| Object i ves:To discuss the energy range of scar healing while treat the superficial vascular dermatosis by pulsed dye laser and Nd:YAG laser in clinical。Discuss the energy range of preventing scar tissue proliferation while treat the pathological scar by the two kinds of laser。Methods:To cultivate the HT1080, PDL and Nd:YAG laser irradiate the HT1080With different energy, respectively, then continue to cultivate for24hours. Using tetramethyl azo thiazole blue colorimetric experiment (determined by MTT method) to detect the proliferation activity of HT1080. Using ELISA method to detect TGF-β1and the expression of TGF-β3level. Training mice, With different energy of PDL and Nd:YAG laser irradiation in mice skin respectively. Extracting the pathological materials before exposure,24hours after exposure and7days after exposure, respectively, and comparing the pathological changes before and after irradiation. Results:1.PDL and Nd:YAG laser irradiated the HT1080respectively, then continue to culture for24hours, Compared with control group, there was no significant statistically difference of cell proliferation activity between experimental groups with different energys (P>0.05).2. Continue to culture the HT1080for24hours after irradiating by PDL and Nd:YAG laser respectively, then Compared with control group, the TGF-β1concentration were increased in all experimental groups with different energys, the difference were statistically significant (P<0.05). There were no statistically significant difference of TGF-β1concentration between PDL group with different energys (P>0.05); There were no statistically significant difference of TGF-β1concentration between Nd:YAG group with different energys (P>0.05).3. PDL and Nd:YAG laser irradiated the HT1080respectively, continue to culture for24hours, compared with control group, the TGF-β3concentration were increased in all experimental groups with different energys, the difference were statistically significant (P<0.05). There were significant difference of TGF-β3concentration between PDL group with different energys (P<0.05); There were statistically significant difference of TGF-β3concentration between Nd:YAG group with different energys (P<0.05), it increased gradually as the energy increases..4. Pathological:compared with control group (normal mice skin), with the PDL laser energy density as7and15J/cm2irradiation in mice after24hours.there was no skin burns necrotic tissue in the pathology of mice, but dermis visible neutrophil distribution; Burn skin necrosis tissue could been seen after39J/cm2irradiation, and more neutrophil distributed in the dermis; With Nd:YAG laser energy density as15J/cm" irradiation in mice after24hours, there was no skin burns necrotic tissue in the pathology, only a small amount of lymphocytes dermis distribution; But burn skin necrosis tissue could been seen55J/cm irradiation, and more neutrophil distributed in the dermis; Burn necrotic tissue penetrating the dermis could been seen after175J/cm2irradiation, and dermis visible a large number of neutrophil distribution. With PDL laser irradiation in mice after7days, its pathological expressed as with the energy increased, the dermal fibroblast proliferated evidently. With Nd:YAG laser irradiation in mice after7days, its pathological expressed as in the low energy range, along with the energy increased, the dermal fibroblast proliferated evidently, but while the energy reaches more than175J/cm, the dermal fibroblast proliferated not obviously than before. Compared the pathologic of PDL energy density as39J/cm2with Nd:YAG laser energy density as55J/cm2and175J/cm2, The former with wider distance between the skin and appendages, suggested that PDL promote fibrosis obviously.Conelusions:1. In the scope of energy using in the experiment, the value of MTT were no statistical significance between the different energy of PDL and Nd:YAG laser irradiating HT1080respectively, It is showed that there was no effect on human fibroblasts proliferation activity after two kinds of laser irradiating. It proved that in certain energy range, PDL and Nd:YAG laser irradiating wound not increase the risk of increasing the scar.2. In the scope of energy using in the experiment, It can promote the secretion of TGF-β1and TGF-β3after different energy of PDL irradiation, It consider that the application of PDL to treat skin disease will stimulate and inhibit fibrosis in human fibroblasts. Combined with animal experiments show that it is relative safety. Within Normal PDL energy range, it don’t promote scar proliferation, also don’t inhibit scar tissue proliferation. Therefore, it can be appropriately using large energy when useing of PDL treat superficial vascular dermatosis, but must pay attention to the skin pigment factors. In the treatment of pathological scar, it is not suitable for obsolete scarring lacking of blood vessels.3. In the scope of energy using in the experiment, It can promote the secretion of TGF-β1and TGF-β3after different energy of Nd:YAGL laser irradiation. The TGF-β1concentration has no statistical significance between the experimental group,(P>0.05), but the TGF-β3concentration difference was statistically significant (P<0.05), it showed a trend of increase as the energy increases. Combined with animal experiments showed that within the scope of the low energy, Nd:YAG laser would not perform on scar proliferation. It was appeared to inhibit scar proliferation step by step as energy increased gradually. Therefore, the energy should not be too high while using Nd:YAG laser to treatment superficial vascular dermatosis; But, it was applicable to all types of scar in the treatment of pathological scar, and the higher the energy, the better the results. |
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