Background:Skin expansion is a useful method for harvesting extra tissue.However,the outcome is hardly predictable.Methods:A total of 158 patients with 277 expanded skin cases were reviewed and evaluated via photograp...Background:Skin expansion is a useful method for harvesting extra tissue.However,the outcome is hardly predictable.Methods:A total of 158 patients with 277 expanded skin cases were reviewed and evaluated via photographs.The review and evaluation were conducted to determine the skin’s regenerative condition.The overall texture of the expanded skin,which was deemed good,fair,or poor,was evaluated.The occurrence of five indications of the limitation of skin regeneration(thinning,color change,stretch marks,varicose vessels,and skin lesions)during expansion was recorded.The correlation between the five indications and the overall texture was statistically analyzed.Results:Among the 277 retrospectively reviewed expansion cases,the occurrence rate of skin deterioration showed significant differences between the expansion sites(P<0.01).Skin deterioration was most commonly seen on the neck and at the back.The occurrence of each indication varied among locations.The odds ratios of color change,stretch marks,varicose vessels,thinning,and skin lesions between good and poor skin conditions were 44.97,5.09,22.26,89.79,and 4.61,respectively(all P<0.001).Conclusion:Skin color,stretch marks,varicose vessels,thickness,and skin lesions are closely correlated with the skin regenerative capacity.An integrated evaluation can help predict the regenerative capacity of expanded skin.展开更多
Background:In plastic surgery,tissue expansion is widely used for repairing skin defects.However,low expansion efficiency and skin rupture caused by thin,expanded skin remain significant challenges in promoting skin r...Background:In plastic surgery,tissue expansion is widely used for repairing skin defects.However,low expansion efficiency and skin rupture caused by thin,expanded skin remain significant challenges in promoting skin regeneration during expansion.S100 calcium-binding protein A9(S100A9)is essential in promoting wound healing;however,its effects on skin regeneration during tissue expansion remain unclear.The aim of the present study was to explore the role of S100A9 in skin regeneration,particularly collagen production to investigate its importance in skin regeneration during tissue expansion.Methods:The expression and distribution of S100A9 and its receptors-toll-like receptor 4(TLR-4)and receptor for advanced glycation end products were studied in expanded skin.These character-istics were investigated in skin samples of rats and patients.Moreover,the expression of S100A9 was investigated in stretched keratinocytes in vitro.The effects of S100A9 on the proliferation and migration of skin fibroblasts were also observed.TAK-242 was used to inhibit the binding of S100A9 to TLR-4;the levels of collagen I(COL I),transforming growth factor beta(TGF-β),TLR-4 and phospho-extracellular signal-related kinase 1/2(p-ERK1/2)in fibroblasts were determined.Furthermore,fibroblasts were co-cultured with stretched S100A9-knockout keratinocytes by siRNA transfection and the levels of COL I,TGF-β,TLR-4 and p-ERK1/2 in fibroblasts were investigated.Additionally,the area of expanded skin,thickness of the dermis,and synthesis of COL I,TGF-β,TLR-4 and p-ERK1/2 were analysed to determine the effects of S100A9 on expanded skin.Results:Increased expression of S100A9 and TLR-4 was associated with decreased extracellular matrix(ECM)in the expanded dermis.Furthermore,S100A9 facilitated the proliferation and migration of human skin fibroblasts as well as the expression of COL I and TGF-βin fibroblasts via the TLR-4/ERK1/2 pathway.We found that mechanical stretch-induced S100A9 expression and secretion of keratinocytes stimulated COL I,TGF-β,TLR-4 and p-ERK1/2 expression in skin fibroblasts.Recombined S100A9 protein aided expanded skin regeneration and rescued dermal thinning in rats in vivo as well as increasing ECM deposition during expansion.Conclusions:These findings demonstrate that mechanical stretch promoted expanded skin regeneration by upregulating S100A9 expression.Our study laid the foundation for clinically improving tissue expansion using S100A9.展开更多
The expanded skin specimens of dogs and their controls atdifferent stages after grafting were studied. The stress-strain,stress-relaxation viscoelastic characteristics and tensile strengthwere measured. The results sh...The expanded skin specimens of dogs and their controls atdifferent stages after grafting were studied. The stress-strain,stress-relaxation viscoelastic characteristics and tensile strengthwere measured. The results show that, during the initial stage aftergrafting, the biomechanical properties of expanded speci- mensdeviate from those controls significantly. But the biomechanicalproperties of expanded speci- mens and their controls begin to closegradually in a longer recovering time. And when the recovering timereaches 24 weeks or longer, the experimental specimens exhibit thesame mechanical characteristics as their controls. It is shown thatviscoelasticity of expansive skin varies with time after grafting.展开更多
Classification of skin lesions is a complex identification challenge.Due to the wide variety of skin lesions,doctors need to spend a lot of time and effort to judge the lesion image which zoomed through the dermatosco...Classification of skin lesions is a complex identification challenge.Due to the wide variety of skin lesions,doctors need to spend a lot of time and effort to judge the lesion image which zoomed through the dermatoscopy.The diagnosis which the algorithm of identifying pathological images assists doctors gets more and more attention.With the development of deep learning,the field of image recognition has made long-term progress.The effect of recognizing images through convolutional neural network models is better than traditional image recognition technology.In this work,we try to classify seven kinds of lesion images by various models and methods of deep learning,common models of convolutional neural network in the field of image classification include ResNet,DenseNet and SENet,etc.We use a fine-tuning model with a multi-layer perceptron,by training the skin lesion model,in the validation set and test set we use data expansion based on multiple cropping,and use five models’ensemble as the final results.The experimental results show that the program has good results in improving the sensitivity of skin lesion diagnosis.展开更多
基金the National Natural Science Foundation of China(no.81971848,no.81620108019,and no.81501678)Clinical Research Plan of SHDC(SHDC2020CR1019B,SHC2020CR402)+1 种基金Shanghai Municipal Key Clinical Specialty(shslczdzk00901)Innovative Research Team of High-level Local University in Shanghai(SSMUZDCX20180700).
