This product is a chemical name: 2 2 - dimethyl-5 - (2,5 - dimethylphenyl-oxy) - valerate.
Its structural formula is:
Molecular formula: C15H22O3
Molecular weight: 250.34
Physical and chemical Properties crystallization from hexane, the melting point of 61-63 ° C, the boiling point of 1158 to 159 ° C/2.67Pa.
generated by the 2,5 - dimethyl phenol and bromochloropropane of reaction of 1 - (2,5 - dimethyl phenoxy) -3 - chloropropane . The reaction in toluene, adding a new clean and destroy refluxed for 5h. 2 the same thing by isobutyl sodium and different amine lithium reaction to generate lithium on behalf of the isobutyric acid. (3) 1 - (2,5 - dimethylphenoxy) -3 - chloro-propane and lithium on behalf of the isobutyric acid synthetic phenoxy valerate. These two intermediates in the 10-15 ℃ slowly mixing, stirring 15min. And then heated to 30 ° C, insulation response 5h.
This product clofibrate acid derivative class of lipid regulating drugs, the mechanism of lipid-lowering effect has not yet fully understood, may involve the peripheral lipolysis, reduce the liver uptake and intrahepatic triglyceride reduction in free fatty acid formation, inhibition of very low density lipoprotein apolipoprotein synthesis to reduce the generation of very low density lipoprotein. This product is to lower blood triglycerides increased blood concentration of high density lipoprotein, can slightly lower blood LDL cholesterol blood concentration, hyperlipoproteinemia type Ⅳ may make low-density lipoprotein has been increased. 5-year placebo-controlled studies have shown that this product can reduce the severe sudden coronary death, myocardial infarction.
10 times the human dose of long-term to rats, liver cancer and benign testicular tumor incidence increase.
This product is absorbed from the gastrointestinal tract completely, the peak plasma concentration 1-2 hours after oral administration; T1/2 of 1.5 hours, plasma protein binding rate about 98%. Hypolipidemic effect began to appear 2-5 days after treatment, the peak role appeared at 4 weeks. Metabolized in the liver, about 70 percent of drug excreted by the kidneys, the prototype. 6% from the feces.
indications for hyperlipidemia. Apply to serious type Ⅳ or Ⅴ hyperlipoproteinemia, and coronary heart disease risk of large and diet control, reduce weight and other treatment fails. Also apply in the type Ⅱ b hyperlipoproteinemia, and coronary heart disease risk of large and diet control, weight loss, and other lipid regulating drug therapy. In view of the potential carcinogenic effects on human risk and should be used strictly limited within the specified range of indications, and the effect was not obvious should be promptly discontinued.
Usage and dosage Adult usual dose oral administration: the first 0.3 to 0.6g, 2 times a day 30 minutes before breakfast and dinner take.
adverse reactions 1. The most common adverse events were gastrointestinal discomfort, such as indigestion, anorexia, nausea, vomiting, a sense of fullness, stomach discomfort, other less common adverse reactions include headache, dizziness, fatigue, skin rashes, itching, impotence .
2. Occasional cholelithiasis or myositis (muscle pain, fatigue). This product is to clofibrate acid derivatives, may cause myositis, myopathy and rhabdomyolysis, leading to elevated serum creatine phosphokinase. Rhabdomyolysis, myalgia merge blood creatine phosphokinase increased, myoglobinuria, and can lead to renal failure, but more rare. Suffering from nephrotic syndrome and other kidney damage caused by the patients or in patients with hyperthyroidism, serum albumin to reduce the increased risk of myopathy.
3. Occasionally, liver function tests (blood amino transferase, lactate dehydrogenase, bilirubin, alkaline phosphatase) exception, but return to normal after stopping.
4. Occasional mild anemia and white blood cell count decreased, but the long-term application can be stable, an individual with severe anemia, leukopenia, thrombocytopenia, and bone marrow suppression.
taboo 1. On gemfibrozil who are allergic to disable.
2. The risk of gallbladder disease, cholelithiasis were banned, this product has the potential to gallbladder disorders symptoms became worse. In patients with liver dysfunction or primary biliary cirrhosis disabled, the product can promote cholesterol excretion, so that the former has a higher
cholesterol levels increased.
3. Patients with severe renal insufficiency disabled, may lead to rhabdomyolysis and severe hyperkalemia in renal insufficiency in patients taking Sutent; nephrotic syndrome caused by patients with reduced serum protein disabled because of the increase in the risk of myopathy.
