Reliability and validity of dermatology life quality index: assessment of quality of life in human immunodeficiency virus/acquired immunodeficiency syndrome patients with pruritic papular eruption

Objective

To test the reliability and validity of dermatology life quality index (DLQI) in simplified Chinese language by assessing the quality of life (QoL) in HIV (human immunodeficiency virus)/AIDS (Acquired immunodeficiency syndrome) patients with pruritic papular eruption (PPE).

Methods

A study of simplified-Chinese-version DLQI was carried out in Henan province, China. The reliability and validity were tested by means of statistical method. Data were processed with SPSS 19.0.

Results

One hundred and seven subjects participated in the study and 106 (99.07%) finished the questionnaire. Eighteen patients were mildly affected; 62 were moderately affected, 24 were highly affected, and 2 were extremely affected. Reliability analysis showed that the split-half reliability coefficient of questionnaire was 0.556 and the reliability of the full test estimated with Spearman-Brown. correction was 0.7146. The Cronbach alpha was 0.673. According to validity analysis, the correlation between the scores of items and the total scores ranged from 0.208 to 0.529 (P<0.05). Three factors were abstracted from10 questions with the principal component analysis and the contribution rate of the 3 common factors was 59.95%.

Conclusion

The simplified-Chinese-version DIQL is an acceptable and valid scale for HIV/AIDS patients with PPE. It can be used to evaluate the QoL of HIV/AIDS patients with PPE in China.     

Governor Vessel Moxibustion: Ancient Chinese Medical Technology with New Vital

Moxibustion is an ancient therapeutic technique used in Chinese medicine. Governor Vessel moxibustion (GVM) was developed from long snake moxibustion, a popular technique used in China’s Jiangsu and Zhejiang Provinces, and is significantly more effective than general moxibustion. We aimed to review GVM, including its theoretical basis, choices of moxibustion points and materials, operation procedures, clinical applications, and contraindications. This information could increase the appropriate use of GVM and support further in-depth research.     

Modified PHBV scaffolds by in situ UV polymerization: Structural characteristic,mechanical properties and bone mesenchymal stem cell compatibility

An ideal scaffold provides an interface for cell adhesion and maintains enough biomechanical support during tissue regeneration. Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) scaffolds with pore sizes ranging from 100 to 500 μm and porosity ～90% were prepared by the particulate-leaching method, and then modified by the introduction of polyacrylamide (PAM) on the inner surface of scaffolds using in situ UV polymerization, with the aim of enhancing the biological and mechanical properties of the PHBV scaffolds. The modified PHBV scaffolds had interconnected pores with porosity of 75.4–78.6% and pore sizes at peak volume from 20 to 50 μm. The compressive load and modulus were up to 62.45 N and 1.06 MPa, respectively. The water swelling percentage (WSP) of the modified PHBV scaffolds increased notably compared with that of the PHBV scaffolds, with the maximum WSP at 537%. Sheep bone mesenchymal stem cells (BMSC) were cultured on the PHBV and modified PHBV. The hydrophilic PAM chains did not influence BMSC viability or proliferation index, but the initial cell adhesion at 1 h of culture was enhanced significantly. Framing PHBV scaffold along with gel-like PAM chains inside is a novel model of inner surface modification for PHBV scaffolds, which shows potential in tissue engineering applications.     

Survival of people living with HIV after treatment with Traditional Chinese Medicine in Henan province of China: a retrospective cohort study

ObjectiveTo provide survival estimates of people living with human immunodeficiency virus (PLHIV) after treatment with Traditional Chinese Medicine (TCM) in rural China, to identify the prognostic factors at enrollment, and to explore the effectiveness of TCM in treating PLHIV.MethodsPLHIV who enrolled in national TCM HIV treatment trial program in October 2004 were analyzed in this study and followed up to October 2010. Survival time was estimated by the Kaplan-Meier curve and hazard ratios, and identifying prognostic factors were computed through Cox proportional hazard models.ResultsA total of 1666 PLHIV were included with 102 591 person-months of follow-up. Overall, 312 (18.7%) patients died. The total mortality rate over the study period was 3.6 per 100 person-years, which was lower than the worldwide rate. The cumulative survival rate was 95.9% at 1 year [95% confidence interval (CI) (94.8-96.8)] and 80.4% at 6 years [95% Cl (78.4-82.3)]. Elevated death risks emerged among males, older individuals, and those with lower CD4+ T-cell counts.ConclusionsTCM could increase survival and lengthen the life span of PLHIV in Henan province of China, as shown by our retrospective cohort study. Factors such as sex, age, education, and CD4+ T-cell counts correlated to survival. However, retrospective cohorts bias the data, so more prospective studies should be performed to confirm our primary results.     

