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Iontophoresis is a non-invasive physical permeation technology, which has been widely applied in transdermal and transmucosal administration. Compared with other permeation technologies, iontophoresis have the advantages of high efficacy, high patient compliance and controllable delivery dose. With the development of microneedles and nano-carrier technology, the combination of iontophoresis and other penetration promotion technologies has gradually become a research hotspot. The penetration mechanism and influencing factors of iontophoresis, and the study on the combination of iontophoresis with hydrogel, microneedles or nano-carrier were reviewed in this paper.
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AIM: To explore the efficacy of Danshen injection iontophoresis in the treatment of retinal vein occlusion(RVO).METHODS: The clinical data of 90 patients(90 eyes)with RVO treated in our hospital from January 2020 to December 2021 were analyzed retrospectively, and they were divided into control group and observation group according to treatment methods. A total of 38 patients(38 eyes)in the control group were treated with intravenous Xueshuantong+oral compound Xueshuantong capsule+enteric-coated aspirin, and 52 patients(52 eyes)in the observation group were treated with Danshen injection iontophoresis on this basis. The treatment time of the two groups was 3mo. The clinical efficacy, best corrected visual acuity, retinal condition and hemorheological indexes(whole blood low shear viscosity, fibrinogen)were compared between the two groups before and after treatment.RESULTS: The total effective rate of the observation group was significantly higher than that in the control group(87% vs 58%,P<0.05)at 3mo after treatment. The best corrected visual acuity in both groups was better than that before treatment, and the observation group was better than the control group(all P<0.05).The circulation time of retinal vein, the relative diameter of retinal vein and the relative area of retinal hemorrhage in the observation group were lower than those before treatment,and the observation group was lower than the control group(all P<0.05). The whole blood low shear viscosity and fibrinogen levels in the two groups were lower than those before treatment, and the observation group was lower than those in the control group(all P<0.05).CONCLUSION: Danshen injection iontophoresis is effective in the treatment of patients with RVO, which can effectively improve the visual acuity, treat fundus lesions and improve the abnormal blood flow.
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@#AIM: To study the clinical effects and safety of iontophoresis of xueshuantong injection combined with anti-vascular endothelial growth factor(VEGF)in the treatment of retinal vein occlusion(RVO)with macular edema(ME). <p>METHODS: Totally 106 patients(106 eyes)with RVO and ME in the hospital between June 2017 and June 2019 were divided into observation group and control group according to the random number table method with 53 cases(53 eyes)in each group, and they were all given intravitreal injection of conbercept, and observation group was additionally given iontophoresis of Xueshuantong injection for intervention, and they were treated for 3mo. Both groups were followed up for 1a and given supplementary therapy according to the condition of the disease. The best corrected visual acuity(BCVA), central retinal thickness(CRT)in macular area, supplementary therapy status, VEGF level in aqueous humor and adverse drug reactions were observed and compared between the two groups before and after treatment. <p>RESULTS: After treatment, the BCVA of the two groups was significantly improved(<i>P</i><0.05)while the CRT in macular area was significantly thinned(<i>P</i><0.05), and the BCVA on the 3, 6 and 12mo of treatment in observation group was better than that in control group while the CRT was thinner than that in control group(<i>P</i><0.05). The macular volume and VEGF level in aqueous humor were significantly reduced in the two groups after treatment(<i>P</i><0.05), and the macular volume and VEGF level on the 1, 3, 6 and 12mo of treatment in observation group were lower than those in control group(<i>P</i><0.05). The injection frequencies of conbercept and triamcinolone acetonide and the proportion of patients with laser photocoagulation in observation group were lower than those in control group(<i>P</i><0.05). During treatment, there was 1 eye of intraocular pressure increase and 3 eyes of subconjunctival hemorrhage in observation group, and there were 2 eyes of subconjunctival hemorrhage and 1 eye of endophthalmitis in control group(<i>P</i>>0.05).<p>CONCLUSION: Xueshuantong iontophoresis combined with intravitreal injection of conbercept for RVO with ME can effectively inhibit the expression of VEGF, reduce the ME and improve the visual acuity of the affected eyes. The efficacy and safety are worthy of recognition.
