5-aminolaevulinic Acid-photodynamic Therapy for the Treatment of Cervical Condylomata Acuminata

Objective To investigate the efficacy and safety of photodynamic therapy （PDT） with topical 5-aminolaevulinic acid （ALA） on cervical condylomata acuminata. Methods Patients with cervical condylomata （n=30） were allocated into primary and recurrent group, and were given topical ALA under occlusive dressing for 3 hours followed by irradiation with semiconductor laser at a dose of 100 Jcm 2 and a power of 100 roW. The treatment was repeated 7 days later if the lesion was not completely removed after the first treatment. Complete response rate and recurrence rate of wart lesions as well as rate of adverse reaction were analyzed. Results The total complete response rate of PDT was 100% and the total recurrence rate was 5% after 3 months of follow-up. Recurrence rate of recurrent group was significantly lower than that of prior managements （100%, P〈0.01）. The side effects of PDT in patients mainly included mild burning and/or stinging restricted to the illuminated areas, and was significant lower than their own control （25% vs. 100%, P〈0.05）. Conclusion Compared with conventional therapies, topical application of ALA-PDT is a simple, effective, safe, well-tolerated, and low recurrence rate treatment for cervical condylomata acuminata.

Influence of CaNa_2 EDTA on topical 5-aminolaevulinic acid photodynamic therapy

Background We asssessed whether the CaNa_2 EDTA could improve the accumulation of protoporphyrin Ⅸ (PpⅨ) and photosensitisation in HEp-2 cells as well as the depth of treatment of skin cancers on the topical 5-Aminolaevulinic acid (5-ALA) PDT.Methods HEp-2 cells were incubated with 5-ALA (0-1mmol/L) and CaNa_2EDTA (0-1mmol/L) for 4 hours,intracellular protoporphyrin Ⅸ content was quantified by extraction,and cell viability was assessed by use of the methyl-tetrazolium (MTT) assay four hours after exposure to light. In comparison with the pictures before and after treatment,depth of treatment could be determined using a Acuson Sequioa 512 phase-array system in paired experiments.Results PpⅨ accumulation increased with increasing extracellular concentrations of ALA (0-1mmol/L). Adding 1mmol/L of CaNa_2EDTA increased 30% PpⅨ accumulation over the same period of incubation in the concentration of 1mmol/L ALA. Significant difference was observed between the 5-ALA alone group and 5-ALA combined CaNa_2 EDTA group in the PpⅨ accumulation ( P <0.01). Cell viability after exposure to light decreased with adding CaNa_2 EDTA,a statistical difference in a same fluence above 1.2 J/cm 2 between two groups was demonstrated ( P <0.05,P <0.01 respectively). Depth of treatment of skin cancers were increased in CaNa_2 EDTA-treated group.conclusion CaNa_2 EDTA could improve the PpⅨ accumulation and photosensitisation in HEp-2 cells. Clinically,CaNa_2 EDTA could increase the depth of treatment in the cutaneous cancers.

Photodynamic Therapy of Cancer Cells with Methanesulfonate Salts of 5-Aminolevulinic Acid and Its Derivatives

A series of 5-aminolevulinic acid and its alkylester methanesulfonates was exploited to photodynamic therapy（PDT） of human lymphocytic cells, U-937 in vitro. The PDT efficiency is influenced by the concentration and incubation time. Generally, for ALA and its alkylester methanesulfonates, the cell survival rate decreases and the accumulation ability of PplX increases with the concentration and incubation time. We found that the longer carbon chain methanesulfonates（C5-S, C6-S, C8-S） exhibit better PDT effect than ALA methanesulfonate. This possibly provides a promising route to the clinical application ofPplX-mediated PDT to cancer cell.

