Polydeoxyribonucleotide(PDRN)has been utilized in clinical practice for an extended period;however,its application in the cosmetics is relatively recent.This study aims to explore the research progress of PDRN regardi...Polydeoxyribonucleotide(PDRN)has been utilized in clinical practice for an extended period;however,its application in the cosmetics is relatively recent.This study aims to explore the research progress of PDRN regarding its skin repair and anti-aging properties.To evaluate the potential skin repair,soothing,anti-wrinkle and firming effects of PDRN essence via both in vitro and in vivo test method.This study employed in vitro and in vivo test to assess the skin repair and anti-wrinkle effects.The 3D skin model(FulKutis®)was utilized to verify the effects of the PDRN essence on anti-inflammation,barrier repair,and anti-aging.In human test,a randomized,half-face comparison test with PDRN essence and the placebo was conducted with 33 Chinese subjects who met the test criteria.During the test,the skin conditions in terms of the a*value,facial red area ratio,and Transepidermal Water Loss(TEWL)were evaluated at 30 min,4 h,1 day,and 3 days;the skin conditions in terms of skin elasticity and firmness,skin wrinkles were evaluated at 42 days.Subjects’self-assessments were collected at 3 days and 42 days.The FulKutis■experiments demonstrated that the PDRN essence significantly decreased the levels of IL-1α,TNF-α,and PGE2,and improved the protein levels of Filaggrin,Loricrin,Collagen I,Collagen IV,and the thickness of the epidermal living cell layer.In the human study,the a*value,red area ratio,TEWL,and skin-related parameters(R2,R5,R7,F4,and skin wrinkles)on the test face side exhibited greater improvement compared to the control face side with statistically significant differences.Additionally,subject selfassessments revealed high satisfaction with the PDRN essence.The PDRN essence applied after non-ablative fractional laser treatment promotes barrier repair and soothing effects,shortens the recovery period,and enhances facial firmness and wrinkle improvement at the crow’s feet and undereye regions.No adverse events related to the tested cosmetics were observed.展开更多
Objective To investigate the clinical effect of botulinum toxin type A injection combined with low-energy CO2 fractional laser periocular rejuvenation treatment.Methods The clinical effect of botulinum type A injectio...Objective To investigate the clinical effect of botulinum toxin type A injection combined with low-energy CO2 fractional laser periocular rejuvenation treatment.Methods The clinical effect of botulinum type A injection alone and botulinum type A injection combined with low-energy CO2 fractional laser was compared in 96 patients who needed to receive periocular rejuvenation treatment from April 2018 to April 2019.Results After the combined low-energy CO2 fractional laser treatment was given on the basis of botulinum toxin type A injection,the follow-up global aesthetic improvement scale(GAIS)scores of the observation group were 86.78±4.67,80.31±3.66,76.94±4.03 and 40.59±4.78.The global aesthetic improvement of the dynamic and static wrinkles was obvious.The total effective rate was 93.7%.The total satisfaction rate of the patients was 95.8%,which was higher than that of the control group(P<0.05).The clinical efficacy was significant.Conclusion The application of the combined periocular rejuvenation treatment can improve the dynamic and static wrinkles simultaneously with remarkable rejuvenation effect,increase the effective rate of treatment and enhance the patients'satisfaction.展开更多
Objective To observe the effect of uitrapulse CO2 laser combined with Erbium fractional laser on treatment facial scars. Methods Total 70 cases with facial scars were treated with ultrapulse CO2 laser combined with Er...Objective To observe the effect of uitrapulse CO2 laser combined with Erbium fractional laser on treatment facial scars. Methods Total 70 cases with facial scars were treated with ultrapulse CO2 laser combined with Erbium fractional laser for 3 times with 2 ～ 3 months interval. Firstly,scar resurfacing was performed展开更多
Objective:Acne scarring is more common in patients with moderate to severe acne,and various monotherapies are useful to treat acne scars,however,studies evaluating the effect of combined treatments are still insuffici...Objective:Acne scarring is more common in patients with moderate to severe acne,and various monotherapies are useful to treat acne scars,however,studies evaluating the effect of combined treatments are still insufficient.This study was aimed to assess the impact of 30.0%supramolecular salicylic acid(SSA)combined with ultra-pulse carbon dioxide(CO_(2))fractional laser therapy on facial atrophic acne scars.Methods:This retrospective study included data from patients with atrophic acne scars treated from June 2020 to June 2022 in Mylike Cosmetology Hospital of Yunnan.The patients were divided into the combination group(SSA combined with ultra-pulse CO_(2)fractional laser therapy)and the laser group(ultra-pulse CO_(2)fractional laser therapy alone)depending on the treatments received.Four treatment sessions were conducted for each group.Follow-up visits were performed every 2 months after each treatment and included assessments of theÉchelle d’Évaluation clinique des cicatrices d’acnéscore,effective rate,and visual analog scale score.Continuous data were analyzed using Student t test.Dichotomous or unordered categorical data were compared using the Chi-square(χ2)test,and ordered categorical data were compared using the Mann-Whitney