Relume光子色素再生仪照射治疗皮肤白斑病的临床观察

目的探索用紫外线B波(ultraviolerB，UV-B)Relume光子色素再生仪照射治疗各种不同类型皮肤白斑的临床效果。方法随机选择各种不同类型皮肤白斑共45例，其中妊娠纹20例、膨胀纹1例、手术后白斑4例、外伤性瘢痕白斑10例、放射性白斑2例、白癜风6例、不明原因的白斑2例。采用Relume UV—B(光谱范围290～320nm)光子色素再生仪的不同的能量密度，照射治疗，1周1次，3～20次不等。结果治疗的45例中，42例完成了治疗和随访，随访时问为14个月，增色效果非常满意的27例占64．3％，其中妊娠纹10例，外伤性白斑8例，手术瘢痕白斑4例，白癜风5例，满意的12例占28．6％，其中妊娠纹7例，外伤性瘢痕白斑1例，白癜风1例，不明原因白斑2例，膨胀纹1例，无效的3例占7．1％。14例占33．3％的患者2～5个月后需要补充治疗。结论不同类型的皮肤白斑可接受UV—B波的照射增色治疗，其增色效果与白斑性质有关，除放射性白斑外其他类型皮肤白斑均可获得满意的增色效果。     

蓝紫光和强脉冲光联合治疗痤疮的临床观察

目的探讨应用两种不同光源的光，联合照射治疗痤疮的临床效果。方法采用405～420nm波长的蓝紫光和560～1200nm的强脉冲光，联合照射治疗不同阶段的痤疮：用Clear light光子痤疮治疗仪405～420nm蓝紫光，照射治疗痤疮的炎症脓疱期，照射6次，3天一次，每次15～18min；用560～1200nm强脉冲光，照射治疗痤疮炎症消退后的红色色素期，照射5、6次，3周一次。结果180例痤疮患者用两种不同光源的光，联合照射治疗后，痊愈165例(91．7％)，好转15例(8．3％)，有效率100％；随访2年，痤疮无复发162例(90％)，好转18例(10％)。结论采用405～420nm波长的蓝紫光和560～1200nm的强脉冲光联合光线疗法，照射治疗痤疮，是安全有效的治疗方法。     

中波紫外线治疗色素减退性皮肤病

目的：探讨在黄种人中应用中波紫外线(UVB)治疗色素减退性皮肤病的方法、效果及影响因素。方法：应用中波紫外线治疗白癜风、妊娠纹、色素减退性瘢痕等色素减退性皮肤病共40例。结果：中波紫外线治疗色素减退性皮肤病的有效率分别为：白癜风60％；妊娠纹80％；色素减退性瘢痕60％；三种疾病的治疗效果无统计学差异。治疗效果与皮损面积有关，面积较小者治疗效果较好，不良反应较轻。结论：中波紫外线是一种安全有效的治疗常见色素减退性皮肤病的方法。     

光子嫩肤技术治疗面部雀斑的临床观察

目的 证明应用光子嫩肤仪治疗面部雀斑是有应用前景，并可推广的治疗方法。方法 采用波长560nm的IPL Quantum SR光子嫩肤仪治疗面部雀斑1～3次，每次间隔3～4周，术前术后拍照对比。观察临床效果，并一一做好记录。结果 671例患者随访6个月至1年。593例治疗效果稳定，78例经第2个疗程治疗后，雀斑基本消退。以雀斑减少50％以上为有效，减少80％以上为显效。667例有效(占99．5％)。568例显效(占84．6％)，4例无效(占0．6％)。结论 使用光子嫩肤仪治疗雀斑方便陕捷，安全有效，操作简单，无需休息，患者易于接受。是目前值得推广、有应用前景的治疗方法之一。     

