Growing evidence suggests that the presence of cancer stem cells(CSCs)is a major challenge in current tumor treatments,especially the transition from non-CSCs to differentiation of CSCs for evading conventional therap...Growing evidence suggests that the presence of cancer stem cells(CSCs)is a major challenge in current tumor treatments,especially the transition from non-CSCs to differentiation of CSCs for evading conventional therapies and driving metastasis.Here we propose a therapeutic strategy of synergistic differentiation therapy and phototherapy to induce differentiation of CSCs into mature tumor cells by differentiation inducers and synergistic elimination of them and normal cancer cells through phototherapy.In this work,we synthesized a biomimetic nanoplatform loaded with IR-780 and all-trans retinoic acid(ATRA)via biomineralization.This method can integrate aluminum ions into small-sized protein carriers to form nanoclusters,which undergo responsive degradation under acidic conditions and facilitate deep tumor penetration.With the help of CSC differentiation induced by ATRA,IR-780 inhibited the self-renewal of CSCs and cancer progression by generating hyperthermia and reactive oxygen species in a synergistic manner.Furthermore,ATRA can boost immunogenic cell death induced by phototherapy,thereby strongly causing a systemic anti-tumor immune response and efficiently eliminating CSCs and tumor cells.Taken together,this dual strategy represents a new paradigm of targeted eradication of CSCs and tumors by inducing CSC differentiation,improving photothermal therapy/photodynamic therapy and enhancing antitumor immunity.展开更多
Early surgical resection and chemotherapy of bone cancer are commonly used in the treatment of bone tumor,but it is still highly challenging to prevent recurrence and fill the bone defect caused by the resection site....Early surgical resection and chemotherapy of bone cancer are commonly used in the treatment of bone tumor,but it is still highly challenging to prevent recurrence and fill the bone defect caused by the resection site.In this work,we report a rational integration of photonic-responsive two-dimensional(2D)ultrathin niobium carbide(Nb2C)MXene nanosheets(NSs)into the 3D-printed bone-mimetic scaffolds(NBGS)for osteosarcoma treatment.The integrated 2D Nb2C-MXene NSs feature specific photonic response in the second near-infrared(NIR-II)biowindow with high tissue-penetrating depth,making it highly efficient in killing bone cancer cells.Importantly,Nb-based species released by the biodegradation of Nb2C MXene can obviously promote the neogenesis and migration of blood vessels in the defect site,which can transport more oxygen,vitamins and energy around the bone defect for the reparative process,and gather more immune cells around the defect site to accelerate the degradation of NBGS.The degradation of NBGS provides sufficient space for the bone remodeling.Besides,calcium and phosphate released during the degradation of the scaffold can promote the mineralization of new bone tissue.The intrinsic multifunctionality of killing bone tumor cell and promoting angiogenesis and bone regeneration makes the engineered Nb2C MXeneintegrated composite scaffolds a distinctive implanting biomaterial on the efficient treatment of bone tumor.展开更多
The enzyme-mediated elevation of reactive oxygen species(ROS)at the tumor sites has become an emerging strategy for regulating intracellular redox status for anticancer treatment.Herein,we proposed a camouflaged bioni...The enzyme-mediated elevation of reactive oxygen species(ROS)at the tumor sites has become an emerging strategy for regulating intracellular redox status for anticancer treatment.Herein,we proposed a camouflaged bionic cascaded-enzyme nanoreactor based on Ti_(3)C_(2)nanosheets for combined tumor enzyme dynamic therapy(EDT),phototherapy and deoxygenation-activated chemotherapy.Briefly,glucose oxidase(GOX)and chloroperoxidase(CPO)were chemically conjugated onto Ti_(3)C_(2)nanosheets,where the deoxygenation-activated drug tirapazamine(TPZ)was also loaded,and the Ti_(3)C_(2)-GOX-CPO/TPZ(TGCT)was embedded into nanosized cancer cell-derived membrane vesicles with high-expressed CD47(m_eTGCT).Due to biomimetic membrane camouflage and CD47 overexpression,m_eTGCT exhibited superior immune escape and homologous targeting capacities,which could effectively enhance the tumor preferential targeting and internalization.Once internalized into tumor cells,the cascade reaction of GOX and CPO could generate HClO for efficient EDT.Simultaneously,additional laser irradiation could accelerate the enzymic-catalytic reaction rate and increase the generation of singlet oxygen(~1O_(2)).Furthermore,local hypoxia environment with the oxygen depletion by EDT would activate deoxygenation-sensitive prodrug for additional chemotherapy.Consequently,m_eTGCT exhibits amplified synergistic therapeutic effects of tumor phototherapy,EDT and chemotherapy for efficient tumor inhibition.This intelligent cascaded-enzyme nanoreactor provides a promising approach to achieve concurrent and significant antitumor therapy.展开更多
Background: At-home phototherapy devices for the treatment of acne have emerged as an appealing treatment option and as an effective adjunct treatment to existing modalities. The principal goal of the study was to det...Background: At-home phototherapy devices for the treatment of acne have emerged as an appealing treatment option and as an effective adjunct treatment to existing modalities. The principal goal of the study was to determine the changes in the number of inflammatory lesions in acne patients. Methods: Patients received instruction for daily at-home use of Silk’n Blue device for 12 weeks. Follow-up visits were conducted at 1 and 3 months to collect data. Results: Fifteen subjects with mild to severe cases experienced improvement over the course of the trial. The decrease in mean inflammatory acne counts (from 41.26 to 24.46) and mean percent reduction (41.8%) were statistically significant (p < 0.001). Some participants experienced percent reductions as great as 67%. No adverse events were recorded. Conclusions: The Silk’n Blue device is a safe and effective modality for at-home treatment of mild, moderate, and severe inflammatory acne vulgaris with proper use.展开更多
BACKGROUND The management of severe extravasation injuries is still controversial.Extravasation injuries can be treated in many ways.AIM To present a series of patients with severe extravasation injuries due to infusi...BACKGROUND The management of severe extravasation injuries is still controversial.Extravasation injuries can be treated in many ways.AIM To present a series of patients with severe extravasation injuries due to infusion who were managed with ethacridine lactate dressing combined with localized closure and phototherapy.METHODS In this study,we evaluated the data of eight patients,including six from the Department of Burn,one(with colorectal carcinoma)from the Veteran Cadre Department,and one(with leukemia)from the Hematology Department.Of these,three patients were male and five were female.Age of the patients ranged from 10 mo to 72 years,including two children(10 and 19 mo of age).In this study,the infusion was stopped immediately when the extravasation was identified.The extravasation event was managed routinely using a blocking solution.A ring-shaped localized closure was performed using the blocking agents.Moreover,ethacridine lactate dressing and phototherapy were applied for 3-5 d.RESULTS In this study,the drugs contained in the infusates were iodixanol,norepinephrine,alprostadil,amino acids,fat emulsion,cefoselis,cefoxitin,and potassium chloride+concentrated sodium chloride.All of the patients achieved complete healing after treatment and no obvious adverse reactions were observed.CONCLUSION The treatment of severe extravasation injuries using a combination of localized closure,ethacridine lactate dressing,and phototherapy resulted in satisfactory outcomes in patients.展开更多
