Pre-patellar bursitis as a first presentation of gout

We describe the case of a patient who presented with an acute pre-patellar bursitis, which did not improve with antibiotics. Aspiration of the bursa when it became fluctuant revealed urate crystals. Diagnosis was a rare first manifestation of gout, the occurrence of which had not been reported previously in orthopaedic literature. We highlight the importance of aspiration in the management of bursitis and its importance when gout is suspected, especially in one in whom non-steroidal anti-inflammatory drugs (NSAIDs) has recently been stopped. It is important to appreciate that the presence of crystals does not exclude the presence of infection. Bursitis can be caused by gouty crystals, but an infective cause of bursitis can result in secondary gout. Uric acid levels are not useful for the management of the first presentation of gout. We propose a simple algorithm for the management of acute bursitis.No grants were received in the production of this report     

Bioactivity of compounds isolated from the leaves of the Lantana camara Linn plant

Two compounds with different bioactivitieswere isolated from the leaves of the Lantana camara Linn plant. Compound 1wastriterpenoid (Lantadene B)(22β-dimethylacroyloxy-3-oxoolean-12-en-28-oic-acid, C₃₅H₅₂O₅), which was isolatedfrom n-hexane fraction and obtained as white solid (amorphous). Compound 2was glycosideflavonoid (5-hydroxy-6,4′-dimethoxyflavon-7-O-glucopyranose, C₂₃H₂₄O₁₁), which was isolated from ethyl acetate and obtained as pale yellow solid (amorphous). Extraction was performed withmaceration method using methanol solvent. Subsequently, fractionation was carried out using n-hexane and ethyl acetate solvents. Isolation and purification of both fractions were conductedusing chromatography method. The structure of the isolated compounds was determined throughspectralanalyses of ultraviolet (UV), infrared (IR), and nuclear magnetic resonance (¹H NMR and ¹³C NMR), distortionless enhancement by polarization transfer (DEPT), heteronuclear multiple bond connectivity (HMBC), heteronuclear single quantum correlation (HSQC), and H-H COSY (¹H-¹H homonuclear correlatedspectroscopy). The cytotoxic activity of compound 1 was tested against MCF-7 breast cancer cellsin vitro using MTT assay (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide), showing very strong cytotoxic activity in inhibiting the growth of MCF-7 breast cancer cells, and the IC₅₀ value was 1.1336 µM. The antioxidant activity of compound 2 was tested using DPPH assay (1,1-diphenyl-2-picrylhydrazyl), showing strong activity in inhibiting free radicals, and its IC₅₀ value was 71.03 mg/L.     

Risk management in clinical practice. Part 8. Temporomandibular disorders

Temporomandibular disorders can arise apparently idiopathically, as a result of macro-trauma or micro-trauma such as parafunction, as a result of a separate disease process or as a consequence of dental treatment. The objectives of this chapter are to make the practitioner aware of his/her responsibilities in any of these situations. Precise record keeping and careful risk management are essential. Guidelines are given to protect not only the practitioner but also the patient.     

中药桔丙酯联合降糖治疗对2型糖尿病患者甲襞微循环及血液流变学的影响

目的观察中药桔丙酯注射液联合降糖治疗对2型糖尿病甲襞微循环及血液流变学的影响,探讨其治疗机制.方法于2005-10/2006-08选择河北北方学院附属校医院、张家口市第一人民医院门诊及住院收治的2型糖尿病患者48例,为治疗组.应用注射用桔丙酯治疗,桔丙酯180 mg,次,1次,d,连用2周;健康志愿者30例为对照组.采用微循环显微镜,于治疗前后常规检查左手第4指甲襞第一排管袢,按田牛加权积分法对16项指标综合定量分析,判断疗效和甲襞微循环的变化.同时观察2型糖尿病患者治疗前后血液流变学各项指标的变化.结果①治疗组治疗前甲襞微循环及血液流变学各项指标均表现为不同程度的异常,治疗后甲襞微循环及血液流变学各项指标明显改善.甲襞微循环由治疗前的中、重度异常恢复到大致正常,治疗后总积分值低于治疗前(分别为1.52±0.69,4.52±0.82,t=3.96,P＜0.05).②血液流变学指标变化表明,血浆黏度、全血黏度、纤维蛋白原及红细胞电泳等各指标经桔丙酯治疗后均明显降低(P＜0 05).结论中药桔丙酯联合降糖治疗能够明显改善2型糖尿病患者血流变异常及微循环障碍.     

Quantitative Computed Tomography: What Clinical Questions Can it Answer in Chronic Lung Disease?

Quantitative computed tomography (QCT) has recently gained an important role in the functional assessment of chronic lung disease. Its capacity in diagnostic, staging, and prognostic evaluation in this setting is similar to that of traditional pulmonary function testing. Furthermore, it can demonstrate lung injury before the alteration of pulmonary function test parameters, and it enables the classification of disease phenotypes, contributing to the customization of therapy and performance of comparative studies without the intra- and inter-observer variation that occurs with qualitative analysis. In this review, we address technical issues with QCT analysis and demonstrate the ability of this modality to answer clinical questions encountered in daily practice in the management of patients with chronic lung disease.

