Comparative Study of Collagen Stimulation Using Semi-Ablative and Non-Ablative Radiofrequency

Objective: Comparison between semi-ablative and non-ablative radiofrequency for collagen stimulation. Method: Three volunteers with scheduled surgical procedures of abdominoplasty were selected. After the evaluation, the abdominal area was divided into three quadrants, with the right region receiving monopolar non-ablative radiofrequency (RF) application. In contrast, the left region received fractionated radiofrequency (FRF) application, using three different needle sizes (0.5, 1.5, and 3.0 mm), and the intermediate area was kept as a control. After 24 hours, surgery was performed, and the skin flaps were collected for histological and immunohistochemical analyses. Results: An increase in total collagen and type I collagen was observed in the treated groups. There was also an increase in the expression of COX-2, CD68 positive cells (macrophages), and lymphocyte markers (CD3, CD20, and NK-CD57). Furthermore, it was seen that only the use of 3.0-mm needles kept the channels open in the superficial tissue after 24 hours. There were no significant differences between the modalities. Conclusion: Non-ablative and sub-ablative radiofrequency have positive and effective results for flaccidity, demonstrating the success in collagen production. Furthermore, this study is the first to present channel opening and permanence time, which are important to optimize the action of drug delivery.

Effects of Cryofrequence on Localized Adiposity: Case Study

Cryofrequence is the combination of cryotherapy with radiofrequency, which promotes a “thermal shock” to the tissue, working simultaneously to skin flaccidity and localized adiposity. The efficacy of dermatological and hypodermic cryofrequency treatment was evaluated. This study reports the case of a 45-year-old woman with complaints of flaccidity and fat located in the infra-umbilical region in the preoperative period of abdominoplasty. The evaluation was performed before and after treatment through evaluation protocols, ultrasound examinations and histological findings through optic microscopy, microfocal and immunohistochemical analysis. The treatment was performed in 4 sessions, with a weekly application, using the BHS 156 FULL®—BODY HEALTH BRASIL®apparatus, the parameters were temperature of -10°C, power in 70%, duration of 8 minutes. After the surgical procedure, parts of treated and untreated abdominal tissues were removed for evaluation. In the tests performed, significant destruction of adipocytes was detected, with consequent reduction of fat and greater expression of caspase-3 in the treated tissue, being constated the macrophage increase by CD68 expression. There was improvement in flaccidity, evidenced by the significant increase in the number of fibroblasts and inflammatory cells positive for Ki67, bringing more quantity and better quality to the collagen.

Clinical and neuroimaging features of enterovirus71 related acute flaccid paralysis in patients with hand-foot-mouth disease

Objective:To investigate clinical and neuroimaging features of enterovirus71(EV71) related acute flaccid paralysis in patients with hand-fool-mouth disease.Methods:Nine patients with acute flaccid paralysis met the criterion of EV71 induced hand-foot-mouth disease underwent spinal and brain MR imaging from May 2008 to Sep 2012.Results:One extremity flaccid was found in four cases(3 with lower limb,1 with upper limb),two limbs flaccid in three cases(2 with lower limbs,1 with upper limbs),and four limbs flaccid in two cases.Spinal MRI studies showed lesion with high signal in T2-weighted images(T2WI) and low signal T1-weighted images(T1WI) in the spinal cord of all nine cases,and the lesions were mainly in bilateral and unilateral anterior hom of cervical spinal cord and spinal cord below thoracic 9(T9) level.In addition,the midbrain,pons, and medulla,which were involved in 3 cases with brainstem encephalitis,demonstrated abnormal signal.Moreover,spinal cord contrast MRI studies showed mild enhancement in corresponding anterior hom of the involved side,and strong enhancement in its ventral root.Conclusions: EV71 related acute flaccid paralysis in patients with hand-foot-mouth disease mainly affected the anterior hom regions and ventral root of cervical spinal cord and spinal cord below T9 level. MR imaging could efficiendy show the characteristic pattern and extent of the lesions which correlated well with the clinical features.

