Treatment of vitiligo with 308-nm excimer laser: our experience from a 2-year follow-up of 979 Chinese patients.

BACKGROUND: The 308-nm excimer laser had been proved to be a time-efficient and potent therapeutic alternative for the management of vitiligo. Different results had been reported in different ethnic populations. OBJECTIVE: To investigate the efficacy and related contributing factors of 308-nm excimer laser in Chinese vitiligo patients. METHODS: A total of 979 Chinese patients (3478 lesions) with progressive-stage vitiligo who had received 308-nm excimer laser treatment were recruited from the vitiligo clinic of Shandong Provincial Hospital of Dermatology &Venereology from 2012 to 2014. Efficacy of treatment was evaluated at the end of session by two independent dermatologists based on the before and after images taken. Repigmentation was graded on a 4-point scale: grade 1, poor repigmentation (0-25%); grade 2, moderate repigmentation (26-50%); grade 3, good repigmentation (51-75%); grade 4, excellent repigmentation (76-100%). RESULTS: The mean grade of repigmentation was 2.29, 44.22% showed less than 25% repigmentation, 16.27% showed 26-50% repigmentation, 5.95% showed 51-75% repigmentation and 33.55% showed more than 76% repigmentation. The repigmentation of facial lesions was better than lesions located elsewhere (P < 0.0001), the best response was noted in the periorbital region, while lesions on hands and feet showed poor repigmentation (P < 0.0001). The degree of repigmentation was negatively correlated with disease duration (r = -0.268, P < 0.001), age (r = -0.095, P < 0.001) and shape of lesions (r = -0.114, P < 0.001), whereas it was positively correlated with treatment frequency (r = 0.270, P < 0.001). Lesions with concurrent poliosis were more likely resistant to treatments. CONCLUSION: 308-nm excimer laser appears to be an effective and safe treatment in Chinese vitiligo patients. The clinical response and treatment efficacy was affected by many factors such as age, affected anatomical area, shape of the lesion, disease duration and treatment frequencies.

[Clinicopathological study of combined preoperative radiotherapy with intracavitary hyperthermia in rectal cancer].

118 specimens of rectal cancer were studied pathologically. 40 cases were treated by both preoperative radiotherapy and intracavitary hyperthermia (group 1), 38 treated by preoperative radiotherapy alone (group 2) and 40 by operation alone (group 3). The tumor disappearance rates by gross observation were 57.5% and 5.3% in groups 1 and 2 (P less than 0.001). The moderate to severe damage of cancer cells (X2-X4) was observed in 90% of cases in group 1 and 31.6% in group 2 (P less than 0.05). In the former, the cancer cell disappearance was observed in 8 cases, while in the latter, only 1 case. The cell degenerations by 30 Gy plus hyperthermia were similar to those by 40 Gy plus hyperthermia, but both were more marked than by 30 Gy alone or 40 Gy alone (P less than 0.05). The lymphocyte, plasma cell infiltration and hyperplasia of fibrous tissue around the tumor in group 1 were more marked than those in groups 2 and 3 (P less than 0.05). The thrombosis around the tumor was more in group 1 than in group 2 (P less than 0.01). Every histological type of the tumor was sensitive to radiotherapy combined with hyperthermia. The lymph node metastatic rates were 35% in group 1 and 31.6% in group 2, both being lower than that in group 3 (52.5%). Immune function of the lymph nodes and the damage of the normal tissues around the tumor are observed. It has been clinically confirmed that neither resection rate is influenced nor postoperative complications are increased by preoperative radiotherapy combined with hyperthermia.

An image analysis on pathological changes in pulmonary arteries in chronic obstructive pulmonary disease.

The changes in small pulmonary arteries of 15 patients with chronic obstructive pulmonary disease (COPD) were investigated by light and electron microscopy, image analysis etc. It was found that the structural changes in the pulmonary arteries of the patients with COPD were characterized by muscularization of non-muscular arterioles, media hypertrophy, longitudinal smooth muscle bundles in the intima and fibrosis in both the media and intima. In the course of time, these lesions resulted in thickening of the arterial wall and narrowing of the lumen. Clinically, the patients developed pulmonary hypertension causing cor pulmonale. Initial data on the structure of arterial wall at different segments were compared statistically. There was very significant difference between the COPD and control groups (P less than 0.001). By Fisher's auto-classification (automatic pattern recognition), the rate recognized was correct in more than 90% in the small arteries of less than 200 microns in diameter. It is suggested that these arteriolar changes are closely related to pulmonary hypertension. The image analysis showed that the ratios of MWA/MVA and MWT/MD were of great value in evaluating the degree of the changes in the arteries of the patients with COPD.