Comparison of the efficacy and safety of 308-nm excimer laser as monotherapy and combination therapy with topical tacrolimus in the treatment of periocular vitiligo.

Vitiligo is an acquired depigmenting disorder in which destruction of skin melanocytes. In recent years, 308-nm excimer laser (308-nm EL) and topical tacrolimus have been extensively used to treat vitiligo. This study aimed to investigate the effectiveness and safety of combined treatment of 308-nm EL and topical tacrolimus for treating periocular vitiligo compared to 308-nm EL monotherapy. This study is a retrospective observational study, involving 58 Chinese patients of periocular vitiligo, divided into two groups: the control group (28 patients) treated with 308-nm EL; and the experimental group (30 patients) treated with 308-nm EL and topical tacrolimus 0.1% ointment. Repigmentation was assessed at four grades. In the control group, there were four patients (14%) with poor repigmentation, eleven patients (39%) with moderate repigmentation, ten patients (36%) with good repigmentation, three patients (11%) with excellent repigmentation. In the experimental group, two patients (7%) experienced poor repigmentation, six patients (20%) experienced moderate repigmentation, fifteen patients (50%) experienced good repigmentation, seven patients (23%) experienced excellent repigmentation. The experimental group efficacy rate (good and excellent repigmentation) was 73.3%, higher than 46.4% for the control group (p = 0.037). Our findings suggest that both treatments are safe and the combination of tacrolimus and 308-nm EL is more effective than 308-nm EL alone for periocular vitiligo.

Observation on the effects of 595- nm pulsed dye laser and 755- nm long-pulsed alexandrite laser on sequential therapy of infantile hemangioma.

BACKGROUND: Infantile hemangioma (IH) can lead to severe complications. The 595-nm pulsed dye laser is poorly effective on thick and deep IH. Long-pulsed alexandrite laser has the proper wavelength of 755 nm and a relatively deep penetration. Thus, this may be a safe and effective treatment method for relatively deep or thick IH. AIMS AND OBJECTIVES: This study aims to determine whether 595-nm pulsed dye laser and 755-nm long-pulsed alexandrite laser in sequential therapy are safer and more effective for relatively deep or thick hemangioma. MATERIALS AND METHODS: This was a prospective study. A total of 194 infantile IH patients (thickness greater than 2 mm and less than 8 mm) were randomly divided into two groups: control group (treated using 595-nm pulsed dye laser) and experimental group (treated by sequential therapy with 755-nm long-pulsed alexandrite laser and 595-nm dye laser). RESULTS: The control group had a total effective rate of 36.1%, while the experimental group had a total effective rate of 76.3%. Enumeration data were compared by X2 -test. The results were considered statistically significant at P < .05. CONCLUSION: Sequential therapy with 755-nm pulsed dye laser and 595-nm long-pulsed alexandrite laser is a safe and effective treatment approach for relatively deep or thick hemangioma.

A Time-Series Analysis of Severe Burned Injury of Skin Gene Expression Profiles.

BACKGROUND/AIMS: Major burn injury is one of the main severe forms of wound which lead to a mass of clinical debilitation, this study was to identify core biomarkers for the recovery of severe burned injury. METHODS: Gene expression profiles (GSE19743) from the Gene Expression Omnibus (GEO) was downloaded, followed by background correction, normalization of raw microarray dataset and identification of differential expression genes (DEGs) . Soft clustering of DEGs was used for the screening of gene clusters that with sustained increasing (SIG) and decreasing expression (SDG) profiles along with the recovery process of burned injury. The significantly enriched Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of SIGs and SDGs were obtained through the Database for Annotation, Visualization, and Integrated Discovery (DAVID), based on which the miRNA-gene regulation network for SIGs and SDGs were constructed from the miRWalk database. RESULTS: Ten clusters were obtained through soft clustering. The SIGs and SDGs were found to be closely associated with the biological processes of immune system. The miRNA-gene regulation network analysis suggested different roles between SIGs and SDGs in the recovery of severe burned injury. Furthermore, a bunch of important biomarkers were identified, which would be helpful in the treatment of burned patients. CONCLUSION: Our current findings suggest an interesting molecular link between transcriptional regulation potentially involved in immunosuppressive state after major burn injury, which warrants further exploration for their utilization in the treatment of major burn injury.

