Clinical evaluation of non-ablative radiofrequency facial rejuvenation

OBJECTIVE: To evaluate the clinical efficacy of non-ablative cutaneous radiofrequency (RF) facial rejuvenation. DESIGN: Prospective study with longitudinal follow-up of a validation cohort set in an urban, private practice of an ambulatory facial plastic surgery center in southern California. METHODS: A consecutive sample was enrolled of 35 healthy adults with moderate facial aging, manifested by skin laxity, rhytids, and ptosis (brow, midface, jowls). Following intravenous sedation anesthesia, the study area was treated with 115-144 J/cm² using the non-ablative RF device (ThermaCool TC^TM). The main outcome measures were the objective measurement of brow height, investigator evaluation of skin parameters, a patient satisfaction questionnaire, and standardized photography, at fixed time intervals. RESULTS: At 12 weeks, a statistically significant increase in mean vertical brow height of 1.6-2.4 mm was observed in patients treated exclusively with the RF device (p<0.0001). All skin parameters (laxity, wrinkles, clarity, pore size) were improved. Complications and side effects were minimal. Patients were uniformly satisfied. CONCLUSIONS: The ThermaCool TC RF system represents a promising non-invasive method of obtaining moderate facial rejuvenation in the appropriately selected patient. Long-term results are pending.     

Forthcoming Meetings

OBJECTIVE: The attributes of the Smoothbeam^TM laser - a 1450 nm diode laser - were considered likely to improve two distinct chronic conditions of flexural skin: Hailey-Hailey disease (HHD) and hidradenitis suppurativa (HS). METHODS: A series of laser treatments were given to the axillae of one patient with each condition. RESULTS: Treatments were painful but tolerated. There were no adverse sequelae following laser treatment. For the patient with HS, partial improvement was achieved after four treatments and sweating was notably reduced. Intermittent laser treatment may be needed to maintain or build upon the improvements gained. Longstanding HS cases, however, with established sinuses and thick scar tissue are unlikely to be helped by this form of laser treatment. There was no subjective or objective improvement seen in the patient with HHD. The only notable beneficial effect was a marked reduction in sweating and elimination of the malodour. CONCLUSIONS: Subsurfacing laser treatment in contrast with resurfacing laser treatment has no benefit in the management of HHD. Why the Smoothbeam laser causes sweat reduction is not known - and its clinical value has yet to be established.     

Contact dermatitis from electrocardiograph-monitoring electrodes: role of p-tert-butylphenol-formaldehyde resin

Three cases of allergic contact dermatitis localized to the sites of electrocardiograph-monitoring electrodes are reported. All patients had positive patch tests to both the gel and the adhesive part of the Red Dot 2239 3M monitoring electrode used and to the p-tert-butylphenol-formaldehyde resin (PTBP-F-R) of the standard series. Two patients had a history of possible exposition to the resin previously but there was no explanation for the third. No information about the presence of PTBP-F-R in the electrodes could be obtained from the manufacturers. Chemical analysis of samples of the electrode, using a gas chromatography-mass spectrometry (GC-MS) and high pressure liquid chromatography (HPLC) analytical system, demonstrated the presence of several PTBP-F-R derivatives in both the gel and the adhesive part.     

金花舒肤胶囊对鼠长期毒性试验的研究

目的：研究金花舒肤胶囊对鼠的长期毒性。方法：实验组大鼠灌服金花舒肤胶囊高、中、低剂量（分别为20．4g，kg、10．2g/kg和3．4g/kg），连续观察3个月，停药后，继续观察2周；对照组大鼠灌服蒸馏水。结果：灌服金花舒肤胶囊不同剂量组大鼠的行为活动、体重、血液学及血液生化学指标，与对照组比较均无显著差异；主要脏器未见明显的病理改变。结论：金花舒肤胶囊对大鼠无明显毒性，长期应用是安全的。     

不同时期放置吉妮致美宫内节育器的临床观察

目的：探讨不同时期放置吉妮致美宫内节育器的临床效果观察,扩大宫内节育器放置范围,提供安全的避孕方法。方法：人工流产术后自愿要求放置吉妮致美宫内节育器的育龄妇女300例为观察组,300例为对照组,于月经干净后2～3d放置吉妮致美宫内节育器。定期随访观察两组术后宫内节育器的放置情况（1、3、6、12个月）,观察避孕效果及不良反应。结果：观察组300例,失访5例,终止使用3例,其中1例是带器妊娠,2例是宫内节育器脱落,无不良反应取出。对照组300例,失访7例,终止使用1例,1例是宫内节育器脱落。结论：不同时期放置吉妮致关宫内节育器均安全、可靠、成功率高,尤其适宜使用其他类型宫内节育器失败者,也适用于宫腔大者,而且术后不良反应明显降低,值得临床推广使用。     

万艾可非药物依赖性习惯（附7例报告）

目的:探讨万艾可(Viagra)非药物依赖性习惯的原因及治疗方法.方法:男性7例,平均年龄38.5岁,根据其主诉采用国际勃起功能指数(IIEF-5)进行评分,并根据患者情况,详细讲解万艾可作用机制及服药方法后给予处方,每次服药25～50 mg,每月服药4～6次.连续服药时间4～8个月,平均6个月后发现患者并非真正患有ED,采用IIEF-5进行重新评分.结果:重新评分后,分值在23～25分,平均分值24分,可排除ED.结合每位病例的不同情况,做好宣教及思想工作,进行正确引导,除1例继续服用药物外,余6例均停止服用万艾可,性生活正常.结论:非ED患者服用万艾可可引起非药物依赖性习惯应引起临床医生注意.     

