Objective To investigate the cosmetic outcome of treatments for mentalis scars with expanded skin flaps.Methods From the experiences of past 26 cases in our department,we summarised the technique for treating the mentalis scars with expanded skin flaps.For simple mentalis scars or localized inferior facial scars,the mentalis,bottom jaw or facial skin were expanded and the expander kept superior to the neck-jaw angle.Otherwise the expander would only fill the angle and the expanding efficiency was reduced.For severe mentalis,neck or facial scars without extra normal treating skin,expanded deltopectoral flaps were chosen to cover the wound after cicatrectomy with pedicles which were cut 3 weeks later.Results All the local ordistant expanded flaps survived successfully in the 26 cases with optimistic outcomes.Conclusions Application of local or distant expanded flaps is a useful technique for mentalis scars treatment.

Objective To develop new repairing techniques for acquired inferior palpebral region defects. Methods Expanded forehead flaps were used to reconstruct the inferior palpebral defects or post-excision wound surface and the flaps were pedicled with supra-trochlea vessels or ramus frontalis arteriae temporalis superficialis. As for supra-trochlea vessels, contralateral ones were prior to the homolateral ones. The incision site located in the scalp and the major axis of the expander parallel to the forehead. Firstly, the leisions were cut and the subcutaneous tissues loosed to regain the anatomy position of inferior palpebra. Secondly, the expanded flaps were transfered onto the defects by the wound sizes with the supra-trochlea vessels as their pedicles. At last, the pedicles were cut 3 weeks later.For ramus frontalis arteriae temporalis superficialis, the flap was transfered with a subdermal pedicle and the donor site was closed directly. Results There were 10 cases in the present group, 6 for supratrochlea vessels and the 4 others for ramus frontalis arteriae temporalis superficialis. All the flaps survived successfully. 3 cases returned with optimistic outcomes 6 months later. Conclusion The expanded forehead flaps are fit for repairing the inferior palpebral defects, which can successfully avoid ectropion. This technique is very useful for reconstructing the texture of the site of defects.

OBJECTIVETo assess subtelomeric chromosome anomalies in patients with idiopathic mental retardation (MR).

METHODSSubtelomeric screening was performed in 46 patients with undiagnosed mental retardation. The patients were selected based on the following criteria: (1) MR with two or more of the following conditions: dysmorphic features, prenatal growth retardation, postnatal growth abnormalities, a suggestive family history; (2) chromosome karyotype at the level >450 bands being normal; (3) exclusion of other identified genetic or environmental diagnosis. Fluorescence in situ hybridization (FISH) was performed using ToTelVysion DNA probes. Abnormal findings were confirmed by FISH with a specific subtelomeric probes and family studies were carried out to determine its inheritance.

RESULTClinically significant aberrations were detected in two cases with 6q and 2q terminal microdeletion. The deletion in one case was inherited from a similarly affected father. Subtle chromosomal subtelomeric abnormalities occurred with a frequency of 7.6% in children with moderate to severe mental retardation and of 3.0% in the children with mild retardation.

CONCLUSIONThe results suggest that cryptic abnormalities of the ends of chromosomes might represent a significant cause of mental retardation, and screening for subtelomeric rearrangements might be warranted in children with unexplained mental retardation.

Adolescent ; Child ; Child, Preschool ; Chromosome Aberrations ; Chromosome Deletion ; Humans ; In Situ Hybridization, Fluorescence ; Infant ; Intellectual Disability ; genetics ; Telomere

OBJECTIVETo investigate suitable treatment method for contracture of inframammary scars.

METHODSNine female patients with contracture of inframammary sear hospitalized in our hospital from July 2000 to July 2007 were subjected to skin expansion around the breast. The sites of incisions were mainly located on the inframammary scars. The expanders were placed around the breast and middle chest near the sternum. On the lateral side of chest, the expander should be inserted at the site parallel to upper level of the breast. The expanders should be placed under deep fascia and superficial to the gland. At II stage of operation, the scars were excised and the subcutaneous tissues should be thoroughly loosened to assure that the soft tissue and mammary gland would be restored to its anatomical position. Expanded skin was then designed as advancement or transposition flaps to repair the defects, or effects were closed with suturing.

