Investigation of optimal energy or density of a fractional CO2 laser system in the treatment of stable non-segmental vitiligo

BackgroundFractional carbon dioxide (CO2) laser has been considered to be an add-on to conventional treatments of vitiligo. Objective: This study aimed to evaluate the optimal energy and density of the fractional CO2 laser system in stable non-segmental vitiligo (NSV) patients. Method: 48 patients were treated with fractional CO2 laser and sequential phototherapies of narrowband ultraviolet B (NB-UVB), after the CO2 laser treatment, a compound betamethasone solution was topically applied. For the fractional CO2 laser, coverages of 8% and 12.6% were set as low density (Ld) and high density (Hd), and energies of 60 mJ and 80 mJ were set as low energy (Le) and high energy (He), respectively. The patients were randomly assigned to Group A (HeHd), Group B (HeLd) or Group C (LeLd). Results: Either after 3 or 6 months of enrollment, the efficacy of Group C was better than Group B (p < 0.05). No difference was seen between Group A and Group B or Group A and Group C (p > 0.05). More patients complained higher pain score in Group A as compared with Group C (p < 0.05). Conclusion: The optimal parameters of the fractional CO2 laser were energy at 60 mJ and density at 8%.     

Safety and one-year efficacy of intrathecal baclofen therapy in children with intractable spastic cerebral palsy

BackgroundProspective studies that address both efficacy and safety of continuous infusion of intrathecal baclofen (CITB) in children with spastic cerebral palsy (CP), and that use outcome measures beyond muscle tone are lacking.AimsTo study the efficacy at 12 months and safety up to 24 months after start of CITB in children with intractable spastic CP.MethodsNine girls and eight boys, aged 13.7 years (SD 2.9), received a SynchroMed pump for CITB. We prospectively recorded effects and adverse events at regular follow-up visits up to 24 months. Outcome measures included the 0–10 visual analogue scale (VAS) for individual problems, Gross Motor Function Measure (GMFM) and health related quality of life as measured with the Child Health Questionnaire-PF50.ResultsCITB for 12 months significantly improved the VAS for individual problems with 4.7 (SD 2.0; p = 0.000), VAS for ease of care with 5.2 (SD 2.1; p = 0.000), VAS for pain with 5.4 (SD 2.7; p = 0.002); GMFM sitting dimension with 3.3 (range ?4.0 to 22.0; p = 0.022), GMFM goal dimension with 4.0 (range 0.0–26.0; p = 0.007); and Child Health Questionnaire-PF50 domains of bodily pain/discomfort with 25.6 (SD 35.9; p = 0.016) and mental health with 9.8 (SD 11.3; p = 0.007). During a mean follow-up of 18.4 months (range 12–24), we recorded 80 adverse events. Eight adverse events were serious, but not life-threatening.ConclusionsCITB was effective at 12 months and safe up to 24 months for carefully selected children with intractable spastic CP. CITB relieved pain, facilitated ease of care and improved mental health. The majority of children could extend their activities and participation.     

卡马西平、左乙拉西坦对伴中央-颞区棘波的良性癫痫患儿认知功能的影响

目的:比较卡马西平、左乙拉西坦对伴中央-颞区棘波的良性癫痫患儿认知功能的影响。方法:选择诊断明确的伴中央-颞区棘波的良性癫痫患儿80例随机分为卡马西平和左乙拉西坦组,均治疗6个月。比较两组患儿治疗前后脑电图、P3潜伏期及认知功能的变化。结果:左乙拉西坦治疗组治疗后临床下痫样放电较卡马西平组减少,P3潜伏期缩短(均P<0.05)。治疗前后两组总智商(FIQ)差异无统计学意义(P>0.05)。左乙拉西坦治疗组儿童语言智商(VIQ)、操作智商(PIQ)较卡马西平组提高(P<0.05)。结论:左乙拉西坦对伴中央-颞区棘波的小儿良性癫痫患儿的认知功能有改善作用。     

The eyes wake up: Screening for benign paroxysmal positional vertigo with polysomnography

