超脉冲CO2激光联合肝素钠治疗睑黄疣疗效评价

目的:观察超脉冲CO2激光联合肝素钠治疗睑黄疣的疗效及复发情况。方法:对77例睑黄疣患者进行联合治疗(治疗组),并设立单用肝素钠局封(药物组65例)和单用超脉冲CO2激光治疗(激光组58例)作为对照。结果:治疗组痊愈58例,显效16例,有效率96.1%;半年随访43例,复发1例,复发率2.3%。药物组有效率78.5%,随访37例,复发9例(24.3%);激光组有效率86.2%,随访27例,复发6例(22.2%)。治疗组与药物组有效率、复发率经x2检验,P<0.01,治疗组疗效优于药物组。治疗组与激光组有效率P>0.01,复发率P<0.05,两组疗效无显著差异,治疗组复发率低于激光组。结论:超脉冲CO2激光联合肝素钠治疗睑黄疣疗效好。     

激光蚀除和选择性光热解在治疗皮肤病中的光热作用研究

目的:探究皮肤病中应用选择性光热解与激光蚀除的光热作用。方法:将我校第三附属医院2014年6月至2015年3月接收的皮肤病患者40例作为研究对象,按数字奇偶法随机分为对照组与治疗组,各20例,对照组应用激光蚀除治疗,治疗组应用激光蚀除加选择性光热解治疗;分析激光蚀除联合选择性光热解治疗皮肤病的光热作用,观察其对皮肤病患者的治疗效果。结果:治疗组治疗疗效为95.00%,对照组治疗疗效为80.00%,组间比较,差异具有统计学意义(p0.05)。结论:激光蚀除与选择性光热解在治疗皮肤病中疗效显著,通过对组织温度分布选择性的强化,能够使选择性光热解治疗效果优化。     

翠绿宝石激光脱毛350例疗效分析

目的:评价翠绿宝石激光脱毛治疗的疗效。方法:使用波长为755 nm的GentleLASE Plus激光对350例门诊患者的不同部位的体毛进行多次治疗,并按不同部位和治疗次数进行分组,分析其疗效。结果:经过多次治疗后,总体治愈率为83.71%,疗效与不同的部位有关,且与治疗次数呈正相关。其中5例出现暂时性色素沉着。结论:使用GentleLASE Plus激光进行脱毛治疗效果良好,并发症少,是目前较为理想的脱毛治疗方法。     

YAG激光光导纤维治疗咽喉部疾病

1981年以来,我科应用激光通过光学耦合系统,由单丝石英光导纤维传递治疗咽喉疾病共106例,经1年以上随访共治愈97例,治愈率达91.5%;好转8例,好转率达7.54%;无效1例,失败率为0.96%。现将治疗情况报道如下。器械装置采用输出功率86～100 W的YAG激光光导纤维治疗系统,光纤直径400～600μm,数值孔径值0.27,发散角9°32′～11°26′。并有氦氖激光同光路装置及脚踏开关相连的时间控制器,整个系统导光率82～92%。     

Q开关532 nm与755 nm激光治疗咖啡斑的疗效对比

本中心回顾性研究咖啡斑患者84例,随机给予Q开关532 nm和755 nm激光治疗,观察临床效果。结果显示,Q开关532 nm激光治疗36例,痊愈10例(27. 8%),显效10例(27. 8%),有效8例(22. 2%),无效8例(22. 2%); Q开关755 nm激光治疗48例,痊愈14例(29. 2%),显效13例(27. 1%),有效11例(22. 9%),无效10例(20. 8%),84例患者总有效率78. 6%。术后半年随访,色素沉着9例,色素减退3例,复发9例。Q开关激光治疗形状不规则的咖啡斑有效率为79. 5%,治疗形状规则的咖啡斑有效率为52. 5%,两组治疗的有效率差异有统计学意义(P <0. 05),Q开关532 nm激光和Q开关755 nm激光对咖啡斑的治疗效果无显著的统计学差异(P> 0. 05)。以上结果表明,Q开关532 nm激光和Q开关755 nm激光对咖啡斑有明确的治疗效果,且外形不规则的咖啡斑治疗效果好。     

