低能量激光是否有镇痛作用?

近十多年来,低能量激光治疗已被内科和理疗医师用以解除炎症或溃疡以及其它疾病引起的疼痛。应用较多的典型激光有633 nm红光He-Ne气体激光,830 nm红外Ga-Al-As二极管激光以及904 nm红外     

输尿管软镜结合输尿管硬镜治疗复杂上尿路结石的效果评价及对预后的影响

目的 探讨输尿管软镜协同输尿管硬镜治疗复杂上尿路结石的临床效果.方法 选择我院收治的复杂上尿路结石患者96例,按入院顺序分为对照组和观察组,每组48例.对照组采取输尿管硬镜钬激光碎石术治疗,观察组采取输尿管软镜协同输尿管硬镜钬激光碎石术治疗.比较两组患者1次性碎石成功率、结石彻底清除率、炎症反应情况以及生活质量、住院时...     

实验性自身免疫性葡萄膜炎模型中肝脏免疫系统紊乱的研究（英文）

葡萄膜炎是一种反复发作的炎症性疾病,可导致免疫系统功能障碍和多器官损伤.然而,葡萄膜炎是否导致肝功能损害尚不十分清楚.本文通过运用流式分析技术和激光共聚焦成像技术,研究了实验性自身免疫葡萄膜炎模型的肝脏病理和功能变化.结果显示肝损伤可出现在葡萄膜炎的炎症后期并与眼损伤程度相关.并且CD3~+CD4~+T细胞、CD3~-NK1.1~+DX5~-NK细胞、和CD11b~~+F4/80~-ly6c~+细胞在感染的眼睛和肝脏中增加.将CD3~+CD4~+T细胞回输给炎症的小鼠后,眼睛和肝脏的病理损伤加重.此外,在炎症的小鼠中可见血管扩张,大量淋巴细胞浸润到炎症的眼和肝脏的血管周围.总之,我们的研究结果提示,肝损伤可以发生在小鼠葡萄膜炎模型中,这种损伤可能与通过外周循环浸润到肝脏的CD3~+CD4~+T细胞有关.     

水激光与超声洁治对中度慢性牙周炎的疗效对比

目的:探讨水激光与超声洁治对中度慢性牙周炎的疗效。方法:选取81例中度慢性牙周炎患者,年龄27-62岁,随机分为两组:激光组(41例)采用水激光治疗,超声组(40例)采用超声洁治法治疗。通过患者治疗后1个月,3个月的菌斑指数(plaque index,PLI),牙龈指数(gingival index,GI),牙周袋深度(probing depth,PD),牙周附着水平(clinical attachment level,CAL),治疗过程中的VAS评分等观察指标,对水激光与超声洁治进行疗效对比。结果:与基线各项牙周指数相比,激光组和超声组治疗后1个月,3个月的各项牙周指数均明显降低(P0.05)。与超声组相比,激光组治疗后1个月的GI值明显低于超声组,治疗后1个月和3个月的PD值和CAL值均低于超声组(P0.05)。治疗前,两组VAS评分相比,差异没有统计学意义(P0.05),治疗后,激光组的VAS评分明显低于超声组(P0.05)。结论:水激光治疗中度慢性牙周炎,治疗过程痛觉感受轻微,能轻易清除引起炎症的牙石及菌斑,促进牙周组织愈合。     

经尿道2微米激光切除术与电切术治疗浅表性膀胱癌的疗效观察

目的:比较经尿道2微米激光切除术与电切术治疗浅表性膀胱癌的临床疗效。方法:按照随机数字表法将2014年1月-2015年1月我院收治的浅表性膀胱癌患者分为两组,观察组(61例)行经尿道2微米激光切除手术,对照组(46例)行电切术,比较两组的手术效果、治疗前后的炎症因子水平及并发症。结果:观察组手术时间、导尿管留置时间、住院时间及术中出血量少于对照组,差异有统计学意义(P0.05)。治疗后两组患者IL-6、IL-10以及TNF-α水平均较治疗前升高,但是观察组治疗后的IL-6及TNF-α水平低于对照组,IL-10水平高于对照组,差异有统计学意义(P0.05)。两组患者术后均发生不同程度的并发症,其中观察组膀胱穿孔、闭孔神经反射的发生率为3.28%、1.64%,分别低于对照组的17.39%、13.04%,差异有统计学意义(P0.05)。结论:浅表性膀胱癌采用经尿道2微米激光切除术治疗具有明显的临床手术效果,减少术后并发症,同时对患者炎症因子的影响较小,临床有重要的参考价值。     

