ObjectiveTo investigate the therapeutic effectiveness of low-power laser on myofascial pain syndrome. Methods73 self-controlled patients with myofascial pain syndrome were irradiated on myofascial trigger points with Nd:YAG laser in wavelength 830nm, power 500mW, 20 minutes per day for 5 times. At pre-and post-treatment,pain intensity and pressure pain of myofascial trigger points were checked. ResultsAfter treatment, score of pain intensity was reduced signficantly from (7.24±2.41) to (2.21±1.22) (P<0.001). The pressure pain of myofascial trigger points were improved . Conclusions Low-power laser can reduce the pain intensity and increase the pressure pain threshold of myoficial trigger points.

Background:Q fever endocarditis,a chronic illness caused by Coxiella burnetii,can be fatal if misdiagnosed or left untreated.Despite a relatively high positive rate of Q fever serology in healthy individuals in the mainland of China,very few cases of Q fever endocarditis have been reported.This study summarized cases of Q fever endocarditis among blood culture negative endocarditis (BCNE) patients and discussed factors attributing to the low diagnostic rate.Methods:We identified confirmed cases of Q fever endocarditis among 637 consecutive patients with infective endocarditis (IE) in the Peking Union Medical College Hospital between 2006 and 2016.The clinical findings for each confirmed case were recorded.BCNE patients were also examined and each BCNE patient's Q fever risk factors were identified.The risk factors and presence of Q fever serologic testing between BCNE patients suspected and unsuspected of Q fever were compared using the Chi-squared or Chi-squared with Yates' correction for continuity.Results:Among the IE patients examined,there were 147 BCNE patients,of whom only 11 patients (7.5％) were suspected of Q fever and undergone serological testing for C.burnetii.Six out of 11 suspected cases were diagnosed as Q fever endocarditis.For the remaining136 BCNE patients,none of them was suspected of Q fever nor underwent relevant testing.Risk factors for Q fever endocarditis were comparable between suspected and unsuspected patients,with the most common risk factors being valvulopathy in both groups.However,significantly more patients had consulted the Infectious Diseases Division and undergone comprehensive diagnostic tests in the suspected group than the unsuspected group (100％ vs.63％,P =0.03).Conclusions:Q fever endocarditis is a serious yet treatable condition.Lacking awareness of the disease may prevent BCNE patients from being identified,despite having Q fever risk factors.Increasing awareness and guideline adherence are crucial in avoiding misdiagnosing and missed diagnosing of the disease.

OBJECTIVETo introduce and evaluate the procedure and the effect of maxillary sinus lift with closed technique by Summers osteotome, bone grafting and simultaneous implant placement.

METHODS66 cases with severely resorbed alveolar bone in maxillary posterior region received sinus lift with Summers osteotome, simultaneously bone grafting and implants placement. The final restoration was finished at 6 months postoperatively.

RESULTSThe operation procedure were eventless in the 66 cases, the sinus floor were elevated by 2-5 mm, three-dimensional reconstruction of the CT scan pictures showed the smooth dome profile of the lifting sites and no signs of laceration on the membrane, and there were no maxillary antritis after operation. After 6 months, no significantly bone graft resorption and good osseointegration were noticed in X-ray imaging. The final restoration was finished at this time. 12-24 months after the restoration, all implants inserted were remain, the hard and soft tissue were healthy, prosthesis were stable and functioned. X-ray showed good osseointegration in the lifting sites, the vertical resorption around the implants were less than 1 mm.

CONCLUSIONWith properly use of Summers osteotome, scraps of the bone in the implant sockets can be pushed into the sinus, these autogenous bone scraps were in favor of the osseogenesis and the sinus floor can be easily elevated by the method with very infrequent complications. It enlarged indication of dental implants and avoided operation of harvesting autogenous bone in other site. The method is simple and valuable to clinical application.

Adult ; Alveolar Bone Loss ; Bone Transplantation ; Dental Implantation, Endosseous ; Dental Implants ; Humans ; Male ; Maxilla ; Maxillary Sinus ; Middle Aged ; Osseointegration ; Osteotomy ; Sinus Floor Augmentation

BACKGROUNDThe first case of pandemic influenza A (H1N1) virus infection in Macau Special Administrative Region (SAR) of the People's Republic of China was documented on June 18, 2009. Subsequently, persons with suspected infection or of contact with suspected cases received screening. All the confirmed cases were hospitalized and treated with oseltamivir. Their clinical features were observed. This may help for better management for later patients and be of benefit to the government of Macau SAR to adjust its strategy to combat the pandemic influenza A (H1N1) virus infection more efficiently.

METHODSFrom June to July 2009, the initial 72 cases of influenza A (H1N1) in Macau were hospitalized in Common Hospital Centre S. Januario (CHCSJ). The infection was confirmed by real-time reverse-transcriptase polymerase chain reaction (RT-PCR). The clinical features of the disease were closely observed and documented. Oseltamivir was given to all patients within 48 hours after the onset of disease and maintained for 5 days.

