The effects of ALA-PDT on microbiota in pilosebaceous units of patients with severe acne: A metagenomic study

Background5-aminolevulinic acid mediated photodynamic therapy (ALA-PDT) is increasingly used to control severe acne. However, its impact on skin microbiota remains uncertain.ObjectivesWe aimed to compare the makeup, diversity, and function of the microbiota in pilosebaceous units of patients with severe acne before and after ALA-PDT.MethodsA longitudinal cohort study was performed on 11 participants with severe facial acne. All patients were given 5%ALA-PDT every two weeks for three sessions in total. The contents of lesions were sampled for metagenomic sequencing at baseline and two weeks after the first ALA-PDT session.ResultsCutibacterium acnes was the most dominant species followed by Staphylococcus epidermidis and Pseudomonas fluorescens. Treatment with ALA-PDT led to clinical improvements in acne severity concurrent with a significant reduction in the relative abundance of C. acnes, while P. fluorescens increased significantly after ALA-PDT. No significant change was identified in other species. ALA-PDT administration was associated with an increased microbiota diversity and reductions in the relative abundance of the functional genes involved in energy metabolism and DNA replication.ConclusionsALA-PDT plays a therapeutic role by killing C. acnes, increasing P. fluorescens and the microbiome diversity, while inhibiting the function of microbiota in pilosebaceous units of severe acne.     

秦皇岛市城近郊肠易激综合征症状患病率及其心理、健康相关生活质量状况

 目的 明确河北省秦皇岛市城近郊社区居民中肠易激综合征(Irritabh Bowel Syndrome,IBS)症状患病率及其心理、健康相关生活质量(HRQOL)状况.方法 (1)用整群、分层、随机抽样的方法 对秦皇岛市城近郊区中3个小区的的常住居民进行面访式问卷调查.问卷包括人口学资料、生活习惯、既往及现患症状情况、SCL-90心理量表和SF-36健康相关生活质量量表.(2)从症状调查结果　中选择符合IBS罗马Ⅱ标准者,分析其心理及生活质量状况.(3)结果　经SPSS软件由专业统计公司完成.结果　(1)调查纳入850人.有效问卷840张(98.8%).(2)符合RomeⅡ标准的IBS症状患病率为4.6%,男女比为1:1.6,女性60岁以上组发病率明显高于其他年龄段.(3)IBS症状人群较其他人群存在更多的心理问题,主要表现为抑郁、焦虑、躯体化、强迫、敌对等;其生活质量较其他人群有不同程度的下降,在总体健康状况、躯体疼痛、躯体角色、社会功能、躯体功能等各维度的积分尤为明显,其中总体健康状况下降最为突出.结论 秦皇岛市城近郊区居民中IBS症状患者存在明显的心理问题,生活质量也有不同程度地下降.     

A new LED device used for photodynamic therapy in treatment of moderate to severe acne vulgaris

ObjectiveThis study investigated the efficacy and safety of a newly designed LED device used in photodiagnosis and photodynamic therapy of moderate to severe acne vulgaris in Chinese patients.MethodsForty-six patients with moderate to severe facial acne showing high degrees of fluorescence by ultraviolet light examination were illuminated during ALA-PDT with two wavelengths of light (543–548 nm, and 630 ± 6 nm, respectively) after 2 h of incubation with ALA. Each patient received treatment once every 30 days for two or three sessions. Two independent investigators assigned an acne severity score at baseline, one week after each treatment, as well as 4, 8, and 12 weeks after the completion of treatment. Adverse effects were recorded during and after each treatment. All patients rated their satisfaction with the results of treatment at a 12-week follow up visit.ResultsThe ALA-PDL treatment regimen showed an overall effectiveness rate of 89.13% (41/46 patients). Some degree of clinical efficacy was seen in 71.42%, 86.67%, and 95.83% of patients with grades IV, V, and VI acne, respectively, and the rate of clinical effectiveness increased with increasing acne severity. When compared with baseline scores, significant reductions in acne scores were obtained at 8, and 12 weeks after completion of treatment. Maximum efficacy was shown at the 12 week follow up. No severe adverse events were observed.ConclusionALA-PDT administered with the newly designed LED device was an effective treatment for moderate to severe acne vulgaris, and side effects were mild and reversible.     