Note 1. This product is in the diagnosis of interference,
hemoglobin, blood cells, hematocrit, white blood cell count is likely to be reduced. Blood creatine phosphokinase, alkaline phosphatase, amino transferase, lactate dehydrogenase may be increased.
2. During the treatment should be regularly checked:
(1) whole blood and platelet count;
② liver function tests;
blood creatine phosphokinase.
3. 3 months after the treatment, such as invalid and shall be discontinued. Cholelithiasis, such as after administration of clinical significant liver function abnormalities, suspicious symptoms of myopathy (muscle pain, tenderness, fatigue, etc.) or blood creatine phosphokinase increased significantly, but also should be discontinued.
4. Blood cholesterol and triglycerides may rebound after the closure of this product more than its original level, it is appropriate to the low-fat diet and to monitor lipids to normal.
5. In the treatment of high blood cholesterol, need attention and treatment of high cholesterol can cause a variety of primary disease, such as hypothyroidism, diabetes, etc.. Certain medications can cause high blood lipids, such as estrogen, thiazide diuretics and β blockers, after stopping, you no longer need anti-high blood cholesterol treatment.
6. The diet has always been the primary method of treatment of high blood cholesterol, coupled with exercise and weight loss, etc., will be superior to any form of drug treatment.
other [pregnant women and lactating women drug]
large doses in animals using the product can cause fetal death, human studies did not report. Whether the product into breast milk is unknown, and therefore pregnant and lactating women should not be using this service.
children's clothing using this research is not sufficient, the application to be weighing the pros and cons.
drugs in elderly patients]
elderly if renal dysfunction should be appropriate to reduce the dosage of the product.
1. The product can significantly enhance the role of oral anticoagulant, and its the same with when the lower dose of oral anticoagulant drugs, frequent monitoring of prothrombin time to adjust the anticoagulant dose. Its mechanism is uncertain, probably because this product can replace out such as warfarin from protein binding sites, making it the enhanced role.
2. This product in combination with other high protein binding rate of drug from the protein combined with locus replaced, leading to the strengthening of its role, such as tolbutamide and other sulfonylurea drugs, phenytoin, furosemide such as taking these drugs, you should adjust the dose of hypoglycemic agents and other drugs in lowering blood pressure during treatment.
3 clofibrate acid derivatives and HMG-CoA reductase inhibitors, such as lovastatin and other combined treatment of hyperlipidemia, will increase both the risk of serious muscle toxicity, can cause muscle pain rhabdomyolysis, blood creatine phosphokinase increased myopathy should avoid joint use.
This product is combined with bile acid resins, such as colestipol in combination, should be at least 2 hours before or 2 hours of taking these drugs after taking gemfibrozil. bile acid-binding drugs can be combined at the same time taking other drugs, thereby affecting the absorption of other drugs.
This product is mainly excreted by the kidney, and immunosuppressants such as cyclosporine in combination, increase the plasma concentrations and renal toxicity of the latter, the risk of leading to deterioration of renal function should be reduced or withdrawal. This product in combination with other nephrotoxic drugs should also pay attention.
There is no reported overdose on this product, such as the occurrence of drug overdose, appropriate supportive therapy should be taken for symptoms of poisoning.
Storage: confined preservation.
Validity: tentative two years.
2010 Chinese pharmacopoeia revised updated content gefitinib Luo qi
the page number: 2005 measure word for sets, works of literature, films, machines -178
[identification] "(1) to remove the goods about 50mg plus ethanol 3ml, dissolved, take the solution to 5 drops of 2% potassium iodide solution and 2 drops of 4% potassium iodate solution, a water bath heat 1 minute, cooling, add 2 drops of starch indicator solution.
that is, blue. The " amended to read " (1) content determination under the chromatogram for the retention time of the test solution peak with the retention time of the reference solution peak.
substances to take this product, dissolved and diluted with the mobile phase made into a solution containing 10mg per 1ml, as the test solution; the precise amount of the check amount, plus the flow diluted in 1ml each containing 0.2mg solution as a control solution. According to the determination of the under chromatographic conditions, taking control solution 10μl into the liquid chromatograph, adjust the sensitivity, so that the principal component peaks, peak height of full scale, 20%. The precise amount of the test solution and control solution 10μl of were injected into the liquid chromatograph, record the chromatograms to the main component peak retention time of two times. chromatogram of the test solution, the single impurity peak area shall not be greater than the control solution peak area of 1/10 (0.2%) of each impurity peak area and shall not be greater than 1/2 of the peak area of the control solution (1.0 %).
