Online electrochemistry coupling liquid chromatography-mass spectrometry for rapid investigation on the phase I and phase II simulated metabolic reactions of flavonoids.

In this study, an online electrochemistry coupling high-performance liquid chromatography-mass spectrometry (EC-HPLC-MS) technology has been developed for simulating metabolic reactions and rapid analysis of metabolites of flavone, quercetin, and rutin, which are not only widely present compounds with pharmacological activity in nature, but also have structural similarity and variability. The simulated metabolic processes of the substrates (phase I and phase II metabolism) were implemented on the surface of glassy carbon electrode (GCE) by using different electrochemical methods. After online chromatographic separation, the products were transmitted to a mass spectrometer for detection, in order to speculate relevant reaction pathways and structural information of the reaction product. The main metabolites, including methylation, hydroxylation, hydrolysis, and conjugation reaction products, had been successfully identified through the designed in situ hyphenated technique. Furthermore, compared with metabolites produced by in vitro incubation of rat liver microsomes, it was found that the products of electrochemical simulated metabolism were more abundant with diverse metabolic pathways. The results indicated that the proposed method exhibited advantages in the sample pretreatment process and detection cycle without compromising the reliability and accuracy of the results.

COVID-19 pandemic: study on simple, easy, and practical relaxation techniques while wearing medical protective equipment.

BACKGROUND: No studies have reported on how to relieve distress or relax in medical health workers while wearing medical protective equipment in coronavirus disease 2019 (COVID-19) pandemic. The study aimed to establish which relaxation technique, among six, is the most feasible in first-line medical health workers wearing medical protective equipment. METHODS: This was a two-step study collecting data with online surveys. Step 1: 15 first-line medical health workers were trained to use six different relaxation techniques and reported the two most feasible techniques while wearing medical protective equipment. Step 2: the most two feasible relaxation techniques revealed by step 1 were quantitatively tested in a sample of 65 medical health workers in terms of efficacy, no space limitation, no time limitation, no body position requirement, no environment limitation to be done, easiness to learn, simplicity, convenience, practicality, and acceptance. RESULTS: Kegel exercise and autogenic relaxation were the most feasible techniques according to step 1. In step 2, Kegel exercise outperformed autogenic relaxation on all the 10 dimensions among the 65 participants while wearing medical protective equipment (efficacy: 24 v. 15, no space limitation: 30 v. 4, no time limitation: 31 v. 4, no body position requirement: 26 v. 4, no environment limitation: 30 v. 11, easiness to learn: 28 v. 5, simplicity: 29 v. 7, convenience: 29 v. 4, practicality: 30 v. 14, acceptance: 32 v. 6). CONCLUSION: Kegel exercise seems a promising self-relaxation technique for first-line medical health workers while wearing medical protective equipment among COVID-19 pandemic.

Post-COVID-19 Epidemic: Allostatic Load among Medical and Nonmedical Workers in China.

BACKGROUND: As the fight against the COVID-19 epidemic continues, medical workers may have allostatic load. OBJECTIVE: During the reopening of society, medical and nonmedical workers were compared in terms of allostatic load. METHODS: An online study was performed; 3,590 Chinese subjects were analyzed. Socio-demographic variables, allostatic load, stress, abnormal illness behavior, global well-being, mental status, and social support were assessed. RESULTS: There was no difference in allostatic load in medical workers compared to nonmedical workers (15.8 vs. 17.8%; p = 0.22). Multivariate conditional logistic regression revealed that anxiety (OR = 1.24; 95% CI 1.18-1.31; p < 0.01), depression (OR = 1.23; 95% CI 1.17-1.29; p < 0.01), somatization (OR = 1.20; 95% CI 1.14-1.25; p < 0.01), hostility (OR = 1.24; 95% CI 1.18-1.30; p < 0.01), and abnormal illness behavior (OR = 1.49; 95% CI 1.34-1.66; p < 0.01) were positively associated with allostatic load, while objective support (OR = 0.84; 95% CI 0.78-0.89; p < 0.01), subjective support (OR = 0.84; 95% CI 0.80-0.88; p < 0.01), utilization of support (OR = 0.80; 95% CI 0.72-0.88; p < 0.01), social support (OR = 0.90; 95% CI 0.87-0.93; p < 0.01), and global well-being (OR = 0.30; 95% CI 0.22-0.41; p < 0.01) were negatively associated. CONCLUSIONS: In the post-COVID-19 epidemic time, medical and nonmedical workers had similar allostatic load. Psychological distress and abnormal illness behavior were risk factors for it, while social support could relieve it.

