ABSTRACT
As society advances and living standards improve, there is a growing emphasis on the impact of mental health on illness and the interaction between them. Diabetes mellitus is one of the most common underlying diseases, and it is often accompanied by depression and anxiety. There are also many complications of diabetes, such as diabetic retinopathy(DR). DR is the leading cause of vision loss in diabetes. Vision loss inevitably increases anxiety and/or depression, which in turn may directly or indirectly affect the treatment or progression of patients with DR. This article reviews how to determine the anxiety and depression status of patients with DR, related assessment tools and methods, and their interaction with the treatment of DR. The interaction of anxiety-depressive states with DR treatment was also discussed. This review aims to raise awareness of the mental health of patients with DR, enhance doctor-patient communication and build doctor-patient trust, thus enhancing treatment adherence and clinical efficacy for individuals with DR and helping them to improve the quality of life.
ABSTRACT
BACKGROUND: The treatment principle, long-term therapeutic effects, and complications of percutaneous kyphoplasty are closely related to blomechanlcs. Its blomechanlcs have attracted wide attention. OBJECTIVE: To establish a virtual digital evaluation system for biomechanical changes and bone cement leakage after percutaneous kyphoplasty and bone cement injection. METHODS: Percutaneous kyphoplasty with bone cement injection was performed based on previously established three-dimensional model of L3-L5. The model was processed using the software Abaqus2016 for finite element analysis. The effects of bone cement injection model, injection pressure, and injection volume on the stress of fractured L4 vertebral endplate were analyzed. RESULTS AND CONCLUSION: (1) After simulated percutaneous kyphoplasty with bone cement injection, the stress of L4 fractured vertebral endplate decreased significantly under the partial pressure of cement. Different injection methods had no significant effect on the stress of fractured L4 vertebral endplate (P > 0.05), but bilateral injection made the distribution of bone cement more uniform and produced the best effect. (2) Different injection pressures had no significant effect on the stress of fractured L4 vertebral endplate (P > 0.05), but with the increase of injection pressure, the distribution of bone cement was more dispersed and leakage was more likely to occur. (3) With increase in bone cement injection dose, the stress of fractured L4 vertebral endplate gradually decreased (P < 0.05). The physiological stiffness of the vertebral body could not be restored when 2 mL of bone cement was injected. The distribution of bone cement was more concentrated when 4 mL of bone cement was injected. The breakdown point was reached when 8 mL of bone cement was injected. (4) After injection of bone cement, the upper endplate of the lower vertebral body was more prone to suffer from fracture than the lower endplate of the upper vertebral body. (5) These results suggest that the stress of L4 vertebral endplate shifted obviously after simulated surgery compared with before surgery, that is, the stress of L4 upper endplate increased and that of L4 lower endplate decreased. Different injection methods had little effect on the surgical results, but the distribution of bone cement injected bilaterally was more uniform, which reduced the incidences of re-fracture and collapse. Lower injection pressure could reduce the risk of cement leakage after surgery. Injection of 4 mL bone cement can restore good stiffness and physiological curvature of the diseased vertebra, without reaching the yield point or causing refracture.
ABSTRACT
Two simple and sensitive high performance liquid chromatography–tandem mass spectrometry (HPLC–MS/MS) methods were developed and validated for the determination of fenticonazole in human plasma after percutaneous and intravaginal administration. Mifepristone was used as an internal standard (IS), and simple protein precipitation by acetonitrile containing 2%acetic acid was utilized for extracting the analytes from the plasma samples. Chromatographic separation was performed on a Kinetex XB-C18 column. The quantitation was performed by a mass spectrometer equipped with an electrospray ionization source in multiple reactions monitoring (MRM) positive ion mode using precursor-to-product ion transitions of m/z 455.2–199.1 for fenticonazole and m/z 430.2–372.3 for mifepristone. The validated linear ranges of fenticonazole were 5–1000 pg/mL and 0.1–20 ng/mL in plasma for the methods A and B, respectively. For the two methods, the accuracy data ranged from 85% to 115%, the intra- and inter-batch precision data were less than 15%, the recovery data were more than 90%, and no matrix interference was observed. The methods A and B were successfully validated and applied to the pharmacokinetic studies of fenticonazole gel in Chinese healthy volunteers after percutaneous and intravaginal administration, respectively.