[Content determination] "octadecyl silane bonded silica as a filler; methanol - water - acetic acid (75:24:1) as mobile phase; detection wavelength was 276nm. theory plate number Luo Qifeng gefitinib calculation of not less than 1500. " amended to read " with octadecylsilane key together silicone as a filler; methanol - water - acetic acid (75:24:1 ) as the mobile phase; detection wavelength was 276nm. take gefitinib Luo qi standard, and 2,5 - dimethyl phenol were diluted with the mobile phase into solution per 1ml 0.2mg and 0.05mg, take 10μl into the liquid chromatograph. gemfibrozil standard, and 2,5 - xylenol peak separation should meet the requirements, the number of theoretical plates calculated according to Kat non-Luo Qifeng should be no less than 1500. "
[check] residual solvents accurately weighed take cyclohexane amount containing 30μg per 1ml of a solution made with dimethyl sulfoxide as the internal standard solution. Take for a test sample of about 0.2g, accurately weighed, set 20ml vial, the precision by adding internal standard solution 5ml, seal and shake, as the test solution; other precision to take ethyl, n-hexane, tetrahydrofuran, methylcyclohexane, toluene amount produced per 1ml of internal standard solution containing about ethyl 200μg, 11.6μg hexane, tetrahydrofuran 28.8μg methylcyclohexane 47.2μg solution of toluene 35.6μg, precision measure 5ml set 20ml vial, sealed, shaken, as the reference solution; determination according to the residual solvents Determination (Appendix VIII P method), using a capillary column, stationary phase methyl polysiloxane (HP-1 ), column temperature 40 ° C for 7 minutes, heated to 200 ° C 15 ° C the rate per minute for five minutes; hydrogen flame ionization detector (FID); were taken of the vial solution, 80 ℃ balance 30 minutes, the precise amount of headspace gas 1ml injected into the chromatograph internal standard method, the test sample containing ethyl, n-hexane, tetrahydrofuran, methylcyclohexane, toluene should be required.
boil is caused by what the?
infection and skin dirty, scratches, high ambient temperature or lower the body resistance to infection-related. Boils can occur in any follicles of the skin area, often to the head, face, neck, armpits and buttocks so often by the friction of the parts is more common.
boil the pathogenic bacteria Staphylococcus aureus based, Streptococcus, Staphylococcus epidermidis, are also caused by the disease. Local and systemic skin's resistance to infection is reduced mainly due to Benbingfasheng, so infants, malnutrition, diabetes is a good risk of this disease. Dirty skin, skin abrasions, high ambient temperatures often lead to local infection such as the direct cause.
(B) the pathogenesis
bacteria invade the hair follicle and their sebaceous glands and sweat glands, in hair follicles and surrounding tissue multiply rapidly, producing toxins, causing local tissue degeneration, necrosis, and the center of the formation of boils, the performance of local congestion, exudation, induration. Aggregation of neutrophils to the damaged body tissue cells and bacteria to be destroyed, and he gradually necrosis and dissolution, the formation of abscesses in the dermis. Due to Staphylococcus aureus, coagulase contain toxins, so the formation of pus bolt, protruding outward. Swelling and induration clinically visible in the center of a yellow-white pus plug. This is Staphylococcus aureus infected lesion characteristics. Ulceration after discharge pus, abscess gradually by the new fibrous tissue repair and healing. [Sign]
boil the early symptoms?
1. redness, swelling, heat, pain summary, cylindrical cone.
2. inflammation to the development of nodules increases, the pain intensified.
3. A few days later nodules central necrosis, abscess formation, dissolution, soft induration, pain relief, the central pus head most of the self-rupture, discharge pus, inflammation subsided recovery.
4. furuncle usually no obvious symptoms, but if the blood flow occurred in the rich parts of the body resistance weakened, it can cause discomfort, chills, fever, headache and loss of appetite and other symptoms of toxemia.
