胰岛素对糖尿病小鼠小肠功能的影响

Objective To investigate the effects of regular insulin (RI)on duodenal smooth muscle in diabetic mice. Methods Diabetes mellitus (DM) model was established by intraperitoneal injection of 150 mg/kg streptozotocin (STZ) in male BALB/c mice. The model mice were divided into DM group and DM treated with RI group with 6 each. Meanwhile, 6 normal mice were served as controls. The mice in treatment group were intraperitoneally injected with 40 U/kg of RI daily.Whereas the mice in DM and control groups were intraperitoneally injected with phosphate buffer solution (pH = 7. 40). After 6 weeks, the small intestinal transit rate of mice was determined by lavage of Indian ink. Interstitial cells of cajal (ICC) in duodenal myenteric plexus were counted using immunohistochemical staining. Slow waves of duodenal smooth muscle cells were recorded with intracellular recordings. Data were analysed by SPSS 17.0 software, and comparisons among three groups were done using LSD test. Results After intervention for 6 months, the clinical presentations,such as more water and food intake and polyuria, were improved in treatment group. The body weight was increased in treatment group [(23.33±3.13) g] compared with DM group [(15.42±1.40) g,P＜0.01] ,but dereased compared with control group [(26.78 ± 2.09) g, P＜0.05]. The level of blood glucose in DM group was significantly higher than that in control and treatment groups(P＜0.01). Small intestine transmission rate was significantly reduced in DM group than that in control and treatment groups (P＜0.01), but it was slower in treatment group than that in control group (P＜ 0. 01 ). Immunohistochemical study showed that the number of c-kit positive cells reduced obviously in DM group than that in control group and treatment group (P＜0.05), whereas it was lower in treatment group than that in control group (P ＜ 0.05). The slow wave frequency and amplitude of duodenal smooth muscle cells in DM group were reduced when compared with control and treatment groups (P＜0.01) and both were lower in treatment group than that in control group (P＜0. 01 ). Conclusion The findings indicate that DM mice have gastrointestinal dysmotility and exogenous insulin may improve small intestinal dysmotility in DM mice.     

胰岛素对糖尿病小鼠小肠功能的影响

Objective To investigate the effects of regular insulin (RI)on duodenal smooth muscle in diabetic mice. Methods Diabetes mellitus (DM) model was established by intraperitoneal injection of 150 mg/kg streptozotocin (STZ) in male BALB/c mice. The model mice were divided into DM group and DM treated with RI group with 6 each. Meanwhile, 6 normal mice were served as controls. The mice in treatment group were intraperitoneally injected with 40 U/kg of RI daily.Whereas the mice in DM and control groups were intraperitoneally injected with phosphate buffer solution (pH = 7. 40). After 6 weeks, the small intestinal transit rate of mice was determined by lavage of Indian ink. Interstitial cells of cajal (ICC) in duodenal myenteric plexus were counted using immunohistochemical staining. Slow waves of duodenal smooth muscle cells were recorded with intracellular recordings. Data were analysed by SPSS 17.0 software, and comparisons among three groups were done using LSD test. Results After intervention for 6 months, the clinical presentations,such as more water and food intake and polyuria, were improved in treatment group. The body weight was increased in treatment group [(23.33±3.13) g] compared with DM group [(15.42±1.40) g,P＜0.01] ,but dereased compared with control group [(26.78 ± 2.09) g, P＜0.05]. The level of blood glucose in DM group was significantly higher than that in control and treatment groups(P＜0.01). Small intestine transmission rate was significantly reduced in DM group than that in control and treatment groups (P＜0.01), but it was slower in treatment group than that in control group (P＜ 0. 01 ). Immunohistochemical study showed that the number of c-kit positive cells reduced obviously in DM group than that in control group and treatment group (P＜0.05), whereas it was lower in treatment group than that in control group (P ＜ 0.05). The slow wave frequency and amplitude of duodenal smooth muscle cells in DM group were reduced when compared with control and treatment groups (P＜0.01) and both were lower in treatment group than that in control group (P＜0. 01 ). Conclusion The findings indicate that DM mice have gastrointestinal dysmotility and exogenous insulin may improve small intestinal dysmotility in DM mice.     