Analysis of reflux as the aetiology of laryngeal dysplasia progression through a matched case-control study.

OBJECTIVES: Laryngeal dysplasia (LD) is a precancerous lesion of the larynx. In this study, the laryngeal tissue of patients with laryngeal dysplasia was taken as the research object, and the aetiology of reflux was analysed. METHOD: Patients with laryngeal dysplasia after surgery were selected as our subjects. The levels of pepsin, enterokinase and bilirubin in laryngeal tissue samples of the two groups were detected by immunohistochemical method. RESULTS: The OR values (95% CI) of pepsin, enterokinase and bilirubin were 0.67 (0.19-2.36), 0.80 (0.22-2.98) and 1.33 (0.30-5.96), respectively, in the univariate analysis. Besides, in the multivariate analysis, the OR values (95% CI) of pepsin, enterokinase and bilirubin were 0.57 (0.14-2.30), 0.73 (0.18-2.92) and 1.40 (0.30-6.53), respectively. CONCLUSION: Larger sample size should be applied to prospective studies on whether reflux is a risk factor for laryngeal cancer.

[Genotype and phenotype studies on fetuses of 22q11.2 deletion syndrome].

OBJECTIVE: To study the genotype and phenotype of fetuses with 22q11.2 microdeletion and other abnormalities such as cardiac malformation and cleft palate. METHODS: Fetal ultrasound was carried out at 12 weeks to 20 to 24 weeks of gestation. After excluding the chromosomal karyotype abnormality, single nucleotide polymorphism (SNP) array was used to detect copy number variations of 5 fetuses with heart development abnormality or other structural abnormalities. The fetus with 22q11.2 microdeletion and its parents were also subjected to multiplex ligation-dependent probe amplification (MLPA) assay. RESULTS: SNP array analysis showed that the 5 fetuses had all carried a 2.27-3.02 Mb deletion of the 22q11.2 region. MLPA assay confirmed that LCR22-A-B was involved in all cases, and that all deletions were de novo in origin. CONCLUSION: It is of great significance to exclude 22q11.2 microdeletions in fetuses with cardiac malformations. The deletion regions of these fetuses are similar but different, and the phenotypic difference is related to their genotypes.

Photoelectrochemical aptasensor for lead(II) by exploiting the CdS nanoparticle-assisted photoactivity of TiO2 nanoparticles and by using the quercetin-copper(II) complex as the DNA intercalator.

A photoelectrochemical (PEC) aptasensor for Pb(II) detection is described. A nanocomposite consisting of CdS (2.5 µm) and TiO2 nanoparticles (10 nm) was used as a photoactive material, and gold nanochains (Au NCs) as the support for immobilization of the Pb(II)-binding aptamer. The quercetin-copper(II) complex was further employed as the intercalator for the improvement of the photoactivity by embedding it into dsDNA. In the presence of Pb(II), a Pb(II)-stabilized G-quadruplex was formed between Pb(II) and DNA S1. This is accompanied by unwinding of the dsDNA and the release of the quercetin-copper(II) complex from the surface of the sensor. This results in a decrease of the photocurrent that drops linearly from 5.0 × 10-12 to 1.0 × 10-8 mol·L-1 Pb(II) concentration range with a detection limit of 1.6 × 10-12 mol·L-1. The method was applied to the determination of Pb(II) in various samples and gave satisfactory results. Graphical abstractA photoelectrochemical aptasensor was fabricated for the detection of Pb(II) based on CdS-TiO2 nanocomposite modified indium tin oxide (ITO) electrode. Gold nanochains (AuNCs) were used as anchor to immobilize the aptamers S1 and S2 that form a double helix structure by DNA hybridization. After embedding of quercetin-copper(II) complex as intercalator and electron donor, the concentrations of Pb(II) were determined by the changes of photocurrents.

