糠秕马拉色菌蛋白酶活性的研究

目的　检测不同来源糠秕马拉色菌菌株的蛋白酶活性并研究蛋白酶活性与其致病性的关系。方法　使用全脂牛奶平板法检测糠秕马拉色菌 3 3株临床分离株和 2 8株正常皮肤分离株蛋白酶活性 ,并选择蛋白酶活性不同的 3株菌以静脉内注射方式感染免疫抑制小鼠进行毒力实验 ,以小鼠死亡率和平均生存时间来评价菌株毒力。结果　糠秕马拉色菌临床分离株蛋白酶活性高于正常皮肤分离株 (t =5 .2 96,P <0 .0 1) ,动物试验表明蛋白酶活性愈高的菌株 ,相应死亡率愈高 ,小鼠平均生存时间愈短 ;蛋白酶活性与菌株致病性呈直接正相关 (r =0 .992 5 ,P <0 .0 1)。结论　糠秕马拉色菌临床分离株蛋白酶活性高于正常皮肤分离株 ,蛋白酶活性高低与菌株的致病性相关     

Q开关Nd:YAG 1 064 nm激光对表皮葡萄球菌活性及结构的影响

 目的:探讨不同能量密度的Q开关Nd:YAG 1 064 nm激光对表皮葡萄球菌的菌体活性及结构的影响。方法: 临床获取毛囊炎标本,用胰蛋白胨大豆肉汤琼脂平板（TSA）培养获取菌落,基因测序进行鉴定,确定表皮葡萄球菌后进行培养,使用Q开关Nd:YAG 1 064 nm激光对菌体进行照射。实验组：激光光斑直径2 mm,脉宽≤8 ns,根据不同能量密度159、191、222、254、287 J/cm2分设5组;对照组不予激光照射。以菌落计数法评估菌体活性,并利用透射电镜观察菌体结构的改变。激光能量与菌落数的相关性采用Pearson相关分析。结果:实验组菌落计数分别为（234 500±12 554）、（89 200±10 485）、（52 200±6 214）、（26 200±4 157）、（8 300±2 213） CFU/mL,对照组菌落数为（276 400±13 150) CFU/mL,各组间差异有统计学意义（F=1 536.97, P<0.05）。激光能量与菌落数呈负相关（r=-0.90,P<0.05）。能量密度在191 J/cm2以上时,对菌体结构有破坏作用,能量越大,破坏程度越大。结论: Q开关Nd:YAG 1 064 nm激光对表皮葡萄球菌有抑菌和结构破坏作用。     

从花斑癣患者的皮损区及非皮损区分离和鉴定马拉色菌

目的 研究花斑癣患者皮损区及非皮损区马拉色菌菌种构成;不同解剖部位、皮损颜色及各菌种的分布情况;患者病情和年龄与菌种构成的关系。方法 用无菌胶带粘取113例花斑癣患者皮损区及非皮损区共629个部位的皮屑,分别接种于含菜子油培养基中分离马拉色菌,用生理生化及形态学方法鉴定菌种。结果 皮损区与相对应的非皮损区马拉色菌分离阳性率无差别,非皮损区额部和胸背部分离阳性率高于上、下肢。共分离到565株马拉色菌,鉴定出合轴马拉色菌(44.78%)、糠秕马拉色菌(32.94%)、球形马拉色菌(11.68%)、钝形马拉色菌(5.84%)及限制马拉色菌(4.76%)共5个种,有27处(5.01%)同时分离到两种菌。皮损区与非皮损区菌种构成无明显差别,限制马拉色菌主要从额部分离出。菌种构成与皮损面积无关,但与皮损颜色和患者年龄有关。皮损颜色与病程无关。结论 花斑癣患者皮损区与非皮损区马拉色菌分离阳性率和菌种构成基本一致,与病情无关,而不同解剖部位、皮损类型及年龄患者的菌种构成有一定差异。     

糠秕马拉色菌对角质形成细胞增殖的作用北大核心

有人用糠秕马拉色菌和角质形成细胞共同培养的方法研究糠秕马拉色菌对角质形成细胞生物学行为的影响。我们采用不同浓度比值的糠秕马拉色菌和角质形成细胞共同孵育的方法,观察不同浓度糠秕马拉色菌作用下角质形成细胞的增殖情况,并对其可能的机制展开研究。     

