Objective To explore clinical effect of distal tibial tubercle-high tibial osteotomy(DTT-HTO)in treating knee osteoarthritis(KO A)with medial meniscus posterior root tear(MMPRT).Methods A retrospective analysis was performed on 21 patients with varus KOA with MMPRT from May 2020 to December 2021,including 3 males and 18 females,aged from 49 to 75 years old with an average of(63.81±6.56)years old,the courses of disease ranged from 0.5 to 18.0 years with an average of(5.9±4.2)years,and 4 patients with grade Ⅱ,14 patients with grade Ⅲ,and 3 patients with grade Ⅳ according to Kellgren-Lawrence;14 patients with type 1 and 7 patients with type 2 according to MMPRT damage classification.The distance of medi-al meniscusextrusion(MME)and weight-bearing line ratio(WBLR)of lower extremity were compared before and 12 months after operation.Visual analogue scale(V AS),Western Ontarioand and McMaster Universities(WOMAC)osteoarthritis index,and Lysholm knee score were used to evaluate knee pain and functional improvement before operation,1,6 and 12 months after operation,respectively.Results Twenty-one patients were followed up for 12 to 18 months with an average of(13.52±1.72)months.MME distance was improved from(4.99±1.05)mm before operation to(1.87±0.76)mm at 12 months after operation(P＜0.05).WBLR was increased from(15.49±7.04)％before operation to(62.71±2.27)％at 12 months after operation(P＜0.05).VAS was decreased from(7.00±1.14)before operation to(2.04±0.80),(0.90±0.62)and(0.61±0.50)at 1,6 and 12 months after operation.WOMAC were decreased from preoperative(147.90±9.88)to postoperative(103.43±8.52),(74.00±9.54)and(47.62±9.53)at 1,6 and 12 months,and the difference were statistically significant(P＜0.05).Lysholm scores were increased from(46.04±7.34)before oepration to(63.19±8.93),(81.10±6.41)and(89.29±3.04)at 1,6 and 12 months after operation(P＜0.05).Conclusion For the treatment of varus KOA with MMPRT,DTT-HTO could reduce medial meniscus pro-trusion distance,improve the ratio of lower limb force line,and effectively reduce knee pain and improve knee joint function.

Bone development shows certain regularity with age. The regularity can be used to infer age and serve many fields such as justice, medicine, archaeology, etc. As a non-invasive evaluation method of the epiphyseal development stage, MRI is widely used in living age estimation. In recent years, the rapid development of machine learning has significantly improved the effectiveness and reliability of living age estimation, which is one of the main development directions of current research. This paper summarizes the analysis methods of age estimation by knee joint MRI, introduces the current research trends, and future application trend.
Epiphyses/diagnostic imaging* ; Age Determination by Skeleton/methods* ; Reproducibility of Results ; Magnetic Resonance Imaging/methods* ; Knee Joint/diagnostic imaging*

OBJECTIVES: To reduce the dimension of characteristic information extracted from pelvic CT images by using principal component analysis (PCA) and partial least squares (PLS) methods. To establish a support vector machine (SVM) classification and identification model to identify if there is pelvic injury by the reduced dimension data and evaluate the feasibility of its application. METHODS: Eighty percent of 146 normal and injured pelvic CT images were randomly selected as training set for model fitting, and the remaining 20% was used as testing set to verify the accuracy of the test, respectively. Through CT image input, preprocessing, feature extraction, feature information dimension reduction, feature selection, parameter selection, model establishment and model comparison, a discriminative model of pelvic injury was established. RESULTS: The PLS dimension reduction method was better than the PCA method and the SVM model was better than the naive Bayesian classifier (NBC) model. The accuracy of the modeling set, leave-one-out cross validation and testing set of the SVM classification model based on 12 PLS factors was 100%, 100% and 93.33%, respectively. CONCLUSIONS In the evaluation of pelvic injury, the pelvic injury data mining model based on CT images reaches high accuracy, which lays a foundation for automatic and rapid identification of pelvic injuries.
Algorithms ; Bayes Theorem ; Data Mining ; Least-Squares Analysis ; Support Vector Machine

