Haemorrhagic bullous lesions in a 3-year-old girl with Henoch-Schölein purpura

Henoch–Schönlein purpura (HSP) is the most common vasculitis in children and is characterized by cutaneous purpura, arthritis, abdominal pain and nephritis. We report a case involving a 3‐year‐old girl with HSP who displayed rapidly evolving haemorrhagic bullae from primary purpuric lesions during systemic corticosteroid therapy. Conclusion: The bullae disappeared within 7 days of systemic corticosteroid therapy, although some scarring of the skin occurred. Also, bullae should not be considered as a poor prognostic factor of renal outcome in HSP.     

Systemic symptoms associated with orbital venous vasculitis

Orbital venous vasculitis has been suggested to cause characteristic periorbital pain in patients with pathologic changes in their orbital phlebograms. The orbital pain is characterized by being unilateral, not shifting side, boring and pressing, but not throbbing, increasing on eye strain, exposure to cold, or weather changes, and resistant to analgesics. It is ameliorated by steroids. Fifty patients with symptoms of orbital venous vasculitis were investigated for other symptoms that could be related to the vasculitis. When the 32 female patients were compared with a randomly selected age- and sex-matched control group, there was a significant increase of symptoms of chronic fatigue, cold feet, gut problems such as constipation and/or diarrhea, arthralgia, memory impairment, rotatory vertigo, spontaneous ecchymoses (all, p less than 0.0001), back pain (p less than 0.012), and thrombophlebitis (p less than 0.022) in the patient group. These symptoms, although commonly occurring, seem in these patients to be related to the vasculitis. Blood tests of the fifty patients showed signs of inflammation which did not disagree with the hypothesis of an immunologic cause of the orbital venous vasculitis.     

Peripheral neuropathy,polymyalgia and arthralgia: A paraneoplastic syndrome associated with myeloma

Summary We describe a patient with peripheral neuropathy, polymyalgia, arthralgia and cervical vertebral osteosclerosis who was subsequently diagnosed to have fatal multiple myeloma with IgG gammopathy and lambda urinary chains. The initial presentation and clinical features are discussed.     

药物引起关节疼痛192例文献分析

目的:探讨药物引起关节疼痛的一般规律及特点。方法:对1994年1月-2005年6月国内医药学术期刊报道的有关药物 引起关节疼痛192例文献进行统计、分析。结果:关节疼痛可出现在静脉滴注用药过程中,也可在用药几个月后,甚至在长期服药几 年后才出现;引起关节疼痛的药物种类以抗微生物药、循环系统药及消化系统药为主,其中由吡嗪酰胺引起的最多,达110例 (57．29％)。结论:临床应重视药物引起的关节疼痛,以确保用药安全。     

Osteoclastogenesis induced by CHIKV-infected fibroblast-like synoviocytes: A possible interplay between synoviocytes and monocytes/macrophages in CHIKV-induced arthralgia/arthritis

Fibroblast-like synoviocytes are known to migrate from joint to joint and are proposed to be one of the key players in the inflammatory cascade amplification in rheumatoid arthritis patients. In the recent CHIKV epidemic, patients developed arthritis-like syndrome and the synoviocyte is one of the suspected players in CHIKV-induced polyarthritis. Thus, to learn more on this syndrome, the responses of fibroblast-like synoviocytes to chikungunya virus (CHIKV) infection, and the interaction between CHIKV-infected synoviocytes and phagocytes, were investigated. Primary human fibroblast-like synoviocyte (HFLS) cultures were infected with clinical isolates of CHIKV at an MOI of 0.001 pfu/cell. Data indicated that HFLS are permissive to CHIKV replication, generating peak titers of 10⁵–10⁶ pfu/ml. Interestingly, CHIKV-infected HFLS cultures secreted mainly the mediators that are responsible for phagocytes recruitment and differentiation (RANKL, IL-6, IL-8 and MCP-1) but not arthritogenic mediators (TNF-α, IL-1β, MMP-1, MMP-2 or MMP-13). The interaction between CHIKV-infected synoviocytes and phagocytes was studied using UV-irradiated, CHIKV-infected HFLS supernatant. Data revealed that supernatants from CHIKV-infected HFLS cultures not only induced migration of primary human monocytes, but also drove monocytes/macrophages into osteoclast-like cells. These differentiated osteoclast-like cells produced high levels of TNF-α and IL-6, principal mediators of arthritis. This data suggests a potential interplay between infected HFLS and recruiting phagocytes which may responsible for the arthralgia/arthritis in CHIKV-infected patients.     

扶正祛邪在痹症中的应用

本文主要讨论了扶正祛邪法在痹症中的应用。     

姚荷生活用防已茯苓汤的案例分析

本文收集了名医姚荷生先生运用防已茯苓汤加减辨冶的亲笔病案77例,通过数据整理、统计分析,客观探讨其运用本方的辨证指征与加减方法,挖掘其活用本方的学术思想与独到经验,推广名方防已茯苓汤的使用范围,启迪后学对经方、经典的活学活用。     

筋骨痛宁胶囊口服配合中药薰洗治疗早期膝骨关节炎的疗效观察

目的：观察口服筋骨痛宁胶囊配合中药薰洗治疗早期膝骨关节炎的临床疗效。方法：将符合要求的120例患者随机分为实验组（A组）和对照组（B组）,每组60例。A组采用口服筋骨痛宁胶囊配合中药薰洗治疗;B组患者进行玻璃酸钠关节内注射。治疗1个疗程后进行观察随访,于治疗结束后第12个月时观察记录2组患者疗效积分,评价其临床疗效。结果：A组疗效优于B组,差异有统计学意义（χ2=7.295,P=0.007）。结论：筋骨痛宁胶囊口服配合中药薰洗可有效缓解早期膝骨关节炎患者的临床症状,促进肢体功能恢复。