Objective To investigate the effects of phototherapy combined with albumin administration on hyperbilirubinemia in newborns. Methods Totally 64 newborns with neonatal hyperbilirubinemia were randomly divided into the ...Objective To investigate the effects of phototherapy combined with albumin administration on hyperbilirubinemia in newborns. Methods Totally 64 newborns with neonatal hyperbilirubinemia were randomly divided into the control group and the study group,with 32 cases in each group. The newborns in control group received phototherapy and routine care,while those in study group were administrated with intravenous injection of albumin in addition to phototherapy and routine care. The concentration of total serum bilirubin,newborns' body weight and amount of milk intake were measured before and after phototherapy. Results There was a significant difference in the milk intake between two groups after phototherapy( P < 0. 05). There was no significant difference in the body weight or total serum bilirubin level of newborns between two groups after phototherapy( P > 0. 05). Conclusion Combined application of phothotherapy and albumin administration on neonatal hyperbilirubinemia could promote the newborns' appetite and improve the recovery of the neonates,but the effect on reducing blood bilirubin level and weight gain needs further study.展开更多
This study evaluates the platelet count changes in neonates with hyperbillirubinemia who received phototherapy. In this Prospective Descriptive-cross sectional study 144 full term newborns with indirect hyperbillirubi...This study evaluates the platelet count changes in neonates with hyperbillirubinemia who received phototherapy. In this Prospective Descriptive-cross sectional study 144 full term newborns with indirect hyperbillirubinemia who received phototherapy in neonatal ward of Bessat hospital in Hamedan province of Iran were studied from September 2007 to February 2008 for evaluation the effect of phototherapy on platelet count. The platelet had counted by cell counter and it had controlled by slide platelet counting. The data were analyzed using spss version. 13 and compared with paired-samples T test. 58 neonates (40.3%) were boys and 86 (59.7%) were girls. The mean age of neonates was 7.04 +/– 5.49 days (2 - 29 days). The mean (± SD) platelet counts were 287833.3 + 92332.4 before and 299444.4 + 98565.2 after phototherapy. Analysis of data with paired T test showed significant difference in platelet count before and after phototherapy. Mean platelet count after phototherapy was higher than that before treatment. The study had propounded that mean platelet count increased with extended mean phototherapy time. This study had propounded this hypothesis that phototherapy in full term icteric newborns leads to increased platelet count. It may be due to accelerated platelet turnover in peripheral microvasculature with adequate platelet reserve.展开更多
Introduction: Phototherapy is the treatment of choice for neonatal hyperbilirubinemia. It converts the unconjugated bilirubin from polar and neurotoxic Z-Z-bilirubin to the more polar photobilirubin. It has been hypot...Introduction: Phototherapy is the treatment of choice for neonatal hyperbilirubinemia. It converts the unconjugated bilirubin from polar and neurotoxic Z-Z-bilirubin to the more polar photobilirubin. It has been hypothesized that high level of hemoglobin or hematocrit interferes in the effectiveness of phototherapy. The objective of the current study is to find out the association of hemoglobin/hematocrit to change in total serum bilirubin concentration during phototherapy. Methods: A prospective cohort study was conducted on 296 neonates with uncomplicated hyperbilirubinemia. Before initiating the phototherapy, hemoglobin, hematocrit and total serum bilirubin levels were measured. After treating the neonates with phototherapy using LED-light for 24 hours, the total serum bilirubin level was measured again. The data were analyzed by using SPSS version-20. Results: The majority of study participants were male (60.8%), with mean postnatal age of 4.66 ±1.65, having mean birth weight of 2.41 ±0.41. Considering Pearson correlation, the hemoglobin had a significant inverse association with ΔTsB0-24 while birth weight and postnatal age also had inverse association but p-values were non-significant, while TsB0 had presented a very weak but significant positive association. The results might be evident of the fact that increase in hemoglobin concentration results in minimal change in total serum bilirubin concentration during phototherapy. Conclusion: Current study found a significant effect of hemoglobin on efficacy of phototherapy, as the change in total serum bilirubin concentration is inversely correlated with the level of hemoglobin. This is important for the physician in treating neonates with hyperbilirubinemia by using phototherapy.展开更多
Phototherapy of a jaundiced neonate is usually started when bilirubin exceeds a threshold in the standard. There are several standards used in the developed countries even though the guideline of American Academy of P...Phototherapy of a jaundiced neonate is usually started when bilirubin exceeds a threshold in the standard. There are several standards used in the developed countries even though the guideline of American Academy of Pediatrics is considered to be a global standard. Although the purpose of phototherapy is the prevention of kernicterus, nowadays the prevalence of kernicterus in otherwise healthy term neonates in the developed countries is rare. Meanwhile several potential adverse effects of phototherapy have been reported. In the present study we tried to estimate how different the rate of phototherapy for the jaundice of neonates at lower risk of kernicterus would be by different standards. For this purpose, we utilized the records of plasma total bilirubin (TB) values of 1893 healthy neonates of 38 weeks and more which were measured on day 6 for the percentile analysis. However, this database did not include the TB values of the neonates who received phototherapy by day 6. Then the database was corrected with an assumption that TB on day 6 would have been normally distributed if no phototherapy had been performed. The mean and the standard deviation (SD) of corrected database were 11.29 mg/dl (193 μmol/l) and 3.63 mg/dl (62 μmol/l), respectively. Using a standard distribution with these mean and SD, the percents of TB values which exceed 18.0, 19.0, 20.0 and 21.0 mg/dl on day 6 were estimated 3.22%, 1.70%, 0.82% and 0.35%, respectively. Results of the present report would help to estimate the relative rate of phototherapy that is performed for the neonates who are term and otherwise healthy by different standards.展开更多
