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Genin VD, Bucharskaya AB, Kirillin MY, Kurakina DA, Navolokin NA, Terentyuk GS, Khlebtsov BN, Khlebtsov NG, Maslyakova GN, Tuchin VV, Genina EA. Monitoring of optical properties of tumors during laser plasmon photothermal therapy. JOURNAL OF BIOPHOTONICS 2024; 17:e202300322. [PMID: 38221797 DOI: 10.1002/jbio.202300322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/04/2023] [Accepted: 12/25/2023] [Indexed: 01/16/2024]
Abstract
We studied grafted tumors obtained by subcutaneous implantation of kidney cancer cells into male white rats. Gold nanorods with a plasmon resonance of about 800 nm were injected intratumorally for photothermal heating. Experimental irradiation of tumors was carried out percutaneously using a near-infrared diode laser. Changes in the optical properties of the studied tissues in the spectral range 350-2200 nm under plasmonic photothermal therapy (PPT) were studied. Analysis of the observed changes in the absorption bands of water and hemoglobin made it possible to estimate the depth of thermal damage to the tumor. A significant decrease in absorption peaks was observed in the spectrum of the upper peripheral part and especially the tumor capsule. The obtained changes in the optical properties of tissues under laser irradiation can be used to optimize laboratory and clinical PPT procedures.
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Affiliation(s)
- Vadim D Genin
- Optics and Biophotonics Department, Saratov State University, Saratov, Russia
- Laboratory of Laser Molecular Imaging and Machine Learning, Tomsk State University, Tomsk, Russia
| | - Alla B Bucharskaya
- Laboratory of Laser Molecular Imaging and Machine Learning, Tomsk State University, Tomsk, Russia
- Core Facility of Experimental Oncology, Saratov State Medical University named after V. I. Razumovsky, Saratov, Russia
| | - Mikhail Yu Kirillin
- Biophotonics Laboratory, Institute of Applied Physics Russian Academy of Sciences, Nizhny Novgorod, Russia
- Applied Mathematics Department, Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia
| | - Daria A Kurakina
- Biophotonics Laboratory, Institute of Applied Physics Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Nikita A Navolokin
- Core Facility of Experimental Oncology, Saratov State Medical University named after V. I. Razumovsky, Saratov, Russia
| | - Georgy S Terentyuk
- Core Facility of Experimental Oncology, Saratov State Medical University named after V. I. Razumovsky, Saratov, Russia
| | - Boris N Khlebtsov
- Laboratory of Nanobiotechnology, Institute of Biochemistry and Physiology of Plants and Microorganisms, Federal Research Centre "Saratov Scientific Centre of the Russian Academy of Sciences" (IBPPM RAS), Saratov, Russia
| | - Nikolai G Khlebtsov
- Optics and Biophotonics Department, Saratov State University, Saratov, Russia
- Laboratory of Nanobiotechnology, Institute of Biochemistry and Physiology of Plants and Microorganisms, Federal Research Centre "Saratov Scientific Centre of the Russian Academy of Sciences" (IBPPM RAS), Saratov, Russia
| | - Galina N Maslyakova
- Core Facility of Experimental Oncology, Saratov State Medical University named after V. I. Razumovsky, Saratov, Russia
| | - Valery V Tuchin
- Optics and Biophotonics Department, Saratov State University, Saratov, Russia
- Laboratory of Laser Molecular Imaging and Machine Learning, Tomsk State University, Tomsk, Russia
- Laboratory of Laser Diagnostics of Technical and Living Systems, Institute of Precision Mechanics and Control, Federal Research Centre "Saratov Scientific Centre of the Russian Academy of Sciences", Saratov, Russia
| | - Elina A Genina
- Optics and Biophotonics Department, Saratov State University, Saratov, Russia
- Laboratory of Laser Molecular Imaging and Machine Learning, Tomsk State University, Tomsk, Russia
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Transient Thermal Response of Blood Vessels during Laser Irradiation Monitored by Laser Speckle Contrast Imaging. PHOTONICS 2022. [DOI: 10.3390/photonics9080520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Real-time monitoring of blood flow and thrombosis formation induced by laser irradiation is critical to reveal the thermal-damage mechanism and successfully implement vascular-dermatology laser surgery. Laser speckle contrast imaging (LSCI) is a non-invasive technique to visualize perfusion in various tissues. However, the ability of the LSCI to monitor the transient thermal response of blood vessels, especially thrombus formation during laser irradiation, requires further research. In this paper, an LSCI system was constructed and a 632 nm He-Ne laser was employed to illuminate a Sprague Dawley rat dorsal skin chamber model irradiated by a 1064 nm Nd: YAG therapy laser. The anisotropic diffusion filtering (ADF) technique is implemented after temporal LSCI (tLSCI) processing to improve the SNR and temporal resolution. The speckle flow index is used to characterize the blood-flow velocity to reduce the computational cost. The combination of the tLSCI and ADF increases the temporal resolution by five times and the SNR by 17.2 times and 16.14 times, without and with laser therapy, respectively. The laser-induced thrombus formation and vascular damage during laser surgery can be visualized without any exogenous labels, which provides a powerful tool for thrombus monitoring during laser surgery.
