Background Air pollution exposure has a significant impact on maternal and child health. However, the research on the association between ambient ozone (O₃) exposure during pregnancy and the risk of premature birth in newborns is limited, and the conclusions are inconsistent. Objective To investigate the association of ambient O₃ exposure during pregnancy with the risk of preterm birth in Guangdong Province. Methods Data of pregnant women in Guangzhou from 2013 to 2019 and Foshan from 2018 to 2023 were collected, and O₃ concentrations during different trimesters were assessed according to maternal residential addresses. Bilinear interpolation was used to evaluate the concentrations of air pollution. A cohort study design was adopted in our study. Restricted cubic spline curves were used to evaluate the exposure-response relationship between O₃ exposure and preterm birth risk and explore potential exposure threshold of O₃. Logistic regression models were used to evaluate the association of O₃ exposure with preterm birth. Results A total of 702 924 pregnant women were included in this study, of whom 43 051 (6.12%) were preterm. The average O₃ exposure concentrations of pregnant women during the first, second, third, and whole trimesters were 95.51, 97.51, 100.60, and 97.87 μg·m⁻³, respectively. We observed J-shaped associations between O₃ exposure and preterm birth risk during the second, third, and whole trimesters of pregnancy using restricted cubic spline curves. This study found that there were threshold concentrations between O₃ exposure and preterm birth risk during different gestational periods, and the threshold concentrations in the first, second, third, and whole trimesters were 112.32, 99.83, 111.74, and 112.46 μg·m⁻³, respectively. During the second, third, and whole trimesters of pregnancy, after adjusting for maternal age, baby sex, pre-pregnancy body mass index, mode of delivery, baby birth weight, gestational diabetes, and gestational hypertension, the odds ratios (OR) of preterm birth were 1.02 (95%CI: 1.01, 1.04), 1.02 (95%CI: 1.00, 1.03), and 1.17 (95%CI: 1.13, 1.21) for each 10 μg·m⁻³ increase in O₃ concentration above the O₃ threshold. No significant association was found between O₃ exposure and the risk of preterm birth during the first trimester. Conclusion There is a nonlinear association between the risk of preterm birth and O₃ exposure during pregnancy, and higher concentrations of O₃ exposure during pregnancy are associated with the risk of preterm birth. Above the O₃ threshold concentration during pregnancy, especially during the second, third, and whole trimesters, the risk of preterm birth elevates with the increase of O₃ exposure concentrations.

Objective:To investigate the clinical efficacy and safety of the triple-arc buried wire method for facial lift surgery.Methods:This study retrospectively included 55 patients who underwent facial lift surgery using the triple-arc buried wire method at Nanjing Medical University Friendship Plastic Surgery Hospital from May 2018 to May 2021, and consisted of 1 male and 54 females, with an age range of 28 to 55 (37.9±7.2) years. Patients were positioned either standing or sitting, with markings made for the suture pathways, entry points, and exit points. The first safety line extended from the outer canthus of the eye to the earlobe, while the second safety line followed the lateral aspect of the nasal artery to form a vertical line with the nose; the aesthetic line was drawn extending 2 cm outward from the oral commissure. Local infiltration anesthesia with a 2% lidocaine and epinephrine solution was applied at the marked entry and exit points, followed by subcutaneous tunnel infiltration anesthesia along the designed suture pathway. Three dual-direction barbed absorbable sutures were deployed in an arc along the midface, repositioning the malar fat pads. Postoperative follow-ups were conducted immediately after surgery and at 1, 6, and 12 months to assess patient satisfaction. The wrinkle severity rating scale (WSRS) was recorded to evaluate the appearance of the nasolabial folds. The incidence of postoperative complications such as hematoma, tightness, asymmetry, and exposed sutures was also documented.Results:All 55 patients experienced significant midface lifting effects immediately after surgery, resulting in a fuller appearance and shallower nasolabial folds. The follow-up rates immediately postoperatively and at 1, 6, and 12 months were 100.0% (55/55), 100.0% (55/55), 94.6% (52/55), and 89.1% (49/55); patient satisfaction rates were 98.2% (54/55), 98.2% (54/55), 98.2% (54/55), and 98.2% (54/55), respectively. The preoperative WSRS score for the 55 patients was 3 (2, 4), while the score at immediately after surgery was 2 (1, 3), indicating a statistically significant difference ( P<0.001). No significant complications such as hematoma, tightness, asymmetry, or exposed sutures were noted in any patients. Two patients developed noticeable ecchymosis on both cheeks within 24 hours postoperatively, which resolved spontaneously after 3 weeks, with facial appearance and chewing function returning to normal after 1 month. One patient had a localized sunken area at the exit point, which self-resolved after 11 months. Conclusions:The triple-arc buried wire method for facial lift surgery is safe and effective, with minimal complications.

