LOW LEVEL LASER THERAPY (LLLT)

850nm红光对生发的作用1. 引言随着生活水平的提高和人们对美的追求，脱发问题逐渐成为困扰许多人的难题。

而近年来，光疗法作为一种非侵入性治疗方式备受关注，其中850nm红光被认为对促进生发具有显著的效果。

本文将对850nm红光对生发的作用进行全面详细、完整且深入的探讨。

2. 850nm红光的特性2.1 波长选择850nm红光的波长处于红外光谱的范围内，具有较高的穿透力。

相比其他波长的光线，850nm红光在穿透皮肤时能够更好地达到毛囊和头皮深层组织，从而更直接地对生发起到作用。

2.2 红光的生物学效应红光作为一种可见光线，对人体具有一定的生物学效应。

在850nm波长的红光照射下，头皮的血液循环得到改善，增加了毛囊的供血量，促进了毛囊的营养供应和氧气供应，从而为健康的头发生长提供了良好的环境。

3. 850nm红光对生发的机制3.1 激活毛囊细胞850nm红光能够激活毛囊细胞，促进其活化和增殖。

实验证明，红光照射能够提高毛囊细胞的代谢活性，增加细胞分裂，并促使毛囊进入生长期，从而增加头发的生长速度和密度。

3.2 抑制毛囊的炎症反应炎症反应是导致脱发的一个重要因素。

850nm红光具有抗炎作用，能够降低头皮的炎症反应，减轻毛囊的炎症程度，从而有助于恢复健康的毛囊功能。

3.3 促进血液循环良好的血液循环对头发的生长至关重要。

850nm红光照射能够扩张头皮血管，增加血液流量，促进血液循环，从而提高毛囊的供血量和氧气供应，为头发的生长提供充足的营养。

4. 850nm红光对生发的临床应用4.1 激光治疗仪器目前市场上已经有一些专门用于头发生长的激光治疗仪器，其中就包括850nm红光。

这些仪器通过照射头皮，将850nm红光直接作用于毛囊，以实现促进生发的效果。

患者可以在家中使用这些仪器进行治疗，方便且安全。

4.2 临床疗效许多临床研究表明，850nm红光对生发具有显著的疗效。

在一项针对男性脱发的研究中，照射850nm红光的患者在治疗后的头发密度和厚度上都有明显的改善。

中国动物保健2022.11激光理疗技术在宠物临床中的应用研究进展李梅清（山东畜牧兽医职业学院山东潍坊261061）激光在宠物医学中的应用范围逐渐广泛，激光理疗在动物康复理疗领域有了很好的发展前景。

本文通过介绍激光理疗的应用原理，分析激光波长、功率以及宠物品种、毛色、毛长等因素对理疗效果的影响；通过对近年来激光理疗在国内外宠物临床应用中的研究进行总结，分析激光理疗技术在宠物皮肤病、内科病、外科病、神经损伤、宠物针灸及骨与关节等疾病中的应用，以期通过激光理疗技术的发展提高宠物疾病治愈率，同时提升宠物医疗福利。

光理疗；镭射；宠物；临床；应用doi:10.3969/j.issn.1008-4754.2022.11.049基金项目：潍坊市科学技术发展计划项目：(2020GX044)。

作者简介：李梅清(1977.10—)，硕士，研究方向为临床兽医学，E-mail ：。

科研动态激光又称镭射（laser ），被描述为“通过受激辐射产生的光”，具有单色性纯、高亮度、方向性好的特点，激光所释放的光子能量不容易发散，可以很精准地到达需要治疗的部位；激光理疗就是利用激光的这种优势，通过使用特定波长的光源直接照射生物组织，产生一系列的生物效应从而达到治疗疾病的目的。

随着宠物行业的高速发展，宠物疾病诊断与治疗手段越发的多元化，激光理疗技术已经应用到宠物临床的外科、内科、皮肤、中兽医及神经等不同学科。

目前，激光疗法被提倡用于治疗多种疾病，包括伤口愈合[1]、皮炎、肌肉骨骼疼痛、关节痛和炎症、神经性疼痛[2]、骨关节炎[3]等。

1激光理疗的应用原理激光理疗又称“光生物调节作用”，是一种以激光为物理因子，利用所产生的生物刺激作用进行物理治疗的一种治疗方法，越来越多的用于人类和动物的康复护理。

当激光照射到生物组织上时会产生生物化学反应，使细胞线粒体合成细胞能量物质（ATP ）的功能增强；同时，激光疗法还可改善血液循环，调节新陈代谢，释放神经传导素缓解疼痛，使动物全身症状得到改善。