RESULTSThe mean age of the 72 patients was 21 years old. Forty of them were men and 32 were women. The median incubation of the virus was 2 days (1 to 7 days). The most common symptoms were fever (97.2%) and cough (77.8%). The rate of gastrointestinal symptoms including nausea, vomiting, and diarrhea was 2.8%. Fever typically lasted for 3 days (1 to 9 days). The median time from the onset to positive results of real-time RT-PCR was 6 days (3 to 13 days). After treatment with oseltamivir, most patients became afebrile within 48 hours. Only one aged patient with a history of glaucoma and hypothyroidism was found to have lung infiltration on chest X-ray.

CONCLUSIONSThe initial cases of pandemic influenza A (H1N1) virus infection in Macau SAR showed that most of the infected persons had a mild course. The virus could be detected by real-time RT-PCR within a median of 6 days from the onset. Oseltamivir was effective.

Adolescent ; Adult ; Aged ; Antiviral Agents ; therapeutic use ; Child ; Child, Preschool ; China ; Female ; Humans ; Influenza A Virus, H1N1 Subtype ; drug effects ; genetics ; pathogenicity ; Influenza, Human ; diagnosis ; drug therapy ; pathology ; Macau ; Male ; Middle Aged ; Oseltamivir ; therapeutic use ; Reverse Transcriptase Polymerase Chain Reaction ; Young Adult

OBJECTIVETo explore the effectiveness of a combined therapy using two types of peginterferon (PEG-IFN) and ribavirin in treating chronic hepatitis C virus (HCV) genotypes 1b/6a infections.

METHODSThe clinical data of 171 patients with chronic HCV genotypes 1b/6a infection in Common Hospital Centre S. Januario, Macau SAR, China, were retrospectively analyzed. Of these patients, 145 (84.8%) were infected with HCV genotype 1b and 26 (15.2%) with HCV genotype 6a. Patients were divided into two groups based on drug therapies: PEG-IFN-2b group (n=140), in which patients were treated with PEG-IFN-2b 1.5 g/kg QW plus ribavirin 800-1 200 mg/d and PEG-IFN-2a group (n=31), in which patients were treated with PEG-IFN-2a 180g QW plus ribavirin 800-1 200 mg/d. Patients was treated for 48 weeks and then followed up for 24 weeks.

RESULTSAll patients completed their therapies. The rates of early viral response (EVR) and sustained virologic response (SVR) were 78.95% and 69.59%, respectively . The two groups were not significantly different in terms of EVR P=0.091 end of treatment virological response (ETVR) (P=0.542), SVR P=0.079, relapse (P=0.497). And the two HCV genotypes patients were not significantly different in terms of EVR (P=0.268), ETVR (P=0.276), SVR (P=0.479), and relapse (P=1.000).

CONCLUSIONSPEG-IFN combined with ribavirin can achieve high viral response in treating chronic hepatitis C. PEG-IFN-2a and PEG-IFN-2b basically are similarly effective in treating HCV genotype 1b or 6a infections.

Adult ; Antiviral Agents ; therapeutic use ; Female ; Hepatitis C, Chronic ; drug therapy ; Humans ; Interferon-gamma ; therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols ; therapeutic use ; Retrospective Studies ; Ribavirin ; therapeutic use ; Treatment Outcome ; Young Adult

BACKGROUNDThe efficacy of montelukast (MONT), a cysteinyl leukotriene receptor antagonist, in nonasthmatic eosinophilic bronchitis (NAEB), especially its influence on cough associated life quality is still indefinite. We evaluated the efficacy of MONT combined with budesonide (BUD) as compared to BUD monotherapy in improving life quality, suppressing airway eosinophilia and cough remission in NAEB.

METHODSA prospective, open-labeled, multicenter, randomized controlled trial was conducted. Patients with NAEB (aged 18-75 years) were randomized to inhaled BUD (200 μg, bid) or BUD plus oral MONT (10 μg, qn) for 4 weeks. Leicester cough questionnaire (LCQ) life quality scores, cough visual analog scale (CVAS) scores, eosinophil differential ratio (Eos), and eosinophil cationic protein (ECP) in induced sputum were monitored and compared.

RESULTSThe control and MONT groups contained 33 and 32 patients, respectively, with similar baseline characteristics. Significant with-in group improvement in CVAS, LCQ scores, Eos, and ECP was observed in both groups during treatment. After 2-week treatment, add-on treatment of MONT was significantly more effective than BUD monotherapy for CVAS decrease and LCQ scores improvement (both P < 0.05). Similar results were seen at 4-week assessment (both P < 0.05). 4-week add-on therapy of MONT also resulted in a higher percentage of patients with normal sputum Eos (<2.5%) and greater decrease of ECP (both P < 0.05).

CONCLUSIONSMONT combined with BUD was demonstrated cooperative effects in improvement of life quality, suppression of eosinophilic inflammation, and cough remission in patients with NAEB.

