OBJECTIVE: To investigate the effectiveness of the suture anchor technique without knots for reconstruction of the anterior talofibular ligament (ATFL) combined with the reinforcement of the inferior extensor retinaculum in treating chronic lateral ankle instability (CLAI). METHODS: The clinical data of 31 patients with CLAI who were admitted between August 2017 and December 2023 and met the selection criteria were retrospectively analyzed. There were 18 males and 13 females, with an age range from 20 to 48 years (mean, 34.6 years). All patients had a history of repeated ankle sprain, with a disease duration of 6-18 months (mean, 9.65 months). The anterior drawer test and inversion stress test were positive, and tenderness was present in the ligament area. Stress X-ray films of the ankle joint showed a talar tilt angle of (10.00±2.78)° and an anterior talar displacement of (9.48±1.96) mm on the affected side. MRI revealed discontinuity, tortuosity, or disappearance of the ATFL structure. Preoperatively, the visual analogue scale (VAS) score was 5.2±2.1, and the American Orthopaedic Foot and Ankle Society (AOFAS) score was 62.9±7.1. All patients underwent arthroscopic debridement of the ankle joint followed by reconstruction of the ATFL using the suture anchor technique without knots combined with reinforcement of the inferior extensor retinaculum. Postoperatively, pain and function were assessed using the VAS and AOFAS scores. Stress X-ray films were taken to measure the talar tilt angle and anterior talar displacement to evaluate changes in ankle joint stability. Patient satisfaction was assessed according to the Insall criteria. RESULTS: All 31 surgeries were successfully completed. One case had wound exudation, while the remaining surgical incisions healed by first intention. Two cases experienced numbness on the lateral aspect of the foot, which disappeared within 1 month after operation. All patients were followed up 15-84 months (mean, 47.2 months). No complication such as anchor loosening, recurrent lateral ankle instability, superficial peroneal nerve injury, rejection reaction, or wound infection occurred postoperatively. The anterior drawer test and inversion stress test were negative at 3 months after operation. Stress X-ray films taken at 3 months after operation showed the talar tilt angle of (2.86±1.72)° and the anterior talar displacement of (2.97±1.32) mm, both of which were significantly different from the preoperative values ( t=12.218, P<0.001; t=15.367, P<0.001). At last follow-up, 2 patients had ankle swelling after exercise, which resolved spontaneously with rest; all 31 patients returned to their pre-injury level of sports or had no significant discomfort in daily activities. At last follow-up, 25 patients were pain-free, 4 had mild pain after exercise, and 2 had mild pain after walking more than 2 000 meters. The VAS score was 0.8±0.9 and the AOFAS score was 91.6±4.1, both of which were significantly different from the preoperative scores ( t=10.851, P<0.001; t=-19.514, P<0.001). According to the Insall criteria, 24 patients were rated as excellent, 4 as good, and 3 as fair, with a satisfaction rate of 90.3%. CONCLUSION The suture anchor technique without knots for reconstruction of the ATFL combined with reinforcement of the inferior extensor retinaculum provides satisfactory short- and mid-term effectiveness in treating CLAI.
Humans ; Male ; Adult ; Female ; Joint Instability/surgery* ; Lateral Ligament, Ankle/surgery* ; Retrospective Studies ; Middle Aged ; Ankle Joint/diagnostic imaging* ; Young Adult ; Suture Anchors ; Treatment Outcome ; Suture Techniques ; Plastic Surgery Procedures/methods* ; Chronic Disease ; Ankle Injuries/surgery*

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 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 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.