AIM: To investigate low intensity laser irradiation phototherapy(LILIP) on the proliferation, mineralization and degradation of dental pulp constructs.METHODS: Stem cells from human exfoliated deciduous teeth(SHED) we...AIM: To investigate low intensity laser irradiation phototherapy(LILIP) on the proliferation, mineralization and degradation of dental pulp constructs.METHODS: Stem cells from human exfoliated deciduous teeth(SHED) were grown to confluence and seeded on collagen scaffolds to create dental pulp constructs. LILIP was delivered to the dental pulp constructs using an 830 nm GaA IAs laser at an output power of 20 m W. The LILIP energy density was 0.4, 0.8, 1.2, and 2.4 J/cm2. After 8 d, the cell proliferation and degradation within the dental pulp constructs were measured using histologic criteria. After 28 d, the effect of LILIP on SHED mineralization was assessed by von Kossa staining.RESULTS: SHED proliferation within the dental pulp constructs varied after exposure to the 0.4, 0.8, 1.2,and 2.4 J/cm2 LILIP energy densities(P < 0.05). The maximum proliferation of SHED in nutrient deficient media was 218% after exposure to a 1.2 J/cm2 LILIP energy density. SHED grown in nutrient deficient media after exposure to a 0.4, 0.8, and 1.2 J/cm2 LILIP energy density, proliferated by 167-218% compared to the untreated(non-LILIP) control group(P < 0.05).SHED exposed to a 0.4, 0.8, and 1.2 J/cm2 LILIP energy density, and grown in optimal nutritional conditions and proliferated by 147%-164% compared to the untreated(non-LILIP) control group(P < 0.05). The exposure of SHED to the highest LILIP energy density(2.4 J/cm2) caused a reduction of the cell proliferation of up to 73% of the untreated(non-LILIP) control(P < 0.05). The amount of mineral produced by SHED increased over time up to 28 d(P < 0.05). The 0.8 and 1.2J/cm2 LILIP energy densities were the most effective at stimulating the increased the mineralization of the SHED from 150%-700% compared to untreated(nonLILIP) control over 28 d(P < 0.05). The degradation of dental pulp constructs was affected by LILIP(P <0.05). The dental pulp constructs grown in optimal nutritional conditions exposed to a 0.8 J/cm2 or 1.2 J/cm2 LILIP energy density had 13% to 16% more degradation than the untreated(non-LILIP) control groups(P < 0.05). The other LILIP energy densities caused a 1%degradation of dental pulp constructs in optimal nutritional conditions(P > 0.05).CONCLUSION: LILIP can enhance or reduce SHED proliferation, degradation and mineralization within dental pulp constructs. LILIP could promote the healing and regeneration of dental tissues.展开更多
Background: Recently, late umbilical cord clamping is generally recommended, which decreases neonatal anemia;however, it may also increase neonatal jaundice and some other poor outcomes. Objectives: We here attempted ...Background: Recently, late umbilical cord clamping is generally recommended, which decreases neonatal anemia;however, it may also increase neonatal jaundice and some other poor outcomes. Objectives: We here attempted to determine whether late clamping actually increases the incidence of phototherapy for jaundice and other poor outcomes of the term “low-risk newborns”. Methods: With the approval of the Brazilian Registry of Clinical Trials (REBEC), a total of 357 low-risk newborns (singleton, uncomplicated pregnancy/delivery, in a Brazilian public institution) were randomized into two groups: group I (n = 114): cord clamping 1 minute (early clamping) or group II (n = 243): cord clamping between 1 - 3 minutes (late clamping). Statistics were used appropriately (i.e., measures of central tendency, dispersion for continuous variables, Shapiro-Wilk, Mann-Whitney test, or Chi-square test). Results: Phototherapy was performed in 5.3% in both groups. Also, there were no statistical differences in the occurrence of secondary outcomes, such as sepsis, neonatal ICU admission, and transient tachypnea of the newborns: i.e., 0.9%, 15.8%, and 3.5%, respectively for group I versus 1.2%, 15.6%, and 5.8%, respectively for group II. Conclusion: Late umbilical cord clamping does not increase the need for phototherapy in low-risk neonates. This result corroborates the current recommendation of late cord clamping, whenever appropriate.展开更多
An evaluation method for the practical photo-protection of eye-patch protectors (EPs) used in phototherapy for neonatal jaundice is developed.The protecting condition of neonatal eyes using EPs under typical photother...An evaluation method for the practical photo-protection of eye-patch protectors (EPs) used in phototherapy for neonatal jaundice is developed.The protecting condition of neonatal eyes using EPs under typical phototherapy light is simulated.The simulation system consists of a neonatal head manikin,an International Light ILT 900 wideband rapid portable spectroradiometer,a standard Air Shields Isolette incubator,and a Medela fluorescent phototherapy unit.The results show that the practical protection of neonatal eyes,provided by EPs which are affected by the material characteristic,shape design,and wearing condition,is comprehensively illustrated using the indices of illuminance (Ev in lux unit) and the spectral irradiance (E in μW/(cm2·nm) unit).展开更多
Combining phototherapy and chemotherapy has been considered a promising modality for cancer therapy due to their synergistic effect.Herein,we developed three D-π-A-structured boron dipyrromethenes(BODIPYs)(named as B...Combining phototherapy and chemotherapy has been considered a promising modality for cancer therapy due to their synergistic effect.Herein,we developed three D-π-A-structured boron dipyrromethenes(BODIPYs)(named as B-B,B-C,and B-C-Pt).Due to their enlargedπ-conjugated structure and high intramolecular charge transfer effect,the synthesized BODIPYs had photothermal conversion capability,and their absorption and fluorescence spectra were red-shifted.The cisplatin-appended BODIPY(B-C-Pt)exhibited good singlet oxygen(^1O_(2))generation ability and near infrared(NIR)absorption and fluorescence(λ_(Abs)=748 nm,λ_(Em)=947 nm).After being encapsulated by distearoyl phosphoethanolamine polyethyleneglycol 2000(DSPE-PEG-2000),which could inhibit the H-aggregation of B-C-Pt,the absorption and fluorescence of the obtained B-C-Pt nanoparticles(NPs)were red-shifted to 762 and 985 nm,respectively.The^1O_(2)quantum yield and photothermal conversion efficiency of the B-C-Pt NPs were 4.0%and 40.6%,respectively.Moreover,B-C-Pt NPs had chemotherapeutic efficacy due to the presence of cisplatin.In vitro and in vivo studies further demonstrated that B-C-Pt NPs had synergistic therapeutic efficacy.Together,B-C-Pt NPs could be employed in NIRⅡfluorescent and photoacoustic imaging-guided synergistic phototherapy and chemotherapy for cancer treatment.展开更多
Immunotherapy has revolutionized the landscape of cancer treatment.However,single immunotherapy only works well in a small subset of patients.Combined immunotherapy with antitumor synergism holds considerable potentia...Immunotherapy has revolutionized the landscape of cancer treatment.However,single immunotherapy only works well in a small subset of patients.Combined immunotherapy with antitumor synergism holds considerable potential to boost the therapeutic outcome.Nevertheless,the synergistic,additive or antagonistic antitumor effects of combined immunotherapies have been rarely explored.Herein,we established a novel combined cancer treatment modality by synergizing p21-activated kinase 4(PAK4)silencing with immunogenic phototherapy in engineered extracellular vesicles(EVs)that were fabricated by coating M1 macrophage-derived EVs on the surface of the nano-complex cores assembled with si RNA against PAK4 and a photoactivatable polyethyleneimine.The engineered EVs induced potent PAK4 silencing and robust immunogenic phototherapy,thus contributing to effective antitumor effects in vitro and in vivo.Moreover,the antitumor synergism of the combined treatment was quantitatively determined by the Compu Syn method.The combination index(CI)and isobologram results confirmed that there was an antitumor synergism for the combined treatment.Furthermore,the dose reduction index(DRI)showed favorable dose reduction,revealing lower toxicity and higher biocompatibility of the engineered EVs.Collectively,the study presents a synergistically potentiated cancer treatment modality by combining PAK4 silencing with immunogenic phototherapy in engineered EVs,which is promising for boosting the therapeutic outcome of cancer immunotherapy.展开更多
