ced glutathione in MHD patients appears to be associated with an improvement of oxidative stress.

Objective To discuss clinical application of descending genicular artery perforator flap.Methods According to the anatomic features of direction,branches and anastomosis of the descending genicular artery,the descending genicular genicular artery perforator flap at medial superior aspect of knee joint was designed to reconstruct the soft tissue defects at the anterior medial 1/3 of the calf and the anterior medial part and popliteal fossa of the knee,with the axis based on the anterior border of the Sartorius and with the pivot point on the site where the cutaneous branches from the superior medial genicular artery pierced out within the triangle concave surface bounded by the vastus medialis,the tendon of adductor magnus and the condylus medialis.Results All flaps survived well in five patients,with primary healing.After a follow-up of 1-12 months,all flaps turned out to be with good texture,near-normal color and good appearance.Conclusion With a constant anatomic location,excellent blood supply and easy surgical procedure,the descending genicular artery perforator flap is one of feasible ways for repair of soft tissue defects around the knee.

Objective To explore the clinical application of perforating branch flap of medial vastus muscle. Methods Perforating branch flap (muscle branch) of medial vastus muscle was designed by using the surface projection of the medial vastus muscle artery as flap anxial line and the given point of direct cutaneous artery as flap center to repair skin and soft tissue defects of the knee in seven patients.Results All flaps survived well with primary healing in all patients, with one stage healing. After a follow-up for 1-18 months, all flaps turned out to be with good texture and satisfactory appearance and function of the flaps. Conclusion The surgery of perforating branch flap of medial vastus muscle is simple,safe and easy handling and provides a new feasible surgical procedure to repair skin and soft tissue defects of medial femur and around the knee.

Objective To report three cases of fulminant ulcerative colitis (FUC) treated with infliximab (IFX) and the positive result for clinical purpose. Methods Three patients with FUC were infused with IFX (5 mg/kg) at interval of 0, 2, 6 wk. Sulfasalazine or probiotics was used for the maintanance of remission. The mucosal healing was evaluated by endoscopy and patholoic examination. ResultsComplete remission was found in 3 patients with FUC. Eight weeks after IFX withdraw, complete remission was found in two of three cases demonstrated by endoscopy, except for one case died from refractory ventricular tachycardia. The remaing 2 cases showed no active manifestation during 8 months' follow-up. Conclusion IFX therapy results in complete remission in 3 cases with FUC. However, further randomized control study is warranted for concrete evaluation on salty and application clinically.

Objective? To explore the intervention effects of the group self-affirmation training on the stigma in the rectal cancer patients with colostomy. Methods? By convenience sampling, 89 rectal cancer patients with colostomy in Yancheng Third People's Hospital from April 2017 to April 2018 were selected and divided into the experimental group (n=45) and control group based on the random number table(n=44).The experimental group received group self-affirmation training on the basis of the conventional nursing care while the control group received the conventional nursing care. The self-designed General Information Questionnaire, Social Impact Scale(SIS), Self-Esteem Scale(SES) were used to evaluate the stigma and level of self-esteem before and after intervention. Results? Before intervention, the two groups had no statistical difference in the scores of stigma (t=-0.323, P=0.747) and level of self-esteem(t=-0.270,P=0.788); after intervention the experimental group had lower scores than the control group in stigma (t=-3.008, P＜0.01) and higher scores than the control group in self-esteem(t=4.033, P＜0.01) with statistical significance. Conclusions? Group self-affirmation training can reduce the stigma of rectal cancer patients with colostomy and improve their self-esteem.

Objective To explore the clinical efficacy of multi-channel functional electrical stimulation cycling ergometer for children with spastic cerebral palsy. Methods A total of 60 children with rehabilitation treatment for spastic cerebral palsy in Outpatient Department were selected and randomly divided into observation group and control group, with 30 cases in each group. The control group received conventional rehabilitation treatments such as exercise therapy, occupational therapy and Chinese medicine massage, while the observation group received multi-channel functional electrical stimulation cycling ergometer training on the basis of the conventional rehabilitation treatments. Before treatment and 12 weeks after treatment, the Gross Motor Function Measure (GMFM-88), Peabody Developmental Measure Scale-Gross Motor (PDMS-GM), Berg Balance Scale (BBS), and Activities of Daily Living (ADL) were used to assess the gross motor function, balance function, and activities of daily living of the children in both groups. Results Before treatment, there were no significant differences in GMFM-88 (D area, E area score, and total score), PDMS-GM (posture score, mobility score, and manipulation score), BBS, and ADL scores between the two groups (P>0.05). After treatment, the GMFM-88 (D area, E area score and total score), PDMS-GM (posture score, mobility score and manipulation score), BBS and ADL scores in both groups improved significantly compared with those before treatment, and all the scores in the observation group were significantly better than those in the control group (P < 0.05). Conclusion Multi-channel functional electrical stimulation cycling ergometer can effectively improve the gross motor function, balance function, and activities of daily living of children with spastic cerebral palsy.

