本研究由重庆市卫生健康委员会和重庆市科学技术局联合开展的医学研究重点项目（2022ZDXM037）、武汉市卫生健康委员会中医药科研基金重点项目（WZ22A03）和重庆市自然科学基金（cstc2020jcyj-msxmX0592）提供资金支持。

所有涉及人类参与者的研究程序均符合重庆市中医院伦理委员会的伦理标准和《赫尔辛基宣言》（1964年）及其后续修正案的原则，并已获得上述伦理委员会的批准。图像数据收集是在患者的口头和书面同意下进行的，并且作为检查的常规部分，为教学目的拍摄的照片是使用多光谱皮肤镜获得的。
1. 患者选择
<ol><li>设置以下纳入标准5:<ol><li>根据面部浅色至深棕色、边界明确的斑块的存在来选择患者，通常具有对称分布、无炎症和脱屑。</li>
		<li>根据是否存在明显的主观症状（如瘙痒、灼热和疼痛）来选择患者。</li>
		<li>考虑到黄褐斑主要发生在女性身上，主要是在青春期之后，选择患者。</li>
		<li>在选择患者时，应考虑病情的季节性变化 - 通常在夏季更严重，在冬季较温和。</li>
		<li>如果存在可能导致色素沉着过度的其他疾病（如颧颧梭蓝痣、Riehl 黑变病和色素性日光性皮炎），则排除患者。</li>
	</ol></li>
</ol>2.滚筒微针治疗的准备工作
<ol><li>术前沟通<ol><li>了解患者的治疗目标和美容愿望，并收集完整的病史，包括用药史、过敏史、禁忌症和过去的美容治疗。</li>
		<li>告知患者治疗的效果、步骤、潜在并发症、恢复时间、持续时间和费用。讨论具体的治疗计划和替代方案，以确保所有患者的疑问都得到解决，帮助他们建立切合实际的期望并实现更高的满意度。</li>
		<li>要求患者签署知情同意书。</li>
	</ol></li>
	<li>环境要求<ol><li>留出一个安静、光线充足的治疗室用于操作滚筒微针，并在手术前用紫外线消毒 30 分钟。</li>
		<li>要求患者在进入治疗室时戴上鞋套和帽子。</li>
	</ol></li>
	<li>准备治疗所需的物品和药物<ol><li>检查并准备 物料清单中列出的所有材料。</li>
	</ol></li>
	<li>卸妆和清洁<ol><li>如果治疗区域被化妆品覆盖，请在清洁前用卸妆液彻底卸妆。</li>
		<li>对于不化妆的人，请用温和的清洁产品清洁治疗区域。</li>
	</ol></li>
	<li>多光谱皮肤镜检查记录 注意: 多光谱皮肤镜使用不同的光源来捕捉面部超高像素图像。<ol><li>治疗前和三次治疗后，使用多光谱皮肤镜从三个不同角度拍摄患者的前部、左侧（45°）和右侧（45°）的照片，并记录患者的紫外线浅层和深层斑点和褐色斑点的值</li>