OPTIMIZATIONS FOR 5-AMINOLEVULINIC ACID BASED PHOTODYNAMIC THERAPY IN PURGING LEUKEMIA CELL HL60

Objective To optimize experimental parameters for the photosensitization of 5-aminolevulinic acid (ALA) in promyelocytic leukemia cell HL60 and compare them with normal human peripheral blood mononuclear cell (PBMC). Methods ALA incubation time, wavelength applied to irradiate, concentration of ALA incubated, irradiation fluence may modulate the effect of 5-aminolevulinic acid based Photodynamic Therapy (ALA-PDT).The high-pressure mercury lamps of 400W served as light source, the interference filter of 410nm, 432nm, 545nm, 577nm were used to select the specific wavelength. Fluorescence microscope was used to detect the fluorescence intensity and location of protoporphyrin IX (PpIX) endogenously produced by ALA. MTT assay was used to measure the survival of cell. Flow cytometry with ANNEXIN V FITC kit (contains annexin V FITC, binding buffer and PI) was used to detect the mode of cell death. Results ① 1mmol/L ALA incubated 1×105/mL HL60 cell line for 4 hours, the maximum fluorescence of ALA induced PpIX was detected in cytomembrane. ② Irradiated with 410nm for 14.4J/cm2 can result in the minimum survivability of HL60 cell. ③ The main mode of HL60 cell death caused by ALA-PDT is necrosis. Conclusion ALA for 1mmol/L, 4 hours for dark incubation time, 410nm for irradiation wavelength, 14.4J/cm2 for irradiation fluence were the optimal parameters to selectively eliminate promyelocytic leukemia cell HL60 by ALA based PDT. The photosensitization of ALA based PDT caused the necrosis of HL60 cell, so it could be used for inactivation of certain leukemia cells.

CO_(2)LASER PLUS PHOTODYNAMIC THERAPY VERSUS CO_(2)LASER IN THE TREATMENT OF CONDYLOMA ACUMINATUM:A RANDOMIZED COMPARATIVE STUDY

To compare the efficacy and safety of CO_(2)laser plus 5-aminolevulinic acid(ALA)photodynamic therapy(PDT)with CO_(2)laser for the treatment of multiple condyloma acuminatum(CA),120 patients with multiple CA were allocated into two groups—combined group(CO_(2)laser plus ALA-PDT,n=60)and CO_(2)laser group(CO_(2)laser plus placebo-PDT,n=60).After CO_(2)laser,a 20%ALA or a placebo solution was applied to the CA area 3 h before illumination with red light(635 nm,100mW/cm^(2),80 J/cm^(2)).The treatment was repeated seven days after the first treatment if the lesions were not completely resolved.The complete response rate,recurrence rate and adverse effects in the two groups were analyzed.After two treatments,the complete response rates in the CO_(2)laser group and combined group were 100%(509/509)and 100%(507/507)in the CA(p>0:05),respectively.The recurrence rates in the CO_(2)laser group and combined group were 44.9%(229/509)and 10.6%(54/507)in the CA(p<0:05),respectively.The adverse effects in CO_(2)laser group was more than that in combined group.The combined group is a more effective treatment for multiple CA compared with CO_(2)laser group.T/S.Style the highlighted text as abstract.

Clinical Effect of Photodynamic Therapy Combined Cryotherapy on Nonmelanoma Skin Cancer

The purpose of this study was to investigate the clinical efficacy of photodynamic combined freezing in patients with non-melanoma skin cancer(NMSC).First,according to the treatment regimen,96 patients with NMSC were divided into study group(n=50)and control group(n=46).The control group was treated with 5-amino-ketovalic acid photodynamic therapy(ALAPDT),while the study group was treated with ala-PDT combined with cryotherapy.Visual analogue scale(VAS)scores,visual satisfaction,clinical efficacy,adverse reactions,and progression-free survival were compared between the two groups.The results showed that VAS score in the study group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).The appearance satisfaction and total effective rate of patients in the study group were higher than those in the control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the study group was slightly higher than that in the control group,but the difference was not statistically significant(P>0.05).3 years progressionfree survival time and 3 years progression-free survival rate were compared between the two groups,and the difference was not statistically significant(P>0.05).Therefore,the combination of PDT and cryotherapy for non-melanoma skin cancer has a good clinical effect,which is conducive to the recovery of skin lesions,high patient satisfaction,fewer adverse reactions,and longer progression-free survival.In addition,the combined therapy can provide a new treatment idea for non-melanoma skin cancer patients who are not suitable for surgical treatment.

