1.Clinical and genetic analysis of a patient with Neuronal intranuclear inclusion body disease characterized by cortical enhancement in the posterior brain region
Jibao WU ; Fengzhen HUANG ; Limei CAO ; Yi ZHANG ; Xiaojun LIU ; Jiangtao LONG ; Jiping YI ; Xiaoxi YAO
Chinese Journal of Medical Genetics 2024;41(8):953-956
Objective:To explore the clinical, imaging, and genetic characteristics of an adult patient with sporadic Neuronal intranuclear inclusion disease (NIID).Methods:A patient who had visited the First People′s Hospital of Chenzhou on August 6, 2023 was selected as the study subject. Results of clinical examination, neuroimaging, and genetic testing were retrospectively analyzed along with a literature review. The number of GGC trinucleotide repeats in the 5′-untranslated region of the NOTCH2NLC gene was determined by GC-PCR. Results:The patient had presented with episodic encephalopathy, with enhanced magnetic resonance imaging showing enhancement features of the posterior cerebral cortex during the period of acute episode. Genetic testing revealed an increased number of GGC repeats ( n = 97) in the 5′- untranslated region of the NOTCH2NLC gene, which confirmed the diagnosis of NIID. Conclusion:Clinical attention should be paid to the enhanced MRI findings of patients with adult-onset NIID, for whom posterior cortical enhancement may be characteristic manifestation during the acute phase of encephalopathy-like episode.
2.Medical quality control management and discipline progress of plastic and aesthetic major under the background of high-quality development policy
Mingzi ZHANG ; Loubin SI ; Jiaojie ZHENG ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Chinese Journal of Plastic Surgery 2024;40(4):357-361
In 2022, general president Xi Jinping pointed out that "high-quality development is the top task of building China into a modern socialist country in all respects" at the 20th National Congress of the Communist Party of China. Since then, various industries have embraced the trend of high-quality development. This article aims to provide a specific reference point for the high-quality development of the plastic and aesthetic industry, based on the understanding of national policy documents and combined with the current situation and characteristics of the plastic and aesthetic specialty.
3.Medical quality control management and discipline progress of plastic and aesthetic major under the background of high-quality development policy
Mingzi ZHANG ; Loubin SI ; Jiaojie ZHENG ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Chinese Journal of Plastic Surgery 2024;40(4):357-361
In 2022, general president Xi Jinping pointed out that "high-quality development is the top task of building China into a modern socialist country in all respects" at the 20th National Congress of the Communist Party of China. Since then, various industries have embraced the trend of high-quality development. This article aims to provide a specific reference point for the high-quality development of the plastic and aesthetic industry, based on the understanding of national policy documents and combined with the current situation and characteristics of the plastic and aesthetic specialty.
4.Effect Evaluation of Responsible Segmental Decompression Combined with Orthopedic Fixation of Short-Segment Fusion Surgery for Treating Degenerative Lumbar Scoliosis
Hui ZENG ; Gangqiang WU ; Can HUANG ; Xiaojun HAN ; Bo LIU ; Cheng CHEN ; Long MA ; Bowen ZHANG ; Honghai WANG
Journal of Medical Biomechanics 2024;39(5):896-902
Objective To investigate the therapeutic effect of segmental decompression combined with corrective short-segment fusion surgery for the treatment of degenerative lumbar scoliosis.Methods In total,124 patients with degenerative lumbar scoliosis were selected and divided into short-and long-segment fusion groups using the random number table method,with 62 patients in each group.Posterior short-segment decompression,fixation,and fusion were performed in the short-segment fusion group;the fusion segment was the adjacent lumbar vertebra.Posterior long-segment decompression,fixation,and fusion were performed in the long-segment fusion group;the fusion segments included multiple adjacent lumbar vertebrae.At the 6th month after surgery,the coronal Cobb angle of lumbar convexity,sagittal Cobb angle of lumbar lordosis,intervertebral foramen height,intervertebral space height,intervertebral foramen area,spinal canal area,spinal canal diameter,Japanese Orthopedic Association(JOA)score,Oswestry Disability Index(ODI),degree of pain in the lower back and lower limbs,and postoperative complications were compared between the groups.Results The Cobb angle of the coronal lumbar scoliosis in the short-and long-segment fusion groups was significantly higher than that before surgery(P<0.05).At the 6th month after surgery,the intervertebral foramen height,intervertebral space height,intervertebral foramen area,spinal canal area,and spinal canal diameter in both groups increased,and those in the short-segment fusion group were higher than those in the long-segment fusion group(P<0.05);at the 6th month after the operation,the JOA scores of the short-segment and long-segment fusion groups were higher than those before surgery,and the JOA score of the short-segment fusion group was higher than that of the long-segment fusion group(P<0.05).The ODI score was lower than that before surgery in the short-and long-segment fusion groups,and the ODI score in the short-segment fusion group was lower than that in the long-segment fusion group(P<0.05).At the 6th month after surgery,the pain scores of the lower back and lower limbs in the short-and long-segment fusion groups were significantly higher than those before surgery(P<0.05).There were two cases of dural tears during decompression caused by lamina dura adhesion in the long-segment fusion group,and no serious complications were observed in the short-segment fusion group.Conclusions Both short-and long-segment decompression fixation fusion using a posterior approach can achieve good therapeutic effects for treating degenerative lumbar scoliosis.However,compared to the long-segment fusion group,the short-segment fusion group undergoing short-segment decompression fixation fusion through a posterior approach had a shorter surgical period,lower intraoperative blood loss,better recovery of lumbar function,and a lower risk of postoperative complications.
