电温针配合中药治疗膝骨关节炎临床观察

目的　观察针药结合治疗膝骨关节炎的临床疗效。方法　将 13 8例患者随机分为治疗组 85例 ,运用电温针配合中药治疗 ;对照组 5 3例 ,以西药内服治疗。经治疗 1个月后停 1个月再行观察作疗效对照。结果　治疗组总有效率 89.4% ,对照组5 6.6% ,两组疗效差别有非常显著性意义 ( P<0 .0 1)。结论　电温针配合中药治疗膝骨关节炎效果明显、确切     

玻璃酸钠与Kenacort-A联合治疗膝骨关节炎合并滑膜炎临床观察

目的探讨玻璃酸钠(SH)联合肾上腺皮质激素类药Kenacort-A关节腔内注射治疗膝骨关节炎(OA)合并滑膜炎(SY)的临床疗效。方法选膝OA合并SY患者205例,随机分为单纯用药组(100例)和联合用药组(105例),单纯用药组给予SH关节腔内注射,联合用药组给予AH+Kenacor-A关节腔内注射。结果联合用药组的起效时间及疗效明显优于单纯用药组。结论SH联合Kenacort-A治疗膝OA合并SY,疗效快,可提高临床治疗效果。     

MMP13在骨性关节炎患者滑膜细胞中的表达

目的 观察在膝关节骨性关节炎（osteoarthritis，OA）患者的滑膜细胞中是否有基质金属蛋白酶13（matrix metalloproteinases-13，MMPl3）的mRNA表达。方法 分别取临床上5例确诊为膝关节骨性关节炎患者的滑液培养滑膜细胞，经形态学和免疫组化法鉴定其为成纤维细胞后，用RT-PCR检测其中MMPl3的mRNA表达。结果 所培养的细胞呈成纤维细胞样，Vimentin蛋白表达阳性，RT-PCR可检测到MMP13的mRNA表达，片断大小和文献报道的相一致。结论 骨性关节炎患者滑膜细胞中有MMP13的mRNA表达。     

中医医院膝关节骨关节炎住院患者的治疗情况--附892份病历分析

为了解中医医院膝关节骨关节炎住院患者的治疗现状,对湖南省12家中医医院5年膝关节骨关节炎住院患者治疗情况进行调查,摘录其相关治疗资料,并进行统计学分析处理.结果显示892例中,78.8%者内服中药汤剂,19.4%外用中药,所用中药性味多为辛温,内服药以祛风湿、补虚类药物居多,外用药以祛风湿、活血化瘀类药物为主.25.1%采用针灸治疗,常用穴位有膝眼、足三里、阳陵泉、阴陵泉、血海、梁丘等.13.1%接受推拿按摩治疗,但大多数病案未记载具体手法.46.2%内服NSAIDs,19.5%使用抗生素,15.4%使用激素类药物.表明中医医院对膝关节骨关节炎住院患者常采用中西医结合方法治疗,中医治疗多为各种方法组合的综合疗法,中药多选择性味辛温之品,祛风湿药、补虚药和活血化瘀类药物为临床常用中药.     

硫酸氨基葡萄糖预防兔膝骨关节炎的实验研究

目的:观察硫酸氨基葡萄糖预防兔实验性早中期骨关节炎(OA)病变发生发展及其对软骨修复作用的程度.方法:24只新西兰白兔切断膝关节前、后交叉韧带建立兔OA模型,随机分为对照组和实验组各12只,实验组术后第9周起加服硫酸氨基葡萄糖90mg·kg-1·d-1,对照组常规饲养.术后17周处死动物,取股骨内髁负重面软骨标本进行苏木紫-伊红(HE)染色、番红O/固绿(Safranin'O/Fast Green)组织化学染色及OA评分、分级.结果:切断兔前后交叉韧带可以成功复制出OA早、中期模型,第17周时实验组OA病理评分低于对照组(P<0.05).结论:硫酸氨基葡萄糖可以较好的预防OA的发生发展,同时对兔膝OA软骨退变有较好的修复作用.     

四环素对实验性骨关节炎MMP-1、NO及PGE_2的作用

研究表明,四环素类药物可阻止胶原分解,干扰软骨细胞分化,改善软骨损伤,对骨关节炎(OA)有一定保护作用[1],但具体机制尚不清楚.OA的发生发展与多种因子如前列腺素E2(PGE2)、一氧化氮(NO) 密切相关;金属蛋白酶-1(MMP-1)是一种新型的OA标志物.     

A systematic review on changed biomechanics of lower extremities in obese individuals: a possible role in development of osteoarthritis

Obesity has been identified as a risk factor for osteoarthritis. For the weight‐bearing joints, the combination of increased load and changed joint biomechanics could be regarded as underlying principle for this relation. This systematic review of the literature focused on the differences between obese and normal‐weight subjects in biomechanics of the hip, knee and ankle joint during every day movements to summarize differences in joint load due to both higher body weight and differences in movement patterns. A systematic search, up to November 2010, was performed in the Pubmed and Embase databases. This review showed that obese individuals adjust their movement strategy of every day movements. At self‐selected speed, obese individuals walked slower, with shorter and wider steps, had longer stance duration and had a greater toe‐out angle compared with normal‐weight individuals. Obese sit‐to‐stand movement was characterized by less hip flexion and greater foot displacement. Obese individuals showed altered biomechanics during every day movements. These altered biomechanics could be related to the initiation of osteoarthritis by a change in the load‐bearing regions of the articular cartilage in the weight‐bearing joints.     

Treatment of osteoarthritis in hypertensive patients

Importance of the field: Osteoarthritis and hypertension commonly co-exist. Treatment of osteoarthritis in hypertensive patients is a therapeutic challenge due to the adverse effects of some analgesics, especially non-steroidal anti-inflammatory drugs (NSAIDs), on blood pressure. Even small drug-induced rises in blood pressure due to therapy may significantly increase cardiovascular risk in these patients if sustained over the long term. Patients treated with certain classes of antihypertensive agent may be at particular risk of deterioration in blood pressure control with NSAID therapy. NSAIDs may also increase cardiovascular risk due to mechanisms other than by raising blood pressure.

Areas covered in this review: We discuss the management of osteoarthritis in the hypertensive patient, review the evidence for the effects of paracetamol and NSAIDs on blood pressure and discuss novel therapeutic strategies for osteoarthritis that might diminish this problem. A literature search was undertaken in PubMed including the years 1980 – 2009.

What the reader will gain: Insight will be gained into the complexity of treating patients with co-existent osteoarthritis and hypertension and into possible new approaches to treating osteoarthritis symptoms effectively in these patients while minimising any adverse impact on blood pressure control.

Take home message: There are ways to minimise the adverse impact of treatment of osteoarthritis on blood pressure control in hypertensive patients.     

Ulnar Neuropathy in Bicyclists

In brief: A common overuse injury associated with bicycling is ulnar neuropathy (handlebar palsy). The cyclist will notice the onset of numbness, weakness, and loss of coordination in one or both hands, usually after several days of cycling. Several corrective measures are suggested, including well-padded bicycling gloves, padded handlebars, correct frame size, correct distance from seat to stem, and frequent changing of hand position on the handlebars. If the pain cannot be alleviated by these measures, the cyclist should stop until improvement occurs.