Objective To observe the effect and safety of Mailuoning Injection(MLN) in treating patients with type 2 diabetes mellitus accompanying lower extremity atherosclerotic obliterans.Methods The selected patients were assigned by randomized digital table to a treated group (120 cases treated with MLN) and a control group (60 cases treated with alprostadil). The clinical efficacy was assessed after 4 weeks of treatment. Results The total effective rate in the treated group was 95.0%, better than that in the control group,83.3%(P＜0.01).Conclusion MLN has the effect of activating blood circulation.dissolving stasis and dredging collaterals, reducing the formation of thrombi. MLN is effective and safe when applied in clinical practice for the treatment of lower extremity diabetic atherosclerotic obliterans.

Objective To observe the effect of Shenqi Jiangtang Keli (SJK) on atherosclerotic disease (LEAD) of lower extremity in patients with early type 2 diabetes meliitus (T2DM). Methods The patients were randomly assigned to a control group and a treatment group. The 30 patients in the treatment group were treated by SJK and the 30 in the control group were given Cilostazo, with both groups were treated for 3 months. Lower extremity vascular color Doppler image, blood levels of interleukin-6 (IL-6) were measured before and after the treatment,. Results The thickness of atherosclerosis (AS) plaque and arterial intimamedia were obviously reduced (t=3.376, 3.468, P< 0.05 ), serum levels of IL-6 were also be lowered obviously (t=3.345, P<0.05) in the treatment group. While these indexes remained unchanged in the control group. Conclusion SJK has remarkable action in reducing the thickness of AS plaque and intima-media of artery. Its mechanism might be related with reducing serum IL-6 level.

Objective To evaluate the feasibility,safety and operation timing of laparoscopic cholecys-tectomy in treatment of gallbladder calculi incarceration. Methods The data of 280 cases of gallbladder stone incarceration performed by LC were retrospectively analyzed. Results Eight out of 280 cases were converted to open cholecystectomy. The successful rate of LC was 97. 1%. There were no complications such as bile and intestinal injury. Conclusion LC for gallbladder calculi incarceration is safe and feasible as long as operators have skilled technique and make right decisions on operation timing.

Objective To observe the effect of Shenqi Jiangtang granule (SJG) on atherosclerotic disease (LEAD) of lower extremity in patients with early type 2 diabetes mellitus (T2DM). Methods The patients were randomly assigned to a control group and a treatment group. 30 patients in the treatment group were treated by SJG and 30 patients in the control group were given Cilostazo. Both groups were treated for 3 months. Lower extremity vascular color Doppler image, blood levels of interleukin-6 (IL-6) were measured before and after the treatment. Results The thickness of atherosclerosis (AS) plaque and arterial media were obviously reduced (t=3.376, 3.468, P<0.05) , serum levels of IL-6 were also be lowered obviously (t=3.345, P<0.05) in the treatment group. While these indexes remained unchanged in the control group. Conclusion SJG has remarkable action in reducing the thickness of AS plaque and media of artery. The mechanism might be related with its reducing serum IL-6 level.

One patient with the pedicle screw threatening the aorta was treated with adjusting the position of pedicle screw by anterolateral approach. No nervous lesion was found after adjusting. Radiograph showed the position and length of screw at T11 left pedicle of vertebral arch were good. No adverse reaction was detected after 2-years of follow-up.

Objective To investigate the attitude toward and perception of the risk of nuclear power plant among the public residing in vicinity of nuclear power plant,as well as the related factors.Methods A face-to-face interview on perceived radiation risks was conducted among 1408 individuals in Liangyungang City, Jiangsu Province.where the Tianwan nuclear power plant was under construction.The four groups was defined according to the distance between the residence of the subjects and the Tianwan nuclear power plant:<4 km,4- 8 km,8-30 km and 30-50 km.A was used to collect information on education,working history,religion, perception of major industries hazards especially nuclear power plant,and major factors may influence their perceptions.Ordinal logistic regression model was used to analyze the data.Results About 91.18% of the interviewee heard about the nuclear power plant,35.36% of them had knowledge about Chernobyl nuclear power plant accident,71.05% of them believed that the nuclear power plant had no negative effects on environments, 37.03% of them believed that the nuclear energy was safe.74.27% of them believed that it was necessary for China to develop nuclear energy.63.29% of them supported the construction of the nuclear power plant in local area.Ordinal logistic regression analysis revealed that the higher education,higher family annual income,male, economic benefits from the nuclear power plant construction,and trust in local government having competency to handling emergencies were positive factors;otherwise,impression on nuclear power plant of bad influences on environment and health were negative factors.An inverted U-shaped with a right tailing relationship between negative attitudes toward nuclear power plant and distance to the plant was found.Conclusions Education, gender,family annual income and expectation of economic benefit returns were the major factors influencing the perception of and attitudes toward nuclear power plant.More works needed to be done to mitigate the negative attitude of the residents in vicinity of nuclear power plant and enhance the public acceptability .

