308 nm准分子激光对豚鼠皮肤黑素细胞的影响

目的:研究308 nm准分子激光对皮肤色素沉着的诱导作用,为其治疗白癜风提供科学依据.方法:以正常棕黄色豚鼠皮肤为实验模型,用不同剂量的308 nm准分子激光进行照射,分别采用肉眼评估、黑素细胞染色(Imokawa法)及黑素颗粒染色(Fontana-Masson法)研究该激光的致色素沉着作用;对不同照射剂量组豚鼠皮肤中的一氧化氮合酶(NOS)进行免疫组化染色,间接观察黑素调节因子一氧化氮(NO)的变化情况;苏木精-伊红染色观察表皮组织学改变.结果:各组的色素沉着评分、平均黑素数量以及多巴阳性黑素细胞数之间差异均具有统计学意义(P＜0.05).结论:308 nm准分子激光可诱导豚鼠皮肤色素沉着,且这种效应随着照射剂量的上升而增强.     

308nm激光对白癜风患者皮肤组织液ET-1和SCF的影响

目的：检测稳定期白癜风患者白斑与非白斑部位皮肤组织液内皮素-1（Endothelin-1．ET-1）、干细胞因子（Stem cell factor,SCF）在308nm激光（下称308激光）照射前后的水平,探讨308激光治疗白癜风的作用机制。方法：采用ELISA法检测30例白癜风患者在308激光照射前后白斑和非白斑部位皮肤组织液内ET-1和SCF水平。结果：白斑皮肤组织液中ET-1和SCF水平分别为669．84±119．64pg／mL和398．03±70．17pg／mL,明显高于非白斑部位（520．12±117．59pg／mL和269．46±62．24pg／mL）,差异有统计学意义（P〈0．05）。308激光照射后白斑皮肤组织液中ET-1和SCF水平分别为831．75±142．65pg/mL和530．94±70．48pg／mL,与照射前相比明显升高,差异有统计学意义（P〈0．05）。结论：308激光照射能促使角质形成细胞分泌ET-1和SCF,从而诱导黑素细胞的生成。     

GentleYAG 1064nm激光治疗对小鼠皮肤屏障功能及弹性的影响

目的研究GentleYAG1064nm激光嫩肤治疗对皮肤屏障功能的影响。方法GentleYAG1064nm激光照射小鼠背部皮肤,每周1次,在激光照射前、首次照射后1周、连续3次照射后1周和连续4次照射后4周时检测皮肤经表皮失水(tramsepidermalwaterloss,TEWL)、含水量和皮肤弹性的变化。结果首次激光照射小鼠皮肤后1周时TEWL,皮肤含水量和皮肤弹性基本上较正常对照组无显著性改变(P>0.05);连续3次激光照射小鼠皮肤后1周时TEWL值和皮肤含水量仍较正常对照组无显著性改变(P>0.05),但是皮肤弹性较正常对照组有显著性改善(P<0.05);连续4次激光照射小鼠皮肤后4周时TEWL值和皮肤含水量仍较正常对照组无显著性改变(P>0.05),皮肤弹性较正常对照组有显著性改善(P<0.05),其值高于连续3次激光照射后1周时,但两者间差异无显著性(P>0.05);用动态冷却系统(dynamiccoolingdevice,DCD)组和不用DCD组的TEWL值、皮肤含水量和皮肤弹性值在各个时间点上均无显著性差异(P>0.05)。结论①单次GentleYAG1064nm激光照射小鼠皮肤对皮肤屏障功能无明显的损伤。②多次GentleYAG1064nm激光照射可以改善皮肤弹性,说明多次GentleYAG1064nm激光照射有显著的嫩肤效果。③使用DCD对激光嫩肤效果无明显的促进作用。     

治疗剂量308nm准分子光对小鼠皮肤的致癌性

目的 探究常规治疗剂量308nm准分子光长期照射对小鼠皮肤的致癌性。方法 将96只昆明小鼠根据308nm准分子光照射时间(4周、8周、12周、16周、20周和24周)不同分为6组,每组8只,每个时间组均设正常对照组;参考人非增生性皮肤病变治疗剂量,初始照射剂量60mJ/cm2,1次/周,再根据治疗反应逐渐增加治疗剂量。照射结束后观察小鼠皮肤组织病理变化(HE染色)和免疫组化法检测P53蛋白表达。结果 正常对照组小鼠皮肤组织病理无明显改变,P53阳性表达率随照射时间增加无明显变化(P>0.05);308nm准分子光照射16周后,部分小鼠皮肤开始出现角质形成细胞的非典型增生及鳞状细胞癌病理表现,P53蛋白阳性表达率随照射时间延长而逐渐增加(P<0.05);照射16周、20周和24周时,308nm准分子光组阳性率均高于对照组,差异均有统计学意义(P均<0.05)。结论 308nm准分子光对小鼠皮肤具有一定致癌性,致癌风险同照射时间呈正相关。     

