1.A report of breast carcinoma with rare pathologic diagnosis
Guimei LI ; Xiangzhou LI ; Meizhao LE ; Dianqian ZHANG ; Chunshu WANG ; Sumei PAN
Journal of Medical Postgraduates 2003;0(11):-
Objective:To study the clinical pathologic characteristics and differential diagnosis of rare type carcinoma of the breast. Methods:According to the new World Health Organization Classification of Tumors(2003),42 cases of rare type carcinoma of the breast were studied by clinical data and correlated investigation of pathology.Results: All the slides of the breast carcinoma in our department were reviewed,9 cases of glycogen-rich,clear cell carcinoma,4 cases of mucinous carcinoma,2 cases of tubular carcinoma,18 cases of metaplastic carcinoma,6 cases of apocrine carcinoma,1 case of secretary carcinoma,and 2cases of lipid-rich carcinoma were found.Different histologic type has different appearance in the light microscopy,special staining and electromicroscopy.Conclusion:Definite histological classification of breast carcinoma will be helpful in guiding the clinical treatment and estimating patients' prognosis.
2.Effects of double eyelid plasty with incision in eyelids margin position and internal fixation
Jialu XIE ; Yuting ZHAO ; Xiangzhou ZHANG
Chinese Journal of Medical Aesthetics and Cosmetology 2022;28(5):372-374
Objective:To explore the clinical efficacy of the double eyelid plasty with incision in eyelids margin position and internal fixation.Methods:A retrospective analysis was carried out in 47 patients who underwent double eyelid surgery in the outpatient department of our hospital from September 2015 to June 2017. There were 5 males and 42 females, aged from 17 to 32 (25±4) years. The skin was incised above the eyelid margin of 1-2 mm after anesthesia, orbicularis oculi muscle under the eyelid line, loose organization, and orbital septum fat were stripped and removed. The dermis and the tarsus were sutured under the double eyelid line, and the skin was sutured without any tension.Results:After collecting and analyzing 47 cases from September 2015 to June 2017 in our hospital with this method, we found that all 47 patients achievedⅠincision healing, which showed slight swell, natural and smooth radian of double eyelid, and without complications such as infection, hematoma and ptosis. And this method showed no obvious scar hyperplasia around incision line and thus possessed high patient satisfaction.Conclusions:With the advantage of less trauma, quick recovery, unobvious scar, natural and beartiful double eyelids, this method can be used as a supplementary method for the reconstruction of the blepharoplasty, which is worth promoting.
3.Study on the clinical effect of ablative fractional CO 2 laser in the treatment of hypertrophic scars after burns in children
Fuxi XING ; Quanyou FU ; Xiangzhou ZHANG ; Yong LI ; Dongwei XU ; Dan ZHUO ; Jisong LIU
Chinese Journal of Plastic Surgery 2022;38(2):143-151
Objective:To observe the clinical effect of ablative fractional CO 2 laser in the treatment of hypertrophic scar in children after burn. Methods:The clinical data of patients with post-burn hypertrophic scar in children who met the inclusion and exclusion criteria in the Cosmetic Clinic and Burn Clinic of the Third People’s Hospital of Bengbu City Affiliated to Bengbu Medical College from January 2019 to March 2021 were collected, and a retrospective study was conducted. All patients were divided into laser group and control group, and laser group was further divided into 1-2 times subgroups and 3-4 times subgroups. The laser group received ablative fractional CO 2 laser treatment 1-4 times on the basis of conventional anti-scar treatment (pressure therapy and topical silicone drugs), and the treatment interval was 1-3 months; the control group only received conventional anti-scar treatment. The color, blood vessel distribution, thickness and softness of scar were scored by Vancouver Scar Scale (VSS), before treatment and 2 months after treatment In the laser group, and at 3 and 6 months in the control group, respectively. The degree of pruritus of the scar was scored with Visual Analogue Scale (VAS). The patient’s satisfaction evaluation is graded as four levels: very satisfied, relatively satisfied, generally satisfied, and dissatisfied. All data were analyzed by SPSS 19.0 software with paired t-test, Wilcoxon rank-sum test or chi-square test according to the type and nature of the data. Results:A total of 103 patients with hypertrophic scars were included, with a total of 134 scars, including 58 males and 45 females; the age was (3.9±3.0) years, range 0-11 years old; the scar area accounted for 4.2%±3.1% of the body surface area; the course of scar was (3.6±2.2) months. There were 72 patients (94 scars) in the laser group, including 29 patients (37 scars) in the 1-2 times subgroup and 43 (57 scars) in the 3-4 times subgroup; 31 patients in the control group(40 scars). (1) Vascular distribution, softness and overall score assessed by VSS in 1-2 times subgroup after treatments were significantly lower than those before treatment ( P<0.05). The thickness, blood vessel distribution, softness and overall score assessed by VSS in 3-4 times subgroup after treatments were significantly lower than those before treatment ( P<0.05). The improvement degree of scar after treatment in each group was different. Compared with the control group, the improvement degree in the 1-2 times subgroup and the 3-4 times subgroup was more obvious ( P<0.05). The improvement degree in the 3-4 times subgroup was better than that in the 1-2 times subgroups ( P<0.05). (2) Compared with before treatment, the VSS scores of scars after laser treatment in different parts were significantly different except for the thickness scores of face and neck, trunk, and upper limbs group ( P<0.05). (3) The degree of pruritus was assessed by VAS method. The