Objective To investigate the outcome of the finger reconstruction using one toe transfer to repair the tissue defects of two fingers at the same time. Methods Two fingers joint tissue missing and finger defect of 8 fingers in 4 cases were reconstructed with dissociative transplants harvested from two parts of the same toe at the same time.Using the paratelum of the second toes reconstructed the indicis paratelum or finger tip,and using the proximal interphalangeal joint of the second toes repaired the proximal interphalangeal joint's tissue defects of the middle finger at the same time in 2 cases.Using the distal interphalangeal joint and the proximal interphalangeal joint of one second toe reconstructed the proximal interpha langeal joints of the index finger and the middle finger in 1 case.Using the proximal interphalangeal joint and the metatarsophalangeal joint of one second toe reconstructed the metacarpophalangeal joints of the index finger and the middle finger in 1 case. Results All the transplants survived.The patients were followed-up from 2 months to 46 months postoperatively.The function and shape of 2 resconstruction fingers were excellent as assessed with Criterion on Functional Evaluation on Finger Reconstruction issued by Chinese Society of Hand Surgery.Five resconstruction fingers were good.One resconstruction finger was fire. Conclusion For some appropriate cases with the tissue defects of 2 fingers such as the finger's paratelum,the interphalangeal joint or the metacarpophalangeal joint,this operated technique was a good method.

Objective To summarize and investigate the therapeutic effects of reconstruction of contracture of the first web space with snuff-box flap. Methods Eighteen patients with contracture of the first web space were treated by snuff-box flap. The width and the angle of the first web space was 19 mm and 20°on average. According to the first web space skin defects, the flap designed to nasopharyngeal fossa centers as rotation point, the radial line when the forearm in the neutral position as the axis. Results The followedup for 5-26 months revealed that 17 flaps had a success, but 1 case was partly necrosis. The width of the first web space was augmented by an aveage of 45 mm, the angle of the first web space was augmented by an average of 50°. Conclusion It is ralatively simple and reliable to repair the contracture of the first web space using the snuff-box flap.

Objective To explore small size toe tissue flap for aesthetic reconstruction of the thumb and / or finger. Methods Six kinds of small size toe tissue transplants had been applied in repairing skin-bone-joint composite tissue defects of the thumb or finger in 74 cases. Results Among 83reconstructed flaps of the 74 patients, 81 flaps survived completely. Follow-up examination made three to forty-eight months postoperatively showed that the outward appearance were excellent in most cases. The function of the thumbs or fingers were good. The donor feet can walk normally with no pain. Conclusion A variable combinations of toe tissues including skin, soft tissue, bone and joint can be harvested to form a lot of small size transplants for refined aesthetic reconstruction of thumb and finger. The functional and aesthetic results are good and the treatment course is shortened.

Objective To investigate the prevalence of chronic kidney disease (CKD) and associated factors in Changsha county of Hunan province. Methods Using a stratified, multistage sampling, 1950 residents (older than 20 years old) from 3 towns of Changsha county were randomly selected to be interviewed and tested for the kidney damage indicators and the associated factors with CKD. Results Eligible data of 1727 subjects were enrolled in the study. After the adjustment of age and gender compenent, the prevalence of albuminuria was 8.5%, hematuria 5.1%, and reduced eGFR 1.5%. Approximately 14.6% subjects had at least one indicator of kidney damage, and the awareness rate was 16.5%. Age, hypercholesteremia, hypertriglyceridemia, hypertension and diabetes were independently correlated with albuminuria. Female, age, hypertriglyceridemia and hyperuricemia were independently correlated with reduced renal function. Female was independently correlated with hematuria. Conclusions The prevalence of chronic kidney disease is 14.6% and the awareness rate is 16.5% in suburban adult population of the central south area of China. The spectrum and correlated factors of CKD in this county undergoing fast economic development are close to those of Guangzhou and developed countries.

