组合无创性方法临床评价祛斑化妆品的功效

目的:组合运用无创性皮肤检测方法临床评价化妆品的美白祛斑功效。方法:选择平均年龄40岁的女性志愿者25名,连续使用化妆品8周,使用产品前和使用后第4周、8周分别用CM-2600d分光光度计测量皮肤的L*、a*、b*、△L、△a、△b、△E值,用SIAscopy仪分析色斑处黑素总量、血红蛋白和胶原蛋白,对照皮肤老化图谱进行色斑临床分级。结果:CM-2600d检测色斑颜色显示试用产品后色斑部位L*值升高,a*值下降。SIAscopy仪检测表明总黑素含量、胶原蛋白和血红蛋白下降,临床分级显示色斑评分降低。结论:组合方法检测皮肤色斑颜色变化结合临床评估可以客观评价美白祛斑产品的功效。     

人工黑化模型用于评价祛斑美白类化妆品美白祛斑功效的临床研究

目的：探讨用紫外线诱导大腿部色素斑模型来评估祛斑类化妆品皮肤美白祛斑的功效。方法：采用日光模拟器人工光源,以2．0倍最小红斑量（2MED）连续紫外线（波段290～400nm）在健康受试者大腿内侧诱导皮肤黑化模型,局部外用试验样品,并设阳性对照（复方氢醌霜）和空白对照组。采用窄谱发射分光光度计（MX18）和三色刺激比色计（CM-2600d）仪器测试靶部位的L值和黑素值,通过前后数值的变化评估测试样品皮肤美白祛斑的功效。结果：人工紫外线可诱导产生大腿部皮肤黑化模型,试验产品皮肤美白功效于第3周明显优于空白对照组,第8周明显差于阳性对照组。结论：人工紫外线诱导的大腿部皮肤黑化模型可作为祛斑类化妆品美白祛斑功效的评估。     

客观测量正常皮肤和紫外线照射后皮肤颜色的变化——比较Chromameter CM2500d和Maxmeter MX18的异同

目的：比较两种仪器Chromameter CM2500d和Maxmeter MX18在客观测量正常皮肤颜色及紫外线照射后皮肤颜色时的异同。方法：Chromameter CM2500d的输出结果为L＊a＊，Maxmeter MX18的输出结果为M和E。其中L＊和M反映皮肤黑素的变化，而a＊和E则反映皮肤红斑的变化。测量正常皮肤曝光和非曝光部位的皮肤颜色，比较两种仪器的异同；分别以最小红斑剂量（MED）、即时黑化量（IPD）和最小持续黑化量（MPPD）的紫外线照射皮肤及反复多次紫外线照射皮肤，比较两种仪器在测量不同形式紫外线照射后皮肤颜色变化的异同。结果：在测量正常皮肤颜色时，两种仪器的检测指标具有很好的相关性；当紫外线照射后，反映色素变化的指标L＊比M更易受皮肤红斑的影响；在测量IPD和MPPD产生的色素以及色素变化规律时两者具有很好的相关性；a＊与E作为反映红斑的指标，在测量MED诱导的红斑时两者有很好的相关一陛，但反复紫外线照射红斑产生过强时，两者的相关性却明显的下降。在记录红斑随时间的变化过程中，两者始终保持较好的相关性。结论：两种仪器在不同情况下测量皮肤颜色时相关性不同，要根据具体情况分析检测结果。     

