1.Application of tunneled subcutaneous pedicle flaps in repair of nasal alar defects
Na YAN ; Lijuan YANG ; Chan ZHAO ; Yan LIU ; Weihui ZENG ; Songmei GENG ; Xuanfeng TAN
Chinese Journal of Dermatology 2022;55(2):161-163
Objective:To investigate clinical efficacy of tunneled subcutaneous pedicle flaps in the repair of ipsilateral nasal alar defects.Methods:A total of 20 patients with nasal alar defects after excision of basal cell carcinoma, which were repaired with ipsilateral tunneled subcutaneous pedicle flaps, were retrospectively collected from January 2018 to January 2020. There were 11 male patients and 9 female patients, with an average age of 60.6 years (range, 48 - 76 years) . According to clinical manifestations, the basal cell carcinoma lesions could be classified into 3 types: nodular-ulcerative type (13 cases) , superficial type (4 cases) and pigmented type (3 cases) , and the skin lesions varied from 0.4 cm × 0.5 cm to 0.9 cm × 1.1 cm in size. All the patients received extended surgical resection of basal cell carcinoma, and nasal alar defects were repaired with tunneled subcutaneous pedicle flaps, with the size of flaps ranging from 0.7 cm × 0.8 cm to 1.2 cm × 1.4 cm.Results:All flaps survived successfully, the nasal alar defects were completely repaired, and all wounds healed primarily. During the postoperative follow-up of 6 - 24 months, neither recurrence of tumors nor obvious scar hyperplasia occurred on the nasal ala, and nasal morphology and appearance were favorable.Conclusion:The tunneled subcutaneous pedicle flap can be used for the repair of ipsilateral nasal alar defects following excision of tumors or other lesions, resulting in favorable therapeutic outcomes and aesthetic appearance.
3.The clinical application of DWI signal intensity at different b values and ADC value in diagnosis of prostatic cancer
Weihui XIE ; Guojin XIA ; Honghan GONG ; Jian JIANG ; Xianjun ZENG
Journal of Practical Radiology 2019;35(6):981-984,1018
Objective To explore the value of DWI and ADC in differential diagnosis of benign prostatic hyperplasia (BPH)and prostatic cancer(PCa).Methods The data of 43 patients with BPH or PCa proven by histopathology were retrospectively reviewed. There were 21 patients with PCa and 22 patients with BPH.All of the patients were examined by DWI at 1.5T MRI.On the DWI,signal intensities in ROI were measured at the b value of 800 s/mm2 and 1 600 s/mm2 ,respectively.On the ADC map,ADC values in ROI were measured.The differences of the ADC values and the signal intensities of DWI were compared between the benign BPH and the PCa by using independent sample tGtest.Diagnostic efficiency of the signal intensity and the ADC value for PCa were analyzed by using ROC curve.Results There were statistically significant differences of the ADC values and the signal intensities of DWI at the b value of 800 s/mm2 and 1 600 s/mm2 between the BPH and the PCa (P<0.05).The ADC at the b value of 1 600 s/mm2 had the highest diagnostic efficiency,the DWI at the b value of 1 600 s/mm2 took a second place,and the DWI at the b value of 800 s/mm2 was worst.Conclusion DWI and ADC are helpful for the diagnosis of PCa,and ADC at b value of 600 s/mm2 has the highest diagnostic efficiency.
4. Changes of hemorheology and blood lipid index in patients with occupational hand-arm vibration disease
Cong LI ; Qifeng WU ; Xiaofeng DENG ; Zifang ZENG ; Bin LI ; Weihui LIANG ; Aichu YANG
China Occupational Medicine 2019;46(05):559-563
OBJECTIVE: To investigate the changes of hemorheology and blood lipid index in patients with occupational hand-arm vibration disease(OHAVD). METHODS: A total of 78 patients with OHAVD were selected as the OHAVD group, and 78 workers without hand transmitted vibration exposure were selected as control group by judgment sampling method. The hemorrheology and blood lipid indexes of the two groups were detected. RESULTS: The whole blood viscosities(low-, medium-and high-shear), hematocrit, erythrocyte aggregation index, and abnormal rate of whole blood viscosities(mid-and high-shear) in the OHAVD group were higher in the OHAVD group than that in the control group(P<0.05). The erythrocyte deformability index and erythrocyte electrophoresis index were lower in the OHAVD group than that of the control group(P<0.05). In the vibration-induced white finger(VWF) subgroup of the OHAVD group, the whole blood viscosity(low-, medium-and high-shear), hematocrit were increased(P<0.05), and the abnormal rate of whole blood viscosity(high-shear) was higher(P<0.017) than that of the control group.The whole blood viscosity(medium shear), hematocrit and erythrocyte aggregation index were increased in the non-VWF subgroup than that of the control group(P<0.017). The concentration of low density lipoprotein cholesterol in the OHAVD group and non-VWF subgroup was higher than that in the control group(P<0.05). The whole blood viscosity(low-, medium-and high-shear), hematocrit, erythrocyte deformability index, erythrocyte aggregation index and erythrocyte electrophoresis index were not correlated with the length of service and age in the OHAVD group(P>0.05). CONCLUSION: The changes of hemorheological properties and blood lipids in OHAVD patients may be associated with vibration vascular injury.