半导体激光联合全蝎软膏对大鼠糖尿病性皮肤溃疡修复的研究

目的:探讨半导体激光联合全蝎软膏对大鼠糖尿病皮肤溃疡(DSU)的修复作用。方法:24只SPF级Wistar大鼠随机平均分为对照组、模型组、全蝎软膏组和联合组,以腹腔注射链脲佐菌素-皮肤缺损法构建大鼠DSU模型;建模后分别用激光和/或全蝎软膏对DSU大鼠进行治疗,观察用药后3 d、7 d、10 d和14 d的大鼠体重、血糖值及创面肉芽组织愈合情况;随后,分别对创面组织进行H.E染色、免疫组化、ELISA法及western blot检测。结果:建模后的DSU大鼠体重、血糖与对照组比较有统计学差异(P0.05),且成模率为73.33%;各治疗组创面愈合率均高于模型组(P0.05),肉芽组织生长旺盛,毛细血管丰富,炎症反应减轻;ELISA和western blot结果显示,与模型组相比,联合组治疗后组织内血管内皮生长因子(v EGF)显著上升(P0.05)、肿瘤坏死因子α(TNF-α)和Smad 4蛋白水平显著降低(P0.05),治疗效果优于全蝎软膏组。结论:半导体激光联合全蝎软膏可有效促进大鼠DSU创面的愈合,减轻炎症反应并修复血管功能,效果优于全蝎软膏组。     

角膜激光共聚焦显微镜在单眼感染性角膜炎疾病诊断中的应用

摘要 目的：探讨角膜激光共聚焦显微镜在单眼感染性角膜炎疾病诊断中的应用价值。方法：回顾性研究2020年6月到2021年6月选择在本院诊治的单眼感染性角膜炎疾病患者62例,所有患者都给予角膜激光共聚焦显微镜检查,记录影像学特征并判断诊断价值（以病原学诊断为金标准）。结果：真菌性角膜炎在角膜激光共焦显微镜下的病变区纵横交错的高反射的真菌菌丝或高反光细长颗粒状的孢子,细菌性角膜炎的病变处会聚集活化的树突状细胞及大量的炎症细胞,病毒性角膜炎的基底膜下神经纤维密度、神经主干的分支数减少,棘阿米巴性角膜炎的包囊表现为圆形高反光厚壁结构。角膜激光共聚焦显微镜判断为病毒性角膜炎17例,诊断病毒性角膜炎的敏感性与特异性为94.4 %和100.0 %;角膜激光共聚焦显微镜判断为棘阿米巴性角膜炎4例,诊断棘阿米巴性角膜炎的敏感性与特异性为94.4 %和100.0 %;角膜激光共聚焦显微镜判断为细菌性角膜炎21例,诊断细菌性角膜炎的敏感性与特异性为95.5 %和97.5 %;角膜激光共聚焦显微镜判断为真菌性角膜炎20例,诊断真菌性角膜炎的敏感性与特异性为94.4 %和93.2 %。ROC曲线分析显示角膜激光共聚焦显微镜诊断细菌性角膜炎、真菌性角膜炎、病毒性角膜炎、棘阿米巴性角膜炎的曲线下面积分别为0.525、0.579、0.777、0.731。结论：角膜激光共聚焦显微镜在单眼感染性角膜炎疾病诊断中的应用能较好的区分细菌性角膜炎、真菌性角膜炎、病毒性角膜炎、棘阿米巴性角膜炎,具有良好的诊断敏感性与特异性。     

