Objective:To investigate clinical efficacy of mucopolysaccharide polysulfate cream combined with sertaconazole nitrate cream in the treatment of scaly hyperkeratotic tinea pedis.Methods:From March 2019 to January 2020, 100 patients with scaly hyperkeratotic tinea pedis were enrolled into this study, and randomly and equally divided into 2 groups by using a random number table: control group treated with topical sertaconazole nitrate cream alone at a dose of 0.5-1 g twice a day; combined group treated with topical mucopolysaccharide polysulfate cream at a dose of 0.5-1 g followed by topical sertaconazole nitrate cream at a dose of 0.5-1 g 30 minutes later, which were performed twice a day. The treatment lasted 4 weeks. The time to clinical symptom relief, efficacy and incidence of adverse reactions were compared between the two groups. Dermatology life quality index (DLQI) was assessed at 0, 2 and 4 weeks after the start of treatment. Two-independent-sample t test, repeated measures analysis of variance and chi-square test were used for statistical analysis. Results:After treatment, the time to pruritus relief and that to desquamation improvement were 6.05 ± 1.98 and 12.03 ± 3.92 days respectively in the combined group, which were significantly shorter than those in the control group (8.39 ± 2.11, 15.11 ± 4.05 days, t = 5.72, 3.86, respectively, both P < 0.001) . During the 4 weeks of treatment, DLQI scores gradually decreased in both the 2 groups (all P < 0.001) , which were significantly lower in the combined group than in the control group at weeks 2 and 4 (both P < 0.001) . After 4-week treatment, the total response rate was 98% (49/50) in the combined group, significantly higher than that in the control group (82%, 41/50; χ2= 7.11, P= 0.007) . There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05) . Conclusion:Mucopolysaccharide polysulfate cream can improve the efficacy of sertaconazole nitrate cream in the treatment of scaly hyperkeratotic tinea pedis.

Objective:To evaluate the role of silent information regulator 1 (SIRT1)/nuclear factor E2 related factor 2 (Nrf2) signaling pathway in sleep deprivation-induced cognitive dysfunction in rats.Methods:Thirty-six adult male Sprague-Dawley rats, aged 54-56 weeks, weighing 600-750 g, were divided into 3 groups ( n=12 each) using a random number table method: control group (group C), sleep deprivation group (group SD) and sleep deprivation+ SIRT1 agonist Srt1720 group (group SD+ Srt). Sleep deprivation model was established by modified multi-platform water environment method.Srt1720 10 mg/kg was injected intraperitoneally every 12 h starting from 24 h before establishing the model in group SD+ Srt, while the equal volume of 0.9% normal saline was injected intraperitoneally in C and SD groups.After the end of sleep deprivation, Morris water maze test was performed to evaluate the cognitive function.Animals were then sacrificed, and their hippocampi were removed for determination of neuronal degeneration rate in hippocampal CA1 region (using HE staining), the apoptosis rate in hippocampal CA1 (using TUNEL assay ), the expression of SIRT1 and Nrf2 in hippocampal CA1 (by immunohistochemistry) and the contents of reactive oxygen species (ROS) and superoxide dismutase (SOD) (by microplate method). Results:Compared with group C, the escape latency was significantly prolonged, the time of staying at the platform quadrant was shortened, and the frequency of crossing the platform was decreased on 2-4 days, the apoptotic rate and neuronal degeneration rate were increased, the expression of SIRT1 and Nrf2 was down-regulated, ROC content was increased, and SOD content was decreased in SD and SD+ Srt groups ( P<0.05). Compared with group SD, the escape latency was significantly shortened, the time of staying at the platform quadrant was prolonged, and the frequency of crossing the platform was increased on 3 and 4 days, the apoptotic rate and neuronal degeneration rate were decreased, the expression of SIRT1 and Nrf2 was up-regulated, ROC content was decreased, and SOD content was increased in group SD+ Srt ( P<0.05). Conclusions:Sleep deprivation can induce oxidative stress response in hippocampus by inhibiting the activation of SIRT1/Nrf2 signaling pathway, leading to cognitive dysfunction in rats.

