Serum level changes of inflammatory cytokines in patients with moderate to severe acne vulgaris treated with dual-wavelength laser

Background:Acne vulgaris(AV)is a common inflammatory skin disease.Although various mechanisms have been indicated in the etiopathogenesis of AV,the exact pathophysiology remains unknown.Various lasers have been used to treat AV;however,the serum level changes of inflammatory cytokines after laser therapy have not been elucidated.We aimed to investigate the relationship between inflammatory changes and remission on the opposite side in patients with moderate to severe AV after treating half of the face with 595-and 1064-nm dualwavelength laser.Methods:In total,18 patients(9 male and 9 female)between 16 and 35 years of age with moderate to severe AV were evaluated in the study.Disease severity was classified according to the Pillsbury grading system of acne.Patients were randomized to receive a series of two treatment sessions at intervals of 2 weeks and followed up at 2 weeks after the final treatment.A 3 mL blood sample was drawn from every subject each time,and serum levels of inflammatory cytokines such as interleukin(IL)-6,IL-8,and IL-22 were determined using enzyme-linked immunosorbent assay at baseline and 2 weeks after each treatment.Improvement was determined by a blinded assessment of photographs taken before and after the final evaluation.Results:Inflammation was significantly reduced on both the treated and untreated sides,and symptoms of AV lesions were alleviated.All patients showed a significant increase in serum IL-22 levels after the first laser therapy,with no significant difference in serum IL-6 and IL-8 levels.After the second laser therapy,serum IL-6,IL-8,and IL-22 levels were significantly decreased.No significant side effects such as bruising,edema,hyperpigmentation,hypopigmentation,or scarring were reported.Conclusion:Half-face treatment with 595-and 1064-nm dual-wavelength laser for moderate and severe AV showed a significant effect of full-face remission,which was associated with a gradual decrease in IL-6,IL-8,and IL-22 levels after half-face topical treatment.This suggests that reducing inflammatory cytokine levels in the serum can relieve inflammation in non-therapeutic sites.This laser treatment is effective,economical,and painless.

Influence of transverse mode on retinal spot size and retinal injury effect:A theoreticalan alysis on 532-nm laser

The fundamental transverse mode(TEM00)is preferable for experimental and theoretical study on the laser-induced retinal injury effect,for it can produce the minimal retinal image andestablish the most strict laser safety standards.But actually lasers with higher order mode werefrequently used in both earlier and recent studies.Generally higher order mode leads to largerretinal spot size and so higher damage threshold,but there are few quantitative analyses on thisproblem.In this paper,a four-surface schematic eye model is established for human and macaque.The propagation of 532-nm laser in schematic eye is analyzed by the ABCD law of Gaussianoptics.It is shown that retinal spot size increases with laser transverse mode order.For relativelower mode order,the retinal spot diameter will not exceed the minimum laser-induced retinallesion(25~30μm in diameter),and so has little effect on retinal damage threshold.While forhigher order mode,the larger'retinal spot requires more energy to induce injury and so the damage threshold increases.When beam divergence is lowered,the retinal spot size decreasescorrespondingly,so the efect of mode order can be compensated.The retinal spot size of macaqueis slightly smaller than that of human and the ratio bet ween them is independent of mode order.We conclude that the laser mode order has significant influence on retinal spot size but limitedinfluence on the retinal injury ffect.

Effects of pulse width and repetition rate of pulsed laser on kinetics and production of singlet oxygen luminescence

Pulsed and continuous-wave(CW)lasers have been widely used as the light sources for photodynamic therapy(PDT)treatment.Singlet oxygen(^(1)O_(2))is known to be a major cytotoxic agent in type-II PDT and can be directly detected by its near-infrared luminescence at 1270 nm.As compared to CW laser excitation,the effiects of pulse width and repetition rate of pulsed laser on the kinetics and production of^(1)O_(2)luminescence were quantitatively studied during photosensitization of Rose Bengal.Significant di®erence in kinetics of^(1)O_(2)luminescence was found under the excitation with various pulse widths of nanosecond,microsecond and CW irradiation with power of 20mW.The peak intensity and duration of^(1)O_(2)production varied with the pulse widths for pulsed laser excitation,while the^(1)O_(2)was generated continuously and its production reached a steady state with CW excitation.However,no significant di®erence(P>0:05)in integral^(1)O_(2)production was observed.The results suggest that the PDT efficacy using pulsed laser may be identical to the CW laser with the same wavelength and the same average°uence rate below a threshold in solution.

