强脉冲光对培养的人成纤维细胞表达MMP-1和TIMP-1的影响

目的：观察强脉冲光照射对体外培养的成纤维细胞表达基质金属蛋白酶（MMP-1）和基质金属蛋白酶组织抑制因子（TIMP-1）的影响，探讨IPL嫩肤作用的分子生物学机制。方法：采用能量密度分别为20、25、30J／cm^2的强脉冲光对培养的人成纤维细胞进行照射，于照射后24h及48h应用ELIsA法测定上清液中MMP-1和TIMP-1的表达并与对照组比较。结果：照射24h后25及30J／cm^2组上清液中检测到的MMP-1、TIMP-1含量轻度升高；48h时各能量组MMP-1均升高，但各组间并无显著性差异。TIMP-1随能量的升高而含量增高。结论：强脉冲光照射成纤维细胞后可引起MMP-1，TIMP-1表达的增加，但是TIMP-1的增加远远大于MMP-1的增加，提示IPL嫩肤作用的生物学机制可能与成纤维细胞产生的TIMP-1增加有关。     

强脉冲光对大鼠皮肤碱性成纤维细胞生长因子表达的影响

目的 通过观察强脉冲光对大鼠皮肤碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)表达的影响,探讨光子嫩肤的分子生物学机制.方法 选择15只远交群(SD)大鼠,每只选3个部位用强脉冲光照射,采用同一照射参数,能量密度34 J/cm2,分为3个脉冲,脉宽各为4、5、6 ms,脉冲延时为20 ms及25 ms.照射后第1、3、5、7、15、30天分别于治疗及非治疗部位切取皮肤样本,免疫组化染色(SABC法)观察.结果 照射后第1天,bFGF未见表达,第3天时出现弱阳性颗粒,随时间增加,bFGF的表达也逐渐增强,第15天时达到高峰并持续至第30天,非治疗部位染色阴性.结论 强脉冲光照射皮肤后可引起bFGF表达的增加,提示bFGF在光子嫩肤过程中对皮肤的重塑起重要作用.     

强脉冲光对成纤维细胞TGF-β1表达的影响

目的 研究强脉冲光(IPL)对皮肤成纤维细胞TGF-β1表达的影响,探索IPL影响皮肤胶原合成的调控机制.方法 将体外分离培养的人包皮原代成纤维细胞,分成照射组和对照组,照射组以波长590～1200 nm、能量密度为29 J/cm2、脉宽15 ms、延时5 ms的IPL对成纤维细胞进行照射.两组细胞均采用无血清DMEM分别培养1、12、24、48 h,然后荧光定量PCR法分别测定4个时间点细胞TGF-β1的表达情况.结果 培养12、24、48 h后,TGF-β1的表达在照射组成纤维细胞中明显增高,与对照组比较,差异有统计学意义(P<0.01).结论 IPL能促进成纤维细胞合成TGF-β1的活性.     

强脉冲光对长波紫外线Ⅰ诱导成纤维细胞光损伤的保护作用

目的 研究强脉冲光（intense pulse light,IPL）对长波紫外线（ultraviolet A,UVA Ⅰ）诱导的正常离体人皮肤成纤维细胞（fibroblast,FB）损伤的保护作用,探讨以IPL为手段的光子嫩肤技术的理论基础.方法 分离并培养人FB,用不同剂量UVA Ⅰ照射FB以诱导细胞光损伤,CCK-8检测其增殖能力的情况,根据预实验结果确定IPL剂量进行照射,流式细胞仪技术枪测细胞周期,Western印迹法检测CylinD1和CDK2蛋白的表达水平.结果 不同剂量的UVA Ⅰ可造成FB的损伤,随着UVA Ⅰ剂量的增加,细胞增殖能力下降,11 J/cm2的剂量可明显导致细胞大量死亡,而7 J/cm2的UVAⅠ对细胞的增殖能力没有明显的影响;经UVA Ⅰ照射2 d后再进行IPL连续照射2 d,细胞增殖活性高于单独UVA Ⅰ处理组,差异具有统计学意义.流式细胞仪检测结果表明该组细胞增殖指数升高.细胞周期蛋白CyclinD1和CDK2的表达水平升高.结论 IPL可通过调节周期蛋白的表达而促进正常FB增殖,从而保护UVAⅠ诱导的FB光损伤,为应用IPL面部美容除皱即光子嫩肤术提供理论依据.     