     

人成釉蛋白C端肽的大量表达及纯化

目的:获得高纯度的重组人成釉蛋白C端肽。方法:实验于2001-01/2004-06在解放军第四军医大学口腔内科实验室解放军第四军医大学基础部生物化学与分子生物学实验室完成。①转化pRSET-A/成釉蛋白原核表达质粒入BL21(DE3)细菌进行大量培养,加入诱导剂IPTG至终浓度为0.1mmol/L,32℃继续振荡诱导培养5h,收集细菌,诱导菌体的裂解上清经金属螯合亲和层析,洗脱Ni-NTA结合蛋白,收集洗脱蛋白,聚丙烯酰胺凝胶电泳法鉴定。②离子交换层析缓冲液(pH 7.4,50 mmol/L Tris·Cl)平衡Q SapharoseHP层析柱,将初步纯化的蛋白样品加在Q Sapharose HP凝胶介质上,梯度洗脱结合的蛋白,收集洗脱峰,制样,聚丙烯酰胺凝胶电泳法鉴定洗脱蛋白。结果:①表达重组人成釉蛋白C端肽的金属螯合亲和层析结果:诱导菌体的裂解上清经金属螯合亲和层析,洗脱下Ni-NTA结合蛋白,经聚丙烯酰胺凝胶电泳法电泳证实获得初步纯化的重组人成釉蛋白C端肽,其中仍含一些杂蛋白。②重组人成釉蛋白C端肽的离子交换层析结果:获得多个蛋白洗脱峰,聚丙烯酰胺凝胶电泳法证实获得纯化的重组人成釉蛋白C端肽。结论:获得了纯化的人成釉蛋白重组蛋白。     

Modified proteinase-activated receptor-1 and -2 derived peptides inhibit proteinase-activated receptor-2 activation by trypsin.

Trypsin activates proteinase-activated receptor-2 (PAR(2)) by a mechanism that involves the release of a tethered receptor-activating sequence. We have identified two peptides, FSLLRY-NH(2) (FSY-NH(2)) and LSIGRL-NH(2) (LS-NH(2)) that block the ability of trypsin to activate PAR(2) either in PAR(2)-expressing Kirsten virus-transformed kidney (KNRK) cell lines or in a rat aorta ring preparation. The reverse PAR(2) peptide, LRGILS-NH(2) (LRG-NH(2)) did not do so and FSY-NH(2) failed to block thrombin activation of PAR(1) in the aorta ring or in PAR(1)-expressing human embryonic kidney cells. Half-maximal inhibition (IC(50)) by FSY-NH(2) and LS-NH(2) of the activation of PAR(2) by trypsin in a PAR(2) KNRK calcium-signaling assay was observed at about 50 and 200 microM, respectively. In contrast, the activation of PAR(2) by the PAR(2)-activating peptide, SLIGRL-NH(2) (SL-NH(2)) was not inhibited by FSY-NH(2), LS-NH(2), or LRG-NH(2). In a casein proteolysis assay, neither FSY-NH(2) nor LS-NH(2) inhibited the proteolytic action of trypsin on its substrate. In addition, FSY-NH(2) and LS-NH(2) were unable to prevent trypsin from hydrolyzing a 20-amino acid peptide, GPNSKGR/SLIGRLDTPYGGC representing the trypsin cleavage/activation site of rat PAR(2). Similarly, FSY-NH(2) and LS-NH(2) failed to block the ability of trypsin to release the PAR(2) N-terminal epitope that is cleaved from the receptor upon proteolytic activation of receptor-expressing KNRK cells. We conclude that the peptides FSY-NH(2) and LS-NH(2) block the ability of trypsin to activate PAR(2) by a mechanism that does not involve a simple inhibition of trypsin proteolytic activity, but possibly by interacting with a tethered ligand receptor-docking site.     

湖北省35~75岁人群高血压流行状况及影响因素分析

目的 了解湖北省35~75岁人群高血压患病、知晓、治疗、控制情况及其影响因素。方法 在6个湖北省心血管病高危人群早期筛查与综合干预项目（简称“高危筛查项目”）点,整群抽样法抽取了35~75岁常住人口共计95371人,采用多水平混合模型分析高血压患病、知晓、治疗和控制情况及其影响因素。结果 50.30%的筛查对象患有高血压,标化后患病率为39.13%,男性患病率（53.60%）高于女性（48.38%）,差异有统计学意义（t=-8.966,P <0.001）。知晓率、治疗率、控制率分别为48.51%、41.83%和10.68%。高血压患者中,年龄较大、受教育程度高、饮酒、罹患糖尿病、肥胖、既往发生过心血管事件的患者具有较高的高血压知晓率、治疗率和控制率(P<0.05)。在接受治疗的高血压人群里,90.49%服用1种降压药物（男:88.94%,女:91.49%）。最常用的降压药物为钙通道阻滞剂（61.09%）。结论 湖北省35~75岁成人患病率高,但知晓率、治疗率和控制率都偏低,且单药使用比例高,应采取有效的干预策略和措施,加强高血压防控。     

气态污染物与上海市浦东新区居民心脑血管疾病死亡相关性的病例交叉研究

目的评估气态污染物与浦东新区居民每日心脑血管疾病死亡的关联性,为制定相应的干预措施提供依据。方法收集浦东新区2005年1月1日-2017年12年31日的气象因素、大气污染及居民心脑血管疾病死亡资料,采用时间分层-病例交叉研究的方法,评估气态污染物对浦东新区居民心脑血管疾病死亡的影响。结果研究期间,上海市SO₂与NO₂的平均浓度分别为31.96μg/m³和45.21μg/m³。SO₂与NO₂与浦东新区居民心脑血管疾病死亡存在相关性。SO₂与NO₂的效应分别在滞后3 d(lag3)与当日(lag0)强度最大,SO₂浓度每上升10μg/m³,在滞后3d(lag3)时居民每日心脑血管疾病死亡将上升1.12%(95%CI:0.69%～1.56%);NO₂浓度每上升10μg/m³,在当日居民每日心脑血管疾病死亡将上升0.85%(95%CI...