Anti-PD1 antibody and not anti-LAG-3 antibody improves the antitumor effect of photodynamic therapy for treating metastatic breast cancer

Photodynamic therapy(PDT)has limited effects in treating metastatic breast cancer.Immune checkpoints can deplete the function of immune cells;however,the expression of immune checkpoints after PDT is unclear.This study investigates whether the limited e±cacy of PDT is due to upregulated immune checkpoints and tries to combine the PDT and immune checkpoint inhibitor to observe the e±cacy.A metastatic breast cancer model was treated by PDT mediated by hematoporphyrin derivatives(HpD-PDT).The anti-tumor effect of HpD-PDT was observed,as well as CD4þT,CD8þT and calreticulin(CRT)by immunohistochemistry and immunofluorescence.Immune checkpoints on T cells were analyzed byflow cytometry after HpD-PDT.When combining PDT with immune checkpoint inhibitors,the antitumor effect and immune effect were assessed.For HpD-PDT at 100 mW/cm2 and 40,60 and 80 J/cm2,primary tumors were suppressed and CD4þT,CD8þT and CRT were elevated;however,distant tumors couldn't be inhibited and survival could not be prolonged.Immune checkpoints on T cells,especially PD1 and LAG-3 after HpD-PDT,were upregulated,which may explain the reason for the limited HpD-PDT effect.After PDT combined with anti-PD1 antibody,but not with anti-LAG-3 antibody,both the primary and distant tumors were signi-cantly inhibited and the survival time was prolonged,additionally,CD4þT,CD8þT,IFN-þCD4þT and TNF-þCD4þT cells were signi-cantly increased compared with HpD-PDT.HpD-PDT could not combat metastatic breast cancer.PD1 and LAG-3 were upregulated after HpD-PDT.Anti-PD1 antibody,but not anti-LAG-3 antibody,could augment the antitumor effect of HpD-PDT for treating metastatic breast cancer.

Tissue optical clearing enhances efficacy of vascular targeted photodynamic therapy of mouse dorsal skin

Vascular-targeted photodynamic therapy(V-PDT)is an effective treatment for port wine stains(PWS).However,repeated treatment is usually needed to achieve optimal treatment outcomes,possibly due to the limited treatment light penetration depth in the PWS lesion.The optical clearing technique can increase light penetration in depth by reducing light scattering.This study aimed to investigate the V-PDT in combination with an optical clearing agent(OCA)for the therapeutic enhancement of V-PDT in the rodent skinfold window chamber model.Vascular responses were closely monitored with laser speckle contrast imaging(LSCI),optical coherence tomography angiography,and stereo microscope before,during,and after the treatment.We further quantitatively demonstrated the effects of V-PDT in combination with OCA on the blood flow and blood vessel size of skin microvasculature.The combination of OCA and V-PDT resulted in significant vascular damage,including vasoconstriction and the reduction of blood flow.Our results indicate the promising potential of OCA for enhancing V-PDT for treating vascular-related diseases,including PWS.

Eccrine porocarcinoma in the tempus of an elderly woman:A case report

BACKGROUND Eccrine porocarcinoma(EPC)is a rare skin tumor that mainly affects the elderly population.Tumors often present with slow growth and a good prognosis.EPCs are usually distinguished from other skin tumors using histopathology and immunohistochemistry.However,surgical management alone may be inadequate if the tumor has metastasized.However,currently,surgical resection is the most commonly used treatment modality.CASE SUMMARY A seventy-four-year-old woman presented with a slow-growing nodule in her left temporal area,with no obvious itching or pain,for more than four months.Histopathological examination showed small columnar and short spindle-shaped cells;thus,basal cell carcinoma was suspected.However,immunohistochemical analysis revealed the expression of cytokeratin 5/6,p63 protein,p16 protein,and Ki-67 antigen(40%),and EPC was taken into consideration.The skin biopsy was repeated,and hematoxylin and eosin staining revealed ductal differentiation in some cells.Finally,the patient was diagnosed with EPC,and Mohs micrographic surgery was performed.We adapted follow-up visits in a year and not found any recurrence of nodules.CONCLUSION This case report emphasizes the diagnosis and differentiation of EPC.