Effects of tongue acupuncture combined with rehabilitation training group of dysarthria on speech function in post-stroke dysarthria patients

正Objective To observe the effects of tongue and nape acupuncture combined with rehabilitation training group of dysarthria on speech function in post-stroke dysarthria patients,and to explore the treatment of dysarthria.Methods Eighty patients with dysarthria were randomly     

Influence of acute hyperglycemia in human sepsis on inflammatory cytokine and counterregulatory hormone concentrations

AIM: In human sepsis, a prominent component of the hypermetabolite is impaired glucose tolerance (IGT) and hyperglycemia. Elevations in plasma glucose concentration impair immune function by altering cytokine production from macrophages. We assessed the role of glucose in the regulation of circulating levels of insulin, glucagon, cortisol,IL-6 and TNF-α in human sepsis with normal or impaired glucose tolerance.METHODS: According to the results of intravenous glucose tolerance test, forty patients were classified into two groups: control group (n=20) and IGT group (n=20).Plasma glucose levels were acutely raised in two groups and maintained at 15 mmol/L for 3 hours. Plasma insulin,glucagon and cortisol levels were measured by radioimmunoassay, the levels of TNF-α and IL-6 were detected by ELISA.RESULTS: In IGT group, the fasting concentrations of plasma glucose, insulin, glucagon, cortisol, IL-6 and TNFα levels were significantly higher than those in control group (P＜0.05). During clamp, the control group had a higher average amount of dextrose infusion than the IGT group (P＜0.01). In control group, plasma insulin levels rose from a basal value to a peak at an hour (P＜0.05) and maintained at high levels. Plasma glucagon levels descended from a basal value to the lowest level within an hour (P＜0.01)and low levels were maintained throughout the clamp. In IGT group, plasma insulin was more significantly elevated (P＜0.01), and plasma glucagon levels were not significantly declined. Plasma cortisol levels were not significantly changed in two groups. In control group, plasma IL-6 and TNF-α levels rose (P＜0.01) within 2 hours of the clamp and returned to basal values at 3 hours. In IGT group, increased levels of plasma cytokine lasted longer than in control group (3 hours vs. 2 hours, P＜0.05), and the cytokine peaks of IGT group were higher (P＜0.05) than those of control group.CONCLUSION: Acute hyperglycemia pricks up hyperinsulinemia and increases circulating cytokine concentrations and these effects are more pronounced in sepsis with IGT. This suggests a potential modulation of immunoinflammatory responses in human sepsis by hyperglycemia.     

Effect of nursing-based on early rehabilitation on quality of life in elderly patients with cardiovascular disease:A randomized controlled trial

Background Patients with cardiovascular disease(CVD) have a reduced quality of life(QOL) partly due to their limited range of physical activity and independence. The objective of this study was to investigate whether the nurse based early cardiac rehabilitation will be improved QOL in elderly patients with CVD after8-week treatment from baseline and post intervention, compared with conventional care. Methods Sixty-six elderly patients with CVD were randomly assigned(using the coin tossing method) to either the ‘early cardiac rehabilitation' group(i.e. the experimental group), and the control group(i.e. routine care group) for 8weeks between June 2013 and June 2014, with 33 participants in each group. The control group received routine CVD care, and the experiment group received early rehabilitation care in addition to routine CVD care.The outcome measures included the Short Form-36 Health Survey(SF-36), and Self-rating Anxiety Scale(SAS). Results There were non-significant differences between the groups at baseline in age, sex, duration of the disease, length of hospitalization, total number of comorbid conditions, and total number of medications(P 0.05). Following 8-week treatment, all groups improved their QOL scores and SAS anxiety scores(P 0.05). In addition, the nursing based on early cardiac rehabilitation group was significantly improved in QOL and SAS anxiety scores(P 0.05), when compared with the control group. Conclusions This study has demonstrated that the nurse based early cardiac rehabilitation is effective in increasing selected aspects of a general QOL and improved the anxiety situation in elderly patients with CVD. It is worthwhile to be widely used in clinical practice.     

