To investigate the effects of carbamazepine (CBZ) on the plasma concentrations of valproic acid (VPA) and its toxic metabolite 2-propyl-4-pentenoic acid (4-ene VPA) in epileptic patients, the plasma concentrations of VPA and 4-ene VPA were determined, and the effect of CBZ on pharmacokinetics of VPA was evaluated. All patients had been divided into two groups (VPA group, n = 87; and VPA+CBZ group, n = 19). As compared to VPA group, the combination of CBZ significantly (P < 0.01) decreased the trough concentration of VPA [VPA group, (69.5 +/- 28.8) microg x mL(-1); VPA+CBZ group, (46.3 +/- 25.6) microg x mL(-1)] and does-adjusted VPA trough concentration [VPA group, (4.89 +/- 2.21) microg x mL(-1) x mg(-1) x kg(-1); VPA+CBZ group, (3.14 +/- 1.74) microg x mL(-1) x mg(-1) x kg(-1)]. However, the addition of CBZ did not influence the concentration of 4-ene VPA. The present study revealed that coadministration of CBZ can reduce VPA plasma concentration and may impact VPA clinical effect, therefore therapeutic drug mornitoring of VPA should be used when combined use of CBZ and VPA.
Adolescent ; Adult ; Anticonvulsants ; blood ; pharmacokinetics ; therapeutic use ; Carbamazepine ; blood ; pharmacokinetics ; therapeutic use ; Drug Interactions ; Drug Therapy, Combination ; Epilepsy ; blood ; drug therapy ; Fatty Acids, Monounsaturated ; blood ; Female ; Humans ; Male ; Valproic Acid ; blood ; pharmacokinetics ; therapeutic use ; Young Adult

OBJECTIVETo investigate the cyclic fatigue modes of Vita mark II machinable ceramics under Hertzian's contact.

METHODSHertzian's contact technique (WC spheres r = 3.18 mm) was used to investigate the cyclic fatigue of Vita mark II machinable ceramic. All specimens were fatigued by cyclic loading in moist environment, furthermore, surviving strength was examined by three point test and morphology damage observation.

RESULTSIn homogeneous Vita mark II machinable ceramics, two fatigue damage modes existed after cyclic loading with spheres under moist environment, including conventional tensile-driven cone cracking (brittle mode) and shear-driven microdamage accumulation (quasi-plastic mode). The latter generated radial cracks and deeply penetrating secondary cone crack. Initial strength degradation were caused by the cone cracks, subsequent and much more deleterious loss was caused by radial cracks.

CONCLUSIONCyclic fatigue modes of Vita mark II machinable ceramics includes brittle and quasi-plastic mode.

Ceramics ; Dental Porcelain ; Humans ; Materials Testing ; Surface Properties

OBJECTIVETo compare the difference in strength degradation and morphology damage of brittle dental ceramic after static load and cyclic fatigue.

METHODSHertzian's contact technique with a tungsten carbide sphere was used to investigate the response of feldspathic dental porcelain to static load and cyclic fatigue. All specimens were subjected to static or cyclic loading in moist environment. Furthermore the surviving strength of specimens was examined by the three-point test and the morphology damage was observed. Statistical analyses were performed with ANOVA and a P-value less than 0.05 was considered to be significant.

RESULTSOuter cone crack and associated strength degradation simultaneously occurred both after the first cyclic loading and static loading. Up to 1,000 cycles, the specimens showed inner cone cracks and strength degradation was aggravated. No significant difference in the strength degradation among all static loading specimens and no inner cone cracks occurred in static loading specimens.

CONCLUSIONSBoth static and cyclic fatigue influence dental ceramic strength, but cyclic fatigue is more deleterious.

Compressive Strength ; Dental Porcelain ; Materials Testing

Objective To analyze clinical data of 6 cases of idiopathic hypertrophic pachymeningitis and review related literatures before, so as to offer a guidance for its clinical diagnosis and therapy. Methods We analyzed the clinical and imaging features and data of follow_up in the patients who were treated in our hospital 2005-2006. Results Idiopathic hypertrophic pachymeningitis was always accompanied by immune fimction abnormality to different degrees. The main clinical manifestation was headache which was found in every case. In these cases, headache was the onset and recur symptom. In addition to headache, various symptoms of nervous system dysfunction especially the cranial nerves could be found in some cases. In these cases, a localized or diffuse thickening of tentorium of cerebellum and/or falciform process of cerebrum was found in MRI, and intensification was presented in enhancement scanning. Corticosteroid was effective to all of the cases. Conclusions Idiopathic hypertrophic pachymeningitis may be an autoimmune disorder, of which the symptoms are various, and need to be discriminated from other diseases. MR/of cranium is important criteria for diagnosis.