RESULTSBlood circulation disturbance occurred at the tip of a flap in one patient, with the size of 4.0 cm x 3.0 cm, and the resulting wound healed after skin grafting. Flaps in the other 8 patients survived, and the wounds healed satisfactorily. Nipples and mammary areola were successfully restored to the anatomical positions. Three patients were followed up for 6 months to 2 years, and the result was satisfactory.

CONCLUSIONSExpanded flap is feasible for repairing contracture of inframammary scar and with good result.

Adolescent ; Breast ; Child ; Cicatrix ; surgery ; Female ; Humans ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Tissue Expansion ; methods ; Young Adult

OBJECTIVETo explore whether chromosomal microdeletions have a role in the pathogenesis of unexplained mental retardation (MR) and the value of fluorescence in situ hybridization (FISH) in the detection of microdeletions in MR.

METHODSSelection of patients was based on the following criteria: (1) MR with two or more of the following: dysmorphic features, prenatal growth retardation, postnatal growth abnormalities, a suggestive family history; (2) Chromosome karyotype at the level >450 bands was normal; (3) Exclusion of other identified genetic or environmental diagnosis. FISH was carried out with specific DNA probe to 47 undiagnosed MR to identify interstitial microdeletions and further screen the integrity chromosome subtelomere.

RESULTSSix cases were analyzed by FISH for special interstitial microdeletions and anomaly was found in one case with 7q11.23 deletion. Subtelomeric FISH analyses were performed in 46 patients, and two cases with a deletion of subtelomeric region of chromosome 6q and 2q respectively were identified.

CONCLUSIONChromosome microdeletions are supposed to be a significant cause of idiopathic MR, once recognizable syndromes have been excluded, FISH analyses for interstitial microdeletions and subtelomeric rearrangements are warranted in children with unexplained MR.

Chromosome Deletion ; Chromosomes, Human, Pair 2 ; genetics ; Chromosomes, Human, Pair 6 ; genetics ; Genetic Predisposition to Disease ; Humans ; In Situ Hybridization, Fluorescence ; Intellectual Disability ; genetics

OBJECTIVETo explore the method to repair large scalp and face scars.

METHODS1-3 expanders under the scalp were needed for repair the scalp scar. The expanded deltopectoral flaps were transferred to repair the face scar.

RESULTS12 cases were treated with satisfactory results. All the flaps survived and the donor sites were closed primarily. 2 cases had expander exposure which didn't affect the treatment results. Atrophic cutaneous striae was occurred because of overexpansion.

CONCLUSIONSSkin expansion is a good method for large scalp and face scar.

Adolescent ; Adult ; Cicatrix ; surgery ; Humans ; Scalp Dermatoses ; surgery ; Skin Transplantation ; Surgical Flaps ; Tissue Expansion ; methods ; Young Adult

OBJECTIVETo investigate the application of expanded deltopectoral flaps for treatment of cervical cicatricial contracture.

METHODSThe cervical cicatricial contracture was corrected in 18 cases with unilateral expanded deltopectoral flaps and 2 cases with bilateral expanded deltopectoral flaps. The size of scar ranged from 8 cm x 5 cm to 12 cm x 13 cm. The size of the unilateral expanded deltopectoral flaps ranged from 9 cm x 16 cm to 12 cm x 18 cm. The defects in donor sites were closed directly. The infraclavicula incision was designed. The flaps were delayed 3 weeks after flap transfer. The pedicle was cut off 4 weeks later.

RESULTSFrom 2007 to 2009, 20 cases with cervical cicatricial contracture were treated with expanded deltopectoral flaps. All the flaps were survived. 6 cases were followed up for 6 months with satisfactory results in 5 cases and conspicuous scar in 1 case.

CONCLUSIONSExpanded deltopectoral flap is very suitable for large size of cervical cicatricial contracture.

Adolescent ; Adult ; Child ; Child, Preschool ; Cicatrix ; surgery ; Dilatation ; methods ; Female ; Humans ; Male ; Neck ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Thorax ; Young Adult

OBJECTIVETo study the characteristics of viral spectrum and clinical features of children in pediatric intensive care unit (PICU).

