Phototherapy and serum blood calcium levels in neonates: is there a need for calcium supplementation?

Background: Phototherapy is the first line of treatment for physiological jaundice. However, it has its own set of complications. Hypocalcaemia is a less frequent but a potential complication of phototherapy. The purpose of this study was to see the effect of 24 hours of phototherapy on the serum blood calcium levels of the newborn after 24 hours of exposure and the need for supplementation in these new born babies.Methods: A cross sectional observational study was conducted at our institute on 31 newborn babies born between June 2022 to December 2022. All term neonates who developed clinically significant physiological jaundice after 48 hours of life were subjected to double surface phototherapy with LED blue light for 24 hours. These babies were screened for their serum calcium levels by venous blood sampling before the commencement of the phototherapy. The same sampling was repeated after 24 hours of exposure to the phototherapy lights to see the effect on serum calcium levels of the newborn.Results: Phototherapy was given for 24 hours. Mean serum calcium measured at 48 hours of life prior to phototherapy was 9.25�62 mg/ml. Also, mean serum calcium at 24 hours post phototherapy was 8.74�38 mg/ml. A highly significant decrease in serum calcium level was seen post phototherapy (p=0.0002). Independent samples t test was used.Conclusions: In healthy term neonates exposed for only 24 hours of phototherapy decrease in serum calcium levels to some extend was noted however it is unlikely to cause clinically significant hypocalcemia.

Factores asociados a ictericia con requerimiento de fototerapia: Estudio de tipo casos y controles en un hospital de Perú / Associated factors with jaundice requiring phototherapy: A case-control study in a hospital in Peru

RESUMEN Objetivo: Determinar los factores asociados a ictericia con requerimiento de fototerapia. Material y Métodos: Estudio observacional, analítico, y retrospectivo de tipo casos y controles. Se revisaron las historias clínicas de 212 pacientes de 0 a 7 días de nacidos del servicio de neonatología del Hospital Carlos Lanfranco La Hoz, divididos en 106 casos (con fototerapia) y 106 controles (sin fototerapia). Resultados: Se encontró una asociación significativa entre los neonatos pretérmino y la necesidad de fototerapia, con un OR:5.526; IC 95% (2.038-14.981), P= 0.001; así como una asociación entre la incompatibilidad ABO y la fototerapia, con un OR:4.373, IC 95% (1.934-9.889), P= 0.001. Conclusiones: Se concluye que existe asociación entre neonatos pretérmino, la incompatibilidad ABO con la necesidad de fototerapia.

ABSTRACT Objective: The aim was to identify the factors linked to jaundice that necessitates phototherapy. Material and Methods: An observational, analytical, and retrospective case-control study was conducted. The medical records of 212 patients aged 0 to 7 days from the neonatology service at Hospital Carlos Lanfranco La Hoz were reviewed, divided into 106 cases (with phototherapy) and 106 controls (without phototherapy). Results: Preterm neonates showed a significant association with an OR: 5.526; 95% CI (2.038-14.981), P= 0.001; and ABO incompatibility had an OR: 4.373, 95% CI (1.934-9.889), P= 0.001. Conclusions: The study concludes an association between preterm neonates, ABO incompatibility, and the necessity for phototherapy.

Intensive phototherapy don't affect cellular immune function and short-term reactions after discharge in neonatal hyperbilirubinemia / 基础医学与临床

Objective To investigate the effect of intensive phototherapy for neonatal hyperbilirubinemia on cellular immune function and short-term immune-related adverse effects.Methods Totally 180 infants with hyperbilirubi-nemia were treated with different light intensity,the efficacy,cellular immune function and immune adverse effects were followed up for six months after discharge.Results After phototherapy,serum interleukin-6(IL-6)in both groups were decreased and CD4+(%)and CD4+/CD8+were increased than that before phototherapy.The decrease rate of total bilirubin in the intensive phototherapy group was significantly faster than that in the conventional photo-therapy group,at the same time,the total duration of phototherapy and hospital stay were significantly shorter than that in the conventional phototherapy group(P＜0.05).No statistical significance in the incidence of diarrhea,rash,fever and hypo-calcemia during hospitalization and no immune-related adverse effects in 6 months after discharge were recorded.Conclusions Compared with conventional phototherapy,intensive phototherapy reduces serum bilirubin level more quickly and shorten the duration of phototherapy and hospital stay.No common adverse effects nor immune-related adverse effects are recorded during hospitalization and the period of six months after discharge.