Voltammetric sensing performances of a carbon ionic liquid electrode modified with black phosphorene and hemin.

A black phosphorene (BPE) and poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS) hybrid was used for the immobilization of hemin on a carbon ionic liquid electrode (CILE). BPE inside the PEDOT:PSS film was stable without adverse effects of water and oxygen. The hemin-modified electrode facilitates electrochemical communication with a couple of well-shaped and enhanced redox waves. Therefore BPE exhibits an accelerating function to the electron movement. This sensor exhibits excellent electrocatalytic effects on the reduction of various substrates including trichloroacetic acid (TCA), nitrite and H2O2. As for TCA, the reduction current at -0.36 V (vs. Ag/AgCl) increases linearly in the concentration range from 2.0 to 180 mmol·L-1 with a detection limit of 0.67 mmol·L-1 (at 3σ). As for nitrite, the reduction current at -0.59 Vis linear in the 1.0 to 10.5 mmol·L-1 concentration range, and the detection limit is 0.33 mmol·L-1 (at 3σ). As for H2O2, the reduction current at -0.033 V (vs. Ag/AgCl) is linear in the concentration range from 4.0 to 35.0 mmol·L-1 and the detection limit is 1.3 mmol·L-1 (at 3σ). The real sample was analyzed with satisfactory results, which indicated that BPE had potential applications in the field of electrochemical biosensor. Graphical abstract Photos of (a) black phosphorene (BPE) solution, (b) poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS), (c) BPE-PEDOT:PSS (1:5) dispersion, and the fabrication procedure of this electrochemical sensor. It was applied to the determination of trichloroacetic acid, nitrite and hydrogen peroxide.

A biomass-derived porous carbon-based nanocomposite for voltammetric determination of quercetin.

Porous carbon was prepared from wheat flour by alkali treatment and carbonization. The resulting biomass-derived porous carbon (BPC) was employed to prepare a Pt-Au-BPC nanocomposite by a hydrothermal method. The material was then placed on the surface of a carbon ionic liquid electrode (CILE). The Pt-Au-BPC was characterized by SEM, XPS, and the modified CILE by electrochemical methods. They revealed a porous structure, a large specific surface with high conductivity. Pt-Au-BPC/CILE was applied to the sensitive determination of quercetin. Electrochemical response was studied by cyclic voltammetry and differential pulse voltammetry (DPV). Under optimized experimental conditions, the oxidation peak current (measured at 0.48 V vs. Ag/AgCl by DPV) increases linearly in the 0.15 to 6.0 µM and in the 10.0 to 25.0 µM quercetin concentration range. The detection limit is 50.0 nM (at 3σ). The Pt-Au-BPC/CILE was applied to the direct determination of quercetin in ginkgo tablets sample and gave satisfactory results. Graphical abstract A Pt-Au-BPC nanocomposite modified carbon ionic liquid electrode was applied to differential pulse voltammetric determination of quercetin. BPC: biomass-derived porous carbon.

Sol-Gel Preparation of Laser Damage Resistant and Moisture-Proof Antireflective Coatings for KDP Crystals.