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Endothelial dysfunction is a well-known component of the pathophysiology of heart failure (HF), with proven prognostic value. Dietary supplementation with whey protein (WP) has been widely used to increase skeletal muscle mass, but it also has vascular effects, which are less understood. This study aimed to evaluate the effects of WP supplementation on the systemic microvascular function of HF patients. This was a blinded, randomized, placebo-controlled clinical trial that evaluated the effects of 12-week WP dietary supplementation on systemic microvascular function, in patients with HF New York Heart Association (NYHA) classes I/II. Cutaneous microvascular flow and reactivity were assessed using laser speckle contrast imaging, coupled with pharmacological local vasodilator stimuli. Fifteen patients (aged 64.5±6.2 years, 11 males) received WP supplementation and ten patients (aged 68.2±8.8 years, 8 males) received placebo (maltodextrin). The increase in endothelial-dependent microvascular vasodilation, induced by skin iontophoresis of acetylcholine, was improved after WP (P=0.03) but not placebo (P=0.37) supplementation. Moreover, endothelial-independent microvascular vasodilation induced by skin iontophoresis of sodium nitroprusside, was also enhanced after WP (P=0.04) but not placebo (P=0.42) supplementation. The results suggested that dietary supplementation with WP improved systemic microvascular function in patients with HF.
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Humans , Male , Middle Aged , Aged , Vasodilation , Heart Failure/drug therapy , Skin , Vasodilator Agents/pharmacology , Endothelium, Vascular , Pilot Projects , Dietary Supplements , Whey Proteins/pharmacology , MicrocirculationABSTRACT
The effect of parasitic ions on the results of ultraviolet A (UVA) cross-linking in iontophoresis was still not clear. In this work, the porcine sclera was cross-linked by riboflavin lactate Ringer's solution (group A) and riboflavin normal saline (group B)
Subject(s)
Animals , Collagen , Cross-Linking Reagents , Ions , Iontophoresis , Permeability , Photosensitizing Agents/pharmacology , Riboflavin , Sclera , Swine , Ultraviolet RaysABSTRACT
Objective:To observe the clinical efficacy of Juanbitang iontophoresis combined with warm acupuncture in treatment of wind cold and blocking collaterals syndrome due to external humeral epicondylitis (EH) and the effect on serum oxidative stress index. Method:From January 2018 to October 2019, 180 patients with EH wind cold and blocking collaterals syndrome were randomly divided into the warm acupuncture group, the traditional Chinese medicine（TCM） group and the combination group, with 60 cases in each group. The TCM group was treated with modified Juanbitang combined local iontophoresis at Quchi (affected side), Zhouliao (affected side), Ashi (affected side), 30 min/time/day, while the warm acupuncture group was treated with warm acupuncture once a day, 5 days/week. The combination group was treated with warm acupuncture in addition to the therapy of the TCM group, and the three groups were treated for 4 weeks. JOA’s elbow joint function scale, HSS’ elbow joint score scale and pain visual simulation score (VAS) were used to evaluate the symptoms and signs and the improvement of daily life before and after treatment. Enzyme linked immunosorbent assay（ELISA） method was used to detect the contents of late oxidized protein products (AOPP), malondialdehyde (MDA), superoxide dismutase (SOD) and heme oxygenase-1 (HO-1) in serum of patients before and after treatment. The cure rate, the total effective rate and the recurrence rate of 1 month and 3 months after treatment were compared. Result:Compared with before treatment, JOA and HSS scores increased, whereas VAS scores decreased (P<0.05). AOPP and MDA contents decreased, while SOD and HO-1 contents increased in the