PURPOSE:To evaluate the clinical features of syphilis optic neuropathy (SON) and explore its underlying pathogenesis by measuring the peripapillary retinal nerve fiber layer (pRNFL). METHODS:This was a prospective cross-sectional study. Syphilitics, regardless of ocular complaints, in the ophthalmology department in 2020 were screened for SON, which was defined as isolated optic neuropathy without overt signs of syphilitic uveitis. We analyzed the demographic and clinical information, including ultra-wide-field fundus photographs, fundus fluorescein angiography (FFA), and pRNFL thickness measured by spectral-domain-OCT (SD-OCT). RESULTS:Of 577 cases with syphilis, 25 patients (4.3% ± 0.8%) presented with optic disc edema and 7 patients (1.2% ± 0.5%) with optic atrophy. Of the eyes with optic disc edema, (35 eyes, 40% biocular), 40% had no ocular symptoms, and 45.7% had visual acuity (VA) better than 20/25, whereas 100% showed optic disc leakage in FFA. Of the eyes with optic atrophy (14 eyes, 100% biocular), 100% were male and presented severe vision impairment (VA worse than 20/70), but no optic disc leakage in FFA. A higher rapid plasma reagin (RPR) level was more frequently observed in patients with SON (p = 0.009). Additionally, the pRNFL thickness in non-ocular syphilis was not related to the RPR level or the syphilis duration (all p > 0.05). CONCLUSION:The SONs could manifest as asymptomatic optic disc edema or blinding optic atrophy, which were independent episodic reactions from ocular or cerebral syphilis, respectively. Our data highlighted the need for ophthalmic screening and prompt neurosyphilis treatment.

Background: Acute respiratory failure (ARF) remains the most common diagnosis for intensive care unit (ICU) admission in acquired immunodeficiency syndrome (AIDS) patients. Methods: We conducted a single-center, prospective, open-labeled, randomized controlled trial at the ICU, Beijing Ditan Hospital, China. AIDS patients with ARF were enrolled and randomly assigned in a 1:1 ratio to receive either high-flow nasal cannula (HFNC) oxygen therapy or non-invasive ventilation (NIV) immediately after randomization. The primary outcome was the need for endotracheal intubation on day 28. Results: 120 AIDS patients were enrolled and 56 patients in the HFNC group and 57 patients in the NIV group after secondary exclusion. Pneumocystis pneumonia (PCP) was the main etiology for ARF (94.7%). The intubation rates on day 28 were similar to HFNC and NIV (28.6% vs. 35.1%, p = 0.457). Kaplan–Meier curves showed no statistical difference in cumulative intubation rates between the two groups (log-rank test 0.401, p = 0.527). The number of airway care interventions in the HFNC group was fewer than in the NIV group (6 (5–7) vs. 8 (6–9), p < 0.001). The rate of intolerance in the HFNC group was lower than in the NIV group (1.8% vs. 14.0%, p = 0.032). The VAS scores of device discomfort in the HFNC group were lower than that in the NIV group at 2 h (4 (4–5) vs. 5 (4–7), p = 0.042) and at 24 h (4 (3–4) vs. 4 (3–6), p = 0.036). The respiratory rate in the HFNC group was lower than that in the NIV group at 24 h (25 ± 4/min vs. 27 ± 5/min, p = 0.041). Conclusions: Among AIDS patients with ARF, there was no statistical significance of the intubation rate between HFNC and NIV. HFNC had better tolerance and device comfort, fewer airway care interventions, and a lower respiratory rate than NIV. Clinical Trial Number: Chictr.org (ChiCTR1900022241).

目的 采用Meta分析评价1996-2021年HIV感染者疲劳发病率情况.方法 检索Pubmed、Embase、Cochrane library和PsycINFO数据库中有关HIV感染者疲劳发病率的观察性研究.使用Stata 16.0软件,计算疲劳合并发病率及其95％CI值,采用敏感性分析和亚组分析探索异质性来源.结果 最终纳入23篇文献,共包括8213例病例.Meta分析显示HIV感染者疲劳合并发病率为62％(95％CI:53％～70％);亚组分析结果显示HIV感染者年龄较小、总体联合抗反转录病毒疗法接受率低、有睡眠障碍和抑郁的群体疲劳发病率更高(P＜0.05).结论 HIV感染者疲劳发病率较高,应引起医务人员重视.