Topical 5‑aminolevulinic acid‑mediated photodynamic therapy versus loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia

Objective To compare effectiveness of topical 5-aminolevulinic acid-mediated photodynamic therapy(5-ALA PDT)and loop electrosurgical excision procedure(LEEP)among patients with cervical intraepithelial neoplasia(CIN).Methods We retrospectively identified patients who underwent either 5-ALA PDT or LEEP from Sep.2012 to Dec.2019 in Chinese PLA general hospital.Patients’outcomes were compared according to the HPV genotyping,cytologi-cal tests within 3–6-month follow-up post-treatment,the pathological examination would be performed if the cyto-logical results indicated the risk of CIN.Propensity score matching(PSM)was adapted to pair the baseline.Complete remission(CR),partial remission(PR)and the remission rate of HPV infections were used to evaluate the efficacy of 5-ALA PDT versus LEEP.Results In total,30 pairs were matched as the matching tolerance was set as 0.03.There was no significant difference about the CR and PR between 5-ALA PDT and LEEP group(73.33%vs 84.00%,P=0.340;3.33%vs 4.00%,P=1.000).Among different CIN group,there was no statistic difference between 5-ALA PDT and LEEP.Moreover,in terms of HPV remission rate,5-ALA PDT showed the same efficacy as LEEP(59.26%vs 53.85%,P=0.691).Conclusions In essence,topical 5-ALA PDT emerges as a non-invasive,repeatable procedure with minimal side effects for cervical lesions,preserving cervical structure.Overall,the efficacy of 5-ALA PDT is comparable to LEEP in achieving successful outcomes.

5-Amino-4-oxopentanoic acid photodynamic diagnosis guided microsurgery and photodynamic therapy on VX2 brain tumour implanted in a rabbit model

Background Complete tumour resection is important for improving the prognosis of brain tumour patients. However, extensive resection remains controversial because the tumour margin is difficult to be distinguished from surrounding brain tissue. It has been established that 5-amino-4-0xopentanoic acid （5-aminolevulinic acid, ALA） can be used as a photodynamic diagnostic marker and a photosensitizer for photodynamic therapy in surgical treatment of brain tumours. We investigated the efficacy of ALA photodynamically guided microsurgery and photodynamic therapy on VX2 brain tumour implanted in a rabbit model. Methods Eighty New Zealand rabbits implanted with VX2 brain tumours were randomly assigned to five groups： control, conventional white light microsurgery, a photodynamic therapy group, a photodynamically guided microsurgery group and a group in which guided microsurgery was followed by photodynamic therapy. The VX2 tumour was resected under a surgical microscope. The tumour resection was confirmed with histological analysis. All animals were examined with MRI for presence of any residual tumour tissue. The survival time of each rabbit was recorded. Results All treatment groups showed a significantly extended survival time compared with the control group. Photodynamically guided microsurgery combined with photodynamic therapy significantly prolonged survival time, compared with guided microsurgery alone. MRI and the autopsy results confirmed removal of most of the tumours. Conclusions Our results suggest that photodynamically guided surgery and photodynamic therapy significantly reduce or delay local recurrence, increase the effectiveness of radical resection and prolong the survival time of tumour bearing rabbits. Their combination has the potential to be used as a rapid and highly effective treatment of metastatic brain tumours.

Boosting 5-ALA-based photodynamic therapy by a liposomal nanomedicine through intracellular iron ion regulation

5-Aminolevulinic acid(5-ALA)has been approved for clinical photodynamic therapy(PDT)due to its negligible photosensitive toxicity.However,the curative effect of 5-ALA is restricted by intracellular biotransformation inactivation of 5-ALA and potential DNA repair of tumor cells.Inspired by the crucial function of iron ions in 5-ALA transformation and DNA repair,a liposomal nanomedicine(MFLs@5-ALA/DFO)with intracellular iron ion regulation property was developed for boosting the PDT of 5-ALA,which was prepared by co-encapsulating 5-ALA and DFO(deferoxamine,a special iron chelator)into the membrane fusion liposomes(MFLs).MFLs@5-ALA/DFO showed an improved pharmaceutical behavior and rapidly fused with tumor cell membrane for 5-ALA and DFO co-delivery.MFLs@5-ALA/DFO could efficiently reduce iron ion,thus blocking the biotransformation of photosensitive protoporphyrin IX(Pp IX)to heme,realizing significant accumulation of photosensitivity.Meanwhile,the activity of DNA repair enzyme was also inhibited with the reduction of iron ion,resulting in the aggravated DNA damage in tumor cells.Our findings showed MFLs@5-ALA/DFO had potential to be applied for enhanced PDT of 5-ALA.

