前臂后皮神经营养血管远端蒂筋膜皮瓣修复手部软组织缺损

目的：探讨前臂后皮神经营养血管远端蒂筋膜皮瓣修复手部软组织缺损的临床效果。方法：对18例手部创伤性软组织缺损创面采用带前臂后皮神经营养血管远端蒂筋膜皮瓣进行修复,其中机器绞伤11例,压砸伤5例,电锯伤2例,皮瓣面积最大为12cm×8cm,最小7cm×5cm。结果：17例皮瓣完全成活;1例皮瓣边缘部分坏死,经清创换药痊愈。术后随访6～12个月,皮瓣质地良好,外观满意。结论：前臂后皮神经营养血管远端蒂筋膜皮瓣切取简便、成功率高,是修复手部软组织缺损的理想供区。     

Immunohistochemical localization of acid-sensing ion channel 2 (ASIC2) in cutaneous Meissner and Pacinian corpuscles of Macaca fascicularis

Acid-sensing ion channel 2 (ASIC2) is a member of the degenerin/epithelial sodium channel superfamily, presumably involved mechanosensation. Expression of ASIC2 has been detected in mechanosensory neurons as well as in both axons and Schwann-like cells of cutaneous mechanoreceptors. In these studies we analysed expression of ASIC2 in the cutaneous sensory corpuscles of Macaca fascicularis using immunohistochemistry and laser confocal-scanner microscopy. ASIC2 immunoreactivity was detected in both Meissner and Pacinian corpuscles. It was found to co-localize with neuron-specific enolase and RT-97, but not with S100 protein, demonstrating that ASIC2 expression is restricted to axons supplying mechanoreceptors. These results demonstrate for the first time the presence of the protein ASIC2 in cutaneous rapidly adapting low-threshold mechanoreceptors of monkey, suggesting a role of this ion channel in touch sense.     

Disorders characterized by predominant or exclusive dermal inflammation

Some cutaneous inflammatory disorders are typified by a predominant or exclusive localization in the dermis. They can be further subdivided by the principal cell types into lymphocytic, neutrophilic, and eosinophilic infiltrates, and mixtures of them are also seen in a proportion of cases. This review considers such conditions. Included among the lymphoid lesions are viral exanthems, pigmented purpuras, gyrate erythemas, polymorphous light eruption, lupus tumidus, and cutaneous lymphoid hyperplasia. Neutrophilic infiltrates are represented by infections, Sweet syndrome, pyoderma gangrenosum, and hidradenitis suppurativa, as well as a group of so-called “autoinflammatory” dermatitides comprising polymorphonuclear leukocytes. Eosinophil-dominated lesions include arthropod bite reactions, cutaneous parasitic infestations, the urticarial phase of bullous pemphigoid, Wells syndrome (eosinophilic cellulitis), hypereosinophilic syndrome, and Churg-Strauss disease. In other conditions, eosinophils are admixed with neutrophils in the corium, with or without small-vessel vasculitis. Exemplary disorders with those patterns include drug eruptions, chronic idiopathic urticaria, urticarial vasculitis, granuloma faciale, and Schnitzler syndrome (chronic urticarial with a monoclonal gammopathy).     

人类疱疹病毒8型的K1基因亚型与鳞状细胞癌不同发病部位的相关性研究

目的 了解鳞癌组织中人类疱疹病毒8型(HHV-8)感染情况,探讨感染HHV-8 K1基因亚型与鳞癌发病部位的关系.方法 对40例皮肤鳞癌、40例食管鳞癌石蜡包埋组织进行HHV-8K1基因的DNA抽提、扩增、双向测序,使用Lagergene软件、CLUSTAL W软件和PHYLIP软件包对测序结果进行系统发生学分析,从而...     