Primary intestinal non-Hodgkin's lymphoma:A clinicopathologic analysis of 81 patients

AIM:To analyze the clinicopathologic features and the prognosis of primary intestinal lymphoma.METHODS:Patients were included in the study based on standard diagnostic criteria for primary gastrointesti-nal lymphoma,and were treated at Sun Yat-sen Univer-sity Cancer Centre between 1993 and 2008.RESULTS:The study comprised 81 adults.The most common site was the ileocaecal region.Twenty-two point two percent patients had low-grade B-cell lym-phoma.Fifty-one point nine percent patients had high-grade B-cell lymphoma and 25.9% patients had T-cell lymphoma.Most patients had localized disease.There were more patients and more early stage diseases in the latter period,and the origin sites changed.The ma-jority of patients received the combined treatment,andabout 20% patients only received nonsurgical therapy.The wverall survival and event-free survival rates after 5 years were 71.6% and 60.9% respectively.The mul-tivariate analysis revealed that small intestine and ileo-caecal region localization,B-cell phenotype,and normal lactate dehydrogenase were independent prognostic factors for better patient survival.Surgery based treat-ment did not improve the survival rate.CONCLUSION:Refined stratification of the patients according to the prognostic variables may allow indi-vidualized treatment.Conservative treatment may be an optimal therapeutic modality for selected patients.

Photodynamic therapy for high-grade dysplasia of bile duct via a choledochoscope

When a distal common bile duct neoplasm is at the stage of carcinoma in situ or high-grade dysplasia,it is difficult for the surgeon to decide whether to perform pancreaticoduodenectomy.Here we describe a patient with a progressive dysplastic lesion in the common bile duct,which developed from moderate-high to highgrade dysplasia in approximately 2 mo.The patient refused major surgery.Therefore,endoscopic-assisted photodynamic therapy was performed.The result at follow-up using a trans-T-tube choledochoscope showed that the lesion was completely necrotic.This report is the first to describe the successful treatment of highgrade dysplasia of the distal bile duct using photodynamic therapy via a choledochoscope.

Strategies and challenges in treatment of varicose veins and venous insufficiency

Patients with varicose veins can be treated with conservative or surgical approaches based on the clinical conditions and patient preferences.In the recent decade,the recommendations for managing symptomatic varicose veins have changed dramatically due to the rise of minimally invasive endovascular techniques.The literature was systematically searched on Medline without language restrictions.All papers on the treatment of varicose veins and venous insufficiency with different procedures were included and reviewed.Endovenous laser ablation(EVLA)and radiofrequency ablation(RFA)both are same safe and effective in terms of occlusion rate,and time to return to normal activity.In comparison with RFA or EVLT,Cure conservatrice et Hemodynamique de l’Insufficience Veineuse en Ambulatoire(CHIVA)may cause more bruising and make little or no difference to rates of limb infection,superficial vein thrombosis,nerve injury,or hematoma.In terms of recurrence of varicose veins,there is little or no difference between CHIVA and stripping,RFA,or EVLT.Great saphenous vein recanalization is highest in the ultrasound-guided foam sclerotherapy(FS)group(51%)during 1 year of follow-up.The 2013 National Institute for Health and Care Excellence clinical guidelines recommend surgery as a third-line therapeutic option after EVLA or RFA and sclerotherapy.Although the mechanochemical endovenous ablation(MOCA)is a non-thermal,non-tumescent option and appears to be of similar efficacy to stab avulsion with no potential risk of nerve damage,the overall success rate of MOCA is lower than those of other procedures such as EVLA,RFA,or high ligation and stripping.EVLA is the most cost-effective therapeutic option,with RFA being a close second for the treatment of patients with varicose veins.Endovenous thermal ablation(EVLA or RFA)is recommended as a first-line treatment for varicose veins and has substituted the high ligation of saphenofemoral junctional reflux and stripping of varicose veins.Ultrasound-guided FS is associated with a high recurrence rate and can be used in conjunction with other procedures.MOCA and cyanoacrylate embolization appear promising,but evidence of their effectiveness is required.