痤疮合剂联合ALA-PDT治疗中重度寻常性痤疮疗效观察

目的观察痤疮合剂联合5-氨基酮戊酸光动力疗法(ALA-PDT)治疗中重度寻常性痤疮的临床疗效和安全性。方法采用随机数表法将2016年8月—2017年12月南通市第三人民医院皮肤科收治的96例中重度寻常性痤疮患者随机分为试验组(46例)与对照组(50例),其中试验组患者采用痤疮合剂联合ALA-PDT治疗,对照组患者采用盐酸米诺环素胶囊治疗,对比观察两组患者的皮损创面愈合情况、不良反应发生情况及复发情况等。结果治疗过程中,试验组患者中有8例患者发生局部不良反应,对照组患者中有5例患者发生局部不良反应,两组对比采用四格表资料的卡方检验,χ~2=1.118,P=0.290,P0.05,差异无统计学意义;治疗后两组患者皮损创面均逐渐好转,创面评分均逐渐降低,其中治疗2、4、6周后两组患者皮损创面评分对比采用t检验,t值分别为7.301、7.050及4.949,P均0.01,差异具有统计学意义;治疗6周后,两组患者临床疗效对比采用等级资料的秩和检验,mann-whitney U=807.000,Z=2.648,P=0.008,P0.01,差异具有统计学意义;3个月后随访,试验组患者中有1例患者复发,对照组患者中有8例患者复发,两组对比采用四格表资料的卡方检验,χ~2=3.886,P=0.021,P0.05,差异具有统计学意义。结论痤疮合剂联合ALA-PDT治疗中重度寻常性痤疮,可有效促进皮损创面痊愈,降低复发率,疗效显著,值得临床推广应用。     

重症脓毒症远期生活质量调查

目的 分析重症脓毒症患者出院2年到5年以后的生活质量,为脓毒症的治疗和康复提供参考.方法 采用前瞻性、观察性、双盲方法,随访2002年1月1日-2007年3月1日出院的重症脓毒症与非脓毒症外科危重病患者,根据纳入及排除标准,共362例进入随访计划,排除死亡、失访及拒绝的病例,最终51例纳入随访分析,采用SF-36量表对...     

股骨头缺血坏死非骨水泥型全髋关节置换后生活质量评估与Harris评分的相关性研究

目的评估非骨水泥型人工全髋关节置换术（THA）治疗股骨头缺血坏死术后患者的生活质量。方法对我院1998年1月-2001年3月采用非骨水泥假体行THA治疗股骨头缺血性坏死患者71例（80髋）进行至少5年（或直至死亡）的随访。所有入选患者均在术前行Harris评分。随访时再对其进行Harris评分和评估健康相关生活质量的SF-36简明健康状况调查量表（the MOS 36-item short form health survey，SF-36）评分，并与四川省居民的生活质量参考值相比较，分析Harris评分与SF-36各项评分之间的相关性。结果共54例（62髋）患者获得至少5年的随访，Harris评分从术前平均44分（21～50分）提高到最新随访时平均92．4分（80～100分）（P〈0．01）。但最新随访时的SF-36评分除了躯体疼痛、情感职能和精神健康外，其余各项得分均较一般人群的参考值低（P〈0．05）。Harris评分与SF-36生理功能和躯体疼痛项评分有相关性（r=0．657，P〈0．01；r=0．524，P〈0．05），但与SF-36其他方面评分相关性不强（P〈0．05，或无相关性（P〉0．05）。结论股骨头缺血坏死患者在接受非骨水泥型THA治疗后，虽然其生理功能和疼痛缓解等生理健康方面的情况能得到较好的恢复，但是术后的生活质量还不理想；Harris评分不能有效地反映出患者除生理功能和疼痛以外其他一些生活质量方面的情况。因此，有必要将SF-36评分引入到全髋关节置换术的疗效评估中，对患者术后的生活质量加以关注。     

骨质疏松症的生命质量研究现状

生命质量是近年来发展起来的一种全新的医学概念,正逐渐替代疾病的传统评价指标.随着人口的老龄化进程加快,骨质疏松症性椎体压缩骨折的发病率也在逐年升高,椎体成形术是其主要治疗手段.生活质量的评价已成为椎体成形术治疗骨质疏松性椎体压缩骨折的主要热点.本文介绍了生命质量的概况,着重阐述了其在骨质疏松症领域及在椎体成形治疗方面的研究方法和现状.     

