[Research Progress in the Correlation Between Oral Microbiota and Chronic Kidney Disease].

Chronic kidney disease (CKD), one of the common clinical urological diseases, is increasingly more prevalent in recent years and has emerged as a major concern of public health around the globe. The continuous recurrence of CKD caused by renal function impairment leads eventually to irreversible renal failure and severe systemic complications, which causes severe negative impact on the quality of life of the patient. As an essential component of human microbiome, oral microbiota plays a major role in maintaining health, and there has been research suggesting close association between oral dysbiosis and CKD. It is therefore of great clinical significance to understand the correlation between CKD and oral microbiota. Herein, we reviewed the characteristics of oral microbiota of CKD patients, the possible mechanisms of oral microbiota's involvement in the pathogenesis and development of CKD, and the latest research findings on oral dysbiosis and CKD, with a view to finding new approaches to early prevention and control of CKD through oral microbial targets.

Effectiveness and Safety of Acupoint Application of Guan Xin Su He Pill () for Patients with Chronic Stable Angina Pectoris: A Multi-Center, Randomized Controlled Trial.

OBJECTIVE: To assess the clinical effectiveness of acupoint application (AP) of Guan Xin Su He Pill (, GXSHP) for patients with chronic stable angina pectoris (CSAP). METHODS: This study was carried out in 3 local hospitals in Chengdu, China. After baseline evaluation, eligible patients were randomly assigned to the placebo application for acupoints (PAA) group or the herbal application for acupoints (HAA) group. Patients in the HAA group underwent AP with herbal powder, which was mainly GXSHP, and patients in the PAA group underwent AP with sham drugs. For each treatment session, unilateral acupoints including Neiguan (PC 6), Danzhong (RN 17), Xinshu (BL 15) and Jueyinshu (BL 14), were stimulated for both groups. AP was performed 3 times a week with a 2-day interval for 4 weeks. The primary outcome was the frequency of angina pectoris attacks per week, while the secondary outcomes included angina pain intensity measured by the Visual Analogue Scale (VAS), dose of rescue oral drugs (nitroglycerin), scores on the Seattle Angina Questionnaire (SAQ), Self-Rating Anxiety Scale scores (SAS) and Self-Rating Depression Scale scores (SDS). Clinical outcomes were measured at week 0, 4 and 8. The safety of AP of GXSHP treatment for CSAP were assessed. RESULTS: A total of 121 patients were enrolled. Baseline characteristics were comparable across the 2 groups. After treatment, the angina attack numbers in the HAA group were significantly reduced from 11.00 to 4.81 (P<0.05). While, for PAA group, the angina frequency was not significantly improved (baseline 10.55; post-treatment 11.05). The HAA group had significantly fewer angina attacks than the PAA group (P<0.05). Pain intensity measured by VAS in HAA group was significantly reduced from 4.06 to 3.02 (P<0.05). While, for PAA group, the VAS was significantly increased (baseline 3.62; post-treatment 3.96; P<0.05). Clinical outcomes showed better improvement after treatment in the HAA group than in the PAA group in terms of oral administration of rescue drugs, SAS, SDS and SAQ scores (P<0.05). The adverse events were also reported. CONCLUSION: AP of GXSHP is a safe and effective treatment for CSAP patients (Registration No. NCT02029118).

[Effects of antimicrobial peptide GH12 on the morphology and composition of cariogenic three-species biofilm].