疤痕止痒软化乳膏联合射频美容修复妊娠纹效果观察

目的:探究采用疤痕止痒软化乳膏联合射频美容修复妊娠纹的效果。方法:选择2017年11月-2018年11月在笔者医院就诊且有妊娠纹的108例患者作为研究对象,按照患者意愿以及随机数字表分组原则依据1:1比例分为对照组与研究组,均为54例,分别采用疤痕止痒软化乳膏和疤痕止痒软化乳膏联合射频美容修复进行治疗。比较两组患者治疗前后妊娠纹情况评分、腹部美容评分、治疗后美容效果、不良反应发生率及妊娠纹治疗效果。结果:两组患者治疗后妊娠纹情况评分均明显减少,且治疗后研究组妊娠纹颜色、严重程度、深度以及皮肤质地评分显著少于对照组,差异有统计学意义(P0.05)。两组治疗后腹部美容评分较治疗前显著下降,研究组明显低于对照组,差异有统计学意义(P0.05)。研究组治疗后美容总有效率(92.59%)显著优于对照组(75.93%),差异有统计学意义(P0.05)。研究组与对照组治疗后不良反应发生率比较差异无统计学意义(11.11% vs 9.26%,P0.05)。结论:产后妊娠纹采用疤痕止痒软化乳膏联合射频美容修复可以有效治疗并淡化,提高腹部美容效果,临床应用价值高。     

维纳斯QS1064nm与755nm激光治疗太田痣982例临床分析

目的：观察维纳斯QS 1064nm与755nm激光治疗太田痣的临床效果。方法：对临床982例太田痣患者根据色素深浅不同，采用QS 1064nm与755nm激光治疗。结果：治疗4次以上，3次、2次和1次的有效率分别为：100％、98．4％、83．59％、63．85％。982例中有674例(占68．64％)数次治疗后达到优效，一般需治疗3-5次。轻型、中型、重型与双侧型一般分别经3、4、5次治疗达到优效。结论：QS 1064nm与755nm激光在治疗太田痣皮肤病变中可依病变色素深浅而选择，疗效令人满意。     

长脉冲1 064nm激光联合高硫型水化硫铝酸钙540nm光子治疗面部毛细血管扩张症

目的探讨应用长脉冲1064nm激光联合高硫型水化硫铝酸钙（AFT）540nm光子治疗面部毛细血管扩张症。观察治疗效果。方法采用“飞顿I号”复合血管治疗仪,根据皮肤分型及治疗反应,选择不同能量密度和脉宽进行治疗。结果60例患者经4～6次治疗,均有疗效;无1例出现瘢痕、色素变化,总有效率达100％。结论长脉冲1064nm激光联合AFT 540nm光子治疗面部毛细血管扩张症效果明显,是一种安全、有效的治疗方法。     

双极多通道射频联合负压治疗仪改善腹部皮肤松弛伴妊娠纹的临床疗效研究

目的:探讨双极多通道射频联合负压治疗仪改善腹部松弛伴妊娠纹的临床疗效及安全性。方法:选择2017年10月-2018年5月于笔者医院行腹部松弛伴妊娠纹修复治疗的10例女性就诊者为研究对象,按照随机数字表法,将每位就诊者左、右半侧腹部随机分为观察侧与对照侧。观察侧给予2个疗程,共8次射频治疗,对照侧不进行治疗。比较就诊者观察侧腹部临床疗效、治疗前后两侧腹部评分差值及就诊者满意度评分,分析双极多通道射频负压治疗仪改善腹部松弛伴妊娠纹的的临床疗效及安全性。结果:治疗后观察侧腹部外观较为紧致且妊娠纹颜色变淡,条纹变窄;1个疗程及2个疗程后观察侧临床总有效率分别为60%和90%;治疗前左右两侧腹部评分差值为(0.1±0.58)分,治疗后左右两侧腹部评分差值为(1.7±0.67)分,差异有统计学意义(P0.05)。就诊者对近期改善度、远期效果维持度、治疗舒适度、治疗安全性及总体满意度评分分别为(14.8±0.92、15.4±0.84、21±1.49、21.3±1.49、72.5±2.51)分,总体满意率为90%。所有就诊者在整个治疗过程中均无严重不良反应发生。结论:双极多通道射频负压治疗仪将射频与负气压相结合,可增强射频能量穿透深度,改善腹部皮肤松弛及妊娠纹,疗效确切、安全。     

