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ABSTRACT Introduction Currently, the physical quality of college students has been declining, contrary to China's goal of building a strong and competitive country for sports. Therefore, developing certain plans to improve students' physical quality and coordination ability is necessary. Objective Study the reflection of muscle strength training in the abdominal core by aerobic gymnastics on students' physical coordination ability. Methods 36 volunteers were randomly divided into experimental and control groups. The explosive strength of the central regions and the body coordination and balance ability of the two groups of students were measured before and after the experiment, and the data were classified. Results In the experimental group, the value of supine, incline, right side, left side, jump 360 °, and single foot rotation 360 ° were improved. The evolution of the experimental group was much higher than the control group. Conclusion Muscular strength training in the abdominal core with aerobic gymnastics can effectively regulate students' physical quality and movement coordination, thus establishing a good physical basis for daily work, studies, and routine. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução Atualmente, a qualidade física dos estudantes universitários vem diminuindo, o que contraria o objetivo da China em construir um país forte e competitivo para o esporte. Portanto, é necessário apresentar certos planos para melhorar a qualidade física e a capacidade de coordenação dos estudantes. Objetivo Estudar o reflexo do treinamento da força muscular no centro abdominal por ginástica aeróbica na capacidade de coordenação física dos estudantes. Métodos 36 voluntários foram divididos aleatoriamente em grupo experimental e grupo de controle. A força explosiva das regiões centrais e a capacidade de coordenação e equilíbrio corporal dos dois grupos de estudantes foram medidas antes e depois do experimento, sendo os dados classificados. Resultados No grupo experimental, o valor de supino, inclinado, lado direito, lado esquerdo, salto 360° e rotação de um único pé 360° foram melhorados. A evolução do grupo experimental foi muito maior do que a do grupo de controle. Conclusão O treinamento de força muscular no centro abdominal com ginástica aeróbica pode efetivamente regular a qualidade física e a coordenação de movimentos dos alunos, estabelecendo assim uma boa base física para o trabalho diário, estudos e rotina. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción En la actualidad, la calidad física de los estudiantes universitarios ha ido disminuyendo, lo que va en contra del objetivo de China de construir un país fuerte y competitivo para el deporte. Por lo tanto, es necesario idear ciertos planes para mejorar la calidad física y la capacidad de coordinación de los alumnos. Objetivo Estudiar el reflejo del entrenamiento de la fuerza muscular en el núcleo abdominal mediante la gimnasia aeróbica en la capacidad de coordinación física de los alumnos. Métodos 36 voluntarios fueron divididos aleatoriamente en grupo experimental y grupo de control. Se midió la fuerza explosiva de las regiones centrales y la coordinación corporal y la capacidad de equilibrio de los dos grupos de estudiantes antes y después del experimento, y se clasificaron los datos. Resultados En el grupo experimental, se mejoró el valor de la posición supina, la inclinación, el lado derecho, el lado izquierdo, el salto de 360° y la rotación de un solo pie de 360°. La evolución del grupo experimental fue muy superior a la del grupo de control. Conclusión El entrenamiento de la fuerza muscular en el núcleo abdominal con gimnasia aeróbica puede regular eficazmente la calidad física y la coordinación de los movimientos de los alumnos, estableciendo así una buena base física para el trabajo diario, los estudios y la rutina. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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From the perspective of data users, ensuring the relevance and reliability of big data in healthcare and medicine via assessments on data appropriateness is a prerequisite for generating high-quality real-world evidence, which could guarantee good representativeness and generalizability of real-world studies. This review summarized the quality dimensions, definitions, evaluation indexes and calculating methods of assessment on the appropriateness of real-world data (RWD) according to guidance from different countries and international organizations, as well as exploring the opportunities and challenges for better assessing RWD appropriateness.