OBJECTIVES: To evaluate the effects of antimicrobial peptide GH12 designed de novo on the structure, morphology, and composition of a cariogenic three-species biofilm. METHODS: The cariogenic three-species biofilm consis-ted of the cariogenic Streptococcus mutans (S. mutans) and commensal bacteria Streptococcus sanguinis (S. sanguinis) and Streptococcus gordonii (S. gordonii). The biofilm was treated using GH12 (2, 4, and 8 mg·L-1), and untreated biofilm was used as the control. Changes in the morphology and structure of the three-species biofilm were evaluated through crystal violet staining, scanning electron microscopy (SEM), and fluorescent in situ hybridization (FISH). Moreover, S. mutans in the biofilm was selectively cultured, and its colony-forming units were counted. RESULTS: The biomass and density of the cariogenic three-species biofilm treated with GH12 decreased compared with those of the control. The number of S. mutans decreased gradually and eventually became undetectable, whereas the number of S. gordonii and S. sanguinis increased and became predominant in the biofilm. CONCLUSIONS: GH12 can reduce the number of S. mutans within the cariogenic three-species biofilm, destroys its integrity, and consequently makes the biofilm easy to remove.

Epidemiological and spatiotemporal analyses of HIV/AIDS prevalence among older adults in Sichuan, China between 2008 and 2019: A population-based study.

OBJECTIVES: To describe epidemiological trends and spatial distributions of HIV/AIDS among older adults (aged ≥50) in Sichuan Province, China during 2008-19, and provide scientific reference for HIV/AIDS prevention, intervention and treatment. METHODS: Data on HIV/AIDS cases reported in 2008-19 was extracted from the Case Report System. The Cochran-Armitage trend test was used to determine epidemic trends. Spatial autocorrelation and space-time analysis were conducted with ArcGIS10.6 and ArcGIS Pro2.4, respectively. RESULTS: A total of 77854 HIV/AIDS cases among older adults were included in the study. Newly reported cases increased from 320 in 2008 to 22189 in 2019, and the reported incidence rate (number of new reported cases/older adult population) rose from 0.001% to 0.077%. Infections through heterosexual transmission increased from 65.3% to 98.2% of total cases in older adults in this period. Spatial analysis at the county-level showed significant clustering throughout Sichuan, with the main hot spots concentrated in the southeast. Spatiotemporal analysis indicated that most of the southeastern counties/districts were Consecutive Hot Spots. CONCLUSIONS: Older adults have become a key population in the HIV/AIDS epidemic in Sichuan; comprehensive prevention and intervention measures targeted to older adults are urgently needed to control the spread of HIV/AIDS.

Photodynamic therapy as an alternative treatment in patients with invasive cutaneous SCC where surgery is not feasible: Single center experience.

The aim of this study was to demonstrate the efficacy of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) as an alternative treatment in cutaneous squamous cell carcinoma (cSCC) patients who are not fit for surgery. Thirty-three invasive cSCC patients who, for some reasons, cannot undergo surgery were enrolled in this study. All patients received plum blossom needle (PBN) pretreated ALA-PDT combined with topical application of 5% imiquimod cream. Two patients dropped the study because of severe pain and two patients discontinue treatment due to lack of response. Of 29 patients, who completed the treatment, 5 patients had complete response after 2-9 sessions of PDT and these patients had no recurrence till 18 months after treatment. Twenty-four patients achieved partial response and are satisfied with treatment outcome in terms of decreased symptoms and improved quality of life. PBN pretreated PDT in combination with topical imiquimod may be a viable treatment option for non resectable cSCC lesions.

Rational Design of ß-sheet Peptides with Self-Assembly into Nanofibres on Remineralisation of Initial Caries Lesions.