Therapeutic efficacy of high-dose vitamin C on acute pancreatitis and its potential mechanisms

AIM: To observe the therapeutic efficacy of high-dose Vitamin C 0/it. C) on acute pancreaUtis (AP), and to explore its potential mechanisms. METHODS: Eghty-four AP patients were divided into treatment group and control group, 40 healthy subjects were taken as a normal group, In the treatment group, Vit. C (10 g/day) was given intravenously for 5 days, whereas in the control group, Vit. C (1 g/day) was given intravenously for 5 days. Symptoms, physical signs, duration of hospitalization, complications and mortality rate were monitored. Meanwhile, serum amylase, urine amylase and leukocyte counts were also determined. The concentration of plasma vitamin C (P-VC), plasma lipid peroxide (P-LPO), plasma vitamin E (P-VE), plasma β-carotene (P-β-CAR), whole blood glutathione (WB-GSH) and the activity of erythrocyte surperoxide dimutase (E-SOD) and erythrocyte catalase (E-CAT) as well as T lymphocyte phenotype were measured by spectrophotometry in the normal group and before and after treatment with Vit. C in the treatment and the control group. RESULTS: Compared with the normal group, the average values of P-VC, P-VE, P-β-CAR, WB-GSH and the activity of E-SOD and E-CAT in AP patients were significantly decreased and the average value of P-LPO was significantly increased, especially in severe acute pancreatitis (SAP) patients (P<0.05. P-VC, P=0.045; P-VE, P=0.038; P=0.041;P-β-CAR, P=0.046; WB-GSH, P=0.039; E-SOD, P=0.019;E-CAT, P=0.020; P-LPO, P=0.038). Compared with the normal group, CD3 and CD4 positive cells in AP patients were significantly decreased. The ratio of CD4/CD8 and CD4 positive cells were decreased, especially in SAP patients (P<0.05. CD4/CDs, P=0.041; CD4, P =0.019). Fever and vomiting disappeared, and leukocyte counts and amylase in urine and blood become normal quicker in the treatment group than in the control group. Moreover, patients in treatment group also had a higher cure rate, a lower complication rate and a shorter in-ward days compared with those in he control group. After treatment, the average value of P-VC was significantly higher and the values of SIL-2R, TNF-α, IL-6 and IL-8 were significantly lower in the treatment group than in the control group (P<0.05 P-VC, P=0.045; SIL-2R, P=0.012; TNF-α, P=0.030; IL-6, P=0.015,and IL-8, P=0.043). In addition, the ratio of CDJCD8 and CD4 positive cells in the patients of treatment group were significantly higher than that of the control group after treatment (P<0.05. CD4/CDs, P =0.039; CD4, P=0.024). CONCLUSION: High-dose vitamin C has therapeutic efficacy on acute pancreatitis. The potential mechanisms include promotion of anti-oxidizing ability of AP patients, blocking of lipid peroxidation in the plasma and improvement of cellular immune function.     

Study on the therapeutic mechanisms of pseudolaric acid in mice with allergic contact dermatitis

