DNMT3A对骨关节炎软骨细胞SOX9基因DNA甲基化修饰的影响

目的 探讨DNMT3A对SOX9基因DNA甲基化修饰的影响。方法 培养正常软骨细胞和OA软骨细胞,显微镜下观察软骨细胞形态,甲苯胺蓝染色、Ⅱ型胶原染色鉴定软骨细胞,qRT-PCR、Western Blot检测DNMT3A、SOX9 mRNA和蛋白表达水平,亚硫酸氢盐测序检测SOX9基因DNA甲基化状态,慢病毒沉默DNMT3A观察SOX9基因DNA甲基化修饰的变化。结果 正常软骨细胞形态规则,体积较大,数量较多,OA软骨细胞形态不规则,体积较小,数量较少。与正常软骨细胞比较,OA软骨细胞中DNMT3A mRNA和蛋白表达量增高（P＜0.05）,SOX9 mRNA和蛋白表达量明显降低（P＜0.05）,SOX9基因DNA甲基化百分比增高。在OA软骨细胞中沉默DNMT3A后,SOX9基因DNA甲基化百分比明显降低。结论 DNMT3A调节SOX9基因DNA甲基化修饰参与OA软骨细胞病变。     

Microheterogeneity of acute phase proteins in patients with clinically active and clinically nonactive osteoarthritis

Summary Microheterogeneity of two acute phase glycoproteins, -1-acid glycoprotein (AGP) and -1-antichymotryspin (ACT), concentrations of AGP, ACT, and C-reactive protein (CRP), and levels of three cytokines: interleukin 1 (IL-1-), interleukin 6 (IL-6), and tumor necrosis factor (TNF-) were determined in 61 serum samples and 7 synovial fluids (SFs) obtained from patients (n=61) with osteoarthritis. Using affinity immunoelectrophoresis with concanavalin A (conA), a significant decrease in the reactivity of AGP and ACT with this lectin was found in patients with clinically active osteoarthritis when compared to those with clinically nonactive disease (p<0.001 and p<0.05, respectively). There was no increase in the concentration of AGP, ACT, and C-reactive protein (CRP) in the sera examined. In particular, no increase in the serum level of these proteins was found in the patients with clinically active disease. Low concentrations of IL-6 and TNF- were found in most sera and SFs examined. In 6 out of 7 SFs available, IL-6 concentrations were higher than in the respective serum samples but for TNF- the same could be shown in one case only. Low concentrations of IL-1- were found in 4 serum samples obtained from patients with clinically active osteoarthritis and in no SF specimen studied. In the entire group, serum level of TNF- correlated weakly with the AGP and ACT reactivity coefficients with conA (r=0.3634, p<0.005 and r=0.3324, p<0.02, respectively).Our findings suggest that there are changes in the microheterogeneity of acute phase glycoproteins in some patients with osteoarthritis similar to those observed in rheumatoid arthritis and other chronic inflammations. Possible mechanisms of the involvement of cytokines in the regulation of glycosylation of acute phase glycoproteins in osteoarthritis are discussed.     

Changes in mean trabecular orientation in the medial condyle of the proximal tibia in osteoarthritis

In osteoarthritis of the knee, degenerative changes occur in the articular cartilage and underlying subchondral bone, particularly of the medial tibial condyle. Cancellous bone sclerosis that accompanies osteoarthritis is not only the result of an increase in bone volume fraction but also a change in trabecular structure. In a comparison with agematched controls (n=4), osteoarthritis (n=11) demonstrated a significant (P0.05) increase in bone volume fraction and trabecular thickness. Overal trabecular orientation in the osteoarthritic group was more vertical or perpendicular to the articular surface than the control group (P0.05) especially in the trabeculae of the cancellous bone layer closest to the articular surface. These alterations in trabecular bone structure could have significant consequences for the mechanical properties of osteoarthritic bone.     

关节镜诊断和治疗膝关节骨性关节炎40例临床分析

目的：探讨关节镜检术对膝关节骨性关节炎（关节退行性病,ＯＡ）的早期诊断和治疗效果。方法：在连续硬膜外麻下,取膝关节内侧入路,用关节镜对４０例膝关节ＯＡ（１９９４～１９９７）进行检查和镜下清理术。结果：随访２～４年（平均２．５年）,术后综合评估１～２年优良率８２．５％,２年以后优良率５２．５％。结论：关节镜检术可对膝关节ＯＡ的诊断和治疗提供较全面而准确的信息;镜下关节清理术对早期ＯＡ疗效良好,具有创伤小、恢复快、并发症少和可重复等优点。     

复方软伤伸筋丸治疗膝关节骨性关节炎临床研究

目的 :探讨复方软伤伸筋丸治疗膝关节骨性关节炎的疗效机理。方法 :采用单盲法将膝关节骨性关节炎患者 2 2 0例 ,随机分为软伤伸筋丸组 (治疗组 ) 1 60例 ,壮骨关节丸组 (对照组 ) 60例 ,对比分析两组临床疗效。结果 :1治疗组临床治愈率为 88.75 % ,总有效率为 99.3 5 % ;对照组临床治愈率为 2 3 .3 3 % ,总有效率为 91 .68% ,治疗组优于对照组 ,具有显著性差异 (P<0 .0 1 )。2复方软伤伸筋丸无毒副作用。3复方软伤伸筋丸的应用可使增生骨刺吸收 ,损伤半月板修复。结论 :复方软伤伸筋丸是一种治疗膝关节骨性关节炎安全有效药物。     

Clinical analysis of knee osteoarthritis treated mainly by acupuncture

目的:了解不同治疗方法对膝关节骨关节炎的临床治疗效果.方法:对148例患膝随机分为4组进行针灸、中药频谱照射法、综合法、西药内服治疗,观察其疗效.结果:4组总有效率分别为78.9%,72.7%,92.3%和78.9%,各组之间无差异(P＞0.05).综合组显效率优于其他各组(P＜0.05).结论:针灸、中药频谱照射对膝骨关节炎有一定疗效,综合法能协同两者作用,使疗效提高.     