Detection of diabetic retinopathy in its early stages using textural features of optical coherence tomography angiography

The aim of this study is to detect whether the quantitative textural features of optical coherencetomography angiography (OCTA) images can be used to detect the eyes in the early stage ofdiabetic retinopathy (DR) from eyes with diabetes and no DR (NDR). Textural features includingfractal dimension, contrast, correlation, entropy, energy, and homogeneity were calculatedfrom the OCTA images. The Student's t-test was performed to identify the textural featuresthat can be able to detect DR in the early stage. The area under the receiver operating characteristic(AUROC) curves, sensitivity, and specicity were calculated between the study groups.Our results indicated that the fractal dimension in ICP and SVP and the correlation in SVCshowed the statistical signicance between mild NPDR patients and NDR patients. The ROCanalysis results showed that the AUROC of the fractal dimension in ICP was 0.736 with 0.773sensitivity and 0.700 specicity. The cuto® point in ICP was 2.616. The OCTA-based fractaldimension was able to discriminate diabetic eyes with early retinopathy from healthy and NDRwith higher sensitivity and specicity. The OCTA-based correlation showed the power to differentiatethe mild NPDR eyes from the normal healthy and diabetic eyes. These results suggestthat texture-based features of OCTA have the potential to assist in the assessment of therapeuticinterventions to prevent early DR in diabetic subjects.

AUTOMATED ASSESSMENT OF EPIDERMAL THICKNESS AND VASCULAR DENSITY OF PORT WINE STAINS OCT IMAGE

Optical coherence tomography(OCT)enables in vivo imaging of port wine stains(PWS)lesions.The knowledge of vascular struct ure and epidermal thickness(ET)of PWS may aid the objectivediagnosis and optimal treatment.To obtain the structural parameters more rapidly and avoiduser intervention,an automated algorithm of energy map is introduced based on intensity andedge information to extract the skin surface using dynamic programming method.Subsequently,an averaged A-scan analysis is performed to obtain the mean ET and the relative intensity ofdermis indicating the corresponding vascular density.This approach is currently successfullyapplied in clinical diagnosis and shows promising guidance and assessment of PDT treatment.

2022 Monkeypox outbreak:Why is it a public health emergency of international concern?What can we do to control it?

The World Health Organization(WHO) called the recent monkeypox(MPX)outbreak a Public Health Emergency of International Concern on July 23,2022.The United States of America(US) alarmed the recent MPX outbreak as the US public health emergency on August 4,2022.Since early May 2022,more than 35000 MPX cases and 12 deaths had been reported to WHO from 92 countries and territories by August 17,2022,and MPX cases continue rising rapidly with improved surveillance,access to diagnosis,and continuous virus spreading globally.Approximately 99% MPX cases are men,of which 95% cases are men who have sex with man.No evidence of MPX being sexually transmitted infections(STIs) is found;however,a high percentage(25%) of concurrent STIs and frequent anogenital symptoms suggest transmission through local inoculation during close intimate contact or sexual activity.Many approaches including a comprehensive international vaccination strategy and adequate supplies are mandatory to prevent MPX pandemic.Education,vaccination,MPX scrutiny and careful monitoring,and crossborder collaborations with international sectors are practical strategy to contain MPX outbreaks.People are educated to reduce the risk of exposure and to reduce the number of sexual partners especially new ones,to avoid contacting travelers from epidemic regions or animals that may carry MPX virus,and avoid traveling to endemic areas.