The Application of Color Doppler Ultrasound in the Evaluation of the Efficacy of 595-nm Pulsed Dye Laser Combined with 755-nm Long-Pulse Alexandrite Laser in the Treatment of Hybrid Infantile Hemangiomas.

Purpose: We used color Doppler ultrasound to conduct an objective evaluation of the 595-nm Pulsed Dye Laser (PDL) combined with 755-nm long-pulse alexandrite sequential laser treatment for hybrid IH. Patients and Methods: A total of 116 cases of hybrid IH were selected for this study. The interval between laser treatments was around 4 weeks, and 6 laser treatments or complete removal of the tumor was the end point. All children underwent color Doppler ultrasonography at the 0th, 1st, 6th months of treatment. Children were grouped by gender, age (<6 months, ≥6 months), thickness (<8 mm, ≥8 mm), and location (face and neck, trunk, and extremities). Calculate the volume of IHs according to color Doppler ultrasound. The volume ratio before and after treatment was defined as the A-value. Treatment outcomes were defined as effective when the A-value <75%. Results: In total, 74 cases (63.79%) had effective outcomes. Overall, the samples showed a statistically significant difference in the reduction of IH volume after 6 months of laser treatment (P < 0.001). The treatment of <6 months group had better efficacy than the ≥6 months group (P < 0.001), the treatment of thickness <8 mm group had better efficacy than the thickness ≥8 mm group (P < 0.001) and there was no significant difference in efficacy between the three different location groups (P > 0.05). Greater reduction in blood flow in the group with the effective outcome than in the group with the ineffective outcome (P < 0.001). Conclusion: Color Doppler ultrasound can be applied to the diagnosis of hybrid IH and to the evaluation of treatment time and outcomes, and it can help clinicians recognize hybrid IH with greater accuracy. The earlier intervention for hybrid IH we perform, the better outcomes will be.

New insights into physicochemical properties of different particulate size-fractions and dissolved organic matter derived from biochars and their sorption capacity for phenanthrene.

To improve the knowledge of the heterogeneity and sorption behavior of biochars on hydrophobic organic contaminants (HOCs), pristine biochars (PBCs, 400 and 700 °C) were fractionated into four particulate fractions (SfBCs) and dissolved organic matter derived from biochars (DBC), then the sorption capacities of them towards phenanthrene were examined. Results showed that the OC-normalized sorption distribution coefficients (Koc) of PBCs were generally at intermediate levels among that of SfBCs and DBCs. The logKoc values of SfBCs increased as particle sizes decreased. By virtue of the higher micropore volume, specific surface area, aromaticity and hydrophobicity, the lowest SfBCs (0.45-10 µm, BC0.45-10) exhibited remarkably higher logKoc. Besides, although SfBCs from 700 °C generally showed larger logKoc than counterparts from 400 °C, almost no difference was observed for logKoc values of BC0.45-10 fractions from 400 and 700 °C. We thus speculated that particle size might have stronger effect on their sorption capacity than pyrolysis temperature. Although DBCs exhibited dramatically lower logKoc values than nano-scale SfBCs, they were interestingly comparable to large-sized SfBCs. Our findings thus suggested the importance of small particulate biochar species and DBCs on HOCs transport should be both highlighted since these fractions were highly dynamic in the environment.

Sequelae After Involution of Superficial Infantile Hemangioma: Early Intervention with 595-nm Pulsed Laser Combined with 755-nm Long-Pulsed Alexandrite Laser versus Wait-and-See.