活化T细胞及其Bcl-2、CD95在马拉色菌毛囊炎中的作用

目的:探讨马拉色菌毛囊炎患者体内细胞免疫,特别是活化T细胞及其凋亡信息在发病中的作用。方法:采用流式细胞仪分别检测研究对象外周血中的CD4 T细胞、CD8 T细胞、CD8 CD28 T细胞、CD8 CD28-T细胞、CD28 淋巴细胞、CD8 CD95 T细胞、CD8 CD95-T细胞、CD4 Bcl-2-与CD4 Bcl-2 和CD8 Bcl-2-与CD8 Bcl-2 。结果:该病患者体内的CD4 T辅助细胞明显减少(P<0.001),而CD8 T细胞明显增多(P<0.001);CD28 淋巴细胞有所减少(P<0.05),但CD8 CD28-明显增多(P<0.001),有显著性差异。CD8 CD28 T细胞有所增多,但无显著性差异(P>0.05)。患者的CD8 CD95 T细胞显著增加(P<0.05)。结论:由于体内CD4 T细胞显著减少,而CD8 CD28-T细胞明显增多,降低了患者体内的免疫应答能力;同时毛囊和表皮细胞凋亡过快。     

紫草素对糠秕马拉色菌作用下HaCaT细胞增殖的影响及其对缺氧诱导因子1α表达的调控

目的:观察紫草素对糠秕马拉色菌作用下角质形成细胞增殖的作用及其对缺氧诱导因子1α（hypoxic-inducible factor-1α,HIF-1α）蛋白及mRNA的作用,探讨紫草素通过抑制低浓度糠秕马拉色菌上调皮肤角质细胞的增殖与HIF-1α信号在银屑病中的可能机制。方法：培养人永生化角质形成细胞（HaCaT）细胞及糠秕马拉色菌,适合浓度糠秕马拉色菌诱导HaCaT细胞增殖,CCK-8法观察细胞增殖、蛋白免疫印迹法（Western Blotting）及实时荧光定量PCR(RT-PCR)法分别检测HIF-1α的蛋白及mRNA表达情况。结果：低浓度糠秕马拉色菌浓度依赖性促进HaCaT细胞增殖（P<0.01）;紫草素抑制低浓度糠秕马拉色菌对HaCaT细胞的促增殖作用（P<0.01）;紫草素抑制低浓度糠秕马拉色菌对HaCaT细胞HIF-1α蛋白及mRNA表达的作用（P<0.01）。结论：低浓度糠秕马拉色菌通过HIF-1α信号通路上调皮肤角质形成细胞的增殖能力;紫草素拮抗低浓度糠秕马拉色菌上调皮肤角质形成细胞的增殖可能与抑制HIF-1α信号通路有关。     

Q开关Nd:YAG 1064 nm激光照射对体外培养的PIG细胞黑素合成的影响

目的 探讨Q开关Nd:YAG 1064 nm激光照射对体外培养的人表皮黑素细胞系PIG细胞黑素合成的影响。方法 选择Medlite C6 Q开关Nd:YAG激光照射体外培养的PIG细胞,MTT法检测PIG细胞的活性,多巴氧化法检测酪氨酸酶活性的变化,荧光定量反转录（RT）-PCR和Westenr印迹分别检测酪氨酸酶相关蛋白（TRP）转录和蛋白表达水平。结果 ①在不影响细胞存活率的范围内,1 J/cm2照射后24 h时,PIG细胞酪氨酸酶活性（0.563 ± 0.014）与空白对照组（0.501 ± 0.019）比较轻度增加（P ＜ 0.05）,酪氨酸酶与TRP-1 mRNA表达（分别为1.40 ± 0.11,1.28 ± 0.03）与空白对照组（1.0）比较明显上调（P ＜ 0.05）,而TRP-2 mRNA表达（0.91 ± 0.17）并无明显变化（P ＞ 0.05）,其蛋白水平的变化与转录水平相符。②在不影响细胞活性的范围内,3 J/cm2照射后24 h时,PIG细胞酪氨酸酶活性（0.343 ± 0.012）与空白对照组（0.501 ± 0.019）比较明显下降（P ＜ 0.05）,酪氨酸酶、TRP-1和TRP-2的mRNA表达（分别为0.70 ± 0.02、0.73 ± 0.04、0.68 ± 0.04）和蛋白表达（分别为0.64 ± 0.05、0.86 ± 0.17、0.69 ± 0.11）与空白对照组（1.0）相比均不同程度的降低（P ＜ 0.05）。结论 Q开关Nd:YAG 1064 nm激光照射可以影响PIG细胞的黑素合成。在不影响细胞存活率的范围内,能量密度为1 J/cm2的Q开关 Nd:YAG 1064 nm激光照射能够刺激黑素合成,而3 J/cm2的照射对黑素合成有抑制作用。     