eMatrix水滴点阵激光联合透明质酸修护敷料治疗腹部妊娠纹

目的:观察eMatrix水滴点阵激光联合透明质酸修护敷料治疗腹部妊娠纹临床疗效。方法:30例腹部妊娠纹就医者随机分为治疗组和对照组,每组各15例。治疗组采用eMatrix水滴点阵激光后外用透明质酸修护敷料,2次/d,共使用7d;对照组使用eMatrix水滴点阵激光治疗。治疗结束后观察创面愈合时间,炎症后色沉的恢复情况。3个月后进行第2次治疗,共治疗3个疗程。结果:最后一次治疗结束后3个月观察评估就医者妊娠纹恢复情况。其中治疗组中9例显效,3例有效,3例无效,只有2例出现色素沉着,总有效率为80%;对照组5例显效,4例有效,6例无效,有8例出现了色素沉着,总有效率为60%,治疗组有效率显著高于对照组(P0.05)。两组就医者均未见瘢痕、皮肤感染等并发症。结论:eMatrix水滴点阵激光联合透明质酸敷料能更好治疗妊娠纹并减少色素沉着的发生。     

单用308nm准分子激光与联合他卡西醇治疗白癜风的疗效对比观察

目的 比较单用308nm准分子激光疗法治疗白癜风与联合局部应用维生素D3类似物他卡西醇治疗白癜风的疗效和安全性。方法 用单盲、自身对照的方法对78例稳定期泛发性的白癜风患者的自身对称或相邻的皮损采用308nm准分子激光治疗,实验组联合外用他卡西醇软膏,对照组用安慰剂软膏,1个月观察1次,拍照对比疗效,对78例患者进行治疗后评价。结果 不同治疗部位疗效评价：实验组头面、躯干、四肢皮损的总有效率分别为93．5l％,84．16％,42．35％,对照组总有效率分别为90．90％,77．45％,34．15％（P〈0．05）;不同类型的皮损治疗效果比较：实验组寻常型和节段型皮损总有效率分别为86．80％,93．33％,对照组分别为73．81％,84．00％（P〈0．05）;照光次数和累积照光剂量比较：实验组最初色素再生时照光次数和光累积量分别为（16．15±3．22）次和（4．40±5．03）J／cm＾2,对照组分别为（18．56±3．50）次和（6．60-i-1．01）J／cm。（P〈0．05）,显效的患者实验组为（20．36±1．50）次和（7．50±3．54）J／cm＾2,对照组为（21．68±2．40）次和（8．80±9．24）J／cm＾2（P〈0．05）。结论 308nm准分子激光治疗白癜风有效而且安全,联合他卡西醇外用可以提高白癜风患者的治疗反应,增强308nm准分子激光的疗效,缩短色素再生的时间,减少照光的能量。     

Narrowband UV-B phototherapy in the treatment of cutaneous graft versus host disease

Graft versus host disease (GVHD) is an important problem following allogenic bone marrow transplantation (BMT). The beneficial effects of photochemotherapy with psoralens plus UVA irradiation (PUVA) have been described repeatedly; however, PUVA is limited by a wide range of unwanted effects. A novel improved form of UV-B phototherapy, narrowband UV-B, has been proven to be very effective in T-cell mediated dermatoses. Therefore, we investigated the effect of narrowband UV-B phototherapy (5 times per week) in 10 patients with cutaneous GVHD (grade 2-3) resistant to standard immunosuppressive drugs. It was tolerated well by all patients, and no side effects were observed. Skin lesions showed complete clearance in 7 out of 10 patients within 3 to 5 weeks. 3 patients showed significant improvement of GVHD. We suggest that narrowband UV-B phototherapy is a nonaggressive treatment that may benefit patients with cutaneous GVHD who already take high doses of immunosuppressive drugs.     