Occupational contact allergy to glyoxal

Glyoxal is a dialdehyde that is used as a disinfectant in health care and dentistry work. Allergic contact dermatitis from glyoxal has been described in these occupations. We analysed our patient data from 1998 to 2004 for allergic reactions to glyoxal. 20 patients had allergic reactions to glyoxal on patch testing. 5 of these patients worked in dentistry and 4 of them had present exposure to glyoxal. 9 patients were machinists without obvious exposure to glyoxal. A grinder with work-related facial dermatitis is described in detail. The chemical analysis of air samples from his workplace revealed 9.4-21 microg/m3 glyoxal. Glyoxal was also present in the used metal-working fluid, and apparently it had been formed during grinding. The remaining 6 patients worked in miscellaneous occupations and had no present exposure to glyoxal. Glyoxal is irritant on patch testing. Especially, solitary reactions to glyoxal 10% in aq. may be false-positive irritant reactions. 9 (45%) of our patients reacted to formaldehyde or glutaraldehyde. Glyoxal is an important allergen in dentistry and medical care, and we recommend it to be added to the antimicrobial patch test series. It also seems to be a 'hidden' allergen in the metal industry.     

Allergic contact dermatitis from salicyl alcohol and salicylaldehyde in aspen bark (Populus tremula)

Salicyl alcohol or 2-methylolphenol is a well-known allergen in phenol-formaldehyde resins and a strong sensitizer in guinea pigs. There is 1 previous report of allergic contact dermatitis from salicyl alcohol in aspen bark. We describe a second case with concomitant allergy to salicylaldehyde. An elk researcher who had handled leaves from various trees presented with eczema of the hands, face, flexures, trunk and extremities. Patch testing showed sensitivity to salicyl alcohol, salicylaldehyde, balsam of Peru (Myroxylon pereirae resin), aspen wood dust and an extract prepared from the bark of aspen (Populus tremula). Weaker reactions were observed to bark extracts of rowan (Sorbus aucuparia), tea-leaved willow (Salix phylicifolia) and goat willow (Salix caprea). We analysed salicyl alcohol and salicylaldehyde in the bark extracts and found the 2 chemicals in equal amounts, about 0.9 microg/mg in aspen bark and in lower concentrations in rowan and the willows. We did not find either of the chemicals in the test substance of balsam of Peru (Myroxylon pereirae). Besides salicyl alcohol, salicylaldehyde is also recommended to be used to screen for contact allergy to aspen. Both of these chemicals should be tested in forest workers in areas where aspen is growing.     

寻常型银屑病患者外周血单个核细胞TLR9-mRNA的表达及与IFN-γ的相关性分析

目的：探讨寻常型银屑病患者外周血外周血单一核细胞（PBMCs）Toll样受体9（Toll—like receptor9,TLR9）的表达及其与血清中IFN-γ浓度的相关性,初步探讨TLR9在寻常型银屑病发病中的作用。方法：采用荧光定量PCR技术检测外周血单个核细胞TLR9的表达,并采用双抗体夹心酶联免疫吸附法（ELISA）检测血清IFN-γ的浓度。另取20例正常人作为对照组．结果：寻常型银屑病患者外周血中单核细胞TLR9的表达较正常人对照组明显增高（P〈0．01）,TLR9表达与血清IFN-γ浓度变化呈正相关（P〈0．05）。结论：结果提示TLR9及其介导的天然免疫鹰答在银屑病发病机制中起重要作用,其机制可能是通过上调IFN-γ的表达促使炎症因子产生和分泌而介导银屑病的发病。     

Concomitant sensitization to triglycidyl isocyanurate, diaminodiphenylmethane and 2-hydroxyethyl methacrylate from silk-screen printing coatings in the manufacture of circuit boards

A 48-year-old female silk-screen printer had worked in the manufacture of circuit boards for 12 years before she got the first symptoms of dermatitis on her wrists and lower arms. On the 1st patch test session, epoxy resin and the remainder of the standard series were negative, while a plastics and glues series gave an allergic reaction to 4,4'-diaminodiphenylmethane (DDM). The 2nd test session revealed allergic reactions to several acrylics, several epoxy compounds and 3 ink components. According to the material safety data sheets, 1 ink hardener contained DDM, but the causative agent in 1 ink and 1 ink hardener remained uncertain. The manufacturers of the 2 inks kindly provided us with their components for further patch tests. 2 of these components gave allergic reactions: triglycidyl isocyanurate (TGIC) and 2-hydroxyethyl methacrylate (2-HEMA). Our case report shows that the manufacture of circuit boards involves exposure to highly sensitizing chemicals. DDM, TGIC and 2-HEMA should be remembered as silk-screen printers' potential contact sensitizers in the manufacture of circuit boards.     