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Changes in Optical Properties of Model Cholangiocarcinoma after Plasmon-Resonant Photothermal Treatment. PHOTONICS 2022. [DOI: 10.3390/photonics9030199] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The heating degree of the inner layers of tumor tissue is an important parameter required to optimize plasmonic photothermal therapy (PPT). This study reports the optical properties of tissue layers of transplanted cholangiocarcinoma and covering tissues in rats without treatment (control group) and after PPT using gold nanorods (experimental group). PPT was carried out for 15 min, and the temperature on the skin surface reached 54.8 ± 1.6 °С. The following samples were cut out ex vivo and studied: skin, subcutaneous connective tissue, tumor capsule, top, center, and bottom part of the tumor. The samples’ absorption and reduced scattering coefficients were calculated using the inverse adding–doubling method at 350–2250 nm wavelength. Diffuse reflectance spectra of skin surface above tumors were measured in vivo in the control and experimental groups before and immediately after PPT in the wavelength range of 350–2150 nm. Our results indicate significant differences between the optical properties of the tissues before and after PPT. The differences are attributed to edema and hemorrhage in the surface layers, tissue dehydration of the deep tumor layers, and morphological changes during the heating.
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Bucharskaya AB, Khlebtsov NG, Khlebtsov BN, Maslyakova GN, Navolokin NA, Genin VD, Genina EA, Tuchin VV. Photothermal and Photodynamic Therapy of Tumors with Plasmonic Nanoparticles: Challenges and Prospects. MATERIALS (BASEL, SWITZERLAND) 2022; 15:1606. [PMID: 35208145 PMCID: PMC8878601 DOI: 10.3390/ma15041606] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/16/2022] [Accepted: 02/16/2022] [Indexed: 01/27/2023]
Abstract
Cancer remains one of the leading causes of death in the world. For a number of neoplasms, the efficiency of conventional chemo- and radiation therapies is insufficient because of drug resistance and marked toxicity. Plasmonic photothermal therapy (PPT) using local hyperthermia induced by gold nanoparticles (AuNPs) has recently been extensively explored in tumor treatment. However, despite attractive promises, the current PPT status is limited by laboratory experiments, academic papers, and only a few preclinical studies. Unfortunately, most nanoformulations still share a similar fate: great laboratory promises and fair preclinical trials. This review discusses the current challenges and prospects of plasmonic nanomedicine based on PPT and photodynamic therapy (PDT). We start with consideration of the fundamental principles underlying plasmonic properties of AuNPs to tune their plasmon resonance for the desired NIR-I, NIR-2, and SWIR optical windows. The basic principles for simulation of optical cross-sections and plasmonic heating under CW and pulsed irradiation are discussed. Then, we consider the state-of-the-art methods for wet chemical synthesis of the most popular PPPT AuNPs such as silica/gold nanoshells, Au nanostars, nanorods, and nanocages. The photothermal efficiencies of these nanoparticles are compared, and their applications to current nanomedicine are shortly discussed. In a separate section, we discuss the fabrication of gold and other nanoparticles by the pulsed laser ablation in liquid method. The second part of the review is devoted to our recent experimental results on laser-activated interaction of AuNPs with tumor and healthy tissues and current achievements of other research groups in this application area. The unresolved issues of PPT are the significant accumulation of AuNPs in the organs of the mononuclear phagocyte system, causing potential toxic effects of nanoparticles, and the possibility of tumor recurrence due to the presence of survived tumor cells. The prospective ways of solving these problems are discussed, including developing combined antitumor therapy based on combined PPT and PDT. In the conclusion section, we summarize the most urgent needs of current PPT-based nanomedicine.