5. Facial Boil such as intracranial infection, facial swelling and severe, may be associated with chills, fever, headache, sinus infections and other embolization.
boil because of location, severity of different clinical manifestations may vary.
local swelling and pain sclerosis: no systemic symptoms of early disease and more, only infection redness, swelling, pain, range of not more than 2cm in diameter, small nodules gradually enlarged, as papules bulge. A few days later lesions extended about 3 ~ 5cm, nodules gradually softened, the center was white, a slight touch of the fluctuations; then ulceration pus, and the emergence of yellow-white pus plug. Pus bolt off, pus shed, the inflammation subsides and healing. There is no pus boil bolt (the so-called headless boil), since the collapse a bit late, need to find ways to promote its pus discharge (Figure 2 ).
fever, swollen lymph nodes: furuncle serious infection, the local area of the lymph nodes, tenderness, and may be associated with body heat, and sometimes lymph node abscess formation.
nose, upper lip and around (called "dangerous triangle") of the surface boil, add or pushed in touch, the bacteria via the angular vein, ophthalmic vein into the brain, causing intracranial suppurative infection. At this point may have fever, headache, vomiting, consciousness disorders.
early follicular redness, swelling, heat, pain, induration. After the white purulent center, there is volatility. May be associated with systemic fever, elevated white blood cell count and differential count. [Aftertreat]
1. composed of: a single head of garlic, honey, 9 grams. Usage: pound evenly wrap the affected area.
2. consists of: single head of garlic amount. Usage: Peel and slice into 2 to 3 mm, with the first affected area with warm salt water when dry wash, and then sticking garlic, and gently massage the 10 to 20 minutes, 2 or 3 times a day, 2 3 There is no more. Indications: Boil, folliculitis. Note: In severe cases, such as local irritation may reduce the massage time, a serious condition should be added to serve anti-inflammatory drugs.
3 . composed of: tea 2 grams of dried honeysuckle 1 gram. Usage: boiling water 6 minutes after each meal drink in a cup. Indications: Boil, exogenous heat.
4. composed of: fresh Malan first 100 grams, the amount of liquor. Usage: Add a little salt before blindly smashed wine Ban Cheng paste, coating the surface of the skin furuncle carbuncle. Indications: furuncle, carbuncle.
5. Composition: rosin 10 grams of white wine. Usage: rosin research to fine tune white wine into a paste, resisting heat, wrap the affected area after dissolution, for the degree of responsibility to cover all of the above and then covered with wax paper and tape securely, to enhance efficacy, can drop a few drops of wine, rosin to keep moist. Indications: furuncle, carbuncle, folliculitis.
6. smashed topical papaya leaves, swollen boil carbuncle treatment drug.
7. fresh peach leaf, plug smashed the lesion, treatment of nasal furuncle.
8. rhizome or fresh banana leaves smashed Jiao Zhi, coating the surface of the skin, cure carbuncles, boils, swelling.
9. almond powder with sesame oil paint, heat treatment boil.
10. Purple cane coal deposit of the skin, powder, paint the affected area or sesame oil dressing, boil carbuncle treatment, stomatitis , eczema.
11. raw taro add a little salt, smashed drunk wrap the affected area twice a day replacement, bones can cure pain, swelling of unknown drugs, pediatric head hot boil, finger boil.
12. raw loofah (or leaf), smashed juice, coated surface of the skin, soak sore treatment days, yellow water sores, heat boils, urticaria .
13. mung bean sugar kelp: seaweed 60 grams, shredded, green beans, 150 grams, with the soup, add brown sugar to taste food. There Sedative, diuretic, soft-kin, Phlegm, scattered gall tumor effect. For hypertension, beriberi edema, neck lymphadenopathy, simple goiter, prickly heat boils hot summer day in children poison, phlegm cough embolism.
14. yi melon soup: melon (not peeled) 500-600 g, yi 50-100 grams of soup. Can be flavored with sugar or salt, on behalf of the tea used, heat, hot weather, diuretic, dehumidification effect. Drugs for Rush boils, eczema athlete's foot, yellow urine deficient.
15. Daozhi raw turnip, vinegar and rub the affected area transfer, heat treatment boil.
16. green beans 30 grams of powder, each 10 grams, water delivery service, boils cure breast swelling and pain.
17. failure to adopt the open rose 3 - 5 朵 wash, add water, two pregnant, suffering from a cup of low heat, ice sugar 30 grams, made of rose soup, until the temperature dose, to cure blood stasis amenorrhea, boils Chung pain, traumatic swelling and pain.
18. boils and pus ulceration of the skin sore or eczema, rinse with water, tea, allow the wound clean and promote healing.