双膦酸盐及其相关性颌骨坏死的机制和治疗魏斌;孙国文【摘要】双膦酸盐相关性颌骨坏死（BRONJ）是长期使用双膦酸盐治疗骨质疏松症，多发性骨髓瘤以及乳腺癌、前列腺癌和肺癌等其他恶性肿瘤骨转移所引起的骨相关性疾病的严重并发症。

BRONJ的发生发展与一些因素密切相关，譬如双膦酸盐的效能、用药方式、牙拔除和不良义齿修复等。

美国口腔颌面外科协会在2007年对BRONJ进行了定义、分级并颁布其治疗指南，在2009年和2014年进对其行了更新。

尽管BRONJ在国际上引起了广泛的重视，但其发病机制仍不完全清楚，治疗措施也存在着较大的争议。

本文就双膦酸盐及其相关性颌骨坏死的机制和治疗等研究进展作一综述。

%Bisphosphonate-related osteonecrosis of the jaw(BRONJ) is a severe complication that occurs f requently in patients subjected to long-term bisphosphonate treatment for osteoporosis, multiple myeloma, and oth er skeletal-related events induced by metastatic malignant diseases, such as breast, pros tate, and lung cancers. The development of BRONJ is associated with some ris k factors, such as bisphosphonate potency and administration model, dental extraction, and poor-fitting dentures. The definition, staging, and treatment guidelines of patients with BRONJ were established by the American Association of Oral and Maxill ofacial Surgeons in 2007 and then updated in 2009 and 2014. Although BRO NJ has been extensively investigated, the pathogenesis of this disease has yet to be fully elucidated, and corresponding treatments have remained controversial. This article briefly introduces new insights into the pathogenesis and tr eatments of BRONJ.【期刊名称】《国际口腔医学杂志》【年(卷),期】2016(043)004【总页数】4页(P445-448)【关键词】双膦酸盐;双膦酸盐相关性颌骨坏死;发病机制;治疗措施【作者】魏斌;孙国文【作者单位】南京市口腔医院•南京大学医学院附属口腔医院口腔颌面外科南京210008;南京市口腔医院•南京大学医学院附属口腔医院口腔颌面外科南京210008【正文语种】中文【中图分类】R782双膦酸盐是抑制骨吸收的一线药物，临床上常用于骨质疏松症、骨肿瘤以及乳腺癌、前列腺癌和肺癌等其他恶性肿瘤骨转移所引起的骨相关性疾病[1]。