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Humans , Big Data , Delivery of Health Care , Reproducibility of ResultsABSTRACT
Objective:To investigate the influencing factors of hyperuricemia(HUA) and explore early intervention of metabolic diseases.Methods:A total of 70 523 participants were selected from the database of check-ups in 2016. Univariate analysis and logistic regression analysis were used to identify related factors of HUA. Correspondence analysis was performed for the aggregation of different levels of uric acid(UA) and related factors. The mediating effect of mean blood pressure(MBP) between abnormal metabolic indicators and abnormal renal function was tested.Results:The age, sex, occupation, body mass index(BMI), systolic blood pressure, diastolic blood pressure, blood urea nitrogen(BUN), creatinine(Cr), estimated glomerular filtration rate(eGFR), fasting plasma glucose(FPG), total cholesterol(TC), triacylglycerol(TG), high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol, plasma viscosity were significantly related to HUA( P<0.001). Logistic regression analysis showed that youth, male, hypertension, TC, TG, and Cr were risk factors for HUA, while HDL-C was a protective factor for HUA( P<0.001). Correspondence analysis showed that during the gradual increase of UA, TC was the first to appear abnormal, followed by hypertension and TG, and the increase of Cr appeared last. Mediating effect showed that in changes of UA, the mediating effects of MBP on TC, TG, and HDL-C were 36.35%, 12.63%, and 9.41%, respectively. In changes of eGFR, the mediating effects of MBP on TC, TG and HDL-C were 30.20%, 27.70%, and 6.13%, respectively. Conclusions:UA is positively correlated with blood pressure, TC, and TG, and inversely with HDL-C. TC and TG have an impact on renal impairment, in which MBP plays a mediating role.
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Protein-protein interactions (PPI) are involved in a variety of biological processes, including cell-to-cell interactions, metabolism and development control. The misregulation, post-translational modification and interference of PPI are related to a variety of human diseases, making the regulation of these interactions a very attractive field of drug discovery. In recent years, the interaction between MDM2 and p53 has become a research hotspot, which plays an important role in the treatment of tumors. But unfortunately there are no such inhibitors approved all over the world. In this view, recent advances of MDM2-p53 inhibitors were briefly described and its inhibitors with potential therapeutic activities in clinical studies were introduced.
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OBJECTIVE@#To estimate the prevalence rate of bone and joint injury in China and to describe the three-dimension distribution of the disease (area, time and people).@*METHODS@#Based on a cross-sectional design, a retrospective study was conducted by using Chinese basic medical insurance database from January 1, 2013 to December 31, 2017 to analyze the epidemiological characteristics of bone and joint injury. The prevalence rate of bone and joint injury in each city was calculated, and then using meta-analyses to estimate the pooled prevalence of each area and the whole country. The pooled prevalence rates were compared among the different groups of populations, in terms of geographical area, time and population characteristics (age and gender).@*RESULTS@#A total of 28 419 264 subjects were included in this study, including 705 793 patients with bone and joint injury. From 2013 to 2017, in Chinese basic medical insurance database, the overall prevalence rate of bone and joint injury was 141.5(95%CI: 90.4－203.7) per 10 000 population, and the prevalence rates of non-specific or polyarticular disease, knee disease, and shoulder disease were 101.6 (95%CI: 63.5－148.4)per 10 000 population, 22.5(95%CI:15.1－31.4)per 10 000 population and 10.9 (95%CI: 6.4－16.4)per 10 000 population. The prevalence rates varied across the areas, the highest rate was observed in North China, with the prevalence of 310.6 (95%CI: 12.6－989.7) per 10 000 population, and the lowest rate was observed in Southwest China, with the prevalence of 59.0 (95%CI: 37.5－85.2) per 10 000 population. The prevalence rate of bone and joint injury increased over the study period, from 111.1 (95%CI: 56.0－182.5)per 10 000 population in 2013 to 175.5 (95%CI: 116.8－245.5)per 10 000 population in 2017. The prevalence of bone and joint injury in the female population was 149.1 (95%CI: 94.2－215.9) per 10 000 population, which was higher than that of men [133.6(95%CI: 86.2－190.9) per 10 000 population]. The higher prevalence of knee disease, unspecified or polyarticular disease, and bone and joint injury were observed in people aged 60 years and older, while the prevalence of shoulder disease peaked in 40－59 years old people [20.6 (95%CI: 12.5－30.5) per 10 000 population].@*CONCLUSION@#This study reported a relative low prevalence of bone and joint injury in China from 2013 to 2017. The prevalence increased over the study period, and the highest prevalence rate was observed in North China. The prevalence rate showed differences among different groups of populations, and higher rates were observed in females and people aged 60 years and older.
