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BACKGROUND: Traditional Chinese medicine (TCM) plays an important role in the primary care system in many places, but research evidence on its effectiveness is largely lacking. The aim of the present study was to compare the effectiveness between TCM and Western medicine (WM) consultations in primary care. OBJECTIVES: To evaluate whether medical consultations could improve the quality of life and health condition of patients in primary care and to find out whether there was any difference in the effectiveness bewteen TCM and WM. DESIGN, SETTING AND SUBJECTS: This was a prospective, longitudinal study on 290 patients of one TCM public and 841 patients of two WM general outpatient clinics (GOPC) in Hong Kong when they consulted for an episodic illness. METHODS: All patients attending a TCM GOPC in TWH, and the two WM GOPC (TWH and ALC), who fullfilled the inclusion criteria were invited to participate. Each patient answered a structured questionnaire on the presenting complaint, socio-demography, chronic morbidity and service utilization, the Chinese Quality of Life instrument (ChQOL) and the SF-36V2 Health Survey immediately before and two weeks after the doctor consultation. The Global Rating on change Scale (GRS) was also administered in the week 2 assessment. OUTCOME MEASURES: The primary outcomes were changes in the ChQOL and SF-36V2 HRQOL scores. Secondary outcomes included the GRS score. The significance of the change within individual were tested by paired t-tests. The differences in change in scores between WM and TCM were tested by independent sample-t-tests or chi-square, as appropriate. Multivariate regresions were used to determine the independent effect of type of medicine on the change in HRQOL scores. RESULTS: Mean ChQOL and SF-36V2 scores of subjects improved significantly two weeks after TCM or WM consultations in all domains except for the Physical form domain of ChQOL. The greatest improvements were found in the SF-36V2 physical-health related domains. 78% TCM clinics and 71% of subjects WM clinics reported an improvement in GRS. The proportion of subjects who had improvement in HRQOL scores were lower among subjects consulting the WM clinic (72.3%) than those consulting TCM clinics (100%) but the difference was not significant after correction for baseline scores. CONCLUSIONS: Both TCM and WM consultations were associated with significant improvement in HRQOL in over 90% of patients. There was no singificant difference between the effectiveness of TCM and WM consultations. The results support the role of TCM as an alternative primary care service in Hong Kong. [ABSTRACT FROM AUTHOR]

Background: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare inherited arrhythmia disorder characterized by ventricular arrhythmia triggered by adrenergic stimulation., Case Presentation: A 9-year-old boy presented with convulsions following physical exertion. Bidirectional ventricular tachycardia (VT) during a treadmill test led to the diagnosis of catecholaminergic polymorphic ventricular tachycardia (CPVT). Genetic testing revealed a pathogenic variant of RYR2:c.720G>A (p.ArG2401His) . Nadolol was initially started. However, he experienced aborted VT arrest three years later. Flecainide was thus added as dual therapy and he underwent left cardiac sympathetic denervation (LCSD). Subsequently, a transvenous implantable cardioverter-defibrillator (ICD) was implanted because he still had several episodes of bidirectional VT. Despite a good compliance to medication, the patient still had exercise induced VT episodes with new onset of atrial fibrillation. High dose nadolol was required and amiodarone was added. Despite maximizing the dosage of these three antiarrhythmics, the patient continued to experience multiple episodes of ventricular fibrillation with appropriate ICD shocks and persistent atrial arrhythmias. Right cardiac sympathetic denervation (RCSD) was performed as the last modality of treatment. Patient had a total elimination of VT post bilateral sympathectomy. He remained asymptomatic on follow up. A follow-up treadmill test showed no recurrence of exercise-induced PVCs and VT., Conclusion: We illustrated the challenges and the complex decision-making process encountered in managing refractory CPVT. In patients unresponsive to conventional therapies, RCSD in additional to LCSD is a safe and effective alternative treatment. A history of LCSD should not preclude physicians from considering RCSD in children with refractory CPVT., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Leung, Kwok, Lau, Lee and Tsao.)

Joining large and complex polymer-matrix composite structures is becoming increasingly important in industries such as automobiles, aerospace, sports, wind turbines, and others. Ultrasonic welding is an ultra-fast joining process and also provides excellent joint quality as a cost-effective alternative to other joining processes. This research aims at investigating the welding characteristics of novel methyl methacrylate Elium ® , a liquid thermoplastic resin. Elium ® is the first of its kind of thermoplastic resin, which is curable at room temperature and is suitable for mass production processes. The welding characteristics of Elium ® composites were investigated by optimizing the welding parameters with specially designed integrated energy directors (ED) and manufactured using the Resin transfer molding process. The results showed a 23% higher lap shear strength for ultrasonically welded composite joints when compared to the adhesively bonded joints. The optimized welding time for the ultrasonic welded joint was found to be 1.5 s whereas it was 10 min for the adhesively bonded joint. Fractographic analysis showed the significant plastic deformation and shear cusps formation on the fractured surface, which are typical characteristics for strong interfacial bonding.