血管内皮细胞生长因子在颞下颌关节骨关节炎中的研究进展

颞下颌关节骨关节炎（temporomandibular joint osteoarthritis, TMJOA）是一种发病率高、危害大的常见颞下颌关节紊乱病,其主要病理过程包括软骨退变、滑膜炎和黏连形成。血管内皮细胞生长因子（vascular endothelial growth factor,VEGF）是一种促进血管生长因子,近年来发现在TMJOA的关节盘、髁突软骨、滑膜组织及关节液中均有表达,故逐渐被认为是TMJOA形成的一种重要可疑因子。本文就VEGF在TMJOA发病过程中的作用及研究进展做一综述。     

色素沉着绒毛结节性滑膜炎行全髋关节置换术治疗的临床评估

目的回顾性研究全髋关节置换术结合滑膜切除治疗晚期髋关节色素沉着绒毛结节性滑膜炎(PVNS)的临床效果。方法对2000年10月至2010年6月间行髋关节切开滑膜清理加人工髋关节置换术治疗的13例晚期髋关节PVNS感染性患者进行回顾性研究,其中8例为局限型,5例为弥漫型,平均年龄33.7岁(21～65岁)。患者术前活动受限症状明显,术前检查提示关节面破坏,关节间隙狭窄,严重的伴有股骨头变形。术中采用关节切开滑膜广泛清理人工髋关节置换。随访分析患者功能恢复情况,比较术前、术后Harris评分及复发情况。结果 10例患者平均术后随访5.6年(0.5～10.3年),未出现复发,假体稳定,Harris评分从术前的47.6分提高到90.8分,能进行日常活动。3例出现复发,其中1例再次行切开清理术,术后良好;1例目前暂时行放射治疗;1例因复发面积广泛压迫下肢血液循环,减容手术无效最终行髋关节离断术。结论全髋关节置换结合增生滑膜切除是治疗局限型PVNS伴有骨质破坏的合适手术方式,能极大改善临床症状,复发率较低。对于弥漫型的治疗,复发率较高,仍待观察。     

色素沉着绒毛结节性滑膜炎的MRI诊断及随访评价

目的评价MRI在色素沉着绒毛结节性滑膜炎(PVNS)术前诊断和鉴别诊断、治疗效果及术后随访的作用。方法回顾性分析2003年1月到2011年1月在本组临床疑诊为大关节PVNS患者的临床及影像学资料,并与关节镜或手术病理进行比较,分析PVNS的MRI影像特点、诊断正确率、误漏诊原因,以及在术后随访及复发的鉴别诊断价值。结果 66例患者的资料纳入分析,54例经过病理确诊为PVNS,男23例,女31例。其中弥漫型为46例,局限型为8例。MRI诊断为PVNS55例,52例确诊为PVNS,MRI诊断PVNS准确率78.8%;术后复发20例,MRI诊断复发准确率100%;7例术后联合放射治疗,1例放疗后病理性骨折。结论 PVNS是一个容易复发的良性滑膜增生性疾病,MRI术前及术后诊断准确率高,MRI在术后随访中具有重要的意义。     

Brodie＇s abscess of medial distal femoral condyle after thorn prick： rare clinical presentation

Thorn prick injuries are generally conceded frivolous and rarely demand medical attention.Howbeit deep seated injuries are well described in the literature.We presented a case of thorn prick injury to ...     

Histology of joint inflammation induced in rats by cell wall fragments of the anaerobic intestinal bacterium Eubacterium aerofaciens

Summary To study the arthropathic properties of human intestinal bacteria, cell wall fragments (CWF) of the anaerobic bowel bacterium Eubacterium aerofaciens were injected intraperitoneally (i.p.) in arthritis-susceptible Lewis rats. Rat paw joints were subsequently studied for histopathological changes. A persisting synovitis accompanied by marginal erosions of cartilage and bone and a marked periosteal apposition of new bone tissue were the main features of the polyarthritis induced. These results are discussed in relation to streptococcal cell wall induced arthritis and compared with histopathological findings in rheumatoid arthritis (RA) in man.     

Neurogenic inflammation in osteoarthritis of the knee

Abstract

The synovium in a knee joint has an extensive neural network in the somatic and autonomic nervous systems. In medial compartmental osteoarthritis of the knee, neuropeptides were most abundant, with an especially large number of substance P and calcitonin gene-related peptide-immunoreactive free nerve endings. Some of the substance P-positive nerve endings were surrounded by monocytes. Substance P and calcitonin gene-related peptide were found more frequently in the medial than in the lateral or suprapatellar areas. Substance P-positive free nerve endings showed more dendritic morphologic features in the medial region than those in the lateral and suprapatellar regions, and small nerves were accompanied by newly developed vessels in synovial villi. In the medial region, the synovitis was more remarkable than in the lateral region. Patients suffering from medial compartmental osteoarthritis of the knee complain of pain on the anteromedial portion of the knee joint when walking or standing. Therefore, these findings suggest that free nerve endings containing substance P may be implicated in the development and persistence of inflammatory synovitis and the pain pathway in osteoarthritis of the knee.