Remarkable progress in phototherapy has been made in recent decades,due to its non-invasiveness and instant therapeutic efficacy.In addition,with the rapid development of nanoscience and nanotechnology,phototherapy sy...Remarkable progress in phototherapy has been made in recent decades,due to its non-invasiveness and instant therapeutic efficacy.In addition,with the rapid development of nanoscience and nanotechnology,phototherapy systems based on nanoparticles or nanocomposites also evolved as an emerging hotspot in nanomedicine research,especially in cancer.In this review,first we briefly introduce the history of phototherapy,and the mechanisms of phototherapy in cancer treatment.Then,we summarize the representative development over the past three to five years in nanoparticle-based phototherapy and highlight the design of the innovative nanoparticles thereof.Finally,we discuss the feasibility and the potential of the nanoparticle-based phototherapy systems in clinical anticancer therapeutic applications,aiming to predict future research directions in this field.Our review is a tutorial work,aiming at providing useful insights to researchers in the field of nanotechnology,nanoscience and cancer.展开更多
The endoplasmic reticulum(ER)is the most widespread organelle within eukaryotic cells,performing various essential functions such as protein synthesis,post-translational modifications,and lipid metabolism.Abnormal flu...The endoplasmic reticulum(ER)is the most widespread organelle within eukaryotic cells,performing various essential functions such as protein synthesis,post-translational modifications,and lipid metabolism.Abnormal fluctuations of biologically active species and microenvironments in the ER can disrupt homeostasis and eventually lead to ER stress,which is closely linked to the occurrence and progression of many human diseases.Therefore,the ER has been regarded as an important analytical object as well as a promising therapeutic target in both bio sensing and biomedicine.Recently,there has been a growing interest in developing photon-excited molecular tools to uncover the physio pathological roles of ER and treat ERrelated disorders.This review presents a comprehensive summary of recent advances in ER-targeted small-molecule probes and their applications for fluorescent sensing and phototherapy,mainly focusing on targeting strategies and probe design principles.Last,we discuss the challenges involved with ER-targeted probes and highlight potential prospects in this field.展开更多
Near-infrared(NIR)-light-triggered nanomedicine, including photodynamic therapy(PDT)and photothermal therapy(PTT), is growing an attractive approach for cancer therapy due to its high spatiotemporal controllability an...Near-infrared(NIR)-light-triggered nanomedicine, including photodynamic therapy(PDT)and photothermal therapy(PTT), is growing an attractive approach for cancer therapy due to its high spatiotemporal controllability and minimal invasion, but the tumor eradication is limited by the intrinsic anti-stress response of tumor cells. Herein, we fabricate a tumor-microenvironment responsive CRISPR nanoplatform based on oxygen-deficient titania(TiO_(2-x)) for mild NIR-phototherapy. In tumor microenvironment, the overexpressed hyaluronidase(HAase) and glutathione(GSH) can readily destroy hyaluronic acid(HA) and disulfide bond and releases the Cas9/sgRNA from TiO_(2-x) to target the stress alleviating regulators, i.e., nuclear factor E2-related factor 2(NRF2) and heat shock protein 90a(HSP90a), thereby reducing the stress tolerance of tumor cells. Under subsequent NIR light illumination, the TiO_(2-x) demonstrates a higher anticancer effect both in vitro and in vivo. This strategy not only provides a promising modality to kills cancer cells in a minimal side-effects manner by interrupting anti-stress pathways but also proposes a general approach to achieve controllable gene editing in tumor region without unwanted genetic mutation in normal environments.展开更多
Background To determine the incidence and risk factors of post-phototherapy rebound hyperbilirubinemia because data about bilirubin rebound in neonates are lacking and few studies have concerned this condition. Method...Background To determine the incidence and risk factors of post-phototherapy rebound hyperbilirubinemia because data about bilirubin rebound in neonates are lacking and few studies have concerned this condition. Methods A prospective observational study was conducted on 500 neonates with indirect hyperbilirubinemia who were treated according to standard guidelines. Total serum bilirubin (TSB) was measured at 24–36 h after phototherapy;significant bilirubin rebound (SBR) is considered as increasing TSB that needs reinstitution of phototherapy. Results A total of 124 (24.9%) neonates developed SBR with TSB increased by 3.4 (2.4–11.2) mg/dL after stopping pho-totherapy. Multiple logistic regression model revealed the following significant risk factors for rebound: low birth weight (B = 1.3,P < 0.001, OR 3.5), suspected sepsis (B = 2.5,P < 0.001, OR 12.6), exposure to intensive phototherapy (B = 0.83, P= 0.03, OR 2.3), hemolysis (B = 1.2,P < 0.001, OR 3.1), high discharge bilirubin level (B = 0.3,P = 0.001, OR 1.3), and short duration of conventional phototherapy (B = ? 1.2,P < 0.001, OR 0.3). Conclusions SBR should be considered in neonates with hemolysis, low birth weight, suspected sepsis, short duration of conventional phototherapy, exposure to intensive phototherapy, and relatively high discharge TSB. These risk factors should be taken into account when planning post-phototherapy follow-up.展开更多
基金supported by National Science and Technology Major Special Project-Major New Drug Creation(2019ZX09301-112)Shandong Natural Science Foundation(ZR2020QH351)+1 种基金Shandong Provincial Program of Taishan Industrial Experts(2019TSCYCX-31)the Fundamental Research Funds of Shandong University(2020GN091)
文摘Growing evidence suggests that the presence of cancer stem cells(CSCs)is a major challenge in current tumor treatments,especially the transition from non-CSCs to differentiation of CSCs for evading conventional therapies and driving metastasis.Here we propose a therapeutic strategy of synergistic differentiation therapy and phototherapy to induce differentiation of CSCs into mature tumor cells by differentiation inducers and synergistic elimination of them and normal cancer cells through phototherapy.In this work,we synthesized a biomimetic nanoplatform loaded with IR-780 and all-trans retinoic acid(ATRA)via biomineralization.This method can integrate aluminum ions into small-sized protein carriers to form nanoclusters,which undergo responsive degradation under acidic conditions and facilitate deep tumor penetration.With the help of CSC differentiation induced by ATRA,IR-780 inhibited the self-renewal of CSCs and cancer progression by generating hyperthermia and reactive oxygen species in a synergistic manner.Furthermore,ATRA can boost immunogenic cell death induced by phototherapy,thereby strongly causing a systemic anti-tumor immune response and efficiently eliminating CSCs and tumor cells.Taken together,this dual strategy represents a new paradigm of targeted eradication of CSCs and tumors by inducing CSC differentiation,improving photothermal therapy/photodynamic therapy and enhancing antitumor immunity.