pruritus score of the 1-2 times subgroups and 3-4 times subgroups before treatment was (4.86±1.35) points, (4.97±0.93) points, and the pruritus score 2 months after treatment was (1.93±0.99) points, (1.90±0.83) points, the pruritus score improved significantly after treatment, and the difference was statistically significant ( P<0.01). The pruritus scores of the control group at 3 months and 6 months were (4.83±0.82) points and (4.22±0.66) points, and the scores at 6 months were slightly improved compared with those at 3 months, and the difference was statistically significant ( P<0.01). (4) In the laser group, 5 patients (6.9%) had pigmentation after the first treatment, and then gradually subsided; 7 patients (9.7%) had blisters after the second treatment, which healed after dressing change. In the control group, 3 cases (9.7%) had erosions, and the erosions improved after adjusting the pressure appropriately. (5) The overall satisfaction of patients in the laser group was higher than that in the control group [100% (72/72) vs. 80.6% (25/31), P<0.05]. Conclusions:Fractional CO 2 laser has a good effect on the treatment of hypertrophic scars in early childhood burns. It can effectively inhibit scar hyperplasia and improve the degree of itching in patients. The satisfaction of both doctors and patients is high.
4.Study on the clinical effect of ablative fractional CO 2 laser in the treatment of hypertrophic scars after burns in children
Fuxi XING ; Quanyou FU ; Xiangzhou ZHANG ; Yong LI ; Dongwei XU ; Dan ZHUO ; Jisong LIU
Chinese Journal of Plastic Surgery 2022;38(2):143-151
Objective:To observe the clinical effect of ablative fractional CO 2 laser in the treatment of hypertrophic scar in children after burn. Methods:The clinical data of patients with post-burn hypertrophic scar in children who met the inclusion and exclusion criteria in the Cosmetic Clinic and Burn Clinic of the Third People’s Hospital of Bengbu City Affiliated to Bengbu Medical College from January 2019 to March 2021 were collected, and a retrospective study was conducted. All patients were divided into laser group and control group, and laser group was further divided into 1-2 times subgroups and 3-4 times subgroups. The laser group received ablative fractional CO 2 laser treatment 1-4 times on the basis of conventional anti-scar treatment (pressure therapy and topical silicone drugs), and the treatment interval was 1-3 months; the control group only received conventional anti-scar treatment. The color, blood vessel distribution, thickness and softness of scar were scored by Vancouver Scar Scale (VSS), before treatment and 2 months after treatment In the laser group, and at 3 and 6 months in the control group, respectively. The degree of pruritus of the scar was scored with Visual Analogue Scale (VAS). The patient’s satisfaction evaluation is graded as four levels: very satisfied, relatively satisfied, generally satisfied, and dissatisfied. All data were analyzed by SPSS 19.0 software with paired t-test, Wilcoxon rank-sum test or chi-square test according to the type and nature of the data. Results:A total of 103 patients with hypertrophic scars were included, with a total of 134 scars, including 58 males and 45 females; the age was (3.9±3.0) years, range 0-11 years old; the scar area accounted for 4.2%±3.1% of the body surface area; the course of scar was (3.6±2.2) months. There were 72 patients (94 scars) in the laser group, including 29 patients (37 scars) in the 1-2 times subgroup and 43 (57 scars) in the 3-4 times subgroup; 31 patients in the control group(40 scars). (1) Vascular distribution, softness and overall score assessed by VSS in 1-2 times subgroup after treatments were significantly lower than those before treatment ( P<0.05). The thickness, blood vessel distribution, softness and overall score assessed by VSS in 3-4 times subgroup after treatments were significantly lower than those before treatment ( P<0.05). The improvement degree of scar after treatment in each group was different. Compared with the control group, the improvement degree in the 1-2 times subgroup and the 3-4 times subgroup was more obvious ( P<0.05). The improvement degree in the 3-4 times subgroup was better than that in the 1-2 times subgroups ( P<0.05). (2) Compared with before treatment, the VSS scores of scars after laser treatment in different parts were significantly different except for the thickness scores of face and neck, trunk, and upper limbs group ( P<0.05). (3) The degree of pruritus was assessed by VAS method. The pruritus score of the 1-2 times subgroups and 3-4 times subgroups before treatment was (4.86±1.35) points, (4.97±0.93) points, and the pruritus score 2 months after treatment was (1.93±0.99) points, (1.90±0.83) points, the pruritus score improved significantly after treatment, and the difference was statistically significant ( P<0.01). The pruritus scores of the control group at 3 months and 6 months were (4.83±0.82) points and (4.22±0.66) points, and the scores at 6 months were slightly improved compared with those at 3 months, and the difference was statistically significant ( P<0.01). (4) In the laser group, 5 patients (6.9%) had pigmentation after the first treatment, and then gradually subsided; 7 patients (9.7%) had blisters after the second treatment, which healed after dressing change. In the control group, 3 cases (9.7%) had erosions, and the erosions improved after adjusting the pressure appropriately. (5) The overall satisfaction of patients in the laser group was higher than that in the control group [100% (72/72) vs. 80.6% (25/31), P<0.05]. Conclusions:Fractional CO 2 laser has a good effect on the treatment of hypertrophic scars in early childhood burns. It can effectively inhibit scar hyperplasia and improve the degree of itching in patients. The satisfaction of both doctors and patients is high.