骨间后神经卡压综合征的临床及神经电生理诊断

目的：探讨骨间后神经卡压综合征的临床和神经电生理特点。方法：回顾性分析2006年2月至2010年2月临床疑诊骨间后神经卡压综合征患者的资料,结合神经电生理检查确诊共23例,分析其临床和神经电生理诊断特点。结果：所有患者虽然临床发病过程、病情轻重有所不同,但23例肌电图都有异常：重点检查食指固有伸肌、伸指总肌及尺侧伸腕肌基本均有自发电位出现。18例（78％）运动传导反应异常;运动传导远端潜伏期、波幅、传导速度异常分别是16例（70％）、17例（74％）和12例（52％）;桡神经浅支感觉传导正常。结论：神经电生理检查是诊断骨间后神经卡压综合征的有效方法,对临床体征不明确、定位困难者,早期肌电图检查更为重要。     

以前臂内侧皮神经及营养血管为蒂筋膜皮瓣的应用解剖

目的:为带前臂内侧皮神经及其营养血管筋膜皮瓣提供形态学基础。方法:在32侧成人上肢标本上,观测前臂内侧皮神经营养血管及其周围皮肤的供血情况。结果:前臂内侧皮神经近侧的血供来源于尺侧返动脉混合肌皮支,起始处外径为0.8mm,穿出筋膜前长度为1.1cm;中段主要来自尺动脉近中段和远中段的粗大皮支,起始处外径均为0.7mm,穿出深筋膜前长度均为1.0cm;远侧有尺动脉腕上皮支,起始处外径为0.9mm,穿出深筋膜前长为2.6cm。其神经旁血管网与神经皮(穿)支及神经内血管广泛吻合组成了皮神经血管轴。结论:可设计成带前臂内侧皮神经及营养血管为蒂筋膜皮瓣,顺行或逆行转位修复邻近部位的软组织缺损。     

The classification and diagnosis of cutaneous lupus erythematosus

Lupus erythematosus (LE) is an inflammatory connective tissue disease of generalized autoimmunity characterized by pathogenic autoantibodies and immune complexes, attributed to loss of immune tolerance. Cutaneous involvement, which appears in the majority of patients with the disease, can present as LE-specific or LE-nonspecific manifestations. The LE-nonspecific manifestations include e.g. vascular skin changes and may be associated with systemic organ manifestations or other autoimmune diseases. In contrast, the LE-specific manifestations encompass the various subtypes of cutaneous lupus erythematosus (CLE), which are classified as separate entities without or with less severe systemic organ involvement. In the “Duesseldorf Classification”, CLE is subdivided into four different categories: acute CLE (ACLE), subacute CLE (SCLE), chronic CLE (CCLE), and intermittent CLE (ICLE). Differentiation between these subtypes is based on clinical features and average duration of the cutaneous lesions, but can also consider histological changes of skin biopsy specimens and laboratory abnormalities. In addition, direct immunofluorescence and photoprovocation may be applied to confirm the diagnosis in specific cases. Further investigations should be considered dependent on the clinical symptoms of the CLE patient and the results of the laboratory tests. A revised scoring system, the Cutaneous Lupus Erythematosus Disease Area and Severity Index (RCLASI) has recently been validated to assess disease activity and damage in CLE. In this review, we focus on the classification of CLE and the diagnostic procedures to identify and confirm the different subtypes of the disease.     

Improved detection of human papillomavirus harbored in healthy skin with FAP6085/64 primers

FAP59/64, FAP6085/6319, and CUT primer sets were designed for detecting cutaneous HPV and have been used in many clinical and epidemiology studies. The FAP6085/64 primer set was first evaluated in this study and the FAP6085/64 combination was found to be much more sensitive than all three original primer sets by using HPV plasmids as a template. To confirm further the effectiveness of the FAP6085/64 primer set in human DNA templates, 90 palmar exfoliated cell DNA samples were used to detect the cutaneous HPV by both the FAP59/64 and FAP6085/64 primer sets. The overall proportion of HPV detection in those skin samples was 77.8% (70/90) using FAP6085/64, as compared to 55.6% (50/90) using FAP59/64. The FAP6085/64 primer set was also applied in a population based study. The proportion of HPV detection was 73.96% (2076/2807) in skin samples collected from healthy individuals, and a total of 336 different PV types were found. Sixty (17.9%) of them were fully characterized HPV types, 127 (37.8%) were putative HPV types which had been described previously, 149 (44.3%) were novel putative HPV types, and two animal PVs were also detected. These results suggest that the FAP6085/64 primer set was sensitive and effective for detection of cutaneous HPV in healthy skin samples.