Establishment and evaluation of an artificial intelligence model for the diagnosis of facial vitiligo / 中华皮肤科杂志

Objective:To construct an artificial intelligence model for the diagnosis of facial vitiligo, so as to realize artificial intelligence-assisted diagnosis of facial vitiligo.Methods:Based on digital single-lens reflex (SLR) camera images of vitiligo skin lesions and YOLO (You Only Look Once) v3 algorithm, a skin lesion detection model Vit3 was established, and its performance was evaluated by comparing its detection results and labeling results of dermatologists. On the basis of the Vit3 model, both optical and ultraviolet images of vitiligo and non-vitiligo skin lesions were taken by using an artificial intelligence-based facial skin image collector, and the gray values of vitiligo and non-vitiligo skin lesion areas on the ultraviolet images were measured by using an image processing technique. According to the gray-value threshold between vitiligo and non-vitiligo skin lesions, a facial vitiligo diagnosis model Vit4 was established. Cochran′s Q test was used to compare the diagnostic results of the Vit4 model and dermatologists, and the diagnostic performance of the Vit4 model was evaluated. Results:For 100 SLR camera images of vitiligo skin lesions (167 lesional sites) and 100 SLR camera images of normal skin, the diagnostic sensitivity of the Vit3 model was 92.81% (155/167) . For 97 pairs of facial skin images (including 50 vitiligo lesions, 30 pityriasis alba lesions, 7 amelanotic nevus leisons, and 10 normal skin tissues) , the diagnostic accuracy rate, sensitivity and specificity of the Vit4 model were 88.66% (86/97) , 88.00% (44/50) and 89.36% (42/47) respectively, and there was no significant difference in the diagnostic accuracy rate between the Vit4 model and dermatologists (92.78%[90/97], χ2=2.323, P > 0.05) . Conclusion:The artificial intelligence model Vit4 was established for the diagnosis of facial vitiligo with favorable diagnostic performance, and could serve as an objective and convenient method for the auxiliary diagnosis of facial vitiligo.

Safety and efficacy of picosecond Alexandrite laser with a diffractive lens array for treatment of facial photoaging / 中华医学美学美容杂志

Objective To evaluate the efficacy and safety of a 755 nm picosecond Alexandrite la-ser with a diffractive lens array in the treatment of facial photoaged skin .Methods Twenty-six pa-tients with facial photoaging were recruited and received 3 treatments at 4-week intervals .Laser energy was applied over the entire face at a fixed spot size of 6 mm ,with a fluence of 0 .71 J/cm2 and 5Hz . Blinded clinical assessment was performed by 2 independent dermatologists on a 5-point global pho-toaging scale (GPS) .Patients were also questioned on the extent of improvement of rhytides ,skin tightening ,and complexion with a 4-point global aesthetic improvement scale (GAIS) and satisfaction . Adverse events were also evaluated .Results Twenty-six patients completed the treatment .Compared with the baseline ,there was a significant improvement in facial photoaged skin after 3 treatments ,and these positive outcomes were maintained up to the 3-month follow-up ,according to the GPS and GAIS scores .Moderate pain and transient erythema were observed as the two main discomforts associated with the treatment .Most patients were satisfied with the treatment .Conclusions This 755 nm pico-second Alexandrite laser with a diffractive lens array optic is effective in the treatment offacial pho -toaged skin ,and the therapy also seems safe and well tolerated .

Analysis of clinical characteristics of subjective tinnitus in patients with perimenopausal syndrome / 中国耳鼻咽喉头颈外科

OBJECTIVE To observe and analyze the characteristics of tinnitus in perimenopausal women. METHODS To do sleep quality assessment, pure-tone test, tinnitus frequency and loudness match, tinnitus questionnaire investigation and FSH testfor 248 subjective tinnitus women with perimenopausal syndrome. RESULTS There was more single tinnitus than double tinnitus, the difference was statistically significant (P＜0. 05); The incidence of tinnitus on left and right ears was basically the same, the difference was not statistically significant;High frequency tinnitus accounted for 62. 73％, medium frequency was 2. 80％, low frequency was 34. 47％; There was no significant correlation between the frequency of tinnitus and hearing loss, There was no significant correlation between loudness and severity of tinnitus; Tinnitus THI loudness rating is mainly grade 2 and 3, accounting for 72. 18％, followed by gradel and grade 4, accounting for 24. 60％, grade 5 is very few, only 3. 22％; There was significant correlation between the FSH and severity of tinnitus, but there was no significant correlation between the FSH and loudness of tinnitus. The incidence of sleep disorders was 58. 06％. With the degree of tinnitus increased, the incidence of sleep disorders increased, and the degree of tinnitus was positively correlated with the quality of sleep. CONCLUSION The characteristics, etiology and pathogenesis of tinnitus in perimenopausal women are different from that of tinnitus happened in auditory system, mainly relate to FSH level. Otologists should pay attention to differential diagnosis, comprehensive analysis and treatment.