U test.Results:The combination and laser groups comprised 72 and 61 patients,respectively,and there were no significant differences in sex,age,or baselineÉchelle d’Évaluation clinique des cicatrices d’acnéscore between the 2 groups.The effective rate(95.8%vs.67.2%,P<0.001)was higher and the pain scores(during and after the intervention)were lower in the combination group than in the laser group(all P<0.001).The severity of erythema,edema,and crusting was milder in the combination group(P<0.001).The proportion of highly satisfied patients was higher(73.6%vs.31.2%,P<0.001)and the Dermatology Life Quality Index showed greater improvement(0.15±0.40 vs.1.39±1.53,P<0.001)in the combination group than that in the laser group.Conclusion:The combination of ultra-pulse CO_(2)fractional laser therapy and 30.0%SSA had improved efficacy in treating facial atrophic acne scars without increasing pain or inducing serious adverse reactions.展开更多
Xiu-Feng Liu,Man-Chang Yu.In the article“Impact of 30.0%Supramolecular Salicylic Acid Combined With Ultra-Pulse Carbon Dioxide Fractional Laser Therapy on Facial Atrophic Acne Scars:A Retrospective Case-Control Study...Xiu-Feng Liu,Man-Chang Yu.In the article“Impact of 30.0%Supramolecular Salicylic Acid Combined With Ultra-Pulse Carbon Dioxide Fractional Laser Therapy on Facial Atrophic Acne Scars:A Retrospective Case-Control Study”by Liu et al.1,the study was incorrectly described as a“retrospective case-control study”in the title,while the study was designed to compare outcomes between groups receiving different interventions,meeting the definition of a cohort study,not a case-control study.展开更多
Objective:Current treatments for atrophic acne scars such as microneedling radiofrequency(MNRF)and fractional carbon dioxide(FCO_(2))laser have shown individual efficacy,but their combined effectiveness remains lackin...Objective:Current treatments for atrophic acne scars such as microneedling radiofrequency(MNRF)and fractional carbon dioxide(FCO_(2))laser have shown individual efficacy,but their combined effectiveness remains lacking.This study aimed to determine the effectiveness and safety of a sequential combination therapy with MNRF followed by FCO_(2) laser compared with each therapy administered alone for the treatment of atrophic acne scars.Methods:An open randomized trial was conducted on 45 patients with atrophic acne scars at Al-Salam Teaching Hospital,Mosul,Iraq,from January 2022 to July 2023.The patients were randomized into 3 groups,with 15 patients in each group:FCO_(2) group(6 sessions of FCO_(2) laser treatment),MNRF group(6 sessions of MNRF treatment),and combined group(3 sessions of MNRF treatment followed by 3 sessions of FCO_(2) laser treatment).The Goodman and Baron Global Quantitative Acne Scar Grading System(GBGQASGS)was used to assess the treatment effectiveness.Adverse effects of treatment were monitored.The pre-treatment and post-treatment GBGQASGS scores and the percentage reductions in the GBGQASGS scores in the 3 groups were assessed by analysis of variance.The effect size of each treatment regimen was assessed using the Cohen d effect size.Results:The 45 patients enrolled comprised 20(44.4%)men and 25(55.6%)women,with a mean age of 25.10±2.80 years and a GBGQASGS score of 28.93±6.19.All 3 types of treatment significantly reduced the GBGQASGS scores after 6 sessions(all P<0.05)as following:FCO_(2) group,from 28.66±5.71 to 11.66±2.71(59.3%reduction;Cohen d=3.80);MNRF group,from 27.26±6.93 to 11.66±3.09(57.2%reduction;Cohen d=2.90);Combined group,from 30.87±5.73 to 9.01±2.03(70.8%reduction;Cohen d=5.08).There was no difference in the GBGQASGS score of post-treatment among 3 groups(P=0.300),however,the combined group exhibited a significant reduction in the GBGQASGS score from pre-treatment to post-treatment(P<0.001).Post-inflammatory hyperpigmentation was reported in FCO_(2) and MNRF groups,tram-track scarring was found in FCO_(2) group,while no serious adverse effects were reported in the combined group.Conclusion:Sequential combination therapy with MNRF followed by FCO_(2) laser was as effective as each monotherapy for the treatment of atrophic acne scars with fewer adverse effects.The results may provide evidence for treatment choice.展开更多
Background:Poor sleep quality is associated with a decrease in quality of life in patients with major burn scars,combined with pruritus and pain.Few interventions have been reported to improve the sleep quality of pat...Background:Poor sleep quality is associated with a decrease in quality of life in patients with major burn scars,combined with pruritus and pain.Few interventions have been reported to improve the sleep quality of patients with scars.In the current prospective cohort study,we investigated the efficacy of CO_(2)-ablative fractional laser(AFL)surgery vs conventional surgery in post-burn patients with hypertrophic scars with sleep quality as the primary study outcome.Methods:In total 68 consecutive patients undergoing scar surgical treatment were recruited,including a CO_(2)-AFL surgery cohort(n=35)and a conventional surgery cohort(n=33).A subgroup from the AFL cohort was selected.Sleep quality,pain and pruritus were evaluated.Multiple linear regression analyses were performed to reveal the effect of CO_(2)-AFL surgery.Results:The CO_(2)-AFL surgery cohort had significantly lower Pittsburgh sleep quality index(PSQI)global scores than the conventional surgery cohort after the last surgical treatment.In the subgroup of patients receiving hardware sleep monitoring,CO_(2)-AFL markedly increased deep sleep time,deep sleep efficiency and reduced