Clinical observation of repigmentation patterns in patients with vitiligo treated with phototherapy and analysis of their influencing factors / 中华皮肤科杂志

Objective:To analyze factors influencing repigmentation patterns in patients with vitiligo treated with phototherapy.Methods:Clinical data were retrospectively collected from patients with vitiligo treated with 308-nm excimer laser or 308-nm excimer lamp at the Department of Dermatology, Xijing Hospital, Air Force Medical University from June 2013 to May 2022. The treatment frequency was thrice weekly, and skin lesions were evaluated via photographs once every 5 sessions of phototherapy. Chi-square test or Fisher′s exact test was used to analyze associations between clinical characteristics and vitiligo repigmentation patterns.Results:A total of 223 patients with vitiligo were included in this study, including 109 males (48.9%) and 114 females (51.1%), and their ages ( M [ Q1, Q3]) were 20 (10, 28) years. Among the 223 patients, 170 (76.2%) were treated with 308-nm excimer laser, and 53 (23.8%) with 308-nm excimer lamp. The repigmentation patterns included the perifollicular pattern in 63 cases (28.3%), marginal pattern in 97 (43.5%), diffuse pattern in 36 (16.1%), and mixed pattern in 27 (12.1%). Analysis of the associations between clinical characteristics and vitiligo repigmentation patterns showed no significant differences in the repigmentation patterns among vitiligo patients of different genders or different Fitzpatrick skin types (both P > 0.05) ; however, the diffuse repigmentation pattern more frequently occurred in the patients aged ≤ 12 years compared with those aged > 12 years ( χ2 = 7.71, P = 0.005), in the patients with vitiligo in the progressive stage compared with those in the stable stage ( χ2 = 4.59, P = 0.030), and in lesions without white hair compared with those with white hair ( χ2 = 6.75, P = 0.009) ; the mixed repigmentation pattern more frequently occurred in the patients with segmental vitiligo compared with those with non-segmental vitiligo ( χ2 = 11.76, P = 0.001) ; the marginal repigmentation pattern more frequently occurred in lesions on the face and neck ( χ2 = 15.82, P<0.001) and extremities ( χ2 = 11.85, P = 0.001) compared with lesions on the trunk; the perifollicular repigmentation pattern more frequently occurred in the patients with stable vitiligo compared with those with progressive vitiligo ( χ2 = 4.70, P = 0.030), and in skin lesions on the trunk compared with those on face and neck ( χ2 = 13.73, P < 0.001) and extremities ( χ2 = 5.49, P = 0.035) ; after 308-nm excimer laser treatment, the proportions of patients with the marginal repigmentation pattern ( χ2 = 12.30, P < 0.001) and those with the diffuse repigmentation pattern ( χ2 = 5.64, P = 0.018) were significantly higher than those after 308-nm excimer lamp treatment, while the proportions of patients with the perifollicular repigmentation pattern ( χ2 = 7.87, P = 0.005) and those with the mixed repigmentation pattern ( χ2 = 17.13, P < 0.001) were significantly higher after 308-nm excimer lamp treatment than those after 308-nm excimer laser treatment. Conclusion:Patients′ age, clinical types and stages of vitiligo, presence or absence of concomitant white hair, skin lesion sites, and phototherapy modalities were factors influencing the repigmentation patterns of vitiligo.