文摘Background:Skin expansion is a useful method for harvesting extra tissue.However,the outcome is hardly predictable.Methods:A total of 158 patients with 277 expanded skin cases were reviewed and evaluated via photographs.The review and evaluation were conducted to determine the skin’s regenerative condition.The overall texture of the expanded skin,which was deemed good,fair,or poor,was evaluated.The occurrence of five indications of the limitation of skin regeneration(thinning,color change,stretch marks,varicose vessels,and skin lesions)during expansion was recorded.The correlation between the five indications and the overall texture was statistically analyzed.Results:Among the 277 retrospectively reviewed expansion cases,the occurrence rate of skin deterioration showed significant differences between the expansion sites(P<0.01).Skin deterioration was most commonly seen on the neck and at the back.The occurrence of each indication varied among locations.The odds ratios of color change,stretch marks,varicose vessels,thinning,and skin lesions between good and poor skin conditions were 44.97,5.09,22.26,89.79,and 4.61,respectively(all P<0.001).Conclusion:Skin color,stretch marks,varicose vessels,thickness,and skin lesions are closely correlated with the skin regenerative capacity.An integrated evaluation can help predict the regenerative capacity of expanded skin.
基金supported by grants from the Natural Science Foundation of China(81971851 and 82172229)the Natural Science Foundation of Shaanxi Province(2022JM-600)the Foundation of Xijing Hospital Grants(XJZT21CM33).
文摘Background:In plastic surgery,tissue expansion is widely used for repairing skin defects.However,low expansion efficiency and skin rupture caused by thin,expanded skin remain significant challenges in promoting skin regeneration during expansion.S100 calcium-binding protein A9(S100A9)is essential in promoting wound healing;however,its effects on skin regeneration during tissue expansion remain unclear.The aim of the present study was to explore the role of S100A9 in skin regeneration,particularly collagen production to investigate its importance in skin regeneration during tissue expansion.Methods:The expression and distribution of S100A9 and its receptors-toll-like receptor 4(TLR-4)and receptor for advanced glycation end products were studied in expanded skin.These character-istics were investigated in skin samples of rats and patients.Moreover,the expression of S100A9 was investigated in stretched keratinocytes in vitro.The effects of S100A9 on the proliferation and migration of skin fibroblasts were also observed.TAK-242 was used to inhibit the binding of S100A9 to TLR-4;the levels of collagen I(COL I),transforming growth factor beta(TGF-β),TLR-4 and phospho-extracellular signal-related kinase 1/2(p-ERK1/2)in fibroblasts were determined.Furthermore,fibroblasts were co-cultured with stretched S100A9-knockout keratinocytes by siRNA transfection and the levels of COL I,TGF-β,TLR-4 and p-ERK1/2 in fibroblasts were investigated.Additionally,the area of expanded skin,thickness of the dermis,and synthesis of COL I,TGF-β,TLR-4 and p-ERK1/2 were analysed to determine the effects of S100A9 on expanded skin.Results:Increased expression of S100A9 and TLR-4 was associated with decreased extracellular matrix(ECM)in the expanded dermis.Furthermore,S100A9 facilitated the proliferation and migration of human skin fibroblasts as well as the expression of COL I and TGF-βin fibroblasts via the TLR-4/ERK1/2 pathway.We found that mechanical stretch-induced S100A9 expression and secretion of keratinocytes stimulated COL I,TGF-β,TLR-4 and p-ERK1/2 expression in skin fibroblasts.Recombined S100A9 protein aided expanded skin regeneration and rescued dermal thinning in rats in vivo as well as increasing ECM deposition during expansion.Conclusions:These findings demonstrate that mechanical stretch promoted expanded skin regeneration by upregulating S100A9 expression.Our study laid the foundation for clinically improving tissue expansion using S100A9.
基金the National Natural Science Foundation of China(No.10072006)
文摘The expanded skin specimens of dogs and their controls atdifferent stages after grafting were studied. The stress-strain,stress-relaxation viscoelastic characteristics and tensile strengthwere measured. The results show that, during the initial stage aftergrafting, the biomechanical properties of expanded speci- mensdeviate from those controls significantly. But the biomechanicalproperties of expanded speci- mens and their controls begin to closegradually in a longer recovering time. And when the recovering timereaches 24 weeks or longer, the experimental specimens exhibit thesame mechanical characteristics as their controls. It is shown thatviscoelasticity of expansive skin varies with time after grafting.
基金This work is supported by Intelligent Manufacturing Standardization Program of Ministry of Industry and Information Technology(No.2016ZXFB01001).
文摘Classification of skin lesions is a complex identification challenge.Due to the wide variety of skin lesions,doctors need to spend a lot of time and effort to judge the lesion image which zoomed through the dermatoscopy.The diagnosis which the algorithm of identifying pathological images assists doctors gets more and more attention.With the development of deep learning,the field of image recognition has made long-term progress.The effect of recognizing images through convolutional neural network models is better than traditional image recognition technology.In this work,we try to classify seven kinds of lesion images by various models and methods of deep learning,common models of convolutional neural network in the field of image classification include ResNet,DenseNet and SENet,etc.We use a fine-tuning model with a multi-layer perceptron,by training the skin lesion model,in the validation set and test set we use data expansion based on multiple cropping,and use five models’ensemble as the final results.The experimental results show that the program has good results in improving the sensitivity of skin lesion diagnosis.