BACKGROUND AND OBJECTIVE: Infantile haemangioma (IH) is the most common benign tumor in children. At present, pulsed dye laser (PDL) has made great progress in the treatment of superficial IH, showing good safety and effectiveness. But some doctors think that superficial IH should choose to wait-and-see. However, studies have reported that most of the IH after resolution still has residual disease, and thickness seems to be an important factor. Therefore, the purpose of this study is to investigate the relationship between Sequelae and thickness after superficial IH involution. In addition, compare the Sequelae difference between 595-nm pulsed laser combined with 755-nm long-pulse alexandrite laser treatment and wait-and-see. MATERIALS AND METHODS: This retrospective observational study included patients with superficial IH evaluated in the past 6 years and divided them into a laser group and an observation group. RESULTS: The incidence of sequelae in the laser group was 44.6%, and the incidence of sequelae in the observation group was 69.5%. The incidence of Sequelae of superficial IH in the laser group was significantly lower than that in the observation group (χ 2-test, χ 2=10.790, P <0.001). In the observation group, the average A scores of the three thickness subgroups (<2mm, 2-5mm, and >5mm) were 4.38, 3.39, and 1.80, and there were significant differences in the A scores between the three groups (Kruskal-Wallis, p<0.05). There is a significant difference in the A score between the laser group and the observation group in the superficial IH with a thickness of 2-5 mm and>5mm (Wilcoxon rank sum test, P<0.05). CONCLUSION: This retrospective study showed that the degree of Sequelae of superficial IH after involution is related to its thickness. In addition, the early intervention of 595-nm pulsed laser combined with 755-nm long-pulse alexandrite laser can reduce the incidence and extent of sequelae.

Construction of small-sized superparamagnetic Janus nanoparticles and their application in cancer combined chemotherapy and magnetic hyperthermia.

Novel Janus nanoparticles (J-NPs) are developed by using single iron oxide (Fe3O4) nanoparticles as the core and hydrophobic/hydrophilic polymeric brushes as the cloak. Because of the superparamagnetism and asymmetric functionality of J-NPs, they are used as drug carriers and therapeutic agents for cancer chemotherapy and magnetic hyperthermia with a magnetic resonance imaging (MRI) guide. The asymmetric functionality is constituted of hydrophobic polymethyl methacrylate (PMMA) brushes and hydrophilic polyacrylic acid (PAA) brushes, which are 'grafting to' or 'grafting from' Fe3O4 nanoparticles via activators regenerated by electron transfer atom transfer radical polymerization. The terminal chains of PMMA and PAA brushes are coordinated with Fe3O4 nanoparticles, so PMMA/Fe3O4/PAA J-NPs possess structural stability in solvents. Because of the brush-structure, PMMA/Fe3O4/PAA J-NPs show high encapsulation efficiency (89.75 ± 2.35%) and loading capacity (8.95 ± 0.26%). Under the alternating magnetic field (AMF), drug-loaded J-NPs achieve the highest cell proliferation-inhibition ratio in the cell proliferation test in vitro and the tumor growth inhibition test in vivo compared to single chemotherapy or magnetic hyperthermia. Meanwhile, J-NPs show good T2 imaging.

Superparamagnetic Iron Oxide Nanoparticles for Cancer Diagnosis and Therapy.

Due to the special magnetic performance and nano-size, superparamagnetic iron oxide nanoparticles (SPIOs) have been extensively investigated in cancer diagnosis and therapy, such as magnetic resonance imaging (MRI), drug delivery, magnetic hyperthermia treatment, and so on. The development of nanomedicine brings challenges and innovations to magnetic materials, multifunction and integration become a kind of trend for material designs. Recent studies show that cancer-targeted MRI and drug delivery, or MRI-guided drug delivery and magnetic hyperthermia treatment in vivo, external magnetic field guided MRI, drug delivery and magnetic hyperthermia treatment in vitro, had become the research hotpots. This account presents a review on the recent progresses of SPIOs' applications in cancer diagnosis and therapy.

Insights into aggregation and transport of graphene oxide in aqueous and saturated porous media: Complex effects of cations with different molecular weight fractionated natural organic matter.