Objective: To observe the clinical efficacy of Dermatix Ultra silica gel and asiaticoside cream for the treatment or repair of scar hyperplasia which was external used in internal corner incision of patients after the internal canthus correction operation. Methods: A total of 90 patients were randomly chosen and divided into three groups. All patients with epicanthus were treated with the same internal canthus correction method by one doctor. There were 30 patients in each group: 30 cases in the control group were treated without any medication, and the postoperative incision healed naturally; 30 cases were treated with Dermatix Ultra silica gel; 30 cases were treated with asiaticoside cream. Patient and observer scar assessment scale (POSAS) was used as the end points to evaluate the clinical efficacy of Dermatix Ultra silica gel and asiaticoside cream 4 weeks and 12 weeks after the operation. The satisfactory degree from all the patients were collected after 6 months follow-up and we compared the scores of three groups. Results: Compared with the control group, the POSAS scores in Dermatix Ultra silica gel group and asiaticoside cream group were low (P<0.05) at 4 weeks and 12 weeks after operation. At 4 weeks after operation, the POSAS score in Dermatix Ultra silica gel group was lower than that in the asiaticoside cream group (P<0.05). At 12 weeks after operation, there was no significant difference in POSAS score between Dermatix Ultra silica gel group and asiaticoside cream group (P>0.05). Follow-up for 6 months, the satisfaction degree of patients in Dermatix Ultra silica gel group and asiaticoside cream group was higher than in the control group (P<0.05); the satisfactory degree of patients in Dermatix Ultra silica gel group was higher than that in asiaticoside cream group (P<0.05). Conclusions Dermatix Ultra silica gel and asiaticoside cream have good clinical effects in repair of scar tissue after the epicanthoplasty. Dermatix Ultra silica gel is better than asiaticoside cream in scar early improvement.

Objective To observe the clinical effect of platelet-rich fibrin (PRF) on prevention of postoperative hemorrhage and facial traumatic swelling in patients with mandibular angle osteotomy.Methods Twenty-five patients with mandibular angle hypertrophy were included in this study from January 2014 to November 2015.Split face comparative study was carried out to use the left and right sides as the experimental side and the control side,respectively.The PRF in the experimental side was placed in the mandibular osteotomy,while the control side was placed in platelet-poor plasma (PPP).After operation,the drainage volume and facial swelling degree were measured.Results The drainage volume of the experimental group (PRF group) was (20.35 ±7.40) ml,the control group (PPP group) was (43.23±11.96) ml,and the difference was statistically significant (P＜0.05).There was no such case without swelling in postoperative third day.The facial swelling score on the experimental side was (1.19±0.40),the control side was (2.62±0.64),and two groups of postoperative facial swelling scores were significantly different (P＜0.05).Conclusions The PRF can reduce postoperative bleeding and facial swelling after mandibular angle osteotomy.

Objective Aged facial contour presents changing facial skeleton and sagging soft tissue.We performed reshaping the facial skeleton simultaneouly during the rhytidectomy to achieve a youthful facial contour.Methods It was a retrospective observational study based on 26 elderly women (42-60 years) that complained of aged face and boosing of the orbital rim,prominent zygoma and mandibular angle.All of them had undergone reduction boosing,malar and mandible combined with rhytidectomy from January 2010 to December 2015.Results The facial skeleton was reshaped with face-lift successfully.No fatal bleeding,respiratory obstruction,cardiovascular accident,severe facial edema,permanent facial nerve injury and other major complications occurred.All of the patients recovered safely.Follow-up for 3-24 months showed that the facial contour and aging were improved,and the youthful face form was preserved.Conclusions The face contour correction combined with face-lift is an effective technique to restore the youthful for elderly patients.

Objective To investigate the impact of blood glucose level on the recurrence of liver cancer after laparoscopic surgery. Methods The clinical data of 98 patients with primary hepatocellular carcinoma from January 2012 to January 2015 were retrospectively analyzed. All patients were treated by laparoscopic radical resection of hepatocellular carcinoma. Patients were divided into elevated blood glucose group (n = 23) and control group (n = 75) according to whether the fasting blood glucose was ≥6.1 mmol/L. The recurrence of liver cancer in 1 year and 2 years after operation was compared. The factors influencing the recurrence of liver cancer were analyzed by univariate and multivariate analysis. Results The recurrence rates were 47.82% and 21.33% respectively in the patients with elevated blood glucose and the control group. The recurrence rates were 73.91% and 36.00%respectively in the 2-year postoperative patients with blood glucose and 1 year and 2 years. The recurrence rate was higher than that of the control group, the difference was statistically significant (P < 0.05). Logistic multivariate analysis showed that fasting blood glucose was high, Child-Pugh grade B, intraoperative blood transfusion, lymphatic invasion, high clinical pathology stage, postoperative alpha-fetoprotein (AFP) high, no postoperative adjuvant therapy (P < 0.05). Conclusion The recurrence rate of patients with elevated liver cancer after laparoscopic surgery is high, and fasting blood glucose is high, Child-Pugh grade is B grade, blood transfusion is high, there is lymphatic invasion, high clinical pathology stage after AFP high, no postoperative adjuvant therapy for its postoperative recurrence of risk factors, should strengthen the monitoring of high-risk patients, reduce postoperative recurrence rate.