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Affiliation(s)
- Alla B. Bucharskaya
- Core Facility Center, Saratov State Medical University, 112 Bol′shaya Kazachya Str., 410012 Saratov, Russia; (G.N.M.); (N.A.N.)
- Science Medical Center, Saratov State University, 83 Astrakhanskaya Str., 410012 Saratov, Russia; (V.D.G.); (E.A.G.); (V.V.T.)
- Laser Molecular Imaging and Machine Learning Laboratory, Tomsk State University, 36 Lenin′s Av., 634050 Tomsk, Russia
| | - Nikolai G. Khlebtsov
- Science Medical Center, Saratov State University, 83 Astrakhanskaya Str., 410012 Saratov, Russia; (V.D.G.); (E.A.G.); (V.V.T.)
- Nanobiotechnology Laboratory, Institute of Biochemistry and Physiology of Plants and Microorganisms RAS, FRC “Saratov Scientific Centre of the Russian Academy of Sciences”, 13 Prospekt Entuziastov, 410049 Saratov, Russia;
| | - Boris N. Khlebtsov
- Nanobiotechnology Laboratory, Institute of Biochemistry and Physiology of Plants and Microorganisms RAS, FRC “Saratov Scientific Centre of the Russian Academy of Sciences”, 13 Prospekt Entuziastov, 410049 Saratov, Russia;
| | - Galina N. Maslyakova
- Core Facility Center, Saratov State Medical University, 112 Bol′shaya Kazachya Str., 410012 Saratov, Russia; (G.N.M.); (N.A.N.)
- Science Medical Center, Saratov State University, 83 Astrakhanskaya Str., 410012 Saratov, Russia; (V.D.G.); (E.A.G.); (V.V.T.)
| | - Nikita A. Navolokin
- Core Facility Center, Saratov State Medical University, 112 Bol′shaya Kazachya Str., 410012 Saratov, Russia; (G.N.M.); (N.A.N.)
- Science Medical Center, Saratov State University, 83 Astrakhanskaya Str., 410012 Saratov, Russia; (V.D.G.); (E.A.G.); (V.V.T.)
| | - Vadim D. Genin
- Science Medical Center, Saratov State University, 83 Astrakhanskaya Str., 410012 Saratov, Russia; (V.D.G.); (E.A.G.); (V.V.T.)
- Laser Molecular Imaging and Machine Learning Laboratory, Tomsk State University, 36 Lenin′s Av., 634050 Tomsk, Russia
| | - Elina A. Genina
- Science Medical Center, Saratov State University, 83 Astrakhanskaya Str., 410012 Saratov, Russia; (V.D.G.); (E.A.G.); (V.V.T.)
- Laser Molecular Imaging and Machine Learning Laboratory, Tomsk State University, 36 Lenin′s Av., 634050 Tomsk, Russia
| | - Valery V. Tuchin
- Science Medical Center, Saratov State University, 83 Astrakhanskaya Str., 410012 Saratov, Russia; (V.D.G.); (E.A.G.); (V.V.T.)
- Laser Molecular Imaging and Machine Learning Laboratory, Tomsk State University, 36 Lenin′s Av., 634050 Tomsk, Russia
- Institute of Precision Mechanics and Control, FRC “Saratov Scientific Centre of the Russian Academy of Sciences”, 24 Rabochaya Str., 410028 Saratov, Russia
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Vascular damage mechanism and parameter optimization under alexandrite laser irradiation: a theoretical study. Lasers Med Sci 2021; 37:1503-1514. [PMID: 34562156 DOI: 10.1007/s10103-021-03375-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
The 755-nm Alexandrite Laser has a good clinical effect in treating resistant port wine stain, without causing thermal damage of normal tissue and side effects such as purpura. However, little is known about the mechanism of vascular damage induced by 755-nm laser irradiation, which restricts the optimization of laser parameters. In this work, the thermal damage model and the pressure damage model were used to study the damage mechanism of 755-nm laser irradiation on vessels, and the incident energy density and pulse width required for vascular damage were determined according to the damage mode. Under the irradiation of 755-nm laser, the vascular injury pattern was the co-occurrence of vessel rupture and vessel constriction, and the energy density required for the treatment of vessels with a diameter of 200 μm to reach the damage threshold was the lowest.