Photodynamic therapy accelerates skin wound healing through promoting re-epithelialization

Background:Epidermal stem cells(EpSCs)that reside in cutaneous hair follicles and the basal layer of the epidermis are indispensable for wound healing and skin homeostasis.Little is known about the effects of photochemical activation on EpSC differentiation,proliferation and migration during wound healing.The present study aimed to determine the effects of photodynamic therapy(PDT)on wound healing in vivo and in vitro.Methods:We created mouse full-thickness skin resection models and applied 5-aminolevulinic acid(ALA)for PDT to the wound beds.Wound healing was analysed by gross evaluation and haematoxylin–eosin staining in vivo.In cultured EpSCs,protein expression was measured using flow cytometry and immunohistochemistry.Cell migration was examined using a scratch model;apoptosis and differentiation were measured using flow cytometry.Results:PDT accelerated wound closure by enhancing EpSC differentiation,proliferation and migration,thereby promoting re-epithelialization and angiogenesis.PDT inhibited inflammatory infiltration and expression of proinflammatory cytokines,whereas the secretion of growth factors was greater than in other groups.The proportion of transient amplifying cells was significantly greater in vivo and in vitro in the PDT groups.EpSC migration was markedly enhanced after ALAinduced PDT.Conclusions:Topical ALA-induced PDT stimulates wound healing by enhancing re-epithelialization,promoting angiogenesis as well as modulating skin homeostasis.This work provides a preliminary theoretical foundation for the clinical administration of topical ALA-induced PDT in skin wound healing.

Clinical applications of 5-aminolevulinic acid-mediated fluorescence for gastric cancer

5-aminolevulinic acid(ALA) is a naturally occurring amino acid that is a protoporphyrin IX(Pp IX) precursor and a next-generation photosensitive substance. After exogenous administration of ALA, Pp IX specifically accumulates in cancer cells owing to the impaired metabolism of ALA to Pp IX in mitochondria, which results in a red fluorescence following irradiation with blue light and the formation of singlet oxygen. Fluorescence navigation by photodynamic diagnosis(PDD) using ALA provides good visualization and detection of gastric cancer lesions and is a potentially valuable diagnostic tool for gastric cancer for evaluating both the surgical resection margins and extension of the lesion. Furthermore, PDD using ALA might be used to detect peritoneal metastases during preoperative staging laparoscopy, where it could provide useful information for the selection of a therapeutic approach. Another promising application for this modality is in the evaluation of lymph node metastases. Photodynamic therapy(PDT) using ALA to cause selective damage based on the accumulation of a photosensitizer in malignant tissue is expected to be a non-invasive endoscopic treatment for superficial early gastric cancer. ALA has the potential to be used not only as a diagnostic agent but also as a therapeutic drug, resulting in a new strategy for cancer diagnosis and therapy. Here, we review the current use of PDD and PDT in gastric cancer and evaluate its future potential beyond conventional modalities combined with a light energy upconverter, a light-emitting diode and nearinfrared rays as light sources.