6-1 Cellulite Removal Tripolar RF Diode Laser LLLT Lipo Laser Cavitation MachineUse ManualInstrument Function and Treatment Principles Product IntrodutionWave fat systemWith collective strong sound wave head, strong sound wave of 40000HZ may be emitted to vibrate fat cells at top speed and produce numerous vacuum air pockets inside and outside the fat cells, robustly impact fat cells to generate introverted blast and disintegrate triglyceride into glycerol and free fatty acids. Then RF waves at frequency of 1M HZ is used for exhausting the integrated glycerol and free fatty acids through hepatoenteral circulation. Finally, vacuum RF and energy electrode are used for positioning and tightening fat. In physics, it is known as "cavitations". Microspore introverted blast inside and outside cell may lead to enhanced molecular motion and a higher energy level and this will finally cause fat cell rupture and thereby achieve the effects of body building and losing weight.Lipo Laser systemit involves the application of a highly sensitive laser to dissolve the fat deposits situated in the upper layers of the human skin. The energy emanating from the laser breaks up the fat cells to produce an oily material. This substance is either naturally eliminated through normally bodily processes or can be removed via a small incision made by the practising surgeon. This leads to a permanent loss of fat as long as a healthy diet is maintained after treatment. It penetrate into skin surface and stimulates the fat cell membranes, changing their permeability, the fat cells reduce their overall size and intracellular fat is released then the fatty trigly cerides flow out of the disrupted cell membranes and into the interstitial space, where they gradually pass through the body's natural metabolic functions with no harmful physiological effects, this process is resulting in inch loss of patients.The subtlety of the treatment carries various advantages over the problems often associated with. Damaged blood vessels and allied physical risks are significantly reduced, and recovery time is condensed. It is also acknowledged that the laser itself is important in encouraging collagen production, thus strengthening the skin.Instrument Function and Treatment Principles 1. 40Khz Ultrasonic handle1. Strong sound wave explosion fat headWith collective strong sound wave head, strong sound wave of 40000HZ may be emitted to human body for impacting fat cells fiercely and Causing friction motion between fat cells. This may cause effective consumption of calories and moisture in fat cells and reduce the size of fat cells. What's more, sound wavevibration may cause fierce impact of fat cells to make them be exploded instantaneously, reduce the amount of fat cells and thereby achieve the effects of removing fat.Operation:1.Press to adjust the time.2. Select the strength by clicking to increase the strength or click to decrease it.3. Press to start the strong sound wave explosion fat head.4. Press to pause operation.Mode a. b. c. d means that:"A" is continuous working for 3 sec and discontinuous for 2 sec. "B" is continuous working for 4 sec and discontinuous for 3sec. "C" is continuous working for 1 sec and discontinuous for 1 sec.2."D" is continuous working for 0.5 sec and discontinuous for 0.5sec.2. Vacuum Bipolar RF handleFor body and face re-shaping and weight loss Vacuum + RF fat-explosion machine can promote tissue metabolism, repel the cellulite, which make fat granule in different depths and shocking make fusion energy, and the deepest receptor can get granule in3CM thick of skin, and rapid expansion and the rapid heating of the cell wall that exceed the elastic limits and arises cells broken, so that the combustion of fatty acids at the same time broken out of a pot, not only the burning consumption of fatty acids but also more directly emptying so rapidly reduce the size of granule.Operation:Body RF Probe (Vacuum) operation1. Press to adjust the time.2. Press to increase suction intensity or to decrease suction intensity3. Press to increase release intensity or to decrease release intensity.4. Press to increase the RF intensity or to decrease RFintensity.5. Press to start RF operation;6. Press to Pause operation.Beautifying: Use the probe to massage the specific part of skin circularly after applying the sliming cream for about 30 to 40 minutes. It could quicken the blood circulation in the part of skin treated and has the effect of decomposing fat, etc. Notes:1. Apply sliming cream or cooling gel to the part of skin to be treated before the treatment.2. Keep close contact between the probe and the skin.3. Adjust the intensity from low level to high level.4. Please do not irradiate eyeball directly with colored light.3.Tripolar RFStick to enhance rejuvenation: use of positive and negative micro-current activation energy release skin cells, so that paid synthesis of fibroblasts collagen, elastic skin revert to the original compact, the skin causing the eliminate wrinkles, prevent skin aging, restoring skin elasticity, facial improvement.Operation:1. Press to adjust the time.2. Select the strength by clicking to increase the strengthor click to decrease it.3. Press to start the strong sound wave explosion fat head.4. Press to pause operation.4. Body RF handleBeing integrated with the most advanced RF technology and radio frequency, the instrument may directly reach the deep-seated fat body and have the excellence oftargeted positioning RF. In thefast-active state, fat cell tissue may generate friction heat, increase local temperature and remove excess fat and toxin from the body through sweat gland,enter hepatic circulation and lymph and ultimately achieve the effect of dissolving fat. With controlled depth technology, inlaid diamond particles of different sizes may rub skin along its pattern, adjust suction strength by means of vacuum draw and rub with negative pressure strong force to directly explode thick