强脉冲光联合近红外光治疗面部皮肤光老化的临床体会

目的评价强脉冲光（intense pulsed light,IPL）联合近红外光（near-infrared light,NIR）治疗面部光老化的临床疗效和安全性。方法面部光老化患者30例,随机分为3组,每组10例。A组：IPL治疗组,采用570 nm、540 nm手具治疗,能量密度14～18J/cm^2,根据皮肤类型选择合适的脉宽。B组：NIR治疗组,选用NIR手具,波长900～1 600 nm,波峰1 300 nm区域滑动治疗。C组：IPL联合NIR治疗组,先行IPL治疗,冷敷面膜30 min后再行NIR治疗。比较各组治疗前后患者面部细小皱纹、毛孔粗大、皮肤松弛、毛细血管扩张的改善情况。结果 IPL治疗面部色斑、肤色灰暗、毛细血管扩张效果好。NIR治疗皮肤细纹增多、皮肤松弛、肤色灰暗等效果明显。三组患者治疗后2个月的有效率差异有显著意义（P〈0.05）,其中IPL联合NIR疗法的疗效最好;治疗后6个月,三组的临床疗效比较差异无显著意义。结论强脉冲联合近红外光能有效提高面部皮肤光老化的疗效,是一种安全、有效、不良反应小的方法。     

Synergistic effects of light-emitting probes and peptides for targeting and monitoring integrin expression

Integrins mediate many biological processes, including tumor-induced angiogenesis and metastasis. The arginine-glycine-aspartic acid (RGD) peptide sequence is a common recognition motif by integrins in many proteins and small peptides. While evaluating a small library of RGD peptides for imaging alpha(V)beta(3) integrin (ABI)-positive tumor cell line (A549) by optical methods, we discovered that conjugating a presumably inactive linear hexapeptide GRDSPK with a near-infrared carbocyanine molecular probe (Cypate) yielded a previously undescribed bioactive ligand (Cyp-GRD) that targets ABI-positive tumors. MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay with A549 cells showed that Cyp-GRD was not cytotoxic up to 100 muM in cell culture. The compound was internalized by cells, and this internalization was blocked by coincubation with a cyclic RGD peptide (cyclo[RGDfV], f is d-phenylalanine) that binds ABI with high affinity. In vivo, Cyp-GRD selectively accumulated in tumors relative to surrounding normal tissues. Blocking studies with cyclo[RGDfV] inhibited the in vivo uptake of Cyp-GRD, suggesting that both compounds target the same active site of the protein. A strong correlation between the Cyp-GRD peptide and mitochondrial NADH concentration suggests that the new molecule could also report on the metabolic status of cells ex vivo. Interestingly, neither a Cypate-labeled linear RGD peptide nor an (111)In-labeled DOTA-GRD conjugate was selectively retained in the tumor. These results clearly demonstrate the synergistic effects of Cypate and GRD peptide for molecular recognition of integrin expression and suggest the potential of using carbocyanines as optical scaffolds for designing biologically active molecules.     

Advanced imaging and technology in gastrointestinal neoplasia: summary of the AGA-NCI Symposium October 4-5, 2004

Imaging and other advanced technologies for detection of gastrointestinal cancers are undergoing a major revolution on several fronts. This is facilitated by convergence of key technologies including advanced endoscopic-detection systems, more specific contrast agents, rapid and high-resolution cross-sectional imaging, and miniaturization of construction systems for making all imaging equipment smaller and less invasive. This convergence is occurring along traditional translational research pathways (clinical medicine-molecular biology) as well as nontraditional lines (clinical medicine-optical physics/engineering and molecular biology-optical physics/engineering). These new efforts are producing a wide array of technologies aimed at improving detection, classification, and monitoring of gastrointestinal neoplasia, especially for colorectal and esophageal cancer because of easier accessibility. A critical goal is to detect lesions at their premalignant stages, thereby permitting meaningful intervention. Inspired by these advances, the American Gastroenterological Association and the National Cancer Institute sponsored a symposium held in Bethesda, MD, from October 4-5, 2004, bringing together leading investigators with diverse backgrounds in imaging technology. The aims of this symposium were to summarize the state of the art and priorities for research in the coming decade in the field of imaging and advanced technology for gastrointestinal neoplasia. In this overview, we summarize the salient results of that symposium. The initial sections discuss the major technologies in each area of endoluminal imaging and molecular imaging followed by applications to specific diseases such as Barrett's esophagus and colon neoplasia. Each section focuses on the current state of the art then lists major priorities for research in the field.     

Prognostic impact of calf muscle near-infrared spectroscopy in patients with a first episode of deep vein thrombosis

Summary. Background: The risk factors that affect the development of post‐thrombotic syndrome (PTS) are not fully recognized, and it is difficult to reliably predict which patients are likely to develop PTS in acute phase of deep vein thrombosis (DVT). Aims: To investigate changes in calf muscle deoxygenated hemoglobin (HHb) levels after DVT, and to determine the indicative parameters reflecting the progression of PTS. Methods: Seventy‐six consecutive patients with a first episode of unilateral DVT were prospectively enrolled. Clinical manifestations were categorized according to the CEAP (Clinical, Etiologic, Anatomical, and Pathophysiologic) classification, and the patients were divided into no‐PTS (C_0–3E_s,A_s,d,p,P_r,o) and PTS (C_4–6E_s,A_s,d,p,P_r,o) groups. Near‐infrared spectroscopy (NIRS) was used to measure calf muscle HHb levels at 6 months after diagnosis of DVT. The calf venous blood filling index (HHbFI) was calculated on standing, and the venous ejection index and the venous retention index (HHbRI) were then obtained after exercise. All patients were followed up for more than 24 months after the diagnosis of DVT. Results: Of 76 patients evaluated, 20 (26.3%) had PTS. The NIRS‐derived HHbFI and HHbRI were significantly increased in patients who developed PTS in comparison with those who did not (P = 0.04 and P = 0.0001, respectively). HHbRI was significantly increased in patients with iliofemoral DVT in comparison with patients with calf DVT (P = 0.041). An optimal cut‐off point of 2.9 for HHbRI showed the strongest ability to predict the development of PTS, with a sensitivity of 100% and a specificity of 82.1%. Conclusions: HHbRI as measured by NIRS is significantly increased in patients with iliofemoral DVT as compared with those with calf DVT. Furthermore, HHbRI > 2.9 is a strong predictor of the development of PTS at 6 months.     