combination group and the TCM group (P<0.05). Compared with the TCM group and the warm acupuncture group after treatment, JOA, HSS score and pain R value increased, whereas VAS score decreased (P<0.05). Compared with the warm acupuncture group after treatment, serum AOPP, MDA content decreased, while SOD, HO-1 content increased (P<0.05). After 4 weeks of treatment, the cure rate and the effective rate of combination group were higher than those of the TCM group (χ2cure rate=4.617, χ2effective rate=6.471, P<0.05) and the warming acupuncture group (χ2cure rate=4.207, χ2effective rate=6.775, P<0.05). One month after the treatment, the cure rate and the effective rate of the combination group were higher than those of the TCM group (χ2cure rate=7.617, χ2effective rate=13.347, P<0.05) and the warm acupuncture group (χ2cure rate=4.762, χ2effective rate=6.277, P<0.05). The recurrence rate of the combination group was lower than that of the TCM group (χ2=9.32, P<0.05) and the warm acupuncture group (χ2=3.899, P<0.05). Three months after the treatment, the cure rate and the effective rate of the combination group were higher than those of the TCM group (χ2cure rate=4.789, χ2effective rate=9.643, P<0.05) and the warm acupuncture group (χ2cure rate=4.458, χ2effective rate=9.251, P<0.05). The recurrence rate of the combination group was lower than that of the TCM group (χ2=4.599, P<0.05) and the warm acupuncture group (χ2=4.518, P<0.05). Conclusion:Modified Juanbitang and the warm acupuncture has a good clinical efficacy in the treatment of EH wind cold and blocking collaterals syndrome and is worthy of clinical promotion.
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@#AIM:To explore the clinical efficacy of physical therapy in the treatment of hyperevaporative dry eyes.<p>METHODS: From October 2018 to April 2019, 70 patients(140 eyes)with evaporative dry eye were diagnosed in the ophthalmology clinic of the Affiliated Hospital of Gansu University of Traditional Chinese Medicine. Randomly divide the patients into 35 cases(70 eyes)in the control group for basic treatment(sodium hyaluronate eye drops), and 35 cases(70 eyes)in the treatment group underwent acupuncture combined with traditional Chinese medicine iontophoresis treatment based on the control group. 1 time/d, treatment 3wk(treatment 6d, rest 1d). Before and after treatment, the tear height(TMH), tear film rupture time(BUT), Schirmer Ⅰ test(SⅠt), and corneal fluorescein staining(FL)were observed.<p>RESULTS: The pre-treatment data of the TMH treatment group and the control group were 0.21(0.15, 0.27)and 0.21(0.15, 0.28)mm respectively; the postoperative data of the treatment group and the control group were 0.24(0.21, 0.29), 0.23(0.19, 0.29)mm. The comparison between groups was <i>P</i><0.05. The preoperative data of the SⅠt treatment group and the control group were 5.00(3.00, 7.00)and 6.00(4.00, 7.00)mm/5min respectively; the postoperative data of the treatment group and the control group were 10.00(8.00, 12.00), 7.00(6.00, 8.00)mm/5min. The preoperative data of the BUT treatment group and the control group were 2.75(1.38, 6.15)and 3.25(1.38, 5.03)s respectively; the postoperative data of the treatment group and the control group were 8.90(6.90, 12.85), 7.15(5.40, 9.53)s. The preoperative data of the SⅠt treatment group and the control group were 4.50(3.00, 6.00)and 5.00(3.00, 6.00)min respectively; the postoperative data of the treatment group and the control group were 1.00(0.75, 2.00), 3.00(2.00, 4.00)min, the comparison between groups was <i>P</i>>0.05. Comparison of the data difference between the treatment group and the control group before and after showed that the treatment group had a more significant effect than the control group(<i>P</i><0.05).<p>CONCLUSION: Physical therapy has a significant clinical effect in treating dry eyes with excessive evaporation, and it is worthy of clinical recommendation.