Identifying and comparing the chemical constituents of wild silkworm cocoon and silkworm cocoon is of great significance for understanding the domestication of silkworm. In this study, we used high temperature and high pressure and methanol-water system to extract cocoon chemical constituents. We used UHPLC-MS to identify and compare cocoon chemical constituents of wild silkworm and domestic silkworm Dazao and Haoyue strains. The cocoon metabolic fingerprints of wild silkworm and domestic silkworm Dazao and Haoyue strains were obtained by using the UHPLC-MS in the positive ion mode and negative ion mode. By annotation, we found that cocoon chemical compounds with high abundances contained amino acids, flavonoids, alkaloids, terpenes, organic acids, and lignans. PLS-DA showed that the cocoon components were significantly different among the wild silkworm and two domestic silkworm strains Dazao and Haoyue. Proline, leucine/isoleucine and phenylalanine showed significantly higher abundances in the cocoon of domestic silkworm Dazao strain than in those of wild silkworm and domestic silkworm Haoyue strain. The flavonoid secondary metabolites are abundant in the Dazao cocoon, including quercetin, isoquercetin, quercetin 3-O-sophoroside, quercetin-3-O-α-L-rhamnoside, quercetin-3-O- rutinoside, and kaempferol. The other secondary metabolites, alkaloids, terpenes and lignans, showed higher abundances in the wild silkworm cocoon than in the domestic silkworm cocoon, including neurine, candicine, pilocarpidine, artemisiifolin, eupassopin, and eudesobovatol. By exposing cocoons to UV light and observing the green fluorescence of flavonoids, we found that Dazao cocoon had the most flavonoids, and Haoyue cocoon had least flavonoids and wild silkworm cocoon had mediate flavonoids. Alkaloids and organic acids are good anti-insect and antimicrobial agents, which have high abundance in the wild silkworm cocoon and could enhance the defense ability of wild silkworm cocoon. Flavonoids are abundant in the cocoon of domestic silkworm Dazao strain, which the main factors are leading to the yellow-green cocoon of Dazao.
Animals ; Bombyx ; Chromatography, High Pressure Liquid ; Flavonoids ; Mass Spectrometry

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.

Objective To explore the correlation between old anterior cruciate ligament (ACL) injury with medial menis-cal tears and posterior slope of tibial plateau. Methods Between July 2014 and February 2016, retrospective analyzed 177 pa-tients diagnosed with old ACL injury (injured to surgery time>3 months) who has been underwent arthroscopic treatment. 93 pa-tients included in this study contained 65 male and 28 female,the average age was (32.36±4.50) years old (ranged from 21 to 44 years). All patients were diagnosed with ACL rupture and no associated medial meniscus tear by MR examination at the time of in-jury and before operation. Posterior slope angle of tibial plateau was measured via MR. The patients were divided into two groups according to the presence of medial meniscus tear by preoperative MR examination. Statistical analysis was employed to analyze the difference between the two groups of patients's age, body mass index (BMI), posterior slope angle of tibial plateau, gender and side. The patients were divided into group of posterior slope of tibial plateau ≥10° and posterior slope of tibial plateau<10° re-spectively. Statistical analysis was employed to analyze the incidence of concomitant medial meniscus tear between the two groups. Result All 93 patients in this study were followed up for the average of 8.63 ± 3.74 months. 51(51/93, 55%) patients were com-firmed of concomitant medial meniscus tear and 42 (42/93, 45%) patients without medial meniscus tear through MR and arthro-scope. There was no statistical difference between two groups in age (t=0.843, P=0.843), gender (χ2=1.027, P=0.338), BMI (t=0.568, P=0.571) and side (χ2=0.110, P=0.438). There was a certain correlation between the medial meniscal tears and posterior slope angle of tibial plateau in this group and the values were considered statistically significant ( r=0.602, P=0.000). Posterior slope angle of tibial plateau of medial meniscus tear group (10.51°±2.83°) was significantly higher than that in non medial menis-cus tear group (7.39°±4.62°). Values were considered statistically significant .71.15%(37/51) of the patients showed medial meniscus tear in the group of posterior slope of tibial plateau ≥10° , however, only 34.14%(14/42) patients indicated medial meniscus tear in group of posterior slope of tibial plateau<10°, and the difference was statistically significant(χ2=12.677,P=0.000). Con-clusion There is a certain correlation between old ACL injury with medial meniscal tears and posterior slope angle of tibial pla-teau. With the continuous increase of ACL injury time, high posterior slope angle of tibial plateau (≥10°) is more likely to increase the incidence of medial meniscus tear.