长脉宽与Q开关1064 nm Nd:YAG激光对皮肤作用的比较

目的:比较长脉宽1064 nm Nd:YAG激光和Q开关1064 nm Nd:YAG激光照射对小鼠皮肤的影响.方法:分别使用长脉宽1064 nm Nd:YAG激光(脉宽为3 ms、50 ms)和Q开关1064 nm Nd:YAG激光(脉宽5 ns)对小鼠背部脱毛后的皮肤进行照射,共照射4次,每次间隔1周.检测照射后不同时间点的皮肤弹性、皮肤羟脯氨酸含量,真皮内胶原增生情况以及红斑指数和经表皮失水量的变化情况.结果:从首次照射后第3或4周至第7周,各实验组的皮肤弹性都明显好于对照组;首次照射7周后各组实验侧的皮肤羟脯氨酸含量和真皮内胶原厚度都较对照组显著增大(P＜0.01),但各实验组之间无显著差异;苦味酸一天狼猩红染色-偏振光法检查显示各组增生的胶原主要为I型胶原.首次激光照射后即刻,各实验组的经表皮失水量及Q开关1064 nm Nd:YAG激光实验组的红斑指数都较其对照组显著增高(P＜0.01),并于1周内恢复.结论:长脉宽1064 nm Nd:YAG激光可以取得与Q开关1064 nm Nd:YAG激光对皮肤相似的效果,且不良反应较轻.     

马拉色菌与人角质形成细胞株共同培养液对培养人黑素细胞生长及酪氨酸酶mRNA表达的影响

目的:观察不同马拉色菌与人角质形成细胞株共同培养液对培养人黑素细胞生长及酪氨酸酶mRNA表达的影响,探讨花斑癣的色素改变是否与马拉色菌的不同菌种有关。方法:将球形、钝形、糠秕、合轴马拉色菌分别与人角质形成细胞株共同培养,24 h后收集上清液,按一定比例加入黑素细胞培养体系中继续培养24 h:①用四甲基偶氮唑兰比色法观察对黑素细胞生长的影响;②用实时荧光定量PCR法测定黑素细胞酪氨酸酶mRNA的表达。结果:各共同培养液对黑素细胞生长无明显影响,但除球形马拉色菌与人角质形成细胞共同培养液可上调黑素细胞酪氨酸酶mRNA的表达(P<0.05)外,未见其它种马拉色菌与人角质形成细胞株共同培养液对黑素细胞酪氨酸酶mRNA的表达有影响。结论:球形马拉色菌与人角质形成细胞株共同培养液刺激黑素细胞后,能提高酪氨酸酶mR-NA的表达,该菌可能与花斑癣的色素沉着有关。     

Q开关Nd:YAG激光和585nm脉冲染料激光治疗色素性、血管性皮肤病1686例

目的评估Q开关Nd:YAG激光和585nm脉冲染料激光治疗色素性皮肤病和血管性皮肤病的疗效。方法分别采用Q开关Nd:YAG激光治疗色素性皮肤病400例、585nm脉冲染料激光治疗血管性皮肤病1177例,并采用二者治疗病毒疣109例,观察疗效。结果Q开关Nd:YAG激光对色素性皮肤病的有效率由高到低依次为:雀斑(100%)、文身(87.50%)、脂溢性角化(84.60%)、斑痣(46.70%)、咖啡斑(40.40%);585nm脉冲染料激光对血管性皮肤病的有效率由高到低为:蜘蛛痣(98.30%)、草莓状血管瘤(91.40%)、红斑期酒渣鼻(83.30%)及颜面毛细血管扩张(80.00%);二者对病毒疣的有效率分别为:寻常疣90.10%、尖锐湿疣66.70%、扁平疣52.60%。结论Q开关Nd:YAG激光治疗色素性皮肤病、585nm脉冲染料激光治疗血管性皮肤病及二者治疗病毒疣疗效较好。     