基金the financial support from the National Key R&D Program of China(Grant No.2016YFA0203700)the National Natural Science Foundation of China(Grant Nos.51872185,51722211,51672303,81672131,81672143,82072417 and 81802247)+2 种基金the Program of Shanghai Academic Research Leader(Grant No.18XD1404300)the National Key Research and Development Project of China(Grant No.2018YFC1106303)the Science and Technology Commission of Shanghai Municipality(Grant No.17060502400).
文摘Early surgical resection and chemotherapy of bone cancer are commonly used in the treatment of bone tumor,but it is still highly challenging to prevent recurrence and fill the bone defect caused by the resection site.In this work,we report a rational integration of photonic-responsive two-dimensional(2D)ultrathin niobium carbide(Nb2C)MXene nanosheets(NSs)into the 3D-printed bone-mimetic scaffolds(NBGS)for osteosarcoma treatment.The integrated 2D Nb2C-MXene NSs feature specific photonic response in the second near-infrared(NIR-II)biowindow with high tissue-penetrating depth,making it highly efficient in killing bone cancer cells.Importantly,Nb-based species released by the biodegradation of Nb2C MXene can obviously promote the neogenesis and migration of blood vessels in the defect site,which can transport more oxygen,vitamins and energy around the bone defect for the reparative process,and gather more immune cells around the defect site to accelerate the degradation of NBGS.The degradation of NBGS provides sufficient space for the bone remodeling.Besides,calcium and phosphate released during the degradation of the scaffold can promote the mineralization of new bone tissue.The intrinsic multifunctionality of killing bone tumor cell and promoting angiogenesis and bone regeneration makes the engineered Nb2C MXeneintegrated composite scaffolds a distinctive implanting biomaterial on the efficient treatment of bone tumor.
基金This work was supported by the National Natural Science Foundation of China(51773231)Shenzhen Science and Technology Project(JCYJ20190807160801664)the Project of Key Laboratory of Sensing Technology and Biomedical Instruments of Guangdong Province(2011A060901013).
文摘The enzyme-mediated elevation of reactive oxygen species(ROS)at the tumor sites has become an emerging strategy for regulating intracellular redox status for anticancer treatment.Herein,we proposed a camouflaged bionic cascaded-enzyme nanoreactor based on Ti_(3)C_(2)nanosheets for combined tumor enzyme dynamic therapy(EDT),phototherapy and deoxygenation-activated chemotherapy.Briefly,glucose oxidase(GOX)and chloroperoxidase(CPO)were chemically conjugated onto Ti_(3)C_(2)nanosheets,where the deoxygenation-activated drug tirapazamine(TPZ)was also loaded,and the Ti_(3)C_(2)-GOX-CPO/TPZ(TGCT)was embedded into nanosized cancer cell-derived membrane vesicles with high-expressed CD47(m_eTGCT).Due to biomimetic membrane camouflage and CD47 overexpression,m_eTGCT exhibited superior immune escape and homologous targeting capacities,which could effectively enhance the tumor preferential targeting and internalization.Once internalized into tumor cells,the cascade reaction of GOX and CPO could generate HClO for efficient EDT.Simultaneously,additional laser irradiation could accelerate the enzymic-catalytic reaction rate and increase the generation of singlet oxygen(~1O_(2)).Furthermore,local hypoxia environment with the oxygen depletion by EDT would activate deoxygenation-sensitive prodrug for additional chemotherapy.Consequently,m_eTGCT exhibits amplified synergistic therapeutic effects of tumor phototherapy,EDT and chemotherapy for efficient tumor inhibition.This intelligent cascaded-enzyme nanoreactor provides a promising approach to achieve concurrent and significant antitumor therapy.
文摘Background: At-home phototherapy devices for the treatment of acne have emerged as an appealing treatment option and as an effective adjunct treatment to existing modalities. The principal goal of the study was to determine the changes in the number of inflammatory lesions in acne patients. Methods: Patients received instruction for daily at-home use of Silk’n Blue device for 12 weeks. Follow-up visits were conducted at 1 and 3 months to collect data. Results: Fifteen subjects with mild to severe cases experienced improvement over the course of the trial. The decrease in mean inflammatory acne counts (from 41.26 to 24.46) and mean percent reduction (41.8%) were statistically significant (p < 0.001). Some participants experienced percent reductions as great as 67%. No adverse events were recorded. Conclusions: The Silk’n Blue device is a safe and effective modality for at-home treatment of mild, moderate, and severe inflammatory acne vulgaris with proper use.
基金Supported by Natural Science Foundation of Hunan Provincial Science and Technology Department,No.2019JJ40527.
