5). Conclusions Q-switched alexandrite laser is an effective approach to the treatment of care -au-lait spots, and its efficacy can be predicted according to different factors that concern.

Objective To evaluate the biological effect of endothelin (ET) antagonist on cultured B16 murine melanoma cells. Methods B16 murine melanoma cells were cultured in the presence of various concentrations (31.25, 62.5, 125, 250, 500 μg/mL) of ET antagonist or licoflavone. Then, melanoma cells were harvested for the detection of tyrosinase activity and melanin content. The proliferation rate of melanoma cells was measured with MTT method. The effect of ET antagonist was compared with that of licoflavone. Results Licoflavone had a concentration-dependent inhibition on melanogenesis. The ET antagonist selectively suppressed the ET-induced stimulation of tyrosinase and cell differentiation of B16 cells, but had no direct inhibitory effect on melanogenesis in culture, and little influence on melanocyte viability. The addition of ET antagonist at 200 μg/mL could significantly inhibit ET (0.5 μg/mL)-induced melanogenesis in Bl6 cells. The cytotoxity of the antagonist was relatively lower than that of licoflavone. Conclusions The results suggest that the ET antagonist is a safe skin-whitening ingredient, and may have a wide application perspective in the prevention of endothelin-induced skin pigmentation after UVB irradiation.

ObjectiveTo determine the protein and mRNA expression levels of interleukin-17 (IL-17) and proportions of Th17 cells in peripheral blood of patients with atopic dermatitis (AD),and to analyze their clinical significance.MethodsVenous blood samples were obtained from 63 patients with AD and 30 normal human controls.Enzyme linked immunosorbent assay was performed to measure the plasma level of IL-17 protein,real time fluorescence reverse transcription (RT)-PCR to detect the mRNA expression level of IL-17 in peripheral blood,flow cytometry to determine the percentage of Th17 cells in peripheral blood mononuclear cells(PBMCs).Spearman's rank correlation analysis was performed to assess the relationship of peripheral blood Th17 cell percentage and IL-17 levels with disease severity in patients with AD.Results The percentage of Th17 cells in PBMCs was 1.83％ ± 0.47％ in patients with acute AD,significantly higher than that in normal human controls (0.85％ ± 0.45％,t =4.128,P ＜ 0.01 ) and in patients with chronic AD ( 1.12％ ± 0.69％,t =2.439,P ＜ 0.05).There was a significant increase in the plasma level (98.37 vs.63.75 ng/L,U =168,P ＜ 0.05) and mRNA expression level of IL-17 in peripheral blood in patients with AD compared with normal controls.Both the Th17 cell percentage and plasma IL-17 level were positively correlated with eczema area and severity index(EASI) score in patients with AD (r =0.681,P ＜ 0.01;r =0.427,P ＜ 0.05).ConclusionsThere is an elevated proportion of Th17 cells and an abnormal expression of IL-17 protein and mRNA in peripheral blood from patients with acute AD,which are positively correlated with disease severity,implicating the possible roles of IL-17 and Th17 cells in the pathogenesis of AD.

Objective To study the management of femoral artery pseudoaneurysm caused by heroin (injection).Methods 11 cases of femoral artery pseudoaneurysm were treated. 4 cases presented with ruptured aneurysm and were treated emergently by direct ligation of the aneurysmal artery through a femoral incision. 2 cases (underwent) elective operation in which the iliac artery was initially exposed through an extraperitoneal (lower) (abdominal) incision to control bleeding, and then the aneurysmal artery was ligated through a femoral (incision).Results All of the operations were successful, and no gangrene of the affected limb occurred.(Conclusions) Arterial ligation for femoral artery pseudoaneurysm caused by heroin injection is simple and (effective). (Intraoperative) observation of distal arterial backflow,measurement of (arterial) pressure and (intraoperative) (arteriography) can improve the safety of the operation.