Surface fogging induced degradation has been a bottleneck problem in potassium dihydrogen phosphate (KDP) crystals due to they are grown from aqueous solution. In this paper, we developed a facile method to prepare a double-layer antireflective coating with moisture-proof and laser damage resistant properties for KDP crystals. The bottom layer was a poly siloxane coating with dense structure and silanol side groups, while the top layer was a hexamethyl-disilazane (HMDS) modified nanoporous SiO2 coating. Both of the sols were nonalkaline and nonaqueous to make sure those are harmless to KDP crystals. The double-layer coated KDP crystal exhibited a maximum transmittance of 99.9% with an average increase of transmitted light of 6-7% over the wavelength range between 351 and 1053 nm. After exposure in a 55% relative humidity environment for 6 months, the double-layer HMDS_SiO2/PS coating coated KDP crystal displayed nearly the same optical transmittance as the original one, whereas the single-layer HMDS_SiO2 coated KDP crystal had a transmittance loss of ∼5%. Moreover, the laser-induced damage threshold of the double-layer coating on KDP crystal reached 11.5 J/cm2 (355 nm, 3 ns). This multifunctional antireflective coating not only can be used for KDP crystals, but also can be applied to thermal-sensitive polymeric substrates.

Penicilindoles A-C, Cytotoxic Indole Diterpenes from the Mangrove-Derived Fungus Eupenicillium sp. HJ002.

Three new indole diterpenes, penicilindoles A-C (1-3), were isolated from the mangrove-derived fungus Eupenicillium sp. HJ002. Their planar structures and absolute configurations were determined by interpretation of NMR spectroscopic data, HR-ESIMS, and X-ray diffraction analysis using Cu Kα radiation. The cytotoxic and antibacterial activities were evaluated in vitro; penicilindole A (1) showed cytotoxic activity against human A549 and HepG2 cell lines with IC50 values of 5.5 and 1.5 µM, respectively.

A novel endoscopic surgery for dysphagia after stroke.

BACKGROUND: Dysphagia is a common complication in stroke patients, which severely affects quality of life. This study aimed to evaluate the effectiveness and safety of temperature-controlled plasma radiofrequency (coblation)-assisted endoscopic cricopharyngeal myotomy (CAECPM) for the treatment sustained (>6 months) dysphagia in stroke patients. METHODS: This retrospective case-control study included a total of 24 stroke patients with sustained dysphagia, who were either treated with transcervical cricopharyngeal myotomy (CPM) (n = 16) or CAECPM (n = 12). The patients' swallowing function was evaluated by the Chinese version of the swallow quality-of-life questionnaire (CSWAL-QOL), and dysphagia and aspiration was evaluated using the videofluoroscopic swallowing study (VFSS) swallowing (VFSS-SWAL) score and VSSF aspiration (VFSS-ASPI) score. In each patient, esophageal pressure and complications were also recorded. RESULTS: The CSWAL-QOL score was increased and the VFSS-SWAL and VFSS-ASPI scores were reduced after CAECPM treatment. The upper esophageal sphincter pressure was significantly reduced after CAECPM. Only 1 of 12 (8.3%) patients had subcutaneous and mediastinal emphysema, and 2 patients had gastric regurgitation. CONCLUSION: This exploratory study demonstrates that CAECPM is worth further investigation for dysphagia after stroke. CAECPM may be an effective and safe treatment for sustained dysphagia in stroke patients. Larges and prospective studies are required to validate these results.

Gold Nanocage-Based Electrochemical Sensing Platform for Sensitive Detection of Luteolin.

