金雀异黄素对CIA大鼠炎症及细胞因子影响的研究

目的研究金雀异黄素(Gen)对类风湿关节炎(RA)动物模型CIA大鼠炎症及细胞因子的作用。方法采用Ⅱ型胶原建立CIA大鼠模型;通过Gen和/或MTX治疗后检测CIA大鼠关节炎指数(AI)评分和后肢容积,摄取大鼠关节X线片;观察大鼠关节病理学改变;Western Blot法检测血清中白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)的表达。结果 CIA大鼠造模成功;Gen治疗组、MTX治疗组及Gen+MTX治疗组大鼠炎症反应较模型对照组减轻,血清中IL-1β、TNF-α表达明显降低(P0.05),Gen+MTX治疗组的效果更佳。结论 Gen能够降低CIA大鼠炎症反应,减缓关节炎病情进展,可能是通过抑制IL-1β、TNF-α的表达而发挥抗炎作用。     

金雀异黄素对CIA大鼠炎症及细胞因子影响的研究

目的 研究金雀异黄素（Gen）对类风湿关节炎（RA）动物模型CIA大鼠炎症及细胞因子的作用.方法 采用Ⅱ型胶原建立CIA大鼠模型;通过Gen和/或MTX治疗后检测CIA大鼠关节炎指数（AI）评分和后肢容积,摄取大鼠关节X线片;观察大鼠关节病理学改变; Western Blot法检测血清中白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）的表达.结果 CIA大鼠造模成功; Gen治疗组、MTX治疗组及Gen＋MTX治疗组大鼠炎症反应较模型对照组减轻,血清中IL-1β、TNF-α表达明显降低（P〈0.05）, Gen＋MTX治疗组的效果更佳.结论 Gen能够降低CIA大鼠炎症反应,减缓关节炎病情进展,可能是通过抑制IL-1β、TNF-α的表达而发挥抗炎作用.     

山苍子根煎剂对CIA大鼠血清TNF-α,IL-1 β水平影响

目的 观察山苍子根对CIA大鼠关节炎指数、血清TNF-α,IL-1β水平的影响,探讨其对类风湿关节炎可能的疗效机制.方法 用鸡Ⅱ型胶原蛋白诱导CIA大鼠模型,记录各组大鼠的关节炎指数(AI); ELISA检测血清TNF-α及IL-1 β水平.结果 造模大鼠68.2%出现关节炎症状(雄鼠52.7%,雌鼠83.6%);给药24d后.山苍子根中、高剂量组AI较模型对照组明显降低(P＜0.01);模型对照组、雷公藤多甙组、强的松组、山苍子根各组血清TNF-α及IL-1 β水平较正常对照明显增高(P均＜0.01);与模型对照组比较雷公藤多甙组、强的松组、山苍子根各组血清TNF-α及IL-1 β水平明显下降(P均＜0.01),且IL-1 β下降水平随山苍子根剂量的增加而增加.结论 山苍子根可缓解CIA大鼠关节肿胀,抑制CIA大鼠血清TNF-α及IL-1 β水平,且随山苍子根剂量的增加其下调血清IL-1 β水平的作用亦随之增加.山苍子根治疗RA的机制可能与其下调血清TNF-α和IL-1 β水平有关.     

骨髓间充质干细胞移植对胶原诱导性关节炎滑膜增殖的影响及机制

目的探讨骨髓间充质干细胞(MSCs)移植对胶原诱导性大鼠(CIA)滑膜增殖的影响及可能的作用机制。方法分离培养SD大鼠MSCs。将40只SD大鼠,随机分为5组,空白对照组、早期MSCs治疗组(初次诱导的同时注射MSCs)、晚期MSCs治疗组(再次诱导的同时注射MSCs)及其相应对照组早期CIA对照组(初次诱导的同时注射生理盐水)和晚期CIA对照组(再次诱导的同时注射生理盐水)。MSCs和生理盐水均从尾静脉注入。疗效观察包括关节炎指数(AI)、关节病理评分及ELISA检测血清血管内皮细胞生长因子(VEGF)、肿瘤坏死因子(TNF)-α和IL-17等。结果 (1)早期治疗组和晚期治疗组的AI、关节病理评分较相应对照组明显下降(P<0.05);(2)早期治疗组与晚期治疗组比较,AI与关节病理评分较低,差异有统计学意义(P<0.05);(3)早期治疗组、晚期治疗组血清VEGF、TNF-α、IL-17水平降低(P<0.05),与AI和关节病理评分呈显著正相关(P<0.05)。结论 MSCs移植可减轻CIA的滑膜增殖,其机制有可能是通过下调VEGF、TNF-α和IL-17的表达来实现的。     