BACKGROUND The Fontan operation is the only treatment option to change the anatomy of the heart and help improve patients’ hemodynamics. After successful operation, patients typically recover the ability to engage in general physical activity. As a better ventilatory strategy, extracorporeal membrane oxygenation (ECMO) provides gas exchange via an extracorporeal circuit, and is increasingly being used to improve respiratory and circulatory function. After the modified Fontan operation, circulation is different from that of patients who are not subjected to the procedure. This paper describe a successful case using ECMO in curing influenza A infection in a young man, who was diagnosed with Tausing-Bing syndrome and underwent Fontan operation 13 years ago. The special cardiac structure and circulatory characteristics are explored in this case. CASE SUMMARY We report a successful case using ECMO in curing influenza A infection in a 23-year-old man, who was diagnosed with Tausing-Bing syndrome and underwent Fontan operation 13 years ago. The man was admitted to the intensive care unit with severe acute respiratory distress syndrome as a result of influenza A infection. He was initially treated by veno-venous (VV) ECMO, which was switched to veno-venous-arterial ECMO (VVA ECMO) 5 d later. As circulation and respiratory function gradually improved, the VVA ECMO equipment was removed on May 1, 2018. The patient was successfully withdrawn from artificial ventilation on May 28, 2018 and then discharged from hospital on May 30, 2018. CONCLUSION After the modified Fontan operation, circulation is different compared with that of patients who are not subjected to the procedure. There are certainly many differences between them when they receive the treatment of ECMO. Due to the special cardiac structure and circulatory characteristics, an individualized liquid management strategy is necessary and it might be better for them to choose an active circulation support earlier.

Notwithstanding their numerous advantages, biological treatments have many limitations when treating patients with psoriasis (PsO) and hepatitis B (HB). Clinicians need to pay careful attention to the issue of hepatitis B virus (HBV) reactivation. In accordance with the PRISMA guidelines, we systematically searched Pubmed, Scopus, Embase, Cochrane Library, and Web of Science databases for observational studies on the topic of HBV reactivation among patients with PsO and HB treated with biologics. The random-effects model was used to pool the reactivation rate by the Freeman–Tukey double arcsine transformation method. We selected Fisher’s exact test to compare multiple rates. To determine the sources of heterogeneity, sensitivity analysis and meta-regression were performed. Ten studies with a total of 238 subjects that met the inclusion criteria were included. The pooled reactivation rate was 1.8% [95% confidence interval (CI) 0.0–5.6%] in patients with PsO and HB. Among them, the viral reactivation rates of HBsAg-positive and HBsAg-negative patients were 4.1% (95% CI 0.0–17.9%) and 0.2% (95% CI 0.0–2.8%). The difference between HBsAg-positive and HBsAg-negative patients was statistically significant (p = 0.002). The viral reactivation rate of individuals who needed antiviral prophylaxis but did not receive it was 26.6% (95% CI 5.8–53.5%), while it decreased to 0.0% (95% CI 0.0–6.6%) after accepting antiviral treatment. The two-sided Fisher’s test exact values between different durations of biological therapy showed no statistical significance (p = 0.104). Without antiviral prophylaxis, HBsAg-positive patients with psoriasis are at high risk of virus reactivation when treated with biological agents. Early and sufficient antiviral prophylaxis will effectively reduce the risk of HBV reactivation and serious complications in HBsAg-positive patients. Prolonging the duration of biological treatment will not increase the risk of reactivation.

青春期后痤疮不同于青少年痤疮,女性发病多于男性,更容易产生多种心理社会问题,影响患者的生活质量.青春期后痤疮的治疗,应考虑到患者的依从性、妊娠和哺乳带来的挑战,女性成人痤疮必须作为一个特殊的群体来对待.青春期后痤疮发病机制,临床表现及治疗和寻常痤疮相比都有所不同,本文就青春期后痤疮的研究进展作一综述.