5-氨基酮戊酸光动力治疗对鲍温病皮损中p53 Caveolin-1表达的影响

目的:探讨5-氨基酮戊酸光动力疗法对鲍温病皮损中p53、Caveolin-1表达的影响及意义。方法:运用5-氨基酮戊酸光动力疗法治疗鲍温病及周围正常皮肤组织各40例,采用免疫组织化学技术(SP法)检测光动力治疗前后鲍温病及周围正常皮肤组织中p53、Caveolin-1的阳性细胞表达率。结果:治疗前p53蛋白在正常皮肤组织及BD中表达的阳性率分别为10%、40%(χ^(2)=11.202,P<0.001),差异有统计学意义。治疗后p53在正常皮肤组织及BD的阳性率为10%、5%(χ^(2)=0.712,P=0.399),两者间差异无统计学意义。治疗前后p53在BD中的阳性表达率差异有统计学意义(χ^(2)=14.811,P<0.001)。治疗前Caveolin-1在正常皮肤组织及BD中阳性表达率为15%、55%(χ^(2)=14.449,P<0.001),两者间差异有统计学意义。治疗后正常皮肤组织及BD中Caveolin-1的阳性率为5%、12.5%(χ^(2)=0.816,P=0.366),差异无统计学意义。治疗前后Caveolin-1在BD中的阳性表达率差异有统计学意义(χ^(2)=19.013,P<0.001)。BD中p53与Caveolin-1阳性表达呈正相关性(r=0.533,P=0.015)。结论:p53及Caveolin-1的高表达可能与BD的发生密切关联,且ALA-PDT能够抑制p53及Caveolin-1的表达,从而抑制疾病的发展。通过更大样本量的研究,p53及Caveolin-1可能会成为皮肤相关疾病的诊断工具,并为其治疗提供新的靶点。

5-Aminolevulinic Acid (5-ALA): Analysis of Preclinical and Safety Literature

Problem: 5-ALA has been used for many years at relatively high dose amounts in single doses for photodynamic therapy and immunofluorescence of tumors. An analysis of compiled data relating to safety and any side-effects about the use of 5-ALA at low doses has not yet been published. Purpose: This report analyzes data about the safety of the use of 5-Aminolevulinic Acid (5-ALA) in low doses as a supplement over an extended period of time. Methods: This investigation is a systematic analysis of the current literature ((Medline, and SBI) and snowballing techniques) related to the safety and efficacy of 5-ALA in animals and humans. Clinical trials in progress using 5-ALA were also analyzed. Constant comparative analyses were used to synthesize the findings. Results: The safety of low-dose 5-ALA as a supplement has been demonstrated by animal and human studies. The results suggest that none of the investigations document the presence of symptoms or abnormal laboratory results of clinical significance. The minor laboratory changes documented were judged not clinically significant.

5-氨基酮戊酸光动力疗法治疗非黑色素瘤性皮肤癌患者的临床疗效

目的探讨5-氨基酮戊酸光动力疗法(ALA-PDT)治疗非黑色素瘤性皮肤癌(NMSC)患者的临床疗效。方法根据治疗方案的不同将52例NMSC患者分为A组(25例)和B组(27例),A组患者接受手术治疗,B组患者在A组的基础上接受ALA-PDT治疗。比较两组患者的临床疗效、血清学指标[转录中介因子1-γ(TIF1-γ)、Nodal、白细胞介素-1β(IL-1β)、转化生长因子-β1(TGF-β1)]、皮损面积、生活质量[生活质量综合评定问卷-74(GQOLI-74)]及外观满意度。结果B组患者的总有效率、外观总满意度均高于A组,差异均有统计学意义(P﹤0.05)。治疗后4周,两组患者TIF1-γ、Nodal、IL-1β、TGF-β1水平均低于本组治疗前,皮损面积均小于本组治疗前,GQOLI-74各维度评分均高于本组治疗前,B组患者TIF1-γ、Nodal、IL-1β、TGF-β1水平均低于A组,皮损面积小于A组,GQOLI-74各维度评分均高于A组,差异均有统计学意义(P﹤0.05)。结论ALA-PDT治疗NMSC患者效果较好,可降低血清学指标水平,减小皮损面积,提高患者外观满意度和生活质量。

行为改变轮理论在5-氨基酮戊酸光动力疗法治疗尖锐湿疣患者中的应用

目的探讨行为改变轮(BCW)理论在5-氨基酮戊酸光动力疗法(ALA-PDT)治疗尖锐湿疣(CA)患者中的应用。方法回顾性分析2021年10月至2023年5月89例在安徽省宣城市中心医院确诊CA的患者的临床资料,根据治疗方案的不同将患者分为观察组(n=47)和对照组(n=42)。两组均接受ALA-PDT治疗,对照组采用常规CA护理方式,观察组在对照组基础上采用BCW理论干预,均干预1个月。在干预前后,比较两组焦虑自评量表(SAS)评分、皮肤病生活指数(DLQI)、健康行为量表(HPL)和自我健康管理能力量表(ESCA)评分。随访3个月,比较两组人乳头瘤病毒(HPV)感染根除率。结果干预后,两组SAS评分均低于干预前,且观察组低于对照组(P<0.05);干预后,两组DLQI各维度评分均低于干预前,且观察组低于对照组(P<0.05);干预后,两组HPL、ESCA评分均高于干预前,且观察组高于对照组(P<0.05)。随访3个月后,观察组HPV感染根除率为89.36%(42/47),对照组HPV感染根除率为83.33%(35/42),两组无显著差异(P>0.05)。结论采用BCW理论干预ALA-PDT治疗的CA患者,可改善患者生活质量,提高其自我管理能力和促进健康行为。