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Extraction of the Structural Properties of Skin Tissue via Diffuse Reflectance Spectroscopy: An Inverse Methodology. SENSORS 2021; 21:s21113745. [PMID: 34071281 PMCID: PMC8199232 DOI: 10.3390/s21113745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/23/2021] [Accepted: 05/25/2021] [Indexed: 01/19/2023]
Abstract
For the laser treatment of vascular dermatosis, the blood vessel morphology and depth in skin tissue is essential to achieve personalized intelligent therapy. The morphology can be obtained from the laser speckle imaging, and vessel depth was extracted by an inverse methodology based on diffuse reflectance spectrum. With optimized spot size of 0.5 mm and known optical properties, the proposed method was experimentally validated via the spectral measurement of microcapillary with known size and depth embedded in an epoxy resin-based skin phantom. Results prove that vessel depth can be extracted with an average relative error of 5%, thereby providing the foundation for a personalized, precise, and intelligent laser treatment of vascular dermatosis.
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Iorizzo TW, Jermain PR, Salomatina E, Muzikansky A, Yaroslavsky AN. Temperature induced changes in the optical properties of skin in vivo. Sci Rep 2021; 11:754. [PMID: 33436982 PMCID: PMC7803738 DOI: 10.1038/s41598-020-80254-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 12/17/2020] [Indexed: 12/02/2022] Open
Abstract
Knowledge of temperature-induced changes of skin optical properties is required for accurate dosimetry of photothermal treatments. We determined and compared in vivo optical properties of mouse ear skin at different temperatures. The diffuse reflectance, total and diffuse transmittance were measured in the spectral range from 400 to 1650 nm using an integrating sphere spectrometer at the temperatures of 25 °C, 36 °C and 60 °C. Target temperatures were attained and maintained using an automated heater equipped with a sensor for feed-back and control. Temperature and temperature induced morphological changes of skin were monitored using an infrared thermal camera and reflectance confocal microscopy, respectively. An inverse Monte Carlo technique was utilized to determine absorption, scattering, and anisotropy factors from the measured quantities. Our results indicate significant differences between the optical properties of skin at different temperatures. Absorption and scattering coefficients increased, whereas anisotropy factors decreased with increasing temperature. Changes in absorption coefficients indicate deoxygenation of hemoglobin, and a blue shift of water absorption bands. Confocal imaging confirmed that our observations can be explained by temperature induced protein denaturation and blood coagulation. Monitoring spectral responses of treated tissue may become a valuable tool for accurate dosimetry of light treatments.
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Affiliation(s)
- Tyler W Iorizzo
- Advanced Biophotonics Laboratory, University of Massachusetts Lowell, 175 Cabot Street, Lowell, MA, 01854, USA
| | - Peter R Jermain
- Advanced Biophotonics Laboratory, University of Massachusetts Lowell, 175 Cabot Street, Lowell, MA, 01854, USA
| | - Elena Salomatina
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, Boston, MA, 02114, USA
| | - Alona Muzikansky
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Anna N Yaroslavsky
- Advanced Biophotonics Laboratory, University of Massachusetts Lowell, 175 Cabot Street, Lowell, MA, 01854, USA. .,Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, Boston, MA, 02114, USA.
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Landro MD, Saccomandi P, Barberio M, Schena E, Marescaux MJ, Diana M. Hyperspectral imaging for thermal effect monitoring in in vivo liver during laser ablation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2019:1851-1854. [PMID: 31946258 DOI: 10.1109/embc.2019.8856487] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Thermal ablation is a minimally invasive technique used to induce a controlled necrosis of malignant cells by increasing the temperature in localized areas. This procedure needs an accurate and real-time monitoring of thermal effects to evaluate and control treatment outcome. In this work, a hyperspectral imaging (HSI) technique is proposed as a new and non-invasive method to monitor ablative therapy. HSI provides images of the target object in several spectral bands, hence the reflectance/absorbance spectrum for each pixel. This paper presents a preliminary and original HSI-based analysis of the thermal state in the in vivo porcine liver undergoing laser ablation. In order to compare the spectral response between treated and untreated areas of the organ, proper Regions of Interest (ROIs) were chosen on the hyperspectral images; for each ROI, the absorbance variation for the selected wavelengths (i.e., 630, 760, and 960nm, for deoxyhemoglobin, methemoglobin, and water respectively) was assessed. Results obtained during and after laser ablation show that the absorbance of the methemoglobin peaks increases up to 40% in the burned region with respect to the non-ablated one. Conversely, the relative change of deoxyhemoglobin and water peaks is less marked. Based on these results, absorbance threshold values were retrieved and used to visualize the ablation zone on the images. This preliminary analysis suggests that a combination of the absorbance information is essential to achieve a more accurate identification of the ablation region. The results encourage further studies on the correlation between thermal effects and the spectral response of biological tissues undergoing thermal ablation, for final clinical use.