不同紫外线辐射剂量率对大鼠血清25-( OH) D水平及皮肤效应的影响

目的探讨在紫外线总暴露剂量相同情况下,多次小剂量暴露与集中大剂量暴露对生长期大鼠血清25-(OH)D和皮肤效应的影响。方法选用90只21 d断乳雄性wistar大鼠,分为1MED组(27只)、1/3MED组(27只)、1/5MED组(27只)及避光组(9只)4组。饲以维生素D缺乏饲料。1/5MED组大鼠连续照射15 d,每日照射剂量为1/5MED;1/3MED组实验期内间断照射9 d,每天照射剂量为1/3MED;1MED组实验期内间断照射3 d,每天照射量为1MED;实验期内累计暴露剂量均为3MED。避光组接受白炽灯照射,实验期内累计暴露剂量为0 mj/cm~2。实验期为15 d,测定各组血清25-(OH)D水平,观察皮肤改变情况。结果 4组大鼠血清25-(OH)D浓度差异明显(F=20.695,P0.001)。其中1/5MED组的血清25-(OH)D浓度为(151.97±73.52)nmol/L,高于1/3MED组的(136.21±71.39)nmol/L,但差异无统计学意义(P=0.966);1/5MED、1/3MED组均显著高于1MED组(54.50±20.52)nmol/L和避光组(15.63±0.82)nmol/L,差异有统计学意义(P0.001);1MED组高于避光组(P0.001)。1/5MED组在照射5次后背部皮肤开始出现轻度红斑、无水肿;1/3MED组在照射3次后开始出现中度红斑,轻度水肿;1MED组大鼠在照射1次后开始出现重度红斑,中度水肿;而对照组在实验期间未出现红斑,水肿。结论紫外线暴露能够促进大鼠内源性维生素D的合成,多次小剂量暴露可明显提高大鼠血清25-(OH)D水平,且皮肤损伤明显减轻。     

白藜芦醇对模拟日光照射所致皮肤损伤的防护作用

目的：观察白藜芦醇对模拟日光照射所致皮肤损伤的防护作用。方法：招募11名健康志愿者,在其背部选取6个非曝光部位。部位1～4分别涂抹白藜芦醇＋抗氧化剂、抗氧化剂、白藜芦醇、基质,半小时后予1.5倍最小红斑量的模拟日光照射,部位5仅给予照射而不涂抹检测物质（阳性对照）,部位6既不照射亦不涂抹检测物质（阴性对照）。照射前后测量皮肤L值、a＊、b＊值。结果：在阴性对照部位无红斑,L值和a＊值分别为63.76和7.10;在阳性对照和涂抹基质的照光部位均出现明显的红斑,L值显著降至56.10和56.38,a＊值显著升至15.55和15.97;涂抹白藜芦醇＋抗氧化剂部位红斑轻微,L值降低及a＊值升高程度显著低于其他照光部位,L值和a＊值分别为59.32和12.96（P＆lt;0.05）。结论：白藜芦醇加抗氧化剂可有效防护模拟日光照射引起的急性光损伤。     

含马齿苋及大豆精华提取物护肤品的美白功效观察

目的：观察含有马齿苋及大豆精华提取物护肤品的美白疗效。方法：将40名光老化受试者随机分为对照组及试验组,三种美白护肤品（日霜、晚霜、精华素）含有不同比例马齿苋及大豆精华提取物。两组均外用日霜及晚霜,试验组加用精华素,共持续12周。应用无创性仪器客观检测面部L＊a＊b＊值、黑素指数（melanin index,MI）及红斑指数（erythema index,EI）,由医生及受试者就皮肤色泽改善程度进行主观评价。结果：对照组于12周时MI均值显著下降;试验组于4周及12周时,L＊值显著升高、b＊及MI值显著下降,两组a＊及EI值均无明显变化。于4周时,对照组轻度改善者占35%,试验组轻、中度改善者占63%;于12周时,对照组及试验组分别有40%及79%的受试者达轻、中度改善,两组均无红斑、毛细血管扩张、皮肤红肿等不良反应发生。结论：三种美白护肤品（日霜、晚霜、精华素）联合应用可安全而有效地改善皮肤色泽。     

正常人在四种不同UV光源辐照后的MPPD和MED分析

目的：测定四种不同紫外线光源下正常人皮肤MPPD和MED,探讨在不同波长紫外线照射下皮肤的反应差异。方法：以紫外线光疗仪（SS-03A/B）和GS2004日光防护指数测定仪为光源,对102名健康志愿者进行MPPD和MED的测定。结果：紫外线光疗仪SS-03A的MPPD值为（24.00±6.19）J/cm2,SS-03B的MED值为（10.15±4.47）mJ/cm2;日光防护指数测定仪UVA的MPPD值为（9.98±2.22）J/cm2,UVB的MED值为（0.52±0.14）J/cm2。GS2004照射下女性的MED显著高于男性。在不同的皮肤光反应类型之间,Ⅱ型皮肤在光源SS-03A的照射下,MPPD显著高于Ⅲ型皮肤和Ⅳ型皮肤（P〈0.05）;Ⅲ型皮肤在光源GS2004照射下的MED显著低于Ⅳ型皮肤（P〈0.05）。结论：不同紫外线光源照射下,皮肤的MPPD与MED的数值是不完全一样的。     

