BACKGROUND:The use of dermatoscopes is constantly increasing globally, but to date, there are no studies on the use of dermatoscopes by Chinese dermatologists. OBJECTIVE:To determine factors influencing the use of dermatoscopes in China. METHODS:A web-based questionnaire was designed by the Department of Dermatology at Huashan Hospital affiliated with Fudan University and was published online via the Shanghai Wheat Color Intelligent Technology Company, China. In 2019 and 2022, 1581 and 1507 dermatologists, respectively, were recruited and completed the questionnaire online. RESULTS:In China, the application rate of dermatoscopy is higher in eastern provinces than in western and remote areas. The proportion of doctors from public tertiary hospitals is the highest, with females being the majority. The age range of 30-40 years has the highest proportion, the proportion of doctors with professional titles of attending physician or above is the highest, and the proportion of doctors with a bachelor's degree or above is the highest. CONCLUSIONS:By improving the education and professional standards of doctors, providing more training opportunities, simplifying access, and promoting dermatoscopy in grassroots hospitals, we can increase the confidence of dermatologists in the use of dermatoscopy.

Background: Although traditionally used for the diagnosis of skin tumors, in the past few years dermoscopy as a clinical diagnostic aid for inflammatory and infectious skin manifestations has also received more and more attention. The clinical variability of cutaneous sarcoidosis (CS) often makes its correct diagnosis challenging. Dermoscopy can be used as an auxiliary examination method. Objective: Our aim was to evaluate the role of dermoscopy in the diagnosis and differential diagnosis of CS. Methods: This was a retrospective analysis of 39 CS clinical and dermoscopic images collected in the Department of Dermatology, Huashan Hospital Affiliated with Fudan University from August 2013 to February 2021. Results: Retrospective dermoscopic evaluation revealed small grouped, translucent orange globular structures in all 39 cases. Variable diameter linear vessels were found in 38 cases. A central scar-like area was seen in 26 cases. Bright white streaks were seen in 30 cases. The follicular plugs were seen in 15 cases. Study limitations: First, the number of cutaneous sarcoidosis cases the authors collected is small. Second, due to the lack of a control group, the sensitivity and specificity of the proposed criteria were not calculated. Finally, since our study mainly includes suspicious lesions that were biopsied for diagnostic purposes, there may be a selection bias. Conclusion: Lesions showing on dermoscopy grouped translucent orange ovoid structures asso-ciated with linear vessels should raise the suspicion of CS. Central scar-like areas and bright white streaks are also helpful in the diagnosis of CS. (c) 2023 Published by Elsevier Espana, S.L.U. on behalf of Sociedade Brasileira de Dermatologia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/ by/4.0/).

Objectives Due to a recent development of high-frequency ultrasound (HFUS) systems, it is easier to realize high-resolution in vivo imaging of the biological tissues. The object of this study was to map the thickness and echo density of skin layers in healthy Chinese people and assess the influence of gender, age, and region on it. Methods A total of 189 volunteers (85 male, 104 female) with age range of 22-75-year old (mean age of 41.2-year old) were enrolled. The thickness and density of the epidermis and dermis layer were detected by high-frequency (22 or 75 MHz) ultrasonography at 13 different anatomical sites, including the forehead, cheeks, flexor and extensor forearms, flexor and extensor upper arms, inner and outer legs, inner and outer thighs, back, and abdomen. Results The thickness and density of epidermis/dermis between different anatomical sites were statistically significant (p < 0.05). The epidermis thickness of the face and trunk were less than that of the limbs, whereas the thicknesses of the dermis were on the contrary. The density of the epidermis/dermis of the face and trunk were less than that of the limbs. The thickness of dermis in most of the sites were higher in male than in female, and the density of epidermis and dermis in most of the sites were less in men than in women. The thicknesses/densities of dermis were lower in older age group in almost all sites, whereas only several sites reached statistical. The difference between the north and south regions showed the environment also influenced the thickness and density of the skin. Conclusion HFUS provides a simple noninvasive method for evaluating the skin thickness and echo-density, which, reflecting intradermal structure, exhibit systematic regional variation. With the establishment of Chinese phenotypic database of skin thickness and density, it will be helpful for the skin disease assessment, skin surgery, and cosmetology technology.