Clinical observation on treatment of 60 cases of osteoarthritis of knee joint by electroacupuncture

Purpose To observe therapeutic effect of electroacupuncture Neixiyan (Ex-LE 4) and Dubi (ST 35) in treating osteoarthritis of knee joint.Method All the 120 cases were randomly divided into electroacupuncture and control groups, 60 cases in each group, and they were given electroacupuncture and Ritalin slowreleased tablet respectively, and pain, mobility and swelling degree of knee joint were observed before and after treatments.Results In treatment group, the average score increased by 18, while in control group, it increased by 12.33 (P<0.05) after treatment.Conclusion Therapeutic effect of electroacupuncture Neixiyan (Ex-LE 4) and Dubi (ST 35) in treating osteoarthritis of knee joint was better than that of administration of Ritalin slow-released tablet. Author: DAI Qi-ping (1966-), female, attending physician Translator: Wu Xue-fei     

骨关节炎软骨细胞凋亡调控基因的研究

目的　比较分析正常人及老年性骨关节炎患者软骨细胞bax和bcl 2的表达及细胞凋亡状况。　方法　取 9例骨关节炎患者的关节软骨做实验标本 ,以 6例无骨关节炎病史的意外死亡者关节软骨作为正常对照 ;采用逆转录 /聚合酶链反应 (RT PCR)方法检测bax和bcl 2mRNA表达 ,免疫组化检测bax和bcl 2蛋白 ;应用TUNEL方法进行凋亡细胞原位检测。　结果　骨关节炎患者和正常对照软骨细胞都能表达bax和bcl 2mRNA ;骨关节炎关节软骨细胞baxmRNA表达量较正常对照显著增高 (P <0 0 1) ,bcl 2mRNA表达量也高于正常对照组 (P <0 0 5 ) ,两组间bax/bcl 2表达量的比值差异无显著性意义 (P >0 0 5 ) ;免疫组化可检测到相应表达水平的蛋白 ;骨关节炎软骨细胞凋亡 (4%～ 14% )多于正常对照 (0～ 2 % )。　结论　软骨细胞凋亡受bax和bcl 2共同调节 ;bax和bcl 2的共同调节结果可能是OA患者软骨细胞凋亡增加 ,但凋亡率不高、病理过程进展缓慢的一个重要的原因     

一氧化氮合酶抑制剂对实验性骨关节炎PGE2的调节作用

目的: 探讨一氧化氮合酶(nitric oxide synthase, NOS)抑制剂在实验性骨关节炎(osteoarthritis, OA)关节滑液中对前列腺素E2(prostaglandin E2, PGE2)的调节作用,为研制针对NO治疗OA的药物提供理论依据. 方法: 采用兔右后腿膝关节伸直位石膏管固定建立实验性OA模型,同时建立对照组,分别给予NOS抑制剂L-硝基精氨酸甲酯(L-NAME)或环氧化酶-2(COX-2)抑制剂塞来昔布, 检测各实验组关节滑液中的NO水平与PGE2的含量. 结果: L-NAME 石膏固定组的NO水平和PGE2浓度, 明显比单纯石膏固定组低,两者的差异有显著的统计意义(P<0.01),而塞来昔布 石膏固定组的NO水平,与单纯石膏固定组NO水平比较,两者的差异没有显著的统计学意义(P>0.05).结论: 实验性OA关节滑液中, NOS抑制剂L-NAME不仅能有效降低OA关节滑液中NO的水平,同时下调PGE2的浓度,而COX-2抑制剂对NO的水平无明显影响.     

养血软坚胶囊治疗膝骨关节炎疗效及安全性评价的随机对照试验

目的比较养血软坚胶囊以及市售中成药抗骨质增生胶囊、西药氨基葡萄糖(商品名维骨力)在治疗膝关节骨关节炎(OA)时的疗效、安全性。方法本试验设计为二家医院进行的随机对照研究。医院1为随机、双盲、阳性中成药抗骨质增生胶囊对照,患者分为2组,每组30例,治疗组服用养血软坚胶囊5粒,每日3次,每粒含药物0.21g、赋形剂0.14g,对照组服用抗骨质增生胶囊5粒,每日3次,每粒含药物0.35g。所有治疗药物均采用双盲、双模拟法完整封装;医院2为随机、西药软骨保护剂氨基葡萄糖对照。患者分为2组,每组30例。治疗组服用养血软坚胶囊3粒,每日3次,每粒含药物0.35g;对照组服用氨基葡萄糖胶囊2粒,每日3次,每粒0.375g。所有患者在停用既往非甾类抗炎药(NSAID)或止痛治疗后2～7d以及服用受试药物治疗后0、2、4周,采用西安大略和麦克马斯特大学骨关节炎调查量表(WOMAC)调查问卷,根据标准疗效判定方法进行评估。结果养血软坚胶囊在改善OA的症状和体征上有显著效果。最大抗炎和镇痛作用出现在2~4周。对骨关节炎临床症状和体征的改善与市售中成药抗骨质增生胶囊及西药维骨力相当。养血软坚胶囊及各对照组均有良好的耐受性。治疗前后,二家医院患者疼痛积分分别下降50%和62%,僵硬积分下降54%和67%,功能积分改善52%和63%。结论养血软