5-氨基酮戊酸光动力治疗Olsen 3级日光性角化病的疗效评估及影响因素分析

背景与目的:日光性角化病(actinic keratosis,AK)是具有皮肤鳞状细胞癌发展潜力的癌前病变,5-氨基酮戊酸光动力疗法(5-aminolevulinic acid photodynamic therapy,ALA-PDT)因其清除率高和美容无创的优势,已成为治疗AK的新选择,但其对以角化过度为特征的Olsen 3级AK病变的疗效仍存在争议。本研究旨在探讨ALA-PDT治疗Olsen 3级AK的疗效、安全性及影响疗效的因素。方法:对2020年1月—2023年7月在复旦大学附属华山医院皮肤科就诊的Olsen 3级AK患者进行连续4次ALA-PDT治疗,并随访至治疗后1年(伦理审批号:2019-491)。所有患者符合入组标准及排除标准。通过治疗后3个月的初始完全清除(initial complete clearance,ICC)和治疗后12个月的持续完全清除(sustained complete clearance,SCC)来评估疗效。同时收集患者治疗前的临床及病理学特征,采用单因素和多因素逻辑回归分析探讨Olsen3级AK患者ALA-PDT治疗失败的危险因素,通过亚组分析进一步探索导致治疗抵抗和复发的危险因素。本临床试验在中国临床试验注册中心注册(注册号:ChiCTR1800019213)。本研究严格遵循《加强流行病学中观察性研究报告质量》(Strengthening the Reporting of Observational Studies in Epidemiology,STROBE)指南中的各项条目。结果:共有38例患者纳入本项研究,其中病例组8例,对照组29例,1例患者在治疗后6个月失访。治疗后3个月,86.84%的患者达到ICC(33/38),随访至12个月,87.88%达到ICC的患者维持SCC(29/33),治疗及随访期间无严重不良反应发生。多因素逻辑回归分析表明,病灶位于多个解剖亚单位是ALA-PDT治疗失败的独立危险因素(P=0.02,OR=28.43),亚组分析证实该因素与治疗抵抗相关(P=0.03,OR=97.54)。结论:ALA-PDT对Olsen 3级AK患者疗效良好且安全性高,为该类患者提供了一种无创的治疗选择。然而,病灶位于多个解剖亚单位的患者更容易出现治疗失败,提示对此类患者的治疗应提高警惕。

5-氨基酮戊酸光动力疗法联合人干扰素α-2β治疗尖锐湿疣的效果分析

目的探讨5-氨基酮戊酸光动力疗法(ALA-PDT)联合人干扰素α-2β治疗尖锐湿疣(CA)的效果及对血清T细胞亚群和趋化因子配体19(CCL19)、基质金属蛋白酶-3(MMP-3)水平的影响。方法选择86例CA患者为研究对象,根据随机数字表法将CA患者分为对照组(ALA-PDT治疗)和观察组(ALA-PDT联合人干扰素α-2β治疗),每组43例。比较2组患者临床疗效以及治疗前后血清T细胞亚群、CCL19、MMP-3水平变化情况,并记录治疗期间不良反应发生情况。随访6个月,记录复发疣体数量和复发率。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,观察组CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)较对照组升高,差异有统计学意义(P<0.05)。与对照组比较,观察组治疗后血清CCL19升高,MMP-3下降,差异有统计学意义(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。对照组复发率、平均复发疣体数量高于观察组,差异有统计学意义(P<0.05)。结论ALA-PDT联合人干扰素α-2β治疗尖锐湿疣效果显著,可调节血清T细胞亚群水平,降低MMP-3水平,提升CCL19水平,且安全性较好。