Objectives : To investigate the acceptability of human papillomavirus (HPV) vaccination among men who have sex with men (MSM) and its associated factors. Methods : We searched studies written in English in PubMed, EMBASE, and Web of Science with no geographical or time restrictions. We evaluated the quality of the included literature. We calculated the pooled acceptability and performed meta-analysis of selected studies, including factors associated with the acceptability among MSM, using Review Manager (v5.3). Results : The acceptability among the 15 studies ( n = 8,658) was 50% (95% CI: 0.27–0.72). The meta-analysis of seven articles ( n = 4,200) indicated that having a college or higher degree (OR = 1.62, 95% CI: 1.35–1.95), disclosure of sexual orientation to healthcare professionals (HCPs; OR = 2.38, 95% CI: 1.47–3.86), vaccination with at least one dose for hepatitis A or B (OR = 2.10, 95% CI: 1.42–3.10), awareness of HPV (OR = 1.85, 95% CI: 1.21–2.83), knowledge of HPV (SMD = 0.28, 95% CI: 0.16–0.39), perceived susceptibility to HPV infection (SMD = 0.31, 95% CI: 0.11–0.50), and perceived severity of HPV-related disease (SMD = 0.40, 95% CI: 0.28–0.51) can promote acceptance of HPV vaccines. Meanwhile, people who have had unprotected anal sex or have more sex partners tend to have low acceptance of HPV vaccines. Conclusions : HPV education should be actively promoted according to the factors that influence the acceptability of HPV vaccines among the MSM population. HPV education should be especially aimed at people with low academic qualifications and people with risky sexual behaviors, and should emphasize the aspects of susceptibility to and severity of HPV-related disease. More intervention trials should be conducted to increase the credibility of the results.

背景 冠状动脉旁路移植术已经成为治疗冠心病的重要方法 ,随着手术技术和器械的改进,国内每年接受该手术的患者逾30000例,且数量持续增加.既往医生对术后患者更多的关注其生理指标的康复效果,而忽视了患者心理康复的相关问题.目的 探讨运动干预对非体外冠状动脉旁路移植术(OPCAB)后中年患者健康相关生存质量(HRQOL)的影响.方法 选择2014年1月—2017年6月在首都医科大学附属北京安贞医院心脏外科单一手术组行OPCAB的中年患者348例作为研究对象,并按照术后6～18个月是否能够达到运动标准分为运动组(144例)和对照组(204例).于术后6个月和18个月分别测定患者的射血分数(EF)及左心室舒张末期内径(LVEDD),并应用简明健康调查量表(SF-36)进行测评,记录生理机能(PF)、生理角色限制(RP)、躯体疼痛(BP)、总体健康(GH)、活力(VT)、社会功能(SF)、情感角色限制(RE)、心理健康(MH)、生理健康内容(PHC)、心理健康内容(MHC)评分及SF-36总分,比较两组间术后6个月及术后18个月各指标间有无差异.结果 术后6个月,两组间EF、LVEDD、PF评分、RP评分、BP评分、GH评分、VT评分、SF评分、RE评分、MH评分、PHC评分、MHC评分、SF-36总分比较,差异均无统计学意义(P>0.05).术后18个月,运动组EF、PF评分、RP评分、BP评分、GH评分、VT评分、SF评分、RE评分、MH评分、PHC评分、MHC评分、SF-36总分均高于对照组(P<0.05);术后18个月,两组间LVEDD比较,差异无统计学意义(P>0.05).对照组及运动组术后18个月的EF、PF评分、RP评分、BP评分、GH评分、VT评分、SF评分、RE评分、MH评分、PHC评分、MHC评分、SF-36总分均高于术后6个月,LVEDD低于术后6个月(P<0.05).结论 达标的运动干预可以明显提升OPCAB后中年患者的HRQOL.

目的 探讨在非体外循环下冠状动脉旁路移植术(CABG)中转为体外循环辅助时是否停跳与手术效果的关系.方法 2016 ～ 2018年北京安贞医院行非体外循环CABG术中转行体外循环辅助的手术患者177例.根据术中心脏是否停跳,将患者分为两组:不停跳组:76例,男45例、女31例,年龄(63.53士6.98)岁,应用体外循环下不停跳CABG;停跳组:101例,男66例、女35例,年龄(63.98±8.37)岁,应用体外循环下改良灌注CABG.比较两组临床效果.结果 全部患者围术期死亡14例.停跳组桥血管平均流量高于不停跳组(P=0.033),桥血管搏动指数低于不停跳组(P=0.001),两组在主动脉内球囊反搏(P=0.036)、体外膜肺氧合(P=0.038)、连续性肾脏替代治疗(P=0.014)、呼吸机辅助时间(P=0.021)、ICU监测时间(P=0.012)、围术期死亡率(P=0.025)和术后6d射血分数(P=0.023)方面差异有统计学意义.结论 非体外循环CABG中转体外循环辅助下改良灌注的停跳CABG较不停跳CABG能够得到更好的围术期临床效果,是值得推荐的手术方式.

