橙皮苷对中波紫外线诱导豚鼠色素沉着抑制作用的研究

目的：研究橙皮苷对皮肤色素沉着的抑制作用，为其治疗色素沉着性皮肤病提供实验依据。方法：选定橙皮苷、甘草提取物、甘草双胺盐及氢醌4种成分制成不同浓度的乳膏，制作棕黄色豚鼠经UVB照射诱导皮肤色素沉着的实验动物模型。采用苏木精—伊红、Schmorl、Imokawa等方法染色，观察外用中药后黑素细胞数量和形态的改变。结果：橙皮苷、甘草提取物、甘草双胺盐均使多巴阳性的黑素细胞及含黑素颗粒的细胞数较对照组明显减少（P〈0．05），其中3％、4％橙皮苷与阳性对照组3％氢醌外用差异无统计学意义（P〉0．05）。结论：橙皮苷、甘草提取物和甘草双胺盐对UVB诱导的色素沉着均具有抑制作用。     

硒霜对小鼠皮肤GSH-Px活性影响的研究

目的：通过局部外用不同浓度的硒霜，观察对小鼠皮肤GSH－Px活性的影响。方法：分别以0％（对照组）、0.5％、1.0％、1．5％硒霜涂抹4组小鼠尾部皮肤，日1次，持续7或14天，观察局部皮肤反应情况，同时取皮肤组织测GSH－Px活性。结果：连续涂抹7天观察局部皮肤无明显刺激现象，1．5％硒霜组的皮肤GSH－Px活性为2．7000±0．5484，明显高于对照组的1．3467±0．6088（t=5．9486p＜0．05）。结论：1．5％硒霜局部外用可明显提高皮肤的GSH－Px活性，且无明显局部皮肤刺激症状。     

非真菌性甲病152例临床观察

目的探讨甲病的临床表现以及可能原因。方法观察152例临床诊断无明显原发病因的非真菌性甲异常患者的甲皱微循环、血液流变学、骨密度和血常规等的变化。结果152例患者中126例(82.89%)有明显的甲皱微循环血流速度减慢,109例(71.71%)有重度红细胞聚集现象;94例(61.84%)具有明显的骨质疏松或骨密度低下;19例(12.50%)血钙浓度下降;对其中的47例患者进行血液流变学检测发现,33例血粘度增高,其影响因素如红细胞压积、红细胞变形指数和红细胞聚集指数都存在明显的异常。结论甲异常中,微循环和血液粘滞性以及骨密度的变化很明显,临床治疗应针对这些方面进行改善。     

指甲疾病

20060987非真菌性甲病152例临床观察/刘斌(四军大西京医院皮肤科),范雪莉∥中国皮肤性病学杂志.-2005,19(2).-95~96观察152例患者中临床诊断无明显原发病因的非真菌性甲异常患者的甲皱微循环、血液流变学、骨密度和血常规等的变化。结果:152例患者中126例(82·89%)有明显的甲皱微循环血流速度减慢,109例(71·71%)有重度红细胞聚集现象;94例(61·84%)具有明显的骨质疏松或骨密度低下;19例(12·50%)血钙浓度下降;对其中的47例患者进行血液流变学检测发现,33例血粘度增高,其影响因素如红细胞压积、红细胞变形指数和红细胞聚集指数都存在明显的…     

急性挤压伤患者机体组织瘀血的分析与研究

目的研究显示急性挤压伤患者机体组织瘀血与微循环相关的血液流变学等。方法采用血液流变学指标检测及甲皱微循环检查方法,对248例急性挤压伤患者进行了多项指标的分析与研究,并与165例健康者对比分析。结果急性挤压伤患者具有因微观血瘀所致的微循环障碍征象,全血比黏度、血浆比黏度、红细胞硬化指数增高,血沉增快;甲皱微循环血色呈暗色,袢顶有扩张,红细胞聚集,血流缓慢瘀滞,甲皱微循环形态积分值、流态积分值、袢周状态积分值及总积分值均增高（均P〈0．01）。其结果揭示了急性挤压伤患者机体组织瘀血有微循环障碍存在的客观现象及内在的相关性。结论对于急性挤压伤患者,在治疗时,迅速清除和纠正机体组织及脏器瘀血,及时改善微循环十分重要。     

