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BACKGROUND: Chronic wounds are a worldwide health problem, with traditional imaging techniques failing in their accurate evaluation. Therefore, an effective imaging evaluation method is needed for the diagnosis and treatment or chronic wounds. This study is to investigate the application value of computed tomography (CT) and magnetic resonance imaging (MRI) sinography/fistulography in assessing the morphology and deep features of chronic wounds. METHODS: We prospectively enrolled 43 chronic wounds patients who received both CT and MRI sinography/fistulography. The morphology and deep features of chronic wound on CT and MRI images were independently evaluated by 2 experienced radiologists. Kappa value and intraclass correlation coefficient (ICC) were calculated to evaluate the interobserver agreement and the consistency between CT and MRI sinography/fistulography in assessing the shape, number of branches, and involvement of body cavity and bones of chronic wounds. RESULTS: There were substantial to almost perfect interobserver agreements for both CT and MRI sinography/fistulography in evaluating the morphology and deep features of chronic wounds. The consistency between CT and MRI was almost perfect for the 2 readers in evaluating the shape (reader 1, kappa value =1.000; reader 2, kappa value =0.932) and the number of branches [reader 1, ICC =0.951 (95% confidence interval: 0.909-0.973, P<0.001); reader 2, ICC =0.874 (95% confidence interval: 0.768-0.932, P<0.001)], and substantial to almost perfect when evaluating the involvement of body cavity (reader 1, kappa value =0.728; reader 2, kappa value =0.775) and bones (reader 1, kappa value =0.659; reader 2, kappa value =0.860). CONCLUSIONS: There was good interobserver agreement and consistency between CT and MRI sinography/fistulography in evaluating the morphology and deep features of chronic wounds.
Subject(s)
Magnetic Resonance Imaging , Tomography, X-Ray Computed , Humans , Prospective StudiesABSTRACT
BACKGROUND: Jingshu Keli (or Jingshu granules), a traditional Chinese medicine, are widely used for treating cervical spondylotic radiculopathy in China; however, no randomized, double-blind, controlled study has verified their effectiveness. PURPOSE: To evaluate the efficacy and safety of Jingshu Keli for the treatment of cervical spondylotic radiculopathy in a randomized controlled trial. DESIGN: From August 2015 to July 2017, a multicenter, randomized, double-blind, placebo-controlled trial was conducted at 13 large- and medium-sized hospitals in China. PATIENT SAMPLE: A total of 360 and 120 patients were initially enrolled in the Jingshu and control groups, respectively; 386 patients completed the study, with 299 in the Jingshu group and 87 in the control group. OUTCOME MEASURES: The main index for evaluating the curative effect was the pain score on a visual analogue scale (VAS; 0-100 points). METHODS: All patients were administered a bag of Jingshu Keli or placebo 3 times a day for 4 weeks, and were interviewed at the second and fourth weeks. The decrease in pain scores and rate of change in pain scores after treatment were calculated, related laboratory indices were reviewed, and adverse reactions were recorded. RESULTS: In the Per Protocol Set (PPS) analysis, the baseline pain VAS scores in the control and Jingshu groups were 49.31 â± â6.97 and 50.06 â± â7.33, respectively, with no significant difference between the groups (P â> â0.05). While there were no differences at 2 weeks between groups, at four weeks the pain VAS scores in the control and Jingshu groups decreased by 12.86 â± â13.45 and 22.72 â± â15.08, respectively relative to the values at baseline, with significant group differences (P â< â0.0001). While there were similar significant differences between the groups (P â< â0.0001) in the Full Analysis Set (FAS) analyses neither group achieved the minimal clinically important difference at any time point. CONCLUSIONS: Jingshu Keli are effective for the treatment of cervical spondylotic radiculopathy. TRANSLATIONAL POTENTIAL STATEMENT: This is the first prospective, multicenter, randomized, double-blind, placebo-controlled clinical trial that confirmed the clinical efficacy and safety of Jingshu Keli for treating cervical spondylotic radiculopathy, which can provide evidence for clinical treatment.
