Relationship Between Juncturae Tendinum and Sagittal Bands

The juncturae tendinum and sagittal bands transmit precise forces through the dorsum of the hand. Both structures are integral in the mechanics of normal digital extension and in stabilization of the metacarpophalangeal (MCP) joints. Extensor tendon injury, or rupture/attenuation of sagittal bands and/or juncturae tendinum, may disrupt the kinematic chain and lead to a number of abnormal hand postures and motions. Early treatment of extensor tendon and/or sagittal band injury is dependent upon proper recognition of primary pathology. Proper evaluation and the use of special clinical tests should be implemented to rule out other pathologies. Once diagnosed, treatment may consist of relative motion splinting and standard pain/edema control measures to increase joint motion, tendon excursion, and functional use of the hand.     

脉压与心脑血管病的关系:一个大样本的随访研究

目的研究脉压(PP)是否与死亡有关,尤其是否与心、脑血管病有关。方法选择了1992-1993年,在韩国医疗保险公司投保年龄在40岁及以上的投保人,共有698796人,随访7年。随访开始时对每个观察对象进行健康检查并调查相关问题,随访期每2年进行1次查体。结果PP与全因死亡、心、脑血管病死亡有正相关关系。无论性别、年龄以及是否患有高血压,均得到相同结果,即随着PP升高,死亡危险性升高。但年龄越大,脉压的影响力度越弱。结论PP与全因死亡率、心脑血管病死亡率呈相关关系,在预测心脑血管病危险性时,PP可以作为一个独立的预测指标。     

Active tuberculosis in inflammatory bowel disease patients under treatment from an endemic area in Latin America

BACKGROUNDThere has been an increase in cases of inflammatory bowel disease (IBD) in recent years. There is also greater access and availability of immunosuppressive and biological agents, which increase the risk of opportunistic infection despite improving the quality of life and promoting mucosal healing. Tuberculosis (TB) remains a public health problem, and it has a high incidence in several countries. Therefore, knowledge of the risk of developing TB in patients with IBD is important.AIMTo evaluate the risk of active TB in patients with IBD under treatment from an endemic area in Latin America.METHODSA standard questionnaire included demographic variables, clinical aspects of IBD disease, history of active TB during treatment, active TB characteristics and evolution, initial screening and results and time from the start of anti-tumor necrosis factor alpha (TNFα) to TB development.RESULTSAzathioprine, anti-TNFα and the combination of these two drugs were associated with a higher risk of active TB incidence. The TNFα blockers increased the relative risk of developing active TB compared to other treatments. All four multivariable models showed that the use of TNFα blockers alone or in combination with azathioprine was an important risk factor for the incidence of active TB. After adjustment for sex, age, type of IBD and latent TB, anti-TNFα with azathioprine increased the relative risk to 17.8 times more than conventional treatment. Late TB, which was diagnosed 3 mo after the start of anti-TNFα, was the most frequent.CONCLUSIONTreatment with anti-TNFα increased the risk of active TB in IBD patients from an endemic area in Latin America. This risk was increased when anti-TNFα was combined with azathioprine. The time from the beginning of the treatment to the active TB diagnosis suggests a new TB infection.     

血液透析中相对血容量与血压的相关性

目的 观察血液透析低血压倾向患者血液透析时相对血容量的改变,并与血压进行相关性分析,以研究相对血容量对预测低血压发生的价值.方法 挑选维持性血液透析者61例（透析龄≥1个月）,持续在线监测相对血容量,每30分钟测定血液和心率.记录140次血液透析过程中低血压的发生次数及相对血容量的数值.采用线性相关分析进行数据统计.结果 相对血容量与收缩压之间无相关性（相关系数r为0.17）.发生低血压时,患者相对血容量变化差异显著.在21例患者中,49例次相对血容量与收缩压呈线形相关.结论 在透析过程中,患者所能耐受的血容量下降程度存在明显的个体差异,但个体内变异不大,患者临床表现结合血容量监测有助于防治透析过程中低血压的发生以及确定合适的超滤量、调整干体质量.     

Incidence of central giant cell granuloma of the jaws with clinical and histological confirmation: an archival study in Northern India

To record the demographics, and correlate histological findings in central giant cell granulomas (CGCGs) of the jaws with their clinical behaviour, 30 paraffin-embedded samples of CGCG were retrieved from the archives of the Department of Oral Pathology and Microbiology, Subharti Dental College, Meerut, India. The diagnosis in each case was made on the basis of clinical, radiographic, and histological findings. Data about age, sex, anatomical site, presentation, radiological features, and laboratory investigations were analysed. Histomorphometric analyses were made in each case with respect to the number of giant cells, mean number of nuclei and giant cells, fractional surface area occupied by giant cells, index of relative size, and mitotic activity. The peak incidence of CGCG was during the second decade of life with a slight female predilection, and the mandible was the most common site. Of the 30 samples considered, 20 tumours were classified clinically as non-aggressive, and 10 as aggressive, based on their clinical behaviour. Histomorphometric analysis showed significant changes between the two groups with respect to the number of giant cells, the fractional surface area, and the mitotic activity. The data obtained showed clinical and histomorphometric features that may be reliable indicators for the differentiation between aggressive and non-aggressive CGCG. These data should be taken into consideration to improve planning of individual treatment and follow-up.     