葡萄籽提取物原花青素对紫外线照射朗格汉斯细胞的影响

目的:评估外用葡萄籽提取物原花青素对皮肤光损伤后朗格汉斯细胞的影响.方法:实验设计正常皮肤组(G1组)、单纯2MED照射组(G2组),基质+2MED照射组(G3组),含葡萄籽提取物原花青素样品外用+2MED照射组(G4)共四组,连续3天同样处理24小时后对皮肤取材,进行CDla免疫组化染色.结果:G2组朗格汉斯细胞明显减少,G4组朗格汉斯细胞数比正常皮肤略有增多,并且树突明显增多变长.结论:葡萄籽提取物原花青素能够保护皮肤免受紫外线照射所致的免疫抑制,其机制可能与防止紫外线照射所致的朗格汉斯细胞减少有关.     

客观测量正常皮肤和紫外线照射后皮肤颜色的变化——比较Chromamter CM2500d和Maxmeter BX18的异同

目的:比较两种仪器Chromamcter CM2500d和Maxmeter MX18在客观测量正常皮肤颜色及紫外线照射后皮肤颜色时的异同.方法:Chromameter CM2500d的输出结果为L*a*,Maxmeter MX18的输出结果为M和E.其中L*和M反映皮肤黑素的变化,而a*和E则反映皮肤红斑的变化.测量正常皮肤曝光和非曝光部位的皮肤颜色,比较两种仪器的异同;分别以最小红斑剂量(MED)、即时黑化量(IPD)和最小持续黑化量(MPPD)的紫外线照射皮肤及反复多次紫外线照射皮肤,比较种仪器在测量不同形式紫外线照射后皮肤颜色变化的异同.结果:在测量正常皮肤颜色时,两种仪器的检测指标具有很好的相关性;当紫外线照射后,反映色素变化的指标L*比M更易受皮肤红斑的影响;在测量IPD和MPPD产生的色素以及色素变化规律时两者具有很好的相关性;a*与E作为反映红斑的指标,在测量MED诱导的红斑时两者有很好的相关性,但反复紫外线照射红斑产生过强时,两者的相关性却明显的下降.在记录红斑随时间的变化过程中,两者始终保持较好的相关性.结论:两种仪器在不同情况下测量皮肤颜色时相关性不同,要根据具体情况分析检测结果.     

早期抗凝治疗脾切除后继发性血小板升高的疗效分析

目的：评价早期使用抗凝药物治疗脾切除术后血小板升高的疗效及安全性。方法回顾性分析2009年8月至2012年8月期间,50例脾切除早期抗凝（早期抗凝组）及50例脾切除常规治疗（常规治疗组）术后1个月血小板变化趋势及差异。采用SPSS13．0进行统计分析,两组患者术后1～31 d血小板平均值比较采用t检验, P＜0．01判断其差异有统计学意义。结果两组脾切除患者均在术后15 d血小板值达到最高峰,早期抗凝组经抗凝治疗,血小板值上升幅度平稳、缓慢,在术后第15天,血小板值未超过500＆#215;109/L。而常规治疗组在术后第15天时血小板值已达到1000＆#215;109/L。早期抗凝组在达到最高峰值后,下降平稳,术后第21天即恢复正常水平。而常规治疗组在术后第21天血小板值仍然偏高,直到术后第25天左右才恢复正常水平。两组经统计学分析差异有统计学意义, t ＝2．857, P ＜0．01。术后3个月全部患者复诊,血小板均在正常范围内。结论早期使用抗凝药物对治疗脾切除术后继发性血小板升高是有效的,安全的。     

Anticonvulsant therapy increases fentanyl requirements during anaesthesia for craniotomy