5-氨基酮戊酸光动力疗法及CO_(2)激光分别联合复方利多卡因凝胶治疗尖锐湿疣的疗效及复发的相关性分析

目的探讨5-氨基酮戊酸光动力疗法(ALA-PDT)及二氧化碳(CO_(2))激光分别联合复方利多卡因凝胶治疗尖锐湿疣(CA)的疗效及复发的相关性分析。方法回顾性分析2021年1月至2023年1月徐州医科大学附属医院收治的121例CA患者的临床资料,根据治疗方式分为A组(n=62)、B组(n=59),A组采用ALA-PDT联合复方利多卡因凝胶治疗,B组采用CO_(2)激光联合复方利多卡因凝胶治疗,比较两组的临床疗效。治疗后6个月随访统计复发情况,并将患者分为复发组(n=34)和未复发组(n=87),分析CA患者复发的影响因素。结果A组临床总有效率高于B组,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,多发CA、偶尔/经常使用或不使用安全套、2名及以上性伴侣、经常熬夜、CO_(2)激光联合复方利多卡因凝胶治疗是CA患者复发的独立危险因素(P<0.05)。结论ALA-PDT联合复方利多卡因凝胶治疗CA的疗效优于CO_(2)激光联合复方利多卡因凝胶治疗,CA数目、安全套使用情况、性伴侣数量、经常熬夜及治疗方式等是CA患者复发的相关因素,临床需重视以上因素并制定针对性干预措施以降低CA复发率。

5-氨基酮戊酸光动力学疗法联合干扰素栓对持续高危型人乳头瘤病毒感染患者病毒清除率及阴道微环境的影响

目的探究5-氨基酮戊酸光动力学疗法(ALA-PDT)联合干扰素栓对持续高危型人乳头瘤病毒(HPV)感染患者HPV清除率及阴道微环境的影响。方法选取2020年1月至2023年1月景德镇市第一人民医院收治的80例持续高危型HPV感染患者作为研究对象,采用随机数字表法将其分为对照组和观察组各40例,对照组采用干扰素栓治疗,观察组采用干扰素栓联合ALA-PDT治疗,观察两组病毒载量变化和HPV清除率、菌群密集度、菌群多样性、优势菌情况、阴道pH变化、Nugnet评分变化以及6个月内复发率。结果观察组治疗后的病毒载量低于对照组,HPV清除率高于对照组,差异有统计学意义(P<0.05);观察组治疗后的菌群密集度正常率、菌群多样性正常率、优势菌群健康率均高于对照组,差异有统计学意义(P<0.05);观察组治疗后的阴道pH、Nugnet评分均低于对照组,差异有统计学意义(P<0.05);观察组6个月内复发率低于对照组,差异有统计学意义(P<0.05)。结论ALA-PDT联合干扰素栓治疗持续高危型HPV感染患者可以提高HPV清除率,改善阴道微环境,降低复发率。

5-氨基酮戊酸光动力疗法联合过氧化苯甲酰凝胶治疗面部中重度痤疮疗效观察

目的:分析5-氨基酮戊酸光动力和过氧化苯甲酰凝胶治疗中重度痤疮患者的效果,以及对其皮损状况、皮肤屏障功能的影响。方法:选择2021年12月-2022年12月于笔者医院治疗的110例中重度痤疮患者为研究对象,随机分为观察组(55例)、对照组(55例)。对照组采用过氧化苯甲酰凝胶治疗,观察组采用5-氨基酮戊酸光动力和过氧化苯甲酰凝胶治疗。比较两组治疗后总有效率、皮损积分、皮肤屏障功能各项指标及不良反应发生情况。结果:治疗后,对照组总有效率80.00%,明显低于观察组的98.18%(P<0.05);两组患者皮损积分经过治疗均明显下降(P<0.05),且观察组低于对照组(P<0.05);两组经过治疗后角质层含水量(SCH)均上升(P<0.05),皮肤油脂、经皮水分丢失量(TEWL)、pH值均下降(P<0.05),且观察组各项皮肤屏障功能指标改善幅度大于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:对中重度痤疮患者采用5-氨基酮戊酸光动力+过氧化苯甲酰凝胶联合治疗,效果较为理想,临床应用价值较高。