目的 系统评价梅毒患者血快速血浆反应素(rapid plasma regain,RPR)滴度≥1:32与神经梅毒(neurosyphilis,NS)的相关性.方法 检索公开发表的有关血RPR滴度≥1:32与NS相关性的观察性研究,对纳入的研究进行数据提取并质量评价,采用RevMan 5.4软件进行Meta分析.结果 纳入14篇文献共16项研究,NS患者1213例.Meta分析结果显示,血RPR滴度≥1:32的梅毒患者发生NS的风险是血RPR滴度<1:32梅毒患者的3.99倍(OR=3.99,95％CI:2.95～5.41,P<0.00001).结论 血RPR滴度≥1:32与NS之间具有一定相关性,是NS发生的危险因素,但不宜仅依据此作为梅毒患者进行腰椎穿刺的指征.

目的 探讨体外循环下冠状动脉旁路移植术(ONCAB)与非体外循环冠状动脉旁路移植术(OPCAB)对心肌损伤的差异.方法 2017～2019年北京安贞医院对558例冠状动脉粥样硬化性心脏病患者施行了冠状动脉旁路移植术,根据是否应用改良灌注的体外循环,将患者分为两组.OPCAB组(OP组):465例,男282例、女183例,年龄(63.58±7.87)岁;ONCAB 组(ON 组):93例,男64例、女29例,年龄(63.91±7.51)岁.观察两组患者术前24 h、术后30 min、12 h、36 h、48 h和6d的肌酸激酶MB(CK-MB)及心肌损伤特异性指标——肌钙蛋白(cTnI).结果 全部患者无围术期死亡.ON组术后12hCK-MB(5.00ng/mLvs.8.60ng/mL,Z=-2.189,P=0.029)、cTnI(3.00 ng/mL vs.7.80 ng/mL,Z=-5.307,P=0.000),术后36 h CK-MB(5.00 ng/mL vs.5.60 ng/mL,Z=-2.280,P=0.023)、cTnI(0.10 ng/mL vs.1.02 ng/mL,Z=-6.418,P=0.000),术后48 h cTnI(0.07 ng/mL vs.0.81 ng/mL,Z=-1.946,P=0.032),均低于OP 组.结论 ONCAB 较OPCAB 对心肌损伤更小.

We reported that the complete genome sequence of SARS-Coronavirus-2 (SARS-CoV-2) was obtained from a cerebrospinal fluid (CSF) sample by ultrahigh-depth sequencing. Fourteen days after onset, seizures, maxillofacial convulsions, intractable hiccups and a significant increase in intracranial pressure developed in an adult coronavirus disease 2019 patient. The complete genome sequence of SARS-CoV-2 obtained from the cerebrospinal fluid indicates that SARS-CoV-2 can invade the central nervous system. In future, along with nervous system assessment, the pathogen genome detection and other indicators are needed for studying possible nervous system infection of SARS-CoV-2.

目的探讨氯吡格雷和阿司匹林停药时间对行不停跳冠状动脉旁路移植术患者术后引流量及输入血制品的影响。方法纳入2017～2019年北京安贞医院454例冠状动脉粥样硬化性心脏病行非体外循环冠状动脉旁路移植术的患者,根据术前氯吡格雷和阿司匹林的停药状况分为3组:指南组,86例,男59例、女27例,年龄（64.12±6.15）岁,术前持续服用阿司匹林100 mg/d,但停用氯吡格雷≥5 d;不停药组,234例,男141例、女93例,年龄（63.71±7.01）岁,术前持续服用阿司匹林100 mg/d,且停用氯吡格雷＜5 d;停药组:134例,男76例、女58例,年龄（62.90±7.78）岁,术前停用阿司匹林,且停用氯吡格雷≥5 d。比较3组临床结果。结果全部患者无围术期死亡。术前血小板计数、凝血功能、肝功能、肾功能和心肌标志物各组差异无统计学意义（P＞0.05）。不停药组术后30 min血色素[97（15）g/L vs. 98（21）g/L vs. 100（20）g/L,F=4.894,P=0.008]低于指南组和停药组;不停药组术后3 h引流量[（399.87±127.19）mL vs.（367.05±125.89）mL vs.（349.63±130.68）mL,F=7.770,P=0.000],术后6 h引流量[600（300）mL vs. 580（245）mL vs. 550（350）mL,Z=8.218,P=0.016],术后12 h引流量[750（370）mL vs.730（350）m L vs. 730（350）m L,Z=8.329,P=0.016],术后24 h引流量[890（365）m L vs. 850（340）m L vs. 850（350）m L,Z=6.585,P=0.037],术后48 h引流量[950（375）mL vs. 940（360）mL vs. 940（380）mL,Z=8.680,P=0.013]多于指南组和停药组;不停药组术后引流管保留时间[3（1）d vs. 3（1）d vs. 3（1）d,Z=6.579,P=0.037]长于指南组和停药组;不停药组术后输入悬浮红细胞量[0（2）U vs. 0（2）U vs. 0（0）U,Z=6.150,P=0.046],输入血浆量[200（200）mL vs. 0（200）mL vs. 0（200）mL,F=4.144,P=0.016],输入血浆例数（119例vs. 34例vs. 47例,Z=10.116,P=0.006）多于指南组和停药组。结论非体外循环冠状动脉旁路移植术术前患者推荐维持阿司匹林治疗,如非必要,至少停服氯吡格雷5 d。

