蛋白组学在骨关节炎中的研究进展

骨关节炎(OA)是运动系统中一种常见疾病,在世界范围内都有着较高的致残率。OA病程较长,在其演变过程中发生了一系列的病理生理改变,包括关节软骨的退化、新骨的形成以及滑膜增生等,疼痛是患者最常见的症状,随着疾病的发展,病变关节的功能逐渐减退,最终导致患者残疾。早期OA引起的损伤是可逆的,但缺乏早期诊断方法以及有效的治疗手段,患者往往都要经历疾病的终末阶段,关节置换是晚期OA患者治疗的唯一有效手段。因此探寻早期OA的诊断手段进而进行早期有效的针对性干预对于改善患者的预后有着重要的临床意义。近年来,蛋白组学在OA中的研究取得了一定的进展,尤其在OA生物学标志物方面;但是,如何将这些研究成果应用于临床有待于进一步研究,本文就蛋白组学在OA中的研究进展作一简要综述。     

外后侧小切口交叉针联合前臂旋后位石膏托固定治疗儿童Gartland Ⅲ型肱骨髁上骨折

目的:评估外后侧小切口交叉克氏针钢丝张力带内固定治疗GartlandⅢ型儿童肱骨髁上骨折的临床疗效。方法:自2005年1月至2010年12月,共62例GartlandⅢ型儿童肱骨髁上骨折患者,男38例,女24例,年龄2～14岁,平均6.8岁。致伤原因均为跌伤,均为新鲜骨折,受伤至手术时间5～20h。采用外后侧小切口、交叉克氏针张力钢丝内固定,术后石膏托外固定于屈肘90°、前臂旋后、掌心向上位。术后10～12周,根据骨折愈合情况摘除克氏针及钢丝。分析相关临床指标和Flynn标准评定疗效。结果:手术时间30～50min,平均45min。切口均甲级愈合,所有病例无针尾部穿出切口造成的钉道感染,无医源性神经、血管损伤、异位骨化,骨折全部愈合。60例患儿获随访,时间6～24个月,平均15个月。术后6个月复查,按Flynn标准:优48例,良9例,差3例。其中差的3例为轻度肘内翻,内翻角均约6°,功能不受影响。结论:外后侧小切口交叉克氏针钢丝张力带内固定治疗GartlandⅢ型儿童肱骨髁上骨折具有显露清楚、固定牢靠的优点,可有效预防肘内翻的发生,是GartlandⅢ型儿童肱骨髁上骨折的一种实用有效的治疗方法。     

High drug loading hydrophobic cross-linked dextran microspheres as novel drug delivery systems for the treatment of osteoarthritis

Drug delivery via intra-articular (IA) injection has proved to be effective in osteoarthritis (OA) therapy, limited by the drug efficiency and short retention time of the drug delivery systems (DDSs). Herein, a series of modified cross-linked dextran (Sephadex, S0) was fabricated by respectively grafting with linear alkyl chains, branched alkyl chains or aromatic chain, and acted as DDSs after ibuprofen (Ibu) loading for OA therapy. This DDSs expressed sustained drug release, excellent anti-inflammatory and chondroprotective effects both in IL-1β induced chondrocytes and OA joints. Specifically, the introduction of a longer hydrophobic chain, particularly an aromatic chain, distinctly improved the hydrophobicity of S0, increased Ibu loading efficiency, and further led to significantly improving OA therapeutic effects. Therefore, hydrophobic microspheres with greatly improved drug loading ratio and prolonged degradation rates show great potential to act as DDSs for OA therapy.