A randomized controlled trial on the effect of focal thermal therapy at acupressure points treating osteoarthritis of the knee.

BACKGROUND: Osteoarthritis of the knee is a common degenerative joint disorder in our ageing population. A combination of thermal therapy with a self-management exercise have shown a positive effect in the management of osteoarthritis of the knee. This study aimed to compare the effectiveness of topical heat pack versus focal application of heat therapy at the acupressure points in the treatment of osteoarthritis of the knee. METHODS: A randomized controlled trial was conducted in 76 patients with osteoarthritis of the knee, diagnosed by an experienced orthopedic surgeon. Following inclusion and exclusion selection, patients were randomly allocated to group 1 (Heat pack) or group 2 (Thermal gun). All patients received 30 min of treatment in each session, twice a week for 4 weeks. They also received an education program and taught home knee exercises. Outcome measurements were the visual analog scale (VAS) for pain intensity, muscle power, knee ROM, WOMAC and SF-12v2. RESULTS: In the Thermal gun group, function and total scores (WOMAC) and Physical Composite Scale (SF-12v2) were significantly improved after 8 sessions. Quadriceps strength was significantly improved after 8 weeks (from 4.42 to 4.63; p = 0.02). In the Heat pack group, flexion was significantly improved after 8 sessions (p = 0.02). Mean VAS scores after Heat pack treatment was consistently better (lower) than mean VAS scores after Thermal gun treatment. CONCLUSION: The combination of focal thermal therapy at acupressure points is a viable conservative treatment in osteoarthritis of the knee. The pressure at the acupressure points has a synergistic benefit than topical thermal therapy alone. TRIAL REGISTRATION: ClinicalTrials.gov , NCT04735029 Date of registration: February 2, 2021 (Retrospectively registered).

Substrate specificity of the NS3 serine proteinase of hepatitis C virus as determined by mutagenesis at the NS3/NS4A junction.

Hepatitis C virus (HCV) encodes a polyprotein that is processed to produce the structural and nonstructural proteins of the virus. Nonstructural protein 3 (NS3) is a serine proteinase that cleaves the polyprotein to release the NS4A, NS4B, NS5A, and NS5B proteins. To characterize the substrate specificity of NS3, we synthesized by in vitro translation the polyprotein NS2*-NS3-NS4*P that includes 70% of the NS2 protein, the complete NS3 protein, and 25% of the NS4 protein region attached to substance P, an epitope tag. We demonstrated that NS3 cleaves at the NS3/NS4A junction to release the NS4*P protein. Subsequently, we used this reaction to evaluate the importance of conserved amino acids that flank the NS3/NS4A junction. We replaced amino acids in the P6, P1, and P1' positions of the scissile bond of this junction using site-directed mutagenesis. When the P6 aspartic acid was changed to asparagine, lysine, or serine, NS3-mediated cleavage occurred. When threonine in the P1 position was replaced with other polar amino acids or with amino acids having aliphatic side chains, cleavage occurred, although it was not detected when arginine or tyrosine was present. Replacement of serine in the P1' position with other polar amino acids, with amino acids having aliphatic side chains, or with arginine resulted in NS3-mediated cleavage. Thus, since fewer amino acids in the P1 position supported cleavage than in the P6 or P1' positions, the P1 position of the scissile bond may play a more important role in defining the substrate specificity of the HCV NS3 proteinase.

Morphology and morphogenesis of viruses of hemorrhagic fever with renal syndrome. II. Inclusion bodies--ultrastructural markers of hantavirus-infected cells.

Three distinctive types of viral inclusion bodies were identified in hantavirus-infected cells by thin-section electron microscopy. The inclusion bodies, designated granular, granulofilamentous, and filamentous, were intracytoplasmic and closely associated with the rough endoplasmic reticulum and Golgi cisternae. Virus specificity of the inclusions was verified by immune colloidal gold and immunoperoxidase labeling. The inclusion bodies were a common morphological marker for 13 strains of hantaviruses studied, irrespective of their origin.

Morphology and morphogenesis of viruses of hemorrhagic fever with renal syndrome (HFRS). I. Some peculiar aspects of the morphogenesis of various strains of HFRS virus.

The morphology and morphogenesis of viruses of hemorrhagic fever with renal syndrome (HFRS) were studied by thin-section electron microscopy. Ten strains of HFRS virus isolated in China and one strain isolated in Korea were compared. The virions varied in size as well as in the shape and character of their inner components. Both intracellular and extracellular ribosome-like, electron-dense, virus-associated granules were seen. A viral antigen layer was often visualized on the surface of HFRS virus-infected cells, as confirmed by immune electron microscopy. Aberrant tailed particles and elongated rod-like particles were seen infrequently. The morphogenesis of HFRS viruses appears to be more complex than that of other members of the family Bunyaviridae. The prototype Hantaan virus shares a common morphology and morphogenesis with the other HFRS viruses studied.

Morphological evidence for identifying the viruses of hemorrhagic fever with renal syndrome as candidate members of the Bunyaviridae family. Brief report.

Thin section immuno-electron microscopy has been successfully applied to investigate and identify the classical and mild form of HFRS viruses isolated in the People's Republic of China. The results showed that all the 8 strains studied (derived from different parts of China, adapted in different cell lines) share a common morphology and morphogenesis. Essentially, the viruses possess characteristics of members of the Bunyaviridae Family, however, differing by a larger size and size variation and formation of cytoplasmic viral inclusions.