Improvement in Resolution of Multiphoton Scanning Structured Illumination Microscopy via Harmonics

We describe a multiphoton(mP)-structured illumination microscopy(SIM)technique,which demonstrates substantial improvement in image resolution compared with linear SIM due to the nonlinear response of fluorescence.This nonlinear response is caused by the effect of nonsinusoidal structured illumination created by scanning a sinusoidally modulated illumination to excite an mP fluorescence signal.The harmonics of the structured fluorescence illumination are utilised to improve resolution.We present an mP-SIM theory for reconstructing the super-resolution image of the system.Theoretically,the resolution of our m P-SIM is unlimited if all the high-order harmonics of the nonlinear response of fluorescence are considered.Experimentally,we demonstrate an 86 nm lateral resolution for two-photon(2P)-SIM and a 72 nm lateral resolution for second-harmonic-generation(SHG)-SIM.We further demonstrate their application by imaging cells stained with F-actin and collagen fibres in mouse-tail tendon.Our method can be directly used in commercial mP microscopes and requires no specific fluorophores or high-intensity laser.

COMBINED EFFECTS OF SELECTIVE PHOTOTHERMAL THERAPY AND IMMUNOADJUVANT AGAINST STAGE IV BREAST CANCER

Metastasis to distant sites is a severe treatment challenge and a major cause of death for breast cancer patients.Laser immunotherapy(LIT)is a novel technique,combining a selective photothermal therapy with local application of glycated chitosan,a potent immunoadjuvant.The pre-clinical studies of LIT have shown its unique characteristics in generating specific antitumor immunity.The clinical application of LIT in the treatment of melanoma patients has achieved preliminary success.Recently,LIT has been used to treat late-stage breast cancer patients.Here we report for the first time the clinical results of this combination therapy in breast cancer patients.The LIT treatment procedures are presented and the medical history of two stage Ⅳ breast cancer patients is reviewed.Most of the breast cancer lesions and the metastasis of lung and brain disappeared after repeated treatments of LIT.One patient achieved complete response;the other achieved partial response at the time of this report.Although there is still a long way for LIT to become a standard modality for breast cancer treatment,the results of this study indicated its promising future.

Spectroscopic measurement of Stark broadening parameter of the 636.2 nm Zn I-line

In this article we will present an attempt to measure the Stark broadening parameter of the Zn I-line at 636.23 nm utilizing the optical emission spectroscopy (OES) technique, taking into consideration the possibility of existence of self absorption. This method is standing on comparison of the Lorentzian FWHM and spectral line intensity of the unknown Stark broadening parameter line (Zn I-636.23 nm—in our case) to a well known Stark parameter line (e.g. Zn I-lines at 472.2, 481 and 468 nm) at a reference electron density of 2.7 × 1017 cm-3 and temperature of 1 eV. We have utilized the emission spectral data acquired from well diagnosed plasma produced by the interaction of Nd: YAG laser at wavelength of 1064 nm with ZnO nanomaterial target in open air. The results indicates that the Stark broadening of the Zn I-line at 636.23 nm is centered at 5.06 ± 0.03 ? with a 25% uncertainty at the given reference plasma parameters. The knowledge of the Stark broadening parameter of the 636.23 nm line may be important in the diagnostics of the laser plasma experiments especially in the absence of the Hα-line.

Observed Enhancement in LIBS Signals from Nano vs. Bulk ZnO Targets: Comparative Study of Plasma Parameters

In this article, we will report an experimental evidence of enhanced LIBS emission upon replacing a Bulk-Based ZnO target by the corresponding Nano-Based target. The plasma was initiated via interaction of a Nd:YAG laser at the fundamental wavelength with both targets in open air under the same experimental conditions. The measurements show an enhanced emission from the Zn I-lines at the wavelengths of 328.26, 330.29, 334.55, 468.06, 472.2, 481.01, 636.38 nm. The measurements were repeated at different delay times in the range from 1 to 5 μs at constant irradiation level and fixed gate time of 1 μs. The average enhancement over the different Zn I-lines was found increases exponentially up to 8-fold with delay time. The electron density to each plasma was measured utilizing the Hα-line appeared in the emitted spectra from each plasma and was found to give similar values. The electron temperatures were measured via Boltzmann plot method utilizing the relative intensities of the Zn I-lines and were found to give very close values. Moreover, the relative population density of the ground state of the zinc atoms (relative concentration) was measured spectroscopically utilizing the Boltzmann plot method and was found to increase in a very similar trend to that of enhancement. The results of the spectroscopic analysis conclude that these signal enhancements can be attributed to the higher concentration of neutral atoms in the Nano-Based material plasma with respect to the corresponding Bulk-based ZnO material.

