1.Mohs micrographic surgery and punch grafting as treatment for acral lentiginous melanoma
Tiaramaria Rosary Q. Valmoria ; Jen-cristina Lourdes Q. Segovia-Santos
Journal of the Philippine Dermatological Society 2024;33(Suppl 1):4-4
A 53-year-old female presented with a 2-year history of an enlarging hyperpigmented plaque on her left foot, which was later accompanied by yellowish, foul-smelling discharge, tenderness, and pain (5/10). A biopsy in Thailand confirmed acral lentiginous melanoma. Following surgical site dehiscence and lesion recurrence, she underwent further examination at Southern Philippines Medical Center. A skin punch biopsy revealed atypical melanocytes, leading to Mohs micrographic surgery. After confirming negative tumor margins, a successful skin punch graft was performed, resulting in full wound healing with no recurrence.
Acral lentiginous melanoma, though rare, is most common in Asians and often presents in areas like the soles, palms, and subungual regions. Mohs micrographic surgery, offering precise margin control, ensures cure rates comparable to traditional excision while sparing more tissue, crucial for areas like the foot. Skin punch grafting, in this case, provided faster wound healing and a high graft survival rate, highlighting its effectiveness in dermatologic surgery.
In conclusion, acral lentiginous melanoma’s subtle presentation often delays diagnosis, but combining Mohs surgery with skin punch grafting offers significant therapeutic benefits—ensuring tissue preservation, faster recovery, and improved graft outcomes.
Human ; Female ; Middle Aged: 45-64 Yrs Old ; Grafts ; Transplants ; Melanoma
2.More than two courses of pre-transplant consolidation therapy benefits patients with acute myeloid leukemia in the first complete remission who underwent human leukocyte antigen-matched sibling allografts: a multicenter study.
Jing LIU ; Depei WU ; Qifa LIU ; Yingjun CHANG ; Yang XU ; Fen HUANG ; Xiaojun HUANG ; Yu WANG
Chinese Medical Journal 2023;136(15):1855-1863
BACKGROUND:
Although the need for consolidation chemotherapy after successful induction therapy is well established in patients with acute myeloid leukemia (AML) in first complete remission (CR1), the value of consolidation chemotherapy before allogeneic hematopoietic stem cell transplantation remains controversial.
METHODS:
We retrospectively compared the effect of the number of pre-transplant consolidation chemotherapies on outcomes of human leukocyte antigen-matched sibling stem cell transplantation (MSDT) for patients with AML in CR1 in multicenters across China. In our study, we analyzed data of 373 AML patients in CR1 from three centers across China.
RESULTS:
With a median follow-up of 969 days, patients with ≥ 3 courses of consolidation chemotherapy had higher probabilities of leukemia-free survival (LFS) (85.6% vs . 67.0%, P < 0.001) and overall survival (89.2% vs . 78.5%, P = 0.007), and better cumulative incidences of relapse (10.5% vs . 19.6%, P = 0.020) and non-relapse mortality (4.2% vs . 14.9%, P = 0.001) than those with ≤ 2 courses of consolidation chemotherapy. Pre-transplantation minimal residual disease-negative patients with AML in CR1 who received MSDT with ≥ 3 courses of consolidation chemotherapy had a higher probability of LFS (85.9% vs . 67.7%, P = 0.003) and a lower cumulative incidence of relapse (9.6% vs . 23.3%, P = 0.013) than those with ≤ 2 courses.
CONCLUSION
Our results indicate that patients with AML in CR1 who received MSDT might benefit from pre-transplant consolidation chemotherapy.
Humans
;
Retrospective Studies
;
Consolidation Chemotherapy/methods*
;
Siblings
;
Hematopoietic Stem Cell Transplantation/methods*
;
Leukemia, Myeloid, Acute/etiology*
;
HLA Antigens
;
Allografts
3.Research progress in nipple projection reconstruction based on tissue graft support.
Xiaoshan ZHANG ; Chengliang DENG
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(8):1031-1036
OBJECTIVE:
To review the advances in methods for reconstructing nipple projection based on tissue graft support.
METHODS:
The literature related to nipple projection reconstruction based on tissue graft support was reviewed and summarized in terms of the advantages and disadvantages of various tissue grafts and the improved nipple projection results.
