BACKGROUND： Musicians are frequently affected by playing-related musculoskeletal disorders （PRMD）. Common solutions used by Western medicine to treat musculoskeletal pain include rehabilitation programs and drugs, ...BACKGROUND： Musicians are frequently affected by playing-related musculoskeletal disorders （PRMD）. Common solutions used by Western medicine to treat musculoskeletal pain include rehabilitation programs and drugs, but their results are sometimes disappointing. OBJECTIVE： To study the effects of self-administered exercises based on Tuina techniques on the pain intensity caused by PRMD of professional orchestra musicians, using numeric visual scale （NVS）. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： We performed a prospective, controlled single-blinded, randomized study with musicians suffering from PRMD. Participating musicians were randomly distributed into the experimental （n = 39） and the control （n = 30） groups. After an individual diagnostic assessment, specific Tuina self-administered exercises were developed and taught to the participants. Musicians were instructed to repeat the exercises every day for 3 weeks. MAIN OUTCOME MEASURES： Pain intensity was measured by NVS before the intervention and after 1, 3, 5, 10, 15 and 20 d of treatment. The procedure was the same for the control group, however the Tuina exercises were executed in points away from the commonly-used acupuncture points. RESULTS： In the treatment group, but not the control group, pain intensity was significantly reduced on days 1, 3, 5, 10, 15 and 20. CONCLUSION： The results obtained are consistent with the hypothesis that self-administered exercises based on Tuina techniques could help professional musicians controlling the pain caused by PRMD. Although our results are very promising, further studies are needed employing a larger sample size and double blinding designs.展开更多
A vaccine must be sufficiently stable and cause no discernible discomfort or organ damage both during administration and at the injection site. To achieve these aims, the skin offers a viable platform, provided, antig...A vaccine must be sufficiently stable and cause no discernible discomfort or organ damage both during administration and at the injection site. To achieve these aims, the skin offers a viable platform, provided, antigens mustpenetrate the skin barrier and then exit the skin through deformable yet stable vesicular carriers to enter thelymphatic system. Even after such antigen delivery into the body, the intended immune response can only beattained if the following immune response has previously been correctly understood at the cellular and molecularlevels. Here we review, the underlying immunological decision tree that has several branching points to generatean optimal immune response. The tolerance versus immunity decision during and after the delivery of an antigen viaskin depends on i) antigen/pathogen application effects on the cutaneous microenvironment, ii) the variousinvolved cells type (skin resident cells or directly the lymph node resident cells), and regulatory molecules. Theskin microenvironment alters due to skin perturbation. The skin is perturbed directly by the antigens/pathogenswhich activate the release of mediators and cytokines and thus trigger an autocrine and paracrine effect, or,indirectly via the antigen/pathogen influence on the commensal microorganisms on the skin (which helpmaintain skin homeostasis). The skin microenvironment changes by the mode of antigen delivery.The cue from cutaneous immunology in vaccine delivery across intact skin may provide insight for future noninvasive vaccination suggesting a possible shift in the vaccination protocols and the essential paradigmrefinement.展开更多
文摘BACKGROUND： Musicians are frequently affected by playing-related musculoskeletal disorders （PRMD）. Common solutions used by Western medicine to treat musculoskeletal pain include rehabilitation programs and drugs, but their results are sometimes disappointing. OBJECTIVE： To study the effects of self-administered exercises based on Tuina techniques on the pain intensity caused by PRMD of professional orchestra musicians, using numeric visual scale （NVS）. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： We performed a prospective, controlled single-blinded, randomized study with musicians suffering from PRMD. Participating musicians were randomly distributed into the experimental （n = 39） and the control （n = 30） groups. After an individual diagnostic assessment, specific Tuina self-administered exercises were developed and taught to the participants. Musicians were instructed to repeat the exercises every day for 3 weeks. MAIN OUTCOME MEASURES： Pain intensity was measured by NVS before the intervention and after 1, 3, 5, 10, 15 and 20 d of treatment. The procedure was the same for the control group, however the Tuina exercises were executed in points away from the commonly-used acupuncture points. RESULTS： In the treatment group, but not the control group, pain intensity was significantly reduced on days 1, 3, 5, 10, 15 and 20. CONCLUSION： The results obtained are consistent with the hypothesis that self-administered exercises based on Tuina techniques could help professional musicians controlling the pain caused by PRMD. Although our results are very promising, further studies are needed employing a larger sample size and double blinding designs.
文摘A vaccine must be sufficiently stable and cause no discernible discomfort or organ damage both during administration and at the injection site. To achieve these aims, the skin offers a viable platform, provided, antigens mustpenetrate the skin barrier and then exit the skin through deformable yet stable vesicular carriers to enter thelymphatic system. Even after such antigen delivery into the body, the intended immune response can only beattained if the following immune response has previously been correctly understood at the cellular and molecularlevels. Here we review, the underlying immunological decision tree that has several branching points to generatean optimal immune response. The tolerance versus immunity decision during and after the delivery of an antigen viaskin depends on i) antigen/pathogen application effects on the cutaneous microenvironment, ii) the variousinvolved cells type (skin resident cells or directly the lymph node resident cells), and regulatory molecules. Theskin microenvironment alters due to skin perturbation. The skin is perturbed directly by the antigens/pathogenswhich activate the release of mediators and cytokines and thus trigger an autocrine and paracrine effect, or,indirectly via the antigen/pathogen influence on the commensal microorganisms on the skin (which helpmaintain skin homeostasis). The skin microenvironment changes by the mode of antigen delivery.The cue from cutaneous immunology in vaccine delivery across intact skin may provide insight for future noninvasive vaccination suggesting a possible shift in the vaccination protocols and the essential paradigmrefinement.
