Paravertebral abscess and bloodstream infection caused by Burkholderia pseudomallei after acupuncture: a case report.

BACKGROUND: Various pathogenic bacterial infections caused by acupuncture have raised widespread concern, but paravertebral abscesses and bloodstream infections of Burkholderia pseudomallei (B.pseudomallei) after acupuncture have not been reported. CASE PRESENTATION: A 49-year-old man was admitted to hospital with recurrent back pain and fever for 1 month, along with the finding of undiagnosed diabetes. He was considered to have tuberculosis because of unrelieved high fever and pulmonary nodules. Bilateral blood culture suggested B.pseudomallei infection, MRI of the lumbar spine suggested paravertebral abscess, and the final diagnosis was paravertebral abscess and bloodstream infection after acupuncture combined with migrating lung infection. He was discharged after abscess debridement and intensive anti-infective therapy, but no further oral antibiotics were administered because of his poor adherence. More than 5 months later, he was readmitted with the urine culture findings of B.pseudomallei. No other abscess formation was observed and he received oral antibiotics for more than 3 months without recurrence. CONCLUSIONS: Acupuncture may lead to B.pseudomallei infection in high-risk groups, and inadequate treatment can lead to recurrent infections.

[Therapeutic effect of Impatiens balsamina, Lawsonia inermis L. and Henna on androgenetic alopecia in mice].

OBJECTIVE: To investigate the therapeutic effect of Impatiens balsamina, Lawsonia inermis L. and Henna in a C57BL/6 mouse model of androgenetic alopecia and explore the mechanisms. METHODS: Forty-eight male C57BL/6 mice were randomized equally into blank control group, androgenetic alopecia model group, Impatiens balsamina group, Lawsonia inermis L. group, Henna group and minoxidil group. In all but those in the blank control group, the mice were subjected to dorsal subcutaneous injection of testosterone propionate solution (daily dose 5 mg/kg) to establish models of androgenetic alopecia and received subsequent treatment with topical application of the corresponding drugs on a daily basis for 35 days. The concentrations of testosterone, dihydrotestosterone and 5α reductase type Ⅱ in the serum and skin tissue were measured, and the histopathological changes of the skin tissues were observed. RESULTS: All the tested drugs were capable of promoting new hair growth in the dorsal skin lesions of the mice. Among these drugs, Henna produced the most pronounced therapeutic effect and resulted in the highest dorsal hair density and a color change of the dorsal skin into gray; Lawsonia inermis L. showed the poorest therapeutic effect and resulted in the lowest dorsal hair density. The total number of follicles and the number of terminal hair follicles in a given field were significantly higher in all the drug treatment groups than in the model group (P < 0.05). In Impatiens balsamina group and Henna group, the contents of testosterone and dihydrotestosterone in the skin were significantly lower than those in the model group (P < 0.05). No significant difference was found in serum testosterone and dihydrotestosterone levels or skin 5α reductase type Ⅱ level between the drug treatment groups and the model group. CONCLUSIONS: Impatiens balsamina, Lawsonia inermis L., and Henna all have therapeutic effects on androgenetic alopecia in C57BL/6 mice. The therapeutic effect of Impatiens balsamina and Henna is possibly achieved by reducing androgen content in local skin tissue.

Photodynamic therapy combined with antifungal drugs against chromoblastomycosis and the effect of ALA-PDT on Fonsecaea in vitro.

BACKGROUND: Chromoblastomycosis is a chronic skin and subcutaneous fungal infection caused by dematiaceous fungi and is associated with low cure and high relapse rates. In southern China, Fonsecaea monophora and Fonsecaea pedrosoi are the main causative agents. PRINCIPAL FINDINGS: We treated 5 refractory and complex cases of chromoblastomycosis with 5-aminolevulinic acid photodynamic therapy (ALA-PDT) combined with oral antifungal drugs. The lesions improved after 4 to 9 sessions of ALA-PDT treatment at an interval of one or two weeks, and in some cases, mycological testing results became negative. The isolates were assayed for susceptibility to antifungal drugs and ALA-PDT in vitro, revealing sensitivity to terbinafine, itraconazole and voriconazole, with ALA-PDT altering the cell wall and increasing reactive oxygen species production. CONCLUSIONS: These results provide the basis for the development of a new therapeutic approach, and ALA-PDT combined with oral antifungal drugs constitutes a promising alternative method for the treatment of refractory and complex cases of chromoblastomycosis.

Clinical efficacy of paiteling in the treatment of condyloma acuminatum infected with different subtypes of HPV.

Condyloma acuminatum (CA) is a type of mucosal benign hyperplasia skin disease that is caused by human papillomavirus (HPV) infection, which mainly occurs in the genitalia and anus. The aim of the present study was to explore the clinical efficacy underlying the traditional Chinese medicine paiteling in the treatment of CA via the detection of HPV. One hundred CA patients were enrolled in the current study and were externally treated with paiteling for 5 weeks. HPV subtypes were examined both before the treatment and at 6 months after the treatment. After the external paiteling therapy, 92 cases were cured, and the apparent efficiency was 92.0% (92/100), while 8 cases exhibited recurrence. Before the external paiteling therapy, the numbers of cases of low-risk, high-risk, and mixed types of HPV were 40, 35, and 25, respectively. At 6 months after treatment, the numbers of negative cases of low-risk, high-risk, and mixed types of HPV were 38, 32, and 20, respectively. The results demonstrated that external paiteling treatment has a good curative effect on the treatment of CA.

Low-level transcutaneous electrical vagus nerve stimulation suppresses atrial fibrillation.

BACKGROUND: Transcutaneous low-level tragus electrical stimulation (LLTS) suppresses atrial fibrillation (AF) in canines. OBJECTIVES: This study examined the antiarrhythmic and anti-inflammatory effects of LLTS in humans. METHODS: Patients with paroxysmal AF who presented for AF ablation were randomized to either 1 h of LLTS (n = 20) or sham control (n = 20). Attaching a flat metal clip onto the tragus produced LLTS (20 Hz) in the right ear (50% lower than the voltage slowing the sinus rate). Under general anesthesia, AF was induced by burst atrial pacing at baseline and after 1 h of LLTS or sham treatment. Blood samples from the coronary sinus and the femoral vein were collected at those time points and then analyzed for inflammatory cytokines, including tumor necrosis factor alpha and C-reactive protein, using a multiplex immunoassay. RESULTS: There were no differences in baseline characteristics between the 2 groups. Pacing-induced AF duration decreased significantly by 6.3 ± 1.9 min compared with baseline in the LLTS group, but not in the control subjects (p = 0.002 for comparison between groups). AF cycle length increased significantly from baseline by 28.8 ± 6.5 ms in the LLTS group, but not in control subjects (p = 0.0002 for comparison between groups). Systemic (femoral vein) but not coronary sinus tumor necrosis factor (TNF)-alpha and C-reactive protein levels decreased significantly only in the LLTS group. CONCLUSIONS: LLTS suppresses AF and decreases inflammatory cytokines in patients with paroxysmal AF. Our results support the emerging paradigm of neuromodulation to treat AF.