OBJECTIVE: To explore the self-assembly and gelation properties of synthetic peptides, and their efficacy on hydroxyapatite (HAP) nucleation and in situ remineralisation of initial caries lesions. METHODS: Mass spectrometry and reversed-phase high performance liquid chromatography (RPHPLC) were used to confirm the successful synthesis of peptides. Their self-assembly properties and conformation stability were evaluated using circular dichroism (CD) spectroscopy and Fourier-transform infrared spectroscopy (FTIR). Cell Counting Kit-8 (CCK-8; Dojindo, Kumamoto, Japan) was used to evaluate their cytotoxicity. The efficacy of the peptides on HAP nucleation and in situ remineralisation of initial caries lesions was explored using FTIR, scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction and transverse microradiography analysis. RESULTS: Two kinds of self-assembly ß-sheet peptides named ID4 and ID8, respectively, were successfully synthesised with purities greater than 95%. Both were stable under neutral physiological conditions and had low cytotoxicity. ID4 and ID8 showed calcium responsive self-assembly properties and could self-assemble into nanofibres. Compared with ID4, ID8 resulted in the rapid formation of hydrogel with a lower concentration of calcium, and self-assembled ID8 hydrogel induced the formation of flower-like HAP and significantly promoted the remineralisation of initial enamel caries. CONCLUSION: ID8 could serve as the template to induce HAP nucleation and promote biomimetic remineralisation of initial caries lesions. These results underpin future research on peptide design, and ID8 may be a promising bioactive component for anti-caries applications.

Development of a Diagnostic Questionnaire for Damp Phlegm Pattern and Blood Stasis Pattern in Coronary Heart Disease Patients (CHD-DPBSPQ).

BACKGROUND: The aim was to develop a diagnostic questionnaire for damp phlegm pattern and blood stasis pattern in coronary heart disease patients (CHD-DPBSPQ). METHODS: The standard procedures of questionnaire development were carried out to develop and assess CHD-DPBSPQ. The patients were assessed using the CHD-DPBSPQ, CHD-DPPQ, and CHD-BSPQ. Four methods were used to select the items on the CHD-DPBSPQ in a pilot study based on data from a Guizhou tertiary grade A hospital. Cronbach's alpha and the split-half reliability, test-retest reliability, content validity, criterion validity, construct validity, and convergent validity were determined in a validation study using a nationwide sample. RESULTS: After item selection, the CHD-DPBSPQ contained 15 items in two domains: the phlegm domain (9 items) and the blood stasis domain (6 items). For the CHD-DPBSPQ, the alpha coefficient was 0.88, the split-half coefficient was 0.90, and the intraclass correlation coefficient was 0.83. The range of the item-level content validity index (I-CVI) was 0.71 to 1.0 and that of the scale-level content validity index/average (Scale-CVI/Ave) was 0.97. The domain scores on the CHD-DPBSPQ were in close relation to the scores on a questionnaire for damp phlegm pattern in coronary heart disease patients (CHD-DPPQ) and a questionnaire for blood stasis pattern in coronary heart disease patient (CHD-BSPQ) (P < 0.01). The root mean square error of approximation (RMSEA) was equal to 0.05 (90% CI: 0.044, 0.059). Convergent validity was demonstrated with a moderate correlation. CONCLUSION: The CHD-DPBSPQ is a reliable and valid instrument.

What is the most relevent factor causing pain during ALA-PDT? A multi-center, open clinical pain score research trial of actinic keratosis, acne and condylomata acuminata.

BACKGROUND: To date, it has been reported that the intrinsic factors(lesions location, lesions area, disease tynpes) and extrinsic factors(fluence rate) contribute to the pain during 5-aminolevulinic acid photodynamic therapy (ALA-PDT). But there are few studies on pain during ALA-PDT and lack of sufficient clinical evidence related to the pain intensity. OBJECTIVE: To investigate pain intensity and its relative factors during ALA-PDT and to provide clinical implication. METHODS: The pain numeric rating scale (PNRS) score was used to evaluate the patients' pain intensity at different times during ALA-PDT irradiation from 0 to 10 min during treatment. Gender, age, lesions location, lesions area, ALA concentration and fluence rate were recored. RESULTS: The trial enrolled 274 patients in total, including 118 acne patients (in face), 30 actinic keratosis(AK)patients(in face), 126 Condylomatata acuminate patients(in genitalia). The average pain score in PDT was highest in the patients with actinic keratosis(7.3 ± 0.7), and that of condylomata acuminata was the lowest (4.5 ± 1.1) (p < 0.05). The highest pain score in patients with AK, acne and condylomata acuminata was 8, 6 and 6 respectively which occurred at 4 min, 4 min and 6 min respectively. The pain score of males was higher compared with females in all of the three diseases (p < 0.05). The pain score of facial diseases (5.6 ± 1.2) was higher than that of the genitalia (4.5 ± 1.1) (p < 0.05). The lesions area was positively correlated with the pain score (p < 0.05). In facial diseases, the pain score of patients with high fluence rate (7.3 ± 0.7) was higher than patients with low fluence rate (5.1 ± 0.9) (p < 0.05). CONCLUSIONS: Intrinsic and extrinsic factors both correlate with pain during PDT. Intrinsic factors are difficult to change, so extrinsic factors are the key point to control. We can reduce the fluence rate and extend the treatment time, relieving pain intensity while still ensuring equivalent efficacy.