光动力学治疗对瘢痕成纤维细胞增殖及其细胞周期的影响

目的 探讨血卟啉单甲醚-光动力学疗法对体外培养瘢痕成纤维细胞的作用.方法 原代培养瘢痕组织来源的成纤维细胞后,建立细胞系,实验采用第4～6代细胞.银染细胞后镜下观察,并计算核仁组成区的相对面积(I.S%);采用流式细胞技术,分析光动力学治疗后各细胞周期中细胞分布比例,并计算增殖指数.结果 ①光动力学治疗后瘢痕成纤维细胞内I.S%显著降低;②流式细胞仪检测结果表明光动力学治疗组S期峰低于对照组,S期细胞比例显著降低,为(11.2±2.3)%;③计算对照组和光动力学治疗组的增殖指数,分别为(35.0±3.4)%和(27.2±3.1)%,两者比较差异有统计学意义(P<0.05).结论 血卟啉单甲醚-光动力学疗法能够抑制瘢痕成纤维细胞的过度增殖,改变其细胞周期分布.     

强脉冲光与Nd：YAG激光面部非剥脱除皱疗效比较分析

目的 比较强脉冲光与Nd：YAG激光在非剥脱面部除皱中的疗效与安全性。方法 64例要求面部非剥脱除皱患者随机等分为两组，皆为Fitzpatrick Ⅲ～Ⅳ型皮肤。一组接受4次640nm强脉冲光治疗。另一组接受4次1064nm Nd：YAG激光治疗，治疗间隔2周。分别于每次治疗后及最后一次治疗2，4，8，12，24周后随访治疗效果。结果 治疗24周后患者主观满意程度(计分1～10)有明显差别。皮肤皱纹改善客观指标亦有明显差别。主要并发症是皮肤水疤及红斑现象。结论 640nm强脉冲光与Nd：YAG激光皆有非剥脱除皱作用,640nm强脉冲光的疗效明显优于Nd：YAG激光。但并发症较多。     

光动力学治疗对瘢痕成纤维细胞增殖及其细胞周期的影响

Objective To investigate the effect of HMME-PDT on the proliferation and cell distribution of hypertrophic scar fibroblast (HSF). Methods HSF were cultured and only 4-6th passages were used in this study. Argyrophilic protein in nucleolar organizer regions( AgNORs) were caculated by I. S% after argyrophilic staining. Flow cytometry was applied to analyze the cell cycle and proliferation index (PI). Results ① I. S% of HSF after HMME-PDT was reduced markedly. ② HMME-PDT inhibited HSF entering S stage from G, stage, cell percentage in S stage was decreased to(11. 2 ± 2. 3 ) % . ③ PI in HMME-PDT group was less than that in control group [( 35.0 ± 3.4) % vs (27. 2 ±3. 1)% , P <0.05]. Conclusions HMME-PDT can inhibite proliferation of HSF, and chang cell distribution.     

光动力学治疗对瘢痕成纤维细胞增殖及其细胞周期的影响

Objective To investigate the effect of HMME-PDT on the proliferation and cell distribution of hypertrophic scar fibroblast (HSF). Methods HSF were cultured and only 4-6th passages were used in this study. Argyrophilic protein in nucleolar organizer regions( AgNORs) were caculated by I. S% after argyrophilic staining. Flow cytometry was applied to analyze the cell cycle and proliferation index (PI). Results ① I. S% of HSF after HMME-PDT was reduced markedly. ② HMME-PDT inhibited HSF entering S stage from G, stage, cell percentage in S stage was decreased to(11. 2 ± 2. 3 ) % . ③ PI in HMME-PDT group was less than that in control group [( 35.0 ± 3.4) % vs (27. 2 ±3. 1)% , P <0.05]. Conclusions HMME-PDT can inhibite proliferation of HSF, and chang cell distribution.     

不同表皮对成纤维细胞增殖及胶原含量的影响

目的 了解不同表皮对成纤维细胞（Fb）增殖的影响，并探寻其机制。方法 将10例增生期瘢痕患者自身的正常皮肤Fb＋正常表皮、瘢痕Fb＋瘢痕表皮进行非接触性共同培养，另培养不加表皮的瘢痕Fb，将这3个培养体系依次设为A、B、C组；另将10例成熟期瘢痕患者的皮肤同法培养，也建立3个培养体系依次为D、E、F组。检测各组Fb培养72h后的细胞数量、培养上清液中I型与Ⅲ型胶原含量及其比值的变化。结果 C组与A组、F组与D组比较，均表现为细胞数显著升高，培养上清液中I、Ⅲ型胶原含量上升，I型与Ⅲ型胶原比值下降（P〈0．05）；B组与C组比较，培养上清液中Ⅲ型胶原含量增高，I型与Ⅲ型胶原的比值下降（P〈0．05），细胞数和I型胶原含量两组相近；E组与F组比较，细胞数显著降低且上清液中I、Ⅲ型胶原含量下降（P〈0．05），两者比值无明显变化。B组与A组、E组与D组比较，细胞数及I、Ⅲ型胶原含量均显著增高（P〈0．05），I型与Ⅲ型胶原的比值均显著下降（A、B组为2．20±0．27、1．16±0．21，D、E组为2．18±0．14、1．93±0．26，P〈0．05）。结论 正常表皮可能通过产生某些活性物质调节Fb增殖及胶原合成，在防止瘢痕增生中发挥重要作用。     

