Objective To investigate the characteristics of lesions and clinical features of ke-loids.Methods This study included a total of 395 patients with keloids who were diagnosed and treated at the Dermatology Department of the Second Hospital of Hebei Medical University between October 2022 and October 2023.Patients'general information,characteristics of onset and treat-ment history were analyzed.Results The male-to-female ratio was 1∶1.04.The peak onset age was between 19～28 years old.The chest(48.35％)and shoulders/back(22.28％)were the two most commonly affected areas.One hundred sixty-two(41.01％)patients had single lesion on single site.Patients with a family history of keloids accounted for 4.30％.Among the 395 pa-tients,74.94％of the patients had not received any treatments,while 25.06％had a history of treatment prior to visiting our clinic.Twelve patients had received multiple or combination modali-ty treatments,and 87 patients had received single modality treatment.Patients who had received previous treatments experienced recurrence.Conclusions Keloids primarily affect young individ-uals,predominantly on the chest and shoulders/back,and mostly present as single lesion on one body site.There are no significant differences in onset sites,clinical classification and lesion sizes between genders.Genetic factors can affect the development of keloids.Patients with keloids are often treated with local drug injection,surgical resection,and other methods.But the recurrence rate is high,indicating a challenge in the treatment of keloids.

目的 探讨三酰甘油-葡萄糖指数(TyG)及单核细胞与淋巴细胞比值即血液单核细胞与淋巴细胞的比值(MLR)与银屑病冠心病共病的相关性.方法 收集银屑病单病者 61 例,银屑病冠心病共病者 64 例的血常规、血脂、空腹血糖等资料,比较 2 组一般临床资料及MLR、TyG等指标.用Spearman相关性分析探讨银屑病冠心病共病与临床特征及MLR、TyG等指标的关系.Logistic回归分析探讨银屑病冠心病共病的相关危险因素,用受试者工作特征(ROC)曲线探讨不同变量对银屑病冠心病共病的诊断效能.结果 银屑病冠心病共病组MLR、TyG均高于银屑病组(P<0.05).Spearman相关性分析显示银屑病冠心病共病与MLR、TyG呈正向相关关系(P<0.05),Logistic回归分析显示性别(男性)、年龄、高血压病、MLR、TYG均为银屑病冠心病共病的显著危险因素.ROC曲线显示TYG为 0.90时诊断银屑病冠心病共病效能最高,此时的敏感度为 78.1%,特异度为 50.8%.MLR为 0.18 时诊断银屑病冠心病共病效能最高,此时的敏感度为 100%,特异度为 27.87%.结论 银屑病冠心病共病组MLR、TYG较银屑病单病组明显升高,两者均为银屑病冠心病共病的危险因素,均有较好的诊断效能.

Objective:To investigate efficacy and advantages of combined local flaps in repairing large defects in patients with nasal and perinasal non-melanoma skin cancers after Mohs micrographic surgery.Methods:From March 2018 to November 2020, 11 patients with nasal and perinasal non-melanoma skin cancers, who underwent Mohs micrographic surgery followed by repair with combined local flaps, were collected from Department of Dermatology, the Second Hospital of Hebei Medical University. According to the location and size of postoperative defects, flaps were designed based on the nasal aesthetic subunit principle. For large defects that could not be directly sutured or covered by a single local flap, 2 or 3 kinds of flaps were applied in combination, such as kite flap, modified diamond flap, nasolabial skin flap, bilobed skin flap, etc.Results:Among the 11 patients, 10 were diagnosed with basal cell carcinoma and 1 with squamous cell carcinoma, and the area of defects ranged from 2.0 cm × 2.3 cm to 2.7 cm × 3.6 cm. After Mohs micrographic surgery combined with local skin flap repair, all skin flaps survived well without blood supply obstruction, the texture, color and contour of the skin flaps were similar to those of the surrounding normal skin, and no obvious scars were formed. During the postoperative follow-up of 4 to 32 months, no recurrence of the tumors occurred, and the patients was satisfied with the appearance.Conclusion:To repair large defects using combined skin flaps of 2 or 3 kinds after Mohs micrographic surgery in patients with nasal and perinasal non-melanoma skin cancers can maintain the normal nasal or perinasal morphological structure and aesthetic appearance, and yield a satisfactory cosmetic effect.

Extracellular vesicles are involved in skin wound healing and diabetes. After enrichment and identification, plasma endothelial cells-derived-extracellular vesicles were cocultured with skin fibroblasts or HaCaT. The gain-and loss-of functions were performed to measure fibroblast proliferation, senescence, and reactive oxygen species. Levels of senescence-related proteins, senescence-associated secretory phenotypes, vascular markers, YAP and the PI3K/Akt/mTOR pathway-related proteins were determined. Diabetic mice were induced to establish skin wound model. After endothelial cells-derived-extracellular vesicles were injected into skin wound modeling mice, skin wound healing was evaluated. Endothelial cells-derived-extracellular vesicles treatment enhanced fibroblast proliferation, and decreased senescence through the elevation of YAP nuclear translocation and activation the PI3K/Akt/mTOR pathway. YAP inhibition reversed the effect of plasma endothelial cells-derived-extracellular vesicles on fibroblast proliferation. Endothelial cells-derived-extracellular vesicles also promoted wound healing in diabetic mice, increased microvascular density, collagen deposition, macrophage infiltration and positive rates of vascular markers, and inhibited YAP phosphorylation and senescence. Plasma endothelial cells-derived-extracellular vesicles prevent fibroblast senescence and accelerate skin wound healing in diabetic mice by reducing YAP phosphorylation and activating the PI3K/Akt/mTOR pathway. This study may provide novel insights for skin disorders in diabetic mice.

目的 探讨血清降钙素原(PCT)对炎症性皮肤病患者伴细菌感染的诊断价值,为早期应用抗生素提供依据.方法 选取2015年7月至2016年9月资料完整的76例炎症性皮肤病患者为研究对象,根据临床表现、实验室检查、病原学检测将患者分为细菌感染组和非感染组,所有患者进行血清PCT、C-反应蛋白(CRP)、白细胞计数(WBC)检查.结果 细菌感染组患者PCT与非感染组患者PCT相比较,差异有统计学意义(U=-6.083,P<0.05),细菌感染组患者CRP与非感染组患者CRP相比较,差异有统计学意义(U=-3.594,P<0.05),细菌感染组患者WBC与非感染组患者WBC相比较,差异无统计学意义(U=-0.437,P>0.05).PCT、CRP、WBC的ROC曲线面积分别为0.906、0.740、0.529,PCT、CRP和WBC的灵敏度分别为80.0％、77.5％、47.5％,PCT、CRP和WBC的特异度分别为83.3％、61.1％、69.4％,差异有统计学意义(P<0.05).结论 选血清PCT有利于炎症性皮肤病伴感染的鉴别诊断,值得临床参考.

目的观察复因冷敷保湿修复敷料（喷）联合皮肤止痒脱敏膜对高频电刀治疗尖锐湿疣创面愈合时间的影响。方法 140例尖锐湿疣患者,外阴部位80例,肛周部位60例。患者随机分为治疗组和对照组,每组70例。治疗组为尖锐湿疣患者经高频电刀治疗后创面使用复因冷敷保湿修复敷料喷和皮肤止痒脱敏膜（商品名蓝科肤宁）,对照组创面单独使用蓝科肤宁,观察临床效果。结果治疗组疗效优于对照组,差异有统计学意义（P＜0.05）。结论复因冷敷保湿修复敷料喷联合蓝科肤宁明显促进高频电刀治疗后创面愈合,缩短愈合时间,减轻患者痛苦,值得临床推广。