	</ol></li>
	<li>局部麻醉的应用<ol><li>将5%利多卡因乳膏均匀涂抹在治疗区域，总剂量为30-40g，并用保鲜膜包裹以增强麻醉效果40-60分钟。 注意:一些患者可能会表现出对局部麻醉剂过敏的症状。患者可能会在应用部位出现严重的瘙痒、灼热或刺痛。如果发生此类反应，请立即移除麻醉剂并提供适当的对症治疗。</li>
		<li>在下次治疗之前，请确保在麻醉应用区域对皮肤进行适当的滋润。</li>
	</ol></li>
	<li>微针溶液的制备<ol><li>使用注射器提取 5 mL 5% 氨甲环酸溶液，并将其放在一边使用。</li>
	</ol></li>
	<li>微针器械的制备<ol><li>选择0.5mm滚筒微针（图1），并将其浸泡在0.1%苯扎溴铵溶液中约20分钟以消毒。</li>
		<li>用生理盐水冲洗微针 3 次以去除消毒剂。 注意:通过为每个患者使用单个滚筒微针来避免交叉污染，以防止由于钝针而对皮肤造成不必要的伤害，并防止疾病在患者之间传播。</li>
	</ol></li>
	<li>去除局部麻醉<ol><li>在局部麻醉应用足够长的时间后，取下保鲜膜并用刮刀刮掉麻醉剂。使用浸泡在0.9%生理盐水溶液中的纱布擦去面部残留的麻醉剂。</li>
	</ol></li>
	<li>消毒<ol><li>露出治疗区域，治疗面部时用消毒毛巾包裹头发，用0.1%苯扎溴铵棉球从顶部到发际线边缘，到下颌边缘和下巴3次消毒面部皮肤，遵循"自下而上，向内向外"的原则，防止感染。</li>
	</ol></li>
</ol>3. 滚筒微针手术
<ol><li>让治疗师洗手，戴上帽子、口罩和无菌手套。</li>
	<li>在告知患者开始手术后，指导患者闭上眼睛，按照左脸颊、右脸颊、前额、下巴、上唇和鼻子的顺序进行治疗。用注射器将适量氨甲环酸溶液注射到皮肤上，用手均匀涂抹，然后用生理盐水冲洗滚筒微针，在治疗区域沿水平、垂直、倾斜方向短距离滚动。</li>
	<li>逐渐在不同区域进行治疗，在滚动时涂抹溶液以增强吸收。在一个区域重复 3-5 次，最好是皮肤潮红且没有明显出血。均匀地用力，不要太重也不要太轻，不要用微针在皮肤上拖动。</li>
</ol>4.功效评价
<ol><li>使用滚筒微针和局部氨甲环酸溶液的组合 3 次治疗黄褐斑，每 4 周一次，作为一个疗程。</li>
	<li>治疗前后使用多光谱皮肤镜，3x，根据患者紫外线浅深斑点和褐色斑点的值观察疗效。值越小，黄褐斑越轻。</li>
	<li>统计分析处理前后UV浅层和深层斑点以及褐色斑点的变化。</li>
</ol>