The stability of nanomaterials in aquatic environment is a critical factor that governs their fate and ecotoxicity. Meanwhile, the interaction between nanomaterials and ubiquitous natural organic matter (NOM) is a vital process that influences the transport and biological effects of nanomaterials in the environment. However, impacts of NOM on the aggregation and transport of two-dimensional nanomaterials, especially for the increasingly used graphene oxide (GO), are not well understood. Particularly, there is lack of exploration on potential impacts of the heterogeneous properties of NOM on GO behaviour, especially that induced by the wide molecular weight (MW) span of NOM. In this study, effects of several kinds of well-characterized MW fractionated Suwannee River NOM (Mf-SRNOMs) on the aggregation and transport of GO in aqueous media and saturated porous media were investigated. Our results suggest that the stability and migration capacity of GO under most investigated electrolyte conditions are promoted by all Mf-SRNOMs, and efficiencies of different Mf-SRNOMs are generally positively correlated with their MW. Primarily, mechanisms including MW-dependent steric hindrance and sorption of Mf-SRNOMs onto GO are critical in stabilizing GO, and thus facilitating its transport. However, the stronger sorption of higher Mf-SRNOMs onto the GO basal plane through π-π interaction further facilitated the cation bridging between both ends of Mf-SRNOM and GO, and resulted in heteroaggregation of NOM-GO. Moreover, the weight analysis indicated that despite the fact that high Mf-SRNOMs only occupied a small percentage of pristine-SRNOM, they showed a stronger contribution towards pristine-SRNOM's capacity in stabilizing GO, when compared with that of lower MW counterpart. These findings pointed out that complex effects of the heterogeneities of NOM and cations should be highly relevant when the aggregation and transport behaviour of two-dimensional nanomaterials is investigated, and NOM fractions that are highly aromatic and of a higher MW should receive greater attention.

Th1/Th2 PB balance and CD200 expression of patients with active severe alopecia areata.

Th1/Th2 peripheral blood balance and CD200 expression in patients with severe alopecia areata (SAA) in the active stage were investigated. Fifty patients with active SAA, 50 patients with stable SAA and 50 healthy controls were continuously selected and expression of Th1/Th2 of peripheral T lymphocytes, and peripheral B lymphocytes was detected by flow cytometry; RT-PCR was used to detect the expression of the PBMC CD200 mRNA and the expression of CD200 in hair follicles of alopecia area was detected by immunohistochemically staining; ELISA was used to detect expression levels of serum LFN-γ and serum interleukin (IL)-10. The expression of CD200 in patients with alopecia areata in active phase on CD3+ T lymphocytes and CD19+ B lymphocytes was significantly lower (P<0.05) than those in stable phase and of the control group. CD200 expression in patients with alopecia areata in stable phase on T lymphocytes was greatly lower than that of the control group (P<0.05). However, the comparison of expression of CD200 in patients with alopecia areata in stable phase on B lymphocytes with the control group were statistically non-significant. The level of the expression of CD200 mRNA in active phase was obviously lower than those of the other two groups and the difference was statistically significant (P<0.05); the moderate positive and strong positive percentage of CD200 in the active phase was significantly lower than those of the other two groups. Positive expression rate of CK15 among the three groups were compared with each other; the differences had no statistical significance. The level of LFN-γ in the active phase had obviously increased while the IL-10 level decreased significantly (P<0.05). In conclusion, the level of expression of CD200 on peripheral blood and hair follicle outer root sheath of patients with SAA was decreased. This may be associated with the imbalance of the Th1/Th2 equilibrium.

Ecthyma gangrenosum in a 3-month-old, previously healthy infant: A Case Report.

RATIONALE: Ecthyma gangrenosum (EG) is an aggressive cutaneous disease caused by local or systemic infection with Pseudomonas aeruginosa. EG is characterized by cutaneous manifestations ranging from nodule and papule, to necrotic ulceration with surrounding erythema, especially with black eschar or central crust. EG presents with characteristic skin lesions which is important to establish diagnosis of sepsis caused by P aeruginosa, a serious condition that can be treated efficiently if diagnosed early. PATIENT CONCERNS: A 3-month-old female infant was presented with characteristic skin lesions of EG and developed sepsis 3 days later. DIAGNOSES: Ecthyma gangrenosum and sepsis caused by Pseudomonas aeruginosa. INTERVENTIONS: Meropenem was used in combination with ceftazidime at first and excision of necrotic skin lesions was performed later. OUTCOMES: Cure. LESSONS: Early recognition of EG plays an important role in providing appropriate empiric antibiotic treatment at early stage of sepsis, and improves the prognosis. Surgical excision may be helpful if no improvement was achieved via antibiotic treatment.