Objective:To study the therapeutic mechanisms of pseudolaric acid on allergic contact dermatitis in mice.Methods:A total of 50 BALB/C mice were selected and randomly divided into control group,model group,and treatment A,B,C groups with 10 rats in each group.ACD model was established in model group,and treatment A,B,C groups but not in control group.Model group received no treatment,but treatment A,B,C groups were treated with external application of the concentration of 0.1%,0.2% and 0.4% of the pseudolaric acid for the lesions of ear skin.And the weight gain and the swelling degree of the mice' ear were recorded,weight of thymus and spleen were measured.Spleen suspension was prepared to test T lymphocyte and B lymphocyte levels of mice in five groups.Changes in serum IFN-ed through the enzyme linked immunosorbent assay(ELISAγ,IL-4 and IL-10 levels were test).Results:The weight gain of mice in model group were significant lower than those of mice in the control group and the treatment A,B,C groups(P0.05).Weight gain of mice in treatment A,B groups were significant lower than that of control group(P0.05),but the difference in weight gain between treatment C group and control group showed no significant difference(P0.05).The swelling degree and the weight of mice ears in model group were significant higher than those of mice in control group and treatment A,B,C groups(P0.05).Swelling degree and the weight of mice ears of treatment A,B,C groups were obviously higher than that of control group(P0.05).The swelling degree and weight of mice' ears in treatment A,B,C groups were decreased with the increase of the drug dosage,but comparison between A,B and C group showed statistically differences(P0.05).The thymus and spleen index of mice in model group were significant higher than those of the other four groups(P0.05),among the four groups,thymus and spleen index of treatment A and B group were higher than control group and treatment C group(P0.05).The stimulation index of T and B cells of mice in model group was significantly higher than the rest four groups(P0.05).The serum IFN-γ level of mice in control group and treatment A,B and C group was obviously lower than that of mice in model group(P0.05).The serum IFN-γ level of mice in treatment A,B and C group were decreased with the increasing of the drug dosage,and the level of C group was obviously lower than that of A and B group(P0.05).Conclusion:The pseudolaric acid has anti-inflammation and immune adjustment the effects showing a remarkable therapeutic effects for the ACD mice.     

瑞舒伐他汀改善糖尿病大鼠血管内皮功能的实验研究

目的 评价不同剂量瑞舒伐他汀对糖尿病大鼠血管内皮功能的保护作用.方法 24只糖尿病大鼠随机分为3组:糖尿病对照组、瑞舒伐他汀20 mg组(RV 20 mg组)和10 mg组(RV 10mg组);8只健康SD大鼠作为正常对照组.给药共8周,分别于给药前和给药后第8周测定血浆内皮素-1(ET-1)、一氧化氮(NO)、血糖、血脂含量.结果 用药前糖尿病大鼠各组血糖均显著高于正常对照组(P＜0.01);RV 20 mg和RV 10 mg组在给药后第8周血糖稍低于糖尿病对照组,但差异无统计学意义(P＞0.05).糖尿病对照组血浆NO浓度明显低于SD正常对照组(P＜0.05),给药8周后,用药组血浆NO浓度明显高于糖尿病对照组(P＜0.01或P＜0.05).糖尿病对照组血浆ET-1浓度高于SD正常对照组(P＜0.05);给药8周后,用药组血浆ET-1浓度明显低于糖尿病对照组(P＜0.01或P＜0.05).RV 20 mg组和RV 10 mg组比较,血浆E-1浓度降低及血浆NO浓度升高(P＜0.05).同时,RV 20 mg组和RV 10 mg组血胆固醇水平明显低于糖尿病对照组(P＜0.01).结论 瑞舒伐他汀可明显降低糖尿病大鼠的血胆固醇水平,同时通过提高血浆NO浓度和降低E-1浓度等机制改善血管内皮功能.

Abstract：

Objective To evaluate the effects of two different dosage of rosuvastatin on endothelial dysfunction in diabetic rats. Methods The 24 diabetic rats were randomly divided into three groups (n=8,each): diabetic control group, 20 mg rosuvastatin daily (RV 20 mg group) and 10mg rosuvastatin daily for 8 weeks (RV 10 mg group) and normal control group (SD group). The levels of blood glucose, lipid, nitric oxide(NO) and endothelin-1 (ET-1) were measured before and 8 weeks after treatment. Results The levels of blood glucose were higher in all diabetic rats groups than in SD group before experiment (P＜0. 01). Compared with diabetic rats control group, blood glucose was slightly lower in RV 10 mg group and RV 20 mg group at 8 weeks (P＞0. 05). The plasma NO level was significantly lower in diabetic rats control group than in SD group (P＜0. 05).After 8 weeks, plasma NO levels were significantly higher in RV 20 mg and RV 10 mg groups than in diabetic rats control group (P＜0. 01 or P＜0. 05). The plasma levels of ET-1 was significantly higher in diabetic rats control group than in SD group (P＜0. 01). After 8 weeks, plasma ET-1 levels were significantly lower in RV 20 mg and RV 10 mg group than in diabetic rats control group (P＜0. 01).Meanwhile, the plasma lipids were lower in RV 20 mg and RV 10 mg group than in diabetic control group (P＜0. 05 or P＜0. 01). Conclusions Rosuvastatin can adjust blood lipids and significantly improve endothelial function in diabetic rats by increasing plasma NO level and decreasing plasma ET-1 level.     