用氨甲环酸和微针疗法加强黄褐斑治疗

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黄褐斑的发病机制复杂，治疗方法包括全身用药、局部脱色剂、化学换肤和激光疗法。不幸的是，没有一种治疗方法对所有患者都普遍有效，不能总是保证满意的结果6.光疗治疗黄褐斑呈下降趋势，部分患者在光疗后黄褐斑恶化。这是由于炎症性黄褐斑中皮肤敏感和皮肤屏障功能受损的个体增加。针对黑色素的激光或其他治疗可能会加剧皮肤的炎症反应，导致黄褐斑症状加重。?...

黄褐斑，也称为黄褐斑，是一种慢性和获得性面部色素沉着过度的皮肤病。临床上，它表现为对称的浅棕色至深棕色斑块，边界不清晰，分布在脸颊、前额和下颌线。亚洲育龄妇女的发病率可高达 30%1。这种疾病很容易诊断，但很难治愈。黄褐斑的发病机制尚不完全清楚，但有三个主要因素促成了黄褐斑的发展:遗传易感性、暴露在阳光下和荷尔蒙变化。黑色素合成增加、皮肤病变部位的血管增生、炎症反应和皮肤屏障功能受损都在黄褐斑2 的发生中起作用。
目前，黄褐斑的治疗选择包括激光疗法和药物治疗，其中透皮给药是一种广泛使用的方法。然而，主要的挑战在于角质层的屏障功能，它阻碍了药物的渗透。微针疗法在短时间内在皮肤中产生多个微通道，破坏角质层，诱导胶原蛋白的产生，并增加皮肤的通透性。这种方法有望使药物扩散到皮肤中，然后迅速重新封闭，从而避免引入有毒或刺激性物质3.
常用的微针工具包括电子水光注射微针、滚筒微针、电助纳米晶微针、梅花微针和单针微针4。滚筒式微针的特点是创伤小，疗效好，操作方便，可以与其他一些药物合用治疗黄褐斑。对黄褐斑具有良好的治疗前景，在临床上值得进一步推广和使用。本文介绍了滚筒微针联合氨甲环酸治疗黄褐斑的操作和注意事项，并通过临床案例论证了滚筒微针联合氨甲环酸治疗黄褐斑的疗效。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>5 mL syringe</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Benzalkonium bromide solution</td>
			<td>Chongqing Traditional Chinese Medicine Hospital</td>
			<td>H20050531</td>
			<td>0.1%</td>
		</tr>
		<tr>
			<td>cling film</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Compound lidocaine cream</td>
			<td>Beijing Ziguang Pharmaceutical Co., Ltd.</td>
			<td>H20063466</td>
			<td>5.0%</td>
		</tr>
		<tr>
			<td>disinfectant towel</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>disposable curved disc</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Multispectral Dermoscope</td>
			<td>CBS Medical Skin Analysis, Wuhan, China</td>
			<td>CBS-2022</td>
			<td></td>
		</tr>
		<tr>
			<td>Roller microneedle</td>
			<td>Guangzhou Yuanxiang Biotechnology Co., Ltd</td>
			<td>221001</td>
			<td>(model: 0.22 x 0.5 mm, Figure 1)</td>
		</tr>
		<tr>
			<td>Sodium chloride solution</td>
			<td>Hubei Tiansheng Pharmaceutical Co., Ltd.</td>
			<td>H42021838</td>
			<td>0.9%</td>
		</tr>
		<tr>
			<td>sterile cotton swab</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>sterile gauze</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>sterile gloves</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>tongue depressor</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Tranexamic acid solution</td>
			<td>Shanghai Hyundai Hasen (Shangqiu) Pharmaceutical Co., Ltd.</td>
			<td>H20184047</td>
			<td>5.0%</td>
		</tr>
		<tr>
			<td>treatment vehicle</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

roller microneedle combined with tranexamic acid solution in treating melasma

黄褐斑是一种常见的获得性面部色素沉着性皮肤病，临床诊断简单明了，但在有效管理方面存在挑战。黄褐斑的确切根本原因仍然难以捉摸，目前的治疗方法主要包括药物和激光干预，疗效有限。透皮给药是黄褐斑的一种普遍治疗方法，通常通过使用微针来促进。其中，氨甲环酸作为一种常用的治疗剂出现。微针的一个子集，称为滚筒微针，在这种方法中发挥着重要作用，它用多根细针巧妙地刺穿表皮，与药物输送协同作用。这种方法不仅可以增强药物吸收，还可以提高治疗效果，同时最大限度地减少组织创伤。这些特性预示着治疗黄褐斑的有希望的途径。本文主要介绍滚筒微针和氨甲环酸溶液联合治疗黄褐斑的情况，并通过临床案例论证了滚筒微针和氨甲环酸溶液治疗黄褐斑的疗效。

病例1为57岁女性，有10年病史，选取治疗及疗效评价。在治疗前和三个治疗疗程（图 2、 Figure 3 和 Figure 4）后评估滚筒微针和氨甲环酸溶液组合的疗效，并使用多光谱皮肤镜从不同角度观察。在正面视图中，紫外线浅斑点、紫外线深点和棕色区域分别减少了 35.91 mm2、163.32 mm2 和 82.4 mm2 。在45°的右侧视图中...

Watch this Scientific Journal Video about Roller Microneedle Combined with Tranexamic Acid Solution in Treating Melasma at JoVE.com

作者聚焦: 黄褐斑的非手术治疗 – 氨甲环酸微针

本文提出了一种通过使用滚筒微针结合氨甲环酸溶液进行黄褐斑治疗的方案，并评估疗效。

滚筒微针联合氨甲环酸溶液治疗黄褐斑

Melasma, a common, acquired facial pigmentation skin disorder, presents a straightforward clinical diagnosis but poses challenges in terms of effective ...