New Fields of Clinical Application of Proton Pump Inhibitor / 胃肠病学

Proton pump inhibitor (PPI) is the first-line drug for treatment of abnormal secretion of gastric acid and acid related diseases,and is effective in the treatment of peptic ulcer,Helicobacter pylori (Hp) infection,upper gastrointestinal bleeding and gastroesophageal reflux disease (GERD).Recent studies have shown that PPI could be used in other clinical fields,such as tumor,pulmonary fibrosis,atrial fibrillation,tuberculosis infection and premature delivery,which provides new insights for the treatment of these diseases.This article reviewed the new fields of clinical application of PPL.

Adverse pregnancy outcomes among women with syphilis in Zhejiang province, 2013-2014 / 中华皮肤科杂志

Objective To investigate the incidence of adverse pregnancy outcomes among women with syphilis in Zhejiang province during 2013-2014,and to explore the influence of anti?syphilis treatment on pregnancy outcomes. Methods A retrospective study was carried out according to the Information Management System for preventing mother?to?child transmission(PMTCT)of syphilis in Zhejiang province during 2013-2014. The incidence of adverse pregnancy outcomes was compared between women with syphilis and general women without syphilis, between treated and untreated women with syphilis, as well as between women with syphilis receiving and not receiving standard anti?syphilis treatment. The effects of anti?syphilis treatment and standard anti?syphilis treatment on pregnancy outcomes were analyzed. Results Data were collected from 3 985 women with syphilis and their children. Of these women, 12 had a stillbirth, and 3 973 a live birth. Totally, 3 210(80.55%)women received anti?syphilis treatment, 967(30.12%, 967/3 210) women received substandard treatment, and 775(19.45%)did not receive anti?syphilis treatment. Of the 3 985 fetuses or neonates born to women with syphilis, 45(1.13%)had abnormal clinical symptoms/signs. The incidence rates of low birth weight and early neonatal death were 7.00%(279/3 985) and 1.13%(45/3 985) respectively in fetuses or neonates born to women with syphilis, both significantly higher than those in fetuses or neonates born to general women without syphilis (3.18%[26 092/819494] and 0.13%[1 029/819 494], respectively, both P < 0.01). Among 775 untreated women with syphilis, the incidence rates of premature birth, low birth weight, early neonatal death, congenital syphilis and abnormal neonatal symptoms/signs were 15.61%(121/775), 10.84%(84/775), 2.45%(19/775), 3.48%(27/775)and 2.84%(22/775)respectively, all significantly higher than those in 3 210 women receiving anti?syphilis therapy (8.26%, 6.07%, 0.81%, 0.81% and 1.03%,respectively, all P < 0.01). Besides, the 967 women receiving substandard anti?syphilis treatment showed higher incidence rates of premature birth, low birth weight, early neonatal death, congenital syphilis and abnormal neonatal symptoms/signs than the 2 243 women receiving standard treatment (10.44%vs. 7.31%, 8.17%vs. 5.17%, 1.55%vs. 0.49%, 1.65%vs. 0.45%, 1.96%vs. 0.62%, respectively, all P<0.01). Conclusions The incidence of adverse pregnancy outcomes is high among women with syphilis in Zhejiang province during 2013-2014. Untreated and inadequately treated maternal syphilis is strongly associated with adverse pregnancy outcomes.