Objective:To investigate the clinical manifestation and the plastic surgery principles of perineal scar contracture deformity.Methods:Patients with perineal deformities admitted to Plastic Surgery Hospital, Chinese Academy of Medical Sciences, were enrolled from January 1, 2010 to December 31, 2018. For the purpose of scar release, wound coverage, and organ defect reconstruction, we applied multiple plastic surgery methods such as tissue expansion techniques, penile lengthening, penile reconstruction, and anoplasty.Patients were followed-up for at least 6 months after operations. Urinary function, defecation function, range of joint motion, the appearance of perineum and the scar of the operation site were evaluated.Results:16 cases, aged 13 to 44 years old, were enrolled in our study and were successfully followed up for 1 to 10 years. There were no postoperative complications in 12 patients, and poor survival of partial flaps was shown in 4 patients, and the wound healed after dress-changing. Satisfactory results were obtained as self-maintenance, self-controllable urination, and defecation were restored.Conclusions:Following principles of subarea reconstruction in plastic surgery and using multiple plastic surgery methods, satisfactory results can be obtained in the repair of perineal scar contracture, which highly improves the life qualities of patients.

Objective:To investigate the clinical manifestation and the plastic surgery principles of perineal scar contracture deformity.Methods:Patients with perineal deformities admitted to Plastic Surgery Hospital, Chinese Academy of Medical Sciences, were enrolled from January 1, 2010 to December 31, 2018. For the purpose of scar release, wound coverage, and organ defect reconstruction, we applied multiple plastic surgery methods such as tissue expansion techniques, penile lengthening, penile reconstruction, and anoplasty.Patients were followed-up for at least 6 months after operations. Urinary function, defecation function, range of joint motion, the appearance of perineum and the scar of the operation site were evaluated.Results:16 cases, aged 13 to 44 years old, were enrolled in our study and were successfully followed up for 1 to 10 years. There were no postoperative complications in 12 patients, and poor survival of partial flaps was shown in 4 patients, and the wound healed after dress-changing. Satisfactory results were obtained as self-maintenance, self-controllable urination, and defecation were restored.Conclusions:Following principles of subarea reconstruction in plastic surgery and using multiple plastic surgery methods, satisfactory results can be obtained in the repair of perineal scar contracture, which highly improves the life qualities of patients.

Objective: To investigate the effect of skin soft tissue expansion on repair of large area of scars on extremities. Methods: Twenty-five patients with large area of scars on extremities were admitted to our department from June 2007 to October 2014. There were 14 males and 11 females, aged 4 to 36 years. Operations were performed under local infiltration anesthesia or general anesthesia. In the first stage, 1 to 5 cylindrical expanders with capacities of 250 to 600 mL were placed at left or right sides or at upper or lower parts of the scars. In the second stage, scars of 21 patients were repaired with expanded transverse propulsive and lateral flaps, and scars of 4 patients were repaired with expanded perforator flaps whose pedicles were perforators of brachial artery, superior ulnar collateral artery, or posterior interosseous artery according to areas and shapes of the scars. The secondary wound areas ranged from 13 cm×7 cm to 34 cm×18 cm after dissolution or excision of scars. The areas of flaps ranged from 13 cm×7 cm to 20 cm×12 cm. The donor sites were sutured directly. The flaps after operation and follow-up of patients were observed and recorded. Results: All expanded flaps survived after operation. And the superficial distal part of flap whose pedicle was perforator of posterior interosseous artery in one patient was with necrosis, and other flaps survived well. During follow-up of 3 to 15 months after operation of the second stage, color and texture of flaps were similar to surrounding skin, while extremities of donor sites were thinner and auxiliary incisional scars formed after expansion. Conclusions Expanded flap is a good way to repair large area of scar on extremities. Bilateral skin of scar is the first choice of donor site of expanded flap. If there isn′t enough skin for expanding on bilateral sides, expanded perforator flap designed at upper or lower part of the scar is another choice to repair the scar.

Objecive: To assess the clinical outcomes of patients who received modified penile augmentation by free dermal-fat grafting. Methods: From April 2012 to December 2014, a total of 15 male adults (18-24 years of age) after hypospadias repairs were included. They underwent modified penile augmentation, including girth enhancement using free dermal-fat grafting, and penile elongation (suprapubic skin advancement-ligamentolysis). Penile measurements were performed using ruler before operation and 6 months after operation. The outcome was evaluated by patients, based on the Male Genital Image Scale. SPSS 22.0 was used to analyze the data. In-paired t-test and Wilcoxon test were applied. Results: In 6-84 months of follow-up, all patients achieved excellent cosmetic results, and satisfied with the appearance and diameter. In weak state, the penile length increased from (5.03±0.47) cm to (6.69±0.49) cm. The increased value was (1.67±0.24) cm (t=8.6, P<0.001). Under traction, the penile length increased from (7.29±0.74) cm to (9.21±0.73) cm. The increased value was (1.93±0.21) cm (t=7.8, P<0.001). In weak state, the diameter of the middle part of penis increased from (7.16±0.25) cm to (8.69±0.44) cm, with the increased value of (1.53±0.23) cm (t=8.2, P<0.001). The MGIS score grew from 31.73±4.86 to 40.20±4.54(Z=3.2, P=0.001). Conclusions This modified technique is safe and effective in enlarging penile size for patients who had underwent hypospadias repair. It is confirmed that physical dimensional enhancement does contribute to improving their self-estimation of penile size.