initial sleep latency.Compared to the conventional surgery cohort,the CO_(2)-AFL cohort presented significantly lower pain and pruritus scores.Correlation analysis showed pain and pruritus were significantly associated with PSQI scores,and there were also significant correlations between pain and pruritus scores.Multiple linear regression analysis showed that surgery method was negatively linearly correlated with visual analog scale(VAS)pain score,brief pain inventory(BPI)total,VAS pruritus score,5-D itch scale total,four-item itch questionnaire(FIIQ)total and PSQI total.Conclusions:CO_(2)-AFL surgery significantly improved sleep quality and reduced pain and pruritus of hypertrophic scar patients.The alleviation of sleep disorder was associated with improvement of deep sleep quality including deep sleep time and deep sleep deficiency.Trial registration:The Chinese Clinical Trial Registry(ChiCTR200035268)approved retrospectively registration on 5 Aug 2020.展开更多
Background:Hypertrophic scars are one of the main complications that affect the quality of life of patients after burns.Many methods have been shown to be effective in the treatment of hypertrophic scars,such as ablat...Background:Hypertrophic scars are one of the main complications that affect the quality of life of patients after burns.Many methods have been shown to be effective in the treatment of hypertrophic scars,such as ablative fractional CO_(2) laser(AFCL)and platelet-rich plasma(PRP).However,there are few studies on the effect of the combined application of these measures.The purpose of this study was to explore the therapeutic effect of AFCL combined with PRP on hypertrophic burn scars.Methods:A retrospective clinical observation study was conducted on 50 patients with hypertrophic burn scars.The AFCL+PRP group included 31 patients who received AFCL combined with PRP treatment;the AFCL group included 19 patients who received AFCL treatment only.The University of North Carolina 4P Scar Scale(UNC4P)and the Vancouver Scar Scale(VSS)scores that were collected before each treatment were used as indicators of the effectiveness of the previous treatment.The scores recorded at the second,fourth and seventh months were analysed.Results:The demographic data of the 2 groups were not significantly different.Before treatment,therewas no difference in the UNC4P and VSS scores between the 2 groups.Therewas a significant decline in the UNC4P and VSS total scores over 6 months in both groups(p<0.05)and scores in the 2 groups were comparable after 3 and 6 months(p<0.05).UNC4P scores in the AFCL+PRP group decreased from a mean of 8.26 to 2.61(p<0.05)with a concomitant drop in VSS scores from a mean of 11.74 to 6.06(p<0.01).In the AFCL group UNC4P and VSS scores decreased from 7.68 to 4.63(p<0.05)and from 10.89 to 8.16(p<0.05),respectively.The sub-items of these 2 assessments were analysed and the results suggest that AFCL combined with PRP can comprehensively improve scarring.Conclusions:This study shows that PRP is an effective adjunct for AFCL in the treatment of hypertrophic burn scars and that the combination of PRP and AFCL proved to be more useful than AFCL alone.This combination may be a new and effective clinical practice for the treatment of scars.However,larger and higher-level clinical studies are still needed to determine its efficacy and possible mechanisms.展开更多
BACKGROUND： Stress urinary incontinence （SUI） is a relatively common disorder that significantly affects the quality of life. Many conservative and surgical treatment methods have been recommended for SUI, but they...BACKGROUND： Stress urinary incontinence （SUI） is a relatively common disorder that significantly affects the quality of life. Many conservative and surgical treatment methods have been recommended for SUI, but they have major limitations. AIMS： To assess the use of the CO2 fractional laser in the treatment of SUI. METHODS： This clinical trial included 55 patients with confirmed SUI. Patients underwent fractional CO2 laser treatment 3 times at 30-day intervals. Data on age, smoking history, sexual activity, menopause, and history of hormone replacement therapy （HRT） were collected. Response to treatment was assessed by SUI severity and the level of sexual satisfaction was assessed using the visual analog scale （VAS）. Patients were evaluated at 3 different time points： before treatment, and 45 days and 6 months after the last laser treatment. RESULTS： The mean patient age was 44.4±11.4 years （range： 28 to 68 years）. Smoking history was positive in 6 patients （9.1%）; 19 （54.3%） were menopausal on HRT. The SUI severity score at baseline （before treatment） was 8.56±0.62 and decreased to 2.28 6 months after treatment （p 〈 0.0001）. The sexual satisfaction score was 3 ± 0.94 at baseline and increased to 7.87±0.93 6 months after treatment （day 180） （p 〈 0.0001, slope = ＋ 2.2） CONCLUSION： Our findings are in line with a previous study that showed the value of transvaginal CO2 fractional laser treatment for alleviation of SUI symptoms and its potential as an alternative treatment. We also observed improved sexual satisfaction in SUI patients.展开更多