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BACKGROUND: Venous thromboembolism (VTE) is a serious health problem for which pharmacological prophylaxis has been proven to be effective. However, there are significant gaps between the guidelines and clinical practice. This study is to evaluate the effect of physician educational intervention (PEI) on VTE pharmacological prophylaxis in medical inpatients from the respiratory department. METHODS: Medical inpatients from the respiratory department between February 2014 and December 2016 were recruited in this retrospective cohort study. They were assigned to the PEI group or the control group according to whether their physicians undertook a quality improvement (QI) project carried out in hospital to raise physician awareness of pharmacological thromboprophylaxis by educational intervention. Any and appropriate pharmacological VTE prophylaxis rates, the use of appropriate anticoagulants, and the occurrence of VTE events in the two groups were calculated and compared using a chi-square test and continuity correction. Poisson regression analysis was used to evaluate the relative risk (RR) of PEI on the occurrence of VTE events. RESULTS: The any pharmacological VTE prophylaxis rate (11.3% vs. 5.9%, P=0.048) and appropriate pharmacological VTE prophylaxis rate (9.3% vs. 5.5%, P=0.036) in high-risk patients without high major bleeding risk were both significantly higher than the control group. Compared with the control group, appropriate anticoagulants in the PEI group took up a larger proportion of all used anticoagulants (90.3% vs. 78.7%, P=0.007). In anticoagulants used for high-risk patients without high major bleeding, appropriate anticoagulants show no statistical difference between the two groups (93.8% vs. 77.8%, P=0.153). There was no difference in the occurrence of VTE events between the two study groups in overall patients (0.5% vs. 0.6%, P=0.913), and among those with high VTE risk (1.7% vs. 1.0%, P=0.554). PEI had no association with the probability of VTE event occurrence (RR, 1.246; 95% CI, 0.478-2.188, P=0.954). CONCLUSIONS: Educational intervention effectively increased physician awareness of VTE prophylaxis in the respiratory department. Further interventions are still necessary since the guidelines were implemented to a relatively low degree.
Subject(s)
Physicians , Venous Thromboembolism , Anticoagulants/therapeutic use , Humans , Inpatients , Retrospective Studies , Risk Factors , Venous Thromboembolism/prevention & controlABSTRACT
In this paper, the aerodynamic characteristic of a ducted tail rotor in hover has been numerically studied using CFD method. An analytical time domain formulation based on Ffowcs Williams-Hawkings (FW-H) equation is derived for the prediction of the acoustic velocity field and used as Neumann boundary condition on a rigid scattering surface. In order to predict the aerodynamic noise, a hybrid method combing computational aeroacoustics with an acoustic thin-body boundary element method has been proposed. The aerodynamic results and the calculated sound pressure levels (SPLs) are compared with the known method for validation. Simulation results show that the duct can change the value of SPLs and the sound directivity. Compared with the isolate tail rotor, the SPLs of the ducted tail rotor are smaller at certain azimuth.
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[This corrects the article DOI: 10.1186/s40064-016-3080-x.].
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Cell division protein, FtsZ, has been identified as a new potential antimicrobial target against multidrug-resistant (MDR) and methicillin-resistant Staphylococcus aureus (MRSA). By using computer-aided simulation, the phenolic compounds magnolol and honokiol from Magnolia officinalis were shown to have high anchor energies to FtsZ of S. aureus. The calculated binding energies of magnolol and honokiol for this FtsZ (PDB Code: 4DXD) were established to be -7.6 kcal/mol and -8.2 kcal/mol, respectively. Both of them showed polymerization inhibition efficacy for this FtsZ at 100 ppm, which confirmed the simulation results. Their antibacterial activity against S. aureus including multidrug-resistant (MDR) and methicillin-resistant S. aureus (MRSA) with minimum inhibitory concentration (MIC) values in the range of 8-16 ppm. These findings support the use of computer-aided simulation to screen natural compounds for this cell division protein, FtsZ, and this method can be a quick and promising approach for the development of antimicrobial agents against multi-drug resistant S. aureus.