肝动脉化疗栓塞后碘油沉积对碳离子放疗剂量的影响

目的 研究肝动脉化疗栓塞治疗后肝脏肿瘤内碘油沉积对碳离子放疗剂量的影响。方法 对比纯碘油、纯凝胶和碘油凝胶混合物实际相对水阻止本领（RLSP）和其CT图像转化获得的RLSP。在7例典型有碘油沉积病例的CT图像上制定碳离子放疗计划,然后基于前述分析结果,将碘油沉积区域RLSP修正为正常肝组织,将先前制定碳离子放疗计划在修正后CT图像上重新计算,比较在不同CT图像上等效水深度和剂量分布的差异。结果 依据CT图像HU值,碘油和碘油凝胶混合物转化的RLSP比实际测量值增加4.6%~139.0%。7例临床病例中,原始图像上碘油沉积可致射野路径上的等效水深度平均增加（0.89±0.41）cm,可使靶区远端1 cm区域内平均剂量升高（3.83±1.71）Gy （相对生物剂量）。结论 在肝动脉化疗栓塞治疗后有碘油沉积的CT图像上制定碳离子治疗计划时需将碘油沉积部位的HU值或RLSP修正为正常肝组织。     

盐酸西替利嗪巴布膏剂的药动学和生物利用度研究

目的研究盐酸西替利嗪巴布膏剂在大鼠体内的药代动力学特征,并与口服给药的药动学进行比较,考察生物利用度。方法选用SD大鼠,分为巴布膏剂组和口服给药组,采用高效液相色谱法测定血药浓度;并剥取剩余的西替利嗪巴布膏剂,测定剩余药量。结果西替利嗪巴布膏剂组的T_(max)为2.35 h,C_(max)为2.68μg/mL,AUC为21.01μg·h/mL,MRT为23.26 h;西替利嗪口服组的T_(max)为1.11 h,C_(max)为11.65μg/mL,AUC为35.62μg·h/mL,MRT为12.13 h。扣除巴布膏剂中的剩余药量,按照实际进入皮肤的剂量计算得西替利嗪巴布膏剂相当于片剂的生物利用度为30.81%;不扣除巴布膏剂中的剩余药量,西替利嗪巴布膏剂相当于片剂的生物利用度为14.75%。结论西替利嗪巴布膏剂的血药浓度平稳而持久,具有缓释的特征。     

卵巢子宫内膜异位症复发的相关因素分析

目的探讨卵巢子宫内膜异位症复发的相关影响因素。方法选择我院2012年1月至2014年1月收治的卵巢子宫内膜异位症患者271例,根据随访期间是否复发分为复发组和未复发组,采用Cox单因素回归模型比较复发组与未复发组临床资料,进行多变量Cox风险回归分析。结果随访入组者共229例,采用Cox单因素回归模型分析,复发组较未复发组术时年龄小[(30.2±6.1)vs.(34.5±7.2)岁]、最大卵巢囊肿直径大[(6.8±2.4)vs.(5.5±2.7)cm]、rAFS评分高[(48.6±26.4)vs.(41.1±23.8)分]、术后受孕率低(12.1%vs.35.7%),差异均有统计学意义(P0.05);复发组与未复发组在初潮年龄、体重指数、痛经、不孕、人流次数、疾病患侧、是否伴有粘连、道格拉斯腔封闭、合并腺肌症、合并子宫肌瘤、腹部手术史、手术途径、术后药物治疗等方面,差异无统计学意义(P0.05);多变量Cox风险回归分析结果显示,术时年龄、rAFS评分、手术方式及术后受孕影响卵巢子宫内膜异位症术后复发,其中术时年龄大、半根治性手术及术后受孕是卵巢子宫内膜异位症术后复发的保护性因素,rAFS评分则是其复发的危险因素。结论患者术时年龄、rAFS评分、手术方式及术后受孕与卵巢子宫内膜异位症的复发相关。术时年龄大、rAFS评分低、半根治性手术及术后受孕的卵巢子宫内膜异位症患者,术后复发风险相对较低。     

Mechanical activation of Efavirenz: the effects on the dissolution and inhibitory behavior

Abstract

A poorly water-soluble drug (Efavirenz) was mechanically activated by ball-milling. The effect of the mechanical activation on the dissolution behavior and bioavailability was investigated revealing possible correlations with the grinding action, in terms of crystallinity, particle size and morphology.With proper selection of the grinding parameters the dissolution kinetics can be controlled, both in terms of dissolution velocity and as amount of dissolved drug. In vitro biological tests show that milling does not impair the ability of Efavirenz to inhibit HIV-1 infection (p value?>0.05); the IC50 values of ground Efavirenz is indeed lower than values for the pristine micronized powder.