Objective:To explore the relationship between long-term blood pressure variability and arteriosclerosis in women with a history of hypertensive disorders in pregnancy (HDP).Methods:This study was a retrospective cohort study. Data were obtained from the Kailuan Research Database. Women with a history of HDP who delivered between January 1990 and December 2020 and completed brachial-ankle pulse wave velocity (baPWV) measurement in the postpartum period were enrolled. Baseline data were obtained from the first post-delivery health examination, while the outcome measure was the baPWV recorded during the last follow-up visit, synchronized with blood pressure measurements. Based on long-term blood pressure variability, the enrolled study subjects were divided into the first, second, and third tertile groups in ascending order using the tertile method, and intergroup differences in clinical characteristics were compared. Multivariable logistic regression was performed to evaluate the impact of long-term blood pressure variability levels on arteriosclerosis risk in women with a history of HDP. Sensitivity analyses excluded individuals with multiple deliveries to validate the robustness of findings. Subgroup analyses were conducted based on delivery age (<40 vs. ≥40 years) and blood pressure measurement frequency (3 vs. >3 times) to explore the potential impact of different population characteristics on the study results.Results:A total of 421 study subjects were enrolled, aged (36.07±6.05) years, with a baPWV value of (1 376.80±238.18) cm/s. Long-term blood pressure variability was 4.66 (3.41, 6.50) mmHg (1 mmHg=0.133 kPa). The first, second and third quartile group included 140, 141 and 140 individuals, respectively. In the total population, the incidence of arteriosclerosis was 40.4% (170/421). The incidence rates in the first, second, and third tertile groups were 34.3% (48/140), 39.0% (55/141), and 47.9% (67/140), respectively. Multivariate logistic regression analysis showed that increased long-term blood pressure variability was an independent risk factor for arteriosclerosis in women with a history of HDP ( OR=1.702, 95% CI 1.018-2.844, P=0.043). The results of sensitivity analyses were consistent with that of the primary analysis ( OR=1.758, 95% CI 1.044-2.959, P=0.034). Subgroup analyses further indicated that in the subgroups with delivery age <40 years ( OR=2.116, 95% CI 1.153-3.885, P=0.016) and blood pressure measurement frequency >3 times ( OR=1.894, 95% CI 1.069-3.355, P=0.029), the association between long-term blood pressure variability and arterial stiffness risk was more significant. Conclusions:For women with a history of HDP, elevated long-term blood pressure variability may increase the risk of arteriosclerosis, and this effect is more pronounced in younger women (delivery age <40 years) and those with high-frequency blood pressure measurements (>3 times). Enhanced monitoring and management of blood pressure variability in this population are crucial to improving long-term cardiovascular health outcomes.

Objective:To evaluate the clinical outcomes of endoscopic-assisted polyether ether ketone (PEEK) patient-specific implant (PSI) revision for over-resected mandibles caused by the mandibular angle osteotomy.Methods:A retrospective analysis was conducted on 24 patients [8 males, 16 females, aged 19-57 (32.5±9.5) years] with 39 over-resected mandibles that underwent PEEK-PSI mandibular angle revision surgery at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from January 2019 to December 2023. Preoperative cone-beam computed tomography (CBCT) data were used to design and fabricate customized PEEK PSIs based on individual anatomical requirements. An intraoral incision approach with endoscopic assistance was employed to meticulously dissect soft tissue attachment around the angle region, followed by the implantation of a customized PEEK PSI. Postoperative CBCT scans were performed for 3D reconstruction, with root mean square error (RMSE) and maximum deviation (MaxD) as accuracy metrics. Patients′ satisfaction was assessed preoperatively and ≥6 months postoperatively using the face questionnaire (FACE-Q) scores, which included overall facial appearance, lower face and jawline, appearance distress, psychological health and social function.Results:All 24 patients achieved satisfactory recovery with primary healing of intraoral incisions. No complications such as infection, nerve injury, or implant rejection occurred during follow-up period. Patients′ facial appearance and jaw line contouring were significantly improved. Fine anatomical fitting between PEEK-PSI and defect areas was observed: RMSE ranged from 0.117 to 0.315 mm, and MaxD was (5.485±1.300) mm. FACE-Q scores demonstrated significant improvements after surgery in overall facial appearance [(49.8±5.4) vs (65.0±5.3) scores], lower face and jawline [(42.5±5.3) vs (56.1±4.6) scores], appearance distress [(60.0±6.9) vs (70.6±6.5) scores], psychological health [(62.0±5.0) vs (70.8±5.3) scores], and social function [(60.3±4.3) vs (69.3±5.8) scores] (all P<0.001). Conclusion:Endoscopic-assisted PEEK-PSI revision for over-resected mandibles following mandibular angle osteotomy exhibits high surgical precision and safety, effectively restoring mandibular contour and significantly enhancing patients′ satisfaction.