新生儿中、重度缺氧缺血性脑病的MRI评估分级价值

目的:探讨MRI对中、重度新生儿缺氧缺血性脑病(HIE)的评估分级价值.方法:回顾性分析32例经临床诊断为中、重度HIE的患儿资料,所有患儿均行MRI常规平扫及DWI扫描,采用Fisher确切概率法对中、重度HIE患儿的脑损伤部位及累及范围进行统计学比较.结果:32例患儿中,中度HIE 18例,重度HIE 14例.MRI结果显示:中度HIE累及皮层和分水岭区的损伤为12例,重度HIE为3例,两者之间差异有统计学意义(P＝0.042);重度HIE损伤基底节区重要灰质核团11例,较中度HIE(4例)多见(P＝0.017);中、重度HIE累及胼胝体损伤分别为6例和7例,两者之间差异无统计学意义(P＝0.534);脑损伤累及范围在中、重度HIE之间差异具有统计学意义(P=0.0032).结论:MRI是诊断和评估中、重度HIE的重要检查方法,可正确判断新生儿脑部受损伤程度和范围,对HIE准确诊断及指导治疗有着重要的参考价值.     

早期低剂量腹膜透析对改善尿毒症患者生活质量的价值

目的探讨早期低剂量腹膜透析治疗尿毒症患者的疗效。方法选择2007年3月-2010年2月慢性肾功能不全患者38例,分为两组:腹透组(n=19):接受常规药物治疗,并予间歇性腹膜透析,每日4000～6000ml,每周4～5d;对照组(n=19):接受常规药物治疗。随访24周。所有患者在治疗前、后采用症状频率和严重指数、SF-36生活质量量表对临床症状、生活质量进行评价,并监测血常规、肝肾功能、血糖、电解质及尿量。结果腹透组血红蛋白、血肌酐均较对照组明显改善。腹透组患者临床症状评分治疗前为11.80±5.41,治疗后第8周和第12周时分别降低至7.15±3.15(P<0.05)和5.94±3.70(P<0.01),对照组在治疗前、治疗后第8周和第12周时评分分别为11.23±5.35、9.80±4.02和10.11±4.48。两组间的差异持续至随访期结束。腹透组患者生活质量明显改善。结论早期低剂量腹膜透析可有效改善尿毒症患者临床症状和生活质量。     

沙美特罗/氟替卡松与布地奈德/福莫特罗对中重度稳定期慢性阻塞性肺病肺功能和生活质量的比较研究

目的比较长期联合吸入布地奈德/福莫特罗和沙美特罗/氟替卡松对中重度稳定期慢性阻塞性肺病(COPD)患者的肺功能、生活质量的影响。方法 180例中重度稳定期COPD患者随机分为规律吸入布地奈德福莫特罗(160μg/4.5μg)组60例,规律吸入沙美特罗/氟替卡松组(50μg/250μg)60例,按需吸入特布他林组60例(对照组)。测定三组试验前及试验后6个月圣.乔治(St.George)呼吸疾病问卷(SGRQ)的评分,6 min行走距离(6-MWD)肺功能。结果布地奈德/福莫特罗组与沙美特罗/氟替卡松组治疗后较对照组生活质量,6-MWD增加,肺功能改善,其差异有统计学意义(P<0.05);布地奈德/福莫特罗组与沙美特罗/氟替卡松组间比较,差异无统计学意义(P>0.05)。结论与沙美特罗/氟替卡松一样,规律吸入布地奈德/福莫特罗能改善中重度稳定期COPD病人的临床症状、运动耐力和肺功能。     

银屑病患者生活质量和心理健康状况调查及其影响因素分析

目的 探讨银屑病患者生活质量和心理健康状况,为进行心理干预提供依据.方法 对2019年1—12月在解放军总医院第三医学中心皮肤科就诊的银屑病患者,采用中文版皮肤病生活质量指数调查表(dermatology life quality index,DLQI)评估银屑病患者的生活质量,采用焦虑自评量表(self-rating...     

