Objective:To study the correction of nasal septum deviation.Methods:From August 2016 to August 2018, a total of 47 patients with nasal septum deviation were treated in Shanghai Mei-gui Medical Cosmetology Hospital, including 11 males and 36 females, aged from 18 to 43 years old, with an average age of 23 years old. After the L-shaped stent was retained during the operation, the nasal septum cartilage was cut off. Firstly, stress and volumetric correction of the dorsal deviation of nasal septum was done by nicked and grafted on the opposite side of the deviation of the nasal septum cartilage, then deviation of caudal of the nasal septum was corrected according to different cases.(1)CategoriesⅠ: The anterior nasal crest is centered. The posterior septum angle is attached to the anterior nasal crest. Caudal septum is arc curved to one side. The concave surface of the bent cartilage was scratched and a cartilage slat was placed on one side to form a unilateral splint and correct the bending.(2) CategoriesⅡ: The anterior nasal crest is centered. The posterior septum angle is attached to the anterior nasal crest and the nasal septum is tilted in a straight line in the forward direction. Volume correction was done by placing the graft forward from the anterior nasal crest on the opposite side of the caudal deflection to ensure that the anterior angle is centered.(3) CategoriesⅢ: The anterior nasal crest is centered. The posterior septum angle emerges from the anterior nasal crest and is tilted to one side. The nasal septum is curved or deviated in a straight line. The posterior angle was detached from the dislocation point and repositioned on the anterior nasal crest. The caudal length should be excised appropriately. Cartilage strengthening transplantation was performed according to the strength and deviating tendency of the caudal cartilage.(4) CategoriesⅣ: The anterior nasal crest is tilted to one side, and the posterior septum angle is connected to the misplaced anterior nasal crest, about 2 mm of cartilage remains above the anterior nasal crest. The anterior nasal crest is detached from the posterior end and repositioned toward the midline. When the displacement distance is large, small cartilage is filled in the gap between the broken ends. If the original anterior nasal crest is too prominent, it can be chiselled out. Then cartilage augmentation grafts were performed according to the strength and inclination of the caudal end. Postoperative effects were observed.Results:A total of 47 cases were included. 8 cases wereⅠ class, 13 cases were Ⅱ class, 5 cases were Ⅲ class and 21 cases were Ⅳ class. The average follow-up period was 3 months to 1 year. Deviation recurrence occurred within 1-3 months after surgery in 1 case of Ⅱ class and 2 case of Ⅳ class. The second adjustment half a year after operation was satisfactory. One side of the nasal cavity was obstructed postoperatively in one case of Ⅲ class. Examination revealed hypertrophy of the inferior turbinate on this side. Nasal congestion is relieved after correction of hypertrophy of inferior turbinate. The other 43 cases recovered well after operation. Dorsal of the nose and the tip and columellar are basically centered. Both nostrils are basically symmetrical, and no other complications occurred.Conclusions:According to different circumstances of dorsal and caudal deviation of the nasal septum L-shaped stent and carry out targeted correction , nasal deformity caused by nasal septum deviation can be effectively treated.

Objective:To study the correction of nasal septum deviation.Methods:From August 2016 to August 2018, a total of 47 patients with nasal septum deviation were treated in Shanghai Mei-gui Medical Cosmetology Hospital, including 11 males and 36 females, aged from 18 to 43 years old, with an average age of 23 years old. After the L-shaped stent was retained during the operation, the nasal septum cartilage was cut off. Firstly, stress and volumetric correction of the dorsal deviation of nasal septum was done by nicked and grafted on the opposite side of the deviation of the nasal septum cartilage, then deviation of caudal of the nasal septum was corrected according to different cases.(1)CategoriesⅠ: The anterior nasal crest is centered. The posterior septum angle is attached to the anterior nasal crest. Caudal septum is arc curved to one side. The concave surface of the bent cartilage was scratched and a cartilage slat was placed on one side to form a unilateral splint and correct the bending.(2) CategoriesⅡ: The anterior nasal crest is centered. The posterior septum angle is attached to the anterior nasal crest and the nasal septum is tilted in a straight line in the forward direction. Volume correction was done by placing the graft forward from the anterior nasal crest on the opposite side of the caudal deflection to ensure that the anterior angle is centered.(3) CategoriesⅢ: The anterior nasal crest is centered. The posterior septum angle emerges from the anterior nasal crest and is tilted to one side. The nasal septum is curved or deviated in a straight line. The posterior angle was detached from the dislocation point and repositioned on the anterior nasal crest. The caudal length should be excised appropriately. Cartilage strengthening transplantation was performed according to the strength and deviating tendency of the caudal cartilage.(4) CategoriesⅣ: The anterior nasal crest is tilted to one side, and the posterior septum angle is connected to the misplaced anterior nasal crest, about 2 mm of cartilage remains above the anterior nasal crest. The anterior nasal crest is detached from the posterior end and repositioned toward the midline. When the displacement distance is large, small cartilage is filled in the gap between the broken ends. If the original anterior nasal crest is too prominent, it can be chiselled out. Then cartilage augmentation grafts were performed according to the strength and inclination of the caudal end. Postoperative effects were observed.Results:A total of 47 cases were included. 8 cases wereⅠ class, 13 cases were Ⅱ class, 5 cases were Ⅲ class and 21 cases were Ⅳ class. The average follow-up period was 3 months to 1 year. Deviation recurrence occurred within 1-3 months after surgery in 1 case of Ⅱ class and 2 case of Ⅳ class. The second adjustment half a year after operation was satisfactory. One side of the nasal cavity was obstructed postoperatively in one case of Ⅲ class. Examination revealed hypertrophy of the inferior turbinate on this side. Nasal congestion is relieved after correction of hypertrophy of inferior turbinate. The other 43 cases recovered well after operation. Dorsal of the nose and the tip and columellar are basically centered. Both nostrils are basically symmetrical, and no other complications occurred.Conclusions:According to different circumstances of dorsal and caudal deviation of the nasal septum L-shaped stent and carry out targeted correction , nasal deformity caused by nasal septum deviation can be effectively treated.