不同波长激光对太田痣治疗的影响

本研究对比Q开关翠绿宝石755 nm激光和Q开关Nd:YAG1 064 nm激光治疗太田痣的疗效和差别,探讨分析原因。分别用Q开关翠绿宝石755 nm激光和Q开关Nd:YAG1 064 nm激光治疗637例太田痣患者,观察患者治疗前后疗效,根据色素减轻百分比进行评定。结果表明Q开关翠绿宝石755 nm激光和Q开关Nd:YAG1 064 nm激光均能安全有效的治疗太田痣,Q开关翠绿宝石755 nm激光治疗太田痣297例,显效率为83.5%,Q开关Nd:YAG1 064 nm激光治疗太田痣340例,显效率为86.76%,显效率没有统计学差异。但Q开关翠绿宝石755 nm激光对褐色太田痣疗效较高:755 nm组褐色显效率为91.62%;1 064 nm组显效率为77.84%,统计学差异有显著性,而Q开关Nd:YAG1 064 nm激光对蓝色太田痣疗效较高:755 nm组蓝色显效率为80.54%;1 064 nm组显效率为92.86%,统计学差异有显著性,且1 064 nm组术后发生色素沉着较755 nm组少     

激光联合氨甲环酸、谷胱甘肽及维生素C 治疗黄褐斑的临床观察

目的：探讨黄褐斑应用激光联合氨甲环酸、谷胱甘肽及维生素C 治疗的临床效果。方法：选择2012 年6 月~2014 年6 月期 间我院皮肤科门诊收治的黄褐斑女性患者117 例,根据随机数字表将其平均分为三组,即激光组、药物组、联合治疗组各39 例。 激光组单纯应用激光治疗,药物组应用氨甲环酸、谷胱甘肽及维生素C治疗,联合治疗组应用激光联合氨甲环酸、谷胱甘肽及维 生素C 治疗。对比三组治疗前后黄褐斑面积及黄褐斑颜色评分、临床疗效及治疗后不良反应。结果：联合组治疗后黄褐斑面积及 黄褐斑颜色评分显著低于激光组、药物组及治疗前（P<0.05）。联合组治疗的总有效率显著高于激光组及药物组（P<0.05）。药物组 不良反应发生率为2.56%,其他两组未见明显不良反应。结论：激光联合氨甲环酸、谷胱甘肽及维生素C 治疗黄褐斑的疗效确切, 可以有效改善黄褐斑面积及颜色,安全性佳,适于临床应用。     

外科新三联疗法治疗糖尿病足的临床观察

目的:观察外科新三联疗法(外科换药-威伐激光-成纤维细胞生长因子)治疗糖尿病足溃疡的临床疗效和安全性。方法:将57例糖尿病足溃疡患者随机分为2组。对照组28例,采用外科换药辅以成纤维细胞生长因子外敷治疗;治疗组29例,在对照组治疗的基础上配合威伐激光照射治疗。疗程为8周,观察两组患者的治疗有效率、愈合时间和不良反应的发生情况。结果:治疗组和对照组的有效率分别为86.21%、57.14%,治疗组显著高于对照组(P0.05);且治疗组溃疡的愈合时间(39.40±2.24天)较对照组(50.67±2.31天)明显缩短(P0.01)。此外,两组患者均无明显的不良反应发生。结论:外科新三联疗法(外科换药-威伐激光-成纤维细胞生长因子)是治疗糖尿病足溃疡的有效方法,且安全性好。     

