Objective:To analyze the efficacy and safety of 3D-printing-assisted anterolateral thigh perforator flap surgery for the treatment of complex soft tissue defects around the ankle joint.Methods:A total of 160 patients with skin and soft tissue defects around the ankle joint at the First People′s Hospital of Xiaoshan District, Hangzhou, from March 2020 to March 2022 were retrospectively analyzed. The patients were divided into a control group and an observation group according to the surgical approach, with 80 patients in each group. The control group underwent traditional anterolateral thigh perforator flap surgery, which included 43 males and 37 females, with an age of 21-62 (34.7±5.6) years. The observation group underwent 3D-printing-assisted anterolateral thigh perforator flap surgery, which included 45 males and 35 females, with an age of 20-66 (34.8±5.6) years. The operative time, flap healing time, and hospital stay duration were compared between the two groups. Serum levels of C-reactive protein (CRP), interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF-α) were compared between the two groups before surgery and 3 days postoperatively. The ankle joint function was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system, the range of motion (ROM) was assessed using the ROM score, and the flap sensation was evaluated using the modified Highet grading system before surgery, 6 months postoperatively, and at the last follow-up. The incidence of adverse reactions such as arterial crisis, venous crisis, infection, and necrosis during the perioperative period was observed. Patient satisfaction was assessed 6 months after treatment.Results:All patients in both groups successfully completed the surgery, with no cases excluded. The operative time, flap healing time, and hospital stay duration were significantly shorter in the observation group than those in the control group (all P<0.001). Compared with preoperative levels, the levels of IL-6, IL-8, CRP, and TNF-α were significantly reduced in both groups 3 days postoperatively (all P<0.001), and these levels were significantly lower in the observation group than those in the control group at 3 days postoperatively (all P<0.001). Six months postoperatively and at the last follow-up, the AOFAS and ROM scores were significantly higher in the observation group than those in the control group (all P<0.05), and the flap sensation grading was significantly better in the observation group than that in the control group (all P<0.05). The incidence of adverse reactions was 7.5% (6/80) in the observation group, which was significantly lower than 18.8% (15/80) in the control group ( P=0.024). The patient satisfaction rate was 95.0% (76/80) in the observation group, which was significantly higher than 72.5% (58/80) in the control group ( P<0.001). Conclusion:3D-printing-assisted anterolateral thigh perforator flap repair for skin and soft tissue defects around the ankle joint can improve perioperative indicators, reduce the incidence of postoperative adverse reactions, promote the recovery of flap sensation and ankle function, attenuate the inflammatory response of the body, and enhance patient satisfaction.

Objective:To analyze the efficacy and safety of 3D-printing-assisted anterolateral thigh perforator flap surgery for the treatment of complex soft tissue defects around the ankle joint.Methods:A total of 160 patients with skin and soft tissue defects around the ankle joint at the First People′s Hospital of Xiaoshan District, Hangzhou, from March 2020 to March 2022 were retrospectively analyzed. The patients were divided into a control group and an observation group according to the surgical approach, with 80 patients in each group. The control group underwent traditional anterolateral thigh perforator flap surgery, which included 43 males and 37 females, with an age of 21-62 (34.7±5.6) years. The observation group underwent 3D-printing-assisted anterolateral thigh perforator flap surgery, which included 45 males and 35 females, with an age of 20-66 (34.8±5.6) years. The operative time, flap healing time, and hospital stay duration were compared between the two groups. Serum levels of C-reactive protein (CRP), interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF-α) were compared between the two groups before surgery and 3 days postoperatively. The ankle joint function was evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system, the range of motion (ROM) was assessed using the ROM score, and the flap sensation was evaluated using the modified Highet grading system before surgery, 6 months postoperatively, and at the last follow-up. The incidence of adverse reactions such as arterial crisis, venous crisis, infection, and necrosis during the perioperative period was observed. Patient satisfaction was assessed 6 months after treatment.Results:All patients in both groups successfully completed the surgery, with no cases excluded. The operative time, flap healing time, and hospital stay duration were significantly shorter in the observation group than those in the control group (all P<0.001). Compared with preoperative levels, the levels of IL-6, IL-8, CRP, and TNF-α were significantly reduced in both groups 3 days postoperatively (all P<0.001), and these levels were significantly lower in the observation group than those in the control group at 3 days postoperatively (all P<0.001). Six months postoperatively and at the last follow-up, the AOFAS and ROM scores were significantly higher in the observation group than those in the control group (all P<0.05), and the flap sensation grading was significantly better in the observation group than that in the control group (all P<0.05). The incidence of adverse reactions was 7.5% (6/80) in the observation group, which was significantly lower than 18.8% (15/80) in the control group ( P=0.024). The patient satisfaction rate was 95.0% (76/80) in the observation group, which was significantly higher than 72.5% (58/80) in the control group ( P<0.001). Conclusion:3D-printing-assisted anterolateral thigh perforator flap repair for skin and soft tissue defects around the ankle joint can improve perioperative indicators, reduce the incidence of postoperative adverse reactions, promote the recovery of flap sensation and ankle function, attenuate the inflammatory response of the body, and enhance patient satisfaction.