Long-term evaluation of urinary,sexual, and quality of life outcomes after brachytherapy for penile carcinoma

PurposeBrachytherapy (BT) is an effective organ-preserving treatment for selected localized penile carcinoma, providing high local control rates. Long-term functional results however, are still insufficiently evaluated.Methods and MaterialsAll consecutive patients treated with low-dose-rate or pulse-dose-rate BT in our institute for a localized penile cancer and who were in first complete remission and followed for at least 3 years were included. A self-reporting questionnaire was sent, to assess: 1/urinary function, 2/sexual function, 3/cosmetic aspect of the penis, and 4/quality of life.ResultsThirty-nine patients fulfilled inclusion criteria and were sent the questionnaire. Twenty-three patients (59%) answered. Median age was 63.4 years, (interquartile range [IR]: 49.7–67.0). Median followup was 5.9 years (IR: 5.2–6.7). The urinary scores showed moderate lower urinary tract symptoms. During the followup, a urethral dilation or self-catheterization had been necessary in 30% and 13%, respectively. Sixteen (70%) patients continued to maintain a sexual activity and the erectile dysfunction was mild. Finally, quality of life was good with a median score of 80/100 (IR = 65–90) and was only impacted by pain (p = 0.02). Overall, 57% and 39% declared having none or moderate pain/discomfort, respectively.ConclusionsAlthough this questionnaire needs to be validated in an independent cohort, our results show the moderate impact of BT on functional outcomes, confirming that it is an adequate first-intent organ-sparing strategy in patients with localized penile carcinoma.     

复方硫磺洗面奶的研制与质量评价

目的:以复方硫磺洗剂处方为基础研制复方硫磺洗面奶.方法:以硫磺、盐酸克林霉素为主药,椰子油单乙醇酰胺、三乙醇胺等药物制成复方硫磺洗面奶;采用化学滴定分析方法测定硫磺的含量.结果:制备的复方硫磺洗面奶细腻、光滑、稳定性好,质量可靠,含量测定简单易行.结论:本品配制简单、合理,符合中国药典2000版的规定.     

通过骨痛量表分析放疗前后肝癌骨转移患者的生活质量及影响因素

目的通过分析肝癌骨转移患者的癌症治疗评估量表-骨痛量表(FACT-BP),研究放疗对肝癌骨转移患者生活质量的影响,分析临床因素对放疗后生活质量的影响。方法回顾性收集2013年1月至2018年12月徐州市肿瘤医院43例肝癌骨转移患者放疗前后FACT骨痛量表,从生活质量总体评分、总体功能状态、疼痛程度、躯体功能、社会心理等5个方面分析放疗前后生活质量评分变化,并对比分析生活质量未改善的患者各方面评分;比较各临床因素与放疗后生活质量改善率的相关性。结果放疗后患者各方面生活质量评分较放疗前均有提高,且差异有统计学意义(t=7.621、5.887、9.407、7.785、4.487,P<0.05)。生活质量未改善患者中,放疗前后生活质量总体评分、社会心理评估评分均降低明显,存在明显差异(t=3.381、4.982,P<0.05)。各临床因素中,骨转移部位软组织块、放疗处方剂量对患者放疗后生活质量改善有明显影响(χ^2=5.180、7.457,P<0.05)。放疗前骨转移部位是否存在软组织肿块,放疗后生活质量改善率分别为50.00%、85.00%。放疗处方剂量<40 Gy及≥40 Gy,放疗后生活质量改善率分别为44.44%、84.00%。多因素分析发现骨转移部位软组织块、放疗处方剂量、疼痛数字评分法(NRS)疼痛评分对生活质量改善的影响有相关性(OR=0.296、0.020、1.592,P<0.05)。结论骨转移部位的放疗能明显改善肝癌骨转移患者生活质量。社会心理状态可影响患者生活质量。放疗处方剂量≥40 Gy更可能改善骨转移部位存在软组织肿块患者的生活质量。     

Forces generated in stabbing attacks: an evaluation of the utility of the mild,moderate and severe scale

International Journal of Legal Medicine - The commonest way of killing in the UK is by a sharp instrument. Knight reported in 1975 that it is impossible to discern with any degree of certainty the...     

