Ultrasonographic evaluation of the femoral cartilage thickness in patients with chronic renal failure

Objective To investigate the effects of chronic renal failure (CRF) on the distal femoral cartilage thickness by using ultrasonography and to determine the relationship between cartilage thickness and certain disease-related parameters. Design Fifty-seven CRF patients (41 male and 16 female) (mean [SD] age, 44.7 [12.1] years) and 60 healthy controls (41 male and 19 female) (mean [SD] age, 43.5 [13.3] years) were enrolled in this study. Demographic and clinical characteristics were recorded. Cartilage thickness measurements were taken from the medial and lateral condyles, and intercondylar areas of both knees. Results Groups were similar in terms of age, weight, height, body mass index and gender (all p>0.05). The mean cartilage thickness was found to be less in CRF patients than in controls (statistically significant for medial condyles and intercondylar areas both in right and the left knees [all p<0.05]). Cartilage thickness showed no correlation with eGFR, and with the levels of serum urea, creatinine, calcium, magnesium, phosphor, hemoglobin, uric acid and as well as steroid use (all p>0.05) in CRF patients. Conclusion In the light of our findings, we imply that patients with CRF have thinner femoral cartilage than healthy controls. This result may support the view that patients with CRF are at increased risk for developing early knee osteoarthritis. Last but not least, clinicians should be aware of the importance of rehabilitation strategies aimed at decreasing onset and progression of knee osteoarthritis in patients with CRF.     

独活寄生汤加味治疗强直性脊柱炎41例临床观察

[目的]观察独活寄生汤加味治疗强直性脊柱炎疗效。[方法]对41名住院和门诊患者使用独活寄生汤加味（细辛3g,肉桂、甘草各6g,人参、川芎各10g,防风12g,川牛膝、秦艽、杜仲、当归、白芍、狗脊、忍冬藤、络石藤各15g,独活、桑寄生、茯苓各20g,熟地黄30g）,水煎服,1剂／d,2次／d。连续治疗1个月为1疗程。观测临床症状、晨僵时间、疼痛程度、夜间疼痛时间、枕墙距、指地距、胸廓扩展度、Schober征、Patrick试验、血沉（ESR）,C-反应蛋白（CRP）,血、尿常规,肝肾功能、不良反应。连续治疗4疗程,判定疗效。[结果]显效622例,有效10例,无效9例,总有效率78．05％。[结论]独活寄生汤加减治疗强直性脊柱炎效果良好,值得推广。     

中医药治疗膝骨性关节炎研究概况

从病因病机（古代、现代）、中医证候、治疗（内服、外用、针灸推拿、综合疗法、其它）、实验研究等方面,介绍中医药治疗膝骨性关节炎研究概况。指出未来期望中医药治疗膝骨性关节炎应朝着更规范、更系统的深层次研究方向努力,充分发挥中医药独特优势。     

独活寄生汤治疗痹证的体会

痹症是临床常见病,多发病。临床上常见的类风湿性关节炎、风湿性关节炎等疾病均属中医学“痹症”范畴。由于这些疾病病程较长,病势缠绵,症状痛苦,给患者身心带来的极大的影响,现代医学对这些疾病目前尚无特效的治疗方法。而中医中药对这些疾病的发病及治疗有较早的认识,对其治疗存在一定的优势,近年来在临床上运动独活寄生汤加减治疗痹症,明显改善了患者的症状,取得满意疗效。     

中医药治疗痛风性关节炎的研究进展

对痛风性关节炎中医药治疗研究进展情况进行研究和分析。论述了中医辨证思路及痛风性关节炎中医药治疗等相关知识。对于痛风性关节炎,采用中医药治疗较为普遍,临床效果较好,患者无明显不良反应。     

Clinical and genetic risk factors for aromatase inhibitor-associated arthralgia in breast cancer survivors

BackgroundArthralgia is a common and debilitating toxicity of aromatase inhibitors (AI) that leads to premature drug discontinuation. We sought to evaluate the clinical and genetic risk factors associated with AI-associated arthralgia (AIAA).MethodsWe performed a cross-sectional study among postmenopausal women with stage 0-III breast cancer who were prescribed a third-generation AI for adjuvant therapy. The primary outcome was patient-reported AIAA occurrence. We extracted and assayed germline DNA for single nucleotide polymorphisms (SNPs) of genes implicated in estrogen and inflammation pathways. Multivariable logistic regression models examined the association between demographic, clinical, and genetic factors and AIAA. Analyses were restricted to White participants.ResultsAmong 1049 White participants, 543 (52%) reported AIAA. In multivariable analyses, women who had a college education [Adjusted Odds Ratio (AOR) 1.49, 95% Confidence Interval (CI) 1.00–2.20], had a more recent transition into menopause (<10 years) (5–10 years AOR 1.55, 95% CI 1.09–2.22; <5 years AOR 1.78, 95% CI 1.18–2.67), were within one year of starting AIs (AOR 1.61, 95% CI 1.08–2.40), and those who received chemotherapy (AOR 1.38, 95% CI 1.02–1.88) were significantly more likely to report AIAA. Additionally, SNP rs11648233 (HSD17B2) was significantly associated with higher odds of AIAA (AOR 2.21, 95% CI 1.55–3.16).ConclusionsTime since menopause and start of AIs, prior chemotherapy, and SNP rs11648233 within the HSD17B2 gene in the estrogen pathway were significantly associated with patient-reported AIAA. These findings suggest that clinical and genetic factors involved in estrogen withdrawal increase the risk of AIAA in postmenopausal breast cancer survivors.     

膝关节手术中射频汽化仪和关节镜技术的应用效果

目的分析膝关节手术中射频汽化仪和关节镜技术的运用效果。方法选取北京市隆福医院2018年9月至2019年9月收治的150例行膝关节手术治疗的膝关节损伤患者,按照随机数字表法分为A组与B组各75例,A组运用关节镜技术治疗,B组运用射频汽化仪和关节镜技术治疗,随访6个月,对比两组的治疗效果与关节疼痛程度(VAS评分)、膝关节功能(HSS评分)以及软骨恢复情况(软骨缺损最大径)。结果B组的总有效率(94.66%)高于A组(77.33%),P<0.05;B组治疗后的VAS评分[(1.07±0.34)分]低于A组[(3.05±0.78)分],P<0.05;B组治疗后的HSS评分[(89.25±4.88)分]高于A组[(75.20±4.31)分],P<0.05;B组治疗后的软骨缺损最大径[(7.83±2.50)mm 2]小于A组[(10.89±2.76)mm 2],P<0.05。结论膝关节手术中射频汽化仪和关节镜技术的运用效果显著,总有效率高,且可显著缓解关节疼痛,改善膝关节功能,促进软骨恢复。     

How to investigate: Pre-clinical rheumatoid arthritis

Multiple studies have shown that there is a pre-clinical period preceding the development of rheumatoid arthritis (RA). During this period, complex interactions between the environmental and genetic causes occur, and the expression “preclinical RA” has been proposed to define it. Early treatment intervention is associated with less joint damage and has an increased possibility of achieving remission. In this review, we provide an overview of the preclinical phases of RA, new immunological and imaging biomarkers, and the clinical features, and the management of individuals at-risk of developing RA.