Objective: To explore the blood supply of expanded lateral neck flap combined with posterior auricular flap pedicled on anterior neck and the feasibility of this kind of flap for facial vulnus′resurfacing. Methods: At the first stage of the treatment, one rectangular expander was implanted in lateral neck in the subcutaneous pockets, overlying the platysma, the volume of the expander is about 200-600 ml. After 2-3 months inflation, the pre-expanded lateral neck flap combined with posterior auricular flap was advanced at the second stage of the operation, the flap was rotated to lateral face to resurface the vulnus defects located on anterior auricle. Results: Twelve cases of facial wounds were included in this research from January 2009 to November 2016. The size of the expanded flaps were ranged from 6 cm×12 cm to 7 cm×15 cm. According to 2 to 24 months follow-up postoperatively, 10 months in average, two flaps showed venous retardation at distal part of expanded flaps, which were recorvered with one-week dress changing after excoriation. The other ten flaps survived with good appearance and function. The flaps matched well to the recipient defects in terms of color, character and elasticity. The appearance and function of face and neck were ideally adjusted after treatment. Conclusions By expanding lateral neck skin overlying platysma, the expanded lateral neck flap combined with posterior auricular flap pedicled on anterior neck was obtained with high quality and maximum use of blood supply in the anterior neck, which guaranteed appearance and function of the donor area and the recipient area at the same time.

Objective: To investigate the therapeuctic effect of one-stage reconstruction of distal urethra with free graft of tublar oral mucosa. Methods: Two strips of oral mucosa graft( 0.4—0.6 cm in width), were harvested and sutured around an oiled silk roll to form mucosa tube. The mucosa tube was used to reconstruct distal urethra. Postoperative pressure dressing and earlier urination were recommended. Results: From May 2007 to October 2015, 16 cases with distal urethra defect or stenosis were treated with this method. The urethra defect was 2—4 cm in length. Urethral fistula happened in 3 patients. All the other 13 cases healed primarily. 10 cases were followed up for 1—5 years by telephone with normal function. Conclusions One-stage reconstruction with free graft of bulbar oral mucosa is suitable and reliable for distal urethra defect less than 4 cm in length.

Objective:To investigate the inhibitory effects of different concentrations of chlorhexidine in the development of peri-odontitis models in rats.Methods:periodontitis models were established by the ligation of bilateral first molars and orally challenge with P.gingivalis W83.0.05%,0.1%,0.2% and 0.5% chlorhexidine were used to wash the periodontal pocket and oral mucosa of the rats.4 weeks later,absolute real time quantitative PCR was used to count the copy of P.gingivalis W83 in rat periodontal pockets.Scanning electron microscopy was used to observe the distribution of P.gingivalis W83 on rat teeth surface.Immunohisto-chemical technique was used to detect the expression of TNF-αin gingival tissue of the rats.Results:0.2% and 0.5% chlorhexi-dine reduced the copy of P.gingivalis W83 on teeth surface and in periodontal pockets (P <0.05);0.1% -0.5% chlorhexidine reduced the expression of TNF-αin gingival tissue (P <0.05).Conclusion:0.1% -0.2% chlorhexidine can inhibit the develop-ment of chronic periodontitis in rats.

OBJECTIVETo discuss the methods for urethral external meatus and glanuloplasty after correction of hypospadias.

METHODSThe V shape flap on the dorsal side of glan, combined with the bilateral glan flaps were moved to the ventral side. The flap at the ventral side of urethral external meatus was turned over. Then the urethral external meatus was repositioned to the top end of glan with the ventral defects covered by the dorsal flaps. Then the coniform glan was reconstructed.

RESULTSFrom January 2008 to December 2013, 28 cases were treated, including glandular hypospadias, postoperative retraction of external urethral meatus and meatal stenosis. 21 patients were followed up for 1 -12 months (average, 1 month) with marked improvement of glan appearance and retraction of external meatus. No meatal stenosis happened.

CONCLUSIONSPostoperative retraction of urethral external meatus and meatal stenosis can be corrected by V shape flap on the dorsal side of glan combined with the bilateral glan flaps. The flat appearance of glan can be improved. It is an ideal method for glandular hypospadias.

Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Postoperative Complications ; surgery ; Postoperative Period ; Surgical Flaps ; Urethra ; surgery ; Urethral Stricture ; etiology ; surgery