Rifaximin improves survival in cirrhotic patients with refractory ascites: A real-world study

BACKGROUND Rifaximin has been shown to reduce the incidence of hepatic encephalopathy and other complications in patients with cirrhosis.However,few studies have investigated the effect of rifaximin in cirrhotic patients with refractory ascites.AIM To evaluate the effects of rifaximin in the treatment of refractory ascites and to preliminarily explore its possible mechanism.METHODS A total of 75 cirrhotic patients with refractory ascites were enrolled in the study(50 in a rifaximin and 25 in a control group).Patients in the rifaximin group were divided into two subgroups according to the presence of spontaneous bacterial peritonitis and treatment with or without other antibiotics(19 patients treated with rifaximin and 31 patients treated with rifaximin plus intravenous antibiotics).All patients received conventional treatment for refractory ascites,while patients in the rifaximin group received oral rifaximin-α200 mg four times daily for at least 2 wk.The ascites grade,fasting weight,liver and kidney function,and inflammatory factors in the plasma were evaluated before and after treatment.In addition,the gut microbiota was determined by metagenomics sequencing to analyse the changes in the characteristics of the gut microbiota before and after rifaximin treatment.The patients were followed for 6 mo.RESULTS Compared with the control group,the fasting weight of patients significantly decreased and the ascites significantly subsided after treatment with rifaximin(P=0.011 and 0.009,respectively).The 6-mo survival rate of patients in the rifaximin group was significantly higher than that in the control group(P=0.048).The concentration of interferon-inducible protein 10 decreased significantly in the rifaximin group compared with that in the control group(P=0.024).The abundance of Roseburia,Haemophilus,and Prevotella was significantly reduced after rifaximin treatment,while the abundance of Lachnospiraceae_noname,Subdoligranulum,and Dorea decreased and the abundance of Coprobacillus increased after treatment with rifaximin plus intravenous antibiotics.The gene expression of virulence factors was significantly reduced after treatment in both subgroups treated with rifaximin or rifaximin plus intravenous antibiotics.CONCLUSION Rifaximin mitigates ascites and improves survival of cirrhotic patients with refractory ascites.A possible mechanism is that rifaximin regulates the structure and function of intestinal bacteria,thus improving the systemic inflammatory state.     

胰岛素对糖尿病小鼠小肠功能的影响

目的 探讨胰岛素(regular insulin,RI)对糖尿病(DM)小鼠小肠功能的影响.方法 一次性给予雄性BALB/c小鼠链脲佐菌素(STZ,150 mg/kg)腹腔注射造模.将造模成功小鼠分为DM组6只,DM+RI组6只,另选血糖正常小鼠6只为对照组.DM+RI组给予RI 40U·kg-1·d-1皮下注射,对照组和DM组每天给予等量的磷酸盐缓冲液(pH=7.4)腹腔注射.所有小鼠干预6周结束后,给予印度墨水灌胃测定胃肠传输速率.免疫组织化学法检测各组小鼠十二指肠组织的c-kit阳性细胞数目.最后处死所有小鼠,用细胞内记录技术记录各组小鼠十二指肠平滑肌细胞内慢波的变化.采用SPSS 17.0软件分析,多组资料间比较采用LSD检验.结果 干预6周后,DM+RI组的多饮、多食、多尿症状比DM组减轻,体重较DM组明显增加[(23.33±3.13)g比(15.42±1.40)g,P＜0.01],但比对照组降低[(26.78±2.09)g,P＜0.05].第6周DM组血糖值显著高于对照组(P＜0.01),但比DM+RI组显著升高(P＜0.01).DM组小肠推进率比DM+RI组和对照组明显降低(P值均＜0.01);DM+RI组也较对照组降低(P＜0.01).光镜下观察到DM组c-kit阳性细胞数明显低于DM+RI组和对照组(P值均＜0.05),DM+RI组比正常组减少(P＜0.05).DM组慢波频率比DM+RI组和对照组显著降低(P值均＜0.01),而DM+RI组慢波频率比对照组降低(P＜0.01).DM组慢波波幅比DM+RI组和对照组明显降低(P值均＜0.01),而DM+RI组慢波波幅比对照组降低(P＜0.01).结论 DM小鼠存在胃肠动力障碍,外源性RI可能对DM小鼠小肠动力障碍有一定的改善作用.