Objective To evaluate the clinical efficacy of factional multiplex laser (AffirmTM) with combined apex pulse (CAP) technology in treating depressive acne scars,post inflammatory erythema and enlarged pores and other lesions.By following up,the correlative factors were analyzed to guide the further use of the factional laser (AffirmTM) with CAP technology.Methods Patients who received the AffirmTM laser therapy from Sept.2007 to July 2008 were enrolled in this retrospective follow-up study.Pictures were taken before and after each treatment during the therapy.Then the pictures were evaluated by dermatologists to attain object variables.Other subject variables from patients were recorded during survey.The relation between the efficacy and age,sex and treatment frequencies were analyzed statistically.Results The effective rate was 25.34 ％ for post-acne scars,36.84 ％ for post-acne erythema.28.57 ％ for enlarged pores,and 14.29 ％ for rythids.Nonparametric test showed no statistical difference with gender or age.There was correlation between efficacy and treatment frequencies.No severe adverse effect was observed.Conclusions AffirmTM laser with CAP technology has a good effect on treating post-acne depressed scars and erythema,enlarged pores and fine rythids.

Objective To evaluate the safety and efficacy of polymethylmethacrylate/PMMA (Artecoll) as an injectable dermal filler after using laser, radiofrequency and intensive pulse light. Methods In vitro, factional photothermolysis (Affirm) was directly used on the PMMA to see if there was any change in the structure or surface smoothness. In vivo, pig and guinea pig were used as the short-term and long-term models, respectively, for Artecoll. The dermal filler was first injected and then laser treatments conducted.The skin sample was observed through light microscope, scanning electronic microscope and transmission electronic microscope to see whether there were any structural changes, infiltration of inflammatory cells and the regeneration of collagen. Results Through the microscopic observation of in vitro experiment and the animal models, no distortion or rupture of the microsphere were found after the laser treatment. No uneven surface was found in the PMMA microsphere either. The microshpere was surrounded by the inflammatory cells. The infiltration was mild to intermediate with few foreign body giant cells even after several treatments of laser. There was no macrophage seen. But the collagen regeneration was distinguishable after the laser treatment. No obvious structural change was found eventually. Conclusion Artecoll is a safe and effective permanent injectable dermal filler for wrinkle reduction and contour refining.

Objective To investigate the efficacy and safety of photodynamic therapy (PDT) in the treatment of different types of rosacea,and to evaluate its benefit by comparing its efficacy with 10％ sodium sulfacetamide and 5％ sulfur emollient foam.Methods Forty-three subjects with rosacea were enrolled in this study.They were randomized to be treated with PDT (twenty-three subjects) or 10％ sodium sulfacetamide and 5％ sulfur emollient foam (twenty subjects).PDT group subjects received PDT once every seven to ten days for three times while the 10％ sodium sulfacetamide or 5％sulfur emollient foam was applied 2 times per day for thirty days in the other group.Digital photographs were taken before and after one month of treatment in both groups.Blinded independent physicians graded improvement based on these photographs utilizing a percentile evaluation scale.A more than sixty percent remission proved the treatment to be effective.All the complications occurred during the therapy were taken notes and their severity was classified by the subjects.Two dermatology life quality index forms were completed before and after treatment by the subjects to evaluate the change in terms of their quality of life.Results After one month of treatment,PDT proved to be effective on sixty-five percent of subjects (seventy-one percent on papulopustular rosacea and fifty percent on erythematotelangiectatic rosacea).The emollient foam proved to be effective on thirty-five percent of subjects.Statistically significant difference was observed between the overall effective rate of PDT and emollient foam (P＜0.05).In addition,a greater improvement in terms of the quality of life was experienced by the PDT group subjects.No irreversible adverse event was observed in both groups during the study.Conclusions PDT proves to be an effective and safe treatment for rosacea with satisfactory efficacy,significant improvement in patients' quality of life and few irreversible side effects.