汉防己甲素对胶原诱导的关节炎大鼠关节腔液中与外周血清中IL-1β、IL-6、TNF-α的调节

目的观察汉防己甲素对胶原诱导的关节炎(CIA)大鼠关节腔和外周血清中白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的影响,探讨汉防己甲素治疗CIA的相关机制。方法以胶原诱导的关节炎Wistar大鼠为动物模型,将大鼠分成正常组、模型组和汉防己甲素组。正常组、模型组注射0.9%氯化钠溶液,汉防己甲素组按80 mg/kg后腿肌肉注射,1次/d,30 d处死动物,采用酶联免疫吸附法(ELISA)检测大鼠血清和膝关节腔液中IL-1β、IL-6、TNF-α含量。结果与正常对照组相比,CIA模型组大鼠关节腔液和血清中IL-1β、IL-6、TNF-α含量升高(P<0.01);经过汉防己甲素治疗后,关节腔液和血清中IL-1β、IL-6、TNF-α含量降低,与模型组相比,差异有统计学意义(P<0.01),而与正常组比较,差异无显著性。结论汉防己甲素可以通过调节细胞因子变化而达到治疗CIA,这也可能是汉防己甲素治疗类风湿关节炎的机制之一。     

CCL20单克隆抗体与雷公藤治疗胶原诱导性关节炎模型小鼠的对照研究

目的 研究趋化因子CCL20在胶原诱导性关节炎(collagen-induced arthritis,CIA)小鼠中的表达,探讨CCL20单克隆抗体对CIA小鼠的治疗作用及临床治疗类风湿关节的潜在价值.方法 ①建立CIA小鼠模型:40只DBA/1小鼠随机分为健康对照组、模型组、CCL20单克隆抗体治疗组、雷公藤治疗组;②观察不同时间点小鼠一般情况、关节肿胀度;③测定造模42天后小鼠血清CCL20、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)的表达水平;④观察各组小鼠关节病理变化.结果 ①模型组、雷公藤组和单抗组CCL20,TNF-α和IL-1β均高于对照组,CCL20(29.45±4.92) ng/L、(18.32±4.80) ng/L、(14.13±3.82) ng/L vs (2.83±1.37) ng/L;TNF-α(63.1±2.82) ng/L、(43.15±2.31) ng/L、(42.91±2.02) ng/L vs (26.78±3.50) ng/L;IL-1β(83.72±4.04) ng/L、(53.78±5.89) ng/L、(56.77±4.98)ng/L vs(16.54±2.45)ng/L,雷公藤组和单抗组的CCL20、TNF-α和IL-1β均低于模型组.②HE染色观察,模型组较正常组滑膜肥厚,排列紊乱、滑膜内有大量炎症细胞浸润,有血管翳形成.雷公藤组和单抗组较模型组明显减轻.结论 CCL20在CIA小鼠中异常高表达,以CCL20单克隆抗体阻断CCL20作用可有效缓解关节炎症,且与雷公藤效果相当,CCL20单克隆抗体在临床治疗类风湿关节炎方面具有潜在价值.     

丙酮酸乙酯对大鼠自身免疫性关节炎的治疗作用

目的观察丙酮酸乙酯对自身免疫性关节炎（CIA）大鼠关节炎症、骨质破坏及血清肿瘤坏死因子α（TNF-α）、白细胞介素10（IL-10）表达水平的影响,探讨其治疗类风湿关节炎的可能机制.方法实验大鼠分为正常对照组、CIA模型组和丙酮酸乙酯（EP）治疗组.用关节炎指数评价关节炎肿胀程度、HE染色、检测关节滑膜炎症及骨质破坏、酶联免疫吸附测定法（ELISA）检测血清TNF-α、IL-10浓度.结果 EP治疗组关节炎指数明显低于CIA模型组（P〈0.05）,EP治疗组炎性细胞渗出及骨质破坏明显低于CIA模型组（P〈0.05）,EP治疗组血清TNF-α水平较CIA模型组明显降低而IL-10水平明显升高（P〈0.05）.结论丙酮酸乙酯能减轻大鼠关节炎症、骨质破坏,能降低血清TNF-α表达水平、提高IL-10表达水平,表明丙酮酸乙酯有望成为治疗类风湿关节炎（RA）的一种新药.     