ObjectiveWhile positional nystagmus of benign paroxysmal positional vertigo (BPPV) has been shown to be detectable in electrooculography (EOG) tracings of polysomnography (PSG), the frequency of undiagnosed BPPV in patients referred for sleep-wake examination has never been investigated.MethodsProspective evaluation of positional nystagmus in 129 patients, referred to a neurological sleep laboratory for sleep-wake examination with PSG. Both in the evening and morning, patients had diagnostic positioning maneuvers under ongoing EOG-PSG registration, followed by visual inspection of EOG for positional nystagmus.ResultsIn 19 patients (14.7%), we found patterns of positional nystagmus, typically appearing few seconds after changes in head position. In 9 of these patients (47%), the nystagmus was also provoked by the positioning maneuvers. Nystagmus only occurred during wakefulness, not during sleep. In a patient with severe cupulolithiasis, we observed disappearance of nystagmus while entering N1 sleep stage. Nocturnal positional nystagmus was independently associated with positive positioning maneuvers.ConclusionsInspection of EOG-PSG demonstrated that positional nystagmus is common, occurring only when wake, and independently associated with positive positioning maneuvers.SignificanceBy routinely searching for positional nystagmus in PSG, sleep physicians may substantially contribute to the identification of patients with so-far undiagnosed BPPV.     

Increased sensitivity to Δ9-THC-induced rewarding effects after seven-week exposure to electronic and tobacco cigarettes in mice

Cigarette (CIG) smoking often precedes the use of illegal drugs. Electronic-cigarettes (e-CIGs) have been promoted as a means of stopping smoking and reducing the harmful effects of CIGs on the population. However, although e-CIGs eliminate some of the morbidity associated with combustible tobacco, they are still nicotine-delivery devices. In order to study whether the nicotine delivered via e-CIG acts as “a gateway drug” to the use of cannabis, we analysed the behavioural and molecular effects of 7 weeks’ pre-exposure to air (AIR), e-CIGs or CIGs on addiction-related conditioned place preference (CPP) in mice using a sub-threshold (0.01 mg/kg) dose of delta-9-tetrahydrocannabinol (Δ⁹-THC), the principal psychoactive constituent of cannabis. After 8 and 66 days of withdrawal, this Δ⁹-THC dose was ineffective in inducing CPP in mice pre-exposed to pump-driven AIR, but very effective in mice pre-exposed to e-CIGs or CIGs. Exposure to e-CIGs or CIGs increases the expression of ΔFosB in the nucleus accumbens (NAc), which remains high during short-term e-CIG or CIG withdrawal and long-term CIG withdrawal and is not influenced by treatment with Δ⁹-THC. At the end of e-CIG or CIG exposure and during withdrawal, the mice also had a higher AMPA receptors GluA1/GluA2-3 ratio in the NAc. Chronic nicotine exposure increases sensitivity to rewarding effects of Δ⁹-THC in mice and produces long-lasting neurobiological changes regardless of the delivery method (CIG vs. e-CIG). The exposure to passive tobacco smoke or e-CIG vapours can similarly increase vulnerability to the effects of cannabis and possibly other drugs of abuse.     

大鼠缺血再灌流脑区半胱氨酸蛋白酶-3活化与神经元凋亡的关系

目的　探讨缺血再灌流脑区半胱氨酸蛋白酶 3(caspase 3)活性变化与神经元凋亡的关系。方法　采用WesternBlotting、原位细胞凋亡检测和免疫组化染色等方法,观察大鼠大脑中动脉栓塞 2h后再灌流 1、6、12、24h时,颞顶叶皮层缺血脑区caspase 3表达和活化、多 (ADP 核糖 )聚合酶(PARP)表达和切割灭活及神经元凋亡程度的变化。结果　再灌流 1、6、12及 24h组,缺血脑区的caspase 3前体及其 12 000切割片段含量的相对灰度值分别为 16 72±2 96、28 36±3 51、51 15±3 10、76 14±3 45及 8 17±2 31、15 36±1 39、31 23±5 43、58 95±6 28;PARP及其 24 000切割片段含量的相对灰度值分别为 12 63±3 02、22 65±4 38、30 81±3 16、67 49±8 59及 6 02±0 73、12 86±2 30、20 76±3 16、27 36±2 63;PARP阳性神经元及凋亡神经元的密度 (细胞数 /0 1mm2 )分别为 68 00±6 67、91 40±9 56、112 20±11 78、127 00±11 51及 83 31±7 53、100 70±6 16、121 53±7 21、197 36±11 78。以上 6种指标的变化彼此间均呈正相关 (r= 0 805 ~0 942, P<0 01 );除 6h与 12h组间PARP含量的差异及 6h与 12h组间和 12h与 24h组间PARP阳性神经元密度的差异无统计学意义外,上述 6种指标的其余组间差异均有统计学意义 (P<0 0