RESULTS:
Loss of nipple projection is a common cause of decreased patient's satisfaction. Reconstructing nipple projection based on tissue graft support is a more common clinical method and can be done with autologous and allogeneic tissues. Autologous tissue grafts include dermis, adipose tissue with dermis, adipose tissue, ear cartilage, rib cartilage, and contralateral nipple tissue. Autologous tissue grafts are easy to obtain and have no immune rejection, but may lead to donor area damage and prolong the surgical time for tissue collection. Allogeneic tissue grafts include acellular dermal matrix, lyophilized rib cartilage, and extracellular matrix collagen, and decellularized nipple tissue. Allogeneic tissue grafts do not cause additional donor area damage, are highly malleable, and can be designed to be utilized according to the recipient area, but the high cost often limits the development of this technique.
CONCLUSION
There is no gold standard regarding tissue graft-assisted nipple projection reconstruction techniques, and there are advantages and disadvantages to both autologous and allogeneic tissue grafts. Surgeons should choose the appropriate graft based on the actual condition of the patient.
Humans
;
Adipose Tissue
;
Autografts
;
Costal Cartilage
;
Nipples/surgery*
;
Transplants
4.Long-term effectiveness of uncemented allograft-prosthesis composite for reconstruction of bone defects after proximal femur tumor resection.
Yang WANG ; Minxun LU ; Yuqi ZHANG ; Xuanhong HE ; Zhuangzhuang LI ; Taojun GONG ; Yitian WANG ; Yong ZHOU ; Yi LUO ; Fan TANG ; Wenli ZHANG ; Hong DUAN ; Chongqi TU ; Li MIN
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(10):1190-1197
OBJECTIVE:
To investigate the long-term effectiveness of uncemented allograft-prosthesis composite (APC) for reconstruction of bone defects after proximal femur tumor resection.
METHODS:
Between June 2007 and March 2014, 21 patients who underwent uncemented APC reconstruction of proximal femur after tumor resection were retrospectively evaluated. There were 9 males and 12 females with an average age of 33.2 years (range, 19-54 years). There were 9 cases of giant cell tumor of bone, 5 cases of osteosarcoma, 4 cases of osteoblastic osteosarcoma, 2 cases of chondrosarcoma, and 1 case of undifferentiated pleomorphic sarcoma. Thirteen cases of benign bone tumors were all classified as stage 3 by Enneking staging; and 8 cases of malignant bone tumors were classified as grade ⅡB in 7 cases and grade ⅡA in 1 case according to the American Joint Committee on Cancer (AJCC) staging system. Among them, 7 patients underwent reoperation after recurrence, and the rest were primary operations; 8 patients presented with pathological fractures. The preoperative Harris hip score (HHS) and American Musculoskeletal Tumor Society (MSTS) score was 40 (30, 49) and 9.1±3.5, respectively. The length of osteotomy was 80-154 mm, with an average of 110 mm. At 1 year after operation and last follow-up, HHS and MSTS scores were utilized to evaluate the function of hip joint; the gluteus medius strength score was used to evaluation of the hip abduction function. Image examinations were taken at 1, 3, 6, 9, and 12 months after operation and every year thereafter to assess the union of allograft-host bone interfaces. Intra- and post-operative complications were also recorded.
RESULTS:
All patients were followed up 84-163 months (mean, 123.5 months). At 1 year after operation and last follow-up, the HHS and MSTS scores significantly improved when compared with the preoperative scores ( P<0.05). However, there was no significant difference in the HHS score, MSTS score, and gluteus medius strength score between the two time points after operation ( P>0.05). Image examination showed that all allograft-host bone interfaces achieved union after 5-10 months (mean, 7.6 months). At last follow-up, all patients had bone resorption, including 11 severe cases, 4 moderate cases, and 6 mild cases; the bone resorption sites included Gruen 1, 2, and 7 regions. Complications included 10 fractures and 1 prosthetic fracture. Local recurrence occurred in 3 patients and pulmonary metastasis in 3 patients.
CONCLUSION
Uncemented APC is a reliable method for the reconstruction of bone defects after proximal femur tumor resection. It has the good long-term effectiveness and possesses obvious advantages in the union at the bone-bone surface.
