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Objective:To compare the efficacy of fractional CO 2 laser combined with topical delivery of fluorouracil versus compound betamethasone injections in the treatment of vitiligo. Methods:Clinical data were collected from 94 patients with localized, non-segmental, and stable vitiligo, who received fractional CO 2 laser combined with drug delivery at the Cosmetological Center, Xijing Hospital, Air Force Medical University from October 2018 to May 2023, and were retrospectively analyzed. Among them, there were 40 cases in the fractional CO 2 laser combined with fluorouracil injection group, and 54 cases in the fractional CO 2 laser combined with compound betamethasone injection group. All the patients received the above treatment once a month for 5 sessions. A 4-level grading scale was used to evaluate the pigmentation improvement, and the clinical efficacy and safety of the two therapeutic regimens were compared. Comparisons between groups were performed using chi-square test, Fisher′s exact test, and t test. Results:In the fractional CO 2 laser combined with fluorouracil injection group, there were 22 males and 18 females, their ages were 21.95 ± 12.88 years, and the disease duration was 25.46 ± 11.42 months; in the fractional CO 2 laser combined with compound betamethasone injection group, there were 36 males and 18 females, their ages were 22.26 ± 8.79 years, and the disease duration was 26.51 ± 12.81 months. One month after the first treatment, no significant difference was observed in the efficacy between the two groups ( χ2 = 1.39, P = 0.238). One month after the fifth treatment, 2 (5.0%) patients showed an excellent response, 4 (10.0%) showed a good response, 12 (30.0%) showed a mild response, and 22 (55.0%) showed a poor response in the fractional CO 2 laser combined with fluorouracil injection group; in the fractional CO 2 laser combined with compound betamethasone injection group, 8 (14.8%) patients showed a good response, 8 (14.8%) showed a mild response, and 38 (70.4%) showed a poor response; there was no significant difference in the efficacy between the two groups after 5 sessions of treatment ( χ2 = 2.35, P = 0.125). After either 1 or 5 sessions of treatment, there were no significant differences in the efficacy for lesions on the face and neck, trunk and limbs, hands and feet between the two therapeutic regimens (all P > 0.05). Comparisons of the efficacy for skin lesions on different body sites showed that one session of the fractional CO 2 laser combined with fluorouracil injection was more effective for the treatment of skin lesions on the face and neck compared with those on the hands and feet ( P = 0.039) ; after 5 sessions of treatment, the two therapeutic regimens both showed better efficacy for facial skin lesions compared with hand and foot skin lesions ( P = 0.005, 0.049). There was no significant difference in the occurrence of adverse reactions such as pigmentation, infection and scarring between the two groups. Conclusion:The fractional CO 2 laser combined with topical delivery of fluorouracil and compound betamethasone injections showed similar efficacy and safety in the treatment of vitiligo, and both can be used as treatment options for vitiligo.
ABSTRACT
Nonspecific low back pain is closely associated with afferent nerve ingrowth into degenerated IVDs and increasing the inflammatory response. Members of the class 3 semaphorins signal their response through two prominent receptors; the NRP (Neuropilin-1) and the Plexin A. Sema3A (Semaphorin3A) is primarily known for their role in modulating neuronal survival as well as neurite outgrowth and guidance via regulation of Sema3A-NRP-1-plexinA signal pathway. Also, sema3A is shown to be conductive to innervate the inner painful degenerated IVDs (Intervertebral discs). Furthermore, sema3A is thought to act as a barrier to endothelial cells survival and migration on vascular endothelial growth factor (VEGF) and inhibition of KLF5-induced (Krüppel-like factor 5) inflammatory mediators within degenerated IVDs. Therefore, Sema3A produce a new perspective of dual-action therapeutic agent for attenuating the regulator of innervation and angiogenesis into degenerated IVDs and inhibition of KLF5-induced inflammation.
Subject(s)
Humans , Endothelial Cells , Low Back Pain , Neuropilin-1 , Semaphorin-3A , Vascular Endothelial Growth Factor AABSTRACT
A melanoma is a highly malignant tumor that originates from melanocytes in the skin, mucosa, or tunica pigmentosa. The incidence and mortality rate of cutaneous melanoma are increasing annually. However, the efficacy of traditional therapy is extremely limited because of its low sensitivity and high toxicity. The application of the anti-CTLA-4 antibody and the BRAF inhibitor dramatically improves the overall survival of patients with advanced melanoma. However, their limited benefit ratio and high drug resistance curtail the use of anti-CTLA-4. Since the US Food and Drug Administration approved the use of the anti-PD-1 and anti-PD-L1 antibodies for ad-vanced melanoma in 2014, a significant survival benefit has been observed in patients with advanced melanoma. This review aims to highlight the applications of the anti-PD-1 antibody (pembrolizumab, nivolumab, and pidilizumab) and the anti-PD-L1 antibody (MP-DL3280A, BMS-936559, and MEDI4736) in the clinical treatment of melanoma by succinctly summarizing the results of recent reports.