Severe acne in monozygotic twins treated with photodynamic therapy.

Acne is a common skin disease in adolescence. It is a chronic inflammatory disease of the pilosebaceous units, which mainly occurs on the face and upper parts of the trunk. Based on severity of the lesions, acne can be mild, moderate or severe. Severe acne is usually featured with a protracted course and residual scars. Photodynamic therapy (PDT) has been demonstrated to be effective in severe acne recently. We report a case of monozygotic twins with severe acne who were successfully treated with PDT.

Vitrectomy with internal limiting membrane peeling versus inverted internal limiting membrane flap technique for macular hole-induced retinal detachment: a systematic review of literature and meta-analysis.

BACKGROUND: To evaluate the effects on vitrectomy with internal limiting membrane (ILM) peeling versus vitrectomy with inverted internal limiting membrane flap technique for macular hole-induced retinal detachment (MHRD). METHODS: Pubmed, Cochrane Library, and Embase were systematically searched for studies that compared ILM peeling with inverted ILM flap technique for macular hole-induced retinal detachment. The primary outcomes are the rate of retinal reattachment and the rate of macular hole closure 6 months later after initial surgery, the secondary outcome is the postoperative best-corrected visual acuity (BCVA) 6 months later after initial surgery. RESULTS: Four studies that included 98 eyes were selected. All the included studies were retrospective comparative studies. The preoperative best-corrected visual acuity was equal between ILM peeling and inverted ILM flap technique groups. It was indicated that the rate of retinal reattachment (odds ratio (OR) = 0.14, 95% confidence interval (CI):0.03 to 0.69; P = 0.02) and macular hole closure (OR = 0.06, 95% CI:0.02 to 0.19; P < 0.00001) after initial surgery was higher in the group of vitrectomy with inverted ILM flap technique than that in the group of vitrectomy with ILM peeling. However, there was no statistically significant difference in postoperative best-corrected visual acuity (mean difference (MD) 0.18 logarithm of the minimum angle of resolution; 95% CI -0.06 to 0.43 ; P = 0.14) between the two surgery groups. CONCLUSION: Compared with ILM peeling, vitrectomy with inverted ILM flap technique resulted significantly higher of the rate of retinal reattachment and macular hole closure, but seemed does not improve postoperative best-corrected visual acuity.

Comparison of 5-Aminolevulinic Acid Photodynamic Therapy and Clobetasol Propionate in Treatment of Vulvar Lichen Sclerosus.

The aim of this study was to evaluate the effectiveness of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) for the treatment of vulvar lichen sclerosus (VLS) and compare its effectiveness with that of clobetasol propionate. Four sessions of topical photodynamic therapy (PDT) were administered at 2-week intervals (n = 20). Clobetasol propionate (0.05%) was used daily for 8 weeks (n = 20). The rate of complete response in the PDT group (14/20) was double that of the clobetasol propionate group (7/20) (p < 0.05, 2 = 4.912). Horizontal visual analogue scores indicated that PDT was more effective than clobetasol propionate. Pain intensity numeric rating scale values for PDT were between 3.05 and 4.45. One month after the final session of PDT, only one patient relapsed and all 7 patients in clobetasol propionate group relapsed. ALA-PDT is a well-tolerated and effective option for the treatment of VLS.