Adult
;
Female
;
Humans
;
Male
;
Allografts/pathology*
;
Bone Neoplasms/surgery*
;
Bone Resorption/pathology*
;
Bone Transplantation/methods*
;
Femur/surgery*
;
Osteosarcoma/pathology*
;
Prostheses and Implants
;
Retrospective Studies
;
Treatment Outcome
;
Young Adult
;
Middle Aged
5.Establishment of Patient-Derived Xenograft (PDX) Zebrafish Model of Multiple Myeloma and Its Application in Drug Screening.
Zhen YU ; Ying LI ; Ke-Fei WANG ; Lu WANG ; Mu HAO
Journal of Experimental Hematology 2023;31(6):1745-1749
OBJECTIVE:
To establish a MM patient-derived tumor xenograft model (MM-PDX) in zebrafish, and to evaluate the anti-myeloma activity of indirubin-3'-monoxime(I3MO) using this model.
METHODS:
Zebrafish embryos 2 days after fertilization were transplanted with fluorescence labeled myeloma primary tumor cells, the survival of primary tumor cells in zebrafish was observed at 0,16 and 24 hours after cell injection. The zebrafish embryos after tumor cell transplantation were randomly divided into control group, BTZ treatment and I3MO treatment group. Before and 24 hours after treatment with BTZ and I3MO, the positive area with calcein or Dil in zebrafish were observed under fluorescence microscope to reflect the survival of tumor cells, and it was verified.
RESULTS:
MM patient derived tumor cells survived in zebrafish. The construction of MM-PDX was successful. Compared with control group, the fluo- rescence area of the BTZ and I3MO treatment groups in zebrafish were significantly decreased(P<0.05), and BTZ and I3MO significantly inhibited the survival of MM cells in zebrafish.
CONCLUSION
MM-PDX model was successfully established. Zebrafish model derived from tumor cells of MM patients can be used as a tool for drug screening of MM.
Animals
;
Humans
;
Bortezomib/therapeutic use*
;
Cell Line, Tumor
;
Disease Models, Animal
;
Drug Evaluation, Preclinical
;
Heterografts
;
Multiple Myeloma/pathology*
;
Xenograft Model Antitumor Assays
;
Zebrafish
6.Treatment of four-part proximal humerus fractures with depressed humeral head collapse using strut allograft with locking plates.
Lie LIU ; Feng YANG ; Cheng-Cheng ZONG ; Jing CHEN
China Journal of Orthopaedics and Traumatology 2023;36(2):116-119
OBJECTIVE:
To evaluate the clinical outcomes of allogeneic femoral head as strut allograft combined with proximal humeral internal locking system (PHILOS) in the treatment of proximal humeral Neer grade Ⅳ fracture with humeral head collapse.
METHODS:
From January 2018 to November 2020, 18 patients with Neer grade Ⅳ fracture with humeral head collapse were treated with strut allograft with PHILOS, including 4 males and 14 females, aged from 55 to 78 years old, with an average of (68.11±7.20) years old. The operation time, intraoperative bleeding, postoperative drainage volume, fracture healing time, neck-shaft angle and the height of the humeral head, failure of internal fixation the shoulder function at the last follow-up was assessed using Neer's scoring system.
RESULTS:
All 18 patients were followed up, and the duration ranged from 10 to 12 months, with an average of (11.08±0.65) months. The operation time was (66.44±5.06) min, the intraoperative bleeding volume was (206.67±36.14) ml, the postoperative drainage volume was (76.11±9.63) ml, and the fracture healing time was (17.28±3.92) weeks. At the last follow-up, the degree of loss of neck-shaft angle was (5.44±0.86) ° and the loss of the height of humeral head was (1.43±0.27) mm. All 18 patients had healing without complications such as fracture, withdrawal, penetration of internal fixation and necrosis of humeral head. According to Neer's evaluation standard, the total score was (89.61±5.60), 10 cases got an excellent result, 6 good, 2 fair.
CONCLUSION
Allogeneic femoral head combined with PHILOS is an appropriate treatment for the four-part proximal humerus fractures with humeral head collapse, exhibiting good clinic outcome.