Second to fourth digit ratio： a predictor of adult penile ength

The second to fourth digit ratio （2D：4D） has been proposed as a putative biomarker for prenatal testosterone and covaries with the sensitivity of the androgen receptor （AR）. Both prenatal testosterone and the AR play a central role in penile growth. In this study, we investigated the relationship between digit ratio and penile length. Korean men who were hospitalized for urological surgery at a single tertiary academic centre were examined in this study, and 144 men aged 20 years or older who gave informed consent were prospectively enrolled. Right-hand second- and fourth-digit lengths were measured by a single investigator prior to measurement of penile length. Under anaesthesia, flaccid and stretched penile lengths were measured by another investigator who did not measure nor have any the information regarding the digit lengths. Univariate and multivariate analysis using linear regression models showed that only height was a significant predictive factor for flaccid penile length （univariate analysis： r=0. 185, P=-0.026; multivariate analysis： r=-0.172, P=0.038） and that only digit ratio was a significant predictive factor for stretched penile length （univariate analysis： r=-0.216, P=0.009; multivariate analysis： r=-0.201, P=0.024; stretched penile length=-9.201 xdigit ratio ＋ 20.577）. Based on this evidence, we suggest that the digit ratio can predict adult penile size and that the effects of prenatal testosterone may in part explain the differences in adult penile length.

Acute flaccid paralysis and neurogenic respiratory failure associated with enterovirus D68 infection in children: Report of two cases

BACKGROUND Acute flaccid paralysis(AFP)and neurogenic respiratory failure rarely occur in children.At the end of 2018,some children with such symptoms were admitted to our hospital.In this study,we aimed to assess two children with AFP and neurogenic respiratory failure associated with enterovirus D68(EV-D68).CASE SUMMARY Two children admitted to our hospital presented with symptoms and imaging results different from those of acute disseminated encephalomyelitis and hand,foot,and mouth disease.Their main symptoms were AFP and neurogenic respiratory failure.Magnetic resonance imaging showed severe inflammatory injury mainly to the anterior horn cells of the spinal cord.Blood and cerebrospinal fluid samples were collected to assess for pathogens,including bacteria,tuberculosis,cryptococcus,herpes virus,and coxsackie virus,and the results were negative.At the beginning,the two cases were not assessed for EV-D68 in the nasopharyngeal,blood,and cerebrospinal fluid specimens.About 2 mo later,EVD68 was detected in the stool sample of one of the cases.The symptom of AFP was caused by injury to the anterior horn cells at levels C5-L5 of the spinal cord,while neurogenic respiratory failure was at levels C3-C5.CONCLUSION We should pay attention to the detection and diagnosis of EV-D68 and make efforts to develop antivirus drugs and vaccines.

Characteristics of Acute Flaccid Paralysis Reported by the Surveillance System and Verified by WHO Officer in Akwa Ibom State-Nigeria, 2006-2012