Objective: To investigate the effect of manganese chloride (MnCl₂) or 1-methyl-4-phenylpyridinium (MPP ⁺) on oxidative stress and autophagy in human neuroblastomaSK-N-SH cells and the mechanism of the neurotoxicity of manganese. Methods: SK-N-SH cells were treated with MnCl₂ or MPP⁺ at doses of 0.062 5, 0.125, 0.25, 0.5, 1.0, and 2.0 mmol/L for 24 hours, and MTT assay was used to measure cell viability. The cells weretreated with MnCl₂ or MPP⁺ at doses of 0.125, 0.25, and 0.5 mmol/L for 24 hours, and flow cytometry was used to measure the content of reactive oxygen species (ROS) in cells, a laser scanning confocal microscope was used to observe autophagosome in cells, and Western blot was used to measure the expression of autophagy-related proteins P62 and LC3-II/LC3-I. Results: Compared with the control group, the 0.0625-2.0 mmol/L MnCl₂ and 0.125-2.0 mmol/L MPP ⁺ treatment groups had significant reductions in the viability of SK-N-SH cells, and the 0.25-2.0 mmol/L MnCl₂ treatment groups had significantly lower viability than the groups treated with the same doses of MPP⁺ (all P<0.05) . Compared with the control group, the 0.125-0.25 mmol/L MnCl₂ and 0.125-0.5 mmol/L MPP⁺ treatment groups had significant increases in the content of ROS, and the 0.25-0.5 mmol/L MPP⁺ treatment groups had significantly higher content of ROS than the groups treated with the same doses of MnCl₂ (all P<0.05) . Compared with the control group, the 0.25-0.5 mmol/L MnCl₂ andMPP⁺ treatment groups had significant increases in autophagy-related proteins LC3-II/LC3-I and significant reductions in P62 expression; the 0.125-0.5 mmol/L MPP⁺ treatment groups had significantly higher LC3-II/LC3-I than the groups treated with the same doses of MnCl₂, and the 0.125 and 0.25 mmol/L MPP ⁺ treatment groups had significantly lower P62 expression than the groups treated with the same doses of MnCl₂ (all P<0.05) . Conclusion Both MnCl₂ and MPP⁺ can induce oxidative stress and autophagy in SK-N-SH cells, and MPP⁺ has a significantly greater inductive effect on autophagy of SK-N-SH cells than MnCl₂.

Objective:To investigate clinical effect of the descending genicular periosteal free flap combined with bone graft in the treatment of tibial nonunions.Methods:From January, 2014 to June, 2018, 15 cases of tibial nonunions were treated with the descending genicular corticoperiosteal free flaps combined with bone graft after soft tissue coverage. All patients had Gustilo III C fracture. In 6 cases, the descending genicular artery of periosteal flap was anastomosed with the branch of anterior tibia artery, 6 cases anastomosed with the branch of posterior tibia artery, other 3 cases had Flow-through anastomosis with the main trunk of anterior tibia artery. The accompanying vein of descending geniculate artery was anastomosed with the vein of anterior tibia or posterior tibia artery. Routine treat- ment, step-by-step functional recovery exercises, monthly X-ray examination were conducted together with close ob- servation of the healing of fracture.Results:All cases were followed-up from 6 to 29 (average, 11) months. Bone u- nion was achieved in 14 cases with the averager time of healing in 5 months. According to the evaluation criteria of Paley fracture healing, 12 cases were excellent, 2 were good and 1 was poor. Fourteen cases were able to take daily normal activities, and 1 case failed to take the daily activities because the fracture was not healed. Six months later, according to the results of Paley functional evaluation, 2 cases were scored excellent, 12 scored good and 1 scored poor.Conclusion:The method of the descending genicular periosteal free flap combined with bone graft in the treatment of tibial nonunions can effectively improve the fracture union rate and reduce the patient treatment time with hidden donor area and simplicity of operation. It is helpful for the patients to take early exercises for the recovery of functions.

