Intense pulsed light vs. pulsed‐dye laser in the treatment of facial acne: a randomized split‐face trial

Background Various laser and light therapy have been increasingly used for the treatment of acne vulgaris. Patients and methods Twenty patients with facial acne were treated using intense pulsed light (IPL) on one side of the face and pulsed dye laser (PDL) on the other to compare the efficacy and safety of IPL and PDL. Treatment was performed 4 times at 2‐week intervals. Treatment effectiveness was determined using lesion counts, acne severity, patient subjective self‐assessments of improvement, and histopathological examinations, which included immunohistochemical staining for transforming growth factor‐β (TGF‐β). Results Numbers of total acne lesions decreased following both treatments. For inflammatory lesions such as papules, pustules and nodules, IPL‐treated sides showed an earlier and more profound improvement than PDL‐treated sides. However, at 8 weeks after the 4th treatment, a rebound aggravation of acne was observed on IPL‐treated sides. On the contrary, PDL produced gradual improvements during the treatment sessions and these improvements lasted 8 weeks after the 4th treatment. Non‐inflammatory lesions as open and closed comedones also showed improvement following both treatments and PDL‐treated sides showed better improvement as the study proceeded. Histopathological examinations showed amelioration in inflammatory reactions and an increase in TGF‐β expression after both treatments, which were more prominent for PDL‐treated sides. Conclusion Both PDL and IPL were found to treat acne effectively, but PDL showed a more sustained effect. TGF‐β might play a key role in the resolution of inflammatory acne lesions.     

高血压血管重构及高血压状态下的颈动脉血管重构

目的:研究高血压颈动脉重构特点、机制,为临床控制高血压并逆转颈动脉重构提供新靶点。资料来源:应用计算机检索维普全文电子期刊数据库所有相关高血压动脉重构及颈动脉重构方面的文献,检索词“动脉重构,颈动脉重构,高血压”,限定文献语言种类为中文。同时计算机检索Entrez PubMed所有相关高血压动脉重构及颈动脉重构方面的文献,检索词“artery remodeling,carotid artery remodeling,hypertention”,限定文献语言种类为English。资料选择:对资料进行初审,选取包括高血压大动脉重构机制及颈动脉重构方面的文献,开始查找全文。纳入标准:有关高血压颈动脉形态学、平滑肌细胞及细胞外基质重构及其机制的文献。排除标准:与高血压颈动脉重构无关的文献。资料提炼:共检索到168篇关于高血压动脉重构及颈动脉重构的文献,最终纳入39篇符合标准的文献。资料综合:颈动脉血管重构导致高血压的发展和并发症的出现。高血压颈动脉的重构形态学上以壁厚/腔径比值增高、顺应性下降为特点。血管中层平滑肌细胞总体积增加及动脉壁细胞外基质组成成分的变化是高血压颈动脉重构的重要内容。高血压颈动脉重构的机制与细胞增殖、凋亡及血管炎症、纤维化有关。结论:高血压的治疗必须重视血管的保护及血管重构的逆转。通过药物干预及基因治疗,逆转血管重构,将成为多种心血管疾病治疗的重要措施。     

4－氨基吡啶诱发组胺释放及某些药物的拮抗作用

４－氨基吡啶（４－ＡＰ）有组胺释放作用。小鼠ｉｐ４－ＡＰ５ｍｇ·ｋｇ－１后，肺中组胺含量明显减低，血中组胺含量显著增高。钙拮抗剂硝苯啶、ＴＭＢ－８及钾通道开放剂米诺地尔均能明显抑制４－ＡＰ诱发的小鼠ＰＭＣ释放组胺。结果提示，ＭＣ可能存在钾通道，４－ＡＰ诱发ＭＣ释放组胺可能与它阻滞钾通道，从而使钙通道开放，增加Ｃａ２＋内流有关。     