Background:Hypertrophic scars are skin fibrotic diseases,characterized by fibroblast hyperprolif-eration and excessive accumulation of extracellular matrix.However,topical drug application for hypertrophic scars are u...Background:Hypertrophic scars are skin fibrotic diseases,characterized by fibroblast hyperprolif-eration and excessive accumulation of extracellular matrix.However,topical drug application for hypertrophic scars are unsatisfactory.The purpose of this study was to explore the permeability of silk nanofiber hydrogels(SNFs)loaded with rhodamine 6G(R6G)and rhodamine 110(R110)mediated by CO_(2)fractional laser irradiation into hypertrophic scar tissues.Methods:In this work,R6G and R110 were chosen as hydrophilic and hydrophobic model molecules.They were loaded inside SNFs.In vivo rabbit ear hypertrophic scars were treated with CO_(2)fractional laser irradiation and then R6G/R110-laden SNFs were applied to the scars to evaluate their synergetic effect on drug penetration efficiency.Their permeability was quantified by fluorescence intensity and measured by confocal laser scanning microscopy on days 1,3,5 and 7.More specifically,the thermal coagulation zone(CZ)and its surrounding area(peri-CZ)caused by the thermal coagulation of the laser were discussed separately.Results:Our data indicated that the SNFs promoted the penetration of R6G but not that of R110 in the peri-CZ on day 1 when combined with laser irradiation.Interestingly,both R6G and R110 were abundant in the CZ and remained stable on days 1,3 and 5.Moreover,rapid re-epithelialization hindered the long-term permeability of both drugs.Conclusion:Combining CO_(2)fractional laser irradiation with SNF drug delivery could improve the efficiency of hydrophilic drug delivery within 24 h before total re-epithelialization.展开更多
Aim:Transconjunctival CO_(2)laser lower blepharoplasty is considered to be a safe and reliable approach.A retrospective review of transconjunctival approached CO_(2)laser lower blepharoplasty associated with fractiona...Aim:Transconjunctival CO_(2)laser lower blepharoplasty is considered to be a safe and reliable approach.A retrospective review of transconjunctival approached CO_(2)laser lower blepharoplasty associated with fractional CO_(2)laser ablation or fractioned non-ablative Fraxel laser resurfacing for lower eyelid rejuvenation is presented for comparison.Methods:From February 1996 to February 2016,250 patients underwent CO_(2)laser lower blepharoplasty with a male to female ratio of 1:7.5.The age ranged from 43 to 68 years(mean 52 years).A CO_(2)laser was applied to make a transconjunctival lower blepharoplasty.Immediately after CO_(2)laser lower blepharoplasty,40 patients received fractional CO_(2)laser and 40 patients took Fraxel laser for resurfacing.Results:Swelling occurred in all patients postoperatively.Complications related to transconjunctival CO_(2)laser lower blepharoplasty were 6(2.4%)patients with conjunctival chemosis,5(2.0%)with ecchymosis,and 3(1.2%)with granulomas.The early complications(≤1 month)related to fractional CO_(2)laser ablation were 40(100%)patients with mild erythema,40(100%)with mild edema,1(2.5%)with hyperpigmentation,1(2.5%)with infection,and 1(2.5%)with scarring.These problems resolved in all patients after 3 months.There was no complication after Fraxel laser right after lower blepharoplasty.The Fraxel group had short recovery time.However,there was no statistically significant difference between the two groups in final outcome(≥6 months).Conclusion:Transconjunctival CO_(2)laser lower blepharoplasty associated with fractional CO_(2)laser ablation or Fraxel laser resurfacing assisted the appearance around the periorbital regions.展开更多
Background:Fractional CO_(2) laser plays an important role in scar management post split-thickness skin graft by loosening the graft contracture and restoring the smoothness of the surface.However,the optimal treatmen...Background:Fractional CO_(2) laser plays an important role in scar management post split-thickness skin graft by loosening the graft contracture and restoring the smoothness of the surface.However,the optimal treatment protocol remains unknown.This study applied a dual-scan protocol to achieve both releasing and ablation of contracted skin graft.We comprehensively describe this treatment method and compare the efficacy and safety between this dual-scan method and the conventional mono-scan mode.Methods:A hypercontracted scar model after split-thickness skin grafting in red Duroc pigs was established.All scars meeting the inclusion criteria were randomly divided into four groups:high fluence–low density(HF–LD),low fluence–high density(LF–HD),combined group and control group.The energy per unit areawas similar in the HF–LD and LF–HD groups.Two laser interventions were performed at a 6-week interval.The efficacy of the treatment was evaluated by objective measures of scar area,release rate,elasticity,thickness and flatness,while the safetywas evaluated based on adverse reactions and melanin index.Collagen structurewas observed histologically.The animals were followed up for a maximum of 126 days after modeling.Results:A total of 28 contracted scars were included,7 in each group.At 18 weeks postoperatively,the HF–LD and the combined groups showed significantly increased scar release rate(p=0.000)and elasticity(p=0.036)and decreased type I/III collagen ratio(p=0.002)compared with the control and LF–HD groups.In terms of flatness,the combined group was significantly better than the HF–LD group for elevations<1mm(p=0.019).No significant skin side effects,pigmentation or scar thickness changes were observed at 18 weeks.Conclusions:Dual-scan protocol could achieve superficial ablation and deep release of contracted split-thickness skin graft in a single treatment,with similar contraction release and texture improvement compared to a single deep scan.Its main advantage is to restore a smoother scar appearance.Adequate laser penetration was necessary for the release of contracted scars.展开更多