Acetates ; therapeutic use ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bronchitis ; drug therapy ; immunology ; Budesonide ; therapeutic use ; Cough ; drug therapy ; Female ; Humans ; Inflammation ; drug therapy ; Male ; Middle Aged ; Quality of Life ; Quinolines ; therapeutic use ; Young Adult

Objective To examine the association between uric acid (UA)levels of patients with acute ischemic stroke at ad-mission and discharged outcome.Methods The acute ischemic stroke patients of Xinganmeng People’s Hospital in Inner Mongolia,from June 1,2009 to May 31,2012 were continuity included in the present study,the included analysis sample size were 3 440 cases.Poor discharged outcome was defined as the occurrence of disability or death.With reference to the Modi-fied Rankin's Scale (MRs)Stroke Scale,Scores were recorded in the questionnaires,score of 3 or more (MRs≥3)was de-fined as disability.The patients were all grouped by P20,P60,P90 of UA,binary logistic regression were used in studying of risk factors,calculated the odds ratios (Odds ratio,OR)and 95% confidence interval (95% Confident interval,95%CI).All tests were two-sided test and a significance level of 0.05.Results A total of 359 people occurred poor outcomes in the stud-y,accounting for 10.44%.Univariate logistic regression analysis of poor outcome occurred showed that relative to the lowest group(P20,UA≤222.6 mmol/L),the second and third group (UA:222.7 ~ 310.9 mmol/L and 311.0~419.7 mmol/L) OR (95% CI)were:0.70(0.53~0.91)(P <0.05)and 0.66(0.49~0.88)(P <0.05).After adjusted age,body tempera-ture,high blood pressure,hyperglycemia,history of stroke,high triglycerides,high LDL-C and smoking,relative to the low-est level group,the second and third group occurred poor outcoming OR (95% CI)were:0.70(0.53~0.93)(P <0.05)and 0.66(0.48~0.90)(P <0.05).Conclusion Higher levels of uric acid levels in patients with acute ischemic stroke may inde-pendently related with occurred poor discharged outcome.

Objective To investigate the myocardial damage in rats fed with corn from Keshan disease area added with bean puree. Methods Male Wistar rats were randomly divided into 3 groups according to their body weights, and fed with corn, corn from Keshan disease area added with bean puree, corn from non-endemic area. The GSH-Px activity of vena cardalis blood was examined in 1 and 3 months, rats were sacrificed after being fed for 6 months to examine the heart changes with HE stain. Results The three groups of GSH-Px activity were different in 1 and 3 months respectively(F=23.60,72.46, all P<0.01); GSH-Px activity was (181.58±22.15), (44.76±28.59)U/L in rats fed with corn, was (195.03±17.66), (30.38±3.35)U/L in those fed with corn added with bean puree from Keshan disease area, lower than the group fed with corn of non-endemic area[(340.90±95.42), (125.17±13.64)U/L, all P < 0.01]. But the difference of GSH-Px activity between simple corn group and corn adding bean puree groups of Keshan disease area was not obvious(P>0.05). Myocardial damage incidence of the three groups was 3/9,1/9,2/7. Difference among three groups did not have statistical significance(χ2=1.33, P> 0.05). Conclusions Only corn from Keshan disease area may induce myocardial damage pathology change. Adding bean puree into corn does not increase damage.

Objective To investigate the relationship between plasma homocysteine on admission and the outcome at discharge of acute ischemic stroke.Methods A non-concurrent cohort study was performed and a total of 1 3 1 9 patients with acute is-chemic stroke were continuously included in this study.According to tertile range of plasma homocysteine,patients were di-vided into three group.Logistic regression analysis was used to assess the independent association between plasma homocys-teine on admission and poor outcome at discharge of acute ischemic stroke.Results The difference of plasma homocysteine on admission between the poor outcome and those with good outcome had statistical significance (P<0.000 1).Without the adj ustment of multiple factors,when comparing to the first group,the second and third tertile seemed to have a tendency of increasing the risk of poor outcome at discharge,the OR (95%CI)was 2.111 (1.297~3.437,P<0.05),2.113 (1.361~3.279,P<0.05).After adjustment for multivariate,the second and third tertile also seemed to have a tendency of increasing the risk of poor outcome at discharge,the OR (95%CI)was 1.876 (1.160~3.036,P<0.05),2.396 (1.414~4.062,P<0.05).Conclusion The current study indicated that higher plasma homocysteine level was an independent risk factor for poor outcome at discharge in ischemic stroke patients.It would increase the risk of the outcome at discharge in patients with acute ischemic stroke,and suggests that there is a dose-response relationship between plasma homocysteine level on admis-sion and the poor outcome at discharge.

5-Aminolevulinate Synthetase/genetics* ; Anemia, Sideroblastic/genetics* ; Genetic Diseases, X-Linked/genetics* ; Humans ; Mutation