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Juvenile localized scleroderma (JLS) is a rare rheumatic immune disease in children, which is characterized by early inflammation and late fibrosis of skin and subcutaneous tissues.At present, the pathogenesis of JLS remains unclear, and lacks specific treatment.This study reviews the research progress of clinical assessment, drug therapy, physiotherapy and surgical therapy of JLS, aiming to provide references for clinical treatment of JLS.
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Objective@#To investigate the BRCA1 and BRCA2 gene mutations in patients with recurrent serous ovarian cancer and their clinical significances.@*Methods@#A total of 57 patients with recurrent serous ovarian cancer in the First Affiliated Hospital of Nanchang University from January 2016 to January 2018 were collected. High-throughput second-generation sequencing technology was used to detect BRCA1 and BRCA2 mutations in patients' blood. Statistical analysis was performed on the relationship between BRCA mutations and clinicopathological factors and prognosis.@*Results@#Of the 57 patients with recurrent serous ovarian cancer, 16 patients (28.07%) had BRCA mutations, among which 3 patients (5.26%) had nonsense mutations, 7 patients (12.28%) had frameshift mutations, and 7 patients (12.28%) had missense mutations. There was no significant difference in BRCA mutation rate among patients with different American Obstetrics and Gynecology Union (FIGO) stage, lymphatic metastasis, tissue differentiation and age stratification (all P > 0.05). Patients with family history of ovarian cancer or breast cancer had a higher BRCA mutation rate than patients without family history (7/12 vs. 9/45, χ2 = 5.13, P = 0.02), and patients who were sensitive to first-line platinum treatment had a higher BRCA mutation rate than those with drug resistant (16/45 vs. 0/12, P = 0.04). Patients with BRCA mutation had a lower serum CA125 level than patients with BRCA wild-type [(774±548)×103 U/L vs. (1 522±1 269)×103 U/L, t = 3.106, P = 0.003], and a longer median progression-free survival (PFS) time (20.5 months vs. 12.0 months, P = 0.01).@*Conclusions@#Serous ovarian cancer patients with BRCA mutations have higher sensitivity to platinum-based chemotherapeutic drugs and better PFS. Detection of BRCA mutations helps to judge prognosis and guide medication.
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Objective To evaluate and compare the clinical efficacy and safety of intense pulsed light (IPL) versus 595-nm pulsed dye laser (PDL) for the treatment of post-acne erythema.Methods A randomized split-face clinical trial was conducted.A total of 20 patients with post-acne erythema were enrolled,and randomized to receive treatment with IPL on one half of the face and 595-nm PDL on the other facial side once every 4 weeks for 3 sessions.Digital photographs were taken using the VISIA,and erythema index was recorded before each treatment and one month after the last treatment.The severity of bilateral facial erythema was evaluated based on a 4-point grading scale before the first treatment and after the last treatment.Pain scores and adverse reactions were recorded using a visual analogue scale (VAS) after each treatment,and a patient satisfaction survey was conducted by questionnaire at the last follow-up.Results The mean erythema index on the IPL side before and after treatment was 472.25 ± 86.02 and 357.15 ±82.71 respectively,and that on the PDL side before and after treatment was 476.40 ± 74.25 and 360.05 ± 64.83 respectively.Repeated measures analysis of variance (ANOVA) showed that the erythema indices on both treated sides significantly decreased over time (F =197.666,P ＜ 0.001),and the efficacy of IPL was better than that of PDL (F =1 173.909,P ＜ 0.001).Erythema severity grades on the IPL side as well as on the PDL side significantly differed between before and after treatment (Z =28.735,31.450,respectively,both P ＜ 0.001).As VAS showed,the pain score on the PDL side was significantly lower than that on the IPL side (t =2.468,P ＜ 0.05).Among the 20 patients,17 and 15 assessed their improvement as good or excellent after PDL and IPL treatment respectively,but there was no significant difference between the two groups (Z =2.696,P ＞ 0.05).The adverse reactions included erythema,burning sensation,tense sensation,blistering and hyperpigmentation on IPL-treated side,and erythema and purpuric reactions on the PDL-treated side,which all disappeared in a few hours to several days.Conclusions Both IPL and 595-nm PDL are effective and safe for the treatment of post-acne erythema,and are worthy of clinical promotion and application.IPL shows superiority in the efficacy,but elicits higher pain sensation compared with PDL.