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 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 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 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.

Objective To systematically review the effect of high blood flow restriction training(BFRT)on patients after anterior cruciate ligament reconstruction(ACLR). Methods Relevant literature was searched in PubMed,Web of Science,Embase,Cochrane Library,CNKI,CBM,Wan-fang data,and VIP databases using subject term search methods from the inception to May 1st,2024.The meth-odological quality of the included literatures was assessed using Physiotherapy Evidence Database(PEDro)scale,and relevant data were extracted for systematic review. Results A total of seven articles were finally included,involving 183 subjects from six countries.The intervention sites were mainly hospital rehabilitation departments and rehabilitation centers.The publication dates ranged from 2016 to 2023.In BFRT group,lower limbs were compressed during conventional rehabilitation training,with in-termittent of 0.5 to 2 minutes or without deflation.BFRT would increase muscle strength,muscle hypertrophy,and improved knee joint function.Total duration of intervention and training intensity affected the improvement. Conclusion High BFRT can improve the condition of the muscles around the knee joint and promote functional recovery after ACLR.To ensure the safety and effectiveness of the training,low-intensity strength training should be em-ployed,with 15 to 30 repetitions per set,four to five sets per session,two to three sessions per week,and a total training duration of at least three weeks.

Objective To review the effect of orthopedic insoles on arch morphology,pain and lower limb motor function in chil-dren and adolescents with flexible flatfoot. Methods Relevant literature was retrieved from PubMed,Web of Science,Embase,CNKI,CBM,Wanfang data and VIP databases,from inception to October,2024,and a scoping review was conducted. Results Ten researches were included,comprising seven cohort studies and three randomized controlled trials,originat-ing from China,Korea,Iran and Romania,involving 520 children and adolescents with flexible flatfoot.Orthope-dic insoles could increase the calcaneal pitch angle,reduce the Meary's angle and arch index;improve motor function of feet and lower limbs,stability of anterior and posterior,medial,and overall,adjust the kinematics and ground reaction force in walking;relieve pain and reduce incidence of pain. Conclusion Wearing orthopedic insoles could improve the arch morphology,dynamic balance and gait function,and re-lieve pain in children and adolescents with flexible flatfeet.

Objective To cultivate competent rehabilitation assistive technology workers and systematically develop the undergradu-ate curriculum courses of assistive technology using World Health Organization Rehabilitation Competency Framework(RCF)and International Classification of Functioning,Disability and Health(ICF). Methods The 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. Results Referring 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. Conclusion The 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.

Objective To summarize the characteristics of chemotherapy-induced peripheral neuropathy(CIPN)in children with acute B-lymphoblast leukemia(B-ALL)and to identify the influencing factors and prognosis of CIPN.Methods The clinical data of 60 children with B-ALL admitted to the 29th Ward of the Department of Hematology and Oncology,Children's Hospital Affiliated to Soochow University from June 2020 to December 2023 who received chemotherapy and had finished chemotherapy for 6 months were retrospectively reviewed.Results There were 37 cases of B-ALL combined with CIPN;the incidence of CIPN was 61.7% .Increasing age of onset was a risk factor for CIPN in children[OR=1.209,95% CI(1.023-1.428),P=0.026]with the highest incidence of sensory nerve dysfunction(78.4% ).Electromyography indicated that B-ALL combined with CIPN was multiple peripheral neurogenic lesions with certain reversibility.In the induction stage of chemotherapy,13 cases(35.1% )showed CIPN,accounting for the highest proportion.The CIPN improvement rate 6 months after chemotherapy was 67.6%,the age of onset[OR=2.418,95% CI(0.212-2.106),P=0.018]and the severity of CIPN[OR=203.394,95% CI(2.29-18 065.04). P=0.02]were risk factors for poor prognosis of children with CIPN.The older the age of onset was,the higher the severity of CIPN and worse prognosis were found.Conclusions Children with B-ALL complicated with CIPN are reversible multiple peripheral nerve lesions,and the occurrence and outcome of CIPN is potentially related to individual differences of children.

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.

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.