滑膜骨软骨瘤病1例

滑膜骨软骨瘤病为一种很少见的良性病变,特征为关节滑膜形成多数软骨或骨结节,一部分结节可脱离滑膜,进入关节囊内成为游离小体。受累的关节常有多年疼痛、强直、肿胀、活动受限,有些病人滑膜     

老年关节滑膜软骨瘤病的诊断和治疗

目的探讨老年关节滑膜软骨瘤病（SC）的临床特征和诊断与治疗经验。方法报导1例老年膝关节SC合并重度骨关节炎患者,实施游离体摘除＋关节置换术。结合相关文献,分析和总结老年型关节SC的临床特征及诊治经验。结果术后随访5个月显示关节轻度肿胀,关节疼痛、弹响及绞锁等症状均消失,关节活动度、功能恢复正常;关节内未见明显高密度影,人工关节位置良好。结论老年型关节SC非常罕见,通常合并骨关节炎,临床表现缺乏特征性,易被漏诊或误诊。其临床诊断基于临床表现、影像学检查和病理组织学检查等综合分析。治疗原则为游离体摘除和滑膜切除术,根据SC的病理分级、骨关节炎程度和患者个体情况而决定手术方式：是否实施滑膜切除、关节镜探查术或关节置换术等。     

低频脉冲超声干预膝骨关节炎模型兔关节软骨及滑膜水通道蛋白3的表达

背景：研究表明,低频脉冲超声能促进全层关节软骨缺损修复,延缓实验性早期骨关节炎的病变进展。水通道蛋白3存在于关节软骨及滑膜上,并在骨关节炎的发病机制中发挥重要作用。 目的：探讨低频脉冲超声对实验性膝骨关节炎兔关节软骨及滑膜水通道蛋白3表达的影响。 方法：成年新西兰兔左后膝关节用管型石膏固定于伸直位制动6周制备实验性兔膝关节骨关节炎模型,造模成功后随机分为两组：实验组予以低频脉冲超声治疗(频率为1 MHz,功率为2.0 W),1次/d,15 min/次;对照组不接受超声治疗。分别于治疗后2,4,8周,采用免疫组织化学方法观察兔关节软骨及滑膜水通道蛋白3的表达。 结果与结论：随着造模后时间的延长,各组兔关节软骨及滑膜水通道蛋白3的表达均有所增加;与对照组比较,实验组兔关节软骨及滑膜水通道蛋白3表达明显降低(P < 0.01)。说明低频脉冲超声能降低实验性兔膝骨关节炎关节软骨及滑膜水通道蛋白3的表达,从而缓解关节肿胀,延缓软骨及滑膜的退变,具有软骨及滑膜保护作用。     

关节软骨修复与相关细胞因子的作用

背景：关节软骨损伤后几乎不能完全修复,在生理负荷下容易发生退行性改变,最终发展成骨性关节炎。利用细胞生长因子构建组织工程化软骨,修复重建受损关节软骨,为骨关节软骨疾病的治疗开辟了新的途径。 目的：全面了解细胞因子特性与正常关节软骨相似的组织工程软骨的构建,明确目前细胞因子促进软骨分化修复的研究进展。 方法：电子检索中国生物医学文献数据库和计算机Medline数据库1994/2009收录的关节软骨修复与相关细胞因子相关综述和论文报告,并分析其研究进展。 结果与结论：共纳入软骨细胞因子相关文献29篇。关节软骨损伤后的修复非常有限,其对创伤、炎症的反应是由软骨细胞、滑膜组织分泌或关节液中含有的细胞因子所介导的。软骨细胞基质中的生长因子,通过不同的细胞信号通路使基因表达启动或关闭,在软骨生长和分化中发挥重要作用,同时软骨细胞周围环境因素也影响调控诱导分化的结果。     

白细胞介素家族在类风湿关节炎中的表达意义

类风湿关节炎(Rheumatoid arthritis,RA)是一种以慢性破坏性关节病变为特征的全身性自身免疫病。以对称性小关节受累为主,亦有相当比例的患者出现关节外系统受累,以关节滑膜和软骨为主要损伤靶点,并持续处于慢性炎症状态,有反复活动     