Fotobiomodulación posexodoncia con diferentes niveles de energía sobre la reparación ósea alveolar en ratas / Post-exodontic Photobiomodulation with Different Levels of Energy on Alveolar Bone Repair in Rats

Introducción: El uso de la fotobioestimulación en la cirugía oral como acelerador de la cicatrización de tejidos se ha incrementado a nivel mundial; sin embargo, la evidencia científica es insuficiente respecto a la energía mínima necesaria para incentivar la cicatrización del alveolo dentario. Objetivo: Determinar el efecto de la fotobiomodulación con diferentes valores de energía sobre la reparación alveolar, posterior a la extracción dental en ratas albinas. Métodos: Treinta y seis ratas albinas hembras se asignaron de forma aleatoria a cuatro grupos: tres con aplicación de láser a 2, 4 y 6 Joules de energía y uno sin aplicación de láser. Se aplicó láser infrarrojo Arseniuro de Galio-Aluminio a 808 nm y 100 miliwatts de forma puntual, perpendicular y única al alveolo dentario. El hueso maxilar se diseccionó y las muestras se tiñeron con hematoxilina eosina para su posterior análisis por conteo celular de osteoblastos a nivel del tercio medio alveolar. Resultados: A los siete días después de la exposición no se observó formación de osteoblasto en el grupo control, pero sí en los grupos experimentales con niveles de energía de 2, 4 y 6 Joules, que mostraron formación de células osteoblásticas similares. Solo el grupo de 4 Joules presentó mayor número de osteoblastos que el grupo control sin irradiación (p = 0,008). A los 14 días la formación de osteoblastos fue similar entre los grupos, sin diferencias significativas (p > 0,05). Conclusiones: La fotobiomodulación tuvo efecto positivo sobre la cicatrización del hueso alveolar en los diferentes parámetros de energía evaluados. El uso de una menor energía es igual de beneficioso, modula la respuesta celular, induce la proliferación osteoblástica y reduce el tiempo de reparación ósea(AU)

Introduction: The use of photobiostimulation in oral surgery as an accelerator of tissue healing has increased worldwide; however, scientific evidence is insufficient regarding the minimum energy needed to encourage healing of the dental alveolus. Objective: To determine the effect of photobiomodulation with different energy values on alveolar repair after tooth extraction in albino rats. Methods: Thirty-six female albino rats were randomly assigned to four groups: three with laser application at 2, 4 and 6 Joules of energy and one without laser application. Gallium-aluminum arsenide infrared lasers at 808 nm and 100 milliwatts were applied pointwise, perpendicularly and uniquely to the tooth socket. The maxillary bone was dissected and the samples were stained with hematoxylin eosin for subsequent analysis by osteoblast cell count at the level of the alveolar middle third. Results: Seven days after exposure, osteoblast formation was not observed in the control group, but was observed in the experimental groups with energy levels of 2, 4 and 6 Joules, which showed similar osteoblast cell formation. Only the 4 Joules group showed a greater number of osteoblasts than the control group without irradiation (p = 0.008). At 14 days, osteoblast formation was similar between groups, with no significant differences (p > 0.05). Conclusions: Photobiomodulation had a positive effect on alveolar bone healing in the different energy parameters evaluated. The use of lower energy is equally beneficial, modulates cellular response, induces osteoblastic proliferation and reduces bone repair time(AU)

Optimizing vitiligo treatment: examining the role of narrow-band ultraviolet B phototherapy

Vitiligo is a common autoimmune-pigment disorder associated with skin depigmentation. Narrow-band ultraviolet B phototherapy (NB-UVB) has become an effective treatment option for this disease, resulting in significant pigmentation in patients, especially those with facial lesions and dark skin tones. However, the best treatment plan is still under discussion, and more research is needed to assess long-term safety, including the risk of skin cancer. In addition, alternative options such as current immunomodulators and herbal therapies are promising but need further studies. This study reviewed the existing literature on NB-UVB phototherapy's efficacy and safety profile for treating vitiligo. The study focused on factors affecting the treatment response and the potential benefits of combining NB-UVB with other treatments. NB-UVB phototherapy is safe and effectively reduces depigmentation in vitiligo patients. Factors such as disease duration, skin type, and scope of vitiligo lesions may influence treatment results. Using NB-UVB with other treatments can increase results. Although UVB NB phototherapy is a safe and effective option for vitiligo treatment, more research is needed to optimize its use and improve treatment outcomes, especially in different patient groups.