抗凝溶栓药物对家兔复苏时微循环的影响

目的探讨心脏骤停（CA）后心肺复苏（CPR）的基本生命支持（BLS）阶段组织微循环变化特点及抗凝溶栓药物对其影响。方法24只家兔随机分为实验组和对照组，每组12只。在交流电诱发CA后，对照组只进行BLS，实验组在此基础上给予尿激酶和肝素进行干预。分别于诱发CA前（0min）和CA后每隔3min测定兔耳的微循环血流量，在复苏30min时取心肌和肾脏组织进行形态学检查。结果对照组兔耳微循环血流量在CA发生后急剧下降（P〈0．05），在BLS阶段随时间的延长不断下降（P〈0．05）。实验组兔耳微循环血流量在CA发生后也急剧下降（P〈0．05），在BLS复苏9min后下降速度趋缓。两组相比微循环血流量变化明显不同（P〈0．05），两条变化曲线约在9min时相交，其后实验组的变化曲线趋于平坦，而对照组仍继续下降。对照组心肌和。肾脏组织的微循环内可观察到红细胞聚集，而实验组无此现象。结论CA后在CPR的BLS阶段微循环血流量下降，有血细胞聚集现象，给予溶栓、抗凝药物的干预可以改善BLS阶段组织的微循环血流灌注，防止微循环内微血栓形成。     

日本鬼鲉螫伤对大鼠红细胞结构和免疫细胞功能的影响

目的：本文探讨在离体条件下日本鬼鲉毒腺提取物对大鼠红细胞结构和免疫细胞功能的影响。方法：应用扫描电镜观察不同浓度(浓度为lμg／ml、10μg／ml、100μg／m1)的日本鬼鲉毒腺提取物对大鼠红细胞结构的影响；MTT法测定毒腺提取液对大鼠血液单个核细胞、胸腺细胞和脾细胞活力的影响；用LDH释放法检测血液和脾脏中NK细胞的活性；用大吞噬法检测毒腺提取物对大鼠腹腔巨噬细胞吞噬力的影响。结果：三种浓度的毒腺提取液均可使大鼠红细胞发生棘突样变，10分钟内红细胞棘变率随毒素的浓度增加而增多，5-30分钟时间内较大剂量的毒液可使80％的红细胞发生棘突样变，但未见红细胞溶血现象。毒腺提取液可明显降低血液单个核细胞、胸腺细胞、脾细胞的活力；明显降低NK活性；并且降低巨噬细胞的吞噬能力。结论：鬼鲉蛰伤后造成的胸闷、憋气甚至休克、蛰伤局部容易感染和难愈合与其毒液导致红细胞变形及其免疫细胞活力下降密切相关。     

珊瑚姜提取物对C3H/He小鼠毛发生长周期及其对小鼠触须毛囊体外培养的影响

目的：探讨中药珊瑚姜对C3H／He小鼠毛发生长周期及其对小鼠触须毛囊体外培养的作用。方法：采用体外局部直接给药的方式，观察珊瑚姜提取物对C3H／He小鼠毛发生长的影响。结果：肉眼观察19d以后，2．0％珊瑚姜用药组小鼠毛已全部长满，0．5％珊瑚姜用药组小鼠也有长毛，较空白组多而长，毛色较空白对照组深，生长速度明显加快，提前进入生长期（P＜0．05）。病理切片显示用药15d后，用药组动物皮肤真皮层黑素分布较多，毛发处于生长期，而空白对照组黑素分布较少，毛发大多处于休止期。结论：珊瑚姜提取物具有明显的促毛发生长作用。     