Background: The Fontan operation is the only treatment option to change the anatomy of the heart and help improve patients’ hemodynamics. After successful operation, patients typically recover the ability to engage in general physical activity. The mortality of patients diagnosed with acute respiratory distress syndrome (ARDS) ranges from 17.3 to 41.4% among critically ill patients with H1N1 infection. As a better ventilatory strategy, extracorporeal membrane oxygenation (ECMO) provides gas exchange via an extracorporeal circuit, and is increasingly being used to improve respiratory and circulatory function. As is known to all, after the modified Fontan operation, circulation was different compared with patients who were not subjected to the procedure. But very few articles describe the special circulation about the case who was post-operative of the modified Fontan operation especially when it received the treatment of E-CMO. This study aims to describe a successful case using E-CMO in curing the influenza A infection in a young man, who was diagnosed with Tausing-Bing syndrome and underwent Fontan operation thirteen years ago. We want to explore the special cardiac structure and circulatory characteristics in this case. Methods: To report a successful case using extracorporeal membrane oxygenation in curing the influenza A infection in a young man, who was diagnosed with Tausing-Bing syndrome and underwent Fontan operation thirteen years ago. In this article, we describe a 23-year-old man, with a history of modified Fontan operation for the Tausing-Bing syndrome, admitted to ICU with severe acute respiratory distress syndrome as a result of influenza A infection. The man was initially treated by V-V ECMO, five days later was switched to V-V-A E-CMO. Results: As circulation and respiratory function gradually improved, the VV-A ECMO equipment was removed on May 1, 2018.The patient was successfully withdrawn from artificial ventilation on May 28, 2018, then discharged from hospital on May 30, 2018. Conclusion: After the modified Fontan operation, circulation was different compared with patients who were not subjected to the procedure. There were certainly many differences between the two sides when they received the treatment of E-CMO. As the special cardiac structure and circulatory characteristics, an individualized liquid management strategy was necessary and it might be better for them to choose an active cycle support earlier.

目的 通过调节性T细胞初步探讨梅毒合并HIV感染的免疫特点.方法 在男男性接触者队列中收集26例早期梅毒、18例HIV感染、18例早期梅毒合并HIV感染患者的临床资料,并选取20例健康者作为对照.流式细胞术统计分析以上四组及早期梅毒组、合并组梅毒不同分期调节性T细胞(Treg细胞)水平差异.结果 HIV组和早期梅毒组Treg细胞占PBMC百分比明显高于健康组(0.80％±0.10％,0.74％±0.07％vs 0.32％±0.05％,均P<0.05);合并感染组Treg细胞所占PB-MC百分比明显高于健康组(1.01％±0.09％vs 0.32％±0.05％,P<0.001).将单纯梅毒与合并感染患者按照不同临床分期进行分组,在一期进展为二期梅毒时Treg细胞占PBMC百分比均升高,但合并感染患者上升斜率更高.结论 Treg细胞占PBMC百分比在早期梅毒合并HIV感染患者中明显升高,提示梅毒合并HIV感染时,机体的免疫抑制更明显.