长脉冲1064nm激光联合酮康唑软膏封包病甲治疗甲真菌病的临床疗效观察

目的观察长脉冲1064 nm激光联合酮康唑软膏封包病甲治疗甲真菌病的临床疗效。方法 将73例甲真菌病门诊患者随机分为两组:联合组(37例,病甲75个)采用长脉冲1064 nm激光联合酮康唑软膏封包病甲治疗;对照组(36例,病甲87个)单纯使用激光治疗。每周1次,连续治疗8周,治疗6个月后随访评估。比较两种方法治疗甲真菌病的临床有效率,观察1064 nm激光联合酮康唑软膏封包病甲治疗甲真菌病患者的临床疗效。结果 联合组治疗甲真菌病的总的临床有效率(74.67%)高于对照组(63.22%),3种临床类型在联合组的临床有效率均高于对照组,尤其近端甲下型(PSO)的临床有效率明显提高,但差异无统计学意义;当9≤SCIO≤15时,联合组治疗甲真菌病的临床有效率高于对照组,差异有统计学意义。结论 对于9≤SCIO≤15的甲真菌病患者,长脉冲1064 nm激光联合酮康唑软膏封包病甲治疗甲真菌病的临床疗效显著高于单纯激光治疗。     

CO_2激光联合胸腺五肽治疗尖锐湿疣的临床效果分析

目的：探讨CO2激光联合胸腺五肽治疗尖锐湿疣的临床疗效。方法：将我院2010年2月-2011年8月期间收治的82例尖锐湿疣患者随机分为两组,治疗组50例采用CO2激光器治疗联合胸腺五肽肌注;对照组32例单纯采用CO2激光器治疗;两组治疗疗程结束后观察临床疗效。结果：治疗组50例,一次治愈者46例,占92%;二次治愈者4例,占8%。对照组32例,一次治愈者19例,占59.4%;二次治愈者13例,占40.6%。两组一次治愈率比较差异明显,具有统计学意义（P〈0.05）。两组术后局部轻度水肿和疼痛,无需处理1~3天缓解或痊愈。结论：CO2激光联合胸腺五肽治疗尖锐湿疣临床疗效好,并具有治疗简便,术后不良反应少,治愈率高等特点。     

光化学疗法治疗神经性皮炎60例临床疗效观察

采用光化学疗法,外涂0.2%8-MOP半小时后以光化肤康灯(主峰波长365 nm,终端输出功率25.4 W连续可调,幅照度:930μW/cm2)照射,治疗神经性皮炎60例,平均治疗间期1月,治愈率51.67%,显效率23.33%,有效率21.67%,无效率3.33%。未发现明显毒副作用。结果显示光化学疗法对神经性皮炎有很好的疗效。     

激光治疗急性踝关损伤40例临床疗效观察

采用SUNDOM-300I型半导体激光（波长810nm,终端输出功率0mW-500mW,连续可调,光速直径5mm）,治疗急性踝关节损伤40例,平均治疗次数为4次,治愈率72.5％,有效率27.5％,示发现明显毒副作用。结果显示激光在治疗软组织疼痛的早期有较好的疗效。     

光化学疗法治疗手角化过度性湿疹60例临床疗效观察

采用光化化学疗法,外涂0．2％8-MOP半小时后以光化肤康灯(主峰波长365nm,终端输出功率25．4W连续可词,幅照度：930UW／cm^2)照射,治疗手角化过度性湿疹60例,平均治疗间期1月,治愈率48．33％,显效率18．33％,有效率28．33％,无效率5％。未发现明显毒副作用。结果显示光化学疗法对手角化过度性湿疹有很好的疗效。     

Treatment of statin adverse effects with supplemental Coenzyme Q10 and statin drug discontinuation