fat. Thus, the effects are very the skin are also changed. By this time, natural electric resistance in the subcutaneous tissue moves and generates heat energy. As the papillary dermis collagen may immediately shrink when the temperature is within the range from 60 to 70 Celsius degree, after wrinkle treatment, client may immediately sense the skin tightening effects as it is being lifted and firmed. When collagen is produced continuously, thickness and density of the skin papillary dermis may be increased to remove wrinkles, eliminate scars, restore skin elasticity and gloss and make it be blonde and smooth. While collagen is increased, fresh skin is generated in the position of operation and wrinkles are removed by large amount of cells. In addition, when cortex without elasticity or that with thick horny layer in the area with wrinkles is separated, surrounding skin will also be renewed.Operation:1. Press to adjust the time.2. Select the strength by clicking to increase the strength or click to decrease it.3. Press to start the strong sound wave explosion fat head.4. Press to pause operation.5. Lipo Laser PaddlesIt involves the application of a highly sensitive laser to dissolve the fat deposits situated in the upper layers of the human skin. The energy emanating from the laser breaks up the fat cells to produce an oily material. This substance is either naturally eliminated through normally bodily processes or can be removed via a small incision made by the practising surgeon. This leads to a permanent loss of fat as long as a healthy diet is maintained after treatment. It penetrate into skin surface and stimulates the fat cell membranes,changing their permeability,the fat cells reduce their overall size and intracellular fat is released then the fatty trigly cerides flow out of the disrupted cell membranes and into the interstitial space,where they gradually pass through the body's natural metabolic functions with no harmful physiological effects,this process is resulting in inch loss of patients.Operation:1. Press to adjust the time.2. Select the strength by clicking to increase the strength or click to decrease it.3. Press to start the Lipo Laser.4. Press to pause operation.InstallationTechinical ParametersPower supply Input:110V/220V 60HZ/50HZ Power :130W40K cavitation head:Power supply output:150V Frequency:40KHz Power:25WVacuum+Bipolar RF head: Power supply output:66V Freqeuncy:450K Power:95W BIO head:Power supply output:24V Freqeuncy:1.5K Power:1WTripolar RF head:Power supply output:66V Freqeuncy:450K Power:35WFace RF head:Power supply output:66V Freqeuncy:450K Power:35WPackage Including:Multipolar RF head(Tripolar RF) X 1 40KHz Cavitation Head X 1 Vacuum Biploar Head x 1 Bipolar RF Head for face X 2 1xPower line(We offer 100-240V,AU/EU/UK/AU plug) 6xBig paddle with 8 diode laser//Each (Total 48 Diode laser) 2xSmall paddle with 3 diode laser//Each (Total 6 Diode laser) 1xMetal holder for diode paddlesBUTTOCKSILLUSTRATIN of OPERATIONFACETreated time: 30 minutes1. Massage the mandible center in circles to produce deep heat.2. Massage lower jaw in lines.3. Massage the triangle zone of both sides of the face in circles.4. Massage from jaw to angulus oris to ear in linesTHIGHTreated time: 30 minutes1. From down to upper, pushing to the groin to dredge the lymph.2. From down to upper, circling push by anticlockwise can help decomposing fatness.3. Also can push by come-and-go to decompose fatness.4. Pull from the knee and muscle texture to upper, can improve the curve. Treated time: 20 to 30 minutes1. Along the lymph direction, pulling to the waist.2. From upper to down, by anticlockwise gesture, pull come-and-go.3. Along the muscle of arm, pull up to lift and tight the muscle.BACKTreated time: 20 to 30 minutes1. First by come-and-go, pushing the bladder nerve 2 to 3 times.2. Circling by anticlockwise to stimulate the underarm lymph node.3. On the back, by anticlockwise circling, can help to decompose the fatness.ing lymph drainage gesture, pull the toxin to the lymph node, can helpimproving the back curve.ARMTreated time: 30 minutesBACK SIDE1.From the inner elbow to the armpit, doing lymph drainage.2. Circling to stimulate the lymph node.3. By anticlockwise or come-and-go pushing, decomposing the fatnes.4. From the elbow to the oxter, doing tightening gesture.Facade1. From the elbow to the oxter, doing tightening gesture.AbdomenTreated time: 20 to 30 minutes1.From small to large, by clockwise direction, circling around the navel, can helpperistalsis of the large intestine.2. From small to large, by anticlockwise direction, circling.3. From the belly and muscle texture, pull to the groin.4. Through lymph drainage gesture, taking the toxin to the place of groin.Attention:1. Pregnant women or women during in menses.2. Epileptic.3. Patients with malignancy.4. Patient whose wound after operation has not healed up.5. Acute inflammation or epidemical patients.6. Whom with heart diseases or with heart pacemaker.7. Who with kidney (gall-stone) disease.8. Who was embedded metal object or silica gel.9. Who in menses, birth control period, emiction incontinence period, or accepting the belly operation.10. Whose body always takes much inner hot.11. Who has the genetic hypersensitivity.Notice:1. Be sure to use the special ultrasonic gel.2. Avoid knocking the us head.3. For avoiding burning the head, during operation, please prepare enough ultrasonic gel.4. Don’t stay in one place, avoid treating on the bone.5. Don’t use disinfectant product to disinfect the us head. We suggest the wet cotton or dry towel enough.6. Check the machine power cord if it is connected well.7. If the machine will not use for a long time, please switch off it, and power off.8. Please take off all metal decoration from the operator and patient’s body.9. If continuous using 1 hour, please pause the machine about 10 minutes, then using again.10. During the operation, be sure not to accept other treatment.。