Phototherapeutic keratectomy: current approaches and changing trends in a tertiary eye clinic / Ceratectomia fototerapêutica: abordagens atuais e tendências de mudança em uma clínica oftalmológica terciária

ABSTRACT Purpose: To examine the efficacy of phototherapeutic keratectomy as a treatment for variable pathologies with anterior corneal opacities and evaluate the distribution of phototherapeutic keratectomy indications over the past 10 years. Methods: The records of 334 eyes from 276 patients who underwent phototherapeutic keratectomy between March 2010 and 2020 were retrospectively reviewed. Etiologies of the patients who underwent phototherapeutic keratectomy were noted, and their changes were examined. Refractive and visual acuity results before and after the operation were recorded and analyzed according to etiology. Results: The mean age of the patients was 40.7 ± 16.2 years (range: 19-84). The mean follow-up was 25.5 ± 19.1 months (range: 3-96). Phototherapeutic keratectomy was most frequently applied for corneal stromal dystrophies (44%, 151 eyes from 111 patients), and granular dystrophy was the most common phototherapeutic keratectomy indication among corneal dystrophies. Unlike other indications, there has been an increase in the application of phototherapeutic keratectomy for persistent subepithelial opacities due to adenoviral conjunctivitis in the past 10 years. There was a significant increase in visual acuity in all groups except for the recurrent epithelial defect group (p<0.05). The greatest improvement in visual acuity was detected for stromal dystrophies in the granular dystrophy subgroup. Conclusion: Despite changing indication trends, phototherapeutic keratectomy remains an effective and reliable treatment for anterior corneal lesions.

RESUMO Objetivo: Examinar a eficácia da ceratectomia fo­toterapêutica para o tratamento de patologias variáveis que apresentarem opacidades anteriores da córnea, e avaliar a distribuição das indicações de ceratectomia fototerapêutica nos últimos 10 anos. Métodos: Foram revisados retrospectivamente os prontuários de 276 pacientes, com 334 olhos tratados com ceratectomia fototerapêutica entre março de 2010 e o ano de 2020. As etiologias dos pacientes submetidos à ceratectomia fototerapêutica foram anotadas e suas alterações foram examinadas. Os resultados refrativos e de acuidade visual antes e após a operação foram registrados e analisados de acordo com a etiologia. Resultados: A idade média dos pacientes foi de 40,7 ± 16,2 anos (faixa: 19-84). O tempo médio de acompanhamento foi de 25,5 ± 19,1 meses (faixa: 3-96). A ceratectomia fototerapêutica foi aplicada com mais frequência para distrofias estromais corneanas (44%, 151 olhos de 111 pacientes); entre as distrofias corneanas como um todo, a distrofia granular foi a indicação terapêutica mais comum desse procedimento. Ao contrário de outras indicações, nos últimos 10 anos houve um aumento na aplicação de ceratectomia fototerapêutica em casos de opacidade subepitelial persistente causada por conjuntivite adenoviral. Houve um aumento significativo na acuidade visual em todos os grupos, exceto para o grupo com defeito epitelial recorrente (p<0,05). A maior melhora na acuidade visual foi detectada em casos de distrofia estromal, no subgrupo das distrofias granulares. Conclusão: Apesar das mudanças nas tendências de indicação, a ceratectomia fototerapêutica continua sendo uma abordagem terapêutica eficaz e confiável para tratar lesões da córnea anterior.