稳定溶解臭氧水对皮肤创面炎症的治疗效果

目的:探讨浓度为1.8-3.2 mg/L溶解臭氧水冲洗控制皮肤创口炎症引发的红肿痛的临床效果。方法:将40例接受激光皮肤除斑治疗的患者分为两组,其中实验组20例患者采用浓度为1.8-3.2 mg/L溶解臭氧水冲洗皮肤创面,而对照组20例患者采用冰袋冷敷的方式处理创面。观察并比较两组患者皮肤创面红肿的改善情况以及两种治疗方法的临床效果。结果:1疼痛症状改善情况:实验组显效20例,对照组显效0例,实验组患者显效率明显高于对照组,差异具有统计学意义(P0.01)。2临床体征改善情况:实验组显效20例,对照组显效0例,实验组患者显效率明显高于对照组,差异具有统计学意义(P0.01)。结论:浓度1.8-3.2mg/L溶解臭氧水对于炎症引发的皮肤创面红肿症状具有显著的疗效,不仅能够抑制炎症发展,而且有利于促进创面愈合,值得在临床广泛推广应用。     

唇腺炎性病变组织的共聚焦显微拉曼光谱特征研究

目的:研究唇腺炎性病变组织的拉曼光谱指纹特征,为拉曼光谱技术临床鉴别诊断唇腺炎性病变提供理论基础。方法:收集舍格伦综合征病变唇腺30例、唇腺急性炎症组织18例及正常唇腺组织30例,应用激光共聚焦显微拉曼光谱仪对唇腺组织进行拉曼光谱检测。应用主成分分析法(Principal component analysis,PCA)及判别函数(Discrimination function analysis,DFA)对光谱数据进行分析,研究唇腺组织光谱指纹诊断价值。结果:唇腺炎症组织与正常组织光谱间存在光谱指纹差异,这些差异代表了某些蛋白、核酸及脂类物质等生物大分子发生改变。PCA-DFA分析发现这些差异性拉曼光谱具有鉴别诊断价值,可以区分不同唇腺组织,总体诊断准确率达91.8%,经交互验证后准确率为89.4%。结论:不同唇腺炎症组织及正常组织间拉曼光谱存在差异,不仅揭示生物大分子改变,还具有临床鉴别诊断价值。拉曼光谱技术在唇腺炎性病变组织鉴别诊断具有巨大应用潜力。     

研究报告: 实验性自身免疫性葡萄膜炎模型中肝脏免疫系统紊乱的研究

葡萄膜炎是一种反复发作的炎症性疾病,可导致免疫系统功能障碍和多器官损伤．然而,葡萄膜炎是否导致肝功能损害尚不十分清楚．本文通过运用流式分析技术和激光共聚焦成像技术,研究了实验性自身免疫葡萄膜炎模型的肝脏病理和功能变化．结果显示肝损伤可出现在葡萄膜炎的炎症后期并与眼损伤程度相关．并且CD3⁺ CD4⁺ T细胞、CD3^- NK1.1⁺ DX5^- NK细胞、和CD11b⁺ F4/80^- ly6c⁺ 细胞在感染的眼睛和肝脏中增加．将CD3⁺ CD4⁺ T细胞回输给炎症的小鼠后,眼睛和肝脏的病理损伤加重．此外,在炎症的小鼠中可见血管扩张,大量淋巴细胞浸润到炎症的眼和肝脏的血管周围．总之,我们的研究结果提示,肝损伤可以发生在小鼠葡萄膜炎模型中,这种损伤可能与通过外周循环浸润到肝脏的CD3⁺ CD4⁺ T细胞有关．     

激光医疗的进展：低功率激光治疗在中国

激光医学尤其是低功率激光治疗在中国已成为发展极为迅速的领域之一。低功率激光照射的光生物效应与传统中医针刺穴位经络相结合在中国低功率激光治疗中开辟了广阔的领域,並已广泛应用于临床各专科如内科、皮肤科、眼科、耳鼻喉科、口腔科、妇产科、整形外科、激光针灸及兽医学,成功地治疗了数百种疾病,效果显著。作者近10年来已成功应用激光穴位麻醉拔牙与施行面部整容小手术。1985～1990年以来开创了激光美容外科。低功率激光治疗已被证实在保证激光美容效果的重要性。     