加替沙星联合体外高频热疗治疗男性非淋菌性尿道炎的临床效果观察

目的：探讨加替沙星配合局部高频热疗治疗男性非淋菌性尿道炎（NGU）的疗效以及安全性分析。方法：选取男性非淋菌性尿道炎患者120例,按数字表法随机分为两组,每组60例,对照组给予加替沙星治疗,观察组采用加替沙星联合高频热疗治疗,采用NIH—CPSI评分表量化,观察两组患者症状疗效以及药物与高频热疗的安全性。结果：治疗前两组CPSI评分无显著差异（P〉0．05）,治疗后两组CPSI评分均显著改善（P〈0．05）,且观察组有效率88．33％显著高于对照组有效率71．67％（P〈0．05）,两组患者均未出现严重不良反应。结论：加替沙星联合体外高频热疗治疗非淋菌性尿道炎效果显著优于单纯服用加替沙星,体外高频热疗为治疗NGU的有效物理疗法,对提高NGU的治愈率、提高患者生活质量有积极的意义。     

FQ-PCR技术在妇科HPV感染中的应用

目的:体现荧光定量PCR检测技术(FQ-PCR)的临床实用价值及优越性,了解当地人群感染的实际情况.方法:针对HPV6.11型(尖锐湿疣)可疑病例及HPV16.18型(宫颈癌高危人群)应用FQ-PCR技术检测,统计学处理为应用几何均数对HPV6.11HPV16.18测定结果计算平均差及对数值.结果:FQ-HPV6.11-PCR尖锐湿疣可疑130例,53例阳性,检出率40.77%,测定值5.05±3.49;FQ-HPV16.18型,高危人群66例,13例阳性,检出率19.69%,测定值为3.48±2.57.结论:FQ-PCR检测技术具有灵敏、简捷、安全、特异性强的特点,避免了单纯PCR高效扩增产生的假阳性,另外定量结果可为临床治疗及观察病情变化提供可靠依据,有较高的临床实用价值.     

建立巢式PCR和异源双链法检测石蜡标本麻风菌DDS耐药株

目的：为了能检出石蜡包埋组织中麻风菌氨苯砜（DDS）的耐药基因folPl，有必要建立敏感、特异的巢式PCR，为开展回顾性麻风菌DDS耐药流行病学研究服务。方法：从石蜡组织中提取麻风菌DNA，建立巢式PCR，优化PCR条件，扩增DDS耐药基因片段。用异源双链法筛选突变菌株，并经直接测序进一步证实。结果：巢式PCR将PCR检测folPl的敏感性，从6．5％（3／46）提高到76．7％（33／43）；优化后的巢式PCR，最终使敏感性更进一步提高至90．7％（39／43）。8株folPl突变菌、两种突变型被发现。结论：巢式PCR是一项快速、简便、可行的方法。通过优化多项PCR条件，提高了石蜡包埋组织中folPl检测的敏感性和特异性。异源双链法可用于筛选DDS耐药突变菌株。     

安定配伍654-2在米非司酮中期引产中的应用

目的:观察安定配伍654-2在米非司酮米索前列醇用于中期妊娠引产的效果。方法:将140例宫内孕14～24周自愿药物终止妊娠的孕妇,口服米非司酮及米索前列醇,待其出现有效宫缩后,用药组静推安定及654-2,对照组不用。统计两组总产程及产后2小时出血量。结果:显示用药组产程缩短,宫缩痛减轻,出血量不增加。结论:应用安定及654-2,缩短引产时间的同时,并不增加产后出血量。     

白癜风患者血浆三种神经肽测定及其临床意义

目的：β内啡肽（β－EP）、神经肽Y（NPY）及降钙素基因相关肽（CGRP）是重要的神经递质,同时也可作为免疫调节因子发挥作用。本研究旨在观察这些神经肽是否可能与白癜风的发病有关。方法：用放射免疫分析法测定40例白癜风处于进展期或稳定期的不同类型患者血浆3种神经肽浓度,并与23例正常对照作比较。结果：寻常型（局限性与泛发性）、节段型、进展期和稳定期白癜风患者血浆β－EP、NPY水平均较正常对照组显著增高;进展期白癜风NPY比稳定期显著提高;泛发性及进展期白癜风血浆CGRP比正常对照组显著增高。结论：结果表明上述三种神经肽与白癜风的发病可能存在一定关系,开发神经肽拮抗剂对于白癜风的治疗可能成为一种新的途径。     

Risks and possibilities in patch testing with contaminated personal objects: usefulness of thin-layer chromatograms in a patient with acrylate contact allergy from a chemical burn

We report a case of a chemical burn from dipropylene glycol diacrylate (DPGDA) spilt on working shoes, followed by active sensitization, thus giving an occupational allergic contact dermatitis on the patient's dorsal feet. Diagnostic tests included patch testing with acetone extracts made from the different shoe layers and thin-layer chromatograms. An invisible spot on the thin-layer chromatography plate gave a test eczema and was further investigated with gas chromatography-mass spectrometry. DPGDA was detected in the spot.