Endoscopic anti-reflux treatment is emerging as a new option for gastroesophageal reflux disease(GERD)treatment in patients with the same indications as for laparoscopic fundoplication.There are many techniques,the fi...Endoscopic anti-reflux treatment is emerging as a new option for gastroesophageal reflux disease(GERD)treatment in patients with the same indications as for laparoscopic fundoplication.There are many techniques,the first of which are transoral incisionless fundoplication(TIF)and nonablative radio-frequency(STRETTA)that have been tested with comparative studies and randomized controlled trials,whereas the other more recent ones still require a deeper evaluation.The purpose of the latter is to verify whether reflux is abolished or significantly reduced after intervention,whether there is a valid high pressure zone at the gastroesophageal junction,and whether esophagitis,when present,has disappeared.Unfortunately in a certain number of cases,and especially in the more recently introduced ones,the evaluation has been based almost exclusively on subjective criteria,such as improvement in the quality of life,remission of heartburn and regurgitation,and reduction or suspension of antacid and antisecretory drug consumption.However,with the most studied techniques such as TIF and STRETTA,an improvement in symptoms better than that of laparoscopic fundoplication can often be observed,whereas the number of acid episodes and acid exposure time are similar or higher,as if the acid refluxes are better tolerated by these patients.The suspicion of a local hyposensitivity taking place after antireflux endoscopic intervention seems confirmed by a Bernstein test at least for STRETTA.This examination should be done for all the other techniques,both old and new,to identify the ones that reassure rather than cure.In conclusion,the evaluation of the effectiveness of the endoscopic anti-reflux techniques should not be based exclusively on subjective criteria,but should also be confirmed by objective examinations,because there might be a gap between the improvement in symptoms declared by the patient and the underlying pathophysiologic alterations of GERD.展开更多
Photodynamic therapy (PDT) shows great efficacy and high tolerability for the treatment of non-melanoma skin cancer (actinic keratosis, basal cell carcinoma, Bowen’s disease) especially in patients with large and mul...Photodynamic therapy (PDT) shows great efficacy and high tolerability for the treatment of non-melanoma skin cancer (actinic keratosis, basal cell carcinoma, Bowen’s disease) especially in patients with large and multiple lesions, in poor-healing sites and patients immunosuppressed or with co-morbidities. Besides, more recently, PDT has been used, widely and with great success, for many off-label diseases and in cosmetic dermatology, especially on photorejuvenation, therefore further and larger prospective studies with long-term follow-up are required to verify its efficacy and safety in treating these condition. The treatment of ageing skin remains a very hot topic, and many systems have been reported as having varying degrees of success. Nowadays our experience and literature data show how topical PDT can be considered a new non-invasive device for the treatment o photoaging skin with no/minimal side effects and able to bridge the world of medical and cosmetic dermatologic surgery.展开更多
Femtosecond laser ablation-driven periodic surface structuring offers a promising method for large-scale and high-throughput nanolithography technique.However,the self-organized periodic structures typically manifest ...Femtosecond laser ablation-driven periodic surface structuring offers a promising method for large-scale and high-throughput nanolithography technique.However,the self-organized periodic structures typically manifest constraints in terms of tunable period and depth,as well as suboptimal regularity,which restricts their broader application potential.Here,in terms of a rarely explored laser-induced photochemical mechanism for nonablative structuring,we demonstrate manufacturing of sub-wavelength oxidative grating structures on silicon films with active structural modulation.In this scenario,the plasmonic field plays a pivotal role in dragging oxygen ions from surface into the silicon,greatly speeding up oxidation rates.While high oxygen doping levels can already be achieved with single-pulse exposure,far superior results are obtained with the application of 40-MHz burst mode pulse trains,mitigating the formation of excessively large nanocrystallites.Furthermore,it is revealed that the periodicity and modulation depth of laser-writing nanograting are both dependent on the number of pulse per burst.This offers a convenient scheme for actively controlling laser plasmonic lithography.展开更多
文摘Endoscopic anti-reflux treatment is emerging as a new option for gastroesophageal reflux disease(GERD)treatment in patients with the same indications as for laparoscopic fundoplication.There are many techniques,the first of which are transoral incisionless fundoplication(TIF)and nonablative radio-frequency(STRETTA)that have been tested with comparative studies and randomized controlled trials,whereas the other more recent ones still require a deeper evaluation.The purpose of the latter is to verify whether reflux is abolished or significantly reduced after intervention,whether there is a valid high pressure zone at the gastroesophageal junction,and whether esophagitis,when present,has disappeared.Unfortunately in a certain number of cases,and especially in the more recently introduced ones,the evaluation has been based almost exclusively on subjective criteria,such as improvement in the quality of life,remission of heartburn and regurgitation,and reduction or suspension of antacid and antisecretory drug consumption.However,with the most studied techniques such as TIF and STRETTA,an improvement in symptoms better than that of laparoscopic fundoplication can often be observed,whereas the number of acid episodes and acid exposure time are similar or higher,as if the acid refluxes are better tolerated by these patients.The suspicion of a local hyposensitivity taking place after antireflux endoscopic intervention seems confirmed by a Bernstein test at least for STRETTA.This examination should be done for all the other techniques,both old and new,to identify the ones that reassure rather than cure.In conclusion,the evaluation of the effectiveness of the endoscopic anti-reflux techniques should not be based exclusively on subjective criteria,but should also be confirmed by objective examinations,because there might be a gap between the improvement in symptoms declared by the patient and the underlying pathophysiologic alterations of GERD.
文摘Photodynamic therapy (PDT) shows great efficacy and high tolerability for the treatment of non-melanoma skin cancer (actinic keratosis, basal cell carcinoma, Bowen’s disease) especially in patients with large and multiple lesions, in poor-healing sites and patients immunosuppressed or with co-morbidities. Besides, more recently, PDT has been used, widely and with great success, for many off-label diseases and in cosmetic dermatology, especially on photorejuvenation, therefore further and larger prospective studies with long-term follow-up are required to verify its efficacy and safety in treating these condition. The treatment of ageing skin remains a very hot topic, and many systems have been reported as having varying degrees of success. Nowadays our experience and literature data show how topical PDT can be considered a new non-invasive device for the treatment o photoaging skin with no/minimal side effects and able to bridge the world of medical and cosmetic dermatologic surgery.
基金supported by the National Natural Science Foundation of China(12474317 and 62105269).
文摘Femtosecond laser ablation-driven periodic surface structuring offers a promising method for large-scale and high-throughput nanolithography technique.However,the self-organized periodic structures typically manifest constraints in terms of tunable period and depth,as well as suboptimal regularity,which restricts their broader application potential.Here,in terms of a rarely explored laser-induced photochemical mechanism for nonablative structuring,we demonstrate manufacturing of sub-wavelength oxidative grating structures on silicon films with active structural modulation.In this scenario,the plasmonic field plays a pivotal role in dragging oxygen ions from surface into the silicon,greatly speeding up oxidation rates.While high oxygen doping levels can already be achieved with single-pulse exposure,far superior results are obtained with the application of 40-MHz burst mode pulse trains,mitigating the formation of excessively large nanocrystallites.Furthermore,it is revealed that the periodicity and modulation depth of laser-writing nanograting are both dependent on the number of pulse per burst.This offers a convenient scheme for actively controlling laser plasmonic lithography.