Objective:To investigate clinical curative effect of multiple composite tissues replantation with microsurgical technique in single hand.Methods:From May 2008 to December 2021, the clinical data of patients who underwent multiple composite tissue replantation in single hand in Chongming Hospital Affiliated to Shanghai University of Medicine & Health Sciences and Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, were retrospectively analyzed. According to the severed site, anatomical level, the injury cause, the severity of injury, the size of severed tissue, and replantation conditions (such as blood vessels for anastomosis), the severed tissue was evaluated and carried out modified classification (type Ⅰ-Ⅳ) before the operation, and the surgical plan was designed. The severed composite tissue was debrided in emergency, the severed bone and muscle tissue were fixed, and the arteries, veins and nerves were anastomosed by microsurgical technique under a high-power microscope. The ratio of arteries to veins was 1∶1-1∶2. If enough arteries and veins could not be found, arteriovenous shunt could be used to form arterial venous flap or venous arterialized flap, or form artery flap by just artery anastomosis, or form venous flap by just vein anastomosis. Then skin tissue was sutured after recanalization. After the operation, the patients received specialized treatment and guided rehabilitation exercise. The wound healing of hand, skin color, skin quality, swelling degree, sensation, pain degree of joint, and activity function were followed up after the operation. At the last follow-up, the patient’s self-evaluation of the treatment effect was divided into three levels: satisfactory, average, and unsatisfactory. One chief physician and one doctor-in-charge were responsible for the comprehensive evaluation of curative effect, according to the assessment standard for upper limb function issued by Chinese Medical Association of Hand Surgery. 80-100 points were excellent, 60-79 points were good, 40-59 points were fair, and <40 points were poor.Results:A total of 94 severed composite tissues in 35 patients, including of 20 male patients and 15 female patients were enrolled. The average age was 36.4 years (range, 16-65 years). Fifty severed tissues in 18 cases were classified into type Ⅰ, 40 severed tissues in 15 cases type Ⅱ, 4 severed tissues in 2 cases type Ⅲ. Among the 35 cases, 1 case of thumb pulp severed tissue was necrotic at the edge (0.3 cm×0.5 cm) due to local contusion, 1 case of index finger lateral severed tissue was necrotic at the edge (0.3 cm×0.8 cm) due to local avulsion injury, and healed after dressing change, and the other replanted composite tissue survived. The patients were followed up for 3 to 65 months (average, 18.5 months). The wounds were completely healed, and the color, elasticity, and quality of the replanted tissue was close to the surrounding normal skin. There was no obvious swelling or atrophy deformity of the hands. According to the patients’ self-assessment, 31 cases were satisfied and 4 cases were average. Comprehensive evaluation of hand function and appearance: excellent in 23 cases, good in 9 cases, fair in 3 cases, excellent and good rate was about 91.4% (32/35).Conclusion:Though multiple composite tissues replantation with microsurgical technique in single hand is difficult, and vascular anastomosis technical requirement is high, once surgery succeeds, the function and appearance can get good recovery, and patient satisfaction is also relatively high.

Objective:To investigate clinical curative effect of multiple composite tissues replantation with microsurgical technique in single hand.Methods:From May 2008 to December 2021, the clinical data of patients who underwent multiple composite tissue replantation in single hand in Chongming Hospital Affiliated to Shanghai University of Medicine & Health Sciences and Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, were retrospectively analyzed. According to the severed site, anatomical level, the injury cause, the severity of injury, the size of severed tissue, and replantation conditions (such as blood vessels for anastomosis), the severed tissue was evaluated and carried out modified classification (type Ⅰ-Ⅳ) before the operation, and the surgical plan was designed. The severed composite tissue was debrided in emergency, the severed bone and muscle tissue were fixed, and the arteries, veins and nerves were anastomosed by microsurgical technique under a high-power microscope. The ratio of arteries to veins was 1∶1-1∶2. If enough arteries and veins could not be found, arteriovenous shunt could be used to form arterial venous flap or venous arterialized flap, or form artery flap by just artery anastomosis, or form venous flap by just vein anastomosis. Then skin tissue was sutured after recanalization. After the operation, the patients received specialized treatment and guided rehabilitation exercise. The wound healing of hand, skin color, skin quality, swelling degree, sensation, pain degree of joint, and activity function were followed up after the operation. At the last follow-up, the patient’s self-evaluation of the treatment effect was divided into three levels: satisfactory, average, and unsatisfactory. One chief physician and one doctor-in-charge were responsible for the comprehensive evaluation of curative effect, according to the assessment standard for upper limb function issued by Chinese Medical Association of Hand Surgery. 80-100 points were excellent, 60-79 points were good, 40-59 points were fair, and <40 points were poor.Results:A total of 94 severed composite tissues in 35 patients, including of 20 male patients and 15 female patients were enrolled. The average age was 36.4 years (range, 16-65 years). Fifty severed tissues in 18 cases were classified into type Ⅰ, 40 severed tissues in 15 cases type Ⅱ, 4 severed tissues in 2 cases type Ⅲ. Among the 35 cases, 1 case of thumb pulp severed tissue was necrotic at the edge (0.3 cm×0.5 cm) due to local contusion, 1 case of index finger lateral severed tissue was necrotic at the edge (0.3 cm×0.8 cm) due to local avulsion injury, and healed after dressing change, and the other replanted composite tissue survived. The patients were followed up for 3 to 65 months (average, 18.5 months). The wounds were completely healed, and the color, elasticity, and quality of the replanted tissue was close to the surrounding normal skin. There was no obvious swelling or atrophy deformity of the hands. According to the patients’ self-assessment, 31 cases were satisfied and 4 cases were average. Comprehensive evaluation of hand function and appearance: excellent in 23 cases, good in 9 cases, fair in 3 cases, excellent and good rate was about 91.4% (32/35).Conclusion:Though multiple composite tissues replantation with microsurgical technique in single hand is difficult, and vascular anastomosis technical requirement is high, once surgery succeeds, the function and appearance can get good recovery, and patient satisfaction is also relatively high.