光学相干断层成像(optical coherence tomography, OCT)通过测量被散射光的回波,对生物组织内部的微结构进行高分辨率、横断面和三维体积成像 [1].OCT是目前最具创新性的光学成像方式之一,因为其与组织学检查不同,可无创地利用活体组织中丰富的形态学和组织功能信息,进行重复成像以阐明病变性质和病情进展情况,监测治疗反应.随着细胞水平OCT技术进入临床应用,由于其具有极佳的分辨率和穿透深度,可用于诊断所有类型的皮肤肿瘤 [2].目前OCT凭借可进行"光学活检"即组织微观结构和病理的实时原位可视化而不需要离体和处理标本的优势,已发展成为生物医学光学和医学的重要光学成像技术.

患者男, 32岁, 因色素减退斑、面部丘疹31年, 甲周丘疹2年就诊。患者出生时躯干、四肢多发叶状色素减退斑。1岁时面中部出现丘疹并逐渐增多, 无自觉症状。面部丘疹曾于外院行组织病理检查, 符合"面部血管纤维瘤"。2年前甲周出现丘疹, 伴轻度压痛。患者母亲面部有类似皮疹, 有癫痫发作史。

Low-intensity pulsed ultrasound (LIPUS) with an intensity (spatial average temporal average, ISATA) of 30 mW/cm2 has been widely proved to be effective on impaired bone healing, but showing little effectiveness in the treatment of osteoporosis. We hypothesized that the intensity of LIPUS may be a key factor in explaining this difference, thus two intensity levels, the widely used 30 mW/cm2 and a higher 150 mW/cm2, were used to simultaneously treat osteoporosis and osteoporotic bone defect in ovariectomized (OVX) rats with a 1-mm drill hole on their left femurs.Results showed that 150 mW/cm2 LIPUS augmented the healing rate of the drill hole than 30 mW/cm2 after 3-week LIPUS treatment, although did not further enhance the healing rate after 6-week LIPUS treatment. For ameliorating osteoporosis, 150 mW/cm2 LIPUS achieved more advantages over 30 mW/cm2 in improving bone density, microstructure and biomechanics 6 weeks after LIPUS intervention. In conclusion, LIPUS with an intensity of 30 mW/cm2 was sufficient to facilitate bone defect healing, but a higher intensity can be considered as a rapid trigger for osteoporotic bone repair. In addition, improving the intensity of LIPUS may be a potentially effective consideration for alleviation of osteoporosis, and the LIPUS regimen in the treatment of osteoporosis remains to be optimized.

In transcranial penetration, ultrasound undergoes refraction, diffraction, multi-reflection, and mode conversion. These factors lead to phase aberration and waveform distortion, which impede the realization of transcranial ultrasonic imaging and therapy. Ray tracing has been used to correct the phase aberration and is computationally more efficient than traditional full-wave simulation. However, when ray tracing has been used for transcranial investigation, it has generally been on the premise that the skull medium is homogeneous. To find suitable homogeneity that balances computational speed and accuracy, the present work investigates how the focus deviates after phase-aberration compensation with ray tracing using time-reversal theory. The waveforms are synthetized with ray tracing for phase aberration, by which the properties of the skull bone are simplified for refraction calculation as those of either (i) the cortical bone or (ii) the mean of the entire skull bone, and the focusing accuracy is evaluated for each hypothesis. The propagation of ultrasound for transcranial focusing is simulated with the elastic model using the k-space pseudospectral method. Unlike the fluid model, the elastic model does not omit shear waves in the skull bones, and the influence of that omission is investigated, with the fluid model resulting in a focal deflection of 0.5 mm. The focusing deviations are huge when the properties of the skull bone are idealized with ray tracing as those of the mean of the entire skull bone. The focusing accuracy improves when the properties of the skull bone are idealized as those of the cortical bone. The results reveal minimal deviation (8.6, 3.9, and 3.2% in the three Cartesian coordinates) in the focal region and suggest that transcranial focusing deflections are caused mostly by ultrasonic refraction on the surface of the skull bone. A heterogeneous skull bone causes wave bending but minimal focusing deflection. The proposed simplification of a homogeneous skull bone is more accurate for transcranial ultrasonic path estimation and offers promising applications in transcranial ultrasonic focusing and imaging.