Objective: To develop a method for Simultaneous and rapid determination of 12 rodenticides including pindone, vacor, coumatetralyl, warfarin, diphacinone, coumachlor, chlorphacinon, difenacoum, brodifacoum, bromadiolone, difethialone and flocoumafen in whole blood and urine samples by high performance liquid chromatography-tandem mass (LC-MS-MS) . Methods: The whole blood samples were precipitated with acetonitrile, purified by OstroTM 96-well plate, The urine samples were extracted by acetonitrile, and then separated on a ODS column, analyzed with high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) . The external standard calibration were tested. Results: A good linearity was observed in their respective concentration ranges of 12 rodenticides. The related coefficients were 0.993 0~0.999 8. The limit of detections were 0.05 μg/L~1.4 μg/L. The rates of recovery were 92.5%~118.0%. The relative standard deviations were between 0.8%~17.3%. Conclusion The method was simple, rapid, sensitive, accurate and suitable for simultaneous detection of the 12 rodenticides in whole blood and urine samples of intoxicated patients.

Objective:To discuss the correction method of secondary nasal deformity after unilateral cleft lip.Methods:Patients with secondary nasal deformity after unilateral cleft lip surgery admitted to Shanghai Rose Medical Cosmetology Hospital from May 2017 to October 2019 were selected. Labial and nasal deformities were treated with surgical method, such as labial and nasal muscle tension lines reconstruction, nasal septum deviation correction, nasal tip cartilage scaffold reconstruction by using autogenous costal cartilage and lower lateral cartilage supported transplantation.Results:A total of 24 patients with secondary nasal deformity after unilateral cleft lip surgery were selected, including 10 males and 14 females, aged 17-22 years old, with an average age of 20 years old. All the patients had primary wound healing, and no delayed healing occurred. After 3-24 months of follow-up, the symmetry of the nose was significantly improved. There was no recurrence in the follow-up period, and the shape of the upper lip and nose was good.Conclusions:For the correction of secondary nasal deformities after cleft lip surgery, the method of labial and nasal muscle tension band reconstruction, nasal septum deviation correction, nasal tip cartilage scaffold reconstruction by using autogenous costal cartilage and lower lateral cartilage strengthening can achieve relatively good result.

Objective:To establish a LC-MS/MS method for determination of paraquat and diquat in plasma and urine samples.Methods:Plasma is precipitated by acetonitrile then diluent with phosphate buffer (pH=7) , urine is diluent with phosphate buffer (pH=7) , then diluent samples extracted with Oasis WCX solid-phase extraction column. Samples were analyzed using LC-MS/MS in multiple reaction monitoring (MRM) mode. The analytical column was XBridge?BEH-HILIC (100 mm×2.1 mm×2.5 μm) and the mobile phase were 100 mmol ammonium formate add 0.5% formic acid and acetonitrile. Paraquat was quantified by internal standard method and diquat by external standard method.Results:The calibration curves of paraquat and diquat were linear in the concentration range of 10.0~120.0 μg/L, the correlation coefficient (r) were 0.9985~0.9994. The limit of detection of paraquat in plasma and urine were 1.98 μg/L and 1.00 μg/L, respectively, the recovery rate were 100.2%~107.3%, the RSD were 1.6%~3.3%. The limit of detection of diquat in plasma and urine were 1.80 μg/L and 2.77 μg/L, respectively, the recovery rate were 85.3%~93.1%, the RSD were 1.8%~5.5%. Conclusion:This method is sensitive and accurate, and can simultaneously determine paraquat and diquat in plasma and urine.