Prevalence of hypocalcemia in term newborns requiring phototherapy

Background: Neonatal hyperbilirubinemia in the first week of life is one of the most prevalent clinical entity observed, affecting 60% of term-babies and 80% of preterm newborn babies, many requiring intervention in the form of phototherapy. The effect of phototherapy on serum calcium levels has not been studied much in Indian literature. The objectives of this study was to evaluate the prevalence of hypocalcemia in healthy, term newborn babies receiving phototherapy for unconjugated hyperbilirubinemia and to determine the association, if any between serum calcium and birth weight, postnatal age at start of phototherapy, weight at enrolment, gestational age at birth, maternal age and duration of phototherapy.Methods: This was a prospective observational study conducted over a period of 10 months among 80 term neonates admitted to the inpatient department at a tertiary care centre in Mumbai. Total serum calcium and ionised calcium levels were measured at the start of phototherapy and on stopping phototherapy/discharge. Data were analysed using statistical package for social sciences (SPSS) version 21 software.Results: Two (2.5%) out of the 80 neonates were found to have hypocalcemia after phototherapy with serum ionic calcium levels less than 1 mmol/l. Even though a larger proportion of neonates showed a decrease in the serum total calcium (56.25%) and serum ionic calcium (58.75%) levels after phototherapy, none of the neonates developed symptomatic hypocalcemia at those levels. A statistically significant association was found between maternal age in years with the serum total calcium levels after phototherapy and age at starting phototherapy (in hours) with the serum ionic calcium levels after phototherapy.Conclusions: The present study concludes that there is significant decrease in the levels of ionised calcium after phototherapy, however there was no significant decrease in the total serum calcium levels and none of the neonates were symptomatic. Hence, we do not recommend regular serum calcium monitoring in healthy term neonates receiving phototherapy and find no indication for the prophylactic use of calcium supplementation in these neonates.

Impact of Saccharomyces boulardii on jaundice in premature infants undergoing phototherapy

Abstract Objectives To evaluate the therapeutic effect of Saccharomyces boulardii supplementation on jaundice in premature infants undergoing phototherapy. Methods In this article, the authors reviewed 100 hospitalized jaundiced premature infants under 35 weeks of gestational age. All infants were assigned to a control group (n= 45) and a treatment group (n= 55) randomly. The infants in the treatment group received S. boulardii supplementation by undergoing phototherapy and the infants in the control group were only treated by phototherapy. The total serum bilirubin levels were detected before and at the end of phototherapy, and transcutaneous bilirubin levels were measured on the 1st, 4th, 8th and 15th day of treatment. The duration of jaundice resolution and phototherapy, stool frequency, and characteristics were compared after phototherapy. Results The duration of jaundice resolution and phototherapy were shortened. Total serum bilirubin level was lower than the control group at the end of phototherapy (p < 0.05). Transcutaneous bilirubin levels decreased more significantly on the 8th and 15th day of treatment (p < 0.05), while there were no significant differences on the post-treatment 1st and 4th day (p > 0.05). In addition, bowel movements including stool frequency and Bristol Stool Form Scale ratings of stools also improved after treatment. Conclusions S. boulardii in combination with phototherapy is effective and safe in reducing bilirubin levels and duration of phototherapy, accelerating jaundice resolution in premature infants with jaundice. The procedure also provided an ideal therapeutic effect of diarrhea induced by phototherapy to promote compliance and maternal-infant bonding.