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To study the clinical application of Jintian'ge capsule in treatment of vertebral compression fracture in senile osteoporosis patients. In the study, 69 senile osteoporotic vertebral compression fracture patients hospitalized in our hospital between January 2012 and June 2014 were selected and randomly divided into the control group and the treatment group. Patients in the control group were treated by percutaneous kyphoplasty (PKP), while those in the treatment group were given Jintian'ge capsule in addition to PKP. Efforts were made to visit the patients before the surgery and in three month after that, observe and compared the vertebral height, Cobb's angle, bone density, visual analogue scale (VAS) and Oswestry disability index between patients in the two groups. According to the findings, compared with before the treatment, patients in the two groups showed significant improvements in the vertebral height, Cobb's angle, bone density, VAS and Oswestry disability index three months after the surgery (P < 0.05); During the visit three months after the treatment, compared with the control group, the treatment group showed notable increases in all parameters (P < 0.05), particularly in the vertebral height, VAS and Oswestry disability index (P < 0.05). Based on the above findings, Jintian'ge capsule is applicable in adjuvant therapy after the osteoporotic vertebral compression facture PKP surgery.
Subject(s)
Female , Humans , Male , Middle Aged , Drugs, Chinese Herbal , Fractures, Compression , Drug Therapy , Osteoporosis , Osteoporotic Fractures , Drug Therapy , Spinal Fractures , Drug Therapy , Treatment OutcomeABSTRACT
OBJECTIVE@#To draw on data about publication patterns and citation indicators of Asian Pacific Journal of Tropical Medicine (APJTM) during 2008 and June 2014 in order to know about the current state of the journal.@*METHODS@#Data used in this study were collected based on publications in APJTM from 2008 to June, 2014. Information including publication issue, type of manuscript, country/region of Corresponding author, funded research paper, and international collaboration were aggregated and analyzed with Excel software. Citation indicators including total cites, average cites of each manuscript, h-index, and impact factors were primarily drawn from Web of Science™ database on June 15, 2014 and changes over the past six and half years were interpreted. The top 10 most cited papers in Web of Science™ database were also analyzed.@*RESULTS@#Number of all submissions has arisen from less than 200 in 2008 to over 1 500 in 2013, manuscript acceptance rate has decreased to be less than 14.00% indicating its improvement in quality over this period of time. Out of the 1 115 publiations, 23.77% were fruits of funded projects or produced by funded co-authors, 87.08% of all publications in APJTM were submited by authors from 10 most contributed countries. During the studied period, each published manuscript in the journal has received an average of 1.05 cites, and at least 10 publications has been cited for more 10 times.@*CONCLUSION@#Detailed analysis shows APJTM has made great progress over the past six and half years, but authors' originating countries are still disproportionate. Efforts should be made to improve its citation indicators.
Subject(s)
Manuscripts as Topic , Periodicals as Topic , PublishingABSTRACT
OBJECTIVES@#To investigate the function of cytokines, chemokines, and regulatory T cells (Tregs) in the pathogenesis of type 1 diabetes mellitus (T1DM) in children.@*METHODS@#A total of 35 children with T1DM and 30 healthy controls were enrolled in this study. Levels of serum cytokines (IL-1α, IL-6, IL-10, IL-12, and TNF-α) and chemokines (MIP-1α, MIP-1α and MCP-1) were detected by enzyme-linked immunosorbent assay. Peripheral blood mononuclear cells (PBMCs) were isolated and culture supernatant of phytohaemagglutinin (PHA)-stimulated PBMCs was subjected to ELISA for levels of cytokines (IL-1α, IL-6, IL-10, IL-12 and TNF-α) in T1DM and control group. Furthermore, flow cytometry was used to determine the percentage of Tregs in PBMCs of two groups.@*RESULTS@#Levels of serum cytokines including IL-1α, IL-6, IL-10 and TNF-α as well as chemokines, such as MIP-1α and MIP-1α in children with T1DM children were significantly higher than those in healthy controls (P<0.05, respectively). PBMCs with PHA stimulation in T1DM group secreted more IL-1α and TNF-α (P<0.05, respectively), but less IL-10 (P<0.05), as compared with control group. Furthermore, the proportion of CD4(+), CD25(+), Foxp3(+), Tregs in PBMCs isolated from children with T1DM was obviously lower than those in healthy controls (P<0.05).@*CONCLUSIONS@#Immune dysfunction, with upregulation of inflammatory factors such as IL-1α, IL-6, TNF-α and MIP-1α, downregulation of IL-10 and Tregs, plays an important role in the pathogenesis of T1DM in children.
