[Prospective randomized controlled trial on 2 940 nm fractional erbium laser combined with fractional micro-plasma radiofrequency in the treatment of facial atrophic acne scars].

Objective: To compare the efficacy and safety of 2 940 nm fractional erbium laser combined with fractional micro-plasma radiofrequency (FMR) therapy and 2 940 nm fractional erbium laser in the treatment of atrophic acne scars. Methods: A prospective randomized controlled research was conducted. A total of 100 atrophic acne scar patients (38 males and 62 females, aged 18-37 years) who were treated in the Scar Laser Clinic of the Department of Plastic and Reconstructive Surgery of Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine from March 2018 to March 2021 and conformed to the inclusion criteria were recruited. The patients were randomly divided into erbium laser+FMR group and erbium laser alone group, with 50 cases in each group. The facial acne scars of patients in erbium laser alone group were treated with 2 940 nm fractional erbium laser, while the facial acne scars of patients in erbium laser+FMR group were treated with erbium laser as above, besides, the scars of U and M types were treated with FMR, once every 3 months for a total of 3 times. Before the first treatment and 3 months after each treatment, the Echelle D'Assessment Clinique des Cicatrices D'Acne (ECCA) was used to score the scar. The occurrence of adverse reaction during the treatment process was observed and recorded, and the incidence was calculated. Three months after the last treatment, the 5-level classification method was used to evaluate the satisfaction of patients with the treatment effect, and the satisfaction rate was calculated. Data were statistically analyzed with independent sample t test and chi-square test. Results: A total of 89 patients completed the study, including 46 patients in erbium laser+FMR group (19 males and 27 females, aged (26±5) years) and 43 patients in erbium laser alone group (15 males and 28 females, aged (27±6) years). The ECCA scores before the first treatment and 3 months after the first treatment of patients were similar between the two groups (P>0.05). The ECCA scores of patients in erbium laser+FMR group at 3 months after the second and third treatment were 72±23 and 61±18, respectively, which were significantly lower than 85±26 and 76±25 in erbium laser alone group (with t values of -2.45 and -3.26, respectively, P<0.05). During the treatment process, the incidence of adverse reaction of patients in erbium laser+FMR group and erbium laser alone group were 23.91% (11/46) and 16.28% (7/43), respectively, and there was no statistically significant difference between the two groups (P>0.05). The satisfaction rate of patients in erbium laser+FMR group was 78.26% (36/46) at 3 months after the last treatment, which was significantly higher than 53.49% (23/43) in erbium laser alone group (χ2=6.10, P<0.05). Conclusions: The 2 940 nm fractional erbium laser combined with FMR is superior to 2 940 nm fractional erbium laser alone in the treatment of facial atrophic acne scars, achieving significantly higher efficacy without significantly increasing the incidence of adverse reaction, and patients are more satisfied with the efficacy. It can be used as a recommended therapy in clinical practice.

[The research progress of multimodal imaging for the diagnosis of reticular pseudodrusen].

The emergence and development of multimodal imaging techniques, such as optical coherence tomography, fundus autofluorescence and adaptive optics, make it much easier to differentiate reticular pseudodrusen (RPD) from other fundus lesions. It is of great significance to understand the imaging characteristics of RPD observed with multimodal imaging techniques. This article reviews the formation mechanism and multimodal imaging characteristics of RPD, so as to provide help for better identification of RPD and assessment of the development and prognosis of the disease.

[Advances in the research of drug intralesional injection therapy in keloid].

Keloid is characterized by tumor-like invasive growth, high incidence, and low remission rate. The pathogenesis of keloid is still unknown. Keloids can not only affect appearance, but also cause severe itching and pain, which may affect physical and mental health of patients. Previous treatments for keloids include surgery, drugs, lasers and so on. Due to the high recurrence rate of surgical treatment accompanied by keloid enlargement, drug therapy has gradually become a hot topic. Among various methods of administration, intralesional injection is widely accepted as it can promote drug absorption to achieve better results. The progress of several drugs used in intralesional injection therapy for keloid is reviewed in this paper.

Impedance cardiography-dipyridamole test in detecting coronary artery disease.

Thallium-201 dipyridamole test (Tl-201DT) has high sensitivity and specificity in the assessment of coronary disease (CAD), but is not always available. We proposed impedance cardiography DT (IDT)instead. To determine the characteristic changes of impedance cardiogram (ICG) in patients with typical angina and to compare with those in normal subjects, 37 subjects undergoing IDT were divided into 3 groups: typical angina (15), suspected chest pain (11) and normals (11). Dipyridamole (DP) was infused intravenously for over 10 minutes at a total dose of 0.75 mg/kg. Simultaneous recording of ECG, PCG, and ICG were repeated immediately 2 minutes and 4 minutes after infusion of DP, and immediately and 5 minutes after intravenous infusion of aminophylline. Eleven parameters, HR, SPRP, QZ/ZA2, HI, SV, CO, A wave, A/C, O wave, O/C, A + O/C were observed. Only in O/C and A + O/C there were changes of significant differences (P less than 0.01) between groups. Specificity was 100% (0/11 positive) in normals. Sensitivity was 80% (12/15 positive) in the angina group, but only 46.7% (7/15) with ECG. The characteristic changes in CAD patients during IDT were angina induced by DP, abnormal O wave on ICG and change from deep A wave to abnormal O wave. No serious complication occurred after IDT. Our results indicate that IDT is a simple, practical and valuable method for detecting CAD.