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Adult , Female , Humans , Male , Middle Aged , China , Databases, Factual , Insurance, Health , Prevalence , Retrospective Studies , Urban PopulationABSTRACT
Pharmacoepidemiology refers to the use of epidemiological research methods in studying the application and use of drugs in large populations to evaluate the safety and efficacy of medical products. Therefore, standardized pharmacoepidemiology research is the basis of the above work. Based on systematic reviews of national and international pharmacoepidemiological methodological standards and guidelines, and in combination with Chinese medical and health practice and experts’ opinions, the Professional Committee of Pharmacoepidemiology of Chinese Pharmaceutical Association developed the group standard, guide on methodological standards in pharmacoepidemiology (T/CPHARMA 002-2019), to better guide the work of pharmacoepidemiology. The guideline was designed to provide advice and reference for pharmacoepidemiology research by government, regulatory agencies, research institutions, and pharmaceutical manufacturers in China.
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Objective To investigate the utilization of antibiotics in emergency departments (EDs) of class Ⅲ general hospitals in China.Methods Data from a national monitoring network for rational use of drugs was used.The data included prescriptions of EDs from 114 class Ⅲ general hospitals in 30 provinces (autonomous regions,municipalities) of China.A total of 10 260 595 prescriptions from October 1,2014 to December 31,2016 were extracted.The Anatomical Therapeutic Chemical Classification/Defined Daily Dose (DDD) system was used for the classification of antibiotics and calculation of antibiotic use intensity.An auto-regression model was used to analyze the trend over time and seasonal variation of antibiotic use in EDs.Results The rate of antibiotic prescriptions was 27.82％ in EDs,among the antibiotics prescribed,25.58％ were for the combination therapy with 2 or more antibiotic agents,and injectable antibiotic prescriptions accounted for 60.59％.Besides,the number of DDDs per 100 patient visits was 81.84.Broad-spectrum agents were the most commonly used antibiotics,among which the second and third generation cephalosporins,quinolones and macrolides accounted for 23.83％,21.68％,19.17％ and 7.89％ of all prescribed antibiotics,respectively.The use of antibiotics,including prescription frequency and use intensity,in EDs had a slight but significant increase tendency (P＜0.05),and the seasonal variation of antibiotic use in EDs was obvious,characterized by the highest frequency and intensity of antibiotic use in winter,the differences were significant (P＜0.05).Conclusion The antibiotic prescription rate in EDs of class Ⅲ general hospitals in China was controlled at a low level,but the proportions of broad-spectrum antibiotics and injectable antibiotics were high,and a significant increase trend in antibiotic use in EDs was found.
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Objective To investigate the utilization of antibiotics in emergency departments (EDs) of class Ⅲ general hospitals in China.Methods Data from a national monitoring network for rational use of drugs was used.The data included prescriptions of EDs from 114 class Ⅲ general hospitals in 30 provinces (autonomous regions,municipalities) of China.A total of 10 260 595 prescriptions from October 1,2014 to December 31,2016 were extracted.The Anatomical Therapeutic Chemical Classification/Defined Daily Dose (DDD) system was used for the classification of antibiotics and calculation of antibiotic use intensity.An auto-regression model was used to analyze the trend over time and seasonal variation of antibiotic use in EDs.Results The rate of antibiotic prescriptions was 27.82％ in EDs,among the antibiotics prescribed,25.58％ were for the combination therapy with 2 or more antibiotic agents,and injectable antibiotic prescriptions accounted for 60.59％.Besides,the number of DDDs per 100 patient visits was 81.84.Broad-spectrum agents were the most commonly used antibiotics,among which the second and third generation cephalosporins,quinolones and macrolides accounted for 23.83％,21.68％,19.17％ and 7.89％ of all prescribed antibiotics,respectively.The use of antibiotics,including prescription frequency and use intensity,in EDs had a slight but significant increase tendency (P＜0.05),and the seasonal variation of antibiotic use in EDs was obvious,characterized by the highest frequency and intensity of antibiotic use in winter,the differences were significant (P＜0.05).Conclusion The antibiotic prescription rate in EDs of class Ⅲ general hospitals in China was controlled at a low level,but the proportions of broad-spectrum antibiotics and injectable antibiotics were high,and a significant increase trend in antibiotic use in EDs was found.