[Analyzing Colonization of Bifidobacteria in Infants with Real-time Fluorescent Quantitative PCR].

OBJECTIVES: In order to know how intestinal Bifidobacteria community could be built in the infants and whether the environmental factors could affect them, the present study was conducted to characterizethe species composition and trace the quantitative changes of intestinal Bifidobacteria of the infants in their early stages with non-culture dependent molecular method. The possible association of Bifidobacteria community of the infants with their health was also discussed. METHODS: Total 16 of full-term newborn infants born between March and April 2013 were recruited for the present study. Fecal samples were collected from them at 1 day, 2 days, 4 days, 7 days, 10 days, 14 days, 28 days, 3 months, 6 months and 1 year after birth. Real-time fluorescent quantitative PCR with genus and species specific premiers was used to detect Bifidobacteria and 8 predominate species in human intestine qualitatively and quantitatively present in these collected fecal samples. RESULTS: Total 136 fecal sample were collected and Bifidobacteria were detected from 93.4% (127/136) of them with the concentration of 1.0×10 5 to 1.0×10 11 CFU/g. Bifidobacteria were found in 83.3% of the fecal samples collected from the first day after birth with more than about 10 5 CFU/g. However, Bifidobacteria were detected relative low until 14 days and were taxonomically belonged only to one or two species. Bifidobacteria were found in almost 100% of the fecal samples collected after birth 28 days with more than 108 CFU/g, and the detected species of Bifidobacteria was increased to 3 species after 28 days to 6 months. All of the fecal samples collected from one year had more than 3 species of Bifidobacteria with high cell counts. Among the detected Bifidobacteria were B.breve 92.1%, B.infantis 66.1%, B. catenulatum 59.8%, B. bifidum 25.2%, B. longum 24.4%, B.dentium 13.4%, B.angulatum 5.5% and B.adolescentis 1.6%, respectively. CONCLUSIONS: The detected Bifidobacteria greatly varied qualitatively and quantitatively after birth to one year which could be considered as the important and sensitive period for Bifidobacteria to colonize and built its communityin the infants. Different from previous studies, the colonization of Bifidobacteria in the tested infants was found delayed and the composition and diversity of Bifidobacteria species was different from other studies. These might result from different deliveryway, feeding pattern and other environmental factors related to the tested infants.

[Colonization and development of intestinal bifidobacteria in early infancy].

OBJECTIVE: To study the characteristics of the colonization of 8 species of bifidobacteria by systematically profiling fecal bifidobacterial community in the early life of infants. METHODS: Fresh fecal samples including meconium samples were collected for culture and isolation of fecal bifidobacteria from 16 cases of full-term newborn infants born between March and April 2013 at their life of 2, 4, 7, 10, 14, 28, and 90 days. The isolated fecal bifidobacteria were taxonomically identified to genus and 8 species with PCR analysis. RESULTS: One hundred and fifty-two predominant bifidobacteria strains were detected in the fecal samples, the detection rate of B. breve (22.4%) were the highest. Bifidobacteria were found in the feces of 8% infants 4 days after birth. The colonization rates increased to 54% and 60% at 28 days and 3 months respectively, significantly exceeding the colonization rate at 4 days after birth (P<0.05). Adult-type bifidobacteria B. catenulatum were found in the infants 10 days after birth, and infant-type bifidobacteria B. infantis were found at 14 days after birth, but infant-type bifidobacteria B. infantis were detected at a high level until 3 months after birth. The most tested infants had 2 species or less of bifidobacteria. CONCLUSIONS: Intestinal bifidobacteria in infants might have less diversity in early infancy. Infant-type bifidobacteria appear late, while adult-type bifidobacteria colonize earlier.

Evaluation of 5-aminolevulinic acid-mediated photorejuvenation of neck skin.

