of that before the outbreak of COVID-19. The incidence of scarlet fever dropped significantly. The incidence rate in Minhang District was still the highest. The cases were mainly four to eight years old, and there was no substantial difference of the proportions before and after COVID-19 pandemic, with the incidence rate of six years old group the highest. The proportion of male was more than female in reported case, while the male ratio in reported cases was not significantly different before and after COVID-19 pandemic.Conclusions:The incidence rate of scarlet fever in Shanghai City has dropped sharply after COVID-19 pandemic. The main epidemiological characteristics of the regional and population distribution of cases remain unchanged.

Objective To investigate amethod of building supporting structure in nasal reconstruction with more stable effect and better aestheticresult .It was intended to highlight the key points during the process of nasal reconstruction .Methods A retrospective analyze was done to all the patients in our center from January 2010 to July 2015. Patients' characteristics, flaps, supporting framework, defect location by subunits were recorded .Results 233 patients were included ( 126 males and 97 females) in this study.The age ranged from 4 to 60 years old with an average of 25.4 ys.Defects most commonly involved were nasal ala and tip with the average defect location of 4.39 subunits. Reconstructionmethod was given priority to expanded forehead flapto cover the costal cartilage framework . Postoperative follow-up was from 6 to 36 months.All the patients reported increased nasal appearance and function evaluation .Conclusions The stable and strong supporting structure has become an important factor to achieve the final esthetical and functionalresult of nasal reconstruction , no matter which kind of the flaps was used in the process .Costal cartilage enjoyswide applications and reliable effect , so it is a recommendable material for supporting structure in nasal reconstruction .

Objective To investigate amethod of building supporting structure in nasal reconstruction with more stable effect and better aestheticresult .It was intended to highlight the key points during the process of nasal reconstruction .Methods A retrospective analyze was done to all the patients in our center from January 2010 to July 2015. Patients' characteristics, flaps, supporting framework, defect location by subunits were recorded .Results 233 patients were included ( 126 males and 97 females) in this study.The age ranged from 4 to 60 years old with an average of 25.4 ys.Defects most commonly involved were nasal ala and tip with the average defect location of 4.39 subunits. Reconstructionmethod was given priority to expanded forehead flapto cover the costal cartilage framework . Postoperative follow-up was from 6 to 36 months.All the patients reported increased nasal appearance and function evaluation .Conclusions The stable and strong supporting structure has become an important factor to achieve the final esthetical and functionalresult of nasal reconstruction , no matter which kind of the flaps was used in the process .Costal cartilage enjoyswide applications and reliable effect , so it is a recommendable material for supporting structure in nasal reconstruction .

Objective:To discuss the method of building the costal cartilage framework and improving the stability of the framework in reconstructive rhinoplasty.Methods:Fifteen patients (9 males and 6 females)underwent nasal reconstruction with the use of mortise and tenon structure in costal cartilage framework during January 2016 to February 2019 were included. The age ranged from 6 to 43 years old, with an average of 21 years old. Eight patients were nasal defect. Five patients were Tessier No.0 cleft (median cleft face syndrome) and two patients were Binder syndrome. Mortise and tenon structure were used in all the cases when building the costal cartilage framework.Results:Postoperative follow-up was from 4 to 46 months. There’s no collapse of the cartilage framework. One patient with proboscis lateralis suffered from evident framework displacement while others’ framework was in the middle. Patients were satisfied with the outcome.Conclusions:Costal cartilage framework makes great contribution to the three-dimensional structure and resist the tension of the flap. Mortise and tenon structure can effectively improve the stability of the framework which maintains long term result.

Objective:To investigate the validity of a simple technique of drilling nasal spine in costal cartilage based rhinoplasty.Methods:From August 2018 to October 2020, the clinical data of patients whom received costal cartilage rhinoplasty in Plastic Surgery Hospital of Chinese Academy of Medical Sciences were retrospectively analyzed. During the operation, the towel clamp was slid into the space of the nasal spine, with minor adjustments of its position, slowly and steadily, the towel clamps were tightened until the bilateral tips were met, and the perforation procedure was successful. Then, based on this aperture, the columellar strut was firmly fixed to the nasal spine, and the cartilage framework was established. Postoperative follow-up was conducted to investigate the satisfaction of the patients, as well as a third-party plastic surgeon was introduced to evaluate the pre-and post-operative photos of the patients by the observer’s overall cosmetic improvement score (IGAIS).Results:A total of 35 female patients with the age of (27.7±2.3) years (22-37 years old) were included. All patients presented low tip and dorsum, with flat, flaring alae. There were no significant short-term complications such as infection, mucosal perforation and graft exposure. The patients were followed up for 6 to 24 months. Two cases presented cartilage warping, and was corrected after revision surgery. The appearance of the nose was significantly improved, and the subjective satisfaction was 97.1% (34/35). The third-party physician evaluation results were: in 35 cases, 33 cases achieved significant improvement, 2 cases achieved moderate improvement, 100% (35/35) of the patients reached the improvement, and the improvement score was 1.08±0.28.Conclusions:The drilling technique of utilizing a towel forcep is simple and practical which facilitates stable fixation of nasal columellar support graft, and renders a good outcome in the clinical application of autologous costal cartilage rhinoplasty.