abnormal vaginal bleeding requiring intervention had no statis-tical difference between VP and WVP patients group (p=0.3074)as other complications as well(table1).Median of related days of vaginal bleeding after the procedure were 7.4days(SD8.75)in VP group and7.34days(SD8.52)in WVP group,with no statistical difference(p=0.912). Conclusions Insert a vaginal pack or not,after LEEP,do not affect the number of postoperative gynecologic intervention due to vaginal bleeding or the amount of postoperative bleed-ing days.Previous pregnancies,hormonal status,cytology or LEEP specimen characteristics did not affect the disclosure. We also could not find any risk factor associated to abnormal bleeding.Based on that,the use of vaginal pack can be omit-ted with no further complications.IGCS19-0405382LATERALLY EXTENDED ENDOPELVIC RESECTION(LEER) AND NEOVAGINE,PATIENT WITH RECTALADENOCARCINOMA AND RECURRENCE IN CERVIX,VAGINA AND PELVIC WALL:A PURPOSE OF A CASE1J Torres*,2J Saenz,3O Suescun,3M Medina,4L Trujillo.1Especialista en entrenamiento–Universidad Militar Nueva Granada–Instituto Nacional de Cancerologia,Department of Gynecologic Oncology,Bogota D.C.,Colombia;2Especialista en entrenamiento–Universidad Militar Nueva Granada–Instituto Nacional de Cancerologia,Department of Gynecologic Oncology,Bogota D.C,Colombia;3Instituto Nacional de Cancerologia, Department of Gynecologic Oncology,Bogota D.C,Colombia;4Instituto Nacional de Cancerologia,Department of Gynecologic Oncology,Bogota D.C.,Colombia10.1136/ijgc-2019-IGCS.382Objectives Exenteration is used to treat cancers of the lower and middle female genital tract in the irradiated pelvis. Höckel described laterally extended endopelvic resection (LEER)as an approach in which the resection line extends to the pelvic side wall.Methods A49-year-old patient diagnosed with rectal adenocar-cinoma10years ago,managed with chemotherapy plus radio-therapy.T umor relapse at3years,management with low abdominoperineal resection and definitive colostomy.Second relapse4years later,compromising the posterior aspect of the coccyx and right side of the pelvis with irresecability criteria, management was decided with chemotherapy with capecita-bine,oxaliplatin and bevacizumab.New relapse at2years in the cervix,vagina and pelvic wall.Images without distance disease,type LEER management with extension of pelvic floor margins and resection of muscle pubococcygeus and right lat-eral iliococcygeus with neovagina(Singapore flap)and non-continent urinary derivation with bilateral cutaneous ureteros-tomy,achieving adequate lateral margin with curative intent. During follow-up with favorable evolution.Results LEER combines at least two procedures:total mesorec-tal excision,total mesometrial resection or total mesovesical resection.It may even require resection of the pelvic wall, internal obturator muscle,pubococcygeus,iliococcygeus,coccy-geus or internal iliac vessels.In combination with neovagina, it would offer better results in non-gynecological cancer relapses.Conclusions LEER with neovagina can be offered as a new therapy to a selected subset of patients with relapse in adja-cent gynecological organs with good oncological,functional and aesthetic results.Symptom Management–Supportive Cancer CareIGCS19-0706383PHOTOBIOMODULATION AND MANUAL LYMPHDRAINAGE FOR NIPPLE NECROSIS TREATMENT INBREAST CANCER:A CASE REPORT1J Baiocchi,2L Campanholi,3G Baiocchi*.1Oncofisio,Physical Therapy,Sao Paulo,Brazil;2CESCAGE,Physical Therapy,Ponta Grossa,Brazil;3AC Camargo Cancer Center, Gynecologic Oncology,Sao Paulo,Brazil10.1136/ijgc-2019-IGCS.383Objectives Recently,breast reconstruction after mastectomywith nipple preservation became an option of breast cancer surgery.Despite its efficacy and aesthetic superiority,the nip-ple preservation is associated with several complications in the postoperative period.The photobiomodulation therapy,for-merly known as low-intensity laser therapy,demonstrated tis-sue promotion repair by cellular repair biostimulation, angiogenesis and anti-inflammatory effects.These characteris-tics suggest a potential role for repair of chronic wounds andmay be applicable in necrosis treatment.Our aim was toreport the effects of the physiotherapeutic intervention through photobiomodulation therapy in a patient with nipple necrosis after risk reducing mastectomy.Methods We report a case of a breast cancer surgery with nip-ple necrosis treated with low-level laser therapy.The patientwas a36-year-old women who developed skin nipple necrosisin the right breast after bilateral reconstructive mastectomy.She had6sessions of low-level laser therapy.Results A female subject developed a nipple necrosis of morethan40%on the right breast after mastectomy and recon-struction.She was referred to Physical Therapy(PT)and thePT sessions were composed by manual lymph drainage,man-ual therapy for de AWS,exercises of strength and flexibility, followed by LLLT with laser660nm,2joules per point atevery1cm.Therapy was implemented for12times in total,from May2016to June2016.A re-evaluation was performed monthly from July13,2016to November2017.After18 months of follow-up,the sustained effects of LLLT were found.Conclusions Low-level laser therapy is effective for the skin cicatrization after nipple necrosis.IGCS19-0446384CONTRACEPTION AND FERTILITY COUNSELING INPATIENTS RECEIVING CHEMOTHERAPY1A Elnaggar*,2A Calfee,1LB Daily,2T Hasley,1T Tillmanns.1West Cancer Center and Research Institute,Gynecologic Oncology,Memphis,USA;2University of Tennessee Health Science Center,Obstetrics and Gynecology,Mempis,USA10.1136/ijgc-2019-IGCS.384Objectives Cancer care advances allow more patients to pursue fertility.Unfortunately,treatments may have detrimental effectson fertility and fetus should pregnancy occur.This study examines physician