关节软骨的仿生设计

人体滑膜关节中,天然关节软骨具有多重不可替代的特殊功能和重要作用.本研究从仿生学的视角,综述关节软骨的生物化学、组织形态学、病理学特征,以及生物材料学、生物力学和生物摩擦学性质;从结构、材料、功能三个方面对关节软骨进行宏、微观层次的仿生设计,建立关节软骨仿生设计模型;为带有"软垫轴承"的新型人工关节,以及仿生人工软骨的创新设计与制造,提供理论和实践基础.     

强直性脊椎炎骶髂关节早期改变的MRI诊断

目的:探讨强直性脊柱炎(AS)骶髂关节(SIJ)早期改变的MRI表现及诊断。方法:回顾性分析经病理证实的50个AS骶髂关节早期改变的MRI表现。结果:MRI显示47个SIJ滑膜软骨异常,在这些关节中骨髓水肿、骨髓内脂肪沉积分别有45、28个,骨质侵蚀及骨质硬化各有15、6个。MRI动态增强发现在这47个滑膜软骨异常的关节中,30个轻度强化,17个明显强化。3个关节MRI未见异常,动态增强示这3个关节无异常强化。结论:关节滑膜软骨异常、骨髓水肿、脂肪沉积等是AS骶髂关节早期改变的MRI重要征象,可作为MRI诊断早期AS的依据。     

环状RNA(circRNA)与类风湿性关节炎关系的研究进展

环状RNA(circRNA)是一类不具有3′端poly(A)和5′端帽子结构的、以共价键首尾相连的单链内源闭合环状RNA,具有广泛性、多样性、稳定性和保守性等生物学特点,同时也具有转录调控和蛋白质翻译等功能。类风湿性关节炎(RA)是以滑膜炎、关节软骨进行性破坏和骨损伤为特征的一种慢性炎症性自身免疫性疾病。circRNA广泛参与RA滑膜细胞持续增生、滑膜的慢性炎症、滑膜的增厚、滑膜的纤维样改变、细胞因子之间平衡破坏,以及与血管翳的形成、软骨、软骨下骨的破坏有密切关系。     

IL-17在类风湿性关节炎发病机制中的作用

类风湿性关节炎(RA)是一种以滑膜持续炎症和关节软骨及骨破坏为特征的自身免疫性疾病。RA的发展伴随着滑膜细胞增生、新生血管形成,以及局部大量T细胞浸润[1]。IL-17是主要由Th17细     

低场强四肢关节MRI对膝关节滑膜病变的诊断

目的分析膝关节滑膜病变的MR表现,探讨低场四肢关节MRI的诊断。方法收集本院经关节镜手术及病理检查证实的66例膝关节滑膜病变患者的低场强四肢关节MRI检查资料,主要观察分析滑膜增厚的程度、范围,骨与软骨改变,关节积液程度,并与关节镜对照分析。结果低场强MRI能够显示滑膜增厚的分布、信号特点、软骨及骨质改变及邻近周围软组织结构受累程度具有一定的差异性,MRI表现与关节镜表现一致。结论感染性滑膜炎、原发性滑膜炎与继发性滑膜炎MRI表现有一定特点,在膝关节滑膜病变的诊断中有价值。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

The case for allele‐specific recognition by the TCR

There is a sharp difference in how one views TCR structure–function–behaviour dependent on whether its recognition of major histocompatibility complex‐encoded restriction elements (R) is germline selected or somatically generated. The generally accepted or Standard model is built on the assumption that recognition of R is by the V regions of the αβ TCR, which is not driven by allele specificity, whereas the competing model posits that recognition of R is allele‐specific. The establishing of allele‐specific recognition of R by the TCR would rule out the Standard model and clear the road to a consideration of a competing construct, the Tritope model. Here, the case for allele‐specific recognition (germline selected) is detailed making it obvious that the Standard model is untenable.