Objective:To investigate the clinical outcomes of precapsular pocket repositioning for correcting implant malposition following augmentation mammoplasty.Methods:A retrospective analysis was conducted on 29 female patients aged 25-37 (28.8±3.4) years who underwent precapsular pocket repositioning at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from December 2015 to August 2024. The surgical technique involved preserving the original capsule, creating a new implant pocket anterior to the capsule, and closing the original capsular space. Postoperative complications were recorded, and breast satisfaction was evaluated preoperatively and at 6 months postoperatively using the BREAST-questionnaire (BREAST-Q).Results:All 29 patients successfully underwent precapsular pocket repositioning with primary wound healing. During the follow-up period, all patients were satisfied with the correction of implant malposition. The mean BREAST-Q score improved significantly from (43.56±3.17) scores preoperatively to (72.56±13.49) scores at 6 months postoperatively ( P<0.001). No hematoma, implant rupture, recurrent malposition, capsular contracture, or surgical site infection occurred in any patient. Conclusion:Precapsular pocket repositioning provides favorable clinical outcomes for patients with implant malposition after augmentation mammoplasty, and there are no severe complications .

Objective:To investigate the clinical effect of the divisional design in composite labia minora and clitoral hood reduction.Methods:A retrospective analysis was performed on 57 patients diagnosed with labia minora and clitoral hood hypertrophy at Department of Plastic Surgery, Nanjing Medical University Friendship Plastic Surgery Hospital between July 2018 and May 2021. The ages of the patients ranged from 24 to 45 years with an average of (31.0±8.2) years. Preoperative symptoms and surgical demands included: appearance concerns in 57 cases (100%), irritation during friction in 49 cases (86.0%), and discomfort during intercourse in 22 cases (38.6%). The complex hypertrophy was divided into simple labia minora hypertrophy and clitoral hood hypertrophy. Then the reduction of clitoris hood was performed according to the prepuce morphology, and labiaplasty was performed using edge resection. The operative effects, patient satisfaction, and postoperative complications were assessed.Results:All incisions healed primarily with no flap necrosis or marginal infections. Hematoma occurred in 1 case which recovered well after timely treatment. All patients were followed up for 3-12 months. 54 cases were satisfied with the labia minora and clitoral hood shape and reported no sensory abnormality. Bilateral asymmetry occurred in 2 cases, one of which required further surgical repair. Scar hyperplasia occurred and was gradually softened after 6 months in 1 case. Of the 57 patients with appearance concerns, 55 (96.5%) patients reported improved appearance postoperatively. Of the 49 patients with preoperative friction discomfort, 47 (95.9%) patients achieved symptom relief. Of the 22 patients reporting sexual discomfort, 15 (68.1%) patients noted enhanced sexual satisfaction postoperatively. Overall, 54 (94.7%) patients were satisfied, 2 (3.5%) patients were moderately satisfied, and 1 (1.8%) patient was unsatisfied.Conclusions:For patients with labia minora and clitoral hood hypertrophy, the application of divisional design is surgically simple and safe. It achieves satisfactory outcomes with no severe adverse reactions.