Regulatory role of low-intensity laser radiation on the status of the antioxidant system

On the base of modern literary data it is shown that low level laser red radiation can render the manifested effect on the activity of main antioxidant enzymes. It is determined that the main enzymes of antioxidant system--superoxide dismutase, catalase, ceruloplasmine--absorb in the red part of spectrum and are capable to be reactive under some regimes of red low level laser irradiation. It is one of the main possible mechanisms of biological efficiency of low level red laser radiation of the red part of spectrum.     

Effect of the He-Ne laser irradiation on resistance of the isolated heart to the ischemic and reperfusion injury

The aim of this work was to investigate the myocardial protection against ischemia/reperfusion using low level laser irradiation (LLLI). It has been shown that pulse pressure was higher in the period of post-ischemic reperfusion as compared with the control group. It provided a better restoration of myocardial contractility as well as increasing of coronary flow in the reperfusion period. The amount of ventricular rhythm disorder episodes decreased. These effects of laser application were registered in conditions of coronary flow reduction less than 50%. One of the suggested mechanisms of laser effect is an ATP-sensitive channel activation.     

弱激光的生物学效应及对红细胞变形性的改善作用

简要叙述激光生物效应和弱激光生物刺激作用。概括阐述激光照射血液所产生的生物学效应,叙述了弱激光对红细胞变形性的改善作用并探讨其可能的作用机理。     

Activity of cytochromes P-450p and P-450h in liver microsomes and blood corticosteroid levels in experimental animals under the action of physical factors]

In experiments on male Wistar rats it has been found that physical factors applied in medicine (laser radiation of low intensity with wave length 0.89 microns, microwaves of centimeter range of 2450 MHz, and ultrasound of low intensity 880 KHz) changed catalytic activity of liver microsomal and rostenedione 16 alpha- and 6 beta-hydroxylating cytochromes P-450h and P-450p and blood corticosteroids level. Activities of these two steroid-metabolizing cytochromes decreased under ultrasonic skin application on liver region and increased under microwave and laser action. Contents of physiologically inactive form of corticosterone were not changed by the physical factors action while level of active hormone was increased under ultrasonic and microwave action. These findings suggest association of the activity of liver steroid-metabolizing cytochromes P-450 and level of physiologically active form of corticosterone in blood under physical factors skin application on liver region.     

Efficacy and safety of long pulse 1064 and 2940 nm lasers in noninvasive lipolysis and skin tightening

Noninvasive body shaping is becoming a growing demand. The aim of this study was to investigate the efficacy and safety of the combined treatments of 1064 nm Nd:YAG and 2940 nm Er:YAG in noninvasive lipolysis and skin tightening. Ten females were enrolled, and all women's side of the waist or the lower part of the abdomen were treated. In the first step, the 1064 nm Nd:YAG was used. As a second step, the 2940 nm Er:YAG laser was applied. Each woman was treated four times, once every 2 weeks. The effects were determined by comparative photo documentation, waist circumference measurement, two‐dimensional B‐mode ultrasonography and low‐dose native computer tomography (CT), whereas body fat was monitored with bioelectric impedance. The tissue firmness was measured by ultrasound shear wave elastography. Combined laser treatment significantly reduced waist circumference and total body fat. Ultrasonography has revealed that the treatment considerably decreased fat thickness and improved skin stiffness in the treated region. Subcutaneous fat volume, measured by low‐dose CT, displayed a moderate decrease in the waist region. The combined 1064 nm Nd:YAG and 2940 nm Er:YAG laser treatment results in the reduction of fat tissue and tightens the skin as confirmed by objective measurements.      