A simple and sensitive electrochemical sensor was developed for the detection of tracelevels of luteolin. The sensoris based on a novel type of chemically modified electrode: gold nanocage (AuNCs)-modified carbon ionic liquid electrode (CILE). To construct this electrochemical sensing platform for luteolin, CILE is initially prepared by using 1-hexylpyridinium hexafluorophosphate as the binder and then AuNCs are coated on the surface of CILE to fabricate AuNCs-modified CILE (AuNCs/CILE). Electrochemical studies have shown that AuNCs/CILE can exhibit enhanced electrocatalytic activity toward the redox reaction of luteolin, therefore, the redox peak current of luteolin can be greatly improved, resulting in the high sensitivity of the developed sensor. Under the optimal conditions, the oxidation peak currents of the sensor increase linearly with an increase in the luteolin concentration in a range from 1 to 1000 nM with a detection limit of 0.4 nM, which is lower than those of most reported electrochemical luteolin sensors. Moreover, the reproducibility, precision, selectivity, and stability of this sensor are excellent. Finally, the sensing system was applied to the analysis of luteolin-spiked drug samples and the recovery in all cases was 95.0⁻96.7%, indicating the potential application of this simple, facile, and sensitive sensing system in pharmaceutical analysis.

Dihydroisocoumarins from the Mangrove-Derived Fungus Penicillium citrinum.

Three new dihydroisocoumarin penicimarins G-I (1-3), together with one known dihydroisocoumarin (4) and three known meroterpenoids (5-7), were obtained from a fungus Penicillium citrinum isolated from the mangrove Bruguiera sexangula var. rhynchopetala collected in the South China Sea. Their structures were elucidated by the detailed analysis of spectroscopic data. The absolute configuration of 1 was determined by the X-ray diffraction analysis using Cu Kα radiation. The absolute configurations of 2 and 3 were determined by comparison of their circular dichroism (CD) spectra with the literature. All compounds were evaluated for their antibacterial activities and cytotoxic activities.

Wuzi Yanzong pill, a Chinese polyherbal formula, alleviates testicular damage in mice induced by ionizing radiation.

BACKGROUND: Chinese medicine Wuzi Yanzong pill (WZYZP) was firstly documented in ancient Chinese medical works "She Sheng Zhong Miao Fang" by Shi-Che Zhang in 1550 AD. The traditional herbal formula is widely used in treating nephrasthenia lumbago, prospermia, erectile dysfunction and male sterility. The present study was to explore the effects of WZYZP on ionizing irradiation-induced testicular damage in mice. METHODS: The pelvic region of male mice was exposed to X-rays for inducing testicular damage. The effects of WZYZP on testicular damage were evaluated in terms of testes weight, sperm quantity and motility, testes oxidative status and serum hormone levels. The alterations in testicular structure were examined by hematoxylin-eosin staining. Additionally, changes in proliferating cell nuclear antigen (PCNA) expression of testes were explored by western blot. RESULTS: Pelvic exposure to x-ray induced reduction in testes weight and sperm quality, along with oxidative stress and abnormal testicular architecture in testes. Oral administration of WZYZP for 3 weeks markedly increased testes weight, sperm quantity and motility, and attenuated testicular architecture damage. Meanwhile, WZYZP treatment significantly reversed the reduction of serum testosterone, and decreased testes malondialdehyde (MDA) and Oxidative stress index (OSI) relative to the radiated mice. Additionally, WZYZP effectively prevented the downregulation of PCNA expression in testes induced by x-ray irradiation. CONCLUSION: These findings suggest WZYZP exhibits ameliorating effects against ionizing irradiation-induced testicular damage in mice, which may be related to its antioxidation.

[Effect of Scalp Penetration Acupuncture on the Expression of NGF in Brain Tissue around Hematoma of Intracerebral Hemorrhage Rats].