Background: Acute Flaccid Paralysis (AFP) was adopted by World Health Organization (WHO) in 1988 as a key pillar used in monitoring progress towards the global polio eradication initiative. High quality AFP surveillance is essential to support this global initiative. We applied recently developed case verification methods for the quantitative evaluation of AFP cases reported to the surveillance systems to evaluate the quality of AFP reports in Akwa Ibom State, Nigeria. Objectives: The aim of this study is to identify the demographic, clinical and epidemiological attributes and quality of acute flaccid paralysis surveillance. Methods: All AFP cases reported in children 0 - 14 years during January 2006 to December 2012 were investigated and verified by WHO surveillance officers, using standard questionnaire. Two stool samples 24 - 48 hours apart from a total of 1184 AFP cases were collected within 14 days of onset of paralysis with the prior oral/verbal informed consent and transported to the national polio laboratory under reverse cold chain. Result: In all, 885/1184 representing 75% of the AFP cases reported were verified by WHO officers in the period under review. Overall, 534/885 (60.3%) of AFP cases had more than >3 doses of Oral Polio Vaccine (OPV), while 196/885 (22.2%) received 3 dose of OPV and 128/885 (14.5%) received between 1 - 2 doses of OPV. It was interesting that 27/885 (3%) never received OPV before. Overall, 743/885 (84.0%) were reported within ≤14 days of paralysis onset, while 142/885 (16%) were reported after ≥14 days of paralysis onset. In total, 797/885 (90.1%) of cases were found to have fever at the onset of paralysis;paralysis was found to be asymmetric in 805/885 (91%). Wasting or diminished muscle tone was observed in 34.0% of cases verified, while deep tendon reflexes were good (normal) in 79% of cases. Gullain-Barre syndrome was observed in 50.9% of the reported cases followed by injection neuritis (25.0%) and transverse myelitis (2.0%). However, other causes recorded 22.1%. The legs (90.2%) are the parts of the body mostly affected, while arm recorded 9.8% of the AFP cases reported and verified. Conclusions: The result of this study indicates that the characterization of AFP cases reported to the surveillance network could provide better understanding of age, and sex distribution, common clinical causes of AFP and impact of distance to health facilities on the health seeking behaviours of AFP cases.

Acupuncture combined with modern rehabilitation therapy for post-stroke flaccid paralysis

Stroke has been in a high incidence,and stroke sequelae have become the main cause of motor dysfunction.The treatment of flaccid paralysis is critical to stroke recovery.In recent years,traditional treatment,especially acupuncture therapy has achieved certain effects for the treatment of post-stroke flaccid paralysis.Acupuncture treatment can promote the recovery of nerve conduction,increase muscle strength and improve joint flexibility,and correct abnormal movement patterns of limbs.Acupuncture combined with rehabilitation training will be the focus for the treatment of post-stroke flaccid paralysis.In this review,the combination of different acupuncture therapies with modern rehabilitation for the treatment of post-stroke flaccid paralysis has been summarized in order to effectively promote the recovery of motor function and significantly improve their life quality.

Clinical Observation of Electroacupuncture and Acupoint Injection in Treating Common Fibular Nerve Paralysis

Objective： To observe the clinical efficacy of combined electroacupuncture and nerve growth factor（NGF） injection at acupoints in the treatment of common fibular nerve paralysis and provide evidences for integrative Chinese ＆ western medicine against diabetic peripheral neuropathy（DPN）. Methods： Forty subjects were randomized into two groups and treated by routine therapy. Moreover, treatment group was given electro-acupuncture and NGF injection; and control group was given herbal suffocation, oral Dibazol and compound vitamin B and Mecobalamin Injection. The clinical symptoms and nerve conduction velocity were observed and compared. Results： The cure rate was higher in treatment group than in control group （P〈0.05）; after treatment, the nerve conduction velocity was improved in both groups （P〈0.01）, with a significant improvement in treatment group than in control group （P〈0.01）. Conclusion： Combined electro-acupuncture and NGF injection at acupoints is quite effective in the treatment of common fibular nerve paralysis.

Introduction to Dr CHEN Zhi-gang's Clinical Experience in Acupuncture

1 Post-stroke Sequela Stroke is one of the common and frequent diseases in the middle-aged and old people. With the continuous progress of the diagnostic techniques, the cure rate of stroke has been obviously increased. It is reported, in China, that the cerebrovascular diseases occur in 0.1%-0.5% people, among which 70% of them suffered from disability, bringing about heavy burden to the patient himself, their families and the society.