5. Diagnosis of new occupational lung tumor in Guangdong Province
Qianling ZHENG ; Lihua XIA ; Shijie HU ; Jiabin CHEN ; Ming HUA ; Weihui LIANG ; Jianzhong CHEN ; Feifei ZENG ; Xiaoyi LI ; Lijun YE
China Occupational Medicine 2019;46(06):678-683
OBJECTIVE: To summarize and analyze the diagnostic ideas of new occupational lung tumors in Guangdong Province.METHODS: According to the Law of the People′s Republic of China on the Prevention and Control of Occupational Disease and the GBZ 94-2002 Diagnostic Criteria of Occupational Cancer, the key diagnostic points of 6 new occupational lung tumors diagnosed in Guangdong Province from 2010 to 2011 were analyzed. RESULTS: There were 9 cases of 6 new kinds of new occupational tumors were diagnosed in Guangdong Province in 2010-2011. The cases included 3 occupational lung cancer of coke oven workers, 2 occupational lung cancer caused by asbestos, 1 occupational mesothelioma caused by asbestos, 1 occupational lung cancer caused by arsenate, 1 occupational lung cancer caused by chromate salt, and 1 occupational lung cancer caused by asphalt. During the process, the diagnosis was based on the principles of the comprehensive analysis and the attribution diagnosis, combined with occupational history, occupational disease hazard exposure history, clinical data and auxiliary examination results. If the patients were diagnosed with a primary tumor, the patients′ exposure history to occupational carcinogens should be tracked, traced and confirmed, and the diagnosis should be confirmed by referring to the list of occupational carcinogens and literature reports of the International Labor Organization, and not limited to only the personnel in a particular industry. CONCLUSION: During the diagnostic process of occupational tumors, attention should be paid to confirm the exposure history of occupational carcinogen. The key is to determine the exposure of corresponding occupational carcinogen, the route and the time of exposure and the incubation period.
6.Efficacy of non-ablative fractional laser at different energy and density in the early treatment of hyperplastic scars in a rabbit ear model: a clinical observation
Yaqi FAN ; Birong GUO ; Weihui ZENG ; Yale LIU
Chinese Journal of Dermatology 2018;51(10):752-755
Objective To preliminarily optimize the energy and density of laser radiation for the early treatment of hyperplastic scars in a rabbit ear model,and to explore possible therapeutic mechanisms.Methods Sixty-one hyperplastic scars were successfully established on the ears of 10 healthy New Zealand white rabbits with large ears,and randomly divided into 2 groups:1-week group (30 scars) and 3-week group (31 scars).These 2 groups were separately divided into 5 subgroups:group A treated with laser at a density of 100 PPA and an energy of 10 mJ,group B with laser at a density of 100 PPA and an energy of 50 mJ,group C with laser at a density of 169 PPA and an energy of 10 mJ,group D with laser at a density of 169 PPA and an energy of 50 mJ,and group E receiving no treatment.There were 6 scars in each group,except the group E in the 3-week group.Two healthy New Zealand white rabbits with large ears were not subjected to modeling,and served as group F (blank control group).Immunohistochemical study was performed to determine the expression of matrix metalloproteinase (MMP)-13 in the skin tissues from the rabbit ears 1 week after the treatment.Three weeks after the treatment,the skin tissues from the rabbit ears were subjected to hematoxylin-eosin (HE) staining and Masson staining.Then,the structure of scars was observed,and scar elevation index was calculated.Statistical analysis was carried out by Kruskal-Wallis H test for the comparison of scar elevation index,and by one-way analysis of variance (ANOVA) for the comparison of the average absorbance value of MMP-13.Results As HE staining revealed,the groups A,B,C and D all showed thicker dermis and increased number of collagen fibers compared with the group F (normal skin tissues),but showed thinner dermis,decreased