关节软骨微环境的物质输运研究进展

关节软骨是最常见且研究最多的一种透明软骨;其软骨细胞的物质输运主要由扩散和对流2种方式完成.在关节软骨的胞外基质内,生物活性分子的扩散和对流输运在组织生理调节和细胞生物学响应中起到极为重要的作用.近年来,关节软骨与软骨下骨的交互作用备受关注;其交互作用在骨关节炎的发生发展中不容忽视.本文主要对关节软骨内、关节软骨与软骨下骨间物质输运的实验研究进展进行综述,旨在为研究关节软骨微环境的生理病理作用提供一定参考,并为临床治疗骨关节炎提供一定的新思路.     

关节软骨微环境的物质输运研究进展

关节软骨是最常见且研究最多的一种透明软骨;其软骨细胞的物质输运主要由扩散和对流2种方式完成.在关节软骨的胞外基质内,生物活性分子的扩散和对流输运在组织生理调节和细胞生物学响应中起到极为重要的作用.近年来,关节软骨与软骨下骨的交互作用备受关注;其交互作用在骨关节炎的发生发展中不容忽视.本文主要对关节软骨内、关节软骨与软骨下骨间物质输运的实验研究进展进行综述,旨在为研究关节软骨微环境的生理病理作用提供一定参考,并为临床治疗骨关节炎提供一定的新思路.     

关节软骨与软骨下骨病变的研究进展

骨关节炎(osteoarthritis,OA)是以关节软骨(articular cartilage, AC)和软骨下骨(subchondral bone,SCB)进行性退变为特征的全关节疾病(包括滑膜、半月板、韧带、肌腱和关节脂肪垫等),研究证明在OA的进展中伴随着软骨基质的丢失、潮线的复制、钙化软的前移、软骨下骨的微损伤、骨髓病变、囊肿的发生以及骨的代谢失衡。这些病理改变不仅影响了关节的正常力线结构,还增加了关节内异常的分子信号交流,引发关节的疼痛以及变性。本文就AC和SCB的病理改变和其机制进行综述,分析骨与软骨、与OA发展的潜在联系,为临床评估患者病情及制定治疗方案提供参考。     

骨关节炎中关节软骨和周围骨的变化

骨关节炎（OA）是最常见的关节炎,同时也是造成中老年人伤残的重要原因。曾经一度认为关节软骨的改变是骨关节炎主要的病变,但现在普遍认为,所有关节结构包括软骨钙化区、软骨下骨、骨小梁、关节囊等都会受到影响。然而骨与软骨所起到的作用、之间的关系如何还不明确。本文就骨关节炎中关节软骨和周围骨的变化作一综述。     

软骨下骨病变在骨关节炎发病进程中的作用

膝骨关节炎是一种常见的慢性、进行性骨关节疾病,严重危害中老年人生活质量。对骨关节炎的病理研究以前主要集中在骨关节滑膜、软骨等层面,对于软骨以下的结构研究较少。目前研究认为软骨下骨对骨关节炎的影响巨大,可能是骨关节炎的初始病理改变,因此本文主要探讨关节软骨下骨病理改变对骨关节炎的影响,以其进一步阐明骨关节炎的病理机制。     

血小板衍生生长因子-AA在骨关节炎发生发展中的作用

骨关节炎是一种累及整个关节的慢性退行性疾病,它的发生、发展与软骨、软骨下骨、滑膜等组织的破坏及代谢异常存在密切关系.血小板衍生生长因子-AA(PDGF-AA)是包括软骨细胞、成骨细胞、破骨细胞、间充质干细胞在内的多种细胞重要的促有丝分裂和迁移的生长因子,能够有效地促进创伤修复.本文就软骨、软骨下骨、滑膜在骨关节炎的发展...     

骨-软骨交互作用与骨关节炎的研究进展

骨关节炎(OA)进程中,为适应局部生化环境及生物信号的改变,由软骨及软骨下骨构成的关节功能单位经历了不可控制的分解及合成代谢的重构过程。软骨及软骨下骨信号分子的交互作用使两者在病理上相互影响、相互作用。新生血管及微裂隙的形成为骨-软骨间分子通讯提供结构基础。WNT、骨形态发生蛋白、转化生长因子β和丝裂原活化蛋白激酶等信号通路可能是构成OA中骨-软骨交互作用的分子基础。     

骨关节炎软骨下骨的变化及其分子机制的研究进展

 骨关节炎(osteoarthritis, OA)是一种最常见的慢性骨关节疾病,可累及整个关节。软骨下骨作为关节的重要组成部分,与OA的发生发展密切相关。OA中软骨下骨变化的机制复杂,目前尚未完全阐明。本文通过文献回顾对OA中软骨下骨的病理变化,OPG/RANKL/RANK系统、转化生长因子β (transforming growth factor β, TGFβ)、雌激素-雌激素受体信号通路和脂代谢等因素对软骨下骨的影响进行综述,探讨OA中软骨下骨变化的作用及其分子机制。     

中药诱导干细胞软骨分化的实验研究进展

关节软骨退变和其继发的骨质增生是骨关节炎（Osteoarthritis,OA）的核心病理改变。在机械性和生物性因素作用下,关节软骨细胞、细胞外基质以及软骨下骨正常合成和降解偶联失衡,关节软骨纤维化、溃疡、缺失,软骨下骨的硬化,骨赘形成和软骨下囊变,形成关节炎。膝关节是关节软骨退变最常见部位,致残率高。中医药在治疗骨关节病方面,有丰富的经验,临床疗效也较好。很多学者对中药诱导干细胞软骨分化,治疗骨关节炎的作用机理做了深入研究。本文就相关实验研究情况做一综述。     

骨关节炎病理变化过程的研究进展

骨关节炎(osteoarthritis,OA)是全世界老年人中常见的导致残疾和疼痛的慢性疾病,其特点是关节软骨的退行性改变、软骨下骨硬化、骨赘的形成、骨软骨血管生成和关节炎症,最终发生关节软骨退变、断裂、缺损,甚至整个关节面的损害。目前OA的发病机制尚未阐明,有效的治疗药物仍缺乏。本文就骨关节炎早期到晚期病理变化的动态过程进行综述。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.