慢性乙型肝炎住院患者希望水平与生活质量的相关性分析

目的探讨慢性乙型肝炎住院患者的希望水平与生活质量的相关性。方法对2008—2010年间在我院住院的105例慢性乙型肝炎患者进行调查,采用Herth希望因子量表和简明生活质量量表(SF-36),并分析希望水平与生活质量的相关性。结果总体希望水平为(33.9±12.5),生活质量总平均分(48.5±25.2)分。多因素Logistic回归分析的结果显示,年龄(β=-1.22,OR=0.30)、肝炎分期(β=-2.32,OR=0.10)、病程(β=-3.21,OR=0.04)和希望水平(β=2.21,OR=9.03)与生活质量有着密切关系(P<0.05),其中年龄、肝炎分期和病程与生活质量负相关(β<0,OR<1),希望水平是正相关影响因素(β>0,OR>1)。结论慢性乙型肝炎住院患者希望水平是生活质量重要影响因素,可以通过提高其希望水平来改善其生活质量。     

Long-term results and quality of life after endovascular treatment of venous malformations in the face and neck

Purpose: To evaluate the long-term results of endovascular sclerotherapy in treating venous and venocapillary malformations of the face and neck region, and to assess the quality of life after treatment. Material and Methods: Twenty consecutive patients with endovascularly treated venous and capillary-venous malformation of the face and neck were invited to attend for clinical control and magnetic resonance (MR) imaging. To evaluate the quality of life after treatment, patients were asked to fill in a questionnaire which included 20 multiple-choice questions exploring 4 dimensions: psychological, physical, and social functioning, and pain. Results: In 14 patients, symptoms and MR findings improved, while in 6 patients there was no improvement. Results concerning quality of life showed that most patients did well after endovascular treatment. Patients with venous malformations of the tongue had a worse outcome. Patients under the age of 16 at the beginning of the treatment and patients clinically followed by physicians specialized in vascular malformations had a better quality of life. Conclusion: Endovascular treatment for venous malformations is effective. Results and quality of life proved to be better when the endovascular treatment was begun before puberty and the patients had regular clinical controls after therapy.     

中重度OSAHS患者CPAP治疗前后1H-MRS变化的初步研究

目的：用多体素磁共振波谱(1 H-MRS)探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者持续正压通气(CPAP)治疗前后的变化。方法对25例进行 CPAP 治疗前后的中重度男性 OSAHS 患者及与其性别、年龄相匹配的25例健康对照者的双侧额叶均行头颅多体素1 H-MRS 检查。分别记录额叶各代谢物比值,比较两两之间的差异,并观察有无乳酸(Lac)峰出现。结果治疗前额叶 NAA/Cr、NAA/Cho(2.0212±0.2312和1.6088±0.2571)较健康对照者(2.7268±0.6071和2.4456±0.4375)减低,治疗后额叶 NAA/Cr、NAA/Cho(2.3140±0.3128和2.0164±0.4240)较治疗前(2.0212±0.2312和1.6088±0.2571)升高,治疗后额叶 NAA/Cr、NAA/Cho(2.3140±0.3128和2.0164±0.4240)较健康对照者(2.7268±0.6071和2.4456±0.4375)减低(P <0.01)。治疗前 Cho/Cr(1.2932±0.2615)较健康对照者(1.1292±0.1577)升高(P <0.05)。3组均未检测到 Lac 峰。结论多体素1 H-MRS 能敏感显示 OSAHS 患者 CPAP 治疗前后脑代谢的改变,提供临床疗效及预后评估的影像学依据。     

简体中文版SRS-22量表在中国青少年脊柱侧凸患者手术前后生活质量评估中的初步应用

目的考察简体中文版SRS-22量表评测青少年特发性脊柱侧凸(AIS)患者手术前后不同时期生存质量的信度和效度。方法对SRS-22量表进行文化调适,选择177例AIS患者,分别于术前、术后6个月、术后1年进行SRS-22和SF-36量表问卷调查,其中145例患者完成了全部的3次调查,男26例,女119例,年龄11.1～17.9岁,平均15.8岁,Cobb角41°～109°,平均63°。为评估量表的重测信度,65例患者术前间隔4～6(4.6)d进行了两次测量(收到有效问卷55份),65例患者术后1年随访时间隔7～21(14.7)d后进行了再次评测(收到有效问卷57份)。采用Cronbach's α系数和组内相关系数(ICC)对SRS-22量表内部一致性和重测信度进行评价;通过与SF-36量表的各相关维度进行比较评估同期效度,以Pearson相关系数(r)为评价指标。结果简体中文版SRS-22量表具有较好的信度和效度,平均Cronbach's α系数为0.79～0.85,平均ICC为0.77～0.87。同期效度评估显示,与SF-36量表相关度高(r=0.75～1.00)的域有2个,相关性中等(r=0.50～0.75...