OBJECTIVE: To evaluate the outcomes of the combination of red light or intense pulsed laser (IPL) with 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) in the treatment of photodamaged neck skin. METHODS: The anterior of the neck was divided into four 2 cm × 2 cm sections and randomly assigned to red-light, red-light-PDT, IPL or IPL-PDT group. ALA cream of 5% was applied to PDT regions for 2h prior to light irradiation. Treatment was repeated once. The stratum corneum (SC) hydration, transepidermal water loss (TEWL), L(*), a(*), b(*) values, melanin index (MI), erythema index (EI), skin elasticity and skin thickness were examined by a blinded investigator. The function and volume of thyroid were also measured. RESULTS: After red-light-PDT, IPL-PDT and IPL treatment, the appearance of photoaging lesion was improved. The SC hydration, L(*) value, elasticity and thickness increased, whereas the TEWL and MI value decreased. These changes in red-light-PDT and IPL-PDT group were more obvious than IPL group. The a(*) and EI value increased in red-light-PDT group. No significant change was noticed in red-light group. Partial irradiation of the thyroid did not affect the function and volume of the thyroid. CONCLUSION: IPL-PDT and red-light-PDT showed better rejuvenation effect than IPL or red light alone on the neck skin.

High expression of Bcl-2 protein predicts favorable outcome in non-small cell lung cancer: evidence from a systematic review and meta-analysis.

BACKGROUND: The prognostic value of Bcl-2 protein expression in non-small cell lung cancer (NSCLC) is under debate. We therefore systematically reviewed the evidence for Bcl-2 protein effects on NSCLC survival to elucidate this issue. MATERIALS AND METHODS: An electronic search in Pubmed and Embase complemented by manual searches in article references were conducted to identify eligible studies to evaluate the association between Bcl-2 protein expression and overall survival (OS) as well as disease free survival (DFS) of NSCLC patients. Combined hazard ratios (HRs) with corresponding 95% confidence intervals (95%CIs) were pooled using the random-effects model. RESULTS: A total of 50 trials (including 52 cohorts) encompassing 7,765 patients were pooled in the meta-analysis regarding Bcl-2 expression and OS of NSCLC patients. High expression of Bcl-2 protein had a favorable impact (HR=0.76, 95%CI=0.67-0.86). In the group of Bcl-2 expression and DFS, 11 studies including 2,634 patients were included. The synthesized result indicated high expression of Bcl-2 protein might predict good DFS (HR=0.85, 95%CI=0.75-0.95). CONCLUSIONS: Our present meta-analysis demonstrated favorable prognostic values of Bcl-2 expression in patients with NSCLC. Further prospective trails are welcomed to validate the utility of assessing Bcl-2 in NSCLC patient management.

Comparison of 5-aminolevulinic acid photodynamic therapy and red light for treatment of photoaging.

OBJECTIVE: The aim of this pilot study was to compare the efficacy of ALA-PDT and red light alone in the treatment of photoaging. METHODS: A total of 14 adults with photoaging skin were recruited. ALA-PDT or red light alone was applied to the forearm extensor. Before and after treatment, the treated sites were examined by dermoscopy, the changes in straum corneum (SC) hydration, transepidermal water loss (TEWL), and the L*a*b* values were measured, and microscopic examination of collagens and elastins was performed. RESULTS: After ALA-PDT or red light illumination, the appearance of photoaging lesions improved, SC hydration increased and TEWL decreased. These changes in the ALA-PDT group were more obvious than those in the red light group. No significant change was noticed in the L*a*b* values in both groups. The signs of typical solar elastosis damage were improved in both groups. CONCLUSIONS: ALA-PDT showed better skin rejuvenation effect than red light alone.

In vitro inhibition of bovine enamel demineralization by enamel matrix derivative.