Skin, as the major organ of a human body, is constantly exposed to PM2.5 stimulation, which may exert specific toxic influences on the physiology of skin. This study aims to investigate the effect of PM2.5 on the formation of inflammasomes in skin cells and to explore the potential mechanism linking PM2.5 and skin inflammation. Changes in mRNA and protein levels of inflammasome-related genes were detected by real-time PCR and western blot in human immortalized epidermal cells (HaCaT) treated with PM2.5 at multiple concentrations for 24 hours. The expression of NLRP1 was increased significantly both in mRNA and protein levels after PM2.5 exposure while the elevated secretory protein level of IL-1β in cell culture was detected by ELISA, which is one of the main downstream factors of NLRP1. In addition, the upregulation of NLRP1 and IL-1β could be reversed by NF-κB inhibitor indicating that PM2.5 may promote NLRP1 expression through activating NF-κB pathway. Furthermore, high ROS level was also found in cells treated with PM2.5 and inhibition of ROS could also reverse NK-κB production stimulated by PM2.5 that means ROS is involved in this skin inflammation process.

人老了,岁月在脸上放肆,除了刻刀般的深浅皱纹,还有老年斑的侵袭.谁说老人不要护肤?多看看爸妈的脸,关心皮肤状态,也是关注爸妈健康. 老人护肤抗皱+保湿+防晒 老年人的皮肤经过长期的风吹日晒,相较于青年人,皮肤更加干燥,防御功能下降,更易受到环境损伤,更需加强日常护肤.那么,老年人应该怎样护肤呢?

Ultrasonic guided waves (UGWs) propagating in the long cortical bone can be measured via the axial transmission method. The characterization of long cortical bone using UGW is a multiparameter inverse problem. The optimal solution of the inverse problem often includes a complex solving process. Deep neural networks (DNNs) are essentially powerful multiparameter predictors based on universal approximation theorem, which are suitable for solving parameter predictions in the inverse problem by constructing the mapping relationship between UGW and cortical bone material parameters. In this study, we investigate the feasibility of applying the multichannel crossed convolutional neural network (MCC-CNN) to simultaneously estimate cortical thickness and bulk velocities (longitudinal and transverse). Unlike the multiparameter estimation in most previous studies, the technique mentioned in this work avoids solving a multiparameter optimization problem directly. The finite-difference time-domain (FDTD) method is performed to obtain the simulated UGW array signals for training the MCC-CNN. The network that is exclusively trained on simulated data sets can predict cortical parameters from the experimental UGW data. The proposed method is confirmed by using FDTD simulation signals and experimental data obtained from four bone-mimicking plates and from ten ex vivo bovine cortical bones. The estimated root-mean-squared error (RMSE) in the simulated test data for the longitudinal bulk velocity ( V L ), transverse bulk velocity ( V T ), and cortical thickness (Th) is 97 m/s, 53 m/s, and 0.089 mm, respectively. The predicted RMSE in the bone-mimicking phantom experiments for V L|| , V T|| , and Th is 120 m/s, 80 m/s, and 0.14 mm, respectively. The experimental dispersion trajectories are matched with the theoretical dispersion curves calculated by the predicted parameters in ex vivo bovine cortical bone experiments. Our proposed method demonstrates a feasible approach for the accurate evaluation of long cortical bones based on UGW.