Objective To explore a new method for improving healing of skin graft donor sites.Methods A total of 40 patients who needed intermediate thickness skin graft from thigh,from January 2014 to December 2015,were randomly devided into experiment group and control group.Skin graft donor sites of the experiment group were covered with Physiotulle Ag and Allevyn foam dressing,while donor sites of the control group were covered with petrolatum impregnated gauze,sterile gauze,and compression bandage.Postoperative infection rate,pain scoring during the first dressing change,time of dressing change between operation and complete healing,duration for complete healing,and the area of non-healing two weeks after operation were compared and statistical analysis was performed with SPSS17.0.Results There was no infection in the experiment group.Two patients developed infection in the control group,with wound exudate culture positive for pseudomonas aeruginosa,and the wounds healed after dressing change.The experiment group was significantly better than that of the control group in pain scoring during the first dressing change,time of dressing change between operation and complete healing,duration of complete healing (U=81.5,P=0.001;U=109.5,P=0.011;t=0.769,P＜0.001).Conclusions The Physiotulle Ag combined with Allevyn foam dressing can enhance healing of skin graft donor sites,alleviate pain of the patient,and reduce dressing change.This method is easy to perform,and skin graft donor sites heal well in two weeks,which may lead a prospected application.

Objective To evaluate the safety and efficacy of cross-linked hyaluronic acid Revanesse Ultra for treatment of nasolabial folds in Chinese population .Methods A total of 120 participants were enrolled in this prospective , randomized , positive controlled , non-inferiority clinical trial in accordance to inclusion and ex-clusion criteria , and signed informed consents were obtained .The participants were numbered in the order of en-rollment and randomized into Restylane group and Revanesse group , receiving hyaluronic acid injection to correct bilateral nasolabial folds .Each person received 1 or 2 times of injection ( a touch-up injection could be adminis-tered 4 weeks post the first injection ) .According to the original depth of the wrinkles , no more than 2 ml hyalu-ronic acid was injected into each side .All the participants were followed up at 1, 3, 6, and 12 months after the last injection and standardized photographs were taken at each visit .All the participants were asked to fill the form of local adverse events within the first 15 days after injection.Investigators and the participants both evalu-ated wrinkles based on Wrinkle Severity Rating Scale ( WSRS) .The WSRS score according to the pictures of 6 months post-injection were compared with the pictures which were taken before the injection ( baseline) by in-dependent staff at the end of the trial .One or more grades of WSRS improvement compared with the baseline was considered as effective .Laboratory tests including blood and urine routine , liver and renal function tests were carried out at screening visit and 6 months after injection.Results The baseline features between the two groups were comparable (all P>0.05).There was no significant difference in the WSRS 6 months after injec-tion between the two groups ( P>0.05 ) .There was no significant difference in the WSRS improvement com-pared with baseline between the two groups ( P=0.105 ) .There was no significant difference in the rate of ef-fectiveness between the two groups ( 93.0% vs.96.7%, P=0.431 ) .Two participants reported minor ad-verse events, although both of which might not be associated with the product or procedure .No laboratory test change was found during the trial .Conclusions No severe adverse event associated with the injection material was observed during this clinical trial .According to the result , Revanesse Ultra may have good histocompati-bility and tolerance .It could provide obvious improvement in the nasolabial folds , with effectiveness comparable to that of Restylane .

OBJECTIVETo investigate reliability of the infra-nipple broken line incision for breast augmentation.

METHODSFrom January 2012 to January 2013, 15 patients underwent primary bilateral retromuscular breast augmentation with round textured silicone-gel implants and a novel infra-nipple broken line incision. Preoperatively, a semicircular incision was marked along the inferior base of the nipple. It was then extended bilaterally using two transverse right-angled geometric broken lines within the pigmented areolar skin. Follow-up was performed to evaluate the sensation of nipple-areolar complex, the scar, and the shape and texture of the breasts.

RESULTSThe average follow-up was 6.7 months. Most of the patients complained of paresthesia of the nipple or breast skin, but transient decreased sensation improved within 3 months. No patients showed permanent sensory changes of the nipple areolar complex at a minimum follow-up of 4 months. The scars were imperceptible in all patients.

CONCLUSIONWe believe that for selected patients, the infra-nipple broken line incision is a practical and reliable method to achieve aesthetic result.