文摘BACKGROUND The management of severe extravasation injuries is still controversial.Extravasation injuries can be treated in many ways.AIM To present a series of patients with severe extravasation injuries due to infusion who were managed with ethacridine lactate dressing combined with localized closure and phototherapy.METHODS In this study,we evaluated the data of eight patients,including six from the Department of Burn,one(with colorectal carcinoma)from the Veteran Cadre Department,and one(with leukemia)from the Hematology Department.Of these,three patients were male and five were female.Age of the patients ranged from 10 mo to 72 years,including two children(10 and 19 mo of age).In this study,the infusion was stopped immediately when the extravasation was identified.The extravasation event was managed routinely using a blocking solution.A ring-shaped localized closure was performed using the blocking agents.Moreover,ethacridine lactate dressing and phototherapy were applied for 3-5 d.RESULTS In this study,the drugs contained in the infusates were iodixanol,norepinephrine,alprostadil,amino acids,fat emulsion,cefoselis,cefoxitin,and potassium chloride+concentrated sodium chloride.All of the patients achieved complete healing after treatment and no obvious adverse reactions were observed.CONCLUSION The treatment of severe extravasation injuries using a combination of localized closure,ethacridine lactate dressing,and phototherapy resulted in satisfactory outcomes in patients.
基金Guangxi Medical and Health Plan Project(22015387)
文摘Objective To investigate the effects of phototherapy combined with albumin administration on hyperbilirubinemia in newborns. Methods Totally 64 newborns with neonatal hyperbilirubinemia were randomly divided into the control group and the study group,with 32 cases in each group. The newborns in control group received phototherapy and routine care,while those in study group were administrated with intravenous injection of albumin in addition to phototherapy and routine care. The concentration of total serum bilirubin,newborns' body weight and amount of milk intake were measured before and after phototherapy. Results There was a significant difference in the milk intake between two groups after phototherapy( P < 0. 05). There was no significant difference in the body weight or total serum bilirubin level of newborns between two groups after phototherapy( P > 0. 05). Conclusion Combined application of phothotherapy and albumin administration on neonatal hyperbilirubinemia could promote the newborns' appetite and improve the recovery of the neonates,but the effect on reducing blood bilirubin level and weight gain needs further study.
文摘This study evaluates the platelet count changes in neonates with hyperbillirubinemia who received phototherapy. In this Prospective Descriptive-cross sectional study 144 full term newborns with indirect hyperbillirubinemia who received phototherapy in neonatal ward of Bessat hospital in Hamedan province of Iran were studied from September 2007 to February 2008 for evaluation the effect of phototherapy on platelet count. The platelet had counted by cell counter and it had controlled by slide platelet counting. The data were analyzed using spss version. 13 and compared with paired-samples T test. 58 neonates (40.3%) were boys and 86 (59.7%) were girls. The mean age of neonates was 7.04 +/– 5.49 days (2 - 29 days). The mean (± SD) platelet counts were 287833.3 + 92332.4 before and 299444.4 + 98565.2 after phototherapy. Analysis of data with paired T test showed significant difference in platelet count before and after phototherapy. Mean platelet count after phototherapy was higher than that before treatment. The study had propounded that mean platelet count increased with extended mean phototherapy time. This study had propounded this hypothesis that phototherapy in full term icteric newborns leads to increased platelet count. It may be due to accelerated platelet turnover in peripheral microvasculature with adequate platelet reserve.
文摘Introduction: Phototherapy is the treatment of choice for neonatal hyperbilirubinemia. It converts the unconjugated bilirubin from polar and neurotoxic Z-Z-bilirubin to the more polar photobilirubin. It has been hypothesized that high level of hemoglobin or hematocrit interferes in the effectiveness of phototherapy. The objective of the current study is to find out the association of hemoglobin/hematocrit to change in total serum bilirubin concentration during phototherapy. Methods: A prospective cohort study was conducted on 296 neonates with uncomplicated hyperbilirubinemia. Before initiating the phototherapy, hemoglobin, hematocrit and total serum bilirubin levels were measured. After treating the neonates with phototherapy using LED-light for 24 hours, the total serum bilirubin level was measured again. The data were analyzed by using SPSS version-20. Results: The majority of study participants were male (60.8%), with mean postnatal age of 4.66 ±1.65, having mean birth weight of 2.41 ±0.41. Considering Pearson correlation, the hemoglobin had a significant inverse association with ΔTsB0-24 while birth weight and postnatal age also had inverse association but p-values were non-significant, while TsB0 had presented a very weak but significant positive association. The results might be evident of the fact that increase in hemoglobin concentration results in minimal change in total serum bilirubin concentration during phototherapy. Conclusion: Current study found a significant effect of hemoglobin on efficacy of phototherapy, as the change in total serum bilirubin concentration is inversely correlated with the level of hemoglobin. This is important for the physician in treating neonates with hyperbilirubinemia by using phototherapy.
文摘Phototherapy of a jaundiced neonate is usually started when bilirubin exceeds a threshold in the standard. There are several standards used in the developed countries even though the guideline of American Academy of Pediatrics is considered to be a global standard. Although the purpose of phototherapy is the prevention of kernicterus, nowadays the prevalence of kernicterus in otherwise healthy term neonates in the developed countries is rare. Meanwhile several potential adverse effects of phototherapy have been reported. In the present study we tried to estimate how different the rate of phototherapy for the jaundice of neonates at lower risk of kernicterus would be by different standards. For this purpose, we utilized the records of plasma total bilirubin (TB) values of 1893 healthy neonates of 38 weeks and more which were measured on day 6 for the percentile analysis. However, this database did not include the TB values of the neonates who received phototherapy by day 6. Then the database was corrected with an assumption that TB on day 6 would have been normally distributed if no phototherapy had been performed. The mean and the standard deviation (SD) of corrected database were 11.29 mg/dl (193 μmol/l) and 3.63 mg/dl (62 μmol/l), respectively. Using a standard distribution with these mean and SD, the percents of TB values which exceed 18.0, 19.0, 20.0 and 21.0 mg/dl on day 6 were estimated 3.22%, 1.70%, 0.82% and 0.35%, respectively. Results of the present report would help to estimate the relative rate of phototherapy that is performed for the neonates who are term and otherwise healthy by different standards.