documentation and patient perceptions of fertility and contraception counseling. on December 24, 2023 by guest. Protected by copyright./ Int J Gynecol Cancer: first published as 10.1136/ijgc-2019-IGCS.384 on 18 September 2019. Downloaded fromMethods IRB approval obtained for a cross-sectional study of men and women,ages18–50,with newly diagnosed malig-nancy between May2017and2018.Prior sterilization,secon-dary or synchronous cancer,or prior chemotherapy were exclusionary.Consented patients received a survey regarding perception on receipt and quality of,counseling.Demographic, sexual,and social information was obtained.Differences were evaluated using chi-square tests.Results Fifty-three of179patients identified participated. Majority were women(75v25%).Patients were more likely to have perceived counseling for contraception and fertility than documented.The majority perceived counseling as suffi-cient regarding contraception and fertility.Men were more likely than women to be perceive counsel-ing regarding fertility(85v43%,p=0.010).However,both felt fertility counseling to be sufficient with similar rates of documentation.Caucasians were more likely to perceive receipt of fertility counseling(68v29%)and to perceive it to be sufficient(70v40%),then African Americans,with the same rate of documentation(35%).Conclusions Significant discrepancies in perception counsel-ing regarding contraception and fertility were seen.Gen-der and race were important factors for the perception of fertility counseling,while only race was a factor to qual-ity of perceived counseling.These differences occurred despite equal rates of physician documentation,across all groups.IGCS19-0430385WHO ARE YOU CALLING OLD?PRACTICE PATTERNS AND MANAGEMENT OF NONAGENARIANS PRESENTINGTO A GYNECOLOGIC ONCOLOGIST FOR INITIALCONSULTATIONE Ryan*,B Margolis,B Pothuri.New York University Langone Health,Obstetrics and Gynecology,New York,USA10.1136/ijgc-2019-IGCS.385Objectives T o describe the practice patterns and treatment of nonagenarians who initiated care with a gynecologic oncologist.Methods Retrospective chart review of women aged90or older who presented to a gynecologic oncologist between10/ 09and12/18at an urban academic medical center.Descrip-tive statistics utilized for variables of interest.Results We identified34nonagenarians(median age92,range 90–98):10(29%)had benign disease,8(24%)pre-malignancy or suspected malignancy,and16(47%)malignancy.Of these, 79%had age and/or functional status discussed in the care plan.Of the8with suspected malignancy,5declined further workup.The cancer distribution revealed5(31%)vulvar,5 (31%)uterine,4(25%)ovarian,1(6%)vaginal and1(6%) cervical bined,37%had stage I disease;6% stage3;6%stage4;13%recurrent;and25%unstaged.All received treatment plans:7(47%)with palliative intent and8 (53%)with curative intent.In the curative group,7under-went surgery(1adjuvant chemotherapy)and1chemotherapy/radiation.In the palliative group,4underwent radiation,1 chemotherapy and2declined/unknown.Overall,13(87%) completed the proposed treatment.T reatment-related complica-tions included1superficial skin infection and1thirty-day readmission.Conclusions Nonagenarians often presented with vulvar or endometrial cancer and87%successfully completed treatmentwith minimal adverse effects or toxicity.Age and/or functionalstatus were considered in the care plan for79%of women,but it did not preclude treatments that had the potential to preserve meaningful quality of life and/or cure patients oftheir disease.IGCS19-0646386RISK FACTORS COMPREHENSIVE GERIATRICASSESSMENT FOR EARLY DEATH IN ELDERLY PATIENTSWITH GYNECOLOGICAL CANCER.A PROSPECTIVECOHORT STUDY1J Sales*,2C Azevedo,2C santos,3L sales,4M Bezerra,5G Bezerra,4Z cavalcanti,6MJ Mello.1IMIP,Geriatric Oncology,Recife,Brazil;2IMIP,Oncology,Recife,Brazil;3FPS,Medical Course,Recife,Brazil;4IMIP,geriatric,Recife,Brazil;5HMV,oncology,caruaru,Brazil;6IMIP,post graduation,Recife,Brazil10.1136/ijgc-2019-IGCS.386Objectives T o determine risk factors for early death identifiedthe Comprehensive Geriatric Assessment(CGA)in elderly patients with gynecological cancer(EPGC).Methods Prospective cohort study.Participants with a recent diagnosis of cancer were from eight community hospitals andone cancer center in Northeast Brazil and were recruited dur-ing their first medical appointment at the outpatient oncologic clinic.A basal CGA was done before the treatment decision (ADL,Charlson Comorbidity Index-CCI,Karnofsky Perform-ance status–KPS,GDS15,IPAQ,MMSE,MNA,MNA-SF,PS,PPS,Polipharmacy,TUG).During the follow up of12 months,information about the treatments performed,the tar-geted interventions and early death was collected.Overall sur-vival was estimated using the Kaplan–Meier method,and survival curves were compared using the Log rank test for cat-egorical variables.A multivariate Cox proportional hazardsmodel was used.Results From2015–2017,84EPGC,mean age69,6±7,9;range60–96),were enrolled,25%were metastatic disease.tumor site:40,4%cervical uterine,36,9%endometrial,20,2%ovary and2,3vulva.Nine(10.7%)ECP died in less than12 months of follow-up.In our multivariate model,controlled byage,site of cancer and cancer stage,the remaining significantrisk factors were malnutrition/nonutrition determined byMNA-SF(HR3.70,95%CI1.81–5.99,p<0.001),Katz index(HR 3.60,CI 1.56–3.81,p<0.001)CCI>2(HR2,74,CI1.0.74–10.20,p=0.013)and Polipharmacy(HR2.65,CI0.71–9.81,p<0.001).Conclusions The CGA at admission identified risk factors (Nutritional risk,polypharmacy,functionality for Katz indexand comorbidity index)for premature death in EPGC.They can help to plan a personalized care. on December 24, 2023 by guest. Protected by copyright./ Int J Gynecol Cancer: first published as 10.1136/ijgc-2019-IGCS.384 on 18 September 2019. Downloaded from。