METHODNasopharyngeal aspirate specimens (NPA) from 349 patients(1 from each) and 130 cerebrospinal fluids (CSF) specimens were collected from children who were admitted to the PICU of Second Affiliated Hospital of Shantou University Medical College. Additional 87 NPA specimens were collected from healthy children for routine examination on the physical examination center, and the clinical data were collected. Multiplex PCR was applied to detect 16 kinds of viruses from NPA and CSF. Fluorescence quantitative PCR was applied to detect 13 viruses from CSF and to analyze the clinical data of positive cases.

RESULTThere were 209 samples (59.9%) of the 349 NPA specimens were positive for viruses, which included 117 cases positive for human rhinovirus (HRV), 60 for respiratory syncytial virus (RSV), 20 for influenza virus A (Inf A), 10 for adenovirus (ADV), 6 for parainfluenza virus type 3(PIV-3), 6 for human Boca virus (HBoV), 5 for influenza virus C(Inf C), 4 for parainfluenza virus type 4(PIV-4), 4 for human coronavirus-HKU1/OC43, 3 for influenza virus B (Inf B), 3 for WU Polyomavirus (WUPyV), 2 parainfluenza virus type 1(PIV-1), 2 human metapneumovirus (HMPV) and 1 human coronavirus-NL63/229E. But none from 87 healthy controls were positive for any respiratory virus. Among the 130 CSF specimens, in 58 cases the diagnosis was viral encephalitis. There were 22 samples (37.9%) among the 58 CSF specimens positive for viruses, which included 14 enterovirus (EV), 3 human cytomegalovirus (HCMV), 2 mumps virus, 1 coxsackie virus A16 (Cox-A16), 1 herpes simplex virus (HSV) and 1 human rhinovirus (HRV). The total positive rate was 63.3% (221/349) . Co-infection by at least 2 viral pathogens under study was observed in 45 of the 349 patients (12.9% of the total number of cases, 20.4% of the positives cases). The commonest pathogens in co-infected samples were WUPyV (100%) and HMPV(100%). The positive rate of virus peaked in the first 6 months of life, the rate in boys were higher than in girls and the peak season was summer. The numbers of none serious cases in the virus positive group were less than those in the virus negative group while the numbers of extremely serious cases in the virus positive group were higher than in the virus negative group.

CONCLUSIONViral pathogen is a major cause of infectious disease in pediatric critical illnesses and virus infection may lead to severe illness.

Acute Disease ; Age Distribution ; Child ; Child, Preschool ; Coinfection ; virology ; Encephalitis, Viral ; epidemiology ; virology ; Female ; Humans ; Infant ; Influenza A virus ; isolation & purification ; Intensive Care Units, Pediatric ; Male ; Polymerase Chain Reaction ; RNA Viruses ; isolation & purification ; Respiratory Syncytial Viruses ; isolation & purification ; Respiratory Tract Infections ; epidemiology ; virology ; Rhinovirus ; isolation & purification ; Virus Diseases ; epidemiology ; virology