This study aimed to determine whether enamel matrix derivative (Emdogain) affects the demineralization of bovine enamel in vitro and to assess the agent's anti-caries potential. Bovine enamel blocks were prepared and randomly divided into three groups (n = 15 per group), which were treated with distilled water (negative control), NaF (positive control), or Emdogain. All three groups were pH-cycled 12 times over 6 days. The percentage of surface enamel microhardness reduction (%SMHR), calcium demineralization rate (CDR), surface roughness, lesion depth and mineral loss after demineralization were examined. Surface morphology of specimens was studied by scanning electron microscopy. The Emdogain and positive control groups showed similar surface roughness, lesion depths and mineral loss, which were significantly lower than those in the negative control group. In addition, the enamel surfaces of both the Emdogain and NaF groups showed much narrower intercrystalline spaces than the surfaces of the negative control group, which exhibited extensive microfractures along the crystal edges. %SMHR differed significantly among all three groups, with the smallest value in the Emdogain group and the greatest in the negative control group. These results indicate that enamel matrix derivative (Emdogain) can significantly inhibit demineralization of bovine enamel in vitro, suggesting that it has potential as an anti-caries agent.

Acute urinary retention in elderly female patients after photodynamic therapy of urethral condyloma--report of two cases.

We report two cases of acute urinary retention (AUR) occurred after intra-urethral aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) in elderly females (>66 years old) with urethral condylomas.

A prospective pilot study to evaluate combined topical photodynamic therapy and surgery for extramammary paget's disease.

BACKGROUND AND OBJECTIVE: Extramammary Paget's disease (EMPD) is a rare intra-epithelial neoplasm. Surgical excision is the treatment of choice. The usefulness of topical photodynamic therapy (PDT) in the treatment of EMPD has been reported. The objective of this prospective pilot study was to investigate the feasibility of combined PDT and surgery in the treatment of EMPD. SUBJECTS AND METHODS: A total of 13 patients with 19 large EMPD lesions were recruited and assigned to surgery (n = 5) or PDT + surgery (n = 8) group. For the PDT + surgery group, four sessions of topical PDT mediated with 20% 5-aminolevulinic acid (ALA-PDT) were applied prior to surgery. Patients were followed up for 12 months. Treatment outcomes, adverse reactions and recurrence were compared. RESULTS: In the surgery group, recurrence was seen in 2 out of 8 lesions (25%). In the combination group, over 58% reduction in lesion size was achieved after 4-sessions of PDT and recurrence was seen in 1 out of 11 lesions (9.1%) after surgery. CONCLUSIONS: Multiple ALA-PDT could be applied to reduce the severity of EMPD lesion and improve the success of surgery.

Prospective study of topical 5-aminolevulinic acid photodynamic therapy for the treatment of moderate to severe acne vulgaris in Chinese patients.

BACKGROUND: Topical photodynamic therapy (PDT) mediated with 5-aminolevulinic acid (ALA) offers an alternative option for the treatment of acne vulgaris. OBJECTIVE: To study the effects of ALA dose, incubation time, and lesion type on protoporphyrin IX (PpIX) production and treatment outcomes. METHODS: To examine the time course of PpIX production, 10% ALA was applied to inflammatory papules for 1 to 5 hours and followed by in situ fluorescence examination. To determine the effects of ALA dose and lesion type, 3, 5, and 10% ALA was applied to acne lesions in split-face fashion for 3 hours followed by whole-face light irradiation at 633 nm and 30 to 70 J/cm2. Treatment was repeated twice at 2-week intervals. RESULTS: PpIX reached a stable level after 3 hours of incubation. Similar PpIX levels were seen in areas receiving 3, 5, and 10% ALA. Poisson regression analyses indicated that lesion counts decreased by 0.791 times for a one-unit increase in treatment times (95% CI 0.782-0.799 < .0001) but only by 0.999 times for a one-unit increase in ALA dose (95% CI 0.998-1.000  =  .22). CONCLUSION: The combination of low-dose ALA and a red light is a safe and effective option for the treatment of moderate to severe acne.