This study was designed to determine whether patients receiving chronic anticonvulsant therapy demonstrate an altered requirement for fentanyl during anaesthesia. Sixty-one patients undergoing craniotomy were studied; 20 controls (MED = 0) who had never received anticonvulsants and 41 epileptics in whom therapeutic plasma concentrations of either one (MED = 1), two (MED = 2), or three (MED = 3) different anticonvulsants were documented. During anaesthesia with 60-70 per cent N2O in O2 and 0.2 per cent isoflurane, a maintenance dose (MD) of fentanyl was administered using a continuous variable-rate IV fentanyl infusion, supplemented by intermittent 50 micrograms IV boluses. In order to define the minimal dosage of fentanyl required, the MD was titrated according to increases or decreases in the heart rate and/or mean arterial pressure exceeding 15 per cent of baseline ward values. A progressively higher fentanyl MD was required in the epileptic patients (MED = 1-4.3 +/- 0.5 microgram.kg-1.hr-1; MED = 2-5.4 +/- 0.6; MED = 3-7.6 +/- 0.6) compared with the control MD (MED = 0-2.6 +/- 0.5) (P less than 0.001). These findings indicate that there appears to be a dose-effect relationship between the number of anticonvulsants received and the maintenance dose of fentanyl required during balanced anaesthesia.     

Comparison of high-intensity ultraviolet and NB-UVB on the maturation of melanocytes derived from hair follicle neural crest stem cells

Both high-intensity ultraviolet and narrowband ultraviolet B (NB-UVB) are important therapeutic options for vitiligo management, but high-intensity ultraviolet is more effective than NB-UVB. However, the underlying mechanisms have not been well investigated. Herein, we compare the effects of high-intensity ultraviolet and NB-UVB on the pigmentation of melanocytes derived from hair follicle-derived neural crest stem cells (HF-NCSCs) in vitro and study the underlying mechanisms. The HF-NCSCs were isolated from mouse whisker follicles. After radiation with high-intensity ultraviolet and NB-UVB, respectively, the cell viability by the CCK-8 assay showed gradual inhibitory effects in a dose-dependent manner, which has no apparent difference between the two modalities. The mRNA for melanogenesis factors such as tyrosinase and tyrp1 of the differentiated melanocytes increased significantly with high-intensity ultraviolet compared to the same dose of NB-UVB exposure. Furthermore, the expression of Mc1r was significantly increased by high-intensity ultraviolet in contrast to NB-UVB at the dosage of 0.5 J. By and large, these data suggest that high-intensity ultraviolet exhibited greater efficiency on the maturation of the melanocyte lineage differentiated from HF-NCSCs compared to NB-UVB with the same dose, which was probably due to the stronger stimulatory action of Mc1r. This may provide new insights into the different efficacies of high-intensity ultraviolet and NB-UVB in the treatment of vitiligo repigmentation.     

Resistance to atracurium-induced neuromuscular blockade in patients with intractable seizure disorders treated with anticonvulsants

Previous studies have demonstrated that, with the exception of atracurium, resistance to the neuromuscular blocking effects of various muscle relaxants develops in patients receiving anticonvulsant therapy. We studied the effects of 0.5 mg/kg IV atracurium in 53 neurosurgical patients: 21 nonepileptic patients receiving no anticonvulsant therapy (MED = 0); 14 epileptic patients treated with carbamazepine for years (MED = 1); and 18 epileptic patients treated with carbamazepine plus either phenytoin or valproic acid for years (MED = 2). The evoked compound electromyogram of the adductor pollicis brevis was recorded, and results were analyzed using analysis of covariance, with weight and age as covariables. The onset time was not significantly different among the three groups. Times for recovery of baseline and train-of-four responses to stimuli were significantly shorter in the MED = 1 and MED = 2 groups than in control patients (MED = 0). The recovery index (time between 25% and 75% recovery of baseline electromyogram values) was progressively shorter in the three groups (MED = 0: 8.02 min; MED = 1: 5.93 min; MED = 2: 1.96 min; P less than 0.001). This study demonstrates that atracurium, when used on epileptic patients requiring long-term (that is, years of) anticonvulsant therapy, has a shorter duration of action than when used in nonepileptic patients.     