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<p><b>OBJECTIVE</b>To investigate the major risk factors for congenital heart disease (CHD) in Chinese neonates and to provide a reference for the prevention of CHD.</p><p><b>METHODS</b>A literature search was performed to collect the case-control studies on the risk factors for CHD in Chinese neonates published in 2001-2016. The relevant data were extracted accordingly. The quality of included studies was assessed by Newcastle-Ottawa Scale. Sensitivity analysis was conducted using different models to analyze the same data. The publication bias was assessed by Egger's test.</p><p><b>RESULTS</b>A total of 17 case-control studies involving 2 930 cases and 4 952 controls were included. The Meta analysis showed that the major risk factors for CHD in Chinese neonates were as follows: mother with advanced age (OR=2.649, 95%CI: 1.675-4.189), cold or fever (OR=4.558, 95%CI: 2.901-7.162), medication use in early pregnancy (OR=3.961, 95%CI: 2.816-5.573), passive smoking (OR=2.766, 95%CI: 1.982-3.859), abnormal childbearing history (OR=2.992, 95%CI: 1.529-5.856), noise exposure (OR=3.030, 95%CI: 1.476-6.217), radiation exposure (OR=2.363, 95%CI: 1.212-4.607), decoration (OR=4.979, 95%CI: 3.240-7.653), gestational diabetes (OR=5.090, 95%CI: 3.132-8.274), and pet raising (OR=2.048, 95%CI: 1.385-3.029).</p><p><b>CONCLUSIONS</b>Mothers with advanced age, cold or fever, medication use in early pregnancy, passive smoking, abnormal childbearing history, noise exposure, radiation exposure, decoration, gestational diabetes, and pet raising may increase the risk of CHD in Chinese neonates.</p>
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Humans , Infant, Newborn , Case-Control Studies , Heart Defects, Congenital , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To study the association between depression during pregnancy and low birth weight in neonates, and to provide a scientific basis for the prevention of low birth weight.</p><p><b>METHODS</b>Cohort studies on the association between depression during pregnancy and low birth weight were collected and a Meta analysis was performed. Data were extracted independently by two investigators, and quality assessment was performed according to Newcastle-Ottawa Scale. The Egger's test was used to evaluate publication bias.</p><p><b>RESULTS</b>A total of 12 cohort studies with 37 192 samples were included. The results of the Meta analysis showed that depression during pregnancy was associated with low birth weight (Z=2.08, P=0.038), and the neonates whose mothers had depression during pregnancy tended to have a high risk of low birth weight (RR=1.303, 95%CI: 1.015-1.672). The sensitivity analysis showed that the results of this Meta analysis were stable and reliable, and the Egger's test showed no publication bias.</p><p><b>CONCLUSIONS</b>Depression during pregnancy may be a risk factor for low birth weight in neonates.</p>
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Female , Humans , Infant, Newborn , Pregnancy , Cohort Studies , Depression , Infant, Low Birth Weight , Pregnancy ComplicationsABSTRACT