文摘Polydeoxyribonucleotide(PDRN)has been utilized in clinical practice for an extended period;however,its application in the cosmetics is relatively recent.This study aims to explore the research progress of PDRN regarding its skin repair and anti-aging properties.To evaluate the potential skin repair,soothing,anti-wrinkle and firming effects of PDRN essence via both in vitro and in vivo test method.This study employed in vitro and in vivo test to assess the skin repair and anti-wrinkle effects.The 3D skin model(FulKutis®)was utilized to verify the effects of the PDRN essence on anti-inflammation,barrier repair,and anti-aging.In human test,a randomized,half-face comparison test with PDRN essence and the placebo was conducted with 33 Chinese subjects who met the test criteria.During the test,the skin conditions in terms of the a*value,facial red area ratio,and Transepidermal Water Loss(TEWL)were evaluated at 30 min,4 h,1 day,and 3 days;the skin conditions in terms of skin elasticity and firmness,skin wrinkles were evaluated at 42 days.Subjects’self-assessments were collected at 3 days and 42 days.The FulKutis■experiments demonstrated that the PDRN essence significantly decreased the levels of IL-1α,TNF-α,and PGE2,and improved the protein levels of Filaggrin,Loricrin,Collagen I,Collagen IV,and the thickness of the epidermal living cell layer.In the human study,the a*value,red area ratio,TEWL,and skin-related parameters(R2,R5,R7,F4,and skin wrinkles)on the test face side exhibited greater improvement compared to the control face side with statistically significant differences.Additionally,subject selfassessments revealed high satisfaction with the PDRN essence.The PDRN essence applied after non-ablative fractional laser treatment promotes barrier repair and soothing effects,shortens the recovery period,and enhances facial firmness and wrinkle improvement at the crow’s feet and undereye regions.No adverse events related to the tested cosmetics were observed.
文摘Objective To investigate the clinical effect of botulinum toxin type A injection combined with low-energy CO2 fractional laser periocular rejuvenation treatment.Methods The clinical effect of botulinum type A injection alone and botulinum type A injection combined with low-energy CO2 fractional laser was compared in 96 patients who needed to receive periocular rejuvenation treatment from April 2018 to April 2019.Results After the combined low-energy CO2 fractional laser treatment was given on the basis of botulinum toxin type A injection,the follow-up global aesthetic improvement scale(GAIS)scores of the observation group were 86.78±4.67,80.31±3.66,76.94±4.03 and 40.59±4.78.The global aesthetic improvement of the dynamic and static wrinkles was obvious.The total effective rate was 93.7%.The total satisfaction rate of the patients was 95.8%,which was higher than that of the control group(P<0.05).The clinical efficacy was significant.Conclusion The application of the combined periocular rejuvenation treatment can improve the dynamic and static wrinkles simultaneously with remarkable rejuvenation effect,increase the effective rate of treatment and enhance the patients'satisfaction.
文摘Objective To observe the effect of uitrapulse CO2 laser combined with Erbium fractional laser on treatment facial scars. Methods Total 70 cases with facial scars were treated with ultrapulse CO2 laser combined with Erbium fractional laser for 3 times with 2 ～ 3 months interval. Firstly,scar resurfacing was performed
文摘Objective:Acne scarring is more common in patients with moderate to severe acne,and various monotherapies are useful to treat acne scars,however,studies evaluating the effect of combined treatments are still insufficient.This study was aimed to assess the impact of 30.0%supramolecular salicylic acid(SSA)combined with ultra-pulse carbon dioxide(CO_(2))fractional laser therapy on facial atrophic acne scars.Methods:This retrospective study included data from patients with atrophic acne scars treated from June 2020 to June 2022 in Mylike Cosmetology Hospital of Yunnan.The patients were divided into the combination group(SSA combined with ultra-pulse CO_(2)fractional laser therapy)and the laser group(ultra-pulse CO_(2)fractional laser therapy alone)depending on the treatments received.Four treatment sessions were conducted for each group.Follow-up visits were performed every 2 months after each treatment and included assessments of theÉchelle d’Évaluation clinique des cicatrices d’acnéscore,effective rate,and visual analog scale score.Continuous data were analyzed using Student t test.Dichotomous or unordered categorical data were compared using the Chi-square(χ2)test,and ordered categorical data were compared using the Mann-Whitney U test.Results:The combination and laser groups comprised 72 and 61 patients,respectively,and there were no significant differences in sex,age,or baselineÉchelle d’Évaluation clinique des cicatrices d’acnéscore between the 2 groups.The effective rate(95.8%vs.67.2%,P<0.001)was higher and the pain scores(during and after the intervention)were lower in the combination group than in the laser group(all P<0.001).The severity of erythema,edema,and crusting was milder in the combination group(P<0.001).The proportion of highly satisfied patients was higher(73.6%vs.31.2%,P<0.001)and the Dermatology Life Quality Index showed greater improvement(0.15±0.40 vs.1.39±1.53,P<0.001)in the combination group than that in the laser group.Conclusion:The combination of ultra-pulse CO_(2)fractional laser therapy and 30.0%SSA had improved efficacy in treating facial atrophic acne scars without increasing pain or inducing serious adverse reactions.