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Ma J, Chen B, Li D, Zhang Y, Ying Z. Glucose in Conjunction with Multiple Laser Pulses on Laser Treatment of Port-wine Stain: An in vivo Study. Lasers Med Sci 2018. [PMID: 29542044 DOI: 10.1007/s10103-018-2481-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Port-wine stain (PWS) birthmark is a congenital microvascular malformation of the skin. A 1064-nm Nd:YAG laser can achieve a deeper treatment, but the weak absorption by blood limits its clinical application. Multiple laser pulses (MLPs) are a potential solution to enhance the curative effect of a Nd:YAG laser. To reduce the pulse number (pn) required for the thermal destruction of the blood vessel, the effect of glucose in conjunction with MLP was investigated. In vivo experiments were performed on a dorsal skin chamber model. Different concentrations (20, 25, 30, and 40%) of glucose were applied to the sub-dermal side of the hamster skin before laser irradiation. Identical vessels with diameters of 200 ± 30 and 110 ± 20 μm were chosen as representatives of typical PWS vessels. Instant thermal responses of the blood vessel were recorded by a high-speed camera. The required pn for blood vessel damage was compared with that without glucose pretreatment. Results showed that the use of glucose with a concentration of 20% combined with MLP Nd:YAG laser to damage blood vessels is more appropriate because severe hemorrhage or carbonization easily appeared in blood vessels at higher glucose concentration of 25, 30, and 40%. When 20% glycerol is pretreated on the sub-dermal hamster skin, the required pn for blood vessel damage can be significantly decreased for different power densities. For example, pn can be reduced by 40% when the power density is 57 J/cm2. In addition, generation of cavitation and bubbles in blood vessels is difficult upon pretreatment with glucose. The combination of glucose with MLP Nd:YAG laser could be an effective protocol for reducing the pn required for blood vessel damage. Randomized controlled trial (RCT) and human trials will be conducted in the future.
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Affiliation(s)
- Jun Ma
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China
| | - Bin Chen
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China.
| | - Dong Li
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China
| | - Yue Zhang
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China
| | - Zhaoxia Ying
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China.
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Li D, Li R, Jia H, Chen B, Wu W, Ying Z. Experimental and numerical investigation on the transient vascular thermal response to multi-pulse Nd:YAG laser. Lasers Surg Med 2017; 49:852-865. [DOI: 10.1002/lsm.22695] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Dong Li
- State Key Laboratory of Multiphase Flow in Power Engineering; Xi'an Jiaotong University; Xi'an, Shaanxi 710049 China
| | - Ruohui Li
- State Key Laboratory of Multiphase Flow in Power Engineering; Xi'an Jiaotong University; Xi'an, Shaanxi 710049 China
| | - Hao Jia
- State Key Laboratory of Multiphase Flow in Power Engineering; Xi'an Jiaotong University; Xi'an, Shaanxi 710049 China
| | - Bin Chen
- State Key Laboratory of Multiphase Flow in Power Engineering; Xi'an Jiaotong University; Xi'an, Shaanxi 710049 China
| | - Wenjuan Wu
- State Key Laboratory of Multiphase Flow in Power Engineering; Xi'an Jiaotong University; Xi'an, Shaanxi 710049 China
| | - Zhaoxia Ying
- Department of Dermatology, Laser Treatment Center, Medical School; Xi'an Jiaotong University; Xi'an, Shaanxi 710049 China
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Ma J, Chen B, Zhang Y, Li D, Xing ZL. Multiple laser pulses in conjunction with an optical clearing agent to improve the curative effect of cutaneous vascular lesions. Lasers Med Sci 2017; 32:1321-1335. [DOI: 10.1007/s10103-017-2244-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 05/23/2017] [Indexed: 11/30/2022]
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