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The basolateral amygdala (BLA) receives dense projections from cholinergic neurons of the basal forebrain. Acetylcholine can contributes to amygdala-dependent behaviors: formation and extinction of fear memory and appetitive instrumental learning. However, the cholinergic mechanism at the circuit level has not been defined yet. We demonstrated that cholinergic-induced di-synaptic inhibition of BLA pyramidal neurons exhibits a retrograde form of short-term synaptic inhibition, depolarization-induced suppression of inhibition (DSI). Activation of nicotinic receptors was sufficient to evoke action potentials in cholecystokinin (CCK)-positive inhibitory neurons, which strongly inhibit pyramidal neurons through their perisomatic synapses. Our cell type-specific monosynaptic retrograde tracing also revealed that CCK neurons are innervated by basal forebrain cholinergic neurons. Therefore, our data indicated that CCK inhibitory neurons mediate the cholinergic-induced di-synaptic inhibition of BLA pyramidal neurons.
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Acetylcholine , Action Potentials , Basal Forebrain , Basolateral Nuclear Complex , Cholecystokinin , Cholinergic Neurons , Conditioning, Operant , Iontophoresis , Memory , Neurons , Pyramidal Cells , Receptors, Nicotinic , SynapsesABSTRACT
Objective@#To investigate the effect of ultrasound transdermal delivery in children with swelling and pain after supracondylar fracture of the humerus.@*Methods@#Totally 103 cases of humeral supracondylar fractures from January to June 2017 were divided into control group (50 cases) and experimental group (53 cases) by random number table method. The control group was treated with conventional detumescence and intravenous drug therapy,while the experimental group was given the local target ultrasonic percutaneous delivery in accordance with the doctor′s advice on the basis of routine treatment. By comparing the two groups in terms of postoperative pain, swelling relief, starting time for getting out of bed, hospitalization time, and parental satisfaction of children, we investigated the effect of ultrasonic ultrasound transdermal delivery on children with swelling and analgesia after supracondylar fracture of the humerus.@*Results@#Postoperative pain relief and swelling relief were significantly reduced in the experimental group compared with the control group, and the difference between the two groups was statistically significant (P<0.05).The time of starting to get out of bed activity and hospitalization were respectively (8.20 ± 0.25) hours and (5.12 ± 0.27) days, and the control group was (23.80 ± 0.15) hours, (7.35 ± 0.38) days, respectively.The comparison was statistically significant (t=24.241, 7.654, all P<0.05). The parents' satisfaction in the experimental group was very satisfied, relatively satisfied, basically satisfied and unsatisfied, respectively 88.68% (47/53), 7.55% (4/53), 3.77% (2/53), 0, the control group was 64.00% (32/50), 26.00% (13/50), 10.00% (5/50), 0(0/50), the difference between the two groups was statistically significant (χ2=5.294 2, P<0.05).@*Conclusions@#The accuracy of ultrasonic percutaneous local target placement for the treatment of supracondylar fractures of the humerus in children is effective in the intervention of pain and swelling, and the comfort is better. It is a new choice for the treatment of limb fractures with pain in children.
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@#AIM: To observe the clinical effect of trabeculectomy combined with dexamethasone iontophoresis in the treatment of acute angle-closure glaucoma(PACG)with diabetes mellitus.<p>METHODS: Totally 42 eyes of 42 patients with acute PACG combined with diabetes in our hospital were selected and divided into trabeculectomy combined with iontophoresis group(group A)and trabeculectomy combined with peribulbar injection of methylprednisolone group(group B)according to different ways of controlling inflammation after surgery. Intraocular pressure, anterior chamber inflammation and complications before and after surgery were compared between the two groups.<p>RESULTS: The intraocular pressure of the two groups after surgery was significantly improved compared with that before surgery, and the difference was statistically significant(<i>P</i><0.05). Postoperative anterior chamber inflammation was well controlled in both groups without statistical significance(<i>P</i>>0.05). In terms of complications, group A was significantly superior to group B.<p>CONCLUSION: Trabeculectomy combined with dexamethasone iontophoresis or peribulbar injection of methylprednisolone can effectively control postoperative intraocular pressure and anterior chamber inflammation in patients with acute angle-closure glaucoma complicated with diabetes mellitus. Among them, the effect of combined dexamethasone iontophoresis in reducing complications is better and patients suffer less pain.