非磨削型嫩肤激光对小鼠皮肤失水的影响

目的 研究非磨削型激光嫩肤对皮肤屏障功能的影响.方法 用CooltouchⅡ 1320nm激光、Gentlelase755nm激光、Vbeam595nm激光、GentleYAG1064nm激光照射小鼠皮肤.并用1%透明质酸钠涂抹于GentleYAG 1064nm激光照射后的皮肤,观察1周内皮肤经表皮失水、含水量的变化.结果 激光照射小鼠皮肤1h时就出现了经表皮失水较正常对照组显著性增高(P<0.05),595nm激光照射引起的皮肤经表皮失水值增高在激光照射后的第7天恢复正常(P>0.05).1320nm激光在第2天时恢复正常(P>0.05),1064nm激光在第4天恢复正常(P>0.05),755nm激光在第4天恢复正常(P>0.05).GentleYAG1064nm激光照射部位的皮肤每天用1%透明质酸钠涂抹1次后,经表皮失水值在第4天恢复正常(P>0.05).结论 各种非磨削型嫩肤激光照射小鼠背部皮肤后均引起局部皮肤经表皮失水增加,24h内均未能恢复正常,但是在1周时均可基本恢复正常.波长较短的595nm激光引起的经表皮失水恢复较慢,而波长较长的1320nm激光引起的经表皮失水恢复较快.激光照射后外用1%透明质酸钠无助于皮肤经表皮失水的恢复.     

595nm可调脉宽染料激光治疗皮肤血管异常性疾病不良反应分析

脉冲激光的问世,使皮肤血管异常性疾病的治疗效果大为改观,治疗时不良反应明显减轻,治疗后继发性损害如局部瘢痕形成、色素异常、局部组织坏死和感染等明显减少,与传统的治疗方法相比,脉冲激光具有更大的优越性。     

308nm准分子激光对角质形成细胞分泌细胞因子的影响

目的探讨308nm准分子激光对人角质形成细胞(HKC)增殖及分泌细胞因子的影响。方法CCK-8法检测不同剂量准分子激光照射后12h及24h对HKC增殖的影响;ELISA法检测细胞培养上清液中干细胞生长因子(SCF)、集落细胞生长因子(GM-CSF)、成纤维细胞生长因子(bFGF)的浓度;DNA Ladder法检测准分子激光照射后HKC晚期凋亡情况。结果细胞活力与照射剂量呈负相关,照射后12h的细胞活力与24h相比差异有显著性(P=0.001);308nm准分子激光剂量在100～300mJ/cm2时,HKC分泌SCF,GM-CSF,bFGF的增加呈剂量依赖性,与对照组(0mJ/cm2)比较差异有显著性(P<0.001),6h后分泌的SCF,GM-CSF,bFGF开始增加,24h后达到峰值。准分子激光照射可诱导HKC出现晚期凋亡。结论308nm准分子激光可能通过诱导角质形成细胞分泌SCF,GM-CSF,bFGF等促进黑素细胞增殖分化的细胞因子,使白癜风皮损复色。     

皮肤淋巴瘤诊断和病理生理进展

近年来皮肤淋巴瘤的诊断得益于新技术,免疫标记有助于早期诊断蕈样肉芽肿,对非亲表皮性淋巴瘤可更好地特征化。CD_(30)抗原的表达对于大细胞非亲表皮性T淋巴瘤有预后价值。对抗原的T受体α/β或γ/δ的表达,其预后意义尚待确立。抗T受体可变区抗体可构成某些T淋巴瘤克隆的标记,基因型的确立对于诊断某些非亲表皮性淋巴瘤是一种进步,Southern印迹法未能解决早期诊断蕈样肉芽肿的难题,多聚酶链反应是具有光明前景的新技术。     

