Résumé
Objective:To investigate the efficacy of the Scarf osteotomy in treating adolescents with metatarsus adductus-type hallux valgus.Methods:A retrospective analysis was conducted on 20 patients (30 feet) treated with the Scarf osteotomy for metatarsus adductus-type hallux valgus at the Department of Hand and Foot Surgery, Beijing University of Chinese Medicine Third Affiliated Hospital, from July 2022 to August 2023. This group included 10 patients with bilateral conditions and 10 with unilateral, comprising 4 males and 16 females, with an average of 16.2±2.4 years (range, 14-19 years). The procedure involved the release of the lateral capsule, sesamoid ligaments, and adductor hallucis before osteotomy. After osteotomy, shortening and wedge resection were performed, along with translation and rotation of the distal osteotomy to reposition the first metatarsal beside the second and thereby reduce metatarsus adductus. The outcomes included preoperative, immediate postoperative, and final follow-up angles: hallux valgus angle (HVA), intermetatarsal angle (IMA), metatarsal adduction angle (MAA), and the angle between the second to fifth metatarsals.Results:All 20 patients successfully underwent surgery with good wound healing and no infections; the average clinical healing time of osteotomy site was 5.1±0.7 weeks (range, 4.1-6.6 weeks). Follow-up lasted for 12.0±5.4 months (range, 2-18 months). Significant differences were observed in HVA, which was from 35.40°±5.45° preoperatively to 6.93°±3.60° immediately postoperatively, and 9.83°±2.65° at final follow-up; IMA, which was from 11.50°(9.75°, 14.00°) preoperatively to 1.50°(0.00°, 2.00°) immediately postoperatively, and at final follow-up; MAA, which was from 22.80°±2.60° preoperatively to 20.63°±2.27° immediately postoperatively, and 20.67°±2.20° at final follow-up; the angle between the second to fifth metatarsals,which was from 19.03°±1.85° preoperatively to 15.37°±1.33° immediately postoperatively, and 16.03°±1.73° at final follow-up. Visual analogue scale (VAS) also significantly decreased from 2.60±1.64 preoperatively to 1.30±0.92 at 6-8 weeks postoperatively. No cases of transfer metatarsalgia or recurrence of hallux valgus were reported.Conclusion:The Scarf osteotomy for metatarsus adductus-type hallux valgus effectively corrects the first metatarsal adduction and improves the adduction state of the remaining metatarsals to various degrees.
Résumé
Objective To quantify operation characteristics of the ankle rotating-traction-poking manipulation (RTPM) for treating acute lateral ankle sprain by using motion capture technology, so as to provide objective references for standardized operation of RTPM and its education inheritance. Methods A professional physiotherapist performed the RTPM on 60 volunteers with acute lateral ankle sprain. Motion capture system was used to acquire effective kinematic data during the RTPM, so as to make analysis and summarize rules. Results The average time of ankle rotating for six circles was 11.36 s and the average time of ankle traction and poking was 3.42 s. The average displacement of ankle traction was 36.94 mm and the average displacement of ankle poking was 22.44 mm. The average angle of ankle traction was 23.27°, and the average angle of ankle poking was 22.76°. During the RTPM for treating acute lateral ankle sprain, the average linear velocity of ankle rotating was 58.28 mm/s, and the average linear velocity of ankle traction and poking was 23.81 mm/s. The linear acceleration of ankle rotating was 0.43 mm/s2, and the linear acceleration of ankle traction and poking was 0.54 mm/s2. Conclusions The RTPM can be applied in clinical practice. During the RTMP, the principle of gentleness, rhythmicity and continuity should be followed. Under the premise of following physiological characteristics of ankle joint, treatment of the sprained ankle should be carried out with slow and uniform speed continuously.
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The JAK/STAT/SOCS signaling pathway can mediate a variety of cytokines involved in inflammation, tumor, and autoimmune diseases and it also plays an important role in hepatitis B virus (HBV) infection-related liver diseases. This article briefly reviews the structure and signal pathway regulation of JAK-STAT and SOCS and elaborates on their role in the development and progression of HBV-related chronic hepatitis B, liver cirrhosis, liver failure, and hepatocellular carcinoma. The final analysis shows that the JAK/STAT/SOCS signaling pathway is dysregulated in HBV-related liver disease and is involved in the development and progression of the disease, and it may even influence the treatment and prognosis of the disease.
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Patients with chronic hepatitis B (CHB) often have immune-mediated liver injury, and it is considered that the interaction between viral infection and immune response is an important cause of disease progression. CHB can progress to liver fibrosis, liver cirrhosis, and even hepatocellular carcinoma (HCC). This article reviews the discovery of T helper 17 (Th17) cells and regulatory T (Treg) cells, describes their own features, and elaborates on their role and mechanism of action in maintaining the stability of the immune system. This article also analyzes the role of Th17/Treg cell imbalance in CHB, liver fibrosis, liver cirrhosis, and HCC and points out that Th17/Treg cell imbalance may promote the aggravation of HBV-related liver diseases.