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Objective To investigate the effect of ultrasound transdermal delivery in children with swelling and pain after supracondylar fracture of the humerus. Methods Totally 103 cases of humeral supracondylar fractures from January to June 2017 were divided into control group (50 cases) and experimental group (53 cases) by random number table method. The control group was treated with conventional detumescence and intravenous drug therapy,while the experimental group was given the local target ultrasonic percutaneous delivery in accordance with the doctor′s advice on the basis of routine treatment. By comparing the two groups in terms of postoperative pain, swelling relief, starting time for getting out of bed, hospitalization time, and parental satisfaction of children, we investigated the effect of ultrasonic ultrasound transdermal delivery on children with swelling and analgesia after supracondylar fracture of the humerus. ResuLts Postoperative pain relief and swelling relief were significantly reduced in the experimental group compared with the control group, and the difference between the two groups was statistically significant (P＜0.05).The time of starting to get out of bed activity and hospitalization were respectively (8.20 ± 0.25) hours and (5.12 ± 0.27) days, and the control group was (23.80 ± 0.15) hours, (7.35 ± 0.38) days, respectively.The comparison was statistically significant (t=24.241, 7.654, all P＜0.05). The parents'satisfaction in the experimental group was very satisfied, relatively satisfied, basically satisfied and unsatisfied, respectively 88.68% (47/53), 7.55% (4/53), 3.77% (2/53), 0, the control group was 64.00% (32/50), 26.00% (13/50), 10.00% (5/50), 0(0/50), the difference between the two groups was statistically significant ( χ2=5.294 2, P＜0.05). ConcLusions The accuracy of ultrasonic percutaneous local target placement for the treatment of supracondylar fractures of the humerus in children is effective in the intervention of pain and swelling, and the comfort is better. It is a new choice for the treatment of limb fractures with pain in children.
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Abstract: Iontophoresis is a noninvasive technique, based on the application of a constant low-intensity electric current to facilitate the release of a variety of drugs, whether ionized or not, through biological membranes. The objective of this research was to evaluate the effect of iontophoresis using different electric current intensities on the uptake of fluoride in dental enamel with artificial caries lesions. In this in vitro operator-blind experiment, bovine enamel blocks (n = 10/group) with caries-like lesions and predetermined surface hardness were randomized into 6 groups: placebo gel without fluoride applied with a current of 0.8 mA (negative control), 2% NaF gel without application of any current, and 2% NaF gel applied with currents of 0.1, 0.2, 0.4 and 0.8 mA. Cathodic iontophoresis was applied for 4 min. The concentration of loosely bound fluoride (calcium fluoride) and firmly bound fluoride (fluorapatite) was determined. The results were analyzed by the nonparametric Kruskal-Wallis and Dunn tests. Iontophoresis at 0.8 mA, combined with the application of fluoridated gel (2% NaF), increased fluoride uptake in enamel with caries-like lesions, as either calcium fluoride or fluorapatite.