With the emergence of deep learning techniques based on convolutional neural networks, artificial intelligence (AI) has driven transformative developments in the field of medical image analysis. Recently, large language models (LLMs) such as ChatGPT have also started to achieve distinction in this domain. Increasing research shows the undeniable role of AI in reshaping various aspects of medical image analysis, including processes such as image enhancement, segmentation, detection in image preprocessing, and postprocessing related to medical diagnosis and prognosis in clinical settings. However, despite the significant progress in AI research, studies investigating the recent advances in AI technology in the aforementioned aspects, the changes in research hotspot trajectories, and the performance of studies in addressing key clinical challenges in this field are limited. This article provides an overview of recent advances in AI for medical image analysis and discusses the methodological profiles, advantages, disadvantages, and future trends of AI technologies.
Artificial Intelligence ; Humans ; Image Processing, Computer-Assisted/methods* ; Neural Networks, Computer ; Deep Learning ; Diagnostic Imaging/methods*

Objective:To evaluate the clinical outcomes of endoscopic-assisted polyether ether ketone (PEEK) patient-specific implant (PSI) revision for over-resected mandibles caused by the mandibular angle osteotomy.Methods:A retrospective analysis was conducted on 24 patients [8 males, 16 females, aged 19-57 (32.5±9.5) years] with 39 over-resected mandibles that underwent PEEK-PSI mandibular angle revision surgery at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from January 2019 to December 2023. Preoperative cone-beam computed tomography (CBCT) data were used to design and fabricate customized PEEK PSIs based on individual anatomical requirements. An intraoral incision approach with endoscopic assistance was employed to meticulously dissect soft tissue attachment around the angle region, followed by the implantation of a customized PEEK PSI. Postoperative CBCT scans were performed for 3D reconstruction, with root mean square error (RMSE) and maximum deviation (MaxD) as accuracy metrics. Patients′ satisfaction was assessed preoperatively and ≥6 months postoperatively using the face questionnaire (FACE-Q) scores, which included overall facial appearance, lower face and jawline, appearance distress, psychological health and social function.Results:All 24 patients achieved satisfactory recovery with primary healing of intraoral incisions. No complications such as infection, nerve injury, or implant rejection occurred during follow-up period. Patients′ facial appearance and jaw line contouring were significantly improved. Fine anatomical fitting between PEEK-PSI and defect areas was observed: RMSE ranged from 0.117 to 0.315 mm, and MaxD was (5.485±1.300) mm. FACE-Q scores demonstrated significant improvements after surgery in overall facial appearance [(49.8±5.4) vs (65.0±5.3) scores], lower face and jawline [(42.5±5.3) vs (56.1±4.6) scores], appearance distress [(60.0±6.9) vs (70.6±6.5) scores], psychological health [(62.0±5.0) vs (70.8±5.3) scores], and social function [(60.3±4.3) vs (69.3±5.8) scores] (all P<0.001). Conclusion:Endoscopic-assisted PEEK-PSI revision for over-resected mandibles following mandibular angle osteotomy exhibits high surgical precision and safety, effectively restoring mandibular contour and significantly enhancing patients′ satisfaction.

Objective:To investigate the clinical outcomes of precapsular pocket repositioning for correcting implant malposition following augmentation mammoplasty.Methods:A retrospective analysis was conducted on 29 female patients aged 25-37 (28.8±3.4) years who underwent precapsular pocket repositioning at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from December 2015 to August 2024. The surgical technique involved preserving the original capsule, creating a new implant pocket anterior to the capsule, and closing the original capsular space. Postoperative complications were recorded, and breast satisfaction was evaluated preoperatively and at 6 months postoperatively using the BREAST-questionnaire (BREAST-Q).Results:All 29 patients successfully underwent precapsular pocket repositioning with primary wound healing. During the follow-up period, all patients were satisfied with the correction of implant malposition. The mean BREAST-Q score improved significantly from (43.56±3.17) scores preoperatively to (72.56±13.49) scores at 6 months postoperatively ( P<0.001). No hematoma, implant rupture, recurrent malposition, capsular contracture, or surgical site infection occurred in any patient. Conclusion:Precapsular pocket repositioning provides favorable clinical outcomes for patients with implant malposition after augmentation mammoplasty, and there are no severe complications .