Male
;
Female
;
Humans
;
Middle Aged
;
Aged
;
Humeral Head
;
Shoulder
;
Treatment Outcome
;
Bone Plates
;
Retrospective Studies
;
Humerus
;
Shoulder Fractures/surgery*
;
Fracture Fixation, Internal/adverse effects*
;
Humeral Fractures
;
Allografts
7.A biomimetic nanoplatform for customized photothermal therapy of HNSCC evaluated on patient-derived xenograft models.
Qi WU ; Lan CHEN ; Xiaojuan HUANG ; Jiayi LIN ; Jiamin GAO ; Guizhu YANG ; Yaping WU ; Chong WANG ; Xindan KANG ; Yanli YAO ; Yujue WANG ; Mengzhu XUE ; Xin LUAN ; Xin CHEN ; Zhiyuan ZHANG ; Shuyang SUN
International Journal of Oral Science 2023;15(1):9-9
Cancer cell membrane (CCM) derived nanotechnology functionalizes nanoparticles (NPs) to recognize homologous cells, exhibiting translational potential in accurate tumor therapy. However, these nanoplatforms are majorly generated from fixed cell lines and are typically evaluated in cell line-derived subcutaneous-xenografts (CDX), ignoring the tumor heterogeneity and differentiation from inter- and intra- individuals and microenvironments between heterotopic- and orthotopic-tumors, limiting the therapeutic efficiency of such nanoplatforms. Herein, various biomimetic nanoplatforms (CCM-modified gold@Carbon, i.e., Au@C-CCM) were fabricated by coating CCMs of head and neck squamous cell carcinoma (HNSCC) cell lines and patient-derived cells on the surface of Au@C NP. The generated Au@C-CCMs were evaluated on corresponding CDX, tongue orthotopic xenograft (TOX), immune-competent primary and distant tumor models, and patient-derived xenograft (PDX) models. The Au@C-CCM generates a photothermal conversion efficiency up to 44.2% for primary HNSCC therapy and induced immunotherapy to inhibit metastasis via photothermal therapy-induced immunogenic cell death. The homologous CCM endowed the nanoplatforms with optimal targeting properties for the highest therapeutic efficiency, far above those with mismatched CCMs, resulting in distinct tumor ablation and tumor growth inhibition in all four models. This work reinforces the feasibility of biomimetic NPs combining modular designed CMs and functional cores for customized treatment of HNSCC, can be further extended to other malignant tumors therapy.
Animals
;
Humans
;
Squamous Cell Carcinoma of Head and Neck/therapy*
;
Heterografts
;
Photothermal Therapy
;
Biomimetics
;
Disease Models, Animal
;
Head and Neck Neoplasms/therapy*
;
Cell Line, Tumor
;
Tumor Microenvironment
8.PPAR-γ activation promotes xenogenic bioroot regeneration by attenuating the xenograft induced-oxidative stress.
Tingting LAN ; Fei BI ; Yuchan XU ; Xiaoli YIN ; Jie CHEN ; Xue HAN ; Weihua GUO
International Journal of Oral Science 2023;15(1):10-10
Xenogenic organ transplantation has been considered the most promising strategy in providing possible substitutes with the physiological function of the failing organs as well as solving the problem of insufficient donor sources. However, the xenograft, suffered from immune rejection and ischemia-reperfusion injury (IRI), causes massive reactive oxygen species (ROS) expression and the subsequent cell apoptosis, leading to the xenograft failure. Our previous study found a positive role of PPAR-γ in anti-inflammation through its immunomodulation effects, which inspires us to apply PPAR-γ agonist rosiglitazone (RSG) to address survival issue of xenograft with the potential to eliminate the excessive ROS. In this study, xenogenic bioroot was constructed by wrapping the dental follicle cells (DFC) with porcine extracellular matrix (pECM). The hydrogen peroxide (H2O2)-induced DFC was pretreated with RSG to observe its protection on the damaged biological function. Immunoflourescence staining and transmission electron microscope were used to detect the intracellular ROS level. SD rat orthotopic transplantation model and superoxide dismutase 1 (SOD1) knockout mice subcutaneous transplantation model were applied to explore the regenerative outcome of the xenograft. It showed that RSG pretreatment significantly reduced the adverse effects of H2O2 on DFC with decreased intracellular ROS expression and alleviated mitochondrial damage. In vivo results confirmed RSG administration substantially enhanced the host's antioxidant capacity with reduced osteoclasts formation and increased periodontal ligament-like tissue regeneration efficiency, maximumly maintaining the xenograft function. We considered that RSG preconditioning could preserve the biological properties of the transplanted stem cells under oxidative stress (OS) microenvironment and promote organ regeneration by attenuating the inflammatory reaction and OS injury.