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Animals , Cattle , Cariostatic Agents/pharmacology , Iontophoresis/methods , Dental Caries , Dental Enamel/drug effects , Fluorides/pharmacology , Apatites/analysis , Surface Properties/drug effects , Calcium Fluoride/analysis , Random Allocation , Treatment Outcome , Disease Models, Animal , Electricity , Hardness/drug effectsABSTRACT
Topically applied traditional Chinese medicines (TCM) generally show low transdermal rates and doses, leading to weak therapeutic efficacy. Here, cataplasm of white mustard seed varnish was prepared. The effects of iontophoresis and sonophoresis on the transdermal delivery of this TCM and its anti-asthma effect were evaluated. Active components of white mustard seed, rhizoma corydalis and Radix Kansui were obtained after alcohol extraction, respectively. The volatile oil in Asarum Heterotropoides were obtained with volatile oil extraction equipment. The drug loading ratio of cataplasms was 17% (w/w). Franz cell diffusion method was used to evaluate the accumulated permeation amount and the steady-state transdermal absorption rate of sodium thiocyanate. The improvement of sonophoresis on transdermal absorption was higher than that of iontophoresis.Asthma model of guinea pigs were established. Cataplasms of white mustard seed varnish were applied on the back of guinea pigs. Iontophoresis and sonophoresis obviously promoted the transdermal absorption and enhanced anti-asthma efficacy of white mustard seed varnish cataplasms. Pathological analysis showed that iontophoresis and sonophoresis significantly alleviated inflammation. Compared with the model group, IL-4 and IgE levels in the cataplasm group, cataplasm/iontophoresis group, cataplasm/sonophoresis group decreased obviously, although the IFN-γ levels markedly increased. Moreover, the therapeutic efficacy of cataplasm/sonophoresis group was the best in all the groups, even leading to levels similar to that of healthy animals. Iontophoresis and sonophoresis are effective methods to promote transdermal absorption of cataplasms. Moreover, the effect of sonophoresis is higher than that of iontophoresis. Physical penetration improvement techniques provide a novel insight for the wide application of transdermal TCM.
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OBJECTIVE@#To observe the clinical efficacy of methycobal iontophoresis combined with balance acupuncture in the treatment of peripheral facial paralysis.@*METHODS@#A total of 108 patients with peripheral facial paralysis were randomly divided into a methycobal iontophoresis combined with balance acupuncture group (a combined group), a methycobal iontophoresis group and a simple balance acupuncture group, 36 cases in each one. Basic medical treatment were given in the three groups. The simple balance acupuncture was applied at contralateral lumbago acupoint, rhinitis acupoint, stomachache acupoint in the simple balance acupuncture group. Methycobal through iontophoresis anodic introduction therapy was given in the methycobal iontophoresis group. On the basic treatment of methycobal iontophoresis, in the combined group, acupuncture was supplied at contralateral lumbago acupoint, rhinitis acupoint and stomachache acupoint. The treatment in all groups was given once a day, for 2 weeks. The House-Brackmann grading scale and the modified portmann score (RPA) method were used to observe the degree of nerve function and facial paralysis before and after treatment, and the clinical efficacy of each group was evaluated.@*RESULTS@#The total effective rate of the combined group was 97.2% (35/36), which was higher than 83.3% (30/36) in the methycobal iontophoresis group and 88.9% (32/36) in the simple balance acupuncture group (all 0.05). The RPA score of the combined group was higher than those in the methycobal iontophoresis group and simple balance acupuncture group (both 0.05).@*CONCLUSION@#Compared with methycobal iontophoresis and simple balance acupuncture therapy, methycobal iontophoresis combined with balance acupuncture therapy can effectively improve the clinical symptoms and signs of peripheral facial paralysis.
Subject(s)
Humans , Acupuncture Therapy , Facial Paralysis , Iontophoresis , Treatment OutcomeABSTRACT
Objective To investigatethe effect of LED single wave infrared red light irradiation combined with traditional Chinese medicine iontophoresis on diabetic peripheral neuropathy. Methods During May 2017 and January 2015, 120 patients with diabetic peripheral neuropathy in double lower extremities, hospitalized in the department of endocrinology in our hospital, were randomly divided into the control group and the observation group, with 60 cases in each group. The two groups were both treated with conventional interventions including strict control of blood glucose, blood pressure, diet nursing, exercise therapy, foot care and psychological counseling. In addition to the care as done in the control group, the observation group was treated with iontophoresis of traditional Chinese medicine combined with LED single wave infrared red light irradiation for 3 courses, 14 days for each course, The two groups were compared in terms of limb numbness score, dorsal artery blood flow volume, ankle brachial index and score by Toronto clinical scoring symptom before and after intervention. Results The post-treatment score of numbness in the extremities of the observation group was lower than the post-treatment score of the control group as well as the pre-treatment score of the observation group. The post-treatment blood flow of the dorsum of the foot in the observation group was greater than the post-treatment flow in the control group as well as the pre-treatment flow in the observation group and so it is with the ankle brachial index. Conclusions LED single wave infrared red light irradiation combined with traditional Chinese medicine iontophoresis can to a certain extent control and delay the process of diabetic peripheral neuropathy. It can improve the quality of life of patients.
