Objective:To investigate the effect of Tacroliums(FK506) on the significance of IL-2 and sIL-2R expression in refractory nephrotic syndrome. Methods: The expression of IL-2 and sIL-2R were evaluated by enzyme-linked immunosorbent assay (ELISA) on both pretreatment and post-treatment groups, and supervise the changes of 24hours urinary protein,serum albumin and lipid. Results:Serum IL-2 and sIL-2R level were higher in pre-treatment group than in normal control group(P

Objective To investigate the influence of stigma on QOL of patients with mental disorders.Methods By using Link stigma series scale and schizophrenic quality of life scale,we assessed and analyzed 406 psychiatric patients′stigma and QOL, as well as the correlation and influence between them.Results The score of perceived devaluation-discrimination dimension of the stigma scale had positive correlation with total score of QOL,score of psycho-social dimension and score of motivation and energy dimension (P <0.05).The scores of challenge dimension and separation dimension in the stigma scale had positive correlation with motivation and energy dimension of the QOL scale (P <0.05).Regression analysis showed that stigma did not have influence on QOL of patients with mental disorders.Conclusion Stigma in psychiatric patients has no significant influence on QOL,but correla-tion relationship exists between them.The higher score of perceived devaluation-discrimination dimension,challenge dimension and separation dimension of stigma scale,the poor QOL the patient would have.

Objective To explore the mediating effects of resilience between family function and geriatric depression. Methods By convenient sampling, 212 elderly people who were from the communities in Yuexiu, Guangxhou city were analyzed by using Geriatric Depression Scale (GDS-30) and Family Concern Index Questionnaire (APGAR) and Connor-Davidson Resilience Scale (CD-RISC) and the self-designed General Condition Questionnaire, and a mediating model was proposed and the impacts of resilience on family function and geriatric depression were tested. Results The incidence rate of depression among the community elderly was 23.6% (50/212), and the average score of APGAR was 7.87 ± 2.83, and the average score of CD-RISC was 83.66 ± 12.88. The scores of GDS-30 showed significantly negative correlation with the scores of APGAR (r=-0.582,P<0.01)and the scores of CD-RISC (r=-0.425, P<0.01), and there was positive correlation between the scores of APGAR and the scores of CD-RISC (r=0.335, P < 0.01). The mediating model had high degree of fitting, and level of path had statistical significance (P < 0.01). Resilience was the mediator between family function and geriatric depression. Family function had direct effects (0.50) on geriatric depression and indirect effects (0.11) through resilience, and the combined effects of family function and resilience determined 45%changing range of geriatric depression. Conclusions Family function was a direct predictor of geriatric depression, and resilience had mediating effects between family function and geriatric depression. Community mental health work should pay enough attention to the effects of family function on the life of the aged, and increased the care to the elderly with family dysfunction, while promote and develop family-centered mental health education, propaganda and psychological guidance, so that improves resilience of the aged and help the aged positively coping and maintain good mental health status.

Objective:To explore the advantages and value for clinical application of clavicle segment osteotomy approach with pectoralis major muscle pedicle in surgical resection of posterior brachial plexus tumour.Methods:From April 2010 to December 2020, 6 patients with brachial plexus tumour behind the clavicle were treated. Two patients had the tumour on the left brachial plexus and 4 on the right. Two patients had the tumours located in the upper trunk of brachial plexus, 2 in the middle trunk, 1 in the medial plexus and 1 in the posterior bundle. The neurological function evaluation were grade II in 3 cases and grade III in 1 case preoperatively. The tumours sized from 3.0 cm× 3.0 cm×2.0 cm to 11.0 cm×8.0 cm×6.0 cm. The clavicular segment osteotomy approach with the pedicle of the pectoralis major was applied in order to expose the surgical field and remove the nerve tumour. All patients underwent regular postoperative outpatient clinic follow-up to record the sensation of the affected limb and the recovery of muscle strength, tumour recurrence and fracture healing.Results:In the operation, it was found that there was still a little glial-like tissue in the nerve sheath after complete dissection of the tumours in 2 patients. Postoperative pathological examination reported that there were 4 schwannoma, 1 malignant peripheral schwannoma and 1 neurolipoma. The postoperative follow-up lasted for 6 to 34 months, with an average of 12.8 months. All patients showed no symptoms of brachial plexus injury or tumour recurrence. The clinical symptoms were relieved or disappeared. The neurological function evaluation reached grade III in 5 patients and grade IV in 1 case. At the same time, the internal fixation of the clavicle was satisfactory and achieved bone union in all cases. Fracture healing time was 2.5 to 4.5 months, with an average of 3.2 months. The internal fixation was removed from 3 patients after operation in 1 year. No obvious limb movement disorder and periarthritis of shoulder and other complications occurred.Conclusion:The transclavicular osteotomy approach with the pedicle of the pectoralis major can fully expose the anatomical alignment of the brachial plexus and the relationship adjacent and between the tumour and the surrounding tissues in the surgery for a brachial plexus tumour behind the clavicle, which is helpful for a complete tumour resection. It is a feasible method to treat brachial plexus tumour behind the clavicle by finding residual tumour-like tissue, reducing the risk of surgery and tumour recurrence, and providing excellent blood supply to the osteotomy segment of the clavicle to promote fracture healing.

Objective:To investigate feasibility and clinical effect of free anterolateral thigh flap(ALTF) with reversed arterial flow in repair of foot and ankle wounds in children.Methods:From October 2014 to February 2021, the free ALTF with reversed arterial flow was used to repair the wounds in 7 children with severe soft tissue injury and main blood vessel injury in the Department of Hand & Foot Surgery of the Second Affiliated Hospital of University of South China. Of the 7 injured children, 5 were caused by traffic accident, 1 by mechanical strangulation and 1 by heavy object. The size of wounds ranged from 6.0 cm×8.0 cm to 9.0 cm×11.0 cm. ALTF were designed to be anastomosed with the blood vessels at the recipient sites by retrograde blood supply. The size of flaps ranged from 6.0 cm×8.0 cm to 10.0 cm×11.0 cm. All flap donor sites were pulled together and directly sutured. Follow-ups were conducted through outpatient clinic visits, telephone call and WeChat reviews in the 1st, 3rd, 6th, 12th and 24th months after surgery. The major contents in follow-up were the shape, colour, texture, sensation of flap and function of ankles.Results:All donor sites healed at I stage. A total of 5 flaps survived successfully; One flap had venous occlusion after surgery, and the flap survived after surgical exploration; One flap had partial necrosis after surgery, and repaired with artificial dermis after further debridement. Postoperative follow-up lasted for 6-24 months, with an average of 10.5 months. All flaps appeared in similar colour and texture to the surrounding soft tissues. Two children underwent flap repair after half a year due to bloated flaps. The Ankle-hind foot Function Score of American Orthopedic Foot Ankle Society(AOFAS) was used to evaluate the ankle function. AOFAS achieved 84-94 points, with 5 children in excellent and 2 in good. The sensation recovered to S 3+ in 5 children, S 3 in 1 child and S 2 in 1 child, according to the standard of British Medical Research Council (BMRC). Conclusion:For the children with severe soft tissue injury combined with main vascular injury in foot and ankle, free ALTF with reversed arterial flow can repair the defect and effectively secure the blood supply. It is a feasible method for wound repair.