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<p><b>OBJECTIVE</b>To investigate the correlative factors of non-surgical vertebral fractures after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures(OVCFs).</p><p><b>METHODS</b>From August 2009 to September 2011, 126 patients who underwent single-level PVP for OVCFs were included in this study. They were followed up with an average time of 13.6 months,divided into the refracture group and non-refracture group according to the onset of non-surgical vertebral fractures or not. In refracture group,there were 14 males and 18 females with an average age of (67.63+/-7.28) years(ranged, 54 to 82); and in non-refracture group,there were 40 males and 54 females with an average age of (66.26+/-6.79) years (ranged, 55 to 76). The refracture group wps divided again into adjacent vertebral fracture (AVF) group (7 males and 13 females) and remote vertebral fracture(RVF) group (4 males and 8 females). The age, sex, bone mineral density(BMD), injecting bone cement volume, the recovery rate of vertebral body height,kyphosis corrected degree were recorded and the correlative factors of non-surgical vertebral fractures were analyzed.</p><p><b>RESULTS</b>There was no statistically significant differences in age, sex, BMD, injecting bone cement volume and kyphosis corrected degree between refracture group and non-refracture group (P>0.05), and there was statistically significant difference in the recovery rate of vertebral body height (P<0.05). There was no statistically significant difference in BMD, kyphosis corrected degree between adjacent vertebral fracture group and non-refracture group (P>0.05); and there was statistically significant difference in injecting bone cement volume,recovery rate of vertebral body height(P<0.05). There was no statistically significant difference in BMD,injecting bone cement volume,recovery rate of vertebral body height, kyphosis corrected degree between remote vertebral fracture group and non-refracture group (P>0.05).</p><p><b>CONCLUSION</b>Recovery of vertebral body height may prefigure increasing risk of refracture in non-surgical vertebral body for the patient with OVCFs after PVP, and the adjacent vertebral fracture maybe concerned with injecting bone cement volume and recovery rate of vertebral body height.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Bone Density , Fractures, Compression , General Surgery , Osteoporotic Fractures , General Surgery , Spinal Fractures , VertebroplastyABSTRACT
<p><b>OBJECTIVE</b>To explore clinical effects of anterior cervical decompression and fusion by microscope in treating cervical spondylotic myelopathy.</p><p><b>METHODS</b>From February 2005 to March 2010,21 patients with cervical spondylotic myelopathy, 13 males and 8 females with an average age of 51.5 years (ranged, 32 to 71), were treated with anterior cervical decompression using high-speed bur,then bone grafting and fusion with auto iliac bone and internal fixation by microscope. According to JOA score of cervical spondylosis to evaluate clinical effects before and after operation.</p><p><b>RESULTS</b>All patients were followed up from 18 to 24 months with an average of 20 months. JOA score improved significantly from preoperative 9.26 +/- 1.72 to postoperative 13.64 +/- 1.38 (t = 2.452, P = 0.000). According to JOA score, 12 cases were excellent, 7 good and 2 fair.</p><p><b>CONCLUSION</b>Anterior cervical decompression and fusion by microscope is a refined, safe and effective surgical procedure for cervical spondylotic myelopathy.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Cervical Vertebrae , General Surgery , Decompression, Surgical , Methods , Microscopy , Spinal Fusion , Methods , Spondylosis , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the surgical therapeutic result of thoracolumbar fracture treated by two minimally invasive surgery or by traditional open operation.</p><p><b>METHODS</b>From June 2004 to April 2010, 76 patients (45 males and 31 females, with an average age of 36.4 years, ranging from 21 to 58 years) with thoracolumbar fracture were divided into three groups. In group A, 24 patients were treated with minimally invasive internal fixation by endoscope. In group B, 20 patients were treated by Sextant percutaneous pedicle screws fiaxation. In group C, 32 patients were performed with traditional open fixation surgery. The perioperative index and radiographic factor were compared among the three groups.</p><p><b>RESULTS</b>All patients were followed-up for 1 year in average. The internal fixation devices were taken out averaged 1 year after operation,there were no complications related to the internal fixaton systems. The perioperative index of groups A and B including the incision size, surgical blood loss, surgical draining loss, hospital stay time and post-operation VAS score were significant smaller than group C (P < 0.05). The Cobb's angle, sagittal index, and anterior height of the fracture vertebral body were all significantly different between pre-operation and post-operation in each group (P < 0.05).</p><p><b>CONCLUSION</b>These two methods of minimally invasive surgical treatments are effective and safe for patients with thoracolumbar fracture,because of less damage to muscles, less blood loss and quicker recovery, compared to the traditional open operation.