部分植物提取物及药物对中波紫外线诱导的色素沉着斑的抑制作用

目的:检测植物提取物对皮肤色素沉着的抑制作用.方法:以窄谱中波紫外线(NB-UVB)1.5倍的最小红斑量照射,在受试者腹部皮肤建立人工色素沉着模型,分别用3%和5%烟酰胺、1%美白因子、1%羽扇豆素、1%沙棘油、1%和3%橙皮苷、3%维生素C磷酸酯镁、3%甘草酸二铵乳膏涂抹在模型各区域内,以3%氢醌霜为阳性对照,基质为阴性对照,未用药组作空白对照.分别在照射前、照射后1周(即用药前)、用药后第1、2、4、6、8周进行皮肤颜色测量.结果:紫外线照射后7周内,局部皮肤血红蛋白逐渐减少、胶原蛋白合成增加,表皮黑素总量增加.与空白对照区域和阴性对照区域相比,应用1%羽扇豆素、1%沙棘油、3%橙皮苷、3%烟酰胺等制剂的区域,L*值显著增加,高于(P<0.05)或近似于3%氢醌组(P>0.05);局部血红蛋白含量<氢醌组(P<0.01),与基质组相似(P>0.05);且对局部胶原蛋白的合成有轻度促进作用;用SIAscopy<'TM>测定出的局部黑素总量也显著小于空白对照组和阴性对照组(P<0.01),与氢醌组比较差异无统计学意义(P>0.05).结论:羽扇豆素、沙棘油、橙皮苷、烟酰胺、维生素C磷酸酯镁、甘草酸二铵、美白因子使紫外线照射后的色素沉着减轻,作用与氢醌相当,且刺激性小.     

皮肤肿瘤

982365 葡萄酒样痣光动力治疗后皮肤血流灌注的改变/姜澜（解放军总院）…//中华医学杂志（英文版）.-1998,111（2）.-136 为了解光动力疗法（PDT）对葡萄酒样痣（PWS）治疗作用的客观指征,对24例患者的28处皮损静脉注射光敏药物HpD后,以铜雾激光作为光源照射皮损。激光多普勒灌注（LDI）记录治疗前后皮损处的灌注情况,并与正常作对照。所有皮损在PDT治疗后灌注明显下降。治疗后6个月灌注与治疗前相比,有显著性差异（P<0.01）,但与对照组无差异。皮损处的颜色与微循环灌注量的下降有平行关系,接近于正常皮肤,不留疤痕。作者认为PDT是治疗PWS最有效的方法之一。微循环灌注可客观反映PWS的损害程度,PDT对PWS的治疗机制源于组织微循环反应。图2表1参9 （彭振辉）     

寻常型银屑病皮肤及甲襞微循环变化分析

目的：研究寻常型银屑病患者皮损、非皮损、甲襞微循环血流灌注变化情况。方法：利用激光多普勒散斑血流仪检测88例寻常型银屑病患者胫前皮损、非皮损与100名对照胫前正中及两组指尖血流灌注绝对值。结果：患者皮损、非皮损与正常对照皮肤微循环灌注绝对值分别为（319.96±124.65）BPU，（100.87±19.74）BPU和（60.10±13.90） BPU，三组比较差异有统计学意义（均P＜0.05）。甲银屑病指尖微循环灌注值为（406.31±64.01BPU）,高于无甲受累患者的（270.13±69.41） BPU和对照组的（361.15±113.70） BPU，差异有统计学意义（P＜0.05）；皮损微循环灌注绝对值与PASI评分之间呈正相关（r=0.744）。结论：寻常型银屑病患者皮肤及甲襞微循环血流灌注异常，皮损部位灌注值与病情严重程度相关。     

Changes of skin characteristics during and after local Parafango therapy as used in physiotherapy