文摘Xiu-Feng Liu,Man-Chang Yu.In the article“Impact of 30.0%Supramolecular Salicylic Acid Combined With Ultra-Pulse Carbon Dioxide Fractional Laser Therapy on Facial Atrophic Acne Scars:A Retrospective Case-Control Study”by Liu et al.1,the study was incorrectly described as a“retrospective case-control study”in the title,while the study was designed to compare outcomes between groups receiving different interventions,meeting the definition of a cohort study,not a case-control study.
文摘Objective:Current treatments for atrophic acne scars such as microneedling radiofrequency(MNRF)and fractional carbon dioxide(FCO_(2))laser have shown individual efficacy,but their combined effectiveness remains lacking.This study aimed to determine the effectiveness and safety of a sequential combination therapy with MNRF followed by FCO_(2) laser compared with each therapy administered alone for the treatment of atrophic acne scars.Methods:An open randomized trial was conducted on 45 patients with atrophic acne scars at Al-Salam Teaching Hospital,Mosul,Iraq,from January 2022 to July 2023.The patients were randomized into 3 groups,with 15 patients in each group:FCO_(2) group(6 sessions of FCO_(2) laser treatment),MNRF group(6 sessions of MNRF treatment),and combined group(3 sessions of MNRF treatment followed by 3 sessions of FCO_(2) laser treatment).The Goodman and Baron Global Quantitative Acne Scar Grading System(GBGQASGS)was used to assess the treatment effectiveness.Adverse effects of treatment were monitored.The pre-treatment and post-treatment GBGQASGS scores and the percentage reductions in the GBGQASGS scores in the 3 groups were assessed by analysis of variance.The effect size of each treatment regimen was assessed using the Cohen d effect size.Results:The 45 patients enrolled comprised 20(44.4%)men and 25(55.6%)women,with a mean age of 25.10±2.80 years and a GBGQASGS score of 28.93±6.19.All 3 types of treatment significantly reduced the GBGQASGS scores after 6 sessions(all P<0.05)as following:FCO_(2) group,from 28.66±5.71 to 11.66±2.71(59.3%reduction;Cohen d=3.80);MNRF group,from 27.26±6.93 to 11.66±3.09(57.2%reduction;Cohen d=2.90);Combined group,from 30.87±5.73 to 9.01±2.03(70.8%reduction;Cohen d=5.08).There was no difference in the GBGQASGS score of post-treatment among 3 groups(P=0.300),however,the combined group exhibited a significant reduction in the GBGQASGS score from pre-treatment to post-treatment(P<0.001).Post-inflammatory hyperpigmentation was reported in FCO_(2) and MNRF groups,tram-track scarring was found in FCO_(2) group,while no serious adverse effects were reported in the combined group.Conclusion:Sequential combination therapy with MNRF followed by FCO_(2) laser was as effective as each monotherapy for the treatment of atrophic acne scars with fewer adverse effects.The results may provide evidence for treatment choice.
基金supported by the Special Scientific Research Fund of the Public Welfare Profession of China(201502028)the Excellent Discipline Leader Training Program of Shanghai Health System(No.2017BR037)+2 种基金the NationalNatural Science Foundation of China(No.81772091)Clinical Research Plan of Shanghai Hospital Devel-opment Center(No.SHDC2020CR3039B)Shanghai Rising-Star Program(17QB1403300).
文摘Background:Poor sleep quality is associated with a decrease in quality of life in patients with major burn scars,combined with pruritus and pain.Few interventions have been reported to improve the sleep quality of patients with scars.In the current prospective cohort study,we investigated the efficacy of CO_(2)-ablative fractional laser(AFL)surgery vs conventional surgery in post-burn patients with hypertrophic scars with sleep quality as the primary study outcome.Methods:In total 68 consecutive patients undergoing scar surgical treatment were recruited,including a CO_(2)-AFL surgery cohort(n=35)and a conventional surgery cohort(n=33).A subgroup from the AFL cohort was selected.Sleep quality,pain and pruritus were evaluated.Multiple linear regression analyses were performed to reveal the effect of CO_(2)-AFL surgery.Results:The CO_(2)-AFL surgery cohort had significantly lower Pittsburgh sleep quality index(PSQI)global scores than the conventional surgery cohort after the last surgical treatment.In the subgroup of patients receiving hardware sleep monitoring,CO_(2)-AFL markedly increased deep sleep time,deep sleep efficiency and reduced initial sleep latency.Compared to the conventional surgery cohort,the CO_(2)-AFL cohort presented significantly lower pain and pruritus scores.Correlation analysis showed pain and pruritus were significantly associated with PSQI scores,and there were also significant correlations between pain and pruritus scores.Multiple linear regression analysis showed that surgery method was negatively linearly correlated with visual analog scale(VAS)pain score,brief pain inventory(BPI)total,VAS pruritus score,5-D itch scale total,four-item itch questionnaire(FIIQ)total and PSQI total.Conclusions:CO_(2)-AFL surgery significantly improved sleep quality and reduced pain and pruritus of hypertrophic scar patients.The alleviation of sleep disorder was associated with improvement of deep sleep quality including deep sleep time and deep sleep deficiency.Trial registration:The Chinese Clinical Trial Registry(ChiCTR200035268)approved retrospectively registration on 5 Aug 2020.