Fifty consecutive new cardiology clinic patients who were on statin drug therapy (for an average of 28 months) on their initial visit were evaluated for possible adverse statin effects (myalgia, fatigue, dyspnea, memory loss, and peripheral neuropathy). All patients discontinued statin therapy due to side effects and began supplemental CoQ(10) at an average of 240 mg/day upon initial visit. Patients have been followed for an average of 22 months with 84% of the patients followed now for more than 12 months. The prevalence of patient symptoms on initial visit and on most recent follow-up demonstrated a decrease in fatigue from 84% to 16%, myalgia from 64% to 6%, dyspnea from 58% to 12%, memory loss from 8% to 4% and peripheral neuropathy from 10% to 2%. There were two deaths from lung cancer and one death from aortic stenosis with no strokes or myocardial infarctions. Measurements of heart function either improved or remained stable in the majority of patients. We conclude that statin-related side effects, including statin cardiomyopathy, are far more common than previously published and are reversible with the combination of statin discontinuation and supplemental CoQ(10). We saw no adverse consequences from statin discontinuation.     

微等离子体射频技术治疗成熟瘢痕50例临床观察

目的:研究新型微等离子体射频技术治疗瘢痕的效果。方法:50例成熟瘢痕患者,包括31例痤疮疤痕,19例外伤或手术疤痕。均采用微等离子体射频技术进行功率为70～90Watt的滑动式或定点式治疗,每4周治疗一次,共治疗2～5次,通过治疗前及治疗后3个月统一衡量标准对比来进行疗效评估。结果:成熟瘢痕表现为身体各部位分布形状不规则形状皮肤组织凹陷或轻度增生。通过临床指标评分,50例患者总有效率为82%。疗效显著18例(36%),有效22例(44%),轻微改善11例(22%),无效9例(18%)。结论:微等离子体射频技术能显著改善成熟瘢痕的色泽、质地和凸凹程度,不良反应少,是治疗成熟瘢痕的有效方法。     

Epimutations in Prader-Willi and Angelman syndromes: a molecular study of 136 patients with an imprinting defect

Prader-Willi syndrome (PWS) and Angelman syndrome (AS) are neurogenetic disorders that are caused by the loss of function of imprinted genes in 15q11-q13. In a small group of patients, the disease is due to aberrant imprinting and gene silencing. Here, we describe the molecular analysis of 51 patients with PWS and 85 patients with AS who have such a defect. Seven patients with PWS (14%) and eight patients with AS (9%) were found to have an imprinting center (IC) deletion. Sequence analysis of 32 patients with PWS and no IC deletion and 66 patients with AS and no IC deletion did not reveal any point mutation in the critical IC elements. The presence of a faint methylated band in 27% of patients with AS and no IC deletion suggests that these patients are mosaic for an imprinting defect that occurred after fertilization. In patients with AS, the imprinting defect occurred on the chromosome that was inherited from either the maternal grandfather or grandmother; however, in all informative patients with PWS and no IC deletion, the imprinting defect occurred on the chromosome inherited from the paternal grandmother. These data suggest that this imprinting defect results from a failure to erase the maternal imprint during spermatogenesis.     

Increased radiation toxicity with germline ATM variant of uncertain clinical significance

BackgroundWhile patients with ataxia telangiectasia are known to have increased radiation sensitivity, patients with germline heterozygous ataxia telangiectasia mutated (ATM) mutations can have widely varying functional and clinical effects, which can make management decisions difficult. With an increased prevalence of gene panel-based testing for breast cancer patients, radiation oncologists are increasingly confronted with patients who carry germline ATM variants of uncertain clinical significance. This study describes the clinical courses and outcomes of 5 breast cancer patients with varying germline heterozygous ATM mutations undergoing radiation therapy at our institution in order to provide additional knowledge of the varying clinical effects to aid future decision making.Case SeriesWe identified 5 patients with breast cancer and varying germline heterozygous ATM mutations treated at the University of North Carolina Hospitals between 2015 and 2017. The median age at breast cancer diagnosis for the patient series was 46. Clinical effects of radiation treatment varied amongst the 5 patients. The one patient with a pathogenic ATM mutation had no increased radiation related toxicity. Of the 4 patients with ATM variants of uncertain significance, one patient had increased radiation sensitivity with Grade 3 dermatitis. All patients have remained recurrence free with a median duration of 18 months.ConclusionOur data illustrates that patients with germline heterozygous ATM mutations can have widely varying clinical effects with radiation therapy. Given the possibility of unpredictable deleterious effects, our study highlights the importance of caution and careful consideration when devising the multi-modality management strategy in these patients.     