Objective:To explore the factors influencing the pulmonary function of persons with mild to moderate adolescent idiopathic scoliosis (AIS).Methods:Forty-four persons with AIS were tested for their pulmonary ventilation functioning. The indicators were the percentage of forced vital capacity (FVC%), the percentage of forced expiratory volume in the first second (FEV1%) and the percentage of maximum chase volume (MVV%). Data including age, gender, course of disease, dancing habits, exercise habits, body mass index (BMI), Cobb angle, rotation angle, diaphragm thickness, and diaphragm excursion (DE) were also collected. Linear regressions were evaluated to analyze the factors best predicting pulmonary functioning. Spearman correlation coefficients were computed to quantify the correlation between respiratory muscle functioning and pulmonary functioning.Results:The univariate analysis showed that dancing and DE independently influence FVC%, FEV1%, and MVV%. DE was the only independent factor significantly predicting pulmonary functioning for mild to moderate AIS patients. DE was also significantly positively correlated with average FVC%, FEV1% and MVV%.Conclusions:Respiratory training aimed at enhancing DE is necessary to improve the pulmonary ventilation of persons with AIS.

Objective:To explore the clinical effects of free anterolateral thigh perforator flap pedicled with descending genicular artery in repairing wounds after lower leg limb-sparing surgery.Methods:A retrospective observational study was conducted. From January 2019 to June 2021, 12 patients with wounds after lower leg limb-sparing surgery who met the inclusion criteria were admitted to Suzhou Ruihua Orthopedic Hospital, including 6 males and 6 females, aged 17 to 74 years, with original wound area ranging from 17 cm×9 cm to 40 cm×15 cm. Five patients had infection in wounds. The wounds were all repaired by free anterolateral thigh perforator flap from contralateral thigh, with area of 18 cm×10 cm to 37 cm×9 cm. The artery of flap was anastomosed with the descending genicular artery, and the wounds in donor areas were sutured directly. Seven patients were transplanted with split-thickness skin grafts from the contralateral thigh to cover the remaining wounds that can not be covered by flap and the wounds in donor areas were covered with gauze. During the operation, the types of perforating branch carried by flap and the types of arteries and veins in recipient areas were recorded. The survival and occurrence of vascular crisis of flap, the survival of skin graft, the wound healing in donor and recipient areas, and the length of hospital stay after flap transplant surgery were recorded. During follow-up, the color and texture of flap, reinfection in lower leg, and fracture healing were recorded. At the last follow-up, the limb salvage function of patients was evaluated according to the functional evaluation criteria of Chen Zhongwei's amputated limb replantation.Results:The types of perforating branches carried by flaps were as follows: 6 cases of only carrying the descending branch of the lateral circumflex femoral artery, 3 cases of only carrying the oblique branch of the lateral circumflex femoral artery, and 3 cases of carrying the descending branch of the lateral circumflex femoral artery and oblique branch of the lateral circumflex femoral artery after internal pressurization anastomosis. The types of arteries in the recipient area of flap were as follows: one case of main trunk of the descending genicular artery, 8 cases of the saphenous branch of the descending genicular artery, and 3 cases of the articular branch of the descending genicular artery. The types of veins in the recipient area of flap were as follows: 8 cases of one accompanying vein of the descending genicular artery and one branch of the great saphenous vein, and 4 cases of two branches of the great saphenous vein. All the flaps survived without vascular crisis, and all the skin grafts also survived. The wounds in the donor and recipient areas were all healed. The length of hospital stay of patient after flap transplant surgery ranged from 13 to 79 days. During the follow-up of 6 to 23 months, the color and texture of flap were both good, with no infection in lower leg wound. Internal or external fixation were removed after fracture healing in 5 patients, and bone graft internal fixation was performed in 7 patients whose fractures were not healed after surgery and all the incisions healed without infection. At the last follow-up, the limb salvage effect of patients was evaluated as followings: excellent in 7 patients, good in 4 patients, and fair in one patient.Conclusions:Free anterolateral thigh flap pedicled with descending genicular artery can effectively repair the wounds after lower leg limb-sparing surgery and control infection with short length of hospital stay, while not increasing the risk of secondary injury of distal limb vessels. Thus, it can obtain satisfactory limb salvage effect which is worthy of clinical promotion.