基金supported by the National Nature Science Foundation of China(81701899)the Youth Incubation Plan of the Military Medical Science and Technology(16QNP091)+1 种基金the CAMS Innovation Fund for Medical Sciences(2019-I2M-5-076)the high level achievement cultivation plan of the Naval Medical University(2018-CGPZ-B03).
文摘Background:Hypertrophic scars are one of the main complications that affect the quality of life of patients after burns.Many methods have been shown to be effective in the treatment of hypertrophic scars,such as ablative fractional CO_(2) laser(AFCL)and platelet-rich plasma(PRP).However,there are few studies on the effect of the combined application of these measures.The purpose of this study was to explore the therapeutic effect of AFCL combined with PRP on hypertrophic burn scars.Methods:A retrospective clinical observation study was conducted on 50 patients with hypertrophic burn scars.The AFCL+PRP group included 31 patients who received AFCL combined with PRP treatment;the AFCL group included 19 patients who received AFCL treatment only.The University of North Carolina 4P Scar Scale(UNC4P)and the Vancouver Scar Scale(VSS)scores that were collected before each treatment were used as indicators of the effectiveness of the previous treatment.The scores recorded at the second,fourth and seventh months were analysed.Results:The demographic data of the 2 groups were not significantly different.Before treatment,therewas no difference in the UNC4P and VSS scores between the 2 groups.Therewas a significant decline in the UNC4P and VSS total scores over 6 months in both groups(p<0.05)and scores in the 2 groups were comparable after 3 and 6 months(p<0.05).UNC4P scores in the AFCL+PRP group decreased from a mean of 8.26 to 2.61(p<0.05)with a concomitant drop in VSS scores from a mean of 11.74 to 6.06(p<0.01).In the AFCL group UNC4P and VSS scores decreased from 7.68 to 4.63(p<0.05)and from 10.89 to 8.16(p<0.05),respectively.The sub-items of these 2 assessments were analysed and the results suggest that AFCL combined with PRP can comprehensively improve scarring.Conclusions:This study shows that PRP is an effective adjunct for AFCL in the treatment of hypertrophic burn scars and that the combination of PRP and AFCL proved to be more useful than AFCL alone.This combination may be a new and effective clinical practice for the treatment of scars.However,larger and higher-level clinical studies are still needed to determine its efficacy and possible mechanisms.
文摘BACKGROUND： Stress urinary incontinence （SUI） is a relatively common disorder that significantly affects the quality of life. Many conservative and surgical treatment methods have been recommended for SUI, but they have major limitations. AIMS： To assess the use of the CO2 fractional laser in the treatment of SUI. METHODS： This clinical trial included 55 patients with confirmed SUI. Patients underwent fractional CO2 laser treatment 3 times at 30-day intervals. Data on age, smoking history, sexual activity, menopause, and history of hormone replacement therapy （HRT） were collected. Response to treatment was assessed by SUI severity and the level of sexual satisfaction was assessed using the visual analog scale （VAS）. Patients were evaluated at 3 different time points： before treatment, and 45 days and 6 months after the last laser treatment. RESULTS： The mean patient age was 44.4±11.4 years （range： 28 to 68 years）. Smoking history was positive in 6 patients （9.1%）; 19 （54.3%） were menopausal on HRT. The SUI severity score at baseline （before treatment） was 8.56±0.62 and decreased to 2.28 6 months after treatment （p 〈 0.0001）. The sexual satisfaction score was 3 ± 0.94 at baseline and increased to 7.87±0.93 6 months after treatment （day 180） （p 〈 0.0001, slope = ＋ 2.2） CONCLUSION： Our findings are in line with a previous study that showed the value of transvaginal CO2 fractional laser treatment for alleviation of SUI symptoms and its potential as an alternative treatment. We also observed improved sexual satisfaction in SUI patients.
基金support from the Natural Science Foundation of Shanghai Project(19ZR1430200).