Department of Dermatology, China-Japan Friendship Hospital, Beijing 100029, China; Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China; Department of Dermatology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui 230032, China; Shanghai Wheat Color Intelligent Technology Company, LTD, Shanghai 200051, China; Department of Dermatology, Air Force General Hospital of People’s Liberation Army, Beijing 100142, China; Department of Dermatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.

Department of Dermatology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230032, China; Department of Dermatology, China-Japan Friendship Hospital, Beijing 100029, China; Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China; Shanghai Wheat Color Intelligent Technology Company, Limited, Shanghai 200051, China; Department of Dermatology, Specialty Medical Center of the Air Force, People’s Liberation Army, Beijing 100142, China; Department of Dermatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China.

The goal of this study is to analyze the statistics of the backscatter signal from bovine cancellous bone using a Nakagami model and to evaluate the feasibility of Nakagami-model parameters for cancellous bone characterization. Ultrasonic backscatter measurements were performed on 24 bovine cancellous bone specimens in vitro and the backscatter signals were compensated for the frequency-dependent attenuation prior to the envelope detection. The statistics of the backscatter envelope were modeled using the Nakagami distribution. Our results reveal that the backscatter envelope mainly followed pre-Rayleigh distributions, and the deviations of the backscatter envelope from Rayleigh distribution decreased with increasing bone density. The Nakagami shape parameter (i.e., m) was significantly correlated with bone densities (R = 0.78-0.81, p < 0.001) and trabecular microstructures ( vertical bar R vertical bar = 0.46-0.78, p < 0.05). The scale parameter (i.e., ,(2) and signal-to-noise ratio (SNR) also yielded significant correlations with bone density and structural features. Multiple linear regressions showed that bone volume fraction (BV/TV) was the main predictor of the Nakagami parameters, and microstructure produced significantly independent contribution to the prediction of Nakagami distribution parameters, explaining an additional 10.2% of the variance at most. The in vitro study showed that statistical parameters derived with Nakagami model might be useful for cancellous bone characterization, and statistical analysis has potential for ultrasonic backscatter bone evaluation.

With the advantages of non-ionizing and low cost, ultrasound imaging has been widely used in clinical diagnosis and treatment. However, due to the significant velocity changes between cortical bone and soft-tissue, the traditional ultrasound beamforming method under the assumption of constant velocity fails to reconstruct the cortical bone image. The velocity model based beamforming has been used in geophysics and non-destructive testing as an effective way to solve the challenges resulting from the velocity changes in multi-layer structure. Since the cortical bone can be modeled as a three-layer structure consisting of soft tissue, cortical bone and marrow, a multi-layer velocity model based synthetic aperture ultrasound method is introduced for cortical bone imaging. In this study, we first utilize synthetic transmit aperture ultrasound to obtain the full-matrix dataset to increase the signal-to-noise ratio. Second, a three-layer cortical bone velocity model is built with the compressed sensing estimated arriving time delay. The bases of compressed sensing consist of a series of excitation pulses with different delays. The received signals are regarded as a composition of the bases with different weights, thus can be projected into the bases by using compressed sensing. The time-delay of each received element is estimated by compressed sensing. According to the time-delay, the full-matrix dataset is reformed into a zero-offset format. By extracting the bases corresponded with the interface reflected signals, the time-delay between and the thickness values of the interfaces can be estimated. The velocity model can thus be built with the estimated cortical bone thickness. Based on the velocity model and zero-offset data, the phase shift migration method is used to reconstruct the cortical bone image. The finite-difference time-domain (FDTD) method is used to simulate the wave propagation in a 3.4-mm-thick cortical bone. The transmitting pulse is a Gaussian-function enveloped tone-burst signal with 6.25 MHz center frequency and 250 MHz iteration rate. The reconstructed image of simulation shows a clear top interface and bottom interface of cortical bone with correct thickness. Further FDTD simulations are carried out on a 3-mm-to-5-mm-thick cortical bone, and the average relative error of estimated thickness is 4.9% with a 13.5% variance. In vitro experiment is performed on a 3.4-mm-thick bovine bone plate to test the feasibility of the proposed method by using Verasonics platform (128-element linear array). The transmitting pulse is a Gaussian-function enveloped tone-burst signal with 6.25 MHz center frequency and 25 MHz sampling rate. The reconstructed image in experiment reveals a clear top interface and bottom interface of cortical bone with correct thickness. The experiment is repeated several times and the average relative error of estimated thickness is 3.6% with a 5.4% variance. The results of simulation and experiment both indicate that compressed sensing is effective in estimating the delay parameters of the velocity model. Finally, we evaluate the capability of compressed sensing in time-delay estimation, and the result shows that compressed sensing is more accurate than Hilbert transform even in a 20 dB-noise condition. In conclusion, the proposed method can be useful in the thickness estimation and the ultrasound imaging of cortical bone. In vivo experiment and clinical application should be further investigated.

