骨性关节炎生物学标志物研究进展

骨性关节炎(oseteoarthritis,OA)是一种随着年龄增长发病率明显升高的退行性变,常累及脊柱、髋、膝等人体负重关节,以关节缓慢发展的疼痛、肿胀,伴功能障碍为临床表现,主要有滑膜增生、软骨破坏、软骨下骨骨化及骨赘形成等一系列病理表现。OA对人类的健康和生活质量影响很大,随着老龄化社会的到来,本病的发病率日趋升高,其研究已成为医学领域中的重要课题。目前,OA的早期诊断、病变监测和有效防治仍是骨科领域亟待解决的疑难问题。随着分子生物学的发展和研究手段的提高,许多研究者都在试图寻找用于临床评价OA的生物学标志物。本文将就OA研究中所使用的主要标志物进行综述,为深入研究OA提供方便。     

uPA系统与骨性关节炎治疗的研究进展

尿激酶型纤溶酶原激活系统(uPA)在骨性关节炎的病理过程中发挥着重要的调控作用.其与骨性关节炎的发病,发展以及结局息息相关;骨性关节炎的治疗也是围绕其展开.近年来.围绕着uPA系统探索骨性关节炎的发病机制及治疗已成为基础和临床研究的热点.本文将uPA系统在骨性关节炎中的作用及骨性关节炎的治疗予以综述.     

骨性关节炎的超声诊断价值

骨性关节炎是目前发病率较高的一组以关节软骨为主要病理特征的临床综合症,目前主要影像学检查方式包括:X线、CT、MRI。近年来随着超声成像技术水平和精确性的不断提高,已能够更加快捷、方便、准确的对骨性关节炎作出较明确的诊断,具有重要的临床价值。     

骨性关节炎软骨细胞凋亡的研究

骨性关节炎是一种以软骨下骨改变和软骨退化为特征的关节退行性疾病.研究证实软骨细胞凋亡在骨性关节炎发生发展中起到关键作用.因此,研究骨关节炎软骨细胞凋亡机制及研发或筛选抗软骨细胞凋亡的药物必将给骨关节炎的防治开辟一条崭新的途径.     

针灸治疗膝关节骨性关节炎的临床研究进展

膝关节骨性关节炎是目前临床上最常见的骨性关节炎之一,且发病率逐年增高.但其发病机理至今尚未完全明了,因此对该病并没用一个确切规范的诊疗方法,临床多以缓解症状,控制疾病发展速度为主要目的.目前,有许多报道显示,针灸尤其是以电针为主治疗膝骨性关节炎已经取得了较好的临床疗效.     

白细胞介素在骨性关节炎中发病机制中的研究现状

骨性关节炎(OA)是临床上常见的关节疾病之一,严重影响患者的关节功能和生活质量,由多种因素相互作用致病,多发于老年人,但是具体的发病原因尚未明确,因此给临床治疗造成障碍。目前研究认为白细胞介素在OA的发生及发展过程中起主要作用,因此可以将白细胞介素作为治疗OA的靶点,为治疗OA提供新思路。本文主要就不同种类白细胞介素在OA的发病机制中的作用进行综述。     

氧化应激反应与膝关节骨性关节炎的相关性探究

目的:了解膝关节骨性关节炎患者机体的氧化应激状态,探讨氧化应激反应与膝关节骨性关节炎发生、发展的关系。方法:收集膝关节骨性关节炎患者及健康人群的血清,采用分光光度法测定和比较其SOD、GSH-Px、MDA水平。结果:与健康对照人群相比,膝关节骨性关节炎患者体内SOD、GSH-Px酶类抗氧化剂活力显著增强(P0.05);MDA脂质过氧化损伤产物明显降低(P0.05)。结论:膝关节骨性关节炎患者体内氧化还原状态发生了改变,可能处于抗氧化应激的慢性代偿状态;氧化应激反应参与了骨性关节炎的发生、发展过程。     

膝关节骨性关节炎临床实施臭氧治疗的疗效分析

目的:探讨对膝关节骨性关节炎患者采用臭氧治疗的临床效果.方法:收集从我院2010年7月至2012年7月门诊收治的膝关节骨性关节炎患者病例96例,并对收集的病例进行分类.治疗组患者进行刺穿后采取臭氧治疗的方式,有55例;对照组患者采用利多卡因、0.9％氯化钠溶液、曲安奈德混合液的治疗方式,有41例.对两组患者进行2个疗程的治疗后,对治疗前后的WAS及WOMAC进行评分,以比较两组的治疗效果.结果:经过2个疗程的治疗后,治疗组和对照组都取得了明显的效果,治疗组的治愈率为70.90％,总有效率为98.18％;对照组的治愈率为63.41％,总有效率为92.68％.结论:对膝关节骨性关节炎患者实施臭氧治疗方式能够获得良好的近期临床效果.     