Q开关Nd:YAG激光联合强脉冲光治疗雀斑临床观察

目的:寻找临床上对雀斑的最佳治疗方法。方法:采用Q开关倍频Nd:YAG激光和强脉冲光联合治疗雀斑,进行疗效观察,并与继往单纯采用Q开关激光治疗的病例进行疗效对比研究。结果:单纯用Q开关激光治疗的224例雀斑患者,痊愈178例(79.5%),采用Q开关激光联合强脉冲光治疗的52例雀斑患者,痊愈50例(96.2%)。两组痊愈率之间差异有显著性。结论:采用激光与强脉冲光联合治疗雀斑疗效好、副作用小,值得临床推广。     

超脉冲CO2激光联合强脉冲光治疗面部瘢痕

目的：观察超脉冲CO2激光联合强脉冲光治疗面部瘢痕的效果。方法：对50例面部瘢痕患者,采用超脉冲CO2激光和强脉冲光联合治疗6次。治疗间隔均为1个月。首先使用超脉冲CO2激光磨削,能量100～200mJ／脉冲,频率10～20脉冲／min。然后使用585nm强脉冲光治疗,脉宽2．5～15ms,能量密度25～35J／cm^2。结果：治疗结束后随访3～6个月,显效者33例,有效者14例,无效者3例。主要并发症为短暂红斑、色素沉着。结论：超脉冲CO2激光与585nm强脉冲光联合治疗面部瘢痕,具有较好的疗效,有操作准确、快捷、损伤小、术后恢复快、并发症少等优点。     

单用强脉冲光、长脉宽Nd:YAG激光以及低能量下两者联合使用治疗微静脉畸形的临床疗效比较

目的:观察单用强脉冲光、长脉宽1064nm Nd:YAG激光以及低能量下两者联合使用治疗微静脉畸形的临床疗效和不良反应。方法:联合应用590～1200nm强脉冲光(能量密度12～16J/cm2,脉宽3.0～5.0ms)以及长脉宽1064nm Nd:YAG激光(能量密度80～90J/cm2,脉宽10～20ms)治疗51例微静脉畸形患者;并与单独应用强脉冲光(能量密度13～20J/cm2)及长脉宽Nd:YAG激光(能量密度120～145J/cm2)治疗结果比较。结果:强脉冲光、长脉宽1064nmNd:YAG激光及低能量下联合使用治疗微静脉畸形的有效率分别为33.1%、40.3%和56.9%,瘢痕发生率分别为0%、10.7%和5.9%。结论:低能量下联合使用强脉冲光及长脉宽1064nm Nd:YAG激光提高了微静脉畸形的有效率,且不良反应小。     

强脉冲光照射兔皮肤后的组织学观察

目的：观察强脉冲光照射兔皮肤后的组织学变化，为临床提供参考信息。方法：用34J／cm^2的强脉冲光对10只兔四个部位分别进行1．2、3、4次照射，术后第1、7、15、30、60、90天行切片观察。结果：一定能量的IPL能治疗光老化，并不引起严重炎症反应；IPL可使表皮层增厚，引起的胶原纤维增生可持续3个月以上。结论：光子嫩肤术可安全有效的治疗光老化，其效果可超过3个月，但它也是一种创伤性刺激。     

机械应力对培养人皮肤成纤维细胞增殖细胞核抗原的表达的影响

目的：研究牵拉幅度为40％的单次持续牵拉作用于培养的人皮肤成纤维细胞对细胞增殖影响。方法：体外培养人正常皮肤成纤维细胞，将细胞转移至牵拉细胞培养模型中的弹性膜上，待细胞贴壁达75％-80％融合时，实施40％单次持续牵拉，用WESTERN-BLOT对牵拉组与非牵拉组48h的增殖细胞核抗原（PCNA）表达进行检测。结果：牵拉组PCNA可见阳性表达而对照组结果呈阴性。结论：单次40％持续牵拉可以引起细胞增殖细胞核抗原（PCNA）表达，应力可以促进细胞增殖。     