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Objective To observe the clinical efficacy of acupoint iontophoresis with Sinomenine hydrochloride in treating knee osteoarthritis (KOA).Method Sixty KOA patients were randomized into a treatment group and a control group, 30 cases each. The treatment group was intervened by iontophoresis with Sinomenine hydrochloride into specific acupoints via a direct current iontophoresis appliance; the control group was intervened by oral administration of Meloxicam tablets. The Lequesne index, Visual Analogue Scale (VAS) and knee joint space were observed before and after the intervention.Result The Lequesne and VAS scores were significantly changed after the treatment in the two groups (P<0.01,P<0.05). After the intervention, there was a significant difference in the Lequesne score between the two groups (P<0.01). After the treatment, the knee joint space didn't show significant intra-group or between- group differences (P>0.05).Conclusion Acupoint iontophoresis with Sinomenine hydrochloride is an effecttive method in treating KOA.
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AIM:To compare the early results of different kinds of transepithelial corneal collagen cross-linking (TE-CXL) in the treatment of progressive keratoconus.METHODS:Retrospective study.Twenty four patients (34 eyes) who were diagnosed with progressive keratoconus were divided into three groups.And 10 eyes in hypotonic CXL group received the treatment of hypotonic corneal collagen cross-linking;14 eyes in Ⅰ-CXL 5min group received the treatment of iontophoresis corneal collagen cross-linking for 5min,and 10 eyes from the Ⅰ-CXL 10min group received the treatment of iontophoresis corneal collagen cross-linking for 10min.Uncorrected distance visual acuity,corrected distance visual acuity,Pentacam,in vivo scanning laser confocal microscopy and anterior segment optical coherence tomography were examined before and after 1wk,1,3 and 6mo postoperatively.RESULTS:Six months postoperatively,corrected distance visual acuity (CDVA) (LogMAR) in Ⅰ-CXL 10min group increased by-0.21 ± 0.23 (t =2.735,P=0.026);Kmax decreased by 2.32± 5.21D (t=1.40,P=0.193),but the differences were not statistically significant.Uncorrected distance visual acuity (UDVA),CDVA and Kmax in hypotonic CXL group and Ⅰ-CXL 5min group were stable,the differences were not statistically significant.The depth of demarcation line was 152.7±42.9μ m in hypotonic CXL group,213.6±42.3μ m in Ⅰ-CXL 5min group and 237.0±46.4μ m in Ⅰ-CXL 10min group 1wk after the surgery,the differences among groups were statistically significant (F =7.111,P =0.006).The phenomenon of stroma cell apotosis-activate regeneration in Ⅰ-CXL 10min group was the most significant after the surgery.The changes of corneal thinnest thickness and endothelial cell density in three groups were stable.CONCLUSION:Three kinds of transepithelial CXL can halt the progression of keratoconus,among which the reaction of corneal tissue in iontophoresis CXL for 10min is the most obvious.
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Objective To investigate the clinical efficacy of extracorporeal shock wave therapy combined with traditional Chinese medicine iontophoresis in elderly patients with knee osteoarthritis (KOA). Methods Fifty-six patients with KOA were randomized into the drug therapy group(n=28) receiving only traditional Chinese medicine iontophoresis therapy for four weeks and the combined treatment group(n= 28)receiving extracorporeal shock wave therapy combined with traditional Chinese medicine iontophoresis therapy for four weeks.WOMAC score as an specific severity-of-illness score was used to evaluate knee joint function of patients before and four-week after treatment. Results WOMAC scores of all patients were significantly decreased which indicated states of an illness were improved after four-week treatment as compared with pre-treatment(all P< 0.05).The combined treatment group versus the drug therapy group showed markedly lower WOMAC scores,including pain score(3.17 ± 1.03 vs.5.27 ± 1.58,t= 7.316,P< 0.05),morning stiffness score(2.23 ± 0.91 vs.3.32 ± 1.14,t= 3.440,P< 0.05),activity restrict of daily living score(20.13 ± 6.46 vs.27.35 ± 13.28,t= 4.691,P< 0.05)and total score(28.37 ± 11.62 vs.40.16 ± 5.93,t=8.015,P<0.05). Conclusions Compared with single traditional Chinese medicine iontophoresis, the extracorporeal shock wave therapy combined with traditional Chinese medicine iontophoresis therapy may significantly reduce the pain and morning stiffness degree,and enhance activities of daily living in elderly patients with KOA.