Effect of phototherapy on platelet count in neonates with unconjugated hyperbilirubinemia

Background: Hyperbilirubinemia in newborn is quite common. Phototherapy (PT) is one of the most common noninvasive methods for the treatment of this hyperbilirubinemia. There are limited studies available on effect of PT on platelet count with contrasting results. So, this study was conducted to determine the effect of phototherapy on platelet counts of hyperbilirubinemic neonates in tertiary care hospital.Methods: This was a hospital based prospective study on 60 eligible neonates admitted in neonatal intensive care unit (NICU) for neonatal hyperbilirubinemia and phototherapy during January 2021 to June 2022. Platelet count was done before starting phototherapy, 24 hours after phototherapy and before discontinuing phototherapy. The results were analyzed statistically using Chi square test and t-test. P value <0.05 was considered as statistically significant.Results: In this study, total of 60 neonates were included of which 33 were males and 27 were females. The mean (±SD) platelet counts were 201764.92±18 before phototherapy and 156578.33±38 after phototherapy. There was a significant decline in the mean platelet count 24 hours after phototherapy and before stopping phototherapy. (p<0.05).Conclusions: In our study, the mean platelet count was decreased significantly after phototherapy. Hence, unnecessary use and prolongation of phototherapy should be avoided.

A prospective study of effect of delayed cord clamping in term babies as well as in preterm babies

Background: Delayed cord clamping (DCC) is lengthening the time between delivery of newborn and the clamping of their umbilical cord. It is usually performed 25 seconds to 5 minutes after birth, which increases the newborn抯 iron storage, vital for healthy brain development.Methods: This prospective observational study was conducted on 100 late preterm and term newborns delivered in the obstetrics and gynaecology department of Calcutta national medical college and hospital, Kolkata over a period of one and half years (March 2019 to August 2020). The umbilical cord was clamped between 60 to 90 seconds after birth of baby. Babies� weight measurement and blood investigations (Haemoglobin (Hb) level, total serum bilirubin (TSB) and serum ferritin) were performed at birth, after 24 hours of birth and at 6 weeks of age.Results: In this study after DCC, there is significant increase in Serum Ferritin levels after 24 hours and 6 weeks as compared to the birth values. As far as the values of TSB and hemoglobin is concerned, the values first showed increment after 24 hours and then decreased at 6 weeks, which is statistically significant (p=0.001). Birth weight which first decreased after 24 hours, increased at 6 weeks. None of the babies needed blood transfusion during the study period. Out of 100 cases, 9 were admitted in NICU and required phototherapy which was not directly associated with umbilical cord clamping time or bilirubin values at birth.Conclusions: Based on the results of this study, we conclude that newborns with DCC had statistically significant higher levels of Hb and ferritin after birth. This may ensure better iron status throughout infancy along with reduced need of blood transfusion and its related adversities. Delaying cord clamping seems to be beneficial in late preterm and term neonates without causing additional morbidities in the first 6 weeks of life.

DRUG THERAPY OF HYPOPIGMENTARY DISORDERS OF THE SKIN: A HOSPITAL-BASED STUDY

Objective: To determine the pattern of drug use, adverse events (AEs), and quality of life (QOL) in hypopigmentary disorders of the skin.Methods: A prospective, observational study was conducted on 48 newly diagnosed and untreated participants with hypopigmentary disorders who attended the dermatology outpatient department (OPD) of a tertiary care hospital in Bangalore, India. The pattern of drug therapy and AEs to the therapy were analyzed using descriptive statistics. The dermatology life quality index (DLQI) score for QOL was assessed before and after treatment using analysis of variance (ANOVA). The participants were monitored every 30 d for three months to study the appropriateness and changes in prescription patterns, AEs, and QOL.Results: Male participants had a mean age of 36.69±15.58, while female participants had a mean age of 40.96±11.88. The different classes of drugs used were calcineurin inhibitors, growth factors, melanizing agents, glucocorticoids (GCs), antifungals, and anti-lepra drugs. QOL improved after treatment. The most common AEs include gastritis (16.6%) and acneiform eruption (10.41%).Conclusion: This study has helped in determining the different patterns of drugs used in hypopigmentary disorders and their positive impact on QOL. The individualized prescribing pattern could improve the clinical and psychosocial outcome of the disease in the future.