ObjectiveTo assess the clinical efficacy and regulation of skin microbiota in children with atopic dermatitis and damp-heat accumulation syndrome treated by Zhaqu Xiaofeng Powder （楂曲消风散， ZXP）. MethodsNinety children were randomized into a treatment group and a control group， each with 45 children. The treatment group received ZXP orally， while the control group received levocetirizine hydrochloride syrup， both for 4 weeks. The atopic dermatitis severity index （SCORAD）score， visual analog scale （VAS）score for itching， children dermatology life quality index （CDLQI）score， and traditional Chinese medicine syndrome score were assessed before and after 2- and 4-week treatment. Simultaneously， adhering to the principles of sample size in microbial sequencing， 25 children were randomly selected from each group （total 50 children）； skin samples were collected before and after treatment， and skin specimen DNA was extracted for 16S rRNA gene amplifier sequencing； the skin microbiota levels were detected， and the distribution of bacteria， diversity of flora， and differences between groups were compared. ResultsThere were five drop-outs in each group， and 40 cases in each group were included in final analysis. After 2- and 4-week treatment， both groups showed a significant reduction in SCORAD scores， VAS scores， and CDLQI scores， and more reductions were shown after 4-week treatment than 2-week treatment （P＜0.01）. The SCORAD score， VAS score， and CDLQI score of the treatment group were significantly lower than those in the control group after 4-week treatment （P＜0.01）. The scores of upset， thirsty， poor appetite， short red urine， and dry stool were reduced in the treatment group （P＜0.05）， while the scores of thirsty， poor appetite， short and red urine decreased after treatment （P＜0.05）. After 4 weeks of treatment， among the differential genera with abundances ＞0.5% in the treatment group， The cumulative relative abundances of Staphylococcus aureus， Streptococcus_mitis， Escherichia coli and Gemella_haemolysans in the treatment group were downregulated after treatment； in the control group， there was a relative cumulative decrease in the abundance of Streptococcus_mitis. The control group had reduced relative abundance of Streptococcus_mitis， Escherichia coli， Staphylococcus aureus and Gemella_haemolysans， after treatment （P＜0.05）. Alpha diversity analysis revealed an increase in both Chaol index and Shannon index after treatment （P＜0.05）， while there was no significant difference in Chaol index and Shannon index in the control group before and after treatment （P＞0.05）. Higher Chaol index and Shannon index were found in the treatment group （P＜0.05）. Beta diversity analysis showed that there were significant differences in the microbial community structure at the lesion site between the treatment group and the control group before treatment. The microbial community structure in the treatment group was similar after treatment， while there was no significant change in the microbial community structure in the control group before and after treatment. There were significant structure differences of key bacteria genus in both groups before and after treatment. ConclusionZXP used in the treatment of pediatric atopic dermatitis （AD）with the syndrome of damp-heat accumulation， has shown efficacy in reducing the severity of skin lesions， alleviating itching， and enhancing the quality of life in children. This modulation aims to decrease the abundance of pathogenic bacteria while promoting the colonization of beneficial bacteria， thereby altering the skin microbiota and contributing to the treatment of pediatric AD.

OBJECTIVE: To screen the serum biomarkers in workers occupationally exposed to titanium dioxide nanoparticles(TiO_2 NPs) using metabolomics technology. METHODS: Using a typical sampling method, 56 workers who have occupationally exposed to TiO_(2 )in a TiO_2 NPs manufacturer were selected as the exposure group and 44 employees without occupational exposure to TiO_2 were selected as the control group. The high performance liquid chromatography-mass spectrometry technology was used to perform non-targeted metabolomics detection. The difference in serum metabolite profiles of the TiO_2 NPs exposure group and the control group were analyzed. Key differential metabolites and potential biomarkers were screened. The sensitivity and specificity of biomarkers were assessed through receiver operating characteristic(ROC) curve.RESULTS: We detected a total of 1 492 mass spectrum peaks in serum samples by serum metabolomics analysis, and 413 well-matched metabolites were obtained after annotation and identification. The results of principal component analysis and orthogonal partial least squares discriminant analysis showed that a total of 296 differentially expressed metabolites were found in the serum of individuals of the exposure group compared with the control group(all P<0.01). Among them the relative expression of metabolites increased in 265 species and decreased in 31 species. The ROC analysis results showed that the area under the ROC curve of five metabolites exceeded 0.900, and these metabolites included tanacetol A,(5 E)-2-hydroxy-4-oxobenzopenta-5-en-1-ylacetic acid, triterpene saponins organic compounds, 9,10,13-trihydroxystearic acid, and liquoric acid. The multiple linear regression analysis showed that the relative expression of all the five metabolites were positively correlated with occupational exposure to TiO_2 NPs after adjusting for the influence of confounding factors such as gender, age, body mass index, smoking and drinking(all P<0.01). CONCLUSION: Occupational exposure to TiO_2 NPs could induce changes in serum metabolite profiles. The metabolites represented by tanacetol A in serum can be used as potential biomarkers for indicating occupational exposure to TiO_2 NPs.