•论著.半导体激光手术切除老年患者口腔粘液腺囊肿的临床观察*王立哲高原朱娜冉岸宫娜赵慧琴栗洪师【摘要】目的：对比观察半导体激光治疗和普通手术方式治疗老年口腔粘液腺囊肿的疗效。

方法：101例患者，随机数法分为试验组和对照组，试验组应用半导体激光手具(波长970nm,6W,10Hz,320|x m光纤直径)接触式，局麻下沿肿物包膜外微创切割口腔黏膜表层，完整剥离肿物，局部止血后应用半导体激光低能量疗法(Low Level Laser Therapy,LLLT)行激光生物治疗(波长970nm, 1.5W,5Hz,200|x m光纤直径)。

对照组应用常规手术刀(15#刀片)，常规梭形切口入路，完整分离肿物后进行创面黏膜对位缝合。

结果：对照组比较，试验组术中出血少(P G0.01),手术时间短(！<0.01),术后1〜5天试验组研究对象主观疼痛指数显著低于对照手术组(!<0.05,!<0.01)。

术后3月随访，试验组治愈率96.0L,对照组治愈率94.1%,两种治疗方法远期疗效无显著差异性(！>0.05)。

结论：半导体激光手术治疗老年口腔粘液腺囊肿术中出血少，手术时间短，创伤小，术后疼痛感明显减小，患者依从性良好。

关键词：半导体激光；低能量疗法；口腔粘液腺囊肿；老年患者［中国图书分类号］R782［文献标识码］A DOI&10.19749/.cjgd.1672-2973.2021.01.002Clinical observation on the removal of senile oral mucocele by diode laser surgeryWANG Li—zhe,GAO Yuan,ZHU Na,RAN An,GONG Na,ZHAO Hui—qin,LI Hong—shi.(Department of Stomatology, Mentougou District Hospital,Beijing102300,China)［Abstract］Objective:To observe the curative effect of Diode laser and general surgery on mucocele in the elderly.Methods: 101patients were randomly divided into the experimental group and the control group.The experimental group was treated with Diodec laser hand tools(Parameters:wavelength970nm,6W,10Hz,320^m fiber diameter)under local anesthesia, continuous minimally invasive cutting along the tumor envelope,complete peeling of t he tumor,Diodelaser LLLT biotherapy after local hemostasis,and the operation process was completed.In the control group,the operation knife(No.15blade)was used for conventional fusiform incision to separate the tumor and suture the wound mucosa.Results:The subjective pain index of the experimental group was significantly lower than that of the control group(!V0.01).The cure rate of the experimental group was96.0%,and that of the control group was94.1%.There was no significant difference in the long­term effect between the two methods(!>0.05).Conclusion:Diode laser treatment of m ucocele in the elderly has less trauma, less postoperative pain and good patient compliance.Key words:diode laser;low level laser therapy;mucocele;aged常见口腔粘液腺囊肿分为两种类型：黏液外渗侧[2],是老年人群常见多发口腔黏膜疾病[3]O临床型和黏液潴留型[1],前者最常发生在下唇、舌尖腹治疗通常用外科手术方法切除肿物，术中常伴有局*基金项目：首都临床特色应用研究专项（编号：Z181100001718021）王立哲北京市门头沟区医院口腔科主治医师北京102300高原解放军空军特色医学中心口腔科主治医师北京100142朱娜解放军空军特色医学中心口腔科主管护师北京100142冉岸解放军空军特色医学中心口腔科主管护师北京100142宫娜解放军空军特色医学中心口腔科住院医师北京100142赵慧琴解放军空军特色医学中心口腔科住院医师北京100142栗洪师通讯作者解放军空军特色医学中心口腔科副主任医师北京1001428部出血，影响术野清晰，术后需复诊拆线。

