The Energy Density and Treatment Times Are the Main Factors That Affect the Efficacy of Long-Pulsed 1,064-nm Nd:YAG Laser Treatment for Onychomycosis Caused by Trichophyton rubrum.

BACKGROUND: No optimal regimen exists for the LPNYL (long-pulsed 1,064-nm neodymium:yttrium-aluminum-garnet laser) for treating onychomycosis. OBJECTIVE: To establish an optimal LPNYL treatment regimen for onychomycosis caused by Trichophyton rubrum (OCTr). PATIENTS AND METHODS: First, 511 infected nails of 177 patients were treated using LPNYL with orthogonally designed regimens according to various energy densities, spot sizes, pulse widths, and treatment times. The optimal treatment regimen was established by multivariate analysis. Next, 69 patients with 221 infected nails were randomized to receive oral itraconazole (drug group) and the optimal regimen of LPNYL treatment (laser group). The clinical efficacy (CE) and mycological efficacy (ME) were evaluated at 6 and 12 months following the start of treatment, and adverse reactions were recorded in both groups. RESULTS: Both CE and ME were significantly correlated with the energy density (p < 0.05) and treatment times (p < 0.05), but not with the spot size (0.071 < p < 0.083) or pulse width (0.051 < p < 0.060), at 6 or 12 months. There were no significant differences at 6 or 12 months (p > 0.05), and no significant difference was observed in CE at 12 months between the two groups (p > 0.05). At 6 months, the CE in the laser group was significantly higher than that in the drug group (p < 0.001). CONCLUSIONS: LPNYL is effective and safe for treating OCTr. The energy density and treatment times are the main factors that affect the efficacy. The optimal regimen for LPNYL is an energy density of 45 J/cm2, pulse width of 35 ms, spot size of 4 mm, frequency of 1 Hz, and 6 treatments with 1-week intervals. Laser treatment has rapid clinical recovery.

Treatment of a patient with multiple cutaneous piloleiomyoma-related pain with a local injection of triamcinolone acetonide.

BACKGROUND: Multiple cutaneous piloleiomyomas are rare, frequently painful and difficult-to-treat benign tumours originating in the arrectores pilorum muscles of the hair follicles. OBJECTIVE: The aim of this study was to determine the efficacy of a local injection of triamcinolone acetonide in relieving cutaneous piloleiomyoma-related pain. METHODS: A patient with multiple painful piloleiomyomas was treated with weekly local injections of triamcinolone acetonide into the nodules and papules for 3 weeks. RESULTS: The patient's nodules and papules became smaller, and the pain disappeared. At 1-year follow-up, there were no side effects, pain recurrence or significant enlargement of any of the injected lesions. CONCLUSION: Our study demonstrates that local injection of triamcinolone acetonide may be a promising new treatment option for multiple painful cutaneous piloleiomyomas.

Validation of the EQ-5D in a general population sample in urban China.

PURPOSE: To evaluate the reliability and validity of the EQ-5D in a general population sample in urban China. METHODS: Thousand and eight hundred respondents in 18 communities of Hangzhou, China were recruited by multi-stage stratified random sampling. Respondents self-administered a questionnaire including the EQ-5D, the SF-36, and demographic questions. Test-retest reliability at 2-week intervals was evaluated using Kappa coefficient, the intraclass correlation coefficient. The standard error of measurement (SEM) was used to indicate the absolute measurement error. Construct validity was established using convergent, discriminant, and known groups analyses. RESULTS: Complete data for all EQ-5D dimensions were available for 1,747 respondents (97%). Kappa values were from 0.35 to 1.0. The ICCs of test-retest reliability were 0.53 for the EQ-5D index score and 0.87 for the EQ VAS score. The SEM values were 0.13 (9.22% range) and 4.20 (4.20% range) for the EQ-5D index and EQ VAS scores, respectively. The Pearson's correlation coefficients between the EQ-5D and the SF-36 were stronger between comparable dimensions than those between less comparable dimensions, demonstrating convergent and discriminant evidence of construct validity. The Chinese EQ-5D distinguished well between known groups: respondents who reported poor general health and chronic diseases had worse HRQoL than those without. Older people, females, people widowed or divorced, and those with a lower socioeconomic status reported poorer HRQoL. Respondents reporting no problems on any EQ-5D dimension had better scores on the SF-36 summary scores than those reporting problems. CONCLUSIONS: The Chinese version of the EQ-5D demonstrated acceptable construct validity and fair to moderate levels of test-retest reliability in an urban general population in China.

Antibacterial activity and mechanism of silver nanoparticles on Escherichia coli.

The antibacterial activity and acting mechanism of silver nanoparticles (SNPs) on Escherichia coli ATCC 8739 were investigated in this study by analyzing the growth, permeability, and morphology of the bacterial cells following treatment with SNPs. The experimental results indicated 10 microg/ml SNPs could completely inhibit the growth of 10(7) cfu/ml E. coli cells in liquid Mueller-Hinton medium. Meanwhile, SNPs resulted in the leakage of reducing sugars and proteins and induced the respiratory chain dehydrogenases into inactive state, suggesting that SNPs were able to destroy the permeability of the bacterial membranes. When the cells of E. coli were exposed to 50 microg/ml SNPs, many pits and gaps were observed in bacterial cells by transmission electron microscopy and scanning electron microscopy, and the cell membrane was fragmentary, indicating the bacterial cells were damaged severely. After being exposed to 10 microg/ml SNPs, the membrane vesicles were dissolved and dispersed, and their membrane components became disorganized and scattered from their original ordered and close arrangement based on TEM observation. In conclusion, the combined results suggested that SNPs may damage the structure of bacterial cell membrane and depress the activity of some membranous enzymes, which cause E. coli bacteria to die eventually.

[Establishment of systemic lupus erythematosus-like murine model with Sm mimotope].

OBJECTIVE: To establish systemic lupus erythematosus (SLE) -like murine model by immunizing BALB/C mice with Sm mimotope. METHODS: Sm mimotope was identified by screening a 12-mer random peptide library with monoclonal anti-Smith antibody. Sm mimotope was initially defined with sandwich ELISA, DNA sequencing, and deduced amino acid sequence; and BALB/C mice were subcutaneously injected with mixture phages clones. Sera Sm antibody, anti-double stranded DNA (dsDNA) antibody, and antinuclear antibody (ANA) of mice were detected using direct immunofluorescence; kidney histological changes were examined by HE staining. RESULTS: Five randomly selected peptides were sequenced and the amino acid sequences IR, SQ, and PP were detected in a higher frequency. High-titer IgG autoantibodies of dsDNA, Sm, and ANA in the sera of experiment group were detected by ELISA 28 days after having been immunized by Sm mimotope. Proteinuria was detected 33 days later; immune complex and nephritis were observed in kidney specimens. CONCLUSION: SLE-like murine model can be successfully induced by Sm phage mimotope.

[Study on the electro-generation of H2O2 using an activated carbon fiber].

The comparative study on the electro-generation of H2O2 using an activated carbon fiber cathode and graphite cathode was investigated. The effect of the operating parameters on the H2O2 generation concentration and current efficiency, such as the initial pH, current density and electrolyte concentration, was also evaluated. The results revealed that the activated carbon fiber cathode was more effective compared to the graphite cathode. The maximum value of H2O2 concentration could be achieved with pH 3.00, current density 8.89 mA/cm2 and electrolyte concentration 0.05 mol/L. However, due to the formation of competitive electrode reactions, the current efficiency of this electrolysis system is lower than other electrolysis system. In addition, a new kinetic model was established to well describe the electro-generation of H2O2. The experimental data were fitted well using the kinetic model.