Optical properties of the electromagnetic waves propagating in an elliptical cylinder multilayer structure

Theoretical description of the wave propagation in an elliptical cylinder multilayer structure under the conditions of H polarization and E polarization is presented. A transfer matrix method has been developed for elliptical cylinder waves. The formulas of reflection and transmission coefficients for an elliptical cylinder multilayer structure are driven. Reflection and transmission coefficients of elliptical cylinder waves by a single elliptical cylinder interface is presented. The obtained formulas can be generalized to the cold plasma filled structures and thus the obtained results in the limit of circular cylinder structures are investigated.

Phlebosclerosis: An overlooked complication of varicose veins that affects clinical outcome: A case report

BACKGROUND Phlebosclerosis is a common age-related fibrotic degeneration of the venous wall.It is a disorder rather than a disease,which may cause venous dysfunction and even venous thrombosis.It is rarely reported in patients with varicose veins.CASE SUMMARY The present report describes the case of a 70-year-old man with varicose veins,vitiligo,and phlebosclerosis.Venous angiography revealed blood reflux in the superficial and deep veins.The patient underwent surgery to remove the saphe-nous veins.During the operation,a calcified vein resembling a wooden stick was found,which was surprisingly extracted from the thickened venous wall.A cross-section of this wooden stick-like vein revealed venous fibrosis and calcification,obvious thickening of the venous wall,extensive collagen deposition on the venous wall,hyaline degeneration,and venous sclerosis causing closure of the venous lumen.CONCLUSION This is probably the first report of a wooden stick-like structure being found in the venous wall in patients with varicose veins and venous ulcers.Phlebosclerosis can be observed in the late stage of varicose veins complicated by frequent infections and worse clinical outcomes.Therefore,it is important to be aware of this condition and address it rather than overlook it.

Factors affecting improvement of fluorescence intensity of quartet and doublet state of NO diatomic molecule excited by glow discharge

We report on the observation of new fluorescence emission spectral transitions obtained from NO diatomic molecule in the region from ultraviolet （UV） to near infrared （NIR） in a low power glow discharge system. This glow discharge electronic excitation populates different quartet and doublet states of NO in its proximity such as the A2Z （/9 = 2）, b4∑- （υ= 3）, B2М （1） = 4）, and X2Л （u= 33-32） states. Due to inter-system crossing, emission lines originating from these levels to lower lying states are recorded and spectral line assignments are performed. The observed systems include b4∑- a4∏, B21∏-a4∏, a4∏-X2I∏, A2∑X2∏, X2∏-X2∏ （33-15）, X2∏-X2∏ （33-17）, X2∏-X2∏ （33-20）, and X2∏-X2∏ （33- 18）. This new information will conduce to the better understanding of the interesting features of NO molecule. Such parameters that affect the recording of low density of NO molecules are also discussed In addition to the factors such as the time evolution, argon gas concentration relative to NO mixture, the percentage of NO molecular gas concentration, discharge electric current signals and discharge applied voltage are studied. Those factors would enhance the fluorescence signal intensity of NO molecules. The recent results might be significant as reference data for optimizing the glow discharge spectrometer and diagnostics of NO gas.

A COMPARATIVE STUDY OF DNA FLOW CYTOMETRY AND MICROSPECTROPHOTOMETRY IN GASTRIC CARCINOMAS

Flow cytometric (FCM) and microspectrophotometric (MSP) measurements of cell nuclear DNA content were made in 53 fresh gastric carcinoma specimens and in 30 gastric mucosal specimens with chronic gastritis. DNA aneuploidy was found in 32/53 (60%) of gastric carcinomas, and appeared more frequently in wellor moderately differentiated tubular adenocarcinomas (90%) than in undifferentiated and mucousa cell carcinomas (23.6%) (P【0.001). No aneuploidy was found in chronic gastritis samples, but their proliferative cell fractions were higher than in normal control gastric mucosa samples (P【0.01). A comparison was made between FCM and MSP analyses of DNA content in 29 cases of gastric carcinoma, a high correlation rate (r=0.90) was found. The advantages and limitations of both methods are discussed, they may be used in combination for more precise cytochemical analysis.