Objective To compare the cl inical effectiveness of the medial plantar flap, the retrograde posterior tibial vascular flap, and the reverse sural neurocutaneous flap in repairing defect caused by resection of cutaneous mal ignant melanoma (CMM) in the heel region. Methods The cl inical data were retrospectively analysed from 24 patients with defect who had CMM in the heel region and were treated by radical excision and flap repairing between March 2007 and March 2010. Defects were repaired with the reverse sural neurocutaneous flaps of 8 cm × 7 cm-14 cm × 12 cm at size in 12 patients (groupA), with the medial plantar flaps of 6 cm × 5 cm-8 cm × 7 cm at size in 7 patients (group B), and with the retrograde posterior tibial vascular flaps of 9 cm × 7 cm-15 cm × 13 cm at size in 5 patients (group C). There was no significant difference in gender, age, duration of illness, cl inical stage, and size of CMM among 3 groups (Pgt; 0.05). The donor site was sutured directly or by free skin graft. Results No significant difference was found in the operation time and the intraoperative blood loss among 3 groups (P gt; 0.05). All skin flaps or grafts survived and wounds healed by first intention. The patients were followed up 1-3 years. The flaps had normal texture and color with no ulcer in 3 groups. At 1 year after operation, the sensory recovery rates of the flaps were 0, 100%, and 20% in groups A, B, and C, respectively, showing significant difference among 3 groups (P=0.001). The patients had normal appearance of heel and pain-free walking [10 (83%) in group A, 6 (86%) in group B, and 4 (80%) in group C] of heel region, showing no significant difference among 3 groups (χ2=40.000, P=0.135). Heel pain existed in weightbearing walking of 3 groups, and there were significant differences in visule analogue scale (VAS) score (Plt; 0.05). There was no significant difference in range of motion of ankle joint among 3 groups (P gt; 0.05). Except 1 patiant of relapse in group A at 1 month after operation, no relapse was observed in the other patients during follow-up. Conclusion The medial plantar flap, the retrograde posterior tibial vascular flap, and the reverse sural neurocutaneous flap can achieve the good cl inical effectiveness in treating heel defect caused by the resection of CMM. And the medial plantar flap is the first choice in small skin defect of heel area.
To explore the inhibitory effect of hydroxyapatite (HA) particles with different sizes on malignant melanoma A375 cells in vitro, we synthesized 4 short rod-like HA particles using TIPS. Their mean diameters were 998.0 nm (HA1), 511.0 nm (HA2), 244.0 nm (HA3), and 71.6 nm (HA4), respectively. Malignant melanoma A375 cells were co-cultured with HA particles in vitro. Results showed that HA particles smaller than 511.0 nm in mean diameter could always inhibit proliferation of A375 cells, and nanometer-HA particles (HA4) had the strongest inhibitory effect on A375 cell proliferation and the strongest inducing effect on apoptosis. HA particles were distributed in plasma of A375 cells. The ultrastructure changes of A375 cells were found most significant in nanometer-HA particles (HA4) group. We conclude that particle size is a very important influencing factor on anti-tumor effects of HA and that nanometer-HA particle has the strongest inhibitory effect on tumor cell proliferation.
ObjectiveTo analyze the epidemiological burden and trend of skin malignant melanoma in China based on the data from the global burden of disease 2019 (GBD 2019). MethodsThe data about quantity of incidences/illnesses/deaths, age-standardized incidence/prevalence rates/mortality, disability-adjusted life years (DALYs), and DALY rate of skin malignant melanoma in China from 1990 to 2019 were obtained from the GBD 2019 databases. The epidemiological trends, age-period-cohort trends, and the relationship between the incidence and sociodemographic index (SDI) were analyzed.ResultsIn 2019, both prevalence and incidence of skin malignant melanoma in China were at low levels in the world, the age-standardized mortality ranked the 35th in the 204 countries GBD researched, the number of prevalent cases and incident cases increased compared with 1990 (12.65% and 3.57%, respectively), the prevalence and incidence rates showed growth trends, while the DALY rate and mortality decreased slowly. The prevalence of skin malignant melanoma peaked age at 50 to 54 years old. The incidence peak age of males was older than that of females (55-59 years old for males vs. 50-54 years old for females), while the mortality peak age of males was younger than that of females (55-59 years old for males vs. 75-79 years old for females). With the increasing of SDI value, the incidence of skin malignant melanoma showed a linear growth trend. DALY rate was negatively correlated with SDI (P<0.05). ConclusionFrom 1990 to 2019, age-standardized incidence and prevalence of skin malignant melanoma in China are increasing, while DALY rate and mortality are decreasing, and these are correlated with social and medical development.