OBJECTIVETo investigate whether three biallelic polymorphisms at the position -592, -819 and -1082 in the promoter region of the IL-10 gene were associated with the incidence of autoimmune liver disease.

METHODSThe IL-10 -592 and IL-10-1082 polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphisms analysis (PCR-RFLP), while polymerase chain reaction- sequence specific primer (PCR-SSP) assay was used to detect IL-10 -819 polymorphisms.

RESULTSAmong 54 Chinese patients with AIH or 77 Chinese patients with PBC versus healthy controls, the frequency of AA, GA genotypes at IL-10 gene promoter -1082 position was 87.0% or 83.1% versus 90.0%, 13.0% or 16.9% versus 10.0%, respectively (P > 0.05), the GG genotype in Chinese populations is absent; the frequency of CC, CT, TT genotypes at IL-10 gene promoter -819 position was 11.11% or 9.1% versus 8.1%, 44.4% or 53.3% versus 45.0%, 44.4% or 37.7% versus 46.9%, respectively (P > 0.05); the frequency of CC, CA, AA genotypes at IL-10 gene promoter -592 position was 4.9% or 14.3% versus 10.0%, 51.2% or 53.3% versus 51.9%, 43.9% or 32.5% versus 38.1%, respectively (P > 0.05). No alleles differed significantly in each groups.

CONCLUSIONThere were no association between IL-10 gene polymorphisms and autoimmune liver disease

Adult ; Aged ; Female ; Hepatitis, Autoimmune ; genetics ; immunology ; Humans ; Interleukin-10 ; genetics ; Liver Cirrhosis, Biliary ; genetics ; Male ; Middle Aged ; Polymerase Chain Reaction ; methods ; Polymorphism, Restriction Fragment Length ; Promoter Regions, Genetic ; genetics

OBJECTIVETo determine the relationship between polymorphisms in the genes encoding IL-1, IL-6, and IL-10 with primary biliary cirrhosis (PBC) in Chinese population.

METHODSWhole-blood samples were taken from 77 patients with PBC and 160 healthy controls. DNA was extracted and the polymorphisms at positions IL-1 +3953, IL-1RN intron 2, IL-6 -174, and IL-10 -1082, -819, and -592 were determined by using sequence-specific polymerase chain reaction (SSP) or polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).

RESULTSThe frequency of IL-1RN1,1 allele in PBC group was significantly higher than in control group (90.9% vs 79.4%, P=0.026), and the frequency of IL-1RN1,2 in PBC group was significantly lower than in control group (6.5% vs 18.8%, P=0.013). There was no significant difference in the frequence of IL-1RN*2 allele between PBC group and control group (P=0.06). Of the 77 patients with PBC, 4 patients were IL-6 -174GC, 73 were IL-6 174GG. All the 160 health controls are IL-6 -174GG (P=0.0036). The frequence of IL-6 -174C allele in PBC group was significantly higher than that in control group (P=0.0038). No significant differences of polymorphisms for IL-1 +3953 and IL-10 (-1082, -819 and -592) were found between PBC group and control group.

CONCLUSIONThe polymorphisms of IL-1RN and IL-6 -174G/C appear to be associated with PBC, and the polymorphisms of IL-1 +3953 and IL-10 promoter gene are not associated with PBC in a Chinese population.