Background/aims: In physiotherapy, fango (mud) application is a frequently used heat therapy. The main therapeutic effects are due to the elevated temperature of the different tissues with a significant redistribution of blood towards the heated area. This may influence several cardiovascular parameters. There is only limited information on the effect of fango application on skin characteristics. It was the aim of the present study to evaluate the effects of fango application on skin temperature, perfusion of the microcirculation and skin colour. At the same time, cardiovascular parameters such as heart rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Method: Eighteen healthy subjects (age 23.7±3.8 years) entered the study. The skin characteristics and cardiovascular parameters were measured before, during and after a 21‐min fango application at 44.5°C. Results: Skin temperature and perfusion of the microcirculation increased significantly during fango application: from 35.5±0.4°C to 44.3±1.2°C for skin temperature and from 23.2±8.8 to 197±41 p.u. for the skin microcirculation. These two parameters remained elevated during the fango application and decreased slowly to baseline values within 21 min after fango removal. Skin colour (CIELAB, a^* parameter) increased from 11.0±2.5 to 17.9±1.9 when comparing pre‐ with post‐treatment values. At the end of the measuring period, the a^* parameter did not return to baseline values (15.8±2.1). Heart rate increased with 8 bpm during the fango therapy and returned to baseline within 3 min after removal of the fango. SBP and DBP varied slightly during the fango application. They returned to baseline values within 21 min after fango removal. Conclusion: The skin parameters indicate a transient temperature effect with an increased perfusion of the microcirculation and a flooding of the superficial capacitance system. The cardiovascular parameters were only slightly influenced and remained in the physiological range. Fango application seems not to be too demanding for the cardiovascular system in healthy subjects.     

NXCL‐4950, a novel composite applicable to peripheral skin,is capable of increasing skin temperature by enhancing capillary circulation

Background. Rapid skin warming and prompt correct medical treatment lead to dramatic improvement in patients with peripheral capillary‐related damage, such as injuries, Raynaud disease and frostbite. Aim. To characterize a novel composite, NXCL‐4950, for use in a cosmetic lotion. Methods. The effects of NXCL‐4950 on enhancing skin blood flow, skin temperature warming, and expansion of peripheral blood vessels and scalp microvessels were investigated. Results. Monitoring by laser Doppler perfusion imaging and thermal imaging showed that application of NXCL‐4950 to the hands increased skin blood flow and temperature relative to the control (or placebo) group. For the 20 participants with a high Raynaud Condition Score, application of NXCL‐4950 to the skin resulted in a mean increase of 215.53% in microvessel diameter and mean increase of 164.96% in the speed of blood flow. When NXCL‐4950 was applied to the scalp, the microvessels around the hair roots were clearly visible after 20 min. Conclusion. NXCL‐4950 is a potential candidate for enhancing peripheral skin temperature, and might be useful in the treatment of capillary‐related disorders.     

Biological effect of far-infrared therapy on increasing skin microcirculation in rats

BACKGROUND/PURPOSE: Insufficient microcirculation of skin leads to acute and chronic tissue ischemia in cases of trauma, reconstructive surgery, diabetes mellitus and peripheral arterial occlusive disease. The autonomic nervous system and nitric oxide (NO) play important roles in maintaining blood perfusion of the skin. Far-infrared (FIR) therapy provides low energy of light emitted from an artificial radiator and has been used to treat many vascular-related disorders. Nevertheless, the mechanisms through which FIR works remain unclear. The present study aims to test the hypothesis that the effect of FIR is through increasing skin microcirculation by a mechanism other than its thermal effect. METHODS: Sixty rats were used in the present study. A WS TY301 FIR emitter was placed 20 cm above the rats. Skin temperature and blood flow were continuously measured by a K-type thermocouple. Under laboratory control, the abdominal skin temperature steadily increased from 38-39 degrees C, and was kept at constant temperature. Skin microcirculation was measured with a continuous laser Doppler flowmeter. RESULTS: There was no significant change of skin blood flow during FIR treatment. Skin blood flow increased significantly soon after the removal of the FIR emitter. The stimulating effect on skin blood flow was more significant in the rats treated with FIR for 45 min and could be sustained as long as 60 min. These findings suggested a non-thermic biological effect of FIR on skin microcirculation. The promotive effect of FIR on increasing skin blood flow was not influenced by pretreatment of APP (atropine, propranolol and phentolamine), but was suppressed by pretreatment with NG-nitro-L-arginine methyl ester (an endothelial nitric oxide synthase inhibitor). CONCLUSION: In conclusion, FIR therapy exerts a NO-related biological effect to increase skin microcirculation in rats. This might bring into perspective the clinical application of FIR to treat ischemic disease by augmenting L-arginine/NO pathway.     

