0.05).No significant histological and ultrastructural changes were observed in the skin biopsies.Conclusion The long pulsewidth Diode Laser is a safe hair removal technique with good result and without adverse effect on the function of axillary sweat gland excretion.

BACKGROUND:Fracture healing in diabetic patients is usual y unsatisfactory because of hormones and metabolic disorder, and an eventual multiple organ dysfunction resulting from high blood glucose. OBJECTIVE:To dynamical y observe the changes of cytokines during the fracture healing process in diabetic rats before and after insulin treatment. METHODS:A total of 120 Sprague-Dawley rats were included in this study. Of them, 90 rats intravenously injected with 5%tetraoxypyrimidine to induce rat models of diabetes were randomized into insulin treatment and diabetes groups, respectively. The remaining 30 rats were intravenously injected with equal volume of saline and selected as control group. The next day, blood glucose was determined. Healing at 1, 4, and 8 weeks after fracture were observed by the X-ray film. Biomechanical strength of the injured right tibia was measured at 4, 6, and 8 weeks after modeling. Cytokines in the osteotylus were determined by immunohistochemical staining and in situ hybridization technique. RESULTS AND CONCLUSION:The X-ray films showed that the speed of fracture healing in the diabetes group was slower than insulin treatment and control groups. Biomechanical strength of the osteotylus in the diabetes group was significantly decreased compared with the insulin treatment and control groups. However, there were no significant differences in above-mentioned parameters between the control and insulin treatment groups. Bone morphogenetic protein 2, basic fibroblast growth factor, transforming growth factor-beta, and vascular endothelial growth factor were widely expressed in the osteotylus and their expressions in diabetes group were significantly lower and slower than those in the control and insulin treatment groups. There was no statistical difference between control and insulin treatment groups. These results indicate that osteotylus formation speed, biomechanical strength, and growth factor expressions at the fracture site in diabetes rats were decreased compared with normal rats. Insulin treatment can enhance cytokine levels at the fracture site, thereby promoting the osteoblast proliferation and fracture healing.

Objective To compare the clinical efficacy and adverse effects of photodynamic therapy (PDT) versus pulsed dye laser(PDL)for the treatment of port wine stains(PWS). Methods Forty?five patients with PWS were enrolled in this study. The PWS lesions in each patient were randomly divided into PDT and PDL areas. Hematoporphyrin monomethyl ether of 5 mg/kg was injected intravenously into the PDT area protected from light, followed by 20?minute irradiation with a 532?nm, solid?state, continuous?wave laser(power density:80-100 mw/cm2;spot diameter: 7 cm)10 minutes later. The PDL area was treated with a single session of 595?nm pulsed dye laser radiation(spot diameter:7 mm;pulse width:10 ms;energy density:10-12 J/cm2). The interval between PDT and PDL treatment was no shorter than two months. Follow up visits were scheduled on day 4 and week 8 after each treatment. Adverse reactions were recorded, and photographs were taken before and 8 weeks after the treatment for evaluation of lesion regression. Results In the case of PDT area, 10 cases(22.22%)were nearly cured, 22(48.89%)achieved marked improvement, 9(20.00%)improvement, 4(8.89%)no improvement. As far as the PDL area is concerned, 6 cases(13.33%)were nearly cured, 16(35.56%)achieved marked improvement, 18(40.00%)improvement, and 5 (11.11%)no improvement. The response rate was significantly higher in the PDT area than in the PDL area(Z=2.48, P<0.05). Hyperpigmentation, which spontaneously subsided within 3 to 6 months, was the main adverse reaction. No significant difference was found in the incidence rate of adverse reactions between the PDL and PDT areas(24.44%vs. 15.56%, Z=1.26, P>0.05). Conclusion For the treatment of PWS, both PDT and PDL are effective and safe, and single?session PDT appears to be superior to single?session PDL.