慢传输型便秘的病因及发病机制研究进展

慢传输型便秘(STC)是由多因素引起的临床上常见的一种顽固疾病,其病因及发病机制尚不明确。目前对慢传输型便秘的病因研究主要集中在:药物的滥用、生活习惯、内分泌、心理因素这几个方面,发病机制的研究主要在肠道动力、胃肠神经肽、肠神经系统、Cajal间质细胞这几方面。从不同的层面分析,寻找关键因子,是本病的研究方向。本文对慢传输型便秘的病因及发病机制的研究进展作最新的综述。     

早产病因及发病机制的研究现状

早产在妇产科临床上比较常见,其作为围生医学当中的一类重要而复杂的妊娠并发症,对早产儿的预后具有较大危害,严重时可能直接导致早产儿死亡。通常而言,早产患者的临床表现主要是子宫收缩,初期表现为不规律的宫缩,并伴有少量的阴道出血亦或是血性分泌物,进而发展成规律性的宫缩,此过程中宫颈管先发生消退,而后扩张。早产儿的体重大多数低于2500 g,且头围小于33 cm,部分胎儿的器官功能及适应能力与足月儿相比明显较差,常需给予特殊的处理。因此,及时梳理导致早产的原因并分析其发病机制,有利于早期掌握防治早产的基础要点。本文就此展开综述,以期为改善母婴妊娠结局提供理论支持。     

心理疲劳的研究进展

心理疲劳是指重复单一作业或从事紧张程度较大的工作,神经系统紧张程度过高,从而出现的心理不安和疲乏感。心理疲劳会造成个体各种心理疾病以及重大事故的出现,但至今心理疲劳的概念还未有统一的标准,病因病机不明确,本文意在探讨其研究进展。笔者对于心理疲劳的国内外研究进展进行了文献整理,从心理疲劳的定义、表现、病因病机以及检测方法四个方面论述,发现心理疲劳由工作强度与持续时间、心理负荷、工作方法和熟练程度、环境因素以及体质、健康和营养状况等原因引起不同脑区的神经系统的变化以及相应物质代谢产生的疲劳。目前对心理疲劳的研究方法和手段有待改进,可将脑磁图、正电子发射断层扫描技术、功能核磁共振成像技术大量应用到研究中,探索其神经生理机制,为预防和治疗心理疲劳提供思路和方法。     

急性胰腺炎的研究进展

急性胰腺炎是临床常见的急腹症之一,其病因及发病机制复杂,死亡率居高不下。目前,急性胰腺炎被定义为一种以急性炎症和胰腺实质坏死为特征的炎症性疾病,按照其严重程度分为轻度急性胰腺炎、中度重症急性胰腺炎、重症急性胰腺炎。急性胰腺炎的发生机制尚未完全阐明,目前主要存在几种学说,包括胰酶的自身消化、腺泡细胞凋亡、过度炎症反应、微循环改变、钙超载及肠道细菌易位学说等。本文主要对急性胰腺炎的定义、病因、分型、发生机制和治疗策略的研究进展进行了综述。     

Degeneration of normal articular cartilage induced by late phase osteoarthritic synovial fluid in beagle dogs

Objective

To investigate the pathogenesis of late phase osteoarthritic (OA) synovial fluid (SF) on normal articular cartilage in vivo and provide an understanding of degenerative cartilage extending in OA joint.

Methods

A random knee, each of 8 beagle dogs, received anterior cruciate ligament transection (ACLT) and was confirmed to have late phase OA degenerative changes at 24 weeks after operation. Thereafter, one random elbow of each canine was injected with autologous late phase OA knee SF. The contralateral elbow was injected with normal saline (NS) of the same volume as SF aspirated from ACLT knee. These two groups of elbows were labeled “SF” and “NS”. 8 other beagle dogs were left intact and placed in Group Control. After aseptic arthrocentesis was performed weekly on both elbows for 24 weeks, morphological changes were observed in the cartilage of the elbows, and expressions of 7 biological etiological factors of chondrocytes of the elbows were determined in Group SF, Group NS and Group Control, respectively.

Results

Morphological changes were observed in articular cartilage of the elbows in Group SF. Levels of unit area of collagen type I in the noncalcified, calcified and full zones of articular cartilage of the elbows in Group SF increased significantly. Level of unit area of collagen type III in the calcified zone of articular cartilage of the elbows in Group SF remained unchanged. Meanwhile, expressions of MMP-1 and MMP-3 of chondrocytes of the elbows in Group SF increased significantly. There was almost no difference between articular cartilage in Group NS and Group Control.

Conclusion

Based on these results, we conclude that OA degeneration of normal articular cartilage can be independently induced by late phase OA SF. Endogenous OA biological etiological factor may be one of the reasons causing degenerative cartilage extending in OA joint.     

Is early osteoarthritis associated with differences in joint congruence?