19. a white sweet potato, peeled and chopped, smashed, can also be added with the same amount of fresh Houttuynia smashed, spreads in the affected area, apply to the local heating that line replace (about two three hours long), and even apply a few days more, boils cure mastitis.
20. soybeans amount, turn on the water immersed soft, add a little alum were smashed drunk, external surface of the skin, swollen boils boil treatment.
21. adzuki beans with water until soft, mash with water or vinegar, or honey or egg amount, into a paste, external surface of the skin, cure mumps, hot boil.
22. Kapok 30 - 50 grams of sugar amount, fry a bowl with water and drink two bowls and a half. Favorable moisture, heat effect. For enteritis, urethritis, eczema, summer boil embolism.
23. fresh buckwheat leaves 60 grams, Shuijianbi day one; or fried yellow noodles with the vinegar into a paste, applied to the lesion, sooner or later be replaced. Governance sore, swollen boils, erysipelas, mastitis, and swelling of unknown drugs.
appropriate patients to eat what?
1, edible grapes plus zinc salt or zinc, other foods such as soy, sunflower seeds, wheat bran, yeast, brown sugar and so on.
2, Yi Shi taste light, the cold food, such as Malan head, purslane, melon, red and white radish, bitter gourd, sponge gourd, mung bean, red bean, lily, chrysanthemum brain and celery.
patients unfit to eat what?
not eat ginger, pepper and other spicy foods , as well as mustard, yellow croaker, shrimp, crab, chicken head, goose, Zhu Tourou so fat objects.
should avoid fried foods and meat, edible oil cans.
data only refer to the specific, please ask a doctor. [Prevent]
how to prevent boils?
boil is born of acute suppurative superficial skin disorders, widely available health, children, young people more common. "Surgical management case" that: "boil persons, birth processes, floating red rootless feet, swollen found in the skin, only the width of an inch, there is less pain, a few days later Microsoft, thin peel, the beginning of the blue water, the latter from breaking the pus out of. "The disease occurs in the summer and autumn, protruding roots shallow, swelling potential limitations, lift the red pain, mostly in the range of about 3cm, easily swollen, easy to collapse, Yi Lian. Early can be divided into a head, without the first two kinds of general light and easy to cure the symptoms, so the saying goes, "no boil the size of a pus like." ;;; ;;;;; ;;;;; ;;;;; But also due to the formation of improper treatment or care "mole cricket boils," or repeated seizures, lack of disunion. Multiple furunculosis ", is difficult to cure. [Treat]
boil precautions before treatment?
attention to the skin clean, timely replacement of underwear and avoid skin injuries, especially in the summer, to bathe, wash your hair, hair, changing clothes, nails, children in particular should pay attention. With honeysuckle and wild chrysanthemum Jiantang tea. Boil the surrounding skin should be kept clean and coated with 70% alcohol to prevent infection spread to nearby hair follicles.
boil Chinese medicine treatment methods
total boil caused by the toxic heat treatment to detoxify the basic principles.
A Differential Treatment:
1. Heat toxin Accumulation card: lesion processes, such as cone, burning pain, or fever, thirst, tongue pink, yellow fur, rapid pulse. Detoxification. Flavors disinfection decoction.
2. Shushi heat Melancholia: seen in summer and autumn, the affected area, such as agglomeration cone, single or multiple, burning pain, chest tightness, anorexia, deficient urination, red tongue, greasy or yellowish, veins slippery. Qingshu dampness, detoxification swelling. Qingshu Decoction.
3. Is virtual evil love cards: distributed in the body, local color dark red, pus scarce, one after another, delayed healing, with fever, irritability, thirst, or fatigue, limb soft, red tongue thin yellow, rapid pulse. Righting detoxification. Liu Wei Di Huang Decoction.
Second, external treatment and other treatment:
1. The beginning of detoxification should be swelling, moderate to henbane, water reconcile, wrap the affected area. Or wishful golden powder for external application. Or green cream Waicha.
2. Pus, the clip bolt out the pus.
3. Unhealed after the collapse, sores can be a little ninety-one Dan to drugs or drug line twist into sores, topical berberine gauze.
4. Oral Meihuadianshe Dan, Niuhuangjiedu, Fang Feng Tong Sheng Wan, Liushen other medicine.
5. Unilateral prescription: Silver Flower 30g, licorice 10g, decoction, on behalf of the tea.
Western boil treatment
1. Local treatment, such as heat, physical therapy, 10% ichthyol coated ointment. Facial Boil should rest in bed should not squeeze or prick Boil, so as not to spread to the brain.