Practitioner-based complementary and alternative therapies in the management of asthma in children and adolescents: a systematic review and meta-analysis

BackgroundAsthma is a chronic inflammatory disorder affecting 334 million people worldwide. Conventional medicines are effective for managing asthma in children, but important concerns exist about potential side-effects, such as increased heartbeat, muscle shake, and hyperactivity. Consequently, many patients turn to complementary and alternative therapies to seek care with a more holistic approach. We systematically reviewed the available evidence on effectiveness of complementary therapies in the management of asthma in children and adolescents (<18 years old).MethodsWe searched Medline, Embase, CINAHL, AMED, and the Cochrane Database of Systematic Reviews to identify articles in English published between Jan 1, 2000, and Dec 13, 2014. Keywords included 57 names of practitioner-based complementary therapies and were combined with “asthma” and either “randomised controlled trial” or “quasi-randomised trial”. Identified abstracts were double screened. Primary outcome of interest was forced expiratory volume in 1 second (FEV₁). Heterogeneity was assessed with the I² statistic. Fixed-effect meta-analysis was done with RevMan software (version 5.2). Quality of the studies was assessed with the Cochrane Collaboration Risk of Bias Assessment Tool.Findings1187 non-duplicate records were found, of which 62 full text articles were assessed for eligibility. 20 additional studies were identified from the bibliographies of studies found. Of these 82 articles screened, 12 trials covering eight therapies were eligible. The trials involved 605 patients, aged 5–17 years. Ten of the 12 studies were assessed to be at high risk of bias. Pooled data from two studies indicated that, compared with standard treatment, massage therapy significantly improved lung function (FEV₁) (standardised mean difference 0·43, 95% CI 0·04–0·82), and that, compared with placebo or standard treatment, acupuncture significantly improved quality of life (0·43, 0·05–0·81). The data could not be pooled for other outcomes. Results from individual trials showed that tai chi and osteopathy were beneficial for improving lung function, and art therapy for quality of life. Only one study assessed adverse events and found laser acupuncture to be safe and well tolerated.InterpretationAlthough meta-analysis from a small number of studies on massage and acupuncture showed some benefit for improving lung function and quality of life, most studies were small and of poor quality. Therefore, the evidence is insufficient to recommend that any of the practitioner-based complementary therapies should be used in the management of asthma in children and adolescents.FundingNone.     

Advantages of Chinese Medicine for Patients with Acquired Immunodeficiency Syndrome in Rural Central China

Objective

To analyze the effect of Chinese medicine (CM) on mortality and quality of life (QOL) of acquired immunodefificiency syndrome (AIDS) patients treated with combined antiretroviral therapy (cART).

Methods

A random sample of AIDS patients enrolled in the National Chinese Medicine Treatment Trial Program (NCMTP) that met the inclusion criteria was included in this study. NCMTP patients were included as the CM+cART group, and those not in the NCMTP were included as the cART group. Survival from September 2004 to September 2012 was analyzed by retrospective cohort study. QOL was analyzed by cross-sectional study.

Results

The retrospective cohort study included 528 AIDS patients, 322 in the CM+cART group and 206 in the cART group. After 8 years, the mortality in the CM+cART group was 3.3/100 person-years, which was lower than the cART group of 5.3/100 person-years (P<0.05). The hazard ratio (HR) for mortality in the cART group was 1.6 times that of the CM+cART group by Cox proportional hazard model analysis. After controlling for gender, age, marital status, education, and CD4⁺ T-cell count, the HR was 1.9 times higher in the cART group compared with the CM+cART group (P<0.05). The cross-sectional study investigated 275 AIDS patients. The mean scores of all QOL domains except spirituality/personal beliefs were higher in the CM+cART group than in the cART group (P<0.05).

Conclusions

For AIDS patients, CM could help to prolong life, decrease mortality, and improve QOL. However, there were limitations in the study, so prospective studies should be carried out to confifirm our primary results.

     

Biospinning by silkworms: Silk fiber matrices for tissue engineering applications

The mechanism of biospinning of natural silk fibers has been an open issue for decades. In this report a natural bio-polymeric matrix based on biospun silk fibers obtained from Antheraea mylitta, a wild non-mulberry tropical tasar silkworm, is put forward for potential applications. This report deals with the conformational transitions of silk fibroin during the biospinning process and its potential to support cell adherence and proliferation. The silk fibers obtained were aligned into linear, mixed or random patterns forming interconnected, macroporous three-dimensional matrices. The matrices were morphologically and functionally characterized with respect to fiber diameter, crystallinity, mechanical strength and biocompatibility using feline fibroblast cells. Drawn silk fibers showed enhanced stability to protease treatment in comparison with naturally occurring native gland fibroin protein. A viability assay suggested biocompatibility of these matrices in vitro. Fluorescence and confocal microscopy indicated normal cell attachment, spreading and proliferation on these biospun silk matrices. The results provided evidence for the use of biospun silk matrices as natural, inexpensive and alternative substrata for tissue engineering applications.     

Neoadjuvant chemotherapy in operable breast cancer

Primary chemotherapy in localised breast cancer may prevent tumour spread during surgical treatment and reduce proliferation of micrometastases. A randomised clinical trial, in 196 premenopausal and postmenopausal patients with operable (T2-3, N0-1b) breast cancer, was started in November 1983 at the Institut Curie to compare neoadjuvant and adjuvant regimens of chemotherapy with radiotherapy with or without surgery. The patients have been followed up for 35–70 months (median 54). A neoadjuvant group received two monthly cycles of intravenous doxorubicin/cyclophosphamide/5-fluorouracil before locoregional therapy and four cycles subsequently. Six months cycles following locoregional therapy were administered to the adjuvant group. Because of inclusion of postmenopausal and/or node-negative patients, compliance was less than optimal in 39 patients who were analysed separately according to actual dose received. Tumour response, evaluated after two cycles of neoadjuvant chemotherapy, was significantly associated with dose (P = 0.003). Survival showed a slight non-significant advantage for the neoadjuvant group. Survival plotted by actual dose was also similar. Neoadjuvant chemotherapy was safe and at least as effective as the adjuvant regimen. Patients have been accrued to a subsequent larger trial of chemotherapy as first-line treatment.