Objective To compare the safety and efficacy of flexible terminal suction ureteral access sheath(FTS-UAS)and negative pressure ureteral access sheath(NPUAS)in flexible ureteroscopic lithotripsy with holmium laser in treatment of renal calculi less than 2 cm in diameter.Methods A total of 68 patients(largest diameter of stone＜2 cm)with renal calculi treated in Yangjiang Hospital Affiliated to Guangdong Medical University during Nov.2022 and Aug.2023 were divided into FTS-UAS group(n=34)and NPUAS group(n=34)according to different surgical methods.The perioperative parameters and stone-free rate(SFR)were compared between the two groups.Results The average SFR on the first day after operation was significantly higher in the FTS-UAS group than in the NPUAS group[85.3％(29/34)vs.61.8％(21/34),P=0.028].The operation time was significantly lower in the FTS-UAS group than in the NPUAS group[(65.85±13.16)min vs.(75.59±20.21)min,P=0.022].For lower calyceal renal calculi,the SFR was significantly higher in the FTS-UAS group than in the NPUAS group[82.4％(14/17)vs.43.8％(7/16),P=0.032].One month after operation,the SFR was higher in the FTS-UAS group than in the NPUAS group[94.1％(32/34)vs.85.3％(29/34),P=0.452].There were no significant differences in hemoglobin reduction,serum creatinine level,postoperative complications,hospital stay and hospitalization costs between the two groups(P＞0.05).Conclusion FTS-UAS in flexible ureteroscopic lithotripsy can shorten the operation time and improve stone-clearance rate,which is safe,effective,and worthy of clinical promotion.

Objective:To review the risk factors for early and medium-term complications of fenestration-branch endovascular thoracic aortic repair (F/B-TEVAR) in patients with complex aortic arch disease.Methods:The clinical and follow-up data of 202 patients undergoing F/B-TEVAR treatment from Feb 2019 to Sep 2023 in these centers were retrospectively analyzed .Results:There were 46 cases suffering from postoperative complications (22.8%). The risk factors with statistical significance included aortic atherosclerotic plaque [ OR=2.843; 95% CI (1.4-5.6); P<0.01], aortic intramural thrombosis [ OR=2.358; 95% CI (1.2-4.6), P=0.011], the aortic dilatation [ OR=4.219; 95% CI (1.6-11.3), P<0.01], the history of stroke [ OR=2.088; 95% CI (1.1-4.1), P=0.032], smoking history [ OR=2.680; 95% CI: (1.3-5.5); P<0.01], duration of surgery [ OR=1.9; 95% CI: (1.2-2.9); P=0.042].While the application of 3D printing assistive technology [ OR=0.392; 95% CI: (0.2-0.9); P=0.048] was in a negative correlation with postoperative complication. Conclusions:The independent risk factors for complications after F/B-TVAR included aortic atherosclerotic plaque, aortic intramural thrombosis, the aortic dilatation, the history of stroke, smoking history,duration of surgery.The application of 3D printing technology can effectively reduce the complication rate.

Objective:To study the application of 3D printing technology in multi-center fenestrated/branched endovascular repair (F/B-EVAR) for endovascular repair of abdominal aortic diseases.Methods:From Feb 2018 to Mar 2023, The clinical and followup data of 316 cases of abdominal aortic lesions undergoing repair with F/B-EVAR at 69 medical centers nationwide using 3D printing technology to guide physician-modified stent graft were retrospectively analyzed.Results:The mean follow-up time of the patients was 23 months (2-60 months), and 24 cases were lost to follow up, the follow-up rate was 92.4% (292/316), the mean postoperative hospitalization time was (8.2±4.9) days. A total of 944 main abdominal branch arteries were reconstructed. Intraoperative reconstruction of 11 branches failed, with a success rate of 98.8% (933/944). Within 30 days after surgery, 8 patients died (2.5%), and 6 patients died during follow-up, a total of 14 patients died (4.4%). There were 11 cases (3.5%) of spinal cord ischemia and no patient suffered from permanent paraplegia. There were 19 patients (6.0%) with postoperative renal function injury. Internal leakage was found in 26 patients, and the rate of internal leakage was 8.2%.Conclusion:3D printing technology can accurately locate the location of branch arteries, simplifing the surgical process, shortening the learning curve , and improving clinical efficacy.