1 064nmNdYAG秒级激光联合长脉宽Er∶YAG激光对腰腹部减脂塑形的疗效及安全性[摘要]目的：?^察1 064nmNd：YAG秒级激光联合长脉宽Er：YAG激光对腰腹部减脂塑形的治疗效果及安全性。

方法：30例就医者，先后使用1 064nmNd：YAG秒级激光和长脉宽Er：YAG激光（SP Dynamis激光治疗仪，Fotona）进行腰腹部照射减脂和塑形。

每10～15d治疗1次，连续8次。

观察治疗前后就医者腹围和B超下皮下脂肪层厚度变化，治疗疼痛度、主观评分及安全性。

结果：29例就医者完成了治疗，就医者的上、中、下腹围均值减小，治疗前分别为（83.550±9.212）cm、（90.047±8.009）cm和（94.384±7.326）cm，治疗后为（80.209±8.219）cm、（87.606±7.695）cm和（92.128±6.478）cm，差异具有显著性（P<0.01）。

同样观察到腰腹部皮下脂肪厚度均值较前减少（P<0.05）。

疼痛VAS评分为4.48±0.91（Nd：YAG激光）和3.28±0.75（Er：YAG激光）。

就医者主观评价腰腹部皮肤紧实度和腹部平坦度得到改善，腰围减小（P<0.01），治疗过程中未观察到不良反应。

结论：1 064nm Nd：YAG秒级激光联合长脉宽Er：YAG可有效进行腰腹部减脂塑形，且具有较好的安全性。

[关键词]秒级激光；1 064nm Nd：YAG激光；Er：YAG激光；无创式；减脂；塑形[中图分类号]Q813.1 [文献标志码]A [文章编号]1008-6455（2018）04-0050-04Observation on the Efficiency and Safety of 1 064nm Nd：YAG Second Laser Combined with Long Pulse Er：YAG Laser for Lumboabdominal Fat Reduction and Body SculptureHAN Yu1，3，GUAN Xin2，JI Qing3，LI Ping3，WANG Bo3，MA Hong-yun3，ZHOU Yang3，SHI Fang3，SU Ming-shan1，3（1.Beijing Yimeihui Medical Cosmetic Clinic，Beijing 100029，China；2. Department of Dermatology，Peking University 3rd Hospital，Beijing 100191，China；3.Beijing Haiyiyuemei Medical Cosmetic Clinic，Beijing 100035，China）Abstract：Objective To observe the therapeutic effect and safety of 1 064 nm Nd：YAG second laser combined withlong-pulse Er：YAG laser for lumboabdominal fat reduction and Body sculpture. Methods Thirty Patients were treated with 1064nm Nd：YAG second laser and long-pulse Er：YAG laser （SP Dynamis device，Fotona），to scan lumboabdominal areas sequentially. A total of eight times treatments were required for each patient，at10-15 days intervals. Abdominal Circumference and the thickness of subcutaneous fat with ultrasound wereobserved before and after therapy as well as evaluation of pain degree，subjective score and safety. Results Twenty nine patients completed the study. The means of upper，middle，lower abdominal Circumference were （83.550±9.212）cm，（90.047±8.009）cm and （94.384±7.326）cm at the baseline，（80.209±8.219）cm，（87.606±7.695）cm and（92.128±6.478）cm after treatment respectively，which showed significant differences before and after treatment （PKey words：second laser；1 064nm Nd：YAG laser；Er：YAG laser；non-invasive；lipoly Sis；body sculpture随着人们生活水平不断地提高，减脂塑形越来越成为大家关注的焦点，近年来，超声、激光、射频、冷冻等各类无创设备的减脂塑形技术得到了广泛应用[1-3]。