10.3969/j.issn.2095-4344.2013.25.024

Objective To measure the changes in levels of tumor necrosis factor α(TNF-α) secreted by human endothelial cells EC-304 after hematoporphyrin monomethyl ether-photodynamic treatment (HMME-PDT),and to explore the relationship between cytokines and inflammation initiation after management of nevus flammeus with photodynamic therapy.Methods EC-304 cells were cultured in 6-well plates,and classified into 4 groups:HMME-PDT group pretreated with HMME followed by irradiation with laser,HMME control group treated with HMME only,laser control group irradiated with laser only,and blank control group without any treatment.Culture supematants of EC-304 cells were collected from HMME-PDT group at 12,24 and 48 hours after the irradiation,and from the other three groups at the same time points.The supernatant TNF-α level was measured with enzyme linked immunosorbent assay (ELISA).Results The difference was statistically significant in the supernatant TNF-α level between different time points in each group (F=62.276.P<0.01) and between the 4 groups at each time point (F=11.538,P<0.01).Multiple comparison analysis showed that HMME-PDT group differed significantly from the other 3 control groups in the supernatant TNF-αlevel at each time point (all P<0.01),while no significant difierence was observed among the other three control groups at any time point (all P>0.05).Conclusion HMME-PDT promotes the secretion of TNF-α by EC-304 cells.

Objective To evaluate the efficacy and safety of AlumaTM functional aspiration controlled electrothermal stimulation (FACES) radiofrequency in the treatment of skin wrinkles and laxity on the face and neck. Methods A total of 30 volunteers with aging skin were recruited in the study. All volunteers were treated with AlumaTM FACES radiofrequency for 6 times at 2-week interval. Photographs were taken for volunteers before every treatment and 1 month after the last treatment. Improvement in lesions was objectively assessed by two separate physicians based on the photographs of volunteers taken before the first,fourth and sixth treatment, and 1 month after the last treatment. Patient satisfaction was measured by ques-tionnaire. Adverse effects were recorded. Results Totally, 24 volunteers completed the treatment. Improve-ment of lesions was achieved in 66.7% of the volunteers after 3 treatments, 90.5% after 5 treatments, and 94.4% one month after the last treatment. About 50% of the volunteers were satisfied with the effect after 3 treatments, 90.5% after 5 treatments, and 100% one month after the last treatment. Slight purpura was the most common side effect. Conehusion Radiofrequency therapy is effective for skin wrinkles and laxity on the face and neck, without obvious side effect.

Objective To compare the absorption characteristics of HMME by a human umbilical vein endothelial cell line ECV 304 versus a human keratinocyte cell line HaCaT.Methods Exponentially growing ECV304 and HaCaT cells were incubated with various concentrations (50,100,150,200 and 250 mg/L) of HMME for 16 h or HMME of 150 mg/L for various durations (15 min,30 min,1 h,3 h,8 h,12 h and 24 h).The quantity of HMME absorbed by the cells were determined by laser scanning confocal microscopy (LSCM).Results The fluorescence intensity was 74.00,125.57,135.24,141.99 and 132.09 for ECV304 cells,93.88,102.45,112.59,108.23 and 104.70 for HaCaT cells,after incubation with HMME of 50,100,150,200 and 250 mg/L,respectively.After treated with HMME of 150 mg/L for 15 min,30 min,1 h,3 h,8 h,12 h and 24 h,ECV304 cells showed a fluorescence intensity of 95.07,103.97,105.96,108.99,112.93,115.36 and 122.91,respectively,and HaCaT cells displayed a fluorescence intensity of 104.25,106.60,108.72,113.75,117.66,114.90 and 118.14,respectively.Conculsions Within a defined range of concentration and duration,the absorption of HMME by both ECV304 and HaCaT cells is,to some extent,concentration- and time-dependent.

Objective To evaluate the long-term effects and safety of diode laser in hair removal.Methods A retrospective study was conducted.In this study,350 patients with hypertrichosis were treated by an 800-nm diode laser with a pulse duration of 30 ms for various sessions.Two groups were divided based on the treatment sessions:group A receiving 6(≥4 for axillae)or more treatments,group B less than 6(＜4 for axillae)treatments.Patients were followed up for 8 months to 3 years(mean 22.5 months)by return visit or telephone.Evaluation of efficacy and side effects were performed.Results Follow-up and evaluation were completed in 235 patients,and a total of 375 sites treated.After 2-18 treatments,a total effective rate of 80.53%(302/375)was achieved.Significant higher effective rates were observed in group B compared with group A at all sites 86.84%(33/38)vs 35.00%(7/20)on the lips,68.42%(26/38)vs 30.77%(4/13)on the face and neck,92.00%(46/50)vs 55.56%(5/9)in lower extremities,86.96%(20/23)vs 50.00%(4/5)on the trunk.93.81%(91/97)vs 55.56%(5/9)at the axillae,92.16%(47/51)vs 73.68%(14/19)in the upper extremities(all P＜0.05),Side effects were noted in only 6 cases,including hyperpigmentation,itching,and development of follicular papules,blisters and white hair.Neither hypopigmentation nor scarring was observed.Conclusions Diode laser system is effective and safe for hair removal.The effect varies with lesional sites and treatment sessions.