A highly bioactive bone extracellular matrix-biomimetic nanofibrous system with rapid angiogenesis promotes diabetic wound healing.

Treatment of diabetic wounds with a rapid healing performance remains a critical clinical challenge. An extracellular matrix (ECM)-biomimetic structure has shown promise in promoting tissue regeneration through a mediating cellular microenvironment. Herein, we report bone ECM-biomimetic cell-free nanofibrous scaffolds for enhancing healing in diabetic full-thickness wounds. This bioactive nanofibrous matrix was composed of ECM-componential collagen (Col, mimicking protein), polycaprolactone (PCL), and bioactive glass nanoparticles (BGNs, mimicking biological apatite) (CPB). The influence and mechanism of CPB on endothelial cell behaviors, angiogenic and healing abilities were investigated in a diabetic wound rat model. CPB significantly improved attachment and proliferation of endothelial cells, and upregulated the expression of the angiogenesis marker (CD31). In vivo, CPB also significantly enhanced the angiogenesis, through greatly upregulating the mRNA and protein expressions of Hif-1α, VEGF, Col1 and α-SMA. Furthermore, due to rapid angiogenesis, granulation tissue formation, collagen matrix remodeling and epidermis differentiation were accelerated in the CPB group, and as a result efficient diabetic wound healing was observed. Our results demonstrated that the cell-free bone-ECM-biomimetic BGN-based nanofibrous matrix could efficiently enhance blood tissue regeneration and diabetic wound healing without additional growth factors. Our biomimetic materials system may also be suitable for other blood vessel-related tissue repair and regeneration processes.

Extramammary Paget's Disease in Two Brothers.

Extramammary Paget's disease (EMPD), which is considered to be an adenocarcinoma of the apocrine glands, is a rare, slow-growing neoplasm. The standard treatment for local EMPD is surgical resection, however, so far, no effective treatment is found for advanced EMPD. Trastuzumab, which is a recombinant monoclonal antibody against the human epidermal growth factor receptor 2 HER2 has been proved to be effective in the treatment of advanced EMPD in some cases where HER2 protein is overexpressed. Herein, we report two cases of EMPD in two brothers. The younger brother who presented as local EMPD on the scrotum received surgical resection and had no recurrence in 15 months following. The older brother suffered from invasive EMPD also on the scrotum with inguinal region multiple metastatic lymph nodes and was treated with combination chemotherapy and Trastuzumab to target HER2 consecutively after a wide surgical excision.

Levels of TGF-ß(1) in serum and culture supernatants of CD4(+)CD25 (+) T cells from patients with non-segmental vitiligo.

Compelling evidences support an autoimmune basis of non-segmental vitiligo, and dysregulation of CD4(+)CD25(+) regulatory T cell (Treg) is assumed to contribute to the pathogenesis of vitiligo. Serum levels of transforming growth factor-ß (TGF-ß), an important immunoregulatory cytokine produced by Treg cells, has been reported significantly decreased in patients with vitiligo. However, relation between the decrease in TGF-ß and the dysfunction of Treg cells in pathogenesis of vitiligo was still undemonstrated. To further reveal the role of TGF-ß in vitiligo, 46 patients with non-segmental vitiligo and 25 age- and sex-matched healthy control subjects were enrolled in the study. CD4(+)CD25(+) T cells isolated from peripheral venous blood with a CD4(+)CD25(+) regulatory T cell isolation kit were cultured with or without anti-CD3 mAbs and anti-CD28 mAbs for 4 days. The TGF-ß1 levels in serum and culture supernatants were detected by enzyme-linked immunosorbent assay in both groups. We have found that the TGF-ß1 levels both in serum and culture supernatants in the presence of anti-CD3 mAbs and anti-CD28 mAbs were decreased in the active vitiligo group when compared with the control group or stable vitiligo group, and were negatively correlated with the percentage of involved body area. These results suggested that TGF-ß may play a role in the pathogenesis of non-segmental vitiligo related to the suppressive function of Tregs.