4-Hydroxyandrostenedione treatment for postmenopausal patients with advanced breast cancer

We have treated 128 postmenopausal women with advanced breast cancer with 4-hydroxyandrostenedione. Of these, 118 were assessable for toxicity and 100 for response to treatment. Response to therapy was seen in 34% of patients and stabilization of disease in 12 patients. Three dose regimens were used (500 mg intramuscularly weekly; 250 mg intramuscularly every 2 weeks; and 500 mg orally daily). There was no difference in response in these three groups. Side effects were minimal and local reaction to injected drug was seen in 13% of patients. The sole severe side effect observed was neutropenia which was transient and reversible on discontinuing therapy. 4-Hydroxyandrostenedione is an effective nontoxic agent in the treatment of breast cancer.     

Clonidine reduces elevated cerebrospinal fluid catecholamine levels in patients with essential hypertension

Cerebrospinal fluid (CSF) catecholamines were measured in normotensive patients and in patients with mild to moderate essential hypertension. CSF-norepinephrine (NE) concentrations were 50% lower in the normotensive individuals (127 ± 28 vs. 240 ± 23 pg/m1) (P<0.01). In hypertensive patients, CSF-NE was inversely related to age (r =-0.68; P<0.01) and directly related to plasma NE (r = 0.61; P<0.05). Clonidine (450 mcg/day for 2 weeks) significantly reduced CSF-NE (?40%) in hypertensive patients. In addition, it decreased blood pressure, plasma and urinary NE. Urinary VMA was not affected by clonidine. No correlation was observed between clonidine effects on BP and on plasma or CSF catecholamines. This study indicates that patients with essential hypertension have elevated levels of CSF-NE which are reduced after treatment with clonidine. The elevation of CSF-NE suggests that central (spinal?) noradrenergic activity may be increased in patients with mild to moderate essential hypertension, and that can be reduced by treatment with clonidine.     

Adverse effects associated with selective serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis

BACKGROUND: The use of antidepressant medications and the resulting costs have increased dramatically in recent years, partly because of the introduction of selective serotonin reuptake inhibitors (SSRIs). An assessment of the clinical and economic aspects of SSRIs compared with the older tricyclic antidepressants (TCAs) was initiated to generate information for purchasers of these drugs as well as clinicians. One component of this study was an examination of the adverse effects associated with the use of these drugs. METHODS: Searches of bibliographic databases (for January 1980 through May 1996) and manual scanning of both peer-reviewed publications and other documents were used to identify double-blind, randomized controlled trials involving at least one SSRI and one TCA. For the study of adverse effects, only trials that had at least 20 patients in each trial arm and that reported rates of adverse effects in both arms were retained. In total 84 trials reporting on 18 adverse effects were available. Meta-analyses were undertaken to calculate pooled differences in rates of adverse effects. The question of whether the method of eliciting information from patients about adverse effects made a difference in the findings was also examined. Finally, differences in drop-out rates due to adverse effects were calculated. RESULTS: The crude rates of occurrence of adverse effects ranged from 4% (palpitations) to 26% (nausea) for SSRIs and from 4% (diarrhea) to 27% (dry mouth) for TCAs. The differences in the rates of adverse effects between the 2 types of drugs ranged from 14% more with SSRIs (for nausea) to 11% more with TCAs (for constipation). The results did not depend on the method of eliciting information from patients. There were no statistically significant differences between drug classes in terms of drop-outs due to adverse effects. INTERPRETATION: SSRIs and TCAs are both associated with adverse effects, although the key effects differ between the drug classes. Further explanation of the adverse effects and their relation to discontinuation of medication will require better studies involving prospective collection of quality-of-life data.