ObjectiveTo systematically develop the courses of rehabilitation based on World Health Organization rehabilitation competency framework (RCF). MethodsThe theories and methods of RCF were used to analyze competency characteristics of rehabilitation workers and educational objectives to construct the curriculum contents in rehabilitation. ResultsThe competency of the rehabilitation workers included practice, professionalism, learning and development, management and leadership, research, values and beliefs in the specific rehabilitation situations. The objectives of rehabilitation medicine education needed to correspond to the competencies of the rehabilitation workers and set up knowledge units that could develop competency in terms of behaviour, activity tasks and proficiency. The curriculum systems of rehabilitation with RCF included the fields of rehabilitation physiotherapy, rehabilitation occupational therapy, hearing and speech rehabilitation, and prosthetic and orthopaedic engineering, etc. ConclusionThe teaching objectives corresponding to the competency characteristics of rehabilitation workers need to be translated into competency-based education. The curriculum contents in rehabilitation needs to be systematically constructed based on RCF from the areas of rehabilitation physiotherapy, rehabilitation occupational therapy, hearing and speech rehabilitation, and prosthetic and orthopaedic engineering.

ObjectiveTo cultivate competent rehabilitation assistive technology workers and systematically develop the undergraduate curriculum courses of assistive technology using World Health Organization Rehabilitation Competency Framework (RCF) and International Classification of Functioning, Disability and Health (ICF). MethodsThe competence of assistive technology workers was discussed based on the ICF, RCF and the service needs of modern assistive devices and technology, and the undergraduate curriculum courses of rehabilitation assistive technology were developed referring to the national vocational competence standards. ResultsReferring to the national vocational competence standards, the entry-level competence of assistive technology workers was developed based on ICF and RCF. The objectives of undergraduate education were set. Moreover, the undergraduate curriculum courses and core course of assistive technology were developed. ConclusionThe undergraduate curriculum courses of assistive technology are developed using ICF and RCF. This will help improve the quantity and competency of rehabilitation assistive technology workers and increase the access for people with disabilities to obtain assistive technology.

Indolylarylsulfones (IASs) are classical HIV-1 non-nucleoside reverse transcriptase inhibitors (NNRTIs) with a unique scaffold and possess potent antiviral activity. To address the high cytotoxicity and improve safety profiles of IASs, we introduced various sulfonamide groups linked by alkyl diamine chain to explore the entrance channel of non-nucleoside inhibitors binding pocket. 48 compounds were designed and synthesized to evaluate their anti-HIV-1 activities and reverse transcriptase inhibition activities. Especially, compound R₁₀L₄ was endowed with significant inhibitory activity towards wild-type HIV-1 (EC_50(WT) = 0.007 μmol/L, SI = 30,930) as well as a panel of single-mutant strains exemplified by L100I (EC₅₀ = 0.017 μmol/L, SI = 13,055), E138K (EC₅₀ = 0.017 μmol/L, SI = 13,123) and Y181C (EC₅₀ = 0.045 μmol/L, SI = 4753) which were superior to Nevirapine and Etravirine. Notably, R₁₀L₄ was characterized with significantly reduced cytotoxicity (CC₅₀ = 216.51 μmol/L) and showed no remarkable in vivo toxic effects (acute and subacute toxicity). Moreover, the computer-based docking study was also employed to characterize the binding mode between R₁₀L₄ and HIV-1 RT. Additionally, R₁₀L₄ presented an acceptable pharmacokinetic profile. Collectively, these results deliver precious insights for next optimization and indicate that the sulfonamide IAS derivatives are promising NNRTIs for further development.

A novel coronavirus pneumonia (NCP) epidemic has occurred in Wuhan, Hubei Province since December 2019, caused by a novel coronavirus (2019-nCoV) never been seen previously in human. China has imposed the strictest quarantine and closed management measures in history to control the spreading of the disease. However, severe trauma can still occur in the NCP patients. In order to standardize the emergency treatment and the infection prevention and control of severe trauma patients with hidden infection, suspected or confirmed infection of 2019-nCoV, Trauma Surgery Branch of Chinese Medical Doctors' Association organized this expert consensus. The consensus illustrated the classification of the NCP patients, severe trauma patients in need of emergency surgery, emergency surgery type, hierarchical protection for medical personnel and treatment places. Meanwhile, the consensus standardized the screening, injury severity evaluation, emergency surgical treatment strategy and postoperative management strategy of severe trauma patients during the epidemic period of NCP, providing a basis for the clinical treatment of such kind of patients.