Comparison of the 585 nm Pulse Dye Laser and the Short Pulsed CO2 Laser in the Treatment of Striae Distensae in Skin Types IV and VI

BACKGROUND: Striae distensae, or stretch marks, are a very common cosmetic problem. The successful management of stretch marks has long been a source of frustration and curiosity for both the clinician and the researcher. Recent studies suggest lasers may have a role in their management. As yet, no study has reported on the effects of either of these lasers in the treatment of stretch marks on persons with skin types 4 to 6. OBJECTIVE: To assess the efficacy of short pulsed CO2 laser and pulsed dye laser for the treatment of stretch marks in skin types 4, 5, and 6. METHODS: Four patients were initially enrolled in the study. All were female with abdominal stretch marks, present for a range of 8 to 19 years. The patients had skin types ranging from 4 to 6. The test area consisted of a stretch mark long enough to be divided into three contiguous 2 cm sections, labeled A, B, and C. Section A served as the short pulsed CO2 test site, section B served as a control, while section C served as the 585 nm pulsed dye site. Patients were seen for evaluation after 1 week, then every 4 weeks for a total of 20 weeks. Patients were evaluated subjectively by the investigators, and the patients' own self-evaluation was reported as well. RESULTS: Following the 585 nm pulse dye laser, at 20 week follow-up patients with type 4 skin showed no improvement, while type 6 skin showed hyperpigmentation. The short pulsed CO2 test site showed persistent erythema in type 4 skin and marked hyperpigmentation in type 6 skin. CONCLUSIONS: For patients with types 4, 5, and 6 skin, laser treatment of striae should be avoided or used with great caution.     

窄谱红蓝光治疗仪联合中药面膜治疗寻常性痤疮疗效观察

目的:探讨蓝光(417nm)和红光(630nm)交替照射治疗轻中度痤疮的疗效。方法:将94例轻中度痤疮患者随机分为治疗组、对照1组和对照2组,共三组。治疗组采用红蓝光照射联合中药面膜;对照1组单用红蓝光照射;对照2组单用自制中药面膜敷脸,均2次/周,三组均外用痤疮洗剂,口服复方珍珠暗疮片,共4周。结果:治疗组总有效率为80.00%,对照1组、对照2组总有效率分别为66.66%、64.51%,治疗组总有效率与对照组比较差异有统计学意义(χ21=4.23,χ22=4.85,P<0.01),对照1组和对照2组比较差异无统计学意义(χ2=12.34,P>0.05)。结论:417nm蓝光和633nm红光联合中药面膜对轻中度痤疮的治疗安全、有效,可以缩短疗程,提高治愈率。     

Striae Distensae After Subfascial Breast Augmentation

Striae distensae or stretch marks after breast augmentation are a rare complication. To date, 10 cases have been published. In seven of these cases, the implant was placed in a subglandular position and in the other three cases, placement was submuscular. Two cases of stretch marks in two young nulliparous women who underwent subfacial breast augmentation are presented. To the best of the authors’ knowledge, this is the first report of striae distensae after subfascial breast augmentation.     

Effects of phototherapy on newborn rat testicles

Phototherapy is the most widespread treatment for lowering bilirubin concentration in neonates. In the routine, phototherapy has some side effects including skin eruption, fluid loss, abdominal distention, mild hemolysis and mild thrombocytopenia. The aim of the study was to investigate the possible mutagenic and gametocidal side effects of 72 h continuous phototherapy on the rat testicle. We observed decreases in spermatogonia numbers per tubule (S/T values), tubular fertilization index (TFI) and sperm sertoli cell index (SSCI), which are the most reliable methods in estimating future fertility potential, due to sensitivity to phototherapy. The differences between study and control groups for S/T, TFI and SSCI values were statistically significant (p = 0.008, p = 0.02 and p = 0.004, respectively). There were significant differences in seminiferous tubule diameters between the control and study groups (p < 0.005), but no significant difference in DNA index values between the control (0.66 +/- 0.12) and study (0.59 +/- 0.05) groups (p > 0.05). As a conclusion, phototherapy seems to have some side effects on the newborn rat testicle. Further studies with larger groups, designed for investigation of the effects of phototherapy on seminiferous tubules, may give more beneficial results.     