祛斑类化妆品祛斑功效评价方法的探讨

目的：探讨祛斑类化妆品祛斑功效的评估方法。方法：选择40例黄褐斑受试者，采用研究者评估、受试者自评和仪器测量的评估方法对某公司祛斑化妆品祛斑功效进行评估。结果：医生评估和爱试者自评可反映受试者整体色斑的变化，仪器测试可以客观地反映靶部位色斑的改变。结论：靶部位色斑的仪器测量结合研究者和受试者的评价是祛斑化妆品用于祛斑功效评价的简单有效方法。     

Elite Smile超冷光牙齿美白的临床效果评价

目的：评价Elite Smile超冷光牙齿美白技术对牙齿漂白的临床效果和安全性。方法：应用Elite Smile超冷光牙齿美白技术对30例门诊患者（四环素牙22例,先天性黄染牙8例）进行漂白治疗,用Vita比色板进行治疗前后比色,半年后复查随访。结果：进行Elite Smile超冷光牙齿美白术后牙齿增白明显,比色板色级和色差值有显著性改变。结论：Elite Smile超冷光美白技术是一种简便、有效、安全的牙齿美容方法。     

色素性化妆品皮炎48例报告分析

目的:探讨色素性化妆品皮炎的病因、发病特点及致病化妆品种类等。方法:采用笔者医院门诊2005年～2011年期间的48例色素性化妆品皮炎临床资料进行分析。结果:48例患者均为女性,年龄19～55岁,平均36.5岁;共使用化妆品种类11类,共计152种;化妆品以美白祛斑类和保湿类为主,共有75种产品(占49.34%);美容院自制产品造成的化妆品皮炎比例较高,23例(占47.92%)。其中44例患者经随访自觉症状好转,但色素沉着无1例完全好转。结论:色素性化妆品皮炎主要以美白祛斑类所致,美容院自制产品占较高比例,色素性化妆品皮炎难恢复,需引起重视。     

冷光美白技术治疗变色牙的临床疗效观察

目的：评价Beyond冷光美白技术对变色牙的,临床治疗效果。方法：将70例变色牙患者（其中四环素牙22例,氟斑牙20例,增龄性黄染牙28例）随机分为两组,分别进行Beyond冷光美白治疗和Opalescence漂白剂家庭漂白治疗。用vita比色板,PR-650分光测色仪进行美白治疗前后牙齿颜色的对比,半年后复查。比较两种方法漂白效果及其稳定性。结果：两组患者治疗后,变色牙齿均有一定程度的增白,实验组有9例患者（25．7％）有轻度牙齿酸胀不适感,对照组16例患者（45．7％）出现不同程度的牙齿酸痛感。统计学分析表明,Beyond冷光美白技术疗效优于Opalescenee家庭美白法（P〈0．05）。结论：Beyond冷光美白技术是一种可靠的美白技术,具有良好的-临床效果和推广价值。     

正常人紫外线最小红斑量的测定与分析

目的 探讨广州地区正常人紫外线最小红斑量（MED）的范围及其与性别、年龄、皮肤光生物学分型、季节和在广州地区生活时间长短的关系.方法 以GS2004型日光紫外模拟系统为光源,测定621例健康志愿者背部正常皮肤的MED值,在照射后（24±2）h由两位经验丰富的观察者同时评定.结果 621例受试者的MED均值为（1170.2±333.2）mJ/cm2,男性MED均值为（1132.8±339.4） mJ/cm2,女性MED均值为（1182.1±330.7） mJ/cm2,两者之间差异无统计学意义（P=0.20）;30～50岁年龄组的MED值（1014.7±359.7）mJ/cm2,显著低于20～29岁年龄组（1222.9±304.3） mJ/cm2和50岁以上年龄组（1179.0±374.3） mJ/cm2的MED值（P＜0.01）;Ⅱ型光生物学皮肤MED值（673.5±228.3） mJ/cm2,显著低于Ⅲ型（1224.3±254.2） mJ/cm2和Ⅳ型皮肤（1363.1±278.5） mJ/cm2的MED值（P＜0.01）;不同季节测定的MED值差异有统计学意义（P＜0.01）,春季（969.2±355.8） mJ/cm2最低,夏季（969.24±355.8） mJ/cm2次之,但是秋季与冬季之间则差异无统计学意义（P＞0.05）;在广州地区生活5～10年组的MED值（1104.9±377.7） mJ/cm2,显著低于1～4年组和10年以上组（P＜0.0l）.结论 广州地区正常人紫外线MED值范围与中国其他地区正常人MEI）值有一定差异,陈与性别无明显关系外,与年龄、皮肤光生物学分型、季节和在广州地区生活时间长短均有关.     