A split-face,investigator-blinded comparative study on the efficacy and safety of Q-switched Nd:YAG laser plus microneedling with vitamin C versus Q-switched Nd:YAG laser for the treatment of recalcitrant melasma

Background: High recurrence has previously been reported in the treatment of melasma with low-fluence 1,064-nm Q-switched neodymium-doped yttrium aluminium garnet (QS-Nd:YAG) laser. On the other hand, the efficacy and safety of the QS-Nd:YAG laser plus microneedling with vitamin C have not been evaluated in patients with mixed-type melasma. Material and methods: Sixteen patients with recalcitrant dermal- or mixed-type melasma were included in the study. One side of patients’ face was treated with QS-Nd:YAG laser plus microneedling with vitamin C (Group A) and the other side with QS-Nd:YAG laser alone (Group B) for four sessions at four-week intervals. Melasma Area Severity Index (MASI) scores and clinician’s evaluation of clinical response were assessed monthly. Results: Group A had a significantly lower mean MASI score and better treatment response than Group B according to clinician’s evaluation. According to MASI scores, in Group B, two patients had a good response while 12 were unresponsive to treatment. Good or very good improvement was reported by 10 patients in Group A and three patients in Group B. Adverse effects and recurrence rates were similar in Groups A and B (31.3 and 43.8%, respectively). Discussion: QS-Nd:YAG increases the blood circulation in the dermis, thereby enhancing the mechanical effect of microneedling to promote the penetration of vitamin C. Conclusion: Vitamin C application with microneedling immediately after treatment with QS-Nd:YAG laser is a promising adjunctive method for the treatment of recalcitrant melasma.     

Q开关1064nm和532nm Nd:YAG激光对大鼠皮肤非剥脱性嫩肤作用的比较

目的:比较Q开关1064 nm和Q开关532 nm Nd:YAG激光照射对大鼠皮肤的非剥脱性嫩肤作用.方法:分别使用上述两种激光的三种不同能量密度对大鼠背部皮肤进行照射,动态观测皮肤弹性和皮肤含水量变化,光镜下观察大鼠背部皮肤真皮层厚度的变化,测定局部皮肤羟脯氨酸含量.结果:末次照射后第4周,大鼠试验侧的皮肤弹性和含水量都明显好于对照侧;试验侧皮肤羟脯氨酸含量和真皮层厚度都较对照侧显著提高(P<0.05).结论:Q开关1064 nm Nd:YAG激光较532 nm Nd:YAG激光具有更为明显非剥脱性嫩肤效果.     

532-nm and 1064-nm Q-switched Nd:YAG laser therapy for reduction of pigmentation in macular amyloidosis patches

Background Macular amyloidosis is a primary form of skin amyloidosis with deposition of small to moderate amyloid material in the upper dermis and mild pigmentary incontinence with resultant clinical hyperpigmentation. Objectives To determine the efficiency of Q‐switched Nd:YAG laser (532 and 1064 nm) in reducing the pigmentations due to skin macular amyloidosis. Methods A prospective, side by side, controlled, clinical trial study was designed. Twenty subjects with clinical diagnosis and pathology confirmation of macular amyloidosis were treated with Q‐switched Nd:YAG laser: 532 nm in a part of their plaques and with 1064 nm in another part of their plaques. Assessment of efficiency was done by colorimetric scores based on Mexameter measurement and also digital photographs before laser therapy and 8 weeks after treatment. Results Mexameter‐based data analysis showed that the two lasers (Q‐switched 532 and 1064 Nd:YAG) are effective in reducing the degree of macular amyloidosis patches pigmentation, and 532 nm is meaningfully more effective than 1064 nm in this matter. Photograph‐based analysis showed that 90% of cases treated by 532 nm had good or very good response, and for the 1064 nm–treated patches, 60% of cases had the good or very good response. Conclusions The results of study showed the net positive effect of Q‐switched Nd:YAG laser, either 532 nm or 1064 nm, in pigment reduction of macular amyloidosis patches, but the 532‐nm laser was more effective than 1064 laser.     