Evaluation of the comparative effects of infrared and red laser photobiomodulation therapy on skeletal muscle atrophy in an immobilization model in rats / Avaliação comparativa dos efeitos da terapia de fotobiomodulação com laser infravermelho e vermelho na atrofia muscular esquelética em modelo de imobilização em ratos

INTRODUCTION: Skeletal muscle atrophy leads to a reduction in muscle strength, functionality, and the quality of life of individuals. OBJECTIVE: To explore the effects of two different wavelengths (red and infrared) of laser PBMT on muscle atrophy and its active ingredients on skeletal muscle atrophy using an in vivo model of muscle atrophy. METHODS: Thirty-two Wistar rats were randomly divided into four experimental groups: control (CG) animals were not immobilized and did not receive any type of treatment; immobilized animals with no treatment (ImC); immobilized animals submitted to red laser with wavelength of 660 nm (ImR) and near-infrared laser with wavelength of 808 nm (ImIR) treatments. The treatments were applied daily, at 2 points in the right gastrocnemius muscle (cranial and caudal), through the punctual contact technique, for 9 sessions, with the first application immediately after removing the cast. RESULTS: The histological results demonstrated that in both treated groups (red and infrared wavelengths) a reduction of the inflammatory infiltrate and less connective tissue thickening when compared to the ImC. However, only infrared light was observed regenerating muscle fibers and an increase in the number of oxidative fibers (type I). CONCLUSION: These results suggest that red and infrared wavelength laser PBMT were able to promote changes in the morphology of the gastrocnemius muscle submitted to atrophy in an experimental immobilization model, reducing the inflammatory infiltrate and the formation of intramuscular connective tissue. However, infrared laser PBMT promoted more evident positive effects by increasing regenerating muscle fibers and the number of oxidative fibers.

Use of prophylactic phototherapy for RhD neonatal disease in a referral service

Abstract Objective: This study aimed to describe the effect of prophylactic phototherapy in the treatment of infants with Neonatal Hemolytic Disease. Method: A retrospective cohort study was carried out with 199 RhD-positive infants, born to RhD-negative mothers, alloimmunized for RhD antigen, between January 2009 and December 2018. Results: The incidence of exchange transfusions in the study population was 9.5%, with a mean maximum bilirubin value of 11.3 mg % (± 4.3mg %). Bilirubin's maximum peak was achieved with a mean of 119.2 life hours (± 70.6h). Conclusions: The low incidence of exchange transfusion, the extended maximum bilirubin peak for later ages, and the low mean of the maximum bilirubin values may indicate a positive effect of prophylactic phototherapy in the treatment of this disease. Further studies must be carried out to confirm these findings.

Real-time SERS monitoring anticancer drug release along with SERS/MR imaging for pH-sensitive chemo-phototherapy

In situ and real-time monitoring of responsive drug release is critical for the assessment of pharmacodynamics in chemotherapy. In this study, a novel pH-responsive nanosystem is proposed for real-time monitoring of drug release and chemo-phototherapy by surface-enhanced Raman spectroscopy (SERS). The Fe3O4@Au@Ag nanoparticles (NPs) deposited graphene oxide (GO) nanocomposites with a high SERS activity and stability are synthesized and labeled with a Raman reporter 4-mercaptophenylboronic acid (4-MPBA) to form SERS probes (GO-Fe3O4@Au@Ag-MPBA). Furthermore, doxorubicin (DOX) is attached to SERS probes through a pH-responsive linker boronic ester (GO-Fe3O4@Au@Ag-MPBA-DOX), accompanying the 4-MPBA signal change in SERS. After the entry into tumor, the breakage of boronic ester in the acidic environment gives rise to the release of DOX and the recovery of 4-MPBA SERS signal. Thus, the DOX dynamic release can be monitored by the real-time changes of 4-MPBA SERS spectra. Additionally, the strong T2 magnetic resonance (MR) signal and NIR photothermal transduction efficiency of the nanocomposites make it available for MR imaging and photothermal therapy (PTT). Altogether, this GO-Fe3O4@Au@Ag-MPBA-DOX can simultaneously fulfill the synergistic combination of cancer cell targeting, pH-sensitive drug release, SERS-traceable detection and MR imaging, endowing it great potential for SERS/MR imaging-guided efficient chemo-phototherapy on cancer treatment.