中药抑制黑素生成作用的筛选研究

目的:通过研究中药对小鼠黑素细胞系Mel-Ab及melan-a黑素生成的影响,筛选出有减少黑素生成作用的中药。方法:药物处理Mel-Ab细胞后分别进行黑素含量和细胞生存率的测定。选取的中药在melan-a与鼠角质形成细胞系SP-1共培养做进一步实验。熊果苷作为阳性对照。结果:川芎、威灵仙、桂枝、麦冬、白果、蒿本、红花、白苏叶的醇提物,五倍子的水提物在细胞培养水平对黑素生成有明显抑制作用,强于相同浓度熊果苷的作用。其中五倍子、威灵仙、白果、川芎在共培养中作用效果更为显著。结论:本研究表明上述九种中药提取物对黑素生成有明显的抑制作用。     

Less systemic cytokine response in patients following microendoscopic versus open lumbar discectomy.

The magnitude of the tissue damage from surgery impacts the trauma response. This response is proportional to the severity of surgical stress. Systemic cytokines are recognized as markers of postoperative tissue trauma. Microendoscopic discectomy (MED) recently has become popular for treating lumbar disc herniations, and is associated with favorable clinical outcomes compared with open discectomy (OD). This study postulates that MED is a less traumatic procedure, and therefore has a lower surgical stress response compared to OD. In this study, a quantitative comparison of the overall effects of surgical trauma resulting from MED and OD was performed through analyzing patient systemic cytokines response. From April, 2002 to June, 2003, 22 consecutive patients who had symptomatic lumbar disc herniations were prospectively randomized to undergo either intracanalicular MED (N=10) or OD (N=12). In this study, the Vertebroscope System (Zeppelin, Pullach, Germany) was used to perform the endoscopic discectomy procedure in all MED patients. Serum levels of tumor necrosis factor-alpha (TNF-alpha), Interleukin-1beta (IL-1beta), Interleukin-6 (IL-6), and Interleukin-8 (IL-8) were measured before surgery and at 1, 2, 4, 8 and 24h after surgery using an enzyme-linked immunosorbent assay. Serum C-reactive protein (CRP) was measured at the same time interval. The results showed the MED patients had shorter postoperative hospital stay (mean, 3.57+/-0.98 vs. 5.92+/-2.39 days, p=0.025) and less intraoperative blood loss (mean, 87.5+/-69.4 vs. 190+/-115 ml, p=0.042). The operating length, including the set-up time, was longer in the MED group (mean, 109+/-35.9 vs. 72.1+/-17.8 min, p=0.01). The mean size of skin incision made for the MED patients was 1.86+/-0.13 cm (range 1.7-2.0 cm); and 6.3+/-0.98 cm for the OD patients (range 5.5-8 cm), p=0.001. The patients' pain severity of the involved limbs on 10-point Visual Analog Scale before operation in MED group was 7.5+/-0.3 (range 6-9) and 8+/-0.2 (range 7-9) in OD group, p=0.17; and after surgery, 1.5+/-0.2 (range 1-2) in MED group and 1.4+/-0.1 (range 1-3) in OD group, p=0.91. CRP levels peaked at 24h in both groups, and OD patients displayed a significantly greater postoperative rise in serum CRP (mean, 27.78+/-15.02 vs. 13.84+/-6.25mg/l, p=0.026). Concentrations of TNF-alpha, IL-1beta, and IL-8 were detected only sporadically. Serum IL-6 increased less significantly following MED than after OD. In the MED group, IL-6 level peaked 8h after surgery, with the response statistically less than in the open group (mean, 6.27+/-5.96 vs. 17.18+/-11.60 pg/ml, p=0.025). A statistically significant correlation was identified between IL-6 and CRP values (r=0.79). Using the modified MacNab criteria, the clinical outcomes were 90% satisfactory (9/10) in MED patients and 91.6% satisfactory (11/12) in OD patients at a mean 18.9 months (range 10-25) follow-up. Based on the current data, surgical trauma, as reflected by systemic IL-6 and CRP response, was significantly less following MED than following OD. The difference in the systemic cytokine response may support that the MED procedure is less traumatic. Moreover, our MED patients had achieved satisfactory clinical outcomes as the OD patients at a mean 18.9 months follow-up after surgery.