Enterovirus A71 antivirals:Past,present,and future

Enterovirus A71(EV-A71)is a significant human pathogen,especially in children.EV-A71 infection is one of the leading causes of hand,foot,and mouth diseases(HFMD),and can lead to neurological complications such as acute flaccid myelitis(AFM)in severe cases.Although three EV-A71 vaccines are available in China,they are not broadly protective and have reduced efficacy against emerging strains.There is currently no approved antiviral for EV-A71.Significant progress has been made in developing antivirals against EV-A71 by targeting both viral proteins and host factors.However,viral capsid inhibitors and protease inhibitors failed in clinical trials of human rhinovirus infection due to limited efficacy or side effects.This review discusses major discoveries in EV-A71 antiviral development,analyzes the advantages and limitations of each drug target,and highlights the knowledge gaps that need to be addressed to advance the field forward.

Case for flaccid tongue treated by Guan’s tongue acupuncture

In this article,one proved case of flaccid tongue treated by Guan’s tongue acupuncture was introduced by the three-step method of"puncture,prick,and swallowing".This case was an elderly female patient with Parkinson disease,which had the main clinical symptoms of flaccid and weak tongue,and speech and swallowing disorder,and was diagnosed as flaccid tongue(deficiency of the both qi and blood,and deficiency syndrome of liver and kidney).The patient received diagnosis and treatment based on an overall analysis of its dialectical characteristics,using the five acupoints of Heart,Jīnjīn(金津EX-HN12),Yùyè(玉液EX-HN13),Tongue root acupoint 1,and Tongue root acupoint 2 in total.First,the four acupoints of EX-HN12,EX-HN13,Tongue root acupoint 1,and Tongue root acupoint 2 were punctured successively,and then using the reinforcing method,the Heart on the tongue surface was pricked.Finally,the patient was advised to make a slow swallowing action.Through tongue acupuncture therapy for 6 times,the patient’s speech and swallowing function was improved,which achieved a satisfactory therapeutic effects.

Corrigendum to“Silent circulation of poliovirus in small populations”[Infectious Disease Modeling 2(2017)431e440]

An error in a previous publication in the calculation of the average age at first infection for the model is corrected here.The average age at first infection for the effective contact rates used to generate the data ranges from 1.2 to 3.3 years of age instead of 3e5 years of age as advertised in the previous version of the paper.This change has an effect on the force of infection generated by this model.In this corrigendum,we demonstrate the correct method to calculate the average age at first infection for the model.We compare the forces of infection that correspond to these ages in our model with the forces of infection in other endemic populations.We show that the modified age range corresponds to forces of infection which are higher than those that are known to exist in historical studies of polioendemic regions.Thus,the results in the paper have limited applicability to real-world endemic situations.

Silent circulation of poliovirus in small populations

Background:Small populations that have been isolated by conflict make vaccination and surveillance difficult,threatening polio eradication.Silent circulation is caused by asymptomatic infections.It is currently not clear whether the dynamics of waning immunity also influence the risk of silent circulation in the absence of vaccination.Such circulation can,nevertheless,be present following a declaration of elimination as a result of inadequate acute flaccid paralysis surveillance(AFPS)or environmental surveillance(ES).Methods:We have constructed a stochastic model to understand how stochastic effects alter the ability of small populations to sustain virus circulation in the absence of vaccination.We analyzed how the stochastic process determinants of the duration of silent circulation that could have been detected by ES were affected by R0,waning dynamics,population size,and AFPS sensitivity in a discrete individual stochastic model with homogeneous contagiousness and random mixing.We measured the duration of silent circulation both by the interval between detected acute flaccid paralysis(AFP)cases and the duration of circulation until elimination.Results:As R0 increased and population size increased,the interval between detected AFP cases and the duration of circulation until elimination increased.As AFPS detection rates decreased,the interval between detected AFP cases increased.There was up to a 22%chance of silent circulation lasting for more than 3 years with 100%AFP detection.The duration of silent circulation was not affected by the waning immunity dynamics.Conclusion:We demonstrated that small populations have the potential to sustain prolonged silent circulation.Surveillance in these areas should be intensified before declaring elimination.To further validate these conclusions,it is necessary to realistically relax the simplifying assumptions about mixing and waning.