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China produces about 15 000 tons of expired drugs every year. Standardized destruction of expired drugs consumes a large number of secondary costs， causing huge economic losses. Improper handling will also lead to serious environmental pollution， endanger national health and even endanger public safety. This paper analyzes the hazards， sources and disposal methods， and research status of expired drugs， introduces the Shelf-Life Extension Program of United States， and put forward feasible measures for the recovery， integration and reuse of expired drugs. It is suggested to construct a scientific and reasonable recovery and disposal system of expired drugs in combination with the actual situation in China， explore the strategy of extending the expiration of drugs， and greatly reduce the waste of drug resources.
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Objective:To observe the effects of "pushing patella and extending knee" manipulation on the protein and mRNA expression levels of integrin β1 (ITGβ1) and phosphorylated adhesion plaque kinase (p-FAK) in rabbit knee osteoarthritis (KOA) model, and to investigate the mechanism of manipulations in the treatment of KOA.Methods:Twenty healthy 6-month-old New Zealand rabbits were divided into the normal group, the model group, the acupuncture group, and the manipulation group according to the random number table method. Among them, the model group, the acupuncture group, and the manipulation group were modeled using the modified Hulth method for KOA. After 7 d of successful modeling, the normal group and the model group did not receive any intervention, while the acupuncture group and the manipulation group received one acupuncture intervention and one "pushing patella and extending knee" manipulation intervention daily, respectively. After 2 weeks of treatment, the rabbit KOA model was executed by air embolization, and the protein and mRNA expression levels of ITGβ1 and p-FAK in knee cartilage were measured by Western blot and real-time polymerase chain reaction (PCR), respectively.Results:Compared with the normal group, the ITGβ1 protein expression level was decreased ( P<0.05) and p-FAK protein expression level was increased ( P<0.05), and the mRNA expression levels of ITGβ1 and p-FAK did not change significantly (all P>0.05) in the model group. Compared with the model group, the ITGβ1 protein expression level was increased ( P<0.05), the p-FAK protein expression level decreased ( P<0.05), and the mRNA expression levels of both ITGβ1 and p-FAK increased (all P<0.05) in the acupuncture group. Compared with the acupuncture group, ITGβ1 protein expression level increased ( P<0.05), p-FAK protein expression level decreased ( P<0.05), and mRNA expression levels of both ITGβ1 and p-FAK increased (all P<0.01) in the manipulation group. Conclusions:The "pushing patella and extending knee" manipulation can optimize the protein and mRNA expression levels of ITGβ1 and p-FAK in the articular cartilage of the rabbit KOA model.
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BACKGROUND:Radial head re-dislocation is one of the alarming complications of old Monteggia fracture. Many treatment methods have described the necessary of fracture and annual ligament reconstruction during treatment, but stil unclear. OBJECTIVE:To emphasize the practicality of annular ligament reconstruction through comparing the children’s treatment in two groups. METHODS:Twelve patients with children’s old Monteggia fracture were included for retrospective analysis. Al the patients were treated with radial head open reduction and internal fixation. Among them, five cases received ulna extending osteotomy and annual ligament reconstruction, and seven cases received ulna extending osteotomy without annual ligament reconstruction. The course was 3-18 months from damage to the clinical manifestations (an average of 9 months). Ten cases with Bado type Ⅰ and two cases were Bado type Ⅱ andⅢ. The reliability of ligament reconstruction was evaluated before and after treatment with Kim standard. RESULTS AND CONCLUSION:Al the 12 cases were fol owed-up for 22 months (8-26 months). Evaluation according to the Kim standard after treatment showed excel ent in 10 cases without abnormalities and pain, the range of motion>250 °, and no elbow was limited, the activities of daily living was 25 points;good in two cases with mild deformity and mild or intermittent pain, the range of motion was 200°-250° with elbow limited, activities of daily living was 15 points;no poor (serious deformity, pain, range of motionosteotomy was 8 weeks (6-14 weeks). The wounds were healed primarily without infection and nonunion. The results indicate that ulna extending osteotomy has great significance in keeping stability of radial head, and annular ligament reconstruction is determined by the time of injury, surgical procedures and intraoperative radial head stability.
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A 60-year old Muslim man was admitted to the Dhaka Hospital of ICDDR,B with an exacerbation of his chronic obstructive pulmonary disease. Incidental hyperpigmented skin lesions were noticed overlying the dorsum of his ankles, knees, and elbows. Such asymptomatic areas of thickened, lichenified and hyperpigmented skin are called ‘prayer marks’ and are well-imprinted on the knees, ankles, and forehead. These are secondary to prolonged periods of pressure over bony prominences during prayer. The patient’s wife stated that the appearance of the elbow marks had coincided with an increase in his breathlessness and subsequent use of his elbows to rise from daily prayers. Prayer marks extending to the elbows could be a sign of worsening chronic disease.
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Bilateral psoas abscesses extending to the gluteal muscle and intrapelvic area are uncommon. We present our experience with computed tomography (CT)-guided percutaneous catheter drainage for the treatment of multiple aggressive abscesses in a diabetic patient. The abscesses completely resolved after the procedures. Psoas abscess should be considered in the differential diagnosis of older diabetic patients with fever, flank or back pain, and flexion contracture of the hip joint. CT scanning is a useful method in diagnosing abscesses, and CT-guided percutaneous catheter drainage is an effective treatment method in selected patients.