Objective:To investigate the clinical effect of the divisional design in composite labia minora and clitoral hood reduction.Methods:A retrospective analysis was performed on 57 patients diagnosed with labia minora and clitoral hood hypertrophy at Department of Plastic Surgery, Nanjing Medical University Friendship Plastic Surgery Hospital between July 2018 and May 2021. The ages of the patients ranged from 24 to 45 years with an average of (31.0±8.2) years. Preoperative symptoms and surgical demands included: appearance concerns in 57 cases (100%), irritation during friction in 49 cases (86.0%), and discomfort during intercourse in 22 cases (38.6%). The complex hypertrophy was divided into simple labia minora hypertrophy and clitoral hood hypertrophy. Then the reduction of clitoris hood was performed according to the prepuce morphology, and labiaplasty was performed using edge resection. The operative effects, patient satisfaction, and postoperative complications were assessed.Results:All incisions healed primarily with no flap necrosis or marginal infections. Hematoma occurred in 1 case which recovered well after timely treatment. All patients were followed up for 3-12 months. 54 cases were satisfied with the labia minora and clitoral hood shape and reported no sensory abnormality. Bilateral asymmetry occurred in 2 cases, one of which required further surgical repair. Scar hyperplasia occurred and was gradually softened after 6 months in 1 case. Of the 57 patients with appearance concerns, 55 (96.5%) patients reported improved appearance postoperatively. Of the 49 patients with preoperative friction discomfort, 47 (95.9%) patients achieved symptom relief. Of the 22 patients reporting sexual discomfort, 15 (68.1%) patients noted enhanced sexual satisfaction postoperatively. Overall, 54 (94.7%) patients were satisfied, 2 (3.5%) patients were moderately satisfied, and 1 (1.8%) patient was unsatisfied.Conclusions:For patients with labia minora and clitoral hood hypertrophy, the application of divisional design is surgically simple and safe. It achieves satisfactory outcomes with no severe adverse reactions.

Objective:To explore the relationship between long-term blood pressure variability and arteriosclerosis in women with a history of hypertensive disorders in pregnancy (HDP).Methods:This study was a retrospective cohort study. Data were obtained from the Kailuan Research Database. Women with a history of HDP who delivered between January 1990 and December 2020 and completed brachial-ankle pulse wave velocity (baPWV) measurement in the postpartum period were enrolled. Baseline data were obtained from the first post-delivery health examination, while the outcome measure was the baPWV recorded during the last follow-up visit, synchronized with blood pressure measurements. Based on long-term blood pressure variability, the enrolled study subjects were divided into the first, second, and third tertile groups in ascending order using the tertile method, and intergroup differences in clinical characteristics were compared. Multivariable logistic regression was performed to evaluate the impact of long-term blood pressure variability levels on arteriosclerosis risk in women with a history of HDP. Sensitivity analyses excluded individuals with multiple deliveries to validate the robustness of findings. Subgroup analyses were conducted based on delivery age (<40 vs. ≥40 years) and blood pressure measurement frequency (3 vs. >3 times) to explore the potential impact of different population characteristics on the study results.Results:A total of 421 study subjects were enrolled, aged (36.07±6.05) years, with a baPWV value of (1 376.80±238.18) cm/s. Long-term blood pressure variability was 4.66 (3.41, 6.50) mmHg (1 mmHg=0.133 kPa). The first, second and third quartile group included 140, 141 and 140 individuals, respectively. In the total population, the incidence of arteriosclerosis was 40.4% (170/421). The incidence rates in the first, second, and third tertile groups were 34.3% (48/140), 39.0% (55/141), and 47.9% (67/140), respectively. Multivariate logistic regression analysis showed that increased long-term blood pressure variability was an independent risk factor for arteriosclerosis in women with a history of HDP ( OR=1.702, 95% CI 1.018-2.844, P=0.043). The results of sensitivity analyses were consistent with that of the primary analysis ( OR=1.758, 95% CI 1.044-2.959, P=0.034). Subgroup analyses further indicated that in the subgroups with delivery age <40 years ( OR=2.116, 95% CI 1.153-3.885, P=0.016) and blood pressure measurement frequency >3 times ( OR=1.894, 95% CI 1.069-3.355, P=0.029), the association between long-term blood pressure variability and arterial stiffness risk was more significant. Conclusions:For women with a history of HDP, elevated long-term blood pressure variability may increase the risk of arteriosclerosis, and this effect is more pronounced in younger women (delivery age <40 years) and those with high-frequency blood pressure measurements (>3 times). Enhanced monitoring and management of blood pressure variability in this population are crucial to improving long-term cardiovascular health outcomes.