Clinical Utility of Intravascular Imaging and Physiology in Coronary Artery Disease

Intravascular imaging and physiology techniques and technologies are moving beyond the framework of research to inform clinical decision making. Currently available technologies and techniques include fractional flow reserve; grayscale intravascular ultrasound (IVUS); IVUS radiofrequency tissue characterization; optical coherence tomography, the light analogue of IVUS; and near-infrared spectroscopy that detects lipid within the vessel wall and that has recently been combined with grayscale IVUS in a single catheter as the first combined imaging device. These tools can be used to answer questions that occur during daily practice, including: Is this stenosis significant? Where is the culprit lesion? Is this a vulnerable plaque? What is the likelihood of distal embolization or periprocedural myocardial infarction during stent implantation? How do I optimize acute stent results? Why did thrombosis or restenosis occur in this stent? One of the legacies of coronary angiography is to presume that one technique will answer all of these questions; however, that often has been proved inaccurate in contemporary practice.     

局部脑氧饱和度监测目标导向治疗在老年重度颅脑损伤患者中的应用

目的 评价局部脑氧饱和度(rScO₂)监测目标导向治疗老年重度颅脑损伤(sTBI)患者的临床价值。方法 选取2018年4月至2020年11月于内蒙古自治区人民医院神经外科重症监护病房(NSICU)治疗的60例老年重度颅脑损伤患者,采用随机数表法分为研究组和对照组,每组各30例。对照组给予神经外科重症传统监护治疗管理,研究组在实施神经外科重症传统监护治疗管理基础上予以rScO₂目标监测指导治疗。比较2组患者格拉斯哥昏迷评分(GCS)和格拉斯哥预后评分(GOS)、NSICU住院时间、死亡率及改良Rankin量表评分。采用SPSS 24.0 统计软件进行数据分析。根据数据类型,分别采用t检验和χ²检验进行组间比较。生存分析采用Kaplan-Meier生存曲线。结果 2组患者出院时GCS评分均较入院初始提高,但差异无统计学意义(P>0.05);出院时研究组患者GCS评分高于对照组,但差异无统计学意义(P>0.05)。研究组在NSICU时间较对照组明显减少(P<0.05)。随访6个月,研究组与对照组相比,改良 Rankin 量表评分更低,GOS更高,生存时间更长,死亡率更低(均P<0.05)。 结论 rScO₂监测目标导向治疗能有效缩短老年STBI患者的NSICU住院时间,改善患者预后,降低病死率。     

Effects of near-infrared laser exposure in a cellular model of wound healing

Background: Clinical studies have demonstrated beneficial outcomes for low-level laser therapy (LLLT) using near-infrared (NIR) wavelengths. It has been hypothesized that the benefits of NIR LLLT are due in part to the thermal effects of NIR exposure. However, it is not clear whether photochemical interactions between NIR light and superficial tissues contribute to beneficial outcomes. To investigate the photochemical effects of NIR exposure, the efficacy of 980 nm NIR LLLT on human fibroblast growth rates is investigated using an in vitro model of wound healing.
Methods: A small pipette is used to induce a wound in fibroblast cell cultures, which are imaged at specific time intervals over 48 h and exposed to a range of laser doses (1.5–66 J/cm²) selected to encompass the range of doses used during other in vivo and in vitro studies. For each image acquired, wound sizes were quantified using a novel application of existing image processing algorithms.
Results: Cell growth rates were compared across different laser exposure intensities with the same exposure duration, and across different laser exposure durations with the same exposure intensity. Exposure to low- and medium-intensity laser light accelerates cell growth, whereas high-intensity light negated the beneficial effects of laser exposure. Cell growth was accelerated over a wide range of exposure durations using medium-intensity laser light, with no significant inhibition of cell growth at the longest exposure durations used in this study.
Conclusion: Low-level exposure to 980 nm laser light can accelerate wound healing in vitro without measurable temperature increases. However, these results also demonstrate the need for appropriate supervision of laser therapy sessions to prevent overexposure to NIR laser light that may inhibit cell growth rates observed in response to lower intensity laser exposure.     

人体运动氧代谢的实时无创测定

为探讨运动过程中肌肉组织氧含量的变化规律，用无损近红外光谱学技术（ＮＩＲＳ）对１０名运动员１２ｍｉｎ递增有氧负荷运动的肌氧含量做了实时连续监测，同时测定了血乳酸和心率，相关分析表明，有氧代谢运动肌氧含量下降与血乳酸上升的测定值呈线性相关（ｒ＝－０．９６２）在相同负荷下对运动员和普通受试者的肌氧和血乳酸等参数的实时变化情况做了比较，此外，还检测和探讨了以无氧运动为主的短跑过程中肌氧含量的下降和恢复规