BACKGROUND:Intertrochanteric fracture can obtain good curative effects after active effective internal fixation in early stage.
OBJECTIVE:To compare dynamic hip screw+trochanter stabilizing plate and Gamma nail fixation for treatment of Evans type IIIB and type IV intertrochanteric fracture.
METHODS:A total of 67 patients with Evans type IIIB and type IV intertrochanteric fracture, including 28 cases undergoing dynamic hip screw+trochanter stabilizing plate and 39 cases undergoing Gamma nail, were selected from Chongming Branch, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from February 2009 to November 2012. Al patients received antibiotics and functional exercises after treatment. Time of therapy, intraoperative bleeding amount, fracture healing time and Harris Hip Score were retrospectively analyzed in patients of both groups.
RESULTS AND CONCLUSION:Al patients were fol owed up for 6-45 months, averagely 21 months. (1) One patient affected infection in the dynamic hip screw+trochanter stabilizing plate group. He was healed after fixation removal half a year after drug exchange. One obese patient experienced injury again during out-of-bed activity at 3 weeks after treatment in the Gamma nail group. Fracture appeared at distal end of lock pin, and healed after replaced by Gamma nail. Trochanteric stabilizing plate was unstable in four patients of the Gamma nail group. They affected severe pneumonia after over 6 weeks of lying in bed, and healed after treatment in the medical department (2) Coxa vara appeared in two cases of the dynamic hip screw+trochanter stabilizing plate group, and three cases in the Gamma nail group. Fracture healing was achieved in al patients. (3) The time of therapy was longer, and intraoperative bleeding amount was significantly more in the dynamic hip screw+trochanter stabilizing plate group compared with the Gamma nail group (P<0.05). No significant difference in healing time and Harris Hip Score was detected between the two groups (P>0.05). Dynamic hip screw+trochanter stabilizing plate and Gamma nail are effective methods for treatment of Evans type IIIB and type IV intertrochanteric fracture. To choose a suitable fixator, we should aggregately analyze fracture stability, healing state and the degree of osteoporosis.

BACKGROUND:With the increasing incidence of distal tibial fractures, locking plate fixation has become the preferred internal fixation method. OBJECTIVE:To analyze the biomechanical performance of distal tibial fractures, and to study the difference between medial and lateral locking plate methods for internal fixation of distal tibial fractures. METHODS:Articles concerning the biomechanics of the internal fixation of distal tibial fractures were col ected by literature search. The articles that met the criteria were analyzed in depth. In this paper, a biomechanical comparison between locking plate fixation and intramedul ary nail fixation was done as wel as the stress distribution and mechanism of the ankle joint. Meanwhile, 60 patients with distal tibial fractures who had received medial or lateral locking plate fixation at the Department of Orthopedics, Chongming Branch, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China from January 2009 to January 2012 were enrol ed for efficiency comparison. RESULTS AND CONCLUSION: For patients with distal tibial fractures, it is easy to cause posterior mal eolus fractures, Y-shaped fractures and anterior tibial compression, respectively, in the plantar flexion position, neutral position, and dorsiflexion position. Locking plate is better than the intramedul ary nail in the torsional force, and the intact fibula contributes to the improvement of fixed effects of these two internal fixation methods. When the fibula cannot be effectively fixed, the locking plate fixation has a better stability than the intramedul ary nail. Moreover, there is no difference in the fracture healing after fixation with medial and lateral locking plates. However, a lower incidence of complications and better function recovery of the ankle joint can be realized after lateral locking plate fixation.