6.Traditional Chinese medicine Master XIONG Jibo’s medication experience in treating arthralgia syndrome through data mining
DENG Wenxiang ; ZHANG Jidong ; ZHANG Wenan ; HE Qinghu
Digital Chinese Medicine 2022;5(2):154-168
Objective This study aimed to examine and propagate the medication experience and group formula of traditional Chinese medicine (TCM) Master XIONG Jibo in diagnosing and treating arthralgia syndrome (AS) through data mining. Methods Data of outpatient cases of Professor XIONG Jibo were collected from January 1, 2014 to December 31, 2018, along with cases recorded in A Real Famous Traditional Chinese Medicine Doctor: XIONG Jibo's Clinical Medical Record 1, which was published in December 2019. The five variables collected from the patients’ data were TCM diagnostic information, TCM and western medicine diagnoses, syndrome, treatment, and prescription. A database was established for the collected data with Excel. Using the Python environment, a customized modified natural language processing (NLP) model for the diagnosis and treatment of AS by Professor XIONG Jibo was established to preprocess the data and to analyze the word cloud. Frequency analysis, association rule analysis, cluster analysis, and visual analysis of AS cases were performed based on the Traditional Chinese Medicine Inheritance Computing Platform (V3.0) and RStudio (V4.0.3). Results A total of 610 medical records of Professor XIONG Jibo were collected from the case database. A total of 103 medical records were included after data screening criteria, which comprised 187 times (45 kinds) of prescriptions and 1 506 times (125 kinds) of Chinese herbs. The main related meridians were the liver, spleen, and kidney meridians. The properties of Chinese herbs used most were mainly warm, flat, and cold, while the flavors of herbs were mainly bitter, pungent, and sweet. The main patterns of AS included the damp heat, phlegm stasis, and neck arthralgia. The most commonly used herbs for AS were Chuanniuxi (Cyathulae Radix), Huangbo (Phellodendri Chinensis Cortex), Cangzhu (Atractylodis Rhizoma), Qinjiao (Gentianae Macrophyllae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqi (Astragali Radix), and Chuanxiong (Chuanxiong Rhizoma). The most common effect of the herbs was “promoting blood circulation and removing blood stasis”, followed by “supplementing deficiency (Qi supplementing, blood supplementing, and Yang supplementing)”, and “dispelling wind and dampness”. The data were analyzed with the support ≥ 15% and confidence = 100%, and after de-duplication, five second-order association rules, 39 third-order association rules, 39 fourth-order association rules, and two fifth-order association rules were identified. The top-ranking association rules of each were “Cangzhu (Atractylodis Rhizoma) → Huangbo (Phellodendri Chinensis Cortex)” “Cangzhu (Atractylodis Rhizoma) + Chuanniuxi (Cyathulae Radix) → Huangbo (Phellodendri Chinensis Cortex)” “Chuanniuxi (Cyathulae Radix) + Danggui (Angelicae Sinensis Radix) + Gancao (Glycyrrhizae Radix et Rhizoma) → Qinjiao (Gentianae Macrophyllae Radix)” and “Chuanniuxi (Cyathulae Radix) + Danggui (Angelicae Sinensis Radix) +Gancao (Glycyrrhizae Radix et Rhizoma) + Huangbo (Phellodendri Chinensis Cortex) → Qinjiao (Gentianae Macrophyllae Radix)”, respectively. Five clusters were obtained using cluster analysis of the top 30 herbs. The herbs were mainly drying dampness, supplementing Qi, and promoting blood circulation. The main prescriptions of AS were Ermiao San (二妙散), Gegen Jianghuang San (葛根姜黄散), and Huangqi Chongteng Yin (黄芪虫藤饮). The herbs of core prescription included Cangzhu (Atractylodis Rhizoma), Chuanniuxi (Cyathulae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Huangbo (Phellodendri Chinensis Cortex), Mugua (Chaenomelis Fructus), Qinjiao (Gentianae Macrophyllae Radix), Danggui (Angelicae Sinensis Radix), and Yiyiren (Coicis Semen). Conclusion Clearing heat and dampness, relieving collaterals and pain, and invigorating Qi and blood are the most commonly used therapies for the treatment of AS by Professor XIONG Jibo. Additionally, customized NLP model could improve the efficiency of data mining in TCM.