国产Nd:YAP激光组织热损伤效应的比较研究

目的:通过比较1 341 nm Nd:YAP与临床常用激光器脉冲Nd:YAG和连续Nd:YAG对皮肤、肌肉、静脉和肝脏组织的热损伤效应,了解Nd:YAP激光的作用特点,为其临床应用提供实验依据。方法:以大鼠作为实验对象,分为皮肤、肌肉组和静脉、肝脏组。皮肤、肌肉组:Nd:YAP激光、连续和脉冲Nd:YAG选择能量密度1000 J/cm2、2 000 J/cm2,静脉、肝脏组采用Nd:YAP激光和连续Nd:YAG两种激光器,能量密度选择500 J/cm2和1 000 J/cm2,对组织进行非接触式点状照射。照射过程中观察组织变化和损伤直径大小,并于照射后即刻、3天取材做病理切片,光镜下观察病理变化,比较相同能量密度下三种激光器对组织的热损伤和损伤修复情况。结果:皮肤、肌肉组:Nd:YAP激光在1 000 J/cm2条件下对组织的损伤以热凝固效应为主,2 000 J/cm2条件下组织发生明显气化、有一定的切割作用。相同能量密度下,脉冲Nd:YAP激光气化作用较两种Nd:YAG激光显著,而凝固损伤范围较连续Nd:YAG浅,较脉冲Nd:YAG深。肝脏、静脉组:Nd:YAP激光对肝脏的热凝固效应与Nd:YAG激光近似,气化作用明显;Nd:YAP激光对血管及其周围组织的凝固及气化作用均较连续Nd:YAG激光明显。结论:Nd:YAP激光具有良好的凝固与气化作用。     

Effect of low intensity laser beam on steroid dehydrogenase activity and steroid hormone production in cultured porcine granulosa cells

Effect of the beam emitted by a helium-neon (He-Ne) laser of a low power (2.8 mW) on the activity of delta 5, 3 beta-hydroxysteroid dehydrogenase (delta 5, 3 beta-HSD), as well as on the estradiol and progesterone production was studied in cultured granulosa cells obtained from porcine ovary. It has been found that the laser beam stimulates the activity of steroid dehydrogenase, increases estrogen levels and exerts a variable influence on the progesterone level. In control cultures the highest level of both hormones occurred simultaneously, while in cultures exposed to the laser beam progesterone level rose at a slower rate and reached maximum when the estrogen level dropped. Hyperplasia and epithelisation were observed only in the experimental cultures. The most intense cytochemical reaction for delta 5, 3 beta-HSD, as well as the most pronounced increase in estrogen and progesterone level occurred in cells exposed to a pulsating beam for 60 sec.     

Immunological and microbiological aspects of low intensity laser effect on the factors of local immunity of the reproductive tract in women with chlamydia infection

Assessment of immunological and microbiological efficacy of Chlamydia cervicitis management was made by a complex method with a low intensity laser. The total number of leukocytes, percentage of viable cells and the number of neutrophils were detected in cervical secrets. Functional status of neutrophils was studied by a content of lysosomes on the ground of spontaneous and induced by latex HCT-reducing capacity, phagocytic activity. A system of cytokines was studied by interleukine level (IL-1 alpha, IL-1 beta, TNF-alpha, IL-8) and IFN-gamma content in cervical mucus. Positive clinical effect of the local use of the low intensity laser for Chlamydia cervicitis treatment was accompanied by positive changes in immunological indices of cervical secret, normal concentration of cytokines in cervical secret, restoration of the number and functions of neutrophils. Local use of the low intensity laser contributed to decreased number of opportunistic pathogenic microorganisms and their associations, and restored local flora.     

遗传性LCAT缺陷症与动脉粥样硬化

卵磷脂：胆固醇酰基转移酶（lecithin：cholesterol acyltransferase,LCAT）参与胆固醇酯的合成并在高密度脂蛋白（high density lipoprotein,HDL）的代谢中起重要作用。遗传性LCAT缺陷症是一种以低HDL-胆固醇（HDL-C）为特点的罕见遗传疾病。近年来,LCAT在HDL-C代谢中以及在动脉粥样硬化发生和发展中的作用逐渐被本领域研究者所关注。本文就LCAT缺陷症的遗传学和生化学特点做一综述,重点阐述为何尽管HDL-C水平明显减低,LCAT突变携带者却并未发生早期动脉粥样硬化。