Objective: To study the effect of titanium dioxide (TiO2) nanoparticles on intestinal glucose absorption in young rats and its size effect.Methods: In the study, 63 small intestine segments were isolated from 63 Sprague-Dawley rats (SD rats, 4-week-old) to prepare the everted gut sac model.In the first part of our work, the everted sacs were exposed to 0, 50 mg/L TiO2 nanoparticles (24 nm) for 2 h with the presence of a series of glucose concentrations (10, 25, 50, 100, 200, 400, and 800 mmol/L), and the glucose absorbing function of the everted sacs were assessed in the process.On the basis of the work, utilizing the same method, further study was carried out to compare the effects of TiO2 nanoparticles (24 nm) and fine-particles (120 nm) on intestinal glucose absorbing function with the presence of 400 mmol/L glucose and 0, 10, 50, 200 mg/L TiO2.3 intestine segments were used in each group.Results: The cumulative glucose absorption increased with time extension and increased glucose concentration.In the first part of our work, with the presence of 400 mmol/L glucose, the group treated with 50 mg/L TiO2 nanoparticles showed significantly lower cumulative glucose absorption and glucose absorbing rate than the control group at the exposure time of 30 min (tcumulative absorption=3.254, P<0.05;tglucose absorbing rate=3.958, P<0.05), 90 min (tcumulative absorption=3.323, P<0.05;tglucose absorbing rate=3.063, P<0.05) and 120 min (tcumulative absorption=2.834, P<0.05;tglucose absorbing rate=3.002, P<0.05).At other glucose concentrations, statistically significant differences in cumulative glucose absorption or glucose absorbing rates were not found between the TiO2 nanoparticle exposed group and the control group.In the second part of our work, when compared with the control group, no significant downregulations in cumulative glucose absorption or glucose absorbing rates were observed in both TiO2 nano-particle treated group and TiO2 fine particle treated group.Differences between the TiO2 nanoparticle treated group and the TiO2 fine particle treated group were not statistically significant.Conclusion: Short-term exposure to TiO2 nanoparticles may downregulate the intestinal glucose absorbing function in young rats, and the difference with TiO2 fine particlesis is not obvious.
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Objective To compare the differences in the long-term survival rate and the tumor shrinkage rate of inoperable hepatocellular carcinoma (HCC) between transcatheter arterial chemoembolization (TACE) combined with percutaneous ablation therapy and simple TACE therapy in order to provide the basis for the clinical treatment of HCC.Methods Randomized controlled trials (RCT) for comparing the difference in survival rates between TACE plus PA and simple TACE for inoperable HCC were searched from medical literature database,from which the relevant data were extracted.According to Cochrane manual standard,the quality of inclusion literature was evaluated.Results A total of 15 RCT papers were included in this study,including 859 HCC patients.The results of meta-analysis showed that all the 1-year,2-year and 3-year survival rates in TACE plus PA group were better than those in simple TACE group (RR=1.454,95％CI=1.333and 1.586,Z=8.56,P＜0.001;RR=1.781,95％CI=1.511 and 2.099,Z=6.88,P＜0.001;RR=2.351,95％CI=1.808 and 3.059,Z=6.37,P＜0.001,respectively).The tumor shrinkage rate in TACE plus PA group was also better than that in simple TACE group (RR=1.314,95％CI=1.190 and 1.452,Z=5.38,P＜0.001).The sensitivity analysis indicated that the results of the differences in survival rate and tumor shrinkage rate between the two groups were reliable.Conclusion The 1-year,2-year and 3-year survival rates as well as the tumor shrinkage rate of TACE plus PA group are higher than those of simple TACE group.