980nm激光经皮光纤介入治疗167例皮肤静脉畸形的疗效观察

目的 观察内窥镜辅助下980 nm波长激光经皮光纤介入治疗静脉畸形的疗效和安全性.方法 167例静脉畸形患者中女102例,男65例,年龄0.5～60岁.皮损见于四肢66例、头面部48例、胸腹部24例、背部13例、颈部10例、阴囊6例.使用980 nm波长激光,固定脉冲0ms ～ 2.5 s,脉宽能量0～20 W,光纤直径400 μm.病灶周围环状浸润麻醉后穿刺,同一穿刺点置入光纤,利用光热效应、热凝固直接或间接破坏血管壁,对于较为深在、重要解剖结构周围的病灶,在内窥镜辅助或者B超引导下行介入治疗.根据瘤体大小及形状,以2～4cm/s的速度往返照射,不同方向扇形插入3～5次直至瘤体缩小甚至消失.再次治疗时间间隔3个月.平均随访4个月.结果 治愈148例(88.6％),显效11例(6.6％),有效4例(2.4％),无效4例(2.4％).有效率为97.6％;159例治疗1次获满意效果,8例需治疗2次,间隔3个月,术后均得到改善;6例(3.6％)术区出现色素沉着,但均较轻微;3例(1.8％)出现皮肤烫伤.3个月后上述症状明显改善.2例(1.2％)有血管再通及病灶残留表现,进行再次手术后得到改善.无出血、瘢痕、肌腱和神经损伤,无功能障碍发生等不良反应.结论 980 nm波长激光经皮光纤介入治疗皮肤静脉畸形,是一种安全、有效的方法.     

308nm准分子激光对寻常型稳定期白癜风患者皮肤组织液TNF-α、bFGF水平的影响

目的:评价308 nm准分子激光对寻常型稳定期白癜风患者皮肤组织液肿瘤坏死因子(TNF-α)、碱性成纤维细胞生长因子(bFGF)水平的影响。方法:对28例寻常型稳定期白癜风患者进行负压吸疱表皮移植,先将白斑、围白斑、正常皮肤分为非激光区和激光区。在移植前,激光区接受308 nm准分子激光治疗10次;非激光区不作处理。吸疱移植时收集各区疱液,采用酶联免疫吸附法(ELISA)测定皮肤组织液中TNF-α和bFGF水平。结果:白斑、围白斑、正常皮肤的激光区分别与各自的非激光区比较,皮肤组织液的TNF-α均有不同程度的降低,而bFGF升高,差异均有统计学意义(P值均0.05)。白斑、围白斑的非激光区和激光区分别与正常皮肤的非激光区和激光区比较,TNF-α较高,bFGF较低,差异均有统计学意义(P值均0.05);而白斑非激光区、激光区的TNF-α、bFGF水平分别与围白斑非激光区、激光区比较,差异均无统计学意义(P值均0.05)。结论:308 nm准分子激光能下调皮肤组织液内的TNF-α水平,提高bFGF的水平,可能是其治疗白癜风的机制之一。     

Effects of the Nd:YAG 1320-nm laser on skin rejuvenation: Clinical and histological correlations

Abstract

The neodymium:yttrium-aluminum-garnet (Nd:YAG) laser is a popular non-ablative treatment used for skin rejuvenation. The purpose of this prospective study was to evaluate the clinical effects, coupled with a quantitative assessment, of the histological changes in response to Nd:YAG 1320-nm laser treatment of periocular wrinkles. Six volunteers with Fitzpatrick skin types III and IV and Glogau class I–II wrinkles were subjected to 3 months of Nd:YAG 1320-nm treatment in the periocular area (six sessions at 2-week intervals). Volunteers were photographed, and skin biopsies were obtained at baseline as well as 3 and 6 months after the start of treatments. Quantitative evaluation of total elastin, newly synthesized tropoelastin, collagen types I, III and VII, and newly synthesized collagen was performed using a computerized morphometric analysis. A noticeable clinical and histological improvement was observed after Nd:YAG 1320-nm treatment. Collagen types I, III and VII, as well as newly synthesized collagen, together with tropoelastin showed a statistically significant increase in response to treatment, while the mean level of total elastin was significantly decreased after treatment. Our data suggest that Nd:YAG 1320 nm is an effective treatment for skin rejuvenation as it stimulates the repair processes, and reverses the clinical, as well as the histopathological, signs of skin aging.     