number and more ordered arrangement of collagen fibers compared with the group E (untreated scar tissues).No obvious difference was observed in the thickness of the dermis among the groups A,B,C and D.The scar elevation index significantly differed among the 6 groups (H =22.757,P < 0.05).Multiple comparisons showed that the scar elevation index was significantly lower in the groups B,C and D (2.597 ± 0.344,2.850 ± 0.282,2.658 ± 0.134,respectively)than in the group E (3.460 ± 0.583,all P < 0.05).As Masson staining revealed,the groups A,B,C and D all showed thinner dermis and more irregular arrangement of collagen fibers compared with the group E.However,no obvious differences were observed in the dermal thickness or number of collagen fibers among the groups A,B,C and D.Immunohistochemical study showed that the expression of MMP-13 was significantly higher in the high-energy (50 mJ) laser groups than in the low-energy (10 mJ) laser groups (P < 0.05) at the same laser density.With the same laser energy,the expression of MMP-13 was significantly higher in the group A than in the group C (P < 0.01),but there was no significant difference between the group B and D (P > 0.05).Conclusions Non-ablative fractional laser is effective for the treatment of early-stage hyperplastic scars.At the same laser density,50-mJ laser was superior to 10-mJ laser for the treatment of hyperplastic scars,likely because high-energy laser can stimulate the recombination of extracellular matrices and up-regulated MMP-13 expression to a greater extent.
7. Intervening effect of bone marrow-derived mesenchymal stem cells for silica-induced pulmonary fibrosis in rats
Yingxun ZHANG ; Ming HUANG ; Fengrong LU ; Ying CHENG ; Jianzhong CHEN ; Weihui LIANG ; Lihua XIA ; Xiaojing ZENG ; Hanlin HUANG
China Occupational Medicine 2017;44(02):121-126
OBJECTIVE: To explore the intervening effects of bone marrow-derived mesenchymal stem cells(BMMSCs) for pulmonary fibrosis of rats exposed to silica dust at different stages. METHODS: Specific pathogen free SD rats were randomly divided into model group,2-week group,4-week group and control group with 6 rats in each group(half males and half females). Rats of the first three groups were one-time endotracheally injected with 0. 5 mL aseptic silica suspension at 30 g/L mass concentration. Rats of control group were injected with 0. 5 mL 0. 90% sodium chloride solution. Rats of 2-week group and 4-week group were injected with 0. 5 mL BMMSCs suspension with cell density was 5 × 10~9/L at 2 weeks and 4 weeks respectively after silica dust exposure,while model group and control group were injected with aseptic 0. 90% sodium chloride solution in the same volume. After that all rats were examined by lung computed tomography(CT) scan,pathological sections were observed,lung coefficient were measured,lung tissue hydroxyproline(HYP) content and serum transforming growth factor β1(TGF-β1) concentration were investigated at the 12 th week after silica dust exposure. RESULTS: Lung CT image showed clean lung field and clear pulmonary parenchyma in control group.Multiple and diffused high density granular shadows of different size and streak/reticular fiber shadows in model group;diffused distribution of very small granular shadows in 2-week group; granular shadows and local reticular fiber shadows in 4-week group,and either the size or the area of granular shadows was smaller than model group. The lung CT value,lung coefficient,lung tissue HYP content and serum TGF-β1 concentration of model group,2-week group and 4-week group were higher than those of control group(P < 0. 05). The lung CT value,lung tissue HYP content and serum TGF-β1 concentration of control group,2-week group,4-week group and model group were elevated in turn(P < 0. 05),while the lung coefficient of model group and 4-week group was higher than that of 2-week group respectively(P < 0. 05).CONCLUSION: BMMSCs could delay pulmonary fibrosis caused by silica dust,and the protective effect is better at early stage than later stage of fibrosis.