Value of capillary microscopy in the diagnosis of hereditary hemorrhagic telangiectasia

BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is a hereditary disorder, leading to easily bleeding telangiectases on the skin and mucosal surfaces. The disease is associated with arteriovenous malformations in multiple organs. Potentially serious complications warrant an early diagnosis. Telangiectases are the hallmark of the disease, but may be difficult to distinguish. OBJECTIVES: To evaluate the value of capillary microscopy in the diagnosis of HHT and to compare the capillary pattern of the fingernail folds in patients with HHT and healthy persons. SETTING: Outpatient department of a general hospital. PARTICIPANTS: A random sample of 54 patients with HHT and a volunteer sample of 40 healthy persons. MAIN OUTCOME MEASURE: The difference in the capillary pattern between patients with HHT and healthy volunteers. RESULTS: Forty-five (83%) of 54 patients with HHT had giant loops between the normal capillaries in the nail fold.Two patients had only enlargement of the draining limb of the capillary. Seven patients (13%) had no vascular abnormalities in the nail fold. Seven of 9 patients with HHT but without cutaneous telangiectases had microvascular abnormalities. None of the volunteers had vascular abnormalities. The difference between both groups was significant (chi2, P<.001). CONCLUSION: Capillary microscopy can be a valuable tool in diagnosing HHT.     

野山楂、女贞子、猪苓和白芨醇提取物混合剂对鼠毛生长影响的研究

目的:研究中药对C57BL/6小鼠毛发生长周期的影响。方法:将143只C57BL/6小鼠按给予不同浓度的野山楂、女贞子、猪苓、白芨醇提取物混合剂以及人参总皂苷,分组采用体外直接给药和灌胃的方法,在给药后的不同时间观察鼠毛生长状况。结果:野山楂、女贞子、猪苓、白芨醇提取物混合剂灌胃中、低剂量组(30g/L和10g/L)和外用中、高剂量组(40g/L和80g/L)较对照组明显诱导小鼠毛发的生长和延长毛发的生长期,早期能加速毛发生长,且高剂量组作用更明显(P<0.05)。人参总皂苷(3g/L和30g/L)外用能诱导小鼠毛发的生长和延长其生长期,早期加速毛发生长,且高剂量组作用更明显(P<0.01)。结论:野山楂、女贞子、猪苓、白芨醇提取物混合剂和人参总皂苷具有明显的促进毛发生长作用。     

Capsaicin treatment induces histamine release and perfusion changes in psoriatic skin

To determine whether neurogenic factors may be of importance in the regulation of histamine release and blood flow in psoriatic plaque, the effect of capsaicin was studied in 22 psoriatic patients with active, untreated psoriatic lesions. In each of 12 patients, one microdialysis fibre was placed in non-lesional skin and one was placed in lesional skin at depths of 0.7 and 0.9 mm, respectively. Dialysates were collected for the analysis of histamine in the resting state and after 60 min of repetitive epicutaneous application of 1% capsaicin above the microdialysis catheter. In 10 patients, topical capsaicin and placebo were applied for 24 h to lesional/lesion-free skin. Skin blood flow and perfusion (evaluated using the 133xenon clearance technique and scanning laser Doppler, respectively) were measured before the application of capsaicin and after removal. After 60 min of capsaicin treatment, both the perfusion and interstitial concentration of histamine, as well as the net release of histamine, were significantly increased in affected (from 38 +/- 6 to 45 +/- 6 nmol/L, mean +/- SEM) and unaffected (from 15 +/- 2 to 19 +/- 2 nmol/L) skin. Compared with placebo, 24 h of treatment with capsaicin caused a 15% decrease in perfusion in lesional skin. The results are compatible with the hypothesis that capsaicin-sensitive nerves may induce histamine release in non-lesional and lesional skin and that afferent unmyelinated nerve fibres may contribute to the high blood flow in psoriatic plaques.     