我们的研究重点是色素性疾病的非手术治疗。我们测试了滚筒微针联合氨甲环酸溶液治疗黄褐斑的疗效。我们将研究使用滚筒微针和氨甲环酸溶液组合治疗黄褐斑的有效性和最大难易程度。

roller-microneedle-combined-with-tranexamic-acid-solution-treating

Research

JoVE Journal

Medicine

Roller Microneedle Combined with Tranexamic Acid Solution in Treating Melasma

664 次观看.  Chongqing Hospital of Traditional Chinese Medicine. 我们的研究重点是色素性疾病的非手术治疗。我们测试了滚筒微针联合氨甲环酸溶液治疗黄褐斑的疗效。我们将研究使用滚筒微针和氨甲环酸溶液组合治疗黄褐斑的有效性和最大难易程度。

视频: 作者聚焦: 黄褐斑的非手术治疗 – 氨甲环酸微针

Tumor Treating Field Therapy in Combination with Bevacizumab for the Treatment of Recurrent Glioblastoma

A novel device that employs TTF therapy has recently been developed and is currently in use for the treatment of recurrent glioblastoma (rGBM). It was FDA approved in April 2011 for the treatment of patients 22 years or older with rGBM. The device delivers alternating electric fields and is programmed to ensure maximal tumor cell kill1.
Glioblastoma is the most common type of glioma and has an estimated incidence of approximately 10,000 new cases per year in the United States alone2. This tumor is particularly resistant to treatment and is uniformly fatal especially in the recurrent setting3-5. Prior to the approval of the TTF System, the only FDA approved treatment for rGBM was bevacizumab6. Bevacizumab is a humanized monoclonal antibody targeted against the vascular endothelial growth factor (VEGF) protein that drives tumor angiogenesis7. By blocking the VEGF pathway, bevacizumab can result in a significant radiographic response (pseudoresponse), improve progression free survival and reduce corticosteroid requirements in rGBM patients8,9. Bevacizumab however failed to prolong overall survival in a recent phase III trial26. A pivotal phase III trial (EF-11) demonstrated comparable overall survival between physicians&#8217; choice chemotherapy and TTF Therapy but better quality of life were observed in the TTF arm10.
There is currently an unmet need to develop novel approaches designed to prolong overall survival and/or improve quality of life in this unfortunate patient population. One appealing approach would be to combine the two currently approved treatment modalities namely bevacizumab and TTF Therapy. These two treatments are currently approved as monotherapy11,12, but their combination has never been evaluated in a clinical trial. We have developed an approach for combining those two treatment modalities and treated 2 rGBM patients. Here we describe a detailed methodology outlining this novel treatment protocol and present representative data from one of the treated patients.

A novel methodology that is employed for the treatment of recurrent glioblastomas is described. This treatment approach employs the application of alternating electric tumor treating fields (TTFields), known as TTF Therapy in combination with bevacizumab, a targeted agent that is currently FDA approved as monotherapy.

肿瘤治疗领域的治疗与联合贝伐单抗治疗复发性胶质母细胞瘤的治疗

A novel device that employs TTF therapy has recently been developed and is currently in use for the treatment of recurrent glioblastoma (rGBM). It was FDA ...

科研

医学

Solubility of Hydrophobic Compounds in Aqueous Solution Using Combinations of Self-assembling Peptide and Amino Acid