Effects Achieved on Stretch Marks by a Nonfractional Broadband Infrared Light System Treatment

BACKGROUND: Infrared light systems reportedly produce collagen-related effects, enabling the treatment of several skin disorders. This study was designed to evaluate effects on stretch marks from an intense pulsed light infrared device, which achieved high fluences with high-frequency stacked pulses on selected areas. METHODS: For this study, 10 patients were recruited for treatment with the NovaPlus infrared device. Three passes per session over four sessions were given 15 days apart. The patients were advised to maintain their weight throughout the study period to avoid any impact on stretch marks. Objective evaluation was performed by using a computer program to compare photographs taken before and 3 months after the last session. Three-dimensional (3D) skin surface analysis also was performed using scores of "worse," "same," "fair," "better," and "much better." Biopsies were taken immediately before the first treatment and 3 months after the last session. Also, responses to questionnaires were evaluated to determine the patients' satisfaction index. RESULTS: Few patients noted improvement. Photographs of stretch marks checked by computer analysis and 3D skin surface imagery gave a practically equal outcome, with no "worse" or "much better" results. However, these objective tests demonstrated greater improvement than shown by the clinician and patient findings. Histology showed positive changes in the epidermis and dermis related to improvement in tissue condition. The satisfaction index from the questionnaires was average. The authors recognize that the small number of subjects possibly limited the statistical power of the study. CONCLUSIONS: Objective improvement observed in the overall skin condition did not match the visual observation. The absence of side effects or complications and good compliance with the treatment suggest that extra treatment sessions with the infrared light device could be tried to obtain a better outcome.     

Juvenile mammary hypertrophy. Early surgical treatment

The elastic and retractile nature of young skin allows glandular reductions to be performed without skin excision for the treatment of mammary hypertrophy in very young girls. These reductions in volume prevent secondary ptosis and stretch marks and are performed via an isolated inframammary incision. The devascularisation induced blocks glandular growth and no recurrence of hypertrophy has been observed in our series of 34 cases with a mean follow-up of 16 months.     

Laparoscopy in the diagnosis of acute appendicitis in pregnant women]

Diagnostic laparoscopy in 96 pregnant women with suspected acute appendicitis revealed inflammation of the vermiform process only in two (2.1%) of them. In 81 cases acute surgical diseases of the abdominal organs were not found, extrauterine pregnancy was revealed in 9 and other diseases of the abdominal organs were detected in 4 cases. The threat of abortion was mistaken for acute appendicitis most frequently. Unjustified operation in such cases intensifies still more the signs of the threat of abortion. Analysis allows the assertion that the laparoscopic method should be decisive in the examination of pregnant women with a doubtful clinical diagnosis in suspected acute appendicitis. Laparoscopy is indicated when the reserves of the generally accepted clinical methods and noninvasive instrumental examination do not allow the diagnosis of acute appendicitis to be established or excluded; it is also recommended in establishing the exact diagnosis and determining the approach and volume of an operative intervention when there is a clinical picture of an acute surgical disease of the abdominal cavity.     

Treatment outcome using prednisone in corticosteroid-responsive primary nephrotic syndrome in children

In children, the nephrotic syndrome is usually corticoid-responsive; approximately 70% of patients experience relapses, frequently triggered by infections. Our paper presents the results obtained using a 4 month prednisone regimen. This retrospective study included 83 children afflicted with nephrotic syndrome over a 10 year span. We analyzed: age at diagnosis, boys/girls ratio, response to corticoid treatment - after one month of prednisone and at the completion of the treatment course, number of relapses and their frequency, complications of prednisone treatment. The median age at diagnosis was 4.8 years, males predominating M:F = 1.5:1. Complete response after 4 weeks of prednisone therapy was noted in 98.79% of cases. We had 116 episodes of relapses during the first year of follow-up, occurring in 67.4% of children (27.9% were frequent relapsers, 11.62% subsequently became corticoid-dependent). Late relapses, after the first year, occurred in 32.55% of cases. We noted mostly mild adverse effects of the prednisone treatment: occurrence of infections during therapy (16.27%), cushingoid facies (37.2%), hirsutism (4.6%), high blood pressure (4.65%), stretch marks (2.32%). In conclusion, the 4 month prednisone treatment regimen is efficient in inducing and maintaining a remission. The incidence of relapses is 32.55%, comparable to the figure cited in larger studies. Serious adverse effects are significantly lower with this regimen compared to other corticoid treatment schemes. Key wo