To explore the antiviral activity of nano-realgar against herpes simplex virus Type II (HSV-2) in vitro.
 Methods: Acyclovir (ACV) as a positive control, the cytotoxicity of nano-realgar at different concentrations (including 200.00, 150.00, 100.00, 50.00, 25.00, 12.50, 6.25, 3.13, 1.54, 0.78, 0.39 and 0 mg/L) on normal Vero cells were determined by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. HSV-2 virus titer was determined by plaque assay, and the Vero cells model of HSV-2 infection was established. Subsequently, the antiviral effects of nano-realgar at different concentrations (including 20.00, 10.00, 5.00, 2.50, 1.25, 0.63, 0.31, 0.15, 0.08, 0.04 and 0 mg/L) on infected cells model were evaluated by the observation of cytopathic effect (CPE) and MTT method under the 3 modes including pre-treatment, treatment and direct inactivation.
 Results: The 50% cytotoxic concentration (CC50) of nano-realgar on Vero cells was 37.15 mg/L. The titer of HSV-2 was 7.30 log PFUs/mL. In the 3 modes, the half-maximal effective concentration (EC50) of nano-realgar on HSV-2 infected Vero cells were 0.13, 1.80 and 0.52 mg/L, and the corresponding therapeutic index (TI) were 285.77, 20.64, 71.44, respectively. The TI value of nano-realgar on pre-treatment mode was higher than that of nano-realgar on treatment and direct inactivation modes.
 Conclusion: Nano-realgar can play a good anti-HSV-2 activity in the 3 modes (pre-treatment, treatment and direct inactivation), and the anti-HSV-2 efficacy of nano-realgar on pre-treatment mode is better than that of nano-realagr on other 2 modes.
Animals ; Antiviral Agents ; Arsenicals ; Chlorocebus aethiops ; Herpesvirus 1, Human ; Herpesvirus 2, Human ; Sulfides ; Vero Cells

Objective:To investigate the distribution of intraocular pressure (IOP) in high-altitude population aged 18 years and over in Xining, Qinghai and establish the reference interval (RI) of IOP.Methods:A cross-sectional study was conducted in Xining, Qinghai Province at 2.271 km above sea level from September 2019 to May 2020.Ophthalmic examinations and IOP measurement were conducted among subjects from Physical Examination Center of Qinghai Provincial People's Hospital.The subjects who had been living in Xining without leaving for three months were enrolled.Ophthalmic examinations included vision examination, IOP measurement, slit-lamp microscopy, fundus photography, anterior and posterior segment optical coherence tomography.IOP was measured using Goldmann applanation tonometry under local anesthesia.Subjects with factors that could cause significant changes in IOP and affect the accuracy of IOP measurement, and those who were unable to receive IOP measurement were excluded.Subjects were grouped according to sex, age and ethnicity, and the distribution and RI of IOP were compared among all groups.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2017-024). Written informed consent was obtained from each subject.Results:A total of 6 120 subjects (6 120 eyes) aged 18-90 years old were enrolled, including 2 850 males and 3 270 females with average age of (45.54±13.85) years.The average IOP of high-altitude population in Xining, Qinghai Province was (14.32±1.93) mmHg (1 mmHg=0.133 kPa), with the RI of 10.54-18.10 mmHg.The average IOP was (14.42±1.98) mmHg in male with the RI of 10.54-18.30 mmHg, (14.23±1.88) mmHg in female with the RI of 10.55-17.91 mmHg.The IOP of male was higher than that of female ( t=3.71, P<0.001). The IOP of Han, Tibetan, Hui and other nationalities were (14.38±1.91), (13.93±2.06), (14.21±1.87), (13.94±1.95) mmHg, respectively, with a statistically significant overall difference ( F=6.73, P<0.001). The IOP of Han nationality was significantly higher than that of Tibetan, Hui and other nationalities, and the differences were statistically significant (all at P<0.05). Conclusions:RI of IOP in high-altitude population from Xining, Qinghai is lower compared with normal altitude area.