文摘AIM: To investigate low intensity laser irradiation phototherapy(LILIP) on the proliferation, mineralization and degradation of dental pulp constructs.METHODS: Stem cells from human exfoliated deciduous teeth(SHED) were grown to confluence and seeded on collagen scaffolds to create dental pulp constructs. LILIP was delivered to the dental pulp constructs using an 830 nm GaA IAs laser at an output power of 20 m W. The LILIP energy density was 0.4, 0.8, 1.2, and 2.4 J/cm2. After 8 d, the cell proliferation and degradation within the dental pulp constructs were measured using histologic criteria. After 28 d, the effect of LILIP on SHED mineralization was assessed by von Kossa staining.RESULTS: SHED proliferation within the dental pulp constructs varied after exposure to the 0.4, 0.8, 1.2,and 2.4 J/cm2 LILIP energy densities(P < 0.05). The maximum proliferation of SHED in nutrient deficient media was 218% after exposure to a 1.2 J/cm2 LILIP energy density. SHED grown in nutrient deficient media after exposure to a 0.4, 0.8, and 1.2 J/cm2 LILIP energy density, proliferated by 167-218% compared to the untreated(non-LILIP) control group(P < 0.05).SHED exposed to a 0.4, 0.8, and 1.2 J/cm2 LILIP energy density, and grown in optimal nutritional conditions and proliferated by 147%-164% compared to the untreated(non-LILIP) control group(P < 0.05). The exposure of SHED to the highest LILIP energy density(2.4 J/cm2) caused a reduction of the cell proliferation of up to 73% of the untreated(non-LILIP) control(P < 0.05). The amount of mineral produced by SHED increased over time up to 28 d(P < 0.05). The 0.8 and 1.2J/cm2 LILIP energy densities were the most effective at stimulating the increased the mineralization of the SHED from 150%-700% compared to untreated(nonLILIP) control over 28 d(P < 0.05). The degradation of dental pulp constructs was affected by LILIP(P <0.05). The dental pulp constructs grown in optimal nutritional conditions exposed to a 0.8 J/cm2 or 1.2 J/cm2 LILIP energy density had 13% to 16% more degradation than the untreated(non-LILIP) control groups(P < 0.05). The other LILIP energy densities caused a 1%degradation of dental pulp constructs in optimal nutritional conditions(P > 0.05).CONCLUSION: LILIP can enhance or reduce SHED proliferation, degradation and mineralization within dental pulp constructs. LILIP could promote the healing and regeneration of dental tissues.
文摘Background: Recently, late umbilical cord clamping is generally recommended, which decreases neonatal anemia;however, it may also increase neonatal jaundice and some other poor outcomes. Objectives: We here attempted to determine whether late clamping actually increases the incidence of phototherapy for jaundice and other poor outcomes of the term “low-risk newborns”. Methods: With the approval of the Brazilian Registry of Clinical Trials (REBEC), a total of 357 low-risk newborns (singleton, uncomplicated pregnancy/delivery, in a Brazilian public institution) were randomized into two groups: group I (n = 114): cord clamping 1 minute (early clamping) or group II (n = 243): cord clamping between 1 - 3 minutes (late clamping). Statistics were used appropriately (i.e., measures of central tendency, dispersion for continuous variables, Shapiro-Wilk, Mann-Whitney test, or Chi-square test). Results: Phototherapy was performed in 5.3% in both groups. Also, there were no statistical differences in the occurrence of secondary outcomes, such as sepsis, neonatal ICU admission, and transient tachypnea of the newborns: i.e., 0.9%, 15.8%, and 3.5%, respectively for group I versus 1.2%, 15.6%, and 5.8%, respectively for group II. Conclusion: Late umbilical cord clamping does not increase the need for phototherapy in low-risk neonates. This result corroborates the current recommendation of late cord clamping, whenever appropriate.
基金Earmarked Research Grant(Hong Kong),China (No.POLYU5299/04E)
文摘An evaluation method for the practical photo-protection of eye-patch protectors (EPs) used in phototherapy for neonatal jaundice is developed.The protecting condition of neonatal eyes using EPs under typical phototherapy light is simulated.The simulation system consists of a neonatal head manikin,an International Light ILT 900 wideband rapid portable spectroradiometer,a standard Air Shields Isolette incubator,and a Medela fluorescent phototherapy unit.The results show that the practical protection of neonatal eyes,provided by EPs which are affected by the material characteristic,shape design,and wearing condition,is comprehensively illustrated using the indices of illuminance (Ev in lux unit) and the spectral irradiance (E in μW/(cm2·nm) unit).
基金supported by National Natural Science Foundation of China(No.62175262)the Science and Technology Innovation Program of Hunan Province(No.2022RC1201)the Fundamental Research Funds for the Central Universities of Central South University(No.2019zzts849)。
文摘Combining phototherapy and chemotherapy has been considered a promising modality for cancer therapy due to their synergistic effect.Herein,we developed three D-π-A-structured boron dipyrromethenes(BODIPYs)(named as B-B,B-C,and B-C-Pt).Due to their enlargedπ-conjugated structure and high intramolecular charge transfer effect,the synthesized BODIPYs had photothermal conversion capability,and their absorption and fluorescence spectra were red-shifted.The cisplatin-appended BODIPY(B-C-Pt)exhibited good singlet oxygen(^1O_(2))generation ability and near infrared(NIR)absorption and fluorescence(λ_(Abs)=748 nm,λ_(Em)=947 nm).After being encapsulated by distearoyl phosphoethanolamine polyethyleneglycol 2000(DSPE-PEG-2000),which could inhibit the H-aggregation of B-C-Pt,the absorption and fluorescence of the obtained B-C-Pt nanoparticles(NPs)were red-shifted to 762 and 985 nm,respectively.The^1O_(2)quantum yield and photothermal conversion efficiency of the B-C-Pt NPs were 4.0%and 40.6%,respectively.Moreover,B-C-Pt NPs had chemotherapeutic efficacy due to the presence of cisplatin.In vitro and in vivo studies further demonstrated that B-C-Pt NPs had synergistic therapeutic efficacy.Together,B-C-Pt NPs could be employed in NIRⅡfluorescent and photoacoustic imaging-guided synergistic phototherapy and chemotherapy for cancer treatment.