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Case-Control Studies , Fracture Fixation, Internal , Methods , Lumbar Vertebrae , Wounds and Injuries , General Surgery , Minimally Invasive Surgical Procedures , Methods , Spinal Fractures , General Surgery , Thoracic Vertebrae , Wounds and Injuries , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical outcomes of improvement technique of double Endobutton plate for the treatment of Tossy III acromioclavicular joint dislocation.</p><p><b>METHODS</b>From June 2008 to June 2009, 18 patients with Tossy III acromioclavicular joint dislocation were treated with improvement technique of double Endobutton plate. There were 11 males and 7 females, with an average age of 35 years old ranging from 28 to 55 years. The time from injury to operation was 2 to 5 days (means 3.5 days). All patients were followed and the clinical outcomes were recorded.</p><p><b>RESULTS</b>These 18 patients were followed up from 4 to 8 months (averaged 6 months). All acromioclavicular joint dislocation were reduced. According to the scales of Karlsson, the post-operation function 1 of shoulder-joint in 16 patients were A grade and 2 patients were B grade.</p><p><b>CONCLUSION</b>The improvement technique of double Endobutton plate is an effective ideal treatment methods for Tossy III acromioclavicular joint dislocation due to its less invasion and convenience and good biocompatibility.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Acromioclavicular Joint , Wounds and Injuries , Bone Plates , Fracture Fixation, Internal , Methods , Joint Dislocations , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To evaluate the short and long term results of discectomy for lumbar intervertebral disc herniation.</p><p><b>METHODS</b>From 2000 to 2007, 400 patients (male 220 and female 180, the age was from 16 to 73 years old with an average of 42.3 years) with lumbar intervertebral disc herniation underwent discectomy by posterior mini-incision less than 5 cm and vertebrae plate was ectomized in 2 cm x 2 cm winder,and nerve root was compressied. The short and long term clinical result were analyzed with SPSS 10.0 software.</p><p><b>RESULTS</b>Three hundred and eighty patients were followed up in the short term (less than 2 years after operation), 308 cases obtained excellent result, 48 good, fair 24, the excellent and good rate was 93.7%. Three hundred and forty-eight patients were followed up in the long term (more than 3 years after operation), 244 cases obtained excellent result, 48 good, fair 56,the excellent and good rate was 83.9%. There was significant difference in follow-up between the short and long term (P < 0.05).</p><p><b>CONCLUSION</b>The clinical effect of discectomy for lumbar intervertebral disc herniation decreased with time lapse.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Diskectomy , Follow-Up Studies , Intervertebral Disc Displacement , General Surgery , Therapeutics , Lumbar Vertebrae , Pathology , Time Factors , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the differences of psychological and behavioral development between children aged 1 to 3 years fostered by grandparents and those by parents.</p><p><b>METHODS</b>Psychological and behavioral development of 443 children aged 1 to 3 years fostered by their grandparents and of aged-matched 443 children fostered by their parents were assessed with DST, an intellectual developmental screening test developed by Pediatric Hospital of Fudan University in Shanghai.</p><p><b>RESULTS</b>The abilities of social adaptation and intelligence development in children fostered by their grandparents were obviously retarded as compared with those in children fostered by their parents.</p><p><b>CONCLUSIONS</b>There are shortcomings in psychological and behavioral development in children aged 1 to 3 years fostered by grandparents.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Child Behavior , Child Development , Child Rearing , Intelligence , Intergenerational Relations , Parents , Social AdjustmentABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical effect of minimally invasive Trochanteric Antegrade Nail (TAN) for the treatment of intertrochanteric fractures of femur in elder.</p><p><b>METHODS</b>From January 2005 to June 2008, 80 patients with intertrochanteric fractures of femur were treated with minimally invasive fixation of Trochanteric Antegrade Nail. There were 16 males and 64 females with an average age of 75 years ranging from 65 to 93 years. According to Evans classification, there were 8 cases of type I, 32 of type II, 30 of type III, 6 of type IV and 4 of type V. After the operation of minimally invasive Trochanteric Antegrade Nail fixation,patients begun to do the continuous passive motion (CPM) and active motion of the injured hip joint and knee joint.</p><p><b>RESULTS</b>All patients were followed from 5 to 18 months with an average of 10 months. All factures were healing in time from 10 to 14 weeks with none screw breakage. Proximal screw exiting out about 0.5 cm occurred in 3 patients without obvert symptom. Three patients appeared lower limb deep venous thrombosis and were cured with medicine. According to the scales of Sanders, pain score was 9.08 +/- 1.19, ambulation score 8.85l +/- 1.09, function score 9.10 +/- 1.27, muscle strength score 9.13 +/- 1.18, daily life score 8.91 +/- l.07, X-ray evaluation score 9.34 +/- 1.09, so as the results were excellent in 56 cases, good in 20, poor in 4.</p><p><b>CONCLUSION</b>With the advantage of mini-invasion, operative convenience and stable fixation, minimally invasive TAN fixation is an effective method for intertrochanteric fractures in elder.</p>