Objective: Dermoscopy is a useful technique for improving the diagnostic accuracy of various types of skin disorders. In China, dermoscopy has been widely accepted, and domestic researchers have made tremendous progress in the field of dermoscopy. The main purpose of this review is to summarize the current status of dermoscopy in China and identify its future directions. Data sources: Articles included in this review were obtained by searching the following databases: Wanfang, China National Knowledge Infrastructure, PubMed, and the Web of Science. We focused on research published before 2019 with keywords including dermoscopy, dermoscopic, dermoscope and trichoscopy. Study selection: A total of 50 studies were selected. Of these studies, 20 studies were in Chinese and 30 in English, research samples of all the studies were collected from Chinese populations. Results: Since 2000, more than 380 articles about dermoscopy have been published in domestic or foreign journals. Dermoscopy can improve the diagnostic accuracy of neoplastic diseases, evaluating the therapeutic effect of treatment, and determining the treatment endpoint, and it can also assist in the differential diagnosis of inflammatory diseases and in the assessment of the severity of the disease. In addition, researches about the applications of dermoscopy during surgical treatment have been published. Training courses aiming to improve the diagnostic ability of dermatologists, either face-to-face or online, have been offered. The Chinese Skin Image Database, launched in 2017 as a work platform for dermatologists, has promoted the development of dermoscopy in China. Computer-aided diagnostic systems based on the Chinese population are ready for use. In the future, cooperation, resource sharing, talent development, image management, and computer-aided diagnosis will be important directions for the development of dermoscopy in China. Conclusion: Dermoscopy has been widely used and developed in China, however, it still needs to address more challenges in the future.

Objective: the purpose of this paper was to investigate the effect of spectral computation methods on the estimation of the four ultrasonic backscatter parameters, namely, the apparent integrated backscatter (AIB), the zero frequency intercept of apparent backscatter (FIAB), the frequency slope of apparent backscatter (FSAB), and the backscatter spectral centroid shift (SCS) from the backscattered signal of interest (SOI), and their subsequent correlations with cancellous bone parameter [bone volume/total volume (BV/TV)]. Methods: ultrasonic backscatter measurements were performed on 26 bovine cancellous bone specimens using a 1.0-MHz focused transducer. Four spectral estimation algorithms, including the classical periodogram, the autoregressive (AR) Burg algorithm, the AR covariance algorithm, and the AR modified covariance algorithm, were used to calculate the ultrasonic parameters. Influence of the signal’s delay time (T1) and its length (T2) on the strength of correlation between BV/TV and backscatter parameters was also studied. Results: the results have demonstrated that the AR-based estimators provide much more reliable and stronger correlations between the BV/TV and backscatter parameters than the classical periodogram. Recommendations for choosing SOI were also suggested. Conclusion: these results indicate that the AR-based method has a promising potential to enhance the performance of evaluation and diagnosis of the cancellous bone using the ultrasonic backscatter method. Significance: the enhancement of the correlation may provide a positive impact on the ultrasonic backscatter method to diagnose and monitor the bone quantity.