Sidestream dark field imaging: the evolution of real-time visualization of cutaneous microcirculation and its potential application in dermatology

Technological advances during the last years have enhanced the image quality of the microcirculation. Intravital microscopy (IM) has been considered the “gold standard” for many years, but it can be used mostly in anesthetized animals which is a disadvantage. The nailfold videocapillaroscopy, a non-invasive examination that includes a microscope with an epiillumination system, came afterward, but its major disadvantage is the restricted area available for investigation namely the nailfold capillary bed. The orthogonal polarization spectral (OPS) imaging technique, where reflected light allows the visualization of the microcirculation, was the next non-invasive exam, but it still presents some drawbacks such as suboptimal capillary visualization and image blurring due to red blood cell movements. Excessive probe pressure modifies red blood cell velocity. There is suboptimal imaging of capillaries due to motion-induced image blurring by movements of OPS device, tissue and/or flowing red blood cells. Sidestream dark field (SDF) imaging is the newest tool for microcirculatory research. Illumination is provided by concentrically placed light-emitting diodes to avoid image blurring and to enhance image contrast. It represents a simple and non-invasive imaging technique, with low cost, good portability and high sensitivity that provides fine, well-defined images. In addition, the microcirculation can be studied through laser Doppler flowmetry (LDF) or reflectance-mode confocal-laser-scanning microscopy (RCLM). However, LDF cannot show microcirculatory vessels and high cost of RCLM can be an inconvenience. New applications of SDF technique could include skin microcirculatory evaluation and allow dermatological studies on psoriasis, skin tumors and leprosy.     

剥脱性皮炎(红皮症)44例临床及实验室分析报告

报告44例剥脱性皮炎.采用中西医结合的方法洽疗,治愈率为97.7多,死亡1人,平均住院时间为85夫.治疗前后对18例进行免疫球蛋白等测定,未见明显改变,对11例散了LTT及ERFCT检查.8例进行了血液流变检查,T例做了微循环俭查,治疗前均有异常,治疗后均有不同程度的改变.     

Capillary blood cell velocity in periulcerous regions of the lower leg measured by laser Doppler anemometry

BACKGROUND: The capillary blood flow of the nailfold can be measured by means of modern non-invasive techniques like the videocapillary microscope in vivo. To quantify the capillary blood cell velocity, apart from the nailfold capillaries, we used a new technique, the so-called laser Doppler anemometry (LDA). OBJECTIVE: The present study investigated how far laser Doppler fluxmetry (LDF), transcutaneous partial pressure of oxygen (tcpO2), and LDA are capable of quantifying differences of cutaneous microcirculation between patients with leg ulcera and a healthy control group. The effects of intravenous prostaglandin E1 and pentoxifylline were also investigated. PATIENTS AND METHODS: Ten patients with venous leg ulcers and 10 patients with mixed venous/arterial ulcers were investigated with LDF, tcpO2, and LDA before and after injection of prostaglandin E1 and pentoxifylline. We measured the resting capillary blood cell velocity (rCBV), the maximum hyperemia, and the time to peak capillary blood cell velocity (tpCBV) during hyperemia after 4 min of suprasystolic occlusion and compared them with the results of a contol group of 20 patients. RESULTS: Laser Doppler flow was increased in all patients during resting period, whereas the tcpO2 was significantly decreased. LDF did not show an extension of tpCBV during reactive hyperemia after suprasystolic occlusion compared to the control group (73.6+/-31.1 vs. 164.1+/-52.5 s, P=0.003). TcpO2 revealed significantly decreased tpCBV in patients with venous and mixed venous/arterial ulcers (90.1+/-61.7 vs. 162.7+/-65.5 s, P< or =0.0001). LDA showed no significant differences between patients and control group (P>0.8). After application of prostaglandin E1, LDA revealed a significant increase of erythrocyte velocity (0.5+/-0.18 to 0.74+/-0.28 mm/s [P=0,01]), whereas pentoxifylline had no significant effect. Capillary density increased significantly after application of prostaglandin E1 (5,1+/-2.7/mm2 to 8.9+/-3/mm2 [P=0.001]) and pentoxifylline (5.3+/- 1.8/mm2 to 8+/-2.1/mm2 [P=0.006]). CONCLUSION: The LDA is an important additional investigation tool for cutaneous microcirculation.