Adult ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; methods ; Middle Aged

Objective To investigate reliability of the infra-nipple broken line incision for breast augmentation.
Methods From January 2012 to January 2013, 15 patients underwent primary bilateral retromuscular breast augmentation with round textured silicone-gel implants and a novel infra-nipple broken line incision. Preoperatively, a semicircular incision was marked along the inferior base of the nipple. It was then extended bilaterally using two transverse right-angled geometric broken lines within the pigmented areolar skin. Follow-up was performed to evaluate the sensation of nipple-areolar complex, the scar, and the shape and texture of the breasts.
Results The average follow-up was 6.7 months. Most of the patients complained of paresthesia of the nipple or breast skin, but transient decreased sensation improved within 3 months. No patients showed permanent sensory changes of the nipple areolar complex at a minimum follow-up of 4 months. The scars were imperceptible in all patients.
Conclusion We believe that for selected patients, the infra-nipple broken line incision is a practical and reliable method to achieve aesthetic result.

BACKGROUNDSince its first description in 1841, numerous variations and treatments of Poland's syndrome (congenital deficiency of the pectoralis major muscle associated with brachysyndactyly) have been reported. None of the reports, however, involved female Chinese patients.

METHODSA retrospective study of 24 female patients was conducted to guide the selection of methods of surgical reconstruction. The patients were divided into three groups according to the degree of thoracic tissue development. Type I (mild): Limited tissue loss which can be treated with simple filling with autologous fat and/or an artificial breast implant. Type II (moderate): Moderate thoracic tissue hypoplasia where the breast parenchyma can still offer adequate implant coverage. Mammoplasty using a latissimus dorsi muscular flap with an implant was performed in this group. The flap was used to fill the infraclavicular hollow, and the implant was placed in the dual-plane pocket. Type III (severe): Severe thoracic tissue hypoplasia, without sufficient parenchyma to offer implant coverage. A latissimus dorsi muscular flap was used to form a total submuscular pocket in which an implant was placed.

RESULTSThe numbers of Type I, II, and III patients were 15, 3, and 6, respectively. All of the flaps and injected fat demonstrated good survival. Satisfactory cosmetic results were exhibited during the follow-up period of 1 to 9 years.

CONCLUSIONSAlthough this group of patients showed varied conditions, they can be roughly divided into three types according to the degree of thoracic tissue development. In our experience, this classification is simple and useful in choosing the breast reconstruction options.

Female ; Humans ; Poland Syndrome ; classification ; diagnosis ; Retrospective Studies

OBJECTIVETo investigate the relationship between the survival rate of expanded flap and expansion volume.

METHODSThe minipigs were used and divided into 5 groups according to different expansion volume of the tissue expanders: injection to full content, 50% over content, 100% over content, 0% content and normal control. In each animal, 4 expanders (100 ml) were designed to be implanted at the bilateral side of back. Normal skin control was also designed at the back. The skin histologic change and flap survival rate were detected and analyzed when the expansion volume changed.

RESULTSThe flap survival rate increased along with the increase of expansion volume. While the survival rate decreased when the expansion volume was exceeded to 100% over content.

CONCLUSIONSIn soft tissue and skin expansion, the flap survival rate and the flap size increased as the expansion is over the standard volume, while over-expansion to 100% over content may cause decreased survival rate of expanded flap.

Animals ; Back ; Graft Survival ; Surgical Flaps ; physiology ; Swine ; Swine, Miniature ; Tissue Expansion ; Tissue Expansion Devices

OBJECTIVETo investigate the feasibility and therapeutic effect of acellular cadaveric dermis (ACD)-assisted immediate breast reconstruction.

METHODSFrom Sep. 2009 to May 2010, 10 cases received ACD-assisted immediate breast reconstruction. During the operation, the ACD was used to cover inferior and lateral portion of the implants in 2 cases and expanders in 8 cases.

RESULTSThe patients were followed up for an average period of 4 months with satisfactory breast appearance. The complications included infection in 2 cases and dehiscence in 2 cases. But no implant or expander was taken out.

CONCLUSIONSThe ACD-assisted immediate breast reconstruction is a technically simple procedure with minimal morbidity. Satisfactory clinical outcome can be achieved with appropriate candidates.

Acellular Dermis ; Adult ; Breast Implants ; Dermis ; transplantation ; Female ; Humans ; Mammaplasty ; methods ; Middle Aged ; Skin Transplantation ; Surgical Flaps ; Tissue Expansion Devices ; Treatment Outcome