Objective:Dermoscopy is a useful technique for improving the diagnostic accuracy of various types of skin disorders. In China, dermoscopy has been widely accepted, and domestic researchers have made tremendous progress in the field of dermoscopy. The main purpose of this review is to summarize the current status of dermoscopy in China and identify its future directions.Data sources:Articles included in this review were obtained by searching the following databases: Wanfang, China National Knowledge Infrastructure, PubMed, and the Web of Science. We focused on research published before 2019 with keywords including dermoscopy, dermoscopic, dermoscope and trichoscopy.Study selection:A total of 50 studies were selected. Of these studies, 20 studies were in Chinese and 30 in English, research samples of all the studies were collected from Chinese populations.Results:Since 2000, more than 380 articles about dermoscopy have been published in domestic or foreign journals. Dermoscopy can improve the diagnostic accuracy of neoplastic diseases, evaluating the therapeutic effect of treatment, and determining the treatment endpoint, and it can also assist in the differential diagnosis of inflammatory diseases and in the assessment of the severity of the disease. In addition, researches about the applications of dermoscopy during surgical treatment have been published. Training courses aiming to improve the diagnostic ability of dermatologists, either face-to-face or online, have been offered. The Chinese Skin Image Database, launched in 2017 as a work platform for dermatologists, has promoted the development of dermoscopy in China. Computer-aided diagnostic systems based on the Chinese population are ready for use. In the future, cooperation, resource sharing, talent development, image management, and computer-aided diagnosis will be important directions for the development of dermoscopy in China.Conclusion:Dermoscopy has been widely used and developed in China, however, it still needs to address more challenges in the future.

The ultrasonic backscatter technique holds the promise of characterizing bone density and microstructure. This paper conducts ultrasonic backscatter parametric imaging based on measurements of apparent integrated backscatter (AIB), spectral centroid shift (SCS), frequency slope of apparent backscatter (FSAB), and frequency intercept of apparent backscatter (FIAB) for representing trabecular bone mass and microstructure. We scanned 33 bovine trabecular bone samples using a 7.5 MHz focused transducer in a 20 mm × 20 mm region of interest (ROI) with a step interval of 0.05 mm. Images based on the ultrasonic backscatter parameters (i.e., AIB, SCS, FSAB, and FIAB) were constructed to compare with photographic images of the specimens as well as two-dimensional (2D) μ-CT images from approximately the same depth and location of the specimen. Similar structures and trabecular alignments can be observed among these images. Statistical analyses demonstrated that the means and standard deviations of the ultrasonic backscatter parameters exhibited significant correlations with bone density (|R| = 0.45-0.78, p < 0.01) and bone microstructure (|R| = 0.44-0.87, p < 0.001). Some bovine trabecular bone microstructure parameters were independently associated with the ultrasonic backscatter parameters (ΔR2 = 4.18%-44.45%, p < 0.05) after adjustment for bone apparent density (BAD). The results show that ultrasonic backscatter parametric imaging can provide a direct view of the trabecular microstructure and can reflect information about the density and microstructure of trabecular bone.

Ultrasonic backscattering signals changed with the different regions of interest(ROI)in ultrasonic backscattering bone evaluation,resulting in the decrease of diagnostic accuracy. The purpose of this paper is to study the variation of ultrasonic backscatter signals with the ROI changes. 35 cancellous bone specimens were measured in vitro by spatial scanning measurement. Ultrasonic backscattering parameters were transformed from the spatial domain to the spatial frequency domain. The results show that the main spatial frequency components of ultrasonic backscattering parameters were concentrated in the low frequency part. The maximum magnitude of ultrasonic backscattering parameters in spatial frequency domain(MASF)had highly significant correlation with bone mineral density and other parameters (R2=0.45～0.83, p<0.001). The attenuation coefficients of ultrasonic backscattering parameters in spatial frequency domain (AC) were also significantly related to the cancellous bone density and structure parameters (R2= 0.41 ～ 0.72, p < 0.001). This article shows that the method of spatial frequency domain transformation is helpful for clarifying the variation of ultrasonic backscatter signals with the ROI changes. The new parameters obtained by ultrasonic backscattering in spatial frequency domain are feasible to evaluate cancellous bone.