Objective:To investigate the clinical outcomes of using autologous mandibular outer cortex "sandwich" grafting to augment mandible for correcting lower facial asymmetry with normal occlusal relationships.Methods:A retrospective analysis was conducted on the clinical data of patients with lower facial asymmetry treated at the Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, from January 2016 to December 2019. Preoperative cone-beam CT (CBCT) scans of the maxillofacial region were obtained to acquire three-dimensional data of the maxillofacial skeleton. Computer-aided design was used to determine the osteotomy range of the mandibular outer cortex and design osteotomy guide template. The outer cortex of the larger mandibular side (donor site) was harvested according to the osteotomy guide template and sectioned. The segmented mandibular outer cortex was then contoured to match the arc of the recipient side’s mandibular outer cortex and fixed to the inner side of the recipient mandibular outer cortex, thus increasing the width and thickness of the expanded mandible. Follow-up was conducted at 7th day and 6 months postoperatively, CBCT scan was performed to measure the changes in ramus height (Co-Go), mandibular body length (Go-Me), and mandibular outer cortex thickness, and volume, and the patient satisfaction with facial appearance (1 to 5 points, with higher scores indicating higher satisfaction), were assessed to evaluate surgical outcomes. Statistical analysis was performed using SPSS 12.0 software. Paired t-tests were used to compare patient satisfaction scores preoperatively and six months postoperatively. Repeated measurement ANOVA was used to compare Co-Go and Go-Me measurements preoperatively, 7th day, and 6 months postoperatively. If a statistically significant difference is found, further analysis using post-hoc testing(Tukey’s HSD test) will be conducted to examine the data. Results:Sixteen patients with lower facial asymmetry were included, comprising of 5 males and 11 females, aged 18 to 40 years, with an average age of 25.2 years. Surgical method included contralateral mandibular outer cortex "sandwich" grafting to the expanded mandible in 9 cases and simultaneous genioplasty in 7 cases. Follow-up ranged from 6 months to 5 years, with an average follow-up of 18.6 months. All patients experienced numbness of the lower lip postoperatively, which resolved within six months, and no severe complications occurred. The symmetry of lower facial contour improved significantly and remained stable. Patient satisfaction score for facial appearance increased from (1.63±0.62) points preoperatively to (4.19±0.75) points six months postoperatively( P<0.01). The differences in Co-Go on the donor side and Go-Me on the recipient side across the three time points(preoperatively, 7th day and 6 months postoperatively) were not statistically significant(all P>0.05). However, the differences in Go-Me on the donor side and Co-Go on the recipient side across the three time points were statistically significant(all P<0.05). On the donor side, the mandibular outer cortex thickness decreased by a maximum of 6 mm on 7th day postoperatively and increased by a maximum of 2 mm at 6 months postoperatively compared to 7th day. On the recipient side, mandibular outer cortex thickness increased by a maximum of 6 mm on 7th day postoperatively and decreased by a maximum of 2 mm at six months postoperatively compared to 7th day. The volume of the mandibular outer cortex on the recipient side increased by (4 415.94±1 017.21)mm 3 at 7th day postoperatively compared to preoperatively, and decreased by (202.63±300.85)mm 3 at 6 months postoperatively. Conclusion:For lower facial asymmetrical with normal occlusal relationships and no occlusal plane deviation, contralateral mandibular outer cortex "sandwich" bone grafting can effectively increase the width and volume of the mandible on the grafted side, achieving favorable clinical outcomes.