Objective To evaluate the clinical effect of the facial soft tissue defect treated with platelet-rich plasma (PRP) mixed with purified fat.Methods 35 patients with facial soft-tissue defects were treated by PRP mixed with centrifuged fat tissue.Using Fuzzy judgment method the clinical effectiveness of therapeutic outcomes were evaluated on fullness,injection of frequency and satisfaction during 3 to 6 months of follow-up.Results The therapeutic outcomes showed that the reconstructed face became a relative symmetrical and natural appearance with not evidently fat resorption and stable after operation.Both patients and surgeons were satisfied with the results.The score of effectiveness was highest in Fuzzy judgment.Conclusions The efficacy of PRP is significant in enhancing fat graft,reducing fat necrosis and resorption.The fat tissue mixed with PRP is a reliable reconstruction option for the facial soft tissue defect.

Objective To investigate a safe and effective method of lengthening the short nose.Methods Thirty-nine cases of short nose were corrected by the bilateral septal spreader graft and columellar strut using autologous cartilage,combined with expanded polytetrafluoroethylene (e-PTFE)to reconstruct the supporting structures to improve the forward and upward strength of the nasal tip in order to increase the nasal length and to correct the over rotation of nasal tip.The shield and cap grafts were also used for the patients whose nasal tip were too low with vertical dome division technique.Results All the patients showed preserved nasal length after surgery with well-proportioned nasal features and the nasal lip angles were normal.There was no evidence of postoperative nasal shortening.No operative or postoperative complications were observed by follow-up for 6 months to 1 year,except for 2 cases with graft cartilage being apparent on nasal tip.All the patients were satisfied with the surgical results achieved.Conclusions It is necessary to provide powerful forward and upward strength to lengthen nose and correct the over rotation of nasal tip effectively and safely.The application of bilateral septal spreader graft and columellar strut using autologous cartilage and combined with e-PTFE represents a valuable tool for the short nose and proper cartilage grafts of nasal tip can improve the height of the nasal tip and further correct the over rotation of the nasal tip.

OBJECTIVETo explore the most appropriate imaging examinations for solitary osteochondroma in primary hospitals.

METHODSA retrospective evaluation was performed to analyze the imaging examinations (including X-ray, CT, and ultrasound) of 62 patients undergoing surgeries for solitary osteochondroma in terms of the diagnostic results and preoperative expenditure of the patients.

RESULTSX-ray and CT have a high diagnostic value for solitary osteochondroma, but X-ray cannot display cartilage and lesions in surrounding soft tissues. Ultrasound is limited in diagnosis of solitary osteochondroma, but performed well as CT in displaying cartilage and lesions in surrounding soft tissues. There was no statistical difference between combined X-ray and ultrasound and CT in diagnosis of solitary osteochondroma (P>0.05), but the former had a lower cost (P<0.05).

CONCLUSIONX-ray combined with ultrasound has almost comparable value with CT in the diagnosis of solitary osteochondroma and is more practical for application in primary hospitals.

Adolescent ; Adult ; Bone Neoplasms ; diagnostic imaging ; Child ; Female ; Humans ; Male ; Osteochondroma ; diagnostic imaging ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography ; X-Rays ; Young Adult

Objective To explore the most appropriate imaging examinations for solitary osteochondroma in primary hospitals. Methods A retrospective evaluation was performed to analyze the imaging examinations (including X-ray, CT, and ultrasound) of 62 patients undergoing surgeries for solitary osteochondroma in terms of the diagnostic results and preoperative expenditure of the patients. Results X-ray and CT have a high diagnostic value for solitary osteochondroma, but X-ray cannot display cartilage and lesions in surrounding soft tissues. Ultrasound is limited in diagnosis of solitary osteochondroma, but performed well as CT in displaying cartilage and lesions in surrounding soft tissues. There was no statistical difference between combined X-ray and ultrasound and CT in diagnosis of solitary osteochondroma (P>0.05), but the former had a lower cost (P<0.05). Conclusion X-ray combined with ultrasound has almost comparable value with CT in the diagnosis of solitary osteochondroma and is more practical for application in primary hospitals.