刺蒺藜果中一种新桂皮酰胺类成分的分离和鉴定

从刺蒺藜(Tribulus terrestris L)果实中分得两个化合物,经理化常数测定和光谱(UV,IR,¹HNMR,¹³CNMR,¹H-¹³CCOSY和MS)解析。化合物I鉴定为N-对羟基苯乙酮基-3-甲氧基-4-羟基取代桂皮酰胺,为一新化合物,命名为蒺藜酰胺(terrestriamide)。化合物II为8-甲基氢化茚酮-1,首次从该植物中获得。     

商陆多糖Ⅰ联合白细胞介素2对小鼠脾细胞杀瘤活性的影响

商陆多糖Ⅰ(PAP-I),0.3～3μg·ml^-1和小鼠脾细胞培养3～5d可显著增强其杀伤P815肿瘤细胞活性及IL-2(250～500IU·ml^-1)诱导的LAK细胞活性,最适浓度为1μg·ml^-1。PAP-I及IL-2和脾细胞培养的上清液对P815肿瘤细胞无细胞毒作用,但能增强脾细胞及LAK细胞杀瘤活性。PAP-I,5,10及50mg·kg-1,ip可增强脾细胞杀伤P₈₁₅和L₉₂₉细胞的活性及IL-2诱导的LAK细胞活性。     

柴胡皂甙q及其甙元的结构鉴定

从小叶黑柴胡(Bupleurum smithii Wolffvar;parvifolium ShanetY.Li)的根中得到3个化合物,柴胡皂甙元A和Q及柴胡皂甙q。柴胡皂甙元Q和柴胡皂甙q为新化合物,根据理化性质和波谱分析,确定其结构分别为齐墩果烷-11,13(18)-二烯-3β,16β,23,28,30-五醇和3β,16β,23,28,3O-五羟基齐墩果烷-11,13(18)-二烯-3-O-β-D-吡喃葡萄糖基(1→6)-[α-L-吡喃鼠李糖基(1→4)]-β-D-吡喃葡萄糖甙。     

双能X射线骨密度仪测量不同个体腰椎椎骨骨面积、骨矿含量的精度差异

目的：对不同个体椎骨短期精度进行观察,发现骨质疏松的严重程度不同其短期精度不同。分析DPX-MD双能X射线骨密度仪测量不同个体椎骨骨面积、骨矿含量、椎体宽、椎体高的短期精密度,了解上述指标对骨矿含量或骨密度测定的影响,以便为骨矿含量或骨密度检测质量控制和减少误差提供依据。 方法：实验于2004-05/2006-12在川北医学院人体解剖实验室与川北医学院附属医院内分泌科骨密度室完成。①对象：铝体模;3个活体椎体（38岁骨密度正常男性;40岁骨质疏松症男性;62岁轻微骨量减少女性）;1个带软组织的死体椎体（由川北医学院人体解剖实验室提供）。②方法及评估：采用美国Lunar公司生产的DPX-MD双能X射线骨密度仪测量各椎体的椎骨面积、骨矿含量、椎体宽、椎体高及骨矿含量/椎体宽。3次/d,连续测定5d。铝体模和死体椎体两端均用小木块固定在6.5cm的高度,放在15cm的水浴中,为减少误差由一人操作。由不同椎骨面积、骨矿含量、椎体宽、椎体高及骨矿含量/椎体宽可得到各自的变异系数。 结果：①腰椎各椎体和L2～4的骨矿含量的变异系数：各椎体或L2～4骨矿含量变异系数从正常男性椎体、骨质疏松症男性椎体、轻微骨量减少女性椎体与死体椎体呈依次增大。②各椎体和L2～4的椎骨面积、椎体宽、椎体高的变异系数：椎骨面积、椎体宽的值从铝体模、正常男性椎体、骨质疏松症男性椎体、轻微骨量减少女性椎体与死体椎体呈依次增大,尤其是轻微骨量减少女性椎体与死体椎体较大;椎体高的变异系数以骨质疏松症男性椎体与轻微骨量减少女性椎体较大,尤其是轻微骨量减少女性椎体的变异系数最大。 结论：不同个体椎骨骨面积、骨矿含量、椎体宽、椎体高的精度不同,对骨密度测定的影响不同。椎间隙欠清楚者由于椎体分椎线难于确定,椎体高度的测定对骨密度测定影响较椎间隙清楚者大;有骨质增生和骨质疏松越严重者由于椎体边缘线难于确定,椎体宽度的测定对骨密度测定影响较无骨质增生和骨密度正常者大;有骨质增生存在和骨质疏松越严重,骨面积的测定对骨密度测定影响越大;骨质疏松越严重,骨矿含量测定对骨密度测定影响越大。     