基金the National Natural Science Foundation of China(32101157,82104105,31871003,32171394,32030060)National Key Research&Development Program of China(2021YFA1201000,2021YFE0106900,2021YFC2302400,2018YFE0117800)+1 种基金the Fundamental Research Funds for the Central Universities(2022CX01013,China)China Post-doctoral Science Foundation(2021M693966)。
文摘Immunotherapy has revolutionized the landscape of cancer treatment.However,single immunotherapy only works well in a small subset of patients.Combined immunotherapy with antitumor synergism holds considerable potential to boost the therapeutic outcome.Nevertheless,the synergistic,additive or antagonistic antitumor effects of combined immunotherapies have been rarely explored.Herein,we established a novel combined cancer treatment modality by synergizing p21-activated kinase 4(PAK4)silencing with immunogenic phototherapy in engineered extracellular vesicles(EVs)that were fabricated by coating M1 macrophage-derived EVs on the surface of the nano-complex cores assembled with si RNA against PAK4 and a photoactivatable polyethyleneimine.The engineered EVs induced potent PAK4 silencing and robust immunogenic phototherapy,thus contributing to effective antitumor effects in vitro and in vivo.Moreover,the antitumor synergism of the combined treatment was quantitatively determined by the Compu Syn method.The combination index(CI)and isobologram results confirmed that there was an antitumor synergism for the combined treatment.Furthermore,the dose reduction index(DRI)showed favorable dose reduction,revealing lower toxicity and higher biocompatibility of the engineered EVs.Collectively,the study presents a synergistically potentiated cancer treatment modality by combining PAK4 silencing with immunogenic phototherapy in engineered EVs,which is promising for boosting the therapeutic outcome of cancer immunotherapy.
基金The Academy of Finland(Grants Nos.331151 and 331106),the Sigrid Jus´elius Foundation,the China Scholarship Council,and the UMCG Research Funds are acknowledged for financial support.
文摘Remarkable progress in phototherapy has been made in recent decades,due to its non-invasiveness and instant therapeutic efficacy.In addition,with the rapid development of nanoscience and nanotechnology,phototherapy systems based on nanoparticles or nanocomposites also evolved as an emerging hotspot in nanomedicine research,especially in cancer.In this review,first we briefly introduce the history of phototherapy,and the mechanisms of phototherapy in cancer treatment.Then,we summarize the representative development over the past three to five years in nanoparticle-based phototherapy and highlight the design of the innovative nanoparticles thereof.Finally,we discuss the feasibility and the potential of the nanoparticle-based phototherapy systems in clinical anticancer therapeutic applications,aiming to predict future research directions in this field.Our review is a tutorial work,aiming at providing useful insights to researchers in the field of nanotechnology,nanoscience and cancer.
基金financial support from the National Natural Science Foundation of China(21974013)Hunan Graduate Research and Innovation Project(CX20210814)+1 种基金Open Research Fund of School of Chemistry and Chemical Engineering,Henan Normal University(2022A04)National Students’Platform for Innovation and Entrepreneurship Training Program(202210542049)
文摘The endoplasmic reticulum(ER)is the most widespread organelle within eukaryotic cells,performing various essential functions such as protein synthesis,post-translational modifications,and lipid metabolism.Abnormal fluctuations of biologically active species and microenvironments in the ER can disrupt homeostasis and eventually lead to ER stress,which is closely linked to the occurrence and progression of many human diseases.Therefore,the ER has been regarded as an important analytical object as well as a promising therapeutic target in both bio sensing and biomedicine.Recently,there has been a growing interest in developing photon-excited molecular tools to uncover the physio pathological roles of ER and treat ERrelated disorders.This review presents a comprehensive summary of recent advances in ER-targeted small-molecule probes and their applications for fluorescent sensing and phototherapy,mainly focusing on targeting strategies and probe design principles.Last,we discuss the challenges involved with ER-targeted probes and highlight potential prospects in this field.
基金supported by the National Key R&D Program of China (2019YFA0709200)the financial support from the National Natural Science Foundation of China (21874066, 81601632, and 31901010)+5 种基金the Natural Science Foundation of Jiangsu Province(BK20160616, China)the Fundamental Research Funds for Central Universitiesthe Priority Academic Program Development of Jiangsu Higher Education Institutions (Integration of Chinese and Western Medicine, China)the Key International Cooperation of the National Natural Science Foundation of China (No.81920108029)the Key Foundation for Social Development Project of the Jiangsu Province,China (BE2021741)Jiangsu Specially Appointed Professorship Foundation (China)
文摘Near-infrared(NIR)-light-triggered nanomedicine, including photodynamic therapy(PDT)and photothermal therapy(PTT), is growing an attractive approach for cancer therapy due to its high spatiotemporal controllability and minimal invasion, but the tumor eradication is limited by the intrinsic anti-stress response of tumor cells. Herein, we fabricate a tumor-microenvironment responsive CRISPR nanoplatform based on oxygen-deficient titania(TiO_(2-x)) for mild NIR-phototherapy. In tumor microenvironment, the overexpressed hyaluronidase(HAase) and glutathione(GSH) can readily destroy hyaluronic acid(HA) and disulfide bond and releases the Cas9/sgRNA from TiO_(2-x) to target the stress alleviating regulators, i.e., nuclear factor E2-related factor 2(NRF2) and heat shock protein 90a(HSP90a), thereby reducing the stress tolerance of tumor cells. Under subsequent NIR light illumination, the TiO_(2-x) demonstrates a higher anticancer effect both in vitro and in vivo. This strategy not only provides a promising modality to kills cancer cells in a minimal side-effects manner by interrupting anti-stress pathways but also proposes a general approach to achieve controllable gene editing in tumor region without unwanted genetic mutation in normal environments.
文摘Background To determine the incidence and risk factors of post-phototherapy rebound hyperbilirubinemia because data about bilirubin rebound in neonates are lacking and few studies have concerned this condition. Methods A prospective observational study was conducted on 500 neonates with indirect hyperbilirubinemia who were treated according to standard guidelines. Total serum bilirubin (TSB) was measured at 24–36 h after phototherapy;significant bilirubin rebound (SBR) is considered as increasing TSB that needs reinstitution of phototherapy. Results A total of 124 (24.9%) neonates developed SBR with TSB increased by 3.4 (2.4–11.2) mg/dL after stopping pho-totherapy. Multiple logistic regression model revealed the following significant risk factors for rebound: low birth weight (B = 1.3,P < 0.001, OR 3.5), suspected sepsis (B = 2.5,P < 0.001, OR 12.6), exposure to intensive phototherapy (B = 0.83, P= 0.03, OR 2.3), hemolysis (B = 1.2,P < 0.001, OR 3.1), high discharge bilirubin level (B = 0.3,P = 0.001, OR 1.3), and short duration of conventional phototherapy (B = ? 1.2,P < 0.001, OR 0.3). Conclusions SBR should be considered in neonates with hemolysis, low birth weight, suspected sepsis, short duration of conventional phototherapy, exposure to intensive phototherapy, and relatively high discharge TSB. These risk factors should be taken into account when planning post-phototherapy follow-up.