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Objective:To understand the cognition and behavior of drug safety in Beijing middle school students and provide advice for relevant education.Methods:A cross-sectional survey using paper questionnaires was carried out on the student body of nine Beijing middle schools.Multi-stage proportionate stratified cluster sampling was adopted to enroll participants.In addition to demographic questions,the questionnaire included 17 questions assessing the cognition and behavior of safe drug use,prioritizing questions that aligned with the health education guideline for primary and secondary school students from Chinese Ministry of Education.Descriptive statistical methods were applied using the SAS 9.2 software.Results:Of the 4 220 students investigated,2 097(49.7％) were males and 2 123(50.3％) were females.The average age was (14.3 ± 1.7) years.2 030(48.1％) students were from downtown areas,1 511(35.8％) were from urban-rural linking areas and 679(16.1％) were from rural areas.Half (51.5％) of the respondents were junior high school students,and the others were from senior high schools (34.2％) and vocational high schools (14.3％).Most of the students (89.6％) lived off campus.The awareness rate of drug safety knowledge was 74.4％,the median score of drug safety behavior was 4 points (full score was 5 points) and there was a statistically positive correlation between the two (Spearman's correlation coefficient was 0.156,P ＜0.001).Both the awareness rates and the drug safety behavior scores were statistically different among the students in different regions,different school types and different residence types (P ＜ 0.001).Multiple factors analysis demonstrated the correlation between the cognition degrees of both drug safety knowledge,behavior and the above factors.Of all the students,80.4％ agreed that any drug could have adverse drug reactions;40.5％ were aware that antibiotics couldn't kill viruses;as many as 49.6％ mistook aspirin as antibiotic;97.4％ would read drug instructions before taking them;Only 42.4％ put expired drugs into special recycling bins;49.8％ would deviate from the suggested dosage and frequency of their medication when they were sick with common diseases.Conclusion:Overall,the cognition of drug safety in Beijing middle school students is good,but problems still exist in medication adherence,the management of expired drugs and the antibiotics cognition,which need to be fixed through specific,pointed way of education.And more efforts should be made to improve the cognition in rural regions,vocational high schools and on campus students.
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Objective To evaluate the safety of Tanreqing injection among children in thereal world.Methods A multicenter,large sample,ambispective cohort study,with registration-type clinical safety monitoring.A total of 6 188 inpatients and patients from the emergency units,aged ≤14 years who all had been using Tanreqing injection in 59 secondary and tertiary hospitals in China,were recruited between January,2014 and May,2015.The main outcomes would include incidence and severity of adverse drug reaction (ADR)/adverse drug event (ADE) of Tanreqing injection.Univariate analysis was used to explain the risk factors of ADR.Results The overall incidence of ADE was 4.20％ (26 cases),including 4 serious ones.The incidence of ADR was 3.07％ (19 cases),including 17 cases of general ADR and 2 cases of new ADR.All the ADR cases were mild or moderate,mostly showing damages in skin and appendages.The onset of disease happened in 24 hours after the Tanreqing injection but all the ADR cases got improved or cured.Having histories of allergies to drugs or foods would increase the incidence of ADR.Conclusion Tanreqing injection caused low incidence of ADR in children.Progams as stratifying high-risk patients and improving administrative management could further increase the safety level of Tanreqing injection.
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Objective To evaluate the safety of Tanreqing injection among children in thereal world.Methods A multicenter,large sample,ambispective cohort study,with registration-type clinical safety monitoring.A total of 6 188 inpatients and patients from the emergency units,aged ≤14 years who all had been using Tanreqing injection in 59 secondary and tertiary hospitals in China,were recruited between January,2014 and May,2015.The main outcomes would include incidence and severity of adverse drug reaction (ADR)/adverse drug event (ADE) of Tanreqing injection.Univariate analysis was used to explain the risk factors of ADR.Results The overall incidence of ADE was 4.20％ (26 cases),including 4 serious ones.The incidence of ADR was 3.07％ (19 cases),including 17 cases of general ADR and 2 cases of new ADR.All the ADR cases were mild or moderate,mostly showing damages in skin and appendages.The onset of disease happened in 24 hours after the Tanreqing injection but all the ADR cases got improved or cured.Having histories of allergies to drugs or foods would increase the incidence of ADR.Conclusion Tanreqing injection caused low incidence of ADR in children.Progams as stratifying high-risk patients and improving administrative management could further increase the safety level of Tanreqing injection.