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Topical drug delivery is an interesting approach to treat skin diseases and to avoid pain and low patient compliance in cases where a systemic delivery is required. However, the stratum corneum, which is the outermost skin layer, strongly protects the body from the entrance of substances, especially those hydrophilic. In this context, different physical methods have been studied to overcome the stratum corneum barrier and facilitate penetration of drugs into or through the skin. Among them, iontophoresis, low-frequency ultrasound and microneedles have been widely employed for transdermal drug delivery. More recently, they are also studied to aid in the treatment of dermatological disorders, such as skin tumors and inflammation. Basically, iontophoresis refers to the movement of charged and non-charged hydrophilic molecules through the skin due to the application of a low constant electric current and the contributions of electromigration and electroosmosis. In low-frequency ultrasound, cavitation is the main mechanism for skin permeabilization that consists on the formation of microbubbles that disorganize the stratum corneum. Microneedles are microprojections, minimally invasive, that can be designed with different lengths, materials and geometry to increase skin permeability. In this review, concepts, mechanisms and applications of these three physical methods will be presented and discussed with focus on their use in dermatological treatments. Moreover, comparative studies using different physical methods will be presented and also some clinical perspectives will be addressed
Subject(s)
Skin , Administration, Topical , Skin Diseases/drug therapy , Ultrasonics/methods , Administration, Cutaneous , Iontophoresis/methodsABSTRACT
Objective To evaluate the differences of the thinnest-point corneal thickness (TCT) decrease after three different corneal crosslinking (CXL) protocols for progressive keratoconus.Methyds Retrospective clinical case study.From August 2010 to November 2015,consecutive 85 patients (110 eyes) with progressive keratoconus were enrolled and treated with CXL in Department of Opthalmology,Navy General Hospital.21 patients of 25 eyes underwent standard epithelium-off corneal crosslinking (S-CXL),14 patients of 22 eyes underwent 1 g · L-1 riboflavin-sodium lactate Ringer's solution iontophoresis-assisted CXL (I-CXLa),and 50 patients of 63 eyes underwent 0.1％ riboflavin-distilled water solution I-CXLb.Preoperative and postoperative TCT were measured by ALLEGRO oculyzer.The differences of TCT decrease after treatment were compared among the three CXL protocols.Results The differences of TCT from baseline after 3 months,6 months and 12 months in the S-CXL group were (-14.93 ±27.16) μm,(-31.94 ±22.89) μm,(-27.71 ±26.01) μm,respectively,the I-CXLa group were (-20.14 ± 19.09) μm,(-10.10 ± 24.28) μm,(-7.11 ± 22.26)μm,respectively,the I-CXLb group were (-28.08 ± 26.14) μm,(-21.08 ± 25.62) μm,(-15.91 ± 19.19)μm,respectively.Three months after treatment,the differences of TCT decrease in the three groups was not statistically significant (P =0.188);Six and 12 months after treatment,the differences between S-CXL and I-CXLa were statistically significant (all P ＜0.05),but the differences between S-CXL and I-CXLb,between I-CXLb and I-CXLa showed no significant difference (all P ＞ 0.05).Conclusion Six and 12 months after treatment,TCT decrease is related to the CXL protocol.TCT decrease degree may reflect the intensity of crossinking.TCT decrease in I-CXLb is smaller than that in S-CXL,but there is no statistical difference.