8. Comparative analysis on inter-laboratory detection of free silica indust in Guangdong Province,2012-2015
Yi SUN ; Junyi HUANG ; Aihua ZHANG ; Banghua WU ; Zhengnong HUANG ; Weihui WANG ; Xiaozhong YANG ; Feifei ZENG
China Occupational Medicine 2017;44(02):207-210
OBJECTIVE: To evaluate the technical level and ability of the detection of free silica in dust in occupational health technical service institutions of Guangdong Province through inter-laboratory comparison. METHODS: The interlaboratory detection of free silica in dust in 55,61,58 and 66 occupational health technical service institutions were carried out and compared in 2012-2015. The results were statistically analyzed by four points robust statistical technique,and the relative deviation between the laboratory test results and the Median of them was used as the auxiliary evaluation index of the laboratory's technical ability. RESULTS: The stable coefficient of variation(CV) of samples with free silica content > 20. 00% was less than 5. 00%,and the stable CV of samples with free silica content ≤20. 00% was more than5. 00%. The qualified rate in 2012-2015 were 89. 09%,81. 97%,77. 59% and 81. 82%,respectively. There was no statistical difference(P > 0. 05) in the annual reference between private and non-private institutions compared to the qualified rate in 2012-2015. There was no statistical difference(P > 0. 05) in the qualified rate of the institutions in the Pearl River Delta region and in the non-triangular regions of the Pearl River Delta in 2012-2015. CONCLUSION: Comparison of the detection technology service ability in the detection of free silica in dust should be conducted to improve its technical service quality.
9. Clinical pathway on occupational medicamentosa-like dermatitis due to trichloroethylene
Qifeng WU ; Lihua XIA ; Zifang ZENG ; Weihui LIANG ; Bin LI ; Yongshun HUANG ; Cong LI ; Hanlin HUANG
China Occupational Medicine 2017;44(04):420-429
OBJECTIVE: To establish the clinical pathway of occupational medicamentosa-like dermatitis due to trichloroethylene(OMDT).METHODS: OMDT was selected as the clinical disease category.The diagnosis and treatment schemes of OMDT were determined and the clinical pathway was developed on the basis of evidence-based medicine,clinical data analysis,and the expert opinion as well as GBZ 185—2006 Diagnostic Criteria of Occupational Medicamentosa-like Dermatitis due to Trichloroethylene.The initial clinical validation was performed.RESULTS: We formulated the clinical pathway of OMDT for medical staffs,including standard hospitalization procedures(including normative use of glucocorticoids),Clinical Path Form,and Informed Consent for Glucocorticoid Therapy.The Clinical Pathway Notification of OMDT for patients or their family members was established.Based on the initial clinical verifications,the clinical pathway was conducive to optimize the medical process,none of the patients suffered from rebounds and complications,and the awareness of OMDT and satisfaction with treatments were improved.CONCLUSION: The clinical pathway for OMDT is scientific and reasonable,which is suitable for use to regulate medical behaviors.
10.Melkersson-Rosenthal Syndrome with Genitalia Involved in a 12-Year-Old Boy.
Zhaowei CHU ; Yanting LIU ; Huan ZHANG ; Weihui ZENG ; Songmei GENG
Annals of Dermatology 2016;28(2):232-236
Melkersson-Rosenthal syndrome (MRS) is an uncommon granulomatous disease characterized by the triad of relapsing facial paralysis, orofacial swelling, and fissured tongue. Genital swelling in MRS is rarely reported. We presented the first case of complete MRS with genital swelling in a child. Biopsy examinations of both the child's lower lip and penis showed noncaseating granuloma and intralymphatic granuloma infiltration. No symptoms or signs of other systemic disease (Crohn's disease or sarcoidosis) were observed after 2 years of follow-up. Genetic screening for CARD15/NOD2 in this patient showed negative, which further confirmed the diagnosis of MRS. Eleven other cases of suspected complete or incomplete MRS with genitalia involved were reviewed. Our case emphasizes the specific clinical feature of MRS with genitalia involved, which was genetically different from Crohn's disease and could be an independent entity. Lymphatic obstruction is responsible for localized edema in MRS.
Biopsy
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Child*
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Crohn Disease
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Diagnosis
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Edema
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Facial Paralysis
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Follow-Up Studies
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Genetic Testing
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Genitalia*
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Granuloma
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Humans
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Lip
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Lymphatic Vessels
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Male*
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Melkersson-Rosenthal Syndrome*
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Penis
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Tongue, Fissured

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