5.Multicenter evaluation of minimal residual disease monitoring in early induction therapy for treatment of childhood acute lymphoblastic leukemia
Xiaojun WU ; Ning LIAO ; Huirong MAI ; Xinyu LI ; Wuqing WAN ; Lihua YANG ; Libin HUANG ; Xiangqin LUO ; Chuan TIAN ; Qiwen CHEN ; Xingjiang LONG ; Yunyan HE ; Ying WANG ; Chi-Kong LI ; Honggui XU
Chinese Journal of Pediatrics 2024;62(4):337-344
Objective:To evaluate the role of minimal residual disease (MRD) monitoring during early induction therapy for the treatment of childhood acute lymphoblastic leukemia (ALL).Methods:This was a multicenter retrospective cohort study. Clinical data of 1 164 ALL patients first diagnosed between October 2016 and June 2019 was collected from 16 hospitals in South China Children′s Leukemia Group. According to MRD assay on day 15 of early induction therapy, they were divided into MRD<0.10% group, MRD 0.10%-<10.00% group and MRD≥10.00% group. According to MRD assay on day 33, they were divided into MRD<0.01% group, MRD 0.01%-<1.00% group and MRD≥1.00% group. Age, onset white blood cell count, central nervous system leukemia (CNSL), molecular genetic characteristics and other data were compared between groups. Kaplan-Meier method was used for survival analysis. Cox regression model was used to analyze prognostic factors.Results:Of the 1 164 enrolled patients, there were 692 males and 472 females. The age of diagnosis was 4.7 (0.5, 17.4) years. The white blood cell count at initial diagnosis was 10.7 (0.4, 1 409.0) ×10 9/L. Among all patients, 53 cases (4.6%) had CNSL. The follow-up time was 47.6 (0.5, 68.8) months. The 5-year overall survival (OS) and 5-year relapse-free survival (RFS) rates were (93.1±0.8) % and (90.3±1.1) %. On day 15 of early induction therapy, there were 466 cases in the MRD<0.10% group, 523 cases in the MRD 0.10%-<10.00% group and 175 cases in the MRD≥10.00% group. The 5-year OS rates of the MRD<0.10% group, MRD 0.10%-<10.00% group and MRD≥10.00% group were (95.4±1.0) %, (93.3±1.1) %, (85.4±2.9) %, respectively, while the RFS rates were (93.2±1.6) %, (90.8±1.4) %, (78.9±4.3) %, respectively ( χ2=16.47, 21.06, both P<0.05). On day 33 of early induction therapy, there were 925 cases in the MRD <0.01% group, 164 cases in the MRD 0.01%-<1.00% group and 59 cases in the MRD≥1.00% group. The 5-year RFS rates in the MRD 0.01%-<1.00% group was lowest among three groups ((91.4±1.2) % vs. (84.5±3.2) % vs. (87.9±5.1) %). The difference between three groups is statistically significant ( χ2=9.11, P=0.010). Among ALL patients with MRD≥10.00% on day 15 of induction therapy, there were 80 cases in the MRD <0.01% group on day 33, 45 cases in the MRD 0.01%-<1.00% group on day 33 and 45 cases in the MRD≥1.00% group on day 33. The 5-year RFS rates of three groups were (83.9±6.0)%, (67.1±8.2)%, (83.3±6.9)% respectively ( χ2=6.90, P=0.032). Univariate analysis was performed in the MRD≥10.00% group on day 15 and the MRD 0.01%-<1.00% group on day 33.The 5-year RFS rate of children with CNSL was significantly lower than that without CNSL in the MRD≥10.00% group on day 15 ((50.0±20.4)% vs. (80.3±4.4)%, χ2=4.13, P=0.042). Patients with CNSL or MLL gene rearrangement in the MRD 0.01%-<1.00% group on day 33 had significant lower 5-year RFS rate compared to those without CNSL or MLL gene rearrangement ((50.0±25.0)% vs. (85.5±3.1)%, χ2=4.06, P=0.044;(58.3±18.6)% vs. (85.7±3.2)%, χ2=9.44, P=0.002). Multivariate analysis showed that age ( OR=0.58, 95% CI 0.35-0.97) and white blood cell count at first diagnosis ( OR=0.43, 95% CI 0.27-0.70) were independent risk factors for OS. The MRD level on day 15 ( OR=0.55,95% CI 0.31-0.97), ETV6-RUNX1 fusion gene ( OR=0.13,95% CI 0.03-0.54), MLL gene rearrangement ( OR=2.55,95% CI 1.18-5.53) and white blood cell count at initial diagnosis ( OR=0.52,95% CI 0.33-0.81) were independent prognostic factors for RFS. Conclusions:The higher the level of MRD in early induction therapy, the worse the OS. The MRD levels on day 15 is an independent prognostic factor for RFS.The MRD in early induction therapy guided accurate risk stratification and individualized treatment can improve the survival rate of pediatric ALL.