Objective To evaluate the use and effectiveness of Human-Computer Interaction (HC1) -based risk prediction of diabetes among Chinese adults.MethodsHCI-based risk prediction of diabetes was performed in 639 non-diabetics aged 23 to 61years old.Risk prediction results,main risk factors of diabetes and helpful suggestions were reported and used for self-management.After l-year follow-up,the participants received another assessment to find the changes of disease risk and risk factors.Non-parametric or Chi-square test was used for comparison of continuous or categorical variables,respectively.Receiver Operating Characteristic (ROC) curve was used to calculate the sensitivity and specificity of HCI.Results After1-year follow-up,the incidence of diabetes per year was1.4％,and all newly diagnosed diabetes was found in high-risk individuals.The proportion of high-risk individuals was 56.8％ and 57.9％before and after follow-up ( x2 =0.36,P ＞ 0.05 ).In comparison with baseline,average risk score of high-risk individuals was significantly declined ( 2.25 vs 2.91,Z =- 4.32,P ＜ 0.05 ).Oversized waist circumstance,higher total cholesterol (TC) and lower high-density lipoprotein cholesterol (HDL-C) was identified in 76.2％,36.2％ and 3.8％ of high risk individuals at1year,lower than those of baseline ( 87.3％,42.2％ and12.4％,respectively ; x2 values were 30.56,6.05 and 22.26,respectively; all P ＜0.05) ; although the prevalence of hypertension was higher (23.5％ vs18.1％,x2 =11.11,P＜0.05).Conclusions HCI and effective control of risk factors could prevent the development of diabetes in high risk individuals.

Objective To compare the diagnostic criteria of metabolic syndrome(MS) developed by the International Diabetes Federation(IDF) in 2005,the 3th Report of National Cholesterol Education Program-Adult Treatment Panel Ⅲ(NCEP-ATP Ⅲ) in 2005,and the Chinese Diabetes Society(CDS) in 2004.Methors A total of 1039 adults aged 23 to 62 year-old were enrolled in this epidemiological investigation to assess the prevalence of MS by above three definitions.Results The MS prevalence rate was 14.8%,14.2% and 10.7% in ATPⅢ,IDF,and CDS,respectively.The diagnoses agreement of IDF with ATPⅢ was stronger(Kappa=0.912) than IDF with CDS(Kappa=0.466) and ATPⅢ with CDS (Kappa=0.504).CDS definition found 5.7% of non-MS individuals had risk factor accumulation.Those defined by ATPⅢ and IDF criteria were presented with central obesity + ypertriglyceridemia + abnormal blood pressure and central obesity + hypertriglyceridemia + low hish-density lipoprotein hyperlipidemia.However,those defined by CDS criterion were commonly presented with obesity + hypertriglyceridemia + abnormal blood pressure or obesity + hypertriglyceridemia + hyperglycemia.Conclusions The agreement of IDF and ATPⅢ definition was relatively stronger.For better screening sensitivity,those three criteria,or CDS and IDF criteria,or CDS and ATPⅢ criteria should be used together.