Self-assembling peptides (SAPs) are promising vehicles for the delivery of hydrophobic therapeutics for clinical applications; their amphipathic properties allow them to dissolve hydrophobic compounds in the aqueous environment of the human body. However, self-assembling peptide solutions have poor blood compatibility (e.g., low osmolarity), hindering their clinical application through intravenous administrations. We have recently developed a generalized platform for hydrophobic drug delivery, which combines SAPs with amino acid solutions (SAP-AA) to enhance drug solubility and increase formulation osmolarity to reach the requirements for clinical uses. This formulation strategy was thoroughly tested in the context of three structurally different hydrophobic compounds &#8211; PP2, rottlerin, and curcumin &#8211; in order to demonstrate its versatility. Furthermore, we examined effects of changing formulation components by analyzing 6 different SAPs, 20 naturally existing amino acids at low and high concentrations, and two different co-solvents dimethyl sulfoxide (DMSO) and ethanol. Our strategy proved to be effective in optimizing components for a given hydrophobic drug, and therapeutic function of the formulated inhibitor, PP2, was observed both in vitro and in vivo. This manuscript outlines our generalized formulation method using SAP-AA combinations for hydrophobic compounds, and analysis of solubility as a first step towards potential use of these formulations in more functional studies. We include representative solubility results for formulation of the hydrophobic compound, curcumin, and discuss how our methodology serves as a platform for future biological studies and disease models.

This protocol describes a clinically-applicable means of dissolving hydrophobic compounds in an aqueous environment using combinations of self-assembling peptide and amino acid solutions. Our method resolves a major limitation of hydrophobic therapeutics, which lack safe, efficient means of solubility and delivery methods into clinical settings.

自组装肽与氨基酸结合的水溶液中疏水性化合物的溶解度

Self-assembling peptides (SAPs) are promising vehicles for the delivery of hydrophobic therapeutics for clinical applications; their amphipathic ...

太极拳配合正念训练治疗糖尿病周围神经病变

Effects of Mindfulness Training Combined with Tai Chi in Patients with Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy (DPN) is one of the most prevalent chronic complications of diabetes. One of its crucial therapy approaches is mind-body exercise. Recently, various exercise modalities, including stepping, resistance, aerobics, balance, and whole-body vibration, were investigated to construct the most suitable form of exercise for patients with DPN. The purpose of this study is to describe a standard protocol for mindfulness training combined with Tai Chi. The convenience sampling method was used to select 90 patients with DPN who met the inclusion and exclusion criteria from three communities. The three communities were randomly divided into the control group (CG), the Tai Chi group (TCG), and the mindfulness training combined with the Tai Chi group (MTCG). The CG was given routine health education guidance once a month, a total of three times. Based on the CG, the TCG practiced Tai Chi three times; the MTCG received mindfulness training combined with Tai Chi exercise a week for a total of 12 weeks. Before the intervention and 12 weeks after the intervention, the clinical symptoms, neurological function, attention awareness level, pain, and quality of life of the subjects were evaluated by Toronto Clinical Scoring System (TCSS), Mindful Attention Awareness Scale (MAAS), Visual analog scale (VAS), Diabetes Specificity Quality of life Scale (DSQL) and tumor necrosis factor-&#945;. Overall, the addition of mindfulness training to Tai Chi effectively enhances the exercise effects of Tai Chi. Therefore, mindfulness training combined with Tai Chi is worthy of promotion and application.

作者聚焦：将太极拳与正念训练相结合，实现有效的身心锻炼 

When studying exercise for treating diabetic peripheral neuropathy (DPN), achieving mind-body exercise is essential. This study proposes a protocol for mindfulness training combined with Tai Chi to achieve mind-body exercise.

正念训练联合太极拳对糖尿病周围神经病变患者的影响

Diabetic peripheral neuropathy (DPN) is one of the most prevalent chronic complications of diabetes. One of its crucial therapy approaches is mind-body ...

Acupoint Application Combined with Acupoint Massage for Treating Constipation in a Patient with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a common and frequent disease in elderly patients, with a tendency for progressive exacerbation. Constipation that reduces the quality of life and triggers the risk of diseases is a common concomitant symptom in patients with COPD. Currently, western medical treatment does not achieve the desired results for patients. A high recurrence rate accompanies it, whereas traditional Chinese medicine (TCM) has a long history and rich experience in treating chronic diseases. Both acupoint application and acupoint massage are characteristic therapies of TCM, with minor side effects, high safety, simple operation, and outstanding advantages. They are effective in treating constipation for patients with COPD and are considered an ideal alternative therapy for patients with chronic constipation. The purpose of this article is to introduce the method of acupoint application combined with acupoint massage for the treatment of constipation in patients with COPD, including the selection of points, items, treatment time, and operation procedure.