6.Comparison of suction blister transplantation and noncultured autologous suspension of epidermal cells in treatment of stable vitiligo in the face and neck region
Yong TAO ; Zhifei LIU ; Mingzi ZHANG ; Xiaohan HU ; Nanze YU ; Fei LONG ; Zenan XIA ; Lan MO ; Xiaojun WANG
Chinese Journal of Medical Aesthetics and Cosmetology 2024;30(3):208-212
Objective:To evaluate the differences and aesthetic meaning of stable vitiligo treatment in the face and neck region using suction blister transplantation or noncultured autologous suspension of epidermal cells.Methods:Sixty-four stable vitiligo patients (25 males and 39 females with age ranges from 10 to 46 years, average 25 years) in the face and neck region were randomly divided into two groups (32 patients in each group): one group received suction blister transplantation, while other group received noncultured autologous suspension of epidermal cells. Patients′treatment effectiveness, pigmentation and piecing deformity were evaluated in postoperative 3 months and 6 months.Results:In the postoperative 3 months and 6 months, the effectiveness of suction blister transplantation group was 68.75% (22/32) and 90.63% (29/32), respectively, while the effectiveness of noncultured autologous suspension of epidermal cells group was 59.37% (19/32) and 87.50% (28/32), respectively, in which no significant differences were found between two groups ( P>0.05). No obvious pigmentation and piecing deformity were found in noncultured autologous suspension of epidermal cells group, which were much better than the suction blister transplantation group in postoperative 3 months and 6 months. Conclusions:Both suction blister transplantation and noncultured autologous suspension of epidermal cells could bring good treatment effectiveness for patients of stable vitiligo in the face and neck region. Compared with suction blister transplantation, noncultured autologous suspension of epidermal cells could offer better aesthetic appearance.
7.Application of autologous ear cartilage combined with retroauricular fascia in primary rhinoplasty
Fei LONG ; Zhifei LIU ; Xiaojun WANG
Chinese Journal of Medical Aesthetics and Cosmetology 2024;30(3):223-226
Objective:To investigate the application and clinical effect of autologous ear cartilage combined with retroauricular fascia in primary rhinoplasty.Methods:A retrospective analysis was conducted on 31 primary rhinoplasty patients admitted to our hospital from January 2019 to January 2022, including 1 male and 30 females; the age range was 17-43 years, with an average of 24.3 years. The patients were followed up for 6-24 months, with an average of 18 months. The changes of nasal length, nasal tip projection, nasal height and nasal dorsum height were compared before operation, 6 months and 12 months after operation respectively.Results:All the 31 patients underwent rhinoplasty using autologous ear cartilage and retroauricular fascia materials. Six months after surgery, the patient′s nasal length increased by (4.4±0.7) mm ( t=3.17, P=0.025), nasal tip projections increased by (4.6± 0.5) mm ( t=6.45, P=0.001), nasal height increased by (3.1±0.4) mm ( t=8.21, P=0.001), and nasal dorsum height increased by (2.6±0.5) mm ( t=5.79, P=0.015). 12 months after surgery, the patient′s nasal length increased by (4.3±0.6) mm ( t=2.99, P=0.030), nasal tip projections increased by (4.2±0.4) mm ( t=5.12, P=0.005), nasal height increased by (2.9±0.3) mm ( t=6.86, P=0.005), and nasal dorsum height increased by (2.2±0.4) mm ( t=4.14, P=0.020). There was no significant difference in the observation indicators at 6 and 12 months after surgery ( P>0.05). Conclusions:The application of autologous ear cartilage and retroauricular fascia in primary rhinoplasty has prominent cosmetic effect, beautiful and natural nasal shape, stable long-term effect and few complications, which is worthy of clinical promotion.