Mice
;
Humans
;
Rats
;
Animals
;
Swine
;
PPAR gamma/pharmacology*
;
Reactive Oxygen Species/pharmacology*
;
Heterografts
;
Hydrogen Peroxide/pharmacology*
;
Rats, Sprague-Dawley
;
Rosiglitazone/pharmacology*
;
Oxidative Stress
9.Establishment of a Patient-Derived T-Cell Acute Lymphoblastic Leukemia Xenograft Model in Novel Immunodeficient NCG Mice.
Peng-Jun JIANG ; Xing-Bin DAI ; Xiang-Tu KONG ; Zu-Qiong XU ; Hui YU ; Jie PANG ; Wen XIA ; Ju-Hua YU ; Guang-Rong ZHU ; Fang TIAN ; Xue-Jun ZHU
Journal of Experimental Hematology 2023;31(2):311-318
OBJECTIVE:
The leukemia cells from patients with T-cell acute lymphoblastic leukemia (T-ALL) were inoculated into NCG mice to establish a stable human T-ALL leukemia animal model.
METHODS:
Leukemia cells from bone marrow of newly diagnosed T-ALL patients were isolated, and the leukemia cells were inoculated into NCG mice via tail vein. The proportion of hCD45 positive cells in peripheral blood of the mice was detected regularly by flow cytometry, and the infiltration of leukemia cells in bone marrow, liver, spleen and other organs of the mice was detected by pathology and immunohistochemistry. After the first generation mice model was successfully established, the spleen cells from the first generation mice were inoculated into the second generation mice, and after the second generation mice model was successfully established, the spleen cells from the second generation mice were further inoculated into the third generation mice, and the growth of leukemia cells in peripheral blood of the mice in each group was monitored by regular flow cytometry to evaluate the stability of this T-ALL leukemia animal model.
RESULTS:
On the 10th day after inoculation, hCD45+ leukemia cells could be successfully detected in the peripheral blood of the first generation mice, and the proportion of these cells was gradually increased. On average, the mice appeared listless 6 or 7 weeks after inoculation, and a large number of T lymphocyte leukemia cells were found in the peripheral blood and bone marrow smear of the mice. The spleen of the mice was obviously enlarged, and immunohistochemical examination showed that hCD3+ leukemia cells infiltrated into bone marrow, liver and spleen extensively. The second and third generation mice could stably develop leukemia, and the average survival time was 4-5 weeks.
CONCLUSION
Inoculating leukemia cells from bone marrow of patients with T-ALL into NCG mice via tail vein can successfully construct a patient-derived tumor xenografts (PDTX) model.
Humans
;
Animals
;
Mice
;
Precursor T-Cell Lymphoblastic Leukemia-Lymphoma
;
Heterografts
;
Bone Marrow
;
Disease Models, Animal
;
T-Lymphocytes
;
Mice, SCID
10.Information Construction of Hospital Medical Consumables Management Based on SPD Mode.
Chinese Journal of Medical Instrumentation 2023;47(3):337-340
To change the traditional hospital medical supplies rough management mode, the hospitals build an information material management platform which combines suppliers and hospitals, information systems and smart devices, clinical needs and professional operations innovatively. Finally, a lean management system called SPD is formed under the guidance of supply chain integration and supported by supply chain management theory and information technology. It has realized the whole process of consumables circulation information traceability, intelligent service in the hospital, and refined management of consumption settlement. The application of SPD in hospitals effectively improves the informatization level and overall operation efficiency of medical consumables management which is an important part of hospital information construction.
Hospital Administration
;
Hospitals
;
Allografts


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