Here we demonstrate acupoint application combined with acupoint massage for treating constipation in a patient with chronic obstructive pulmonary disease (COPD).

穴位应用联合穴位按摩治疗慢性阻塞性肺疾病患者便秘

Chronic obstructive pulmonary disease (COPD) is a common and frequent disease in elderly patients, with a tendency for progressive exacerbation. ...

使用改进的 Videman 方法在兔子中建立 KOA 模型

Application of Acupotomy in a Knee Osteoarthritis Model in Rabbit

Knee osteoarthritis (KOA) is one of the most frequently encountered diseases in the orthopedic department, which seriously reduces the quality of life of people with KOA. Among several pathogenic factors, the biomechanical imbalance of the knee joint is one of the main causes of KOA. Acupotomology believes that restoring the mechanical balance of the knee joint is the key to treating KOA. Clinical studies have shown that acupotomy can effectively reduce pain and improve knee mobility by reducing adhesion, contracture of soft tissues, and stress concentration points in muscles and tendons around the knee joint. 
In this protocol, we used the modified Videman method to establish a KOA model by immobilizing the left hindlimb in a straight position. We have outlined the method of operation and the precautions related to acupotomy in detail and evaluated the efficacy of acupotomy in conjunction with the theory of "Modulating Muscles and Tendons to Treat Bone Disorders" through the detection of the mechanical properties of quadriceps femoris and tendon, as well as cartilage mechanics and morphology. The results show that acupotomy has a protective effect on cartilage by adjusting the mechanical properties of the soft tissues around the knee joint, improving the cartilage stress environment, and delaying cartilage degeneration.

作者聚焦:研究针尖切开术治疗膝骨关节炎的作用机制

In this protocol, a knee osteoarthritis model was prepared using the modified Videman method, and the operation procedures and precautions of acupotomy are detailed. The effectiveness of acupotomy has been demonstrated by testing the mechanical properties of quadriceps femoris and tendon and the mechanical and morphological properties of cartilage.

针灸术在兔膝骨关节炎模型中的应用

Knee osteoarthritis (KOA) is one of the most frequently encountered diseases in the orthopedic department, which seriously reduces the quality of life of ...

一种治疗消瘦性狨猴综合征的有效改良方法

Modification of the Treatment Methods for Wasting Marmoset Syndrome with Tranexamic Acid and Supportive Measures

Wasting marmoset syndrome (WMS), a serious disease in captive common marmoset (Callithrix jacchus) colonies, is associated with a high mortality rate. The specific cause of WMS is still unclear and there are few effective treatments. Previously, we had reported a tranexamic acid therapy with supportive measures as a useful treatment for WMS. In the present study, we describe the modified method: a combination of 0.1 mL of 5% tranexamic acid subcutaneously five times per week, 2.0 mL of amino acid formulation intravenously three times per week, 5.0 mL of Ringer's lactate with 0.1 mL of a vitamin formulation subcutaneously three times per week, and oral administration of 0.1 mL of an iron formulation five times per week. We also describe how to administer the solution intravenously via the saphenous vein with a tip of restraining the animal, as well as the detailed methods for oral and subcutaneous administration. The modified methods have comparable efficiency to the original WMS treatment method.

作者聚焦：为消耗性狨猴综合征 （WMS） 开发更安全、更有效的治疗方案

Here, we describe the modified treatment methods for wasting marmoset syndrome (WMS, also known as inflammatory bowel disease (IBD)-like disease) with tranexamic acid. We also present how to administer the therapeutic agents orally, subcutaneously, and intravenously.

氨甲环酸治疗消耗性狨猴综合征的改良及支持措施

Wasting marmoset syndrome (WMS), a serious disease in captive common marmoset (Callithrix jacchus) colonies, is associated with a high mortality rate. The ...