人骨髓间充质干细胞裂解物对胶原诱导的大鼠关节炎的治疗作用

以往的研究表明,间充质干细胞（mesenchymal stem cells,MSC）对Wistar大鼠胶原诱导性关节炎（colla-gen-induced arthritis,CIA）模型无治疗作用。本研究进一步探讨细胞裂解物是否具有CIA治疗作用。在造模4周后,裂解物治疗组CIA大鼠腹腔内注射1×107人骨髓MSC裂解物,阳性对照组CIA大鼠腹腔注射甲氨蝶呤（meth-otrexate,MTX）1 mg/kg,阴性对照组CIA大鼠腹腔注射生理盐水,以上各组治疗频率皆为每周1次,连续治疗4周。治疗4周后,记录大鼠踝关节肿胀程度变化,并进行病理学及X线摄片检查。结果表明：所有实验组大鼠都出现了关节炎症状,并在实验后期出现了关节畸形。治疗组关节炎综合评分均显著高于正常对照组（P〈0.01）,治疗4周后综合评分分别为6.87±0.83,6.44±1.13和7.33±0.77,治疗组之间无显著差异。病理学分析显示,MSC裂解物治疗组和对照组炎症综合评分分别为2.28±0.48和2.28±0.55,显著高于MTX组（0.71±0.48,P〈0.05）。然而,踝关节X线分析显示,对照组评分为4±0.57,显著高于裂解物治疗组（2.71±0.75）和MTX治疗组（2.57±0.78,P〈0.05）。结论：MSC裂解物对大鼠CIA有一定的治疗作用,但效果不及MTX。     

骨髓间充质干细胞对大鼠失血性休克后急性肺损伤的保护作用研究

目的 探讨骨髓间充质干细胞（MSC）对失血性休克后急性肺损伤（ALI）大鼠的治疗作用及机制.方法 以雄性Wistar大鼠作为供体提取MSC.将36只雄性Wistar大鼠通过气管内注射细菌脂多糖建立大鼠ALI模型,并将其中18只大鼠通过静脉注射MSC予以治疗（MSC组）,余18只为ALI组,同时以8只健康Wistar大鼠作为对照组.其中ALI组及MSC组各取10只大鼠用于大鼠生存时间比较,另每组8只与对照组大鼠进行肺湿/干重比、肺泡灌洗液中肿瘤坏死因子α（TNF-α）、转化生长因子β1 （TGF-β1）、Claudin-4含量监测,并通过Western blotting及逆转录聚合酶链反应（RT-PCR）方法检测肺组织中Claudin-4蛋白及mRNA表达变化. 结果 ALI组和MSC组中大鼠的48 h生存情况比较差异具有统计学意义（x2=5.05,P＜0.05）.ALI组和MSC组大鼠肺组织的湿/干重比及TNF-α较对照组均明显增加,且ALI组大鼠增高更为明显（P均＜0.05）;而对照组及MSC组大鼠的TGF-β1及Claudin-4水平较明显高于ALI组,且MSC组更为显著（P均＜0.05）.RT-PCR结果显示对照组大鼠Claudin-4 mRNA水平高于ALI组,但是明显低于MSC组（P均＜0.05）,与Western blotting结果检测结果一致. 结论 MSC治疗通过上调肺组织中Claudin-4的表达可以减轻大鼠失血性休克后ALI.     

糖基化终末产物对大鼠海马结缔组织生长因子与炎症因子表达的影响

目的探讨糖基化终末产物（AGEs）对大鼠海马区结缔组织生长因子（CTGF）与炎症因子白细胞介素1β（IL-1β）、肿瘤坏死因子（TNF-α）表达的影响及其可能的机制。方法 50只Wistar大鼠随机分为5组（每组10只）,各组用微量注射泵海马内注射法制造动物损伤模型。3周后：通过免疫组织化学检测各组大鼠海马转化生长因子β1（TGF-β1）、CTGF表达;通过Westernblot检测大鼠海马TGF-β1、CTGF以及炎症因子IL-1β和TNF-α表达并进行蛋白半定量分析。结果在AGE-BSA组大鼠的大脑海马区神经元内TGF-β1、CTGF着色呈棕黄色,颜色灰度明显高于正常对照组;AGE-BSA组TGF-β1、CTGF、IL-1β和TNF-α蛋白表达明显高于正常对照组（P〈0.01）;与AGE-BSA组比较,RAGE中和抗体组TGF-β1、CTGF、IL-1β和TNF-α蛋白表达明显减少（P〈0.05）。结论糖基化终末产物通过与其受体（RAGE）结合促进TGF-β1的表达上调,进而导致海马区神经元内CTGF的高表达,而且可以造成炎症因子IL-1β和TNF-α表达增多。     

Shoulder pain: a presentation of bilateral gonococcal arthritis of the shoulders

This is a report of a 47-year-old man presenting to the Emergency Department complaining of bilateral shoulder pain after developing pain in the right shoulder about 1(1/2)-2 weeks prior after heavy lifting while at work. Clinical suspicion of Gonococcal arthritis was confirmed on the basis of laboratory studies. Although Gonococcal arthritis is occasionally associated with uniarticular arthritis, this patient presented with bilateral joint involvement.     