8.Screening process of breast implant associated-anaplastic large cell lymphoma in symptomatic patients with textured breast implants
Wenchao ZHANG ; Jiangmiao XIE ; Zenan XIA ; Mingzi ZHANG ; Xiao LONG ; Xiaojun WANG ; Ang ZENG
Chinese Journal of Medical Aesthetics and Cosmetology 2024;30(4):354-358
Objective:To summarize the clinical diagnosis and treatment process of breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) in symptomatic patients with textured breast implants in Peking Union Medical College Hospital in order to provide reference for the management of such patients in China.Methods:From January 2019 to September 2021, 23 symptomatic patients with textured breast implants were admitted to the Peking Union Medical College Hospital, aged 29-52 years, with an average of 36.2 years. All patients agreed to remove the prosthesis by surgery, and accepted cytology, flow cytometry, and immunohistochemical examination of the fluid around the implants and capsule tissue before or during the operation to complete the BIA-ALCL screening process.Results:All 23 patients presented with unilateral periprosthetic fluid accumulation, with fluid volume ranging from 20 to 130 ml, of which 7 cases were combined with periprosthetic contracture. No tumor cells were found in the pathological findings of effusion and the capsule tissue, and the BIA-ALCL pathologic screening results (CD 30 and ALK) were all negative. No bleeding, infection, wound dehiscence and other complications occurred after the operation.Conclusions:A personalized clinical process should be developed for symptomatic patients with textured breast implants. Attention should be paid to imaging and pathological examinations.
9.Journey and Significance of Quality Control in Medical Safety for China's Plastic Surgery and Aesthetic Medicine Professions
Jiaojie ZHENG ; Mingzi ZHANG ; Loubin SI ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1233-1237
Medical quality and safety are essential safeguards for the harmonious society in China, directly affecting people's sense of security and happiness. Continuously improving medical quality and ensuring medical safety are fundamental and essential to implementing the strategies of the Party Central Committee and the State Council, and promoting the construction of a healthy China. In recent years, with the rapid development of China's economy and the people's increasing emphasis on their own health and safety, China's plastic surgery industry has achieved significant progress and yielded outstanding results. However, along with the rapid growth of the industry, medical quality issues and safety accidents have occurred frequently, attracting widespread attention from all sectors of society. This article briefly outlines the history of quality management and quality control for medical quality and safety in China's plastic surgery specialty. It explores the development of quality management from its origin to medical quality management, as well as the responsibilities and contributions of the National Plastic Surgery Quality Control Center in improving industry standards and ensuring patient safety. It aims to provide support for the standardized management of the plastic surgery industry in the future, so as to promote its healthy and sustainable development.
10.Construction of Medical Quality Control Indicators System for Chinese Plastic and Aesthetic Major
Mingzi ZHANG ; Loubin SI ; Jiuzuo HUANG ; Nanze YU ; Jiaojie ZHENG ; Jie CHEN ; Xiaojun WANG ; Xiao LONG ; Wei XIONG
Medical Journal of Peking Union Medical College Hospital 2024;15(6):1318-1324
To construct a quality control indicators system for Chinese plastic and aesthetic major and lay foundation for medical quality control. National Quality Control Center of Plastic and Aesthetic Major established a working group in February 2023. Guided by the "structure-process-outcome" theory, the working group formulated medical quality control indicators for Plastic and Aesthetic major by learning from relevant indicators of other majors, reviewing literature, discussing in meetings, and combining opinions from quality control experts. The quality control indicators system was finally established by Delphi expert consultation. Delphi survey was 100% of 2 rounds. The authorities of 2 rounds of expert consultation were 0.854 and 0.857. The harmonious coefficients were 0.387 of primary indicators and 0.425 of secondary indicators( The quality control indicators system established in this study for Plastic and Aesthetic major in China has a certain degree of scientificity and rationality, which offers reference for medical quality control of Plastic and Aesthetic major in China. However, this system should be improved and ameliorated in practical application.

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