Fractional 1320 nm Nd : YAG laser in the treatment of acne vulgaris: a pilot study

Thirty-five patients with moderate to severe acne were treated with a fractional 1320 nm neodymium : yttrium aluminum garnet (Nd : YAG) laser. These patients received six treatment sessions at a 2-week interval. Inflammatory and non-inflammatory lesions were counted before and after treatment. Fractional 1320 nm Nd : YAG laser therapy was well tolerated, resulting in the reduction of inflammatory lesions by 57% ( P <0.05) and the reduction of non-inflammatory lesions by 35% ( P <0.05). A significant reduction in the skin sebum level by 30% ( P <0.05) was also noted after treatment.     

Exploring the role of a nonablative laser (1320 nm cooltouch laser) in skin photorejuvenation

Background: Nonablative laser has been used for the treatment and prevention of skin aging for many years. Although the mechanism has not been elucidated, histological evaluation showed that the dermal fibroblasts and its collagen production should be the main target for this rejuvenation. In order to determine the effects of a 1320 nm nonablative laser on the human dermal fibroblasts, the two main secretion factors, basic fibroblast growth factor (bFGF) and transforming growth factor β1(TGF‐β1), in vitro were detected. Methods: The human dermal fibroblasts were cultured and irradiated with a 1320 nm laser at the dose of 15, 20, and 24 J/cm² respectively. The number of fibroblasts was counted and the levels of bFGF and TGF‐β1 were detected by enzyme‐linked immunosorbent assay at the time points of 0, 24, 48, and 72 h after irradiation. Results: The results showed that both the number of fibroblasts and the secretion of bFGF increased after the irradiation at the dose of 20 and 24 J/cm² (P<0.05) compared with that of the control cells. The bFGF secretion in the group exposed to 20 J/cm² was more significant than that of 24 J/cm², and the peak level was 24 h after irradiation. The level of TGF‐β1 secretion decreased after irradiation in a dose‐dependent manner (15 and 20 J/cm², both P<0.05; 24 J/cm², P<0.01), and reached a nadir at 24 h. Conclusion: Our results suggested that the 1320 nm nonablative laser accelerates the vitality of fibroblasts, promotes the secretion of bFGF, and inhibits TGF‐β1 secretion by fibroblasts.     

308nm准分子激光治疗白癜风概述

白癜风治疗方法较多,308 nm准分子激光凭借起效快、疗效高及副作用小等优势而迅速应用于临床。其治疗白癜风的作用机制不清,可能通过诱导皮损处浸润的淋巴细胞凋亡而取得疗效。联合外用他克莫司软膏或吡美莫司乳膏治疗白癜风效果比单独应用308 nm准分子激光更为显著。     

308 nm准分子激光治疗白癜风临床疗效观察

目的：观察308nm氯化氙准分子激光治疗白癜风的临床疗效及不良反应。方法：采用Xtrac颠峰准分子激光系统对77例白癜风患者不同部位共292处皮损进行治疗,每周1～2次。并观察疗效,达到3级色素恢复后对相关因素进行分析。结果：经治疗面颈部皮损起效最快,其次为躯干部、四肢,褶皱部最慢;年龄〈18岁患者皮损起效快于年龄〉18岁患者;不同性别、疾病分期、病程、皮肤类型患者的起效快慢差异无统计学意义。结论：308nm准分子激光治疗白癜风疗效好,不良反应少,其疗效与年龄、皮损部位有关。     

长脉宽1064nm Nd:YAG激光治疗甲真菌病

目的:评价长脉宽1064nm Nd:YAG激光治疗甲真菌病的疗效。方法:60例甲真菌病患者给予长脉宽1064nm Nd:YAG激光治疗,每周1次。结果:治疗结束后6个月有效率为60%。完成4次(23例)和8次治疗(32例)患者的有效率分别为34.8%和78.1%(P0.01)。结论:Nd:YAG1064nm激光治疗甲真菌病有效,疗效与治疗次数相关。     

Q开关1064nm激光及超脉冲CO_2激光治疗340例眼睑汗管瘤

目的观察Q开关1064nm激光及超脉冲CO2激光治疗眼睑汗管瘤的临床疗效。方法应用Q开关1064nm激光及超脉冲CO2激光分别治疗212例及128例患者。结果 340例患者疗效显著,总有效率89.7%,两种激光分别有效率90.1%、89.1%,两者间差异无统计学意义（P〉0.05）。结论 Q开关1064nm激光及超脉冲CO2激光治疗眼睑部汗管瘤安全、有效。