Objective:To discuss the correction method of secondary nasal deformity after unilateral cleft lip.Methods:Patients with secondary nasal deformity after unilateral cleft lip surgery admitted to Shanghai Rose Medical Cosmetology Hospital from May 2017 to October 2019 were selected. Labial and nasal deformities were treated with surgical method, such as labial and nasal muscle tension lines reconstruction, nasal septum deviation correction, nasal tip cartilage scaffold reconstruction by using autogenous costal cartilage and lower lateral cartilage supported transplantation.Results:A total of 24 patients with secondary nasal deformity after unilateral cleft lip surgery were selected, including 10 males and 14 females, aged 17-22 years old, with an average age of 20 years old. All the patients had primary wound healing, and no delayed healing occurred. After 3-24 months of follow-up, the symmetry of the nose was significantly improved. There was no recurrence in the follow-up period, and the shape of the upper lip and nose was good.Conclusions:For the correction of secondary nasal deformities after cleft lip surgery, the method of labial and nasal muscle tension band reconstruction, nasal septum deviation correction, nasal tip cartilage scaffold reconstruction by using autogenous costal cartilage and lower lateral cartilage strengthening can achieve relatively good result.

Objective:To establish a LC-MS/MS method for determination of paraquat and diquat in plasma and urine samples.Methods:Plasma is precipitated by acetonitrile then diluent with phosphate buffer (pH=7) , urine is diluent with phosphate buffer (pH=7) , then diluent samples extracted with Oasis WCX solid-phase extraction column. Samples were analyzed using LC-MS/MS in multiple reaction monitoring (MRM) mode. The analytical column was XBridge?BEH-HILIC (100 mm×2.1 mm×2.5 μm) and the mobile phase were 100 mmol ammonium formate add 0.5% formic acid and acetonitrile. Paraquat was quantified by internal standard method and diquat by external standard method.Results:The calibration curves of paraquat and diquat were linear in the concentration range of 10.0~120.0 μg/L, the correlation coefficient (r) were 0.9985~0.9994. The limit of detection of paraquat in plasma and urine were 1.98 μg/L and 1.00 μg/L, respectively, the recovery rate were 100.2%~107.3%, the RSD were 1.6%~3.3%. The limit of detection of diquat in plasma and urine were 1.80 μg/L and 2.77 μg/L, respectively, the recovery rate were 85.3%~93.1%, the RSD were 1.8%~5.5%. Conclusion:This method is sensitive and accurate, and can simultaneously determine paraquat and diquat in plasma and urine.