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<p><b>BACKGROUND</b>Onychomycosis is a fungal infection of the nail plate and subungual area. In this study, we examined the efficacy of laser treatment using self-controlled study programs involving a long-pulsed Nd:YAG 1064-nm laser combined with oral medication.</p><p><b>METHODS</b>Self-controlled strategies were followed in this study. The patients received treatment with oral itraconazole in conjunction with long-pulsed Nd:YAG 1064-nm laser treatment at the nails of the unilateral limb once a week for a total of four times. A total of 84 affected nails were divided into Group A (mild to moderate) and Group B (severe) according to disease severity. Affected nails with the same Scoring Clinical Index for Onychomycosis scores were selected to compare the therapeutic effects of the pure medication treatment group and the combination treatment group with a 24-week follow-up period.</p><p><b>RESULTS</b>In Group A, at the 8th, 16th, and 24th weeks of follow-up, the efficacies in the pure medication treatment group were 81.0%, 81.0%, and 90.5%, respectively, while those in the combination treatment group were 100%, 95.2%, and 90.5%, respectively. The differences between groups were not significant (8th week: χ2 = 4.421, P> 0.05; 16th week: χ2 = 2.043, P> 0.05; 24th week: χ2 = 0.00, P > 0.05). In Group B, at the 8th, 16th, and 24th weeks of follow-up, the efficacies in the pure medication treatment group were 61.9%, 66.7%, and 52.4%, respectively, while those in the combination treatment group were 95.2%, 90.5%, and 100%, respectively. The differences between groups at the 8th and 24th weeks of follow-up were statistically significant (8th week: χ2 = 6.929, P< 0.05; 24th week: χ2 = 13.125, P < 0.05).</p><p><b>CONCLUSIONS</b>For patients with mild or moderate onychomycosis, we recommended a pure medication treatment or combination treatment with medication and laser. For those patients with severe onychomycosis, we recommended a combination of medication and laser therapy.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antifungal Agents , Therapeutic Uses , Combined Modality Therapy , Itraconazole , Therapeutic Uses , Laser Therapy , Lasers, Solid-State , Therapeutic Uses , Onychomycosis , Drug Therapy , Therapeutics , Treatment OutcomeABSTRACT
Although the ‘self-matched case-only studies' (such as the case-cross-over or self-controlled case-series method) can control the time-invariant confounders (measured or unmeasured) through design of the study,however,they can not control those confounders that vary with time.A bidirectional case-crossover design can be used to adjust the exposure-time trends.In the areas of pharmaco-epidemiology,illness often influence the future use of medications,making a bidirectional study design problematic.Suissa' s case-time-control design combines the case-crossover and the case-control design which could adjust for exposure-trend bias,but the control group may reintroduce selection bias,if the matching does not go well.We propose a "case-case-time-control" design which is an extension of the case-time-control design.However,rather than using a sample of external controls,we choose those future cases as controls for current cases to counter the bias that arising from temporal trends caused by exposure to the target of interest.In the end of this article we will discuss the strength and limitations of this design based on an applied example.
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<p><b>BACKGROUND</b>Mycobacterium abscessus (M. abscessus) can cause a variety of human infections, involving the lung, skin and soft tissues, and is generally believed to be acquired from environmental sources. The aim of this study was to investigate the molecular diversity and antibiotic susceptibility of M. abscessus isolates as the basis for strategies to improve control and management of infection.</p><p><b>METHODS</b>Seventy M. abscessus isolates from patients attending the Guangzhou Thoracic Hospital were identified from 2003 to 2005 by biochemical tests, gas chromatography, polymerase chain reaction (PCR)-restriction analysis (PRA) of heat shock protein gene hsp65, and sequencing of the quinolone resistance determining regions (QRDRs) of gyrA. Susceptibilities to six antibiotics were determined by micro-broth dilution. Isolates were genotyped using randomly amplified polymorphic DNA (RAPD) analysis.</p><p><b>RESULTS</b>Most isolates (63/70; 90%) were susceptible to amikacin but rates of susceptibility to other antibiotics varied from moderate, clarithromycin (60%) and imipenem (43%), to low for ciprofloxacin and ofloxacin (3%), and 87% of isolates had intermediate susceptibility to cefoxitin. RAPD analysis showed that the 70 clinical isolates displayed 69 unique RAPD patterns.</p><p><b>CONCLUSIONS</b>The high genetic diversity of isolates suggests that they are not transmitted from person to person but, presumably, are acquired independently from environmental sources. M. abscessus isolates displayed variable levels of susceptibility to all antibiotics tested, other than amikacin, indicating a need for routine susceptibility testing to guide treatment.</p>