复方丹参注射液对实验性大鼠类风湿关节炎的病理学影响

Rheumatoidarthritis（RA）isakindofautoimmunitydiseases，intheearlyphase，itmainlyaffectssynoviumandthengraduallyextendtojoints．Large－dosedcompoundsagerootinjectioniseffectiveintreatingRAinclinic，therapeuticeffectissatisfying．Inordertostudytheinvolvedmechanism，weestablishedCIAmodelsinducedbycol－lagenIItoinvestigatemechanismspathologically．１Materialsandmethod１．１ExperimentalanimalsNormalWistarratsweighting（１２０±２０）gwereprovidedbyCenterofExperimentalAnimalsofFirstMili－tar…     

大鼠胶原诱导性关节炎模型的制备及评价

目的：制备型胶原诱导性关节炎大鼠模型（CIA模型）。方法：将40只大鼠随机分为正常组和模型组。以酶联免疫吸附测定法（ELISA法）检测模型组和正常组大鼠血清中炎性细胞因子肿瘤坏死因子-α（TNF-α）水平,同时采用组织病理学和X线摄片的方法显示关节炎大鼠的发病程度和病理学特征。结果：与正常组相比,模型组在免疫后第36天关节肿胀达到最高峰。ELISA法检测结果显示模型组TNF-α的水平均较正常组大鼠明显增高（P〈0.05）。组织病理学和X射线摄片结果显示,关节软骨组织、骨组织和滑膜组织呈典型的关节炎病变。结论：胶原诱导的大鼠关节炎模型,其病理特征和人类类风湿关节炎（RA）极为相似,为进一步深入研究人类RA的发病机制及其临床治疗提供了有价值的实验材料。     

Medial thigh abscess mimicking septic arthritis of the knee: a report of two cases

Background

Septic arthritis of the knee joint requires prompt diagnosis and treatment for optimal outcomes. Pyomyositis with abscess formation is uncommon but may present with similar symptoms in the vicinity of a joint.

Objective

This report describes two cases of medial thigh abscess initially diagnosed and treated as septic arthritis, and highlights the need to make an accurate diagnosis.

Case Report

Two patients presenting with knee pain secondary to pyomyositis and abscess formation in the medial thigh were investigated with aspiration and treated subsequently with knee surgery, resulting in contamination of the knee joint in one case and delayed diagnosis with significant morbidity in both.

Conclusion

Failure to identify a soft tissue infection may lead to delayed diagnosis, misdirected treatment, and contamination of a normal joint. Diagnosis is best confirmed with thorough physical examination and specific imaging where available.     

Editorials

Chronic simple glaucoma affects approximately 2 per cent of persons more than 40 years of age. The disease should be diagnosed by suspicion in this age group, especially in the presence of family history of eye disease, structural defects such as a small cornea or shallow anterior chamber, or vague ocular symptoms. Diagnosis may be confirmed only by tonometry. If discovered in its early stages, the condition usually may be controlled with miotic therapy.     

Infection and Arthritis

Reactive arthritis is caused by an infection, and components of the triggering agent can be demonstrated at the site of inflammation. This fact has opened new views in studies regarding other rheumatic diseases, such as rheumatoid arthritis and ankylosing spondylitis. The possible role of infectious agents in their etiology and pathogenesis is being re-evaluated.     

Incidence of rheumatoid arthritis,psoriatic arthritis and polymyalgia rheumatica in an inland area of central Italy: results of the CAMPO-RHE study

Objective: The aim of the CAMPO-RHE study was to determine the incidence of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and polymyalgia rheumatica (PMR) in patients attending a rheumatologic outpatient’s clinic of a new institution in Campobasso, Italy.

Methods: Campobasso is a small town of approximately 50,000 inhabitants located in the inland territory of central Italy (Molise), and Public Health is managed from a single health authority. In Italy, all citizens are registered with a National Health System of General Practitioner (GP) Physicians. Between the 1^st of June 2014 and the 31^st of May 2016, all consecutive adult patients, sent by a GP, of Campobasso with any diagnosis of musculoskeletal symptoms/signs/complaints were evaluated in a single rheumatology outpatient clinic of our Academic Unit. The clinic represents the first and unique reference for GPs about rheumatic diseases in the territory. Subjects were classified using the 2010 EULAR criteria for RA, the CASPAR criteria for PsA and the 2012 ACR classification criteria for PMR.

Results: 1003 adult patients, sent by GPs, with articular or musculoskeletal complaints visited our clinic. Of these, 409 inhabitants of the municipality of Campobasso were evaluated for the study. During the 2-year study period we diagnosed 18, 19 and 12 new cases of RA, PsA and PMR respectively, with a new incident cases rate of 21.4, 22.59 and 27.43/100,000/year on the population at risk.

Conclusion: The results of our study could contribute to better define the incidence of these rheumatic diseases classified with the new classification criteria.