Treatment of progressive Hodgkin's disease with intensive chemoradiotherapy and autologous bone marrow transplantation

Twenty-six patients with progressive Hodgkin's disease after conventional chemotherapy received intensive chemoradiotherapy and autologous bone marrow transplantation (ABMT); 19 also received additional involved-field radiotherapy. Twenty-one patients [81%, 95% confidence intervals (CI) 61% to 94%] attained complete (n = 18) or partial responses. Ten patients (38%, 95% CI 20% to 59%) are disease- free a median of 4.5 years later (range 3.5 to 7.0 years), including seven patients with continuous complete responses. The likelihood of overall response was not significantly influenced by any clinical or treatment variable examined. However, there was a trend favoring patients with higher Karnofsky scores, and higher scores were associated with attainment of complete responses (P = .06 and P = .02, respectively, Mann-Whitney U test). Both higher Karnofsky scores and shorter durations of disease before transplantation were associated with improved survival in a stepwise Cox multivariate analysis. The chief cause of failure was progression at sites previously involved with Hodgkin's disease. No patient relapsed in the marrow, and two of three patients with a history of marrow involvement with Hodgkin's disease achieved durable complete responses after transplantation. These data suggest that inadequate pretransplant conditioning, and not the reinoculation of occult tumor cells in the autologous marrow, caused most relapses. Fatal treatment-related toxicity occurred in six patients. Three patients died of idiopathic interstitial pneumonitis; each had previously received local mediastinal irradiation before intensive chemoradiotherapy. Intensive chemoradiotherapy and ABMT produces durable responses in some patients with Hodgkin's disease incurable with conventional therapy. Use of such therapies at the first sign of failure with conventional chemotherapy and development of more effective conditioning regimens should further improve results.     

The effect of local anesthetic and corticosteroid combinations on chondrocyte viability

Purpose

Local anesthetic and corticosteroid combination injections are often used in clinical practice, however research investigating the chondrotoxic properties of these combinations is minimal. The goal of this study was to evaluate the effect of single injection doses of 1% lidocaine or 0.25% bupivacaine in combination with single injection doses of dexamethasone sodium phosphate (Decadron^?), methylprednisolone acetate (Depo-Medrol^?), betamethasone sodium phosphate and betamethasone acetate (Celestone^? Soluspan^?), or triamcinolone acetonide (Kenalog^?) on human chondrocyte viability.

Methods

All treatment conditions were delivered to human chondrocytes in vitro for the medication’s respective average duration of action using a bioreactor containing a continuous infusion pump constructed to mimic joint fluid metabolism. A two-color fluorescence assay was used to evaluate cell viability. A mixed-effects regression model was used to evaluate the mean differences in cell viability between treatment groups.

Results

At 14?days, a single injection dose of 1% lidocaine or 0.25% bupivacaine in combination with betamethasone sodium phosphate and betamethasone acetate solution illustrated significant chondrotoxicity when compared with the local anesthetics alone (P?P?=?0.013; P?=?0.016, respectively) when used in combination with 1% lidocaine compared with lidocaine alone, but showed no significant chondrotoxicity in combination with 0.25% bupivacaine (P’s?=?n.s.).

Conclusions

Clinicians should use caution when injecting 1% lidocaine or 0.25% bupivacaine in conjunction with betamethasone sodium phosphate and betamethasone acetate solution due to its pronounced chondrotoxic effect in this study. 1% lidocaine used in combination with methylprednisolone acetate or triamcinolone acetonide also led to significant chondrotoxicity.