Objective:To explore the surgical techniques and effects of transfer of the free chimeric functional thoracodorsal artery perforator flap (TDAPF) with latissimus dorsi in reconstruction of dynamic muscle and soft tissue defects in forearm.Methods:From January 2014 to December 2020, a total of 13 transfer surgery of free chimeric functional TDAPF with vascularised latissimus dorsi were performed in the Department of Hand Surgery, Plastic & Reconstructive Surgery, Ningbo Sixth Hospital, to reconstruct forearm composite defects. The patients were 12 males and 1 female with an average age of 33.2 years old. They all had open forearm injuries, with 5 in the left and 8 in the right. Removal of inactivated muscles, exploration and repair of blood vessels and nerves were performed in emergency surgery, and VSD were applied after the surgery. Phase II reconstructive surgery were completed within 4 to 12 days, with 7.5 days in average. The wounds and flaps sized were 9.0 cm×8.0 cm - 21.0 cm×11.0 cm and were 10.0 cm×9.0 cm - 22.0 cm×12.0 cm, respectively. The volume of transferred muscles ranged were 9.0 cm × 2.0 cm × 1.5 cm - 19.0 cm × 9.0 cm × 1.5 cm. Free chimeric functional muscular flaps were transferred to reconstruct the musculus flexor digitorum profundus in 4 patients, the musculus extensor digitorum communis in 8 patients, the musculus flexor carpi radialis in 3 patients, and the musculus flexor pollicis longus in 1 patient. Reconstruction of both of musculus flexor carpi radialis and musculus extensor digitorum communis with 2 functional sub-blocks of latissimus dorsi were performed in 3 patients. All donor sites were closed primarily. All patients were included in the postoperative follow-up to evaluate the appearance of flaps, range of motion of the digits, recovery of muscle strength and gripping power, at the outpatient clinics or through the telephone interview.Results:A total of 12 flaps survived uneventfully after reconstructive surgery. One flap developed a vascular crisis and it was rectified after surgical exploration. Postoperative follow-up ranged from 17 to 52 months, with a mean of 34.1 months. Appearances of limbs and flaps were good without obvious bulky, hyperpigmentation or scar contracture. Four patients with reconstructed musculus flexor digitorum profundus showed muscle strength recovery of M 4, with the fingertips measured lower than 2.0 cm from the centre of palm when clenching a fist, and the average gripping strength of the hand reached 27.5% (20%-35%) to the healthy side. Five patients with reconstructed musculus extensor digitorum communis showed muscle strength recovery of M 4, and there was no obvious limitation in fingers flexion and extension, with the average gripping strength of the hand reached 75.4% (65%-80%) to the healthy side. Of the 3 patients with reconstruction of both power muscles, the recovery of muscle strength of musculus flexor carpi radialis was at M 4 in all the 3 patients, and the musculus extensor digitorum communis was at M 4 in 1 and M 3 in 2 patients. However, the patient who received reconstruction of musculus flexor pollicis had no significant recovery in muscle strength. Conclusion:Transfer of free chimeric functional TDAPF combines the benefits of a perforator flap and a functional muscle transfer together. This surgical technique can effectively reconstruct damaged muscle groups in forearm and resulting in good hand movement. Additionally, it can also restore the aesthetic appearance of forearm, hence makes it an excellent option for complex wound coverage.

Objective: To discuss the use of butterfly costal cartilage as columella strut graft. Methods: On the costal cartilage that being cut, butterfly graft was designed length of 2.8 cm, upper and lower end thickness of 5 mm, middle part thickness of 1.5 mm. The lower end was designed with a groove about 1 cm in length, the width of the lower end of the butterfly graft was determined according to the degree of retraction at the caudal end of the septum, then insert to the nasal crest. The posterior end of two lamella grafts was sutured and fixed with the middle part of the nasal columnar strut graft. Results: From November 2016 to March 2018, about 150 patients underwent rhinoplasty with this method, follow-up was 3 to 12 months. Two cases had mild nasal tip deviation one month after surgery and were adjusted with auricular cartilage three months later. Three patients had mild postoperative hyporotation and adjustment three months postoperatively, residual had good shape. Conclusions The stability and controllability of the sphenoid columella strut graft are good, out of shape not easily, It is a worthy clinical method.

BACKGROUNDIt is desirable to minimize the risk of adverse radiation effects associated with percutaneous coronary intervention. The aim of this study was to determine the impact of prolonging the interval between coronary angiography and percutaneous coronary intervention on X-ray-induced DNA double-strand breaks in blood lymphocytes using γ-H2AX immunofluorescence microscopy.

METHODSBlood samples of eight patients were taken before the first exposure to ionizing radiation, 10 minutes, 20 minutes, 30 minutes, 1 hour, and 24 hours after the last exposure to determine the γ-H2AX foci repair kinetics. Fifty-eight patients undergoing percutaneous coronary intervention were randomized to an intermittent radiation exposure group and a continuous radiation exposure group. Blood samples were taken before coronary angiography and 15 minutes after the last exposure. By enumerating γ-H2AX foci, the impact of prolonging the interval on DNA double-strand breaks was investigated. Student t-test was used to compare the difference in DNA double-strand breaks between the two groups.

RESULTSAn increase in foci was found in all patients received percutaneous coronary intervention. The maximum number of γ-H2AX foci was found 10-20 minutes after the end of the last exposure. There was no statistically significant difference between the two groups in γ-H2AX foci at baseline. On average there were (0.79 ± 0.15) γ-H2AX foci induced by interventional X-rays per lymphocyte in the continuous radiation exposure group and (0.66 ± 0.21) in the intermittent radiation exposure group after exposure (P < 0.05).

CONCLUSIONSA significant number of γ-H2AX foci develop following the percutaneous coronary intervention procedures. The number of X-ray-induced DNA double-strand breaks may be decreased by prolonging the interval time between coronary angiography and percutaneous coronary intervention to 30 minutes.

Adult ; Coronary Angiography ; adverse effects ; DNA Breaks, Double-Stranded ; radiation effects ; Dose-Response Relationship, Radiation ; Female ; Humans ; Lymphocytes ; metabolism ; radiation effects ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; adverse effects