The effects of intense pulsed light (IPL) on blood vessels investigated by mathematical modeling

BACKGROUND AND OBJECTIVES: Intense pulsed light (IPL) sources have been successfully used for coagulation of blood vessels in clinical practice. However, the broadband emission of IPL hampers the clinical evaluation of optimal light parameters. We describe a mathematical model in order to visualize the thermal effects of IPL on skin vessels, which was not available, so far. STUDY DESIGN/MATERIALS AND METHODS: One IPL spectrum was shifted towards the near infrared range (near IR shifted spectrum: NIRSS) and the other was heavily shifted toward the visible range (visible shifted spectrum: VSS). The broadband emission was separated in distinct wavelengths with the respective relative light intensity. For each wavelength, the light and heat diffusion equations were simultaneously solved with the finite element method. The thermal effects of all wavelengths at the given radiant exposure (15 or 30 J/cm2) were added and the temperature in the vessels of varying diameters (60, 150, 300, 500 microm) was calculated for the entire pulse duration of 30 milliseconds. RESULTS: VSS and NIRSS both provided homogeneous heating in the entire vessel. With the exception of the small vessels (60 microm), which showed only a moderate temperature increase, all vessels exhibited a temperature raise within the vessel sufficient for coagulation with each IPL parameter. The time interval for effective temperature raise in larger vessels (diameter >60 microm) was clearly shorter than the pulse duration. In most instances, the vessel temperature was higher for VSS when compared to NIRSS. CONCLUSIONS: We presented a mathematical model capable of calculating the photon distribution and the thermal effects of the broadband IPL emission within cutaneous blood vessels.     

IPL/激光联合氨甲环酸治疗黄褐斑疗效的系统评价

目的:系统评价IPL/激光联合氨甲环酸治疗黄褐斑的效果。方法:对6个在线数据库(PubMed、Web of science、Embase、Cochrane图书馆、CNKI、万方)进行全面的文献检索。检索文献在2020年3月前发表,于2020年3月完成建库。纳入以亚洲Fitzpatrick Ⅲ、Ⅳ、Ⅴ皮肤类型黄褐斑患者为研究对象,比较IPL/激光联合氨甲环酸与单用IPL/激光或氨甲环酸的治疗效果。使用Newcastle-Ottawa量表(The newcastle-ottawa scale,NOS)评估纳入研究的质量,使用RevMan 5.0 软件对MASI值进行Meta分析。结果:共纳入8个病例对照研究,包括599例黄褐斑患者的642例面部皮肤(其中43例患者为自身对照),试验组278例,对照组364例。经Meta分析,韩国和泰国的研究:联合应用与单用对改善m MASI值无差异[OR=-0.30,95%CI(-0.65,0.05),P=0.09]和[OR=-0.13,95%CI(-0.58,0.32),P=0.58];中国的研究:IPL/激光联合氨甲环酸与单用IPL/激光改善m MAS...     

Prospective study on the treatment of postburn hyperpigmentation by intense pulsed light

BACKGROUND AND OBJECTIVES: Postburn hyperpigmentation is a common phenomenon among Asian especially over grafted areas and sometimes over donor sites and healed wounds without skin graft. This condition is difficult to treat and can cause severe psychological distress. Intense pulsed light (IPL) has been used to treat melanocytic lesions with promising result. The role of IPL in treating postburn hyperpigmentation has not been explored. The purpose of this study was to assess the efficacy and complication of IPL in the treatment of postburn hyperpigmentation prospectively. STUDY DESIGN/MATERIALS AND METHODS: Nineteen Chinese patients with postburn hyperpigmentation were treated by IPL. There were 14 females and 5 males. Their age ranged from 8 to 51 years with a mean age of 29.4 +/- 11.6 years. The cutoff filters of 550, 570, and 590 nm were used for 3-7 treatments at intervals of 3-4 weeks. Patients were treated with an energy fluence of 28-46 J/cm(2), pulse width of 1.7-4 milliseconds, double pulse mode, and a delay of 15-40 milliseconds. RESULTS: Treatment results and complications were evaluated and scored after each treatment. Over 78% of the patients showed more than 50% clinical clearance and nearly 32% of the patients were able to achieve more than 75% clearing. Although two patients had no clinical response, one patient had 100% clearing. Three patients developed blisters and one patient had erythema that all resolved within 1 week without leaving permanent marks. They have been followed-up from 11-32 months and there was no recurrence of the hyperpigmentation. CONCLUSIONS: IPL is effective and safe in treating postburn hyperpigmentation in Asian patients.