The effect of syphilis treatment during pregnancy on serological test results in infants born to syphilis mothers / 中华传染病杂志

Objective To discuss the effect of syphilis treatment during pregnancy on serological test results in infants born to syphilis mothers.Methods Data of pregnant women with syphilis and their infants in Zhejiang Province between January 2013 and December 2014 were retrospectively analyzed and the effect of syphilis treatment during pregnancy on non-treponemal antigen serological test results in infants were compared.x2 test was used for positive rate of serological tests,incidence of congenital syphilis,and neonatal mortality in infants with syphilis,and rank sum test was used to compare the titers of rapid plasma reagin (RPR) test and tolulized red unheated serum teat (TRUST).Results A total of 3 953 infants were born to 3 901 mothers with syphilis.Of which 3 262 were tested,including 2 226 by RPR and 1 036 by TRUST.The rate of infants with positive RPR was significant lower in treated mothers (45.02％)compared with untreated mothers (55.04％;x2 =12.88,P＜0.01).The significant differences of titers of RPR or TRUST were observed among mothers with or without treatment (RPR:Z=-2.45,P=0.01;TRUST:Z=-2.65,P=0.01),different course of treatment (RPR:Z=-2.33,P=0.02;TRUST:Z=-2.60,P=0.01).Fifty-seven infants were diagnosed with congenital syphilis.The rate of congenital syphilis was 3.50％(27/772) born to untreated mothers,which was dramatically higher than treated mothers (0.96 ％,30/3 129,x2 =27.72,P＜ 0.01).Forty-two infants died.Neonatal mortality was also higher in the untreated group (2.59 ％,20/772) than the treated group (0.70％,22/3 129,x2 =20.72,P＜ 0.01).Conclusion Adequate treatment for women with syphilis during pregnancy could decrease serological tests of RPR and TRUST among new infants and improve the infants their outcomes.

Autophagy level of bone marrow mononuclear cells in patients with myelodysplastic syndromes / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the change of autophagy level of bone marrow mononuclear cells（BMMNCs）in patients with myelodysplastic syndromes（MDS）.</p><p><b>METHODS</b>Thirty- eight patients with MDS and 26 megaloblastic anemia patients were enrolled in this study. The autophagic vacuoles were observed by transmission electron microscopy （TEM） and the quantity of autophagic vacuoles was detected by monodansylcadaverine （MDC） staining. The LC3 protein positive cells were counted by immunofluorescence assays. The expression of Beclin 1, LC3A, mTOR mRNA were measured by real time PCR. The expression of Beclin 1 proteins were detected by Western blotting.</p><p><b>RESULTS</b>The autophgic vacuoles of double membrane that surrounds lysosomes appeared in MDS patients. The percentage of MDC positive cells was significantly higher in MDS patients［（9.75±2.63）%］than that of controls［（2.90± 0.89）%, P＜0.05）. The percentage of LC3 protein cells was also increased in MDS patients（6.13±1.03）% vs（1.5±0.58）%, P＜0.05）. The expression of Beclin 1 and LC3A mRNA in low-risk and intermediate-1 MDS were higher compared with controls （3.61 ± 3.02 vs 1.55 ± 1.03 and 6.56 ± 3.97 vs 1.21 ± 0.95 respectively, both P＜0.05）. The expression of mTOR mRNA was down- regulated in low- risk and intermediate-1 MDS compared with controls（0.39±0.37 vs 1.50±1.03, P＜0.05）. There were no significant difference in expression of Beclin 1, LC3 and mTOR mRNA among intermediate-2 and high-risk MDS and controls. Beclin 1 protein expression was higher in low- risk and intermediate- 1 MDS patients（1.257 ± 0.197）than that of controls（0.528±0.086）and inermediate-2 and high-risk MDS patients（0.622±0.118）.</p><p><b>CONCLUSION</b>The autophagy levels were increased in low- risk and intermediate- 1 MDS, while not enhanced in intermediate-2 MDS. Autophagy might be considered as a cell protective mechanism in MDS. The relatively defective autophagy in intermediate- 2 and high- risk MDS might contribute to disease's progression.</p>

Assessment of efficacy and safety of a bipolar fractionated radiofrequency device for the treatment of wrinkles of the face and neck / 中华皮肤科杂志