文摘Background:Hypertrophic scars are skin fibrotic diseases,characterized by fibroblast hyperprolif-eration and excessive accumulation of extracellular matrix.However,topical drug application for hypertrophic scars are unsatisfactory.The purpose of this study was to explore the permeability of silk nanofiber hydrogels(SNFs)loaded with rhodamine 6G(R6G)and rhodamine 110(R110)mediated by CO_(2)fractional laser irradiation into hypertrophic scar tissues.Methods:In this work,R6G and R110 were chosen as hydrophilic and hydrophobic model molecules.They were loaded inside SNFs.In vivo rabbit ear hypertrophic scars were treated with CO_(2)fractional laser irradiation and then R6G/R110-laden SNFs were applied to the scars to evaluate their synergetic effect on drug penetration efficiency.Their permeability was quantified by fluorescence intensity and measured by confocal laser scanning microscopy on days 1,3,5 and 7.More specifically,the thermal coagulation zone(CZ)and its surrounding area(peri-CZ)caused by the thermal coagulation of the laser were discussed separately.Results:Our data indicated that the SNFs promoted the penetration of R6G but not that of R110 in the peri-CZ on day 1 when combined with laser irradiation.Interestingly,both R6G and R110 were abundant in the CZ and remained stable on days 1,3 and 5.Moreover,rapid re-epithelialization hindered the long-term permeability of both drugs.Conclusion:Combining CO_(2)fractional laser irradiation with SNF drug delivery could improve the efficiency of hydrophilic drug delivery within 24 h before total re-epithelialization.
基金supported by research grants awarded of Chang Gung Memorial Hospital(CMRP 821,CMRPG3E0581)Additional institutional support was received from the National Science Council(NMRPG9002:NSC 89-2314-B-182A-150),Taiwan.
文摘Aim:Transconjunctival CO_(2)laser lower blepharoplasty is considered to be a safe and reliable approach.A retrospective review of transconjunctival approached CO_(2)laser lower blepharoplasty associated with fractional CO_(2)laser ablation or fractioned non-ablative Fraxel laser resurfacing for lower eyelid rejuvenation is presented for comparison.Methods:From February 1996 to February 2016,250 patients underwent CO_(2)laser lower blepharoplasty with a male to female ratio of 1:7.5.The age ranged from 43 to 68 years(mean 52 years).A CO_(2)laser was applied to make a transconjunctival lower blepharoplasty.Immediately after CO_(2)laser lower blepharoplasty,40 patients received fractional CO_(2)laser and 40 patients took Fraxel laser for resurfacing.Results:Swelling occurred in all patients postoperatively.Complications related to transconjunctival CO_(2)laser lower blepharoplasty were 6(2.4%)patients with conjunctival chemosis,5(2.0%)with ecchymosis,and 3(1.2%)with granulomas.The early complications(≤1 month)related to fractional CO_(2)laser ablation were 40(100%)patients with mild erythema,40(100%)with mild edema,1(2.5%)with hyperpigmentation,1(2.5%)with infection,and 1(2.5%)with scarring.These problems resolved in all patients after 3 months.There was no complication after Fraxel laser right after lower blepharoplasty.The Fraxel group had short recovery time.However,there was no statistically significant difference between the two groups in final outcome(≥6 months).Conclusion:Transconjunctival CO_(2)laser lower blepharoplasty associated with fractional CO_(2)laser ablation or Fraxel laser resurfacing assisted the appearance around the periorbital regions.
基金supported by Shanghai Municipal Education Commission Gaofeng Clinical Medicine Grant Support(20152227)The national natural science foundation of China(81772098)Scientific research foundation of Shanghai Municipal Commission of Health and Family Planning(20154Y0023).
文摘Background:Fractional CO_(2) laser plays an important role in scar management post split-thickness skin graft by loosening the graft contracture and restoring the smoothness of the surface.However,the optimal treatment protocol remains unknown.This study applied a dual-scan protocol to achieve both releasing and ablation of contracted skin graft.We comprehensively describe this treatment method and compare the efficacy and safety between this dual-scan method and the conventional mono-scan mode.Methods:A hypercontracted scar model after split-thickness skin grafting in red Duroc pigs was established.All scars meeting the inclusion criteria were randomly divided into four groups:high fluence–low density(HF–LD),low fluence–high density(LF–HD),combined group and control group.The energy per unit areawas similar in the HF–LD and LF–HD groups.Two laser interventions were performed at a 6-week interval.The efficacy of the treatment was evaluated by objective measures of scar area,release rate,elasticity,thickness and flatness,while the safetywas evaluated based on adverse reactions and melanin index.Collagen structurewas observed histologically.The animals were followed up for a maximum of 126 days after modeling.Results:A total of 28 contracted scars were included,7 in each group.At 18 weeks postoperatively,the HF–LD and the combined groups showed significantly increased scar release rate(p=0.000)and elasticity(p=0.036)and decreased type I/III collagen ratio(p=0.002)compared with the control and LF–HD groups.In terms of flatness,the combined group was significantly better than the HF–LD group for elevations<1mm(p=0.019).No significant skin side effects,pigmentation or scar thickness changes were observed at 18 weeks.Conclusions:Dual-scan protocol could achieve superficial ablation and deep release of contracted split-thickness skin graft in a single treatment,with similar contraction release and texture improvement compared to a single deep scan.Its main advantage is to restore a smoother scar appearance.Adequate laser penetration was necessary for the release of contracted scars.