2. Swelling or have a large range of obvious symptoms, should give systemic antibiotics (third-generation cephalosporin antibiotics).
3. The formation of abscess, incision and drainage should be timely but should be avoided Boil the face cut.
1. The principles of early treatment to promote inflammation subsided, after early drain purulent pus; timely elimination of systemic adverse reactions.
2. Local treatment
(1) Physical therapy: early, ultraviolet micro-irradiation, can promote local anti-inflammatory, to prevent proliferation. Swelling stage, the selection of FM, infrared and other heat, promote Boil liquid. 2 to 3 times / d, 20 ~ 30min / times.
(2) Drug eraser: 0.5% povidone-iodine scrub, the drug not only for skin irritation, and the role of long-lasting, no pigmentation. Can also be used erythromycin, tetracycline ointment.
(3) topical cream: local swelling and a small pustules, use ichthyol, wishful golden powder, Gyokuro powder and so on.
(4) incision and drainage: Boil into pus, nodules soften, a sense of volatility, you can make a small incision drainage or fire needle drainage. Taboo squeeze purulent lesions.
(5) to keep local clean and dry: adhere to local skin cleaning, daily showers are the best conditions. Young children with skin, topical lip after taking a bath in summer, to avoid the formation of multiple Boil.
3. Systemic treatment usually does not require systemic treatment of boils. But facial boils or accompanied by chills, fever, headache, general malaise, etc., should be given antibiotics. Clinical observations and experimental results show that the efficacy of penicillin, cephalothin, cefazolin and amikacin better effect.
(B) the prognosis
generally good prognosis after active treatment, without sequelae. [Examine]
boil should be how?
1. Peripheral blood
(1) white blood cell count: fever, elevated WBC count may have.
(2) white blood cell count: white blood cell count was elevated often accompanied by increased neutrophils .
2. diabetes check
(1) fasting plasma glucose measurement: two fasting blood glucose were increased, should consider the possibility of diabetes.
(2) glycated serum protein: This clinical trial is not the impact of fluctuations in blood glucose higher than normal to help the diagnosis of diabetes.
(3) glycosylated hemoglobin: glycosylated hemoglobin and blood glucose were positively correlated, and the irreversible reaction. Diabetes is often higher than the normal 2 to 3 times.
(1) bacterial culture: the multiple, repeated infections, abscesses can be extracted directly pus for bacterial culture, positive results will help the diagnosis of pathogens.
(2) drug susceptibility testing: bacterial culture in the pus, while line drug susceptibility testing can provide the scientific basis of clinical drug treatment. [Diff]
boil diseases easily confused?
1. Multiple sweat gland abscesses are summer disease, more common in infants and young children and frail mother's head, forehead, etc .. Lesions of multiple subcutaneous abscesses. Surface tenderness, inflammation lighter. No pus bolt, left scars. Usually accompanied by a lot of prickly heat. Generally known as prickly heat poison. It was also known as pseudo furunculosis (Pseudofurunculosis).
2. Hidradenitis suppurativa common in young women, lesions of the skin induration. Subcutaneous abscess formation, followed by skin redness, swelling, heat, pain, ulceration scarring. Lesions occur in the armpits, groin, genital and perianal, umbilical, etc.
3. acne acne mild infection, red, swollen, painful, but the disease is small, the top a little bit like creamy.
4. sebaceous cysts sebaceous cyst infection are redness, swelling, pain, but the previous round has been painless mass over an extended period , the epidermis as usual.
5. carbuncle carbuncle with redness, swelling, pain, but there are several hair follicle infection, lesions larger than the boil. [Disease]
juvenile osteochondrosis of vertebral osteoporosis youth sexual hump sore scoliosis ankylosing spondylitis vitamin D deficiency disease
more back symptoms
small blisters appear back back pain back spasms, back pain does not have subtle linen spine back pain sinus pain Road with sensory ataxia spinal nerve root damage spinal cord hemisection syndrome, spinal cord lesions of hemorrhagic infiltration of the spinal cord injury spinal cord infarction, cauda equina involvement across the spinal cord within the spinal cord gliosis in the spinal cord anterior horn of the spinal cord lesion cavity formed spinal thalamic tract compression