目的:探讨血浆BNP术后早期变化对冠心病患者行非体外冠状动脉旁路移植术(OP-CABG)后早期心功能不全发生率的预测价值.方法:回顾性分析北京安贞医院2019年1月至2019年8月,行OPCABG后ICU内监护的患者288例,分别测量患者术后即刻、术后24 h、术后48 h血浆BNP水平,计算术后第一天(△24 h)及第二天(△48 h)的血浆BNP动态变化率,分析BNP动态变化率与术后早期心功能不全之间的关系,并通过受试者工作特征曲线(ROC)分析其对于OPCABG患者发生术后早期心功能不全的预测价值.结果:共入选288例患者,其中术后早期心功能不全组(心功能不全组)27例,未发生早期心功能不全组(对照组)261例.对照组△24 h BNP[5.61(-87.50,141.40)ng/L]低于心功能不全组[180.56(67.00,389.00)ng/L](P<0.05).△48 h BNP两组间差异无统计学意义.对照组△24 h BNP％及△48 h BNP％[8.48(5.74,9.95)％、10.64(5.23,10.17)％]均低于心功能不全组[50.63(24.50,81.26)％、28.73(11.98,40.18)％](P均<0.05).△24 h BNP％预测术后早期心功能不全成功AUCROC为0.812(95％CI:0.716～0.908)(P<0.001),最佳诊断值为18.05％,敏感性为76.6％,特异性为80.0％.结论:术后早期△24 h BNP％与OPCABG患者术后早期发生心功能不全密切相关,△24 h BNP％越低,术后早期发生心功能不全的可能性越小,对评估和预测OPCABG术后并发症有重要意义.

Jingyuan Liu Capital Mmedical University A liated Beijing Ditan Hospital Chunjing Du Capital Medical University A liated Beijing Ditan Hospital Lin Pu Capital Medical University A liated Beijing Ditan Hospital Haofeng Xiong Capital Medical University A liated Beijing Ditan Hospital Pan Xiang Capital Medical University A liated Beijing Ditan Hospital Chuansheng Li Capital Medical University A liated Beijing Ditan Hospital Ming Zhang Capital Medical University A liated Beijing Ditan Hospital Wen Xie Capital Medical University A liated Beijing Ditan Hospital Zhihai Chen Peking University People's Hospital Ang Li (  liang@ccmu.edu.cn ) Capital Medical University A liated Beijing Ditan Hospital https://orcid.org/0000-0002-1478-3072

Syphilis is an important health problem worldwide; however, few studies have probed the impact of syphilitic infection on T cell turnover. The mechanisms behind the frequency of T cell subset changes and the associations between these subsets during syphilitic infection remain unclear. Herein, we used a cell-staining method and flow cytometry to explore changes in T cell subpopulations and potential contribution of apoptosis and pyroptosis that triggered therein. We investigated caspase-1-mediated pyroptosis and caspase-3-mediated apoptosis of CD4+ and CD8+ T cells, the major effector lymphocytes with pivotal roles in the pathogenesis of infectious diseases. We found that the levels of caspase-1 and caspase-3 increased in both the circulation and intracellularly in CD4+ and CD8+ T cells. Caspase-1 showed a continual increase from early latent stage infection through to phase 2 disease, whereas caspase-3 increased through to phase 1 disease but declined during phase 2. In addition, serum levels and intracellular expression of caspase-1 and caspase-3 were positively correlated. Overall, this study increases our understanding of how syphilitic infection influences CD4+ and CD8+ T-cell turnover, which may help with designing novel and effective strategies to control syphilis infection and prevent its transmission.

目的 分析超分子水杨酸联合强脉冲光治疗中重度寻常痤疮的安全性及有效性.方法 回顾性总结2015年12月—2017年12月在首都医科大学附属北京佑安医院皮肤科就诊的60例中重度痤疮患者,分为两组,每组各30例患者,分别给予强脉冲光联合30％超分子水杨酸治疗及单纯30％超分子水杨酸治疗.试验组首先给予强脉冲光治疗,根据患者皮损特点、肤色、耐受度选择治疗参数,炎症明显处治疗2次;强脉冲光治疗结束后,清洗面部,全面部涂抹30％超分子水杨酸,慢慢揉搓治疗区域,应用蒸馏水防止干燥且保证水杨酸缓慢释放,持续时间根据患者的耐受程度,一般为10～15 min,每月治疗1次,共治疗1次.对照组仅给予30％超分子水杨酸治疗,每月治疗1次,共治疗4次.治疗后1个月门诊随访.结果 试验组的有效率(63.33％)高于对照组(36.67％);试验组治疗后粉刺、炎症丘疹及脓疱、囊肿结节数量比治疗前明显减低.结论 超分子水杨酸联合强脉冲光治疗中重度痤疮疗效较好,减少患者治疗周期,未增加不良反应的发生.