Objective To evaluate the clinical efficacy and safety of a fractional bipolar radiofrequency device for the treatment of wrinkles of the face and neck.Methods This study enrolled 39 volunteers (including 37 females and 2 males aged 35-60 years) with Fitzpatrick skin type Ⅳ-Ⅴ and Fitzpatrick wrinkle scale score of 4-6.All the subjects received three sessions of treatment with a fractional bipolar radiofrequency device at intervals of 4-6 weeks.Follow-up visits were scheduled at one month after each treatment session for evaluation of efficacy (using standardized photography),subjective satisfaction and adverse effects.Results After three sessions of treatment,all the subjects experienced a significant decrease in Fitzpatrick wrinkle scale compared with baseline values,and wrinkle improvement score increased with the increase in treatment sessions.The Fitzpatrick wrinkle scale score for forehead wrinkles,glabella wrinkles,fishtail lines and neck wrinkles in these subjects after three sessions of treatment significandy differed from that before treatment (all P ＜ 0.01).Significant differences were also observed in the wrinkle improvement score for forehead wrinkles between these subjects after two sessions and one session of treatment (P ＜ 0.01),and observed in that for glabella wrinkles,fishtail lines and neck wrinkles between these subjects after three sessions and one session of treatment (P ＜ 0.05 or 0.01).Side effects were mild with no significant downtime.Conclusion Fractional bipolar radiofrequency may be a safe and effective option for the treatment of wrinkles of the face and neck in individuals with Fitzpatrick skin type Ⅳ-Ⅴ.

CT imaging of coexisting pulmonary tuberculosis and lung cancer / 中华放射学杂志

Objective To study the CT characteristics of coexisting pulmonary tuberculosis and lung cancer.Methods One hundred and four patients of coexisting pulmonary tuberculosis and lung cancer proved by histology,cytology or clinical underwent CT examination.All patients were divided into two groups,group Ⅰ were the patients with the lung cancer after tuberculosis or both found simultaneously (group Ⅰ a with peripheral lung cancer and group Ⅰ b with central lung cancer),group Ⅱ with tuberculosis during lung cancer chemotherapy (group Ⅱ a with peripheral lung cancer and group Ⅱ b with central lung cancer).Imaging characteristics of tuberculosis and lung cancer were compared.x2 test and t test were used for the statistical analysis.Results Of 104 patients,there were 92 patients (88.5％) in group Ⅰ and 12 patients (11.5％)in group Ⅱ.Seventy patients (76.1％) of lung cancer and tuberculosis were located in the same lobe and 22 patients (23.9％) in the different lobes in group Ⅰ.There was no significant difference in distribution of tuberculosis between group Ⅰ and group Ⅱ (x2 =4.302,P =0.507).The fibrous stripes,nodules of calcification and pleural adhesion of tuberculosis were statistically significant between the two groups (x2 =22.737,15.193,27.792,P ＜0.05).There were 33 central lung cancers and 71 peripheral lung cancers.In group Ⅰ a (64 patients of peripheral lung cancers),39 patients (60.9％) had typical manifestations and most of the lesions were ≥ 3 cm(n =49,76.6％),solid lesions showed variable enhancement.Conclusions Secondary tuberculosis during lung cancer chemotherapy has the same CT characteristics with the common active tuberculosis.The morphology,enhancement pattern of lesion and follow-up are helpful for the diagnosis of lung cancer after tuberculosis.

Effects of methotrexate enantiomers on ECV304 cell inhibition and its mechanisms / 中国药理学通报

Aim To investigate the effect of MTX(included(±)MTX,(+)MTX and(-)MTX)on the proliferation of ECV304 cells and to explore its mechanisms.Methods ECV304 cells were cultured.The cell proliferation was determined by MTT.The morphological changes were inspected by inverted microscope.Cell cycle phases were assayed by propidium iodide staining flow cytometry.Results ECV304 cells were treated with(+)MTX,(-)MTX and(±)MTX at 1～150 μmol·L~(-1) for 24,48,72 h.The results showed that the proliferation of ECV304 cells was significantly inhibited under different conditions.The order of the inhibited efficacy was(+)MTX>(±)MTX>(-)MTX.The morphology of ECV304 cells were changed by(+)MTX,(-)MTX and(±)MTX treatment,which included the cell shrinkage,chromatin condensation.After administration of 10 μmol·L~(-1) of(+)MTX,(-)MTX and(±)MTX for 48 h,the cell cycle phases were assayed by propidium iodide staining flow cytometry.The result showed DNA replication was interfered by(+)MTX,(-)MTX and(±)MTX treatment.Conclusions The proliferation of ECV304 cells has the chiral selective effects by(+)MTX and(-)MTX treatment,and the inhibition on ECV304 cells proliferation of(+)MTX is significantly stronger than that of (-)MTX.