Research advances in the treatment of Crigler-Najjar syndrome / 临床肝胆病杂志

Crigler-Najjar syndrome (CNS) is an autosomal recessive disorder in which the content of plasma unconjugated bilirubin is increased due to the reduction or complete deficiency of the activity of bilirubin uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1), classified as CNS type Ⅰ and Ⅱ. CNS type Ⅰ is the most severe, which will develop into kernicterus, damage the brain nervous system, and even threaten the life of patients. This article introduces six CNS treatment techniques, including phototherapy, plasma exchange, drug therapy, liver transplantation, hepatocyte transplantation and gene therapy. The applicable patient types, treatment effects and existing deficiencies of each technique were summarized. Phototherapy, plasma exchange, drug therapy and hepatocyte transplantation can temporarily control serum levels and reduce the risk of jaundice, but cannot completely restore UGT1A1 enzyme activity; liver transplantation is currently the only treatment option for CNS type Ⅰ patients, but is limited by suitable liver donors and post-operative immune rejection. Gene therapy has the most promising application in the treatment of genetic disorders such as CNS, which can provide more viable therapeutic techniques for CNS patients.

Research progress of nano delivery system in breast cancer treatment / 中国药房

Breast cancer is a malignant tumor that seriously threatens women’s health at present. Although surgical treatment is the most direct and effective， it is limited by many factors and needs to be assisted by other treatments. In addition to conventional radiotherapy， these adjuvant therapies also include chemotherapy， gene therapy， phototherapy and so on. However， the therapeutic agents used in these treatment methods have some limitations， such as poor water-solubility， instability and targeting. With the development of nano-technology， more and more researchers construct and study nano delivery system for breast tumor treatment， such as response system designed based on tumor microenvironment， temperature sensitive response system， nano delivery system based on specific proteins of tumor cell membrane， etc. The author summarizes the nano delivery system， and finds that these nano delivery systems can not only improve the water-solubility and stability of the therapeutic agents， but also accurately deliver them to the breast tumor site by targeted means， improve the efficacy and reduce toxic side effects， which provides new ideas for the treatment of breast cancer in the future.

Research progress and directions in photodermatology / 中华皮肤科杂志

As an important subdiscipline of dermatology, photodermatology has developed rapidly in recent years. It is not only theoretical science of photodamage-related dermatoses, but also practical science of treatment of photodamage-related dermatoses. This article introduces the basis of photobiology, the pathogenesis of photodamage-related dermatoses, and research hotspots in sunscreens, and elaborates new progress in the clinical application of targeted phototherapy and home phototherapy, with a view to providing a theoretical basis and practical guidance for the treatment of photodamage-related dermatoses.

Photohardening therapy for idiopathic actinic dermatoses / 中华皮肤科杂志

Photohardening therapy, also known as photodesensitization therapy, refers to the phototherapy and photochemotherapy of idiopathic actinic dermatoses, and its goal is to improve the patients′ tolerance to sunlight and prevent disease flares. Its mechanisms of action involve a variety of cellular and inflammatory factors. This therapy is suitable for all idiopathic actinic dermatoses, with definite efficacy and good safety. However, the treatment specificity usually leads to poor compliance. The development of UVA1 rush hardening and home phototherapy is expected to solve this problem.

Photoelectric therapy for rosacea / 中华皮肤科杂志

Rosacea is a chronic inflammatory dermatosis mostly occurring on the central face, and its pathogenesis is still unclear. Currently, drug treatment is the first-line therapy for rosacea. In recent years, photoelectric therapy has showed a favorable therapeutic effect on rosacea by selective photothermolysis. This review summarizes latest advances in photoelectric therapy for rosacea.