A prospective,randomized, double-blinded,split-face pilot study comparing Q-switched 1064-nm Nd:YAG versus 532-nm Nd:YAG laser for the treatment of solar lentigines

Treating photoaging with laser technologies has increased in popularity due to their efficacy, minimal downtime, and side effects. New Q-Switched (QS) Nd:YAG lasers’ frequency doubled with 532 nm wavelength can both target epidermal chromophores as well as stimulate collagen production. The objective of this study was to compare single-pulsed 1064-nm Nd:YAG with dual-pulsed 532-nm/1064-nm QS laser for reducing solar lentigines. Ten subjects with solar lentigines were enrolled in this prospective, randomized, double-blind, split-face study. Subjects received six laser treatments (half-face dual, half single) at 2-week intervals. Blinded investigator and subject assessments were conducted 1 month posttreatment to evaluate global skin improvement, safety, and patient satisfaction. Blinded investigator assessments showed statistically significant improvement in the dual-treated side. Patient satisfaction was also statistically significantly increased in the dual-treated side. In conclusion, dual laser treatment can result in superior and safe global improvement of photoaging.     

Novel technique to treat melasma in Chinese: The combination of 2940-nm fractional Er:YAG and 1064-nm Q-switched Nd:YAG laser

Melasma is one of the most common pigmented lesions in Chinese women. Although topical therapies are the mainstay treatment, lasers are being used increasingly to treat pigmented lesions. Laser treatment of melasma is however still controversial. This is because lasers have not been able to produce complete clearance of melasma and recurrence rates are high. Laser treatments also cause complications such as hypopigmentation and post-inflammatory hyperpigmentation. In this article, we report on a novel technique using a combination of fractional 2940-nm Er:YAG and 1064-nm Q-switched Nd:YAG lasers. We achieved a rapid improvement in two cases of melasma in Chinese type III skin. The improvement was seen rapidly within a month of treatment. Follow-up at 6 months showed sustained results with no complications. This novel technique is able to safely confer excellent and sustained clearance within a short treatment time.     

Picosecond alexandrite laser is superior to Q-switched Nd:YAG laser in treatment of minocycline-induced hyperpigmentation: A case study and review of the literature

Background: Minocycline is a commonly prescribed tetracycline antibiotic used for the treatment of a number of dermatological conditions including acne and rosacea. Long-term adverse effects of minocycline include cutaneous hyperpigmentation. Various treatment options have been suggested for the treatment of minocycline pigmentation. We report a case of a patient on long-term low-dose minocycline for the treatment of rosacea with type III minocycline hyperpigmentation. A comparison was made between Q-Switch Nd:YAG and picosecond laser over a nine 9-period with treatments spaced 1 month apart, with a clearance in the patient pigmentation after four treatments with picosecond laser.     

Effect of piroxicam gel for pain control and inflammation in Nd:YAG 1064-nm laser hair removal

Background Laser‐assisted hair removal is a variably uncomfortable and painful procedure. Objective The aim of this study was to investigate the efficacy of piroxicam gel on pain control and subsequent inflammation in Nd:YAG 1064 nm laser hair removal in women volunteers. Methods Fifty women volunteers were enrolled in this prospective, randomised, placebo‐controlled study over a 6‐month period. Subjects were randomly assigned to receive piroxicam gel as Group P or saline as a control group. Topical analgesic and saline were applied to the treatment sites for 45 minutes. The pain scores (VAS) and side effects were recorded before the hair removal, during the hair removal, at the end of the hair removal, and after 1 hour, 2 hours and 24 hours after the hair removal. Results Subject characteristics and treatment settings in Nd:YAG 1064 nm laser were similar in both groups. The pain scores (VAS) were significantly lower in the Group P than those of the control group during the hair removal (p < 0.001). Inflammatory side effects such as erythema, edema, and folliculitis, were more frequent in the control group than those of Group P during the procedure (p < 0.001). Conclusion This study showed that piroxicam gel provided adequate pain relief after Nd:YAG 1064 nm laser hair removal in women volunteers. Piroxicam gel was associated with lesser inflammatory side effects when compared to placebo because of its anti‐inflammatory effect after the procedure.