Objective To observe the effects of scalp penetration acupuncture on the expression of nerve growth factor (NGF) in brain tissue around hematoma of intracerebral hemorrhage rats. Methods To- tally 120 healthy male Wistar rats were divided into the sham-operation group, the model group, the acupunc- ture group by random digit table, 40 in each group. Rats in each group were further randomly divided into 4 time points, i.e., 6 h, 24 h, day 3, day 7. The intracerebral hemorrhage rat model was prepared by modified autologous arterial blood method, intervened by electroacupuncture (EA) at Baihui (DU20) through Taiyang (EX- HN5). Neuroethological assessment was conducted by Longa score. The expression of NGF positive cells in brain tissue around hematoma was detected using immunohistochemical method. The amount of NGF mRNA expression was measured by q-PCR. Results Compared with the sham-operation group, neurobehavioral scores increased, NGF positive cells increased, NGF mRNA expression increased in the model group at each time point, with statistical difference shown (P <0.05). Compared with the model group, 6 h neurobehavioral scores,NGF positive cells, mRNA expression of NGF did not change significantly in the acupuncture group, with no statistical difference shown (P > 0. 05). Neuroethological scores decreased, NGF positive cells increased, mRNA expression of NGF was up-regulated in the acupuncture group at 24 h, day 3 and 7, respec- tively, with statistical difference shown (P <0. 05). Conclusion scalp penetration acupuncture could up-regulate gene and protein expressions of NGF, and promote recovery of nerve function, showing favorable neuro-protective effects.

Boosting photocatalytic performance of polymeric carbon nitride by adjusting its donor-acceptor structure via functional group modification strategy.

Solar-driven photodegradation of pollutant is attractive for environmental remediation. Herein, we designed and synthetized a new kind of group-modified polymeric carbon nitride (PCN) photocatalyst with urea and 4-Nitro-o-phenylenediamine by one-pot method and applied to degrade bisphenol A (BPA) in aqueous solution. The light response range of photocatalyst had been extended a lot due to conjugation and electron-withdrawing properties of nitrobenzene. Physical analysis shows that 4-Nitro-o-phenylenediamine grafting brings an improved charge separation capacity. EPR and DFT results demonstrate the charge separation is significantly affected by the donor-acceptor structure of PCN, which can be altered via aromatic electron-withdrawing group. The kinetic constant of photocatalytic degradation for BPA was promoted by 8.8-times greater than unmodified PCN and a good recyclability was achieved. To verify the universality of group modification strategies, we prepared other two kinds of photocatalysts via electron-withdrawing group modification strategy and their photocatalytic performance all had been improved obviously.

Transoral Endoscopic Excision of Laryngeal Schwannoma.

OBJECTIVE: Schwannomas originating within the larynx are rare and there is no clear consensus on the diagnostic workup or treatment. This study aims to explore the clinical features of laryngeal schwannoma and evaluate the surgical method of transoral endoscopic excision, especially with coblation. METHODS: Data from patients diagnosed with laryngeal schwannoma who underwent surgery at Peking Union Medical College Hospital from 2017 to 2022 were retrospectively analyzed. All cases were evaluated with a flexible laryngoscope and computed tomography and/or magnetic resonance imaging before surgery. RESULTS: Four patients, comprising one male and three females aged 19 to 61years, were included. All patients presented with persistent and progressive hoarseness, and two also experienced dyspnea on exertion. One patient was a recurrent case who underwent transoral tumor resection with a laser, while another patient had received a transoral incisional biopsy before visiting our hospital. Transoral excision was performed in each case. One tumor was excised using microlaryngeal instruments under a microscope, and the other three with coblation assisted by an operating laryngoscope. All laryngeal schwannomas were removed in a single block. All patients were successfully extubated following surgery, recovered without complications, and showed no evidence of recurrence. CONCLUSION: Transoral surgery better preserves laryngeal function, reduces complications, and shortens hospital stays. Transoral endoscopic excision, particularly when performed with coblation, is highly recommended for its excellent visualization and ability to completely excise the tumor. This method is a safe and effective approach, especially for large laryngeal schwannomas in hard-to-reach locations.

Cross-modal attention network for retinal disease classification based on multi-modal images.