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Amikacin , Pharmacology , Anti-Bacterial Agents , Pharmacology , Cefoxitin , Pharmacology , China , Chromatography, Gas , Ciprofloxacin , Pharmacology , Clarithromycin , Pharmacology , Imipenem , Pharmacology , Microbial Sensitivity Tests , Mycobacterium , Genetics , Polymerase Chain Reaction , Random Amplified Polymorphic DNA TechniqueABSTRACT
<p><b>BACKGROUND</b>Recent research shows that lasers can inhibit fungal growth and that Nd:YAG 1064-nm lasers can penetrate as deep as the lower nail plate. The aim of this study was to observe the effect of a long-pulse Nd:YAG 1064-nm laser on 154 nails of 33 patients with clinically and mycologically proven onychomycosis.</p><p><b>METHODS</b>Thirty-three patients with 154 nails affected by onychomycosis were randomly assigned to two groups, with the 154 nails divided into three sub-groups (II degree, III degree, and IV degree) according to the Scoring Clinical Index of Onychomycosis. The 15 patients (78 nails) in group 1 were given eight sessions with a one-week interval, and the 18 patients (76 nails) in group 2 were given four sessions with a one-week interval.</p><p><b>RESULTS</b>In group 1, the effective rates at 8 weeks, 16 weeks, and 24 weeks were 63%, 62%, and 51%, respectively, and the effective rates in group 2 were 68%, 67%, and 53% respectively. The treatment effect was not significantly different between any sub-group pair (P > 0.05).</p><p><b>CONCLUSIONS</b>Long pulse Nd:YAG 1064-nm laser was effective for onychomycosis. It is a simple and effective method without significant complications or side effects and is expected to become an alternative or replacement therapy for onychomycosis.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Lasers, Solid-State , Therapeutic Uses , Onychomycosis , General SurgeryABSTRACT
<p><b>BACKGROUND</b>Trichophyton rubrum (T. rubrum) is the most common causative agent of dermatophytosis worldwide. In this study, we examined the effect of laser irradiation on the growth and morphology of T. rubrum.</p><p><b>METHODS</b>Colonies of T. rubrum were isolated (one colony per plate), and randomly assigned to 5 treatment groups: Q-switched 694 nm ruby laser treatment, long-pulsed Nd:YAG 1064 nm laser treatment, intense pulsed light (IPL) treatment, 308 nm excimer laser treatment and the blank control group without treatment. Standardized photographs were obtained from grown-up fungal plates prior to treatment. Colonies were then exposed to various wavelengths and fluences of laser light. To compare the growth of colonies, they were re-photographed under identical conditions three and six days post-treatment. To investigate the morphology of T. rubrum, scanning electron microscope (SEM) and transmission electron microscope (TEM) images were obtained from specimens exposed to 24 hours of laser treatment.</p><p><b>RESULTS</b>Growth of T. rubrum colonies was significantly inhibited following irradiation by 694 nm Q-switched and 1064 nm long-pulsed Nd:YAG lasers. Other treatments exerted little or no effect. Q-switched laser irradiation exerted a stronger growth inhibitory effect than long-pulsed Nd:YAG laser irradiation. Following treatment by the Q-switched ruby laser system, T. rubrum hyphae became shrunken and deflated, and SEM images revealed rough, fractured hyphal surfaces, punctured with small destructive holes. TEM images showed that the hyphae were degenerating, as evidenced by the irregular shape of hyphae, rough and loose cell wall, and obscure cytoplasmic texture. Initially high electron density structure was visible in the cell; later, low-density structure appeared as a result of cytoplasmic dissolution. In contrast, the blank control group showed no obvious changes in morphology.</p><p><b>CONCLUSION</b>The Q-switched 694 nm ruby laser treatment significantly inhibits the growth and changes the morphology of T. rubrum.</p>