Adult ; Aged ; Female ; Humans ; Interleukin-1 ; genetics ; Interleukin-10 ; genetics ; Interleukin-6 ; genetics ; Liver Cirrhosis, Biliary ; genetics ; Male ; Middle Aged ; Polymerase Chain Reaction ; methods ; Polymorphism, Restriction Fragment Length

OBJECTIVETo evaluate the effects of combined fixation with splints and plaster after closed reduction for the treatment of distal fractures of radius in elderly patients

METHODSFrom January 2009 to January 2011, 122 patients with distal fractures of radius were treated by the united fixation with splints and plaster after closed reduction. There were 43 males and 79 females, ranging in age from 60 to 86 years with an average of 74 years. Among the patients, traffic accident injury was in 12 cases and fall injury was in 109 cases; all fractures were closed, the time form injury to visit was for 30 min to 7 days. The X-rays, wrist pain, functional status, range of motion and grasp force of patients were observed at follow-up. Cooney modified Green-O'Brien standard was used to evaluate the clinical effects.

RESULTSAll the patients were followed up from 3 months to 2 years with an average of 15.4 months. Re-displacement occurred in 8 cases (including 4 cases radial displacement, 3 cases dorsal displacement, 1 case palmaris displacement) and re-reduction occurred in 4 cases, surgical treatment was in 2 cases, refused to reset or surgical treatment in 2 cases. Radial shorten in 13 cases middle-later period. All fractures obtained healed. According to the Green-O'Brien standard, 46 cases got excellent results, 65 good, 6 fair, and 5 poor.

CONCLUSIONThe combined fixation with splints and plaster after closed reduction is a effective method in treatment of distal fractures of radius in elderly patients, which can more overcome redisplacement of distal fractures of radius, recover function of wrist joint.

Aged ; Aged, 80 and over ; Casts, Surgical ; Female ; Humans ; Male ; Manipulation, Orthopedic ; Middle Aged ; Radius Fractures ; therapy ; Splints

Objective: To investigate the characteristics of non-alcoholic fatty liver disease (NAFLD) and its associated factors in rheumatoid arthritis (RA) patients. Methods: This cross-sectional study recruited 385 RA patients [including 72 (18.7%) male and 313 (81.3%) female] who received abdominal sonographic examination from August 2015 to May 2021 at Department of Rheumatology, Sun Yat-Sen Memorial Hospital. There were 28 RA patients at 16-29 years old and 32, 80, 121, 99, 25 at 30-39, 40-49, 50-59, 60-69, ≥ 70 years old, respectively. Demographic and clinical data were collected including age, gender, history of alcohol consumption, disease duration, body mass index (BMI), waist circumference, blood pressure, RA disease activity indicators and previous medications. Logistic regression analyses were used to identify the associated factors of NAFLD in RA patients. Results: The prevalence of NAFLD was 24.2% (93/385) in RA patients, 26.3% (21/80) in 40-49 age group and 33.1% (40/121) in 50-59 age group. There were 22.1% (85/385) and 3.6% (14/385) RA patients with overweight and obese, in which the prevalence of NAFLD was 45.9% (39/85) and 78.6% (11/14) respectively, which was 2.6 folds and 4.5 folds that of RA patients with normal BMI. Although there was no significant difference of age, gender and RA disease activity indicators between RA patients with or without NAFLD, those with NAFLD had higher proportions of metabolic diseases including obese (11.8% vs. 1.0%), central obesity (47.3% vs. 16.8%), hypertension (45.2% vs. 29.8%) and type 2 diabetes mellitus (24.7% vs. 12.0%), consistent with higher levels of total cholesterol [(5.33±1.31) mmol/L vs. (4.73±1.12) mmol/L], triglyceride [(1.51±1.08) mmol/L vs. (0.98±0.54) mmol/L] and low-density lipoprotein cholesterol [(3.37±0.97) mmol/L vs. (2.97±0.78) mmol/L, all P<0.05]. Multivariate logistic regression analysis showed that BMI (OR=1.314) and triglyceride (OR=1.809) were the independent factors positively associated with NAFLD in RA patients. Conclusion: NAFLD is a common comorbidity in RA patients, especially in those with middle-aged, overweight or obese, which is associated with high BMI or high triglyceride. Screening and management of NAFLD in RA patients especially those with overweight, obese or dyslipidemia should be emphasized.
Adolescent ; Adult ; Aged ; Arthritis, Rheumatoid/epidemiology* ; Cholesterol, LDL ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/epidemiology* ; Obesity/epidemiology* ; Overweight/epidemiology* ; Triglycerides ; Young Adult

Biliary Tract Diseases ; Humans ; Liver Diseases ; Liver Transplantation/adverse effects* ; Postoperative Complications/etiology* ; Retrospective Studies