Multi-modal eye disease screening improves diagnostic accuracy by providing lesion information from different sources. However, existing multi-modal automatic diagnosis methods tend to focus on the specificity of modalities and ignore the spatial correlation of images. This paper proposes a novel cross-modal retinal disease diagnosis network (CRD-Net) that digs out the relevant features from modal images aided for multiple retinal disease diagnosis. Specifically, our model introduces a cross-modal attention (CMA) module to query and adaptively pay attention to the relevant features of the lesion in the different modal images. In addition, we also propose multiple loss functions to fuse features with modality correlation and train a multi-modal retinal image classification network to achieve a more accurate diagnosis. Experimental evaluation on three publicly available datasets shows that our CRD-Net outperforms existing single-modal and multi-modal methods, demonstrating its superior performance.

Effect of silver sulfadiazine on mature mixed bacterial biofilms on voice prostheses.

BACKGROUND: Biofilm formation on voice prostheses disrupts the function and limits the lifespan of voice prostheses. There is still no effective clinical strategy for inhibiting or removing these biofilms. Silver sulfadiazine (SSD), as an exogenous antibacterial agent, has been widely used in the prevention and treatment of infection, however, its effect on voice prosthesis biofilms is unknown. The purpose of this study was to explore the effect of SSD on the mature mixed bacterial biofilms present on voice prostheses. METHODS: Quantitative and qualitative methods, including the plate counting method, real-time fluorescence quantitative PCR, crystal violet staining, the 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) (XTT) reduction assay, scanning electron microscopy, and laser confocal microscopy, were used to determine the effect of SSD on the number of bacterial colonies, biofilm formation ability, metabolic activity, and ultrastructure of biofilms in a mature mixed bacterial (Staphylococcus aureus, Streptococcus faecalis and Candida albicans) voice prosthesis biofilm model. The results were verified in vitro on mature mixed bacterial voice prosthesis biofilms from patients, and the possible mechanism of action was explored. RESULTS: Silver sulfadiazine decreased the number of bacterial colonies on mature mixed bacterial voice prosthesis biofilm, significantly inhibited the biofilm formation ability and metabolic activity of mature voice prosthesis biofilms, inhibited the formation of the complex spatial structure of voice prosthesis biofilms, and inhibited the synthesis of polysaccharides and proteins in the biofilm extracellular matrix. The degree of inhibition and removal effect increased with SSD concentration. CONCLUSIONS: Silver sulfadiazine can effectively inhibit and remove mature mixed bacterial voice prosthesis biofilms and decrease biofilm formation ability and metabolic activity; SSD may exert these effects by inhibiting the synthesis of polysaccharides and proteins among the extracellular polymeric substances of voice prosthesis biofilms.

Efficacy and safety of microneedling, fractional CO2 laser, and cryotherapy combined with 5-aminolevulinic acid photodynamic therapy in the treatment of actinic keratosis: A multicenter prospective randomized controlled study.

BACKGROUND: Photodynamic therapy (PDT) for actinic keratosis (AK) is limited by the depth of treatment. Microneedling or fractional CO2 laser can facilitate the penetration of photosensitizer, while cryotherapy can treat deeper tissues but is not suitable for field cancerization. OBJECTIVE: To investigate the efficacy of microneedling, fractional CO2 laser, and cryotherapy in combination with PDT for AK. METHODS: Patients with AK were randomized into 4 groups, including group A with microneedling + PDT, group B with fractional CO2 laser + PDT, group C with cryotherapy + PDT, and group D with PDT. After 12 weeks, the clinical, dermoscopic, and reflectance confocal microscopy (RCM) outcomes were assessed. RESULTS: A total of 129 patients were included in this study, with 31, 30, 35, and 31 patients in each group, yielding clinical response rates of 90.3%, 93.3%, 97.1%, and 74.2%, respectively (P=0.026). The RCM response rates were 71.0%, 80.0%, 85.7%, and 54.8%, respectively (P=0.030). The dermoscopic response rates were 77.4%, 83.3%, 88.6%, and 60.0%, respectively (P=0.039). Group C showed the best efficacy in terms of clinical, dermoscopic, and RCM outcomes. CONCLUSIONS: All three treatments improved the efficacy of PDT and were well tolerated, with cryotherapy + PDT showing the best efficacy.