BackgroundOsteoarthritis (OA) is a serious health concern worldwide, and patients with OA are in urgent need of proper long-term disease management to prevent disability and improve the quality of life. Research has started to investigate the feasibility and effectiveness of telemedicine in providing disease management for patients with chronic diseases. Guangdong Online Hospital (GOH) is the first officially recognized web-based hospital that widely provides telemedicine services in southern China.ObjectivesThis study aimed to establish the feasibility and effectiveness of GOH in providing long-term disease management for patients with knee OA via a 6-month, randomised control trial (RCT).Methods40 patients with knee OA were randomly assigned to receive conventional therapy (CT) in the clinic or conventional therapy plus a brief GOH-based intervention (CT-GOHT). GOH-based intervention included educational lectures, medical suggestions and psychotherapy. The primary outcome was the drop-out rates and the secondary outcomes included the mean change of the self-reported total score of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Multidimensional Fatigue Inventory (MFI), the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI) from baseline to endpoint.Figure 1Flow chat of trial participationFigure 2A telemedicine intervention to patients with knee OAResultsThe baseline characteristics were comparable between the two groups. 3 patients in CT group and 1 patient in CT-GOHT group lost to follow-up during the study (P = 0.598). A statistically significant difference was observed in the mean change of WOMAC recommended index of joint pain (8.82 ± 5.02 vs. 13.90 ± 7.63, P = 0.026), morning stiffness (3.12 ± 1.50 vs. 4.42 ± 2.06, P = 0.039), functional limitation (27.65 ± 9.91 vs. 38.84 ± 17.28, P = 0.025), HADS-Anxiety (3.24 ± 2.41 vs. 5.32 ± 3.23, P = 0.037), and PSQI global score (2.35 ± 1.54 vs. 4.21 ± 3.34, P = 0.043) from baseline to endpoint when comparing the CT group to the CT-GOHT group. In addition, Guangdong Online Hospital was widely accepted by the including OA patients for their disease management.ConclusionDelivering a telemedicine intervention to patients with knee OA via GOH is a feasible and potentially effective method in long-term disease management, especially for patients living in remote areas. The results provide preliminary experiences and guidance for an upcoming full-scale RCT in disease management via telemedicine.Trial registrationChiCTR1800014465.Reference[1] Huang Z, et al. Implementation of telemedicine for knee osteoarthritis: study protocol for a randomized controlled trial. Trials, 2018, 19(1):232.Table 1Baseline characteristics of the two study groupsVariableCT group(n = 20)CT-GOH group(n = 20)Age72.25 ± 8.8467.25 ± 10.97Female, n1515Education, nPrimary schoolHigh school128146Han Chinese, n2020Income, n<¥2000¥2000 -¥5000>¥5000 81025132BMI, kg/m2 25.85 ± 3.8726.29 ± 2.96Distance to hospital, kilometre105.83 ± 100.35...

No abstract

Patients with chromoblastomycosis (CBM) usually have a history of local skin damage related to outdoor activities, mainly manifested as chronic refractory proliferative pathologic changes. We report a case of a 56-year-old man with CBM, identified as Fonsecaea pedrosoi infection by fungal culture and gene sequencing. This patient was successfully treated with a regimen of oral itraconazole (ITZ) and terbinafine lasting 7 months. Through in vitro drug sensitivity tests, minimum inhibitory concentrations of amphotericin, ITZ, and terbinafine were 1 lg/ml, 0.25 lg/ml, and 1 lg/ml, respectively. In this case, terbinafine was found to be more effective than ITZ.

Objective: Long noncoding RNAs (lncRNAs) participate in cancer immunity. Herein, we characterized the clinical significance of immune-related lncRNA model and its associations with immune infiltrations and chemosensitivity in bladder cancer.Methods: Transcriptome data of bladder cancer specimens were employed from The Cancer Genome Atlas. Dysregulated immune-related lncRNAs were screened via Pearson correlation and differential expression analyses, followed by recognition of lncRNA pairs. Then, a LASSO regression model was constructed. Receiver operator characteristic curves of one-, three- and five-year survival were plotted. Akaike information criterion (AIC) value of one-year survival was determined as the cutoff of high- and low-risk subgroups. The differences in survival, clinical features, immune cell infiltrations and chemosensitivity were compared between subgroups.Results: Totally, 90 immune-related lncRNA pairs were selected, 15 of which were put into the prognostic model. The area under the curves of one-, three- and five-year survival were 0.806, 0.825 and 0.828, confirming the favorable predictive performance of this model. According to the AIC value, we clustered subjects into high- and low-risk subgroups. High-risk score indicated unfavorable outcomes. This risk model was in relation to survival status, age, stage and TNM. In comparison to conventional clinicopathological characteristics, the risk model displayed higher predictive efficacy and was an independent predictor. Also, it could well characterize immune cell infiltration landscape and predict immune checkpoint expression and sensitivity to cisplatin and methotrexate.Conclusion: This model conducted by paring immune-related lncRNAs regardless of expressions exhibited a favorable efficacy in predicting prognosis, immune landscape and chemotherapeutic response in bladder cancer.