Previous studies suggest that osteoarthritis (OA) is related to abnormal or excessive articular contact stress. The peak pressure resulting from an applied load is determined by many factors, among which is shape and relative position and orientation of the articulating surfaces or, referring to a more common nomenclature, joint congruence. It has been hypothesized that anatomical differences may be among the causes of OA. Individuals with less congruent joints would likely develop higher peak pressure and thus would be more exposed to the risk of OA onset. The aim of this work was to determine if the congruence of the first carpometacarpal (CMC) joint differs with the early onset of OA or with sex, as the female population has a higher incidence of OA. 59 without and 38 with early OA were CT-scanned with their dominant or arthritic hand in a neutral configuration. The proposed measure of joint congruence is both shape and size dependent. The correlation of joint congruence with pathology and sex was analyzed both before and after normalization for joint size. We found a significant correlation between joint congruence and sex due to the sex-related differences in size. The observed correlation disappeared after normalization. Although joint congruence increased with size, it did not correlate significantly with the onset of early OA. Differences in joint congruence in this population may not be a primary cause of OA onset or predisposition, at least for the CMC joint.     

新型冠状病毒的相关研究进展

2019年12月出现于湖北武汉的一种新型冠状病毒(SARS-CoV-2)感染所致肺炎疫情,给人类生命安全造成威胁。迄今为止,对2019年出现的SARS-CoV-2的研究仍处于起步阶段,本文就其相关研究进展进行综述,重点阐述了目前关于SARS-CoV-2的病原学与致病机制方面的研究成果,同时对其流行病学以及该病毒引发的肺炎临床特点加以总结,有助于读者及时了解SARS-CoV-2最新的研究动态,并为今后开展治疗药物及疫苗研发提供方向。     

小儿化脓性脑膜炎病原学探讨

本组选择做病原学检查的化脑患儿２９６例行病原学探讨。血培养５１／１１６例（４３．９７％）;脑脊液涂片找细菌３３／１０１例（３２．６７％）;脑脊液培养４３／１３２例（３２．５８％）;硬膜下积液培养１０／４３例（２３．２６％）。三种标本共培养出细菌１０４株,其中金黄色葡萄球菌、肺炎双球菌、大肠埃希氏菌、四联球菌、表皮葡萄球菌分别为３８株、８株、７株、１３株、１１株,其它２７株;～１岁组阳性数最多,分别为２０株、１９株、９株     

Interplay between Clathrin and Rab5 Controls the Early Phagocytic Trafficking and Intracellular Survival of Brucella abortus within HeLa cells

Lipid raft-associated clathrin is essential for host-pathogen interactions during infection. Brucella abortus is an intracellular pathogen that circumvents host defenses, but little is known about the precise infection mechanisms that involve interaction with lipid raft-associated mediators. The aim of this study was to elucidate the clathrin-mediated phagocytic mechanisms of B. abortus. The clathrin dependence of B. abortus infection in HeLa cells was investigated using an infection assay and immunofluorescence microscopy. The redistribution of clathrin in the membrane and in phagosomes was investigated using sucrose gradient fractionation of lipid rafts and the isolation of B. abortus-containing vacuoles, respectively. Clathrin and dynamin were concentrated into lipid rafts during B. abortus infection, and the entry and intracellular survival of B. abortus within HeLa cells were abrogated by clathrin inhibition. Clathrin disruption decreased actin polymerization and the colocalization of B. abortus-containing vacuoles with clathrin and Rab5 but not lysosome-associated membrane protein 1 (LAMP-1). Thus, our data demonstrate that clathrin plays a fundamental role in the entry and intracellular survival of B. abortus via interaction with lipid rafts and actin rearrangement. This process facilitates the early intracellular trafficking of B. abortus to safe replicative vacuoles.     

急性胰腺炎1796例病因及治疗效果分析

目的：分析我院急性胰腺炎（AP）的主要病因及治疗效果,为临床诊疗工作提供参考。方法：回顾性分析2008年1月至2012年12月于我院住院治疗的1796例AP患者的临床资料,统计其病因及治疗效果,对其病因及预后进行分析总结。结果：在1796例患者中,重症急性胰腺炎（SAP）522例,轻症急性胰腺炎（MAP）1274例。胆源性AP1025例,高脂血症性AP209例,酒精性AP200例。高脂血疰性AP中,SAP占49．8％,高于胆道疾病及酒精因素引起的SAP的比例（P〈0．05）。33例患者死亡,总病死率1．8％。结论：胆道疾病、酒精、高脂血症是我国AP主要病因,随着医疗水平的提高,AP的病死率有所下降。     

急性非胆源性胰腺炎病因研究及BISAP预后评估

目的：探讨急性非胆源性胰腺炎病因并对其预后进行BISAP（Beside Index of Severe Acute Pancreatitis）评估。方法：回顾性分析2006年7月~2010年7月我院收治的108例急性非胆源性胰腺炎患者临床资料,并结合BISAP评分对其预后予初步评估。结果：发病病因：大量饮酒及暴饮暴食52例;高脂血症27例;药物12例;妊娠1例;十二指肠憩室1例;诱因不明15例。重症急性胰腺炎8例,5例由暴饮暴食、酗酒所致,2例为高脂血症,1例为十二指肠憩室引起;其中有6例BISAP评分≥3分。结论：明确病因对预防复发、降低胰腺炎并发症、病死率具有重要意义。BISAP评分有利于重症胰腺炎风险早期预测。