Abstract：

Objective To investigate the effects of regular insulin (RI)on duodenal smooth muscle in diabetic mice. Methods Diabetes mellitus (DM) model was established by intraperitoneal injection of 150 mg/kg streptozotocin (STZ) in male BALB/c mice. The model mice were divided into DM group and DM treated with RI group with 6 each. Meanwhile, 6 normal mice were served as controls. The mice in treatment group were intraperitoneally injected with 40 U/kg of RI daily.Whereas the mice in DM and control groups were intraperitoneally injected with phosphate buffer solution (pH = 7. 40). After 6 weeks, the small intestinal transit rate of mice was determined by lavage of Indian ink. Interstitial cells of cajal (ICC) in duodenal myenteric plexus were counted using immunohistochemical staining. Slow waves of duodenal smooth muscle cells were recorded with intracellular recordings. Data were analysed by SPSS 17.0 software, and comparisons among three groups were done using LSD test. Results After intervention for 6 months, the clinical presentations,such as more water and food intake and polyuria, were improved in treatment group. The body weight was increased in treatment group [(23.33±3.13) g] compared with DM group [(15.42±1.40) g,P＜0.01] ,but dereased compared with control group [(26.78 ± 2.09) g, P＜0.05]. The level of blood glucose in DM group was significantly higher than that in control and treatment groups(P＜0.01). Small intestine transmission rate was significantly reduced in DM group than that in control and treatment groups (P＜0.01), but it was slower in treatment group than that in control group (P＜ 0. 01 ). Immunohistochemical study showed that the number of c-kit positive cells reduced obviously in DM group than that in control group and treatment group (P＜0.05), whereas it was lower in treatment group than that in control group (P ＜ 0.05). The slow wave frequency and amplitude of duodenal smooth muscle cells in DM group were reduced when compared with control and treatment groups (P＜0.01) and both were lower in treatment group than that in control group (P＜0. 01 ). Conclusion The findings indicate that DM mice have gastrointestinal dysmotility and exogenous insulin may improve small intestinal dysmotility in DM mice.     

双醋瑞因、硫酸氨基葡萄糖联合透明质酸钠治疗膝骨关节炎疗效观察

目的研究双醋瑞因、硫酸氨基葡萄糖联合透明质酸钠治疗膝骨关节炎的临床疗效。方法将160例骨关节炎患者随机分为2组,治疗组80例给予双醋瑞因50mg,口服,1次／天,硫酸氨基葡萄糖胶囊500mg,口服,3次／天,共服药12周;透明质酸钠注射剂2．5ml膝关节腔内注射,每周1次,连续5周为1个疗程。对照组80例仅予双醋瑞因和硫酸氨基葡萄糖口服（剂量、疗程同前）观察治疗前、治疗后12周、24周临床疗效指标、炎性指标和影像学表现改善情况。结果12周时2组患者在临床疗效指标、炎性指标方面较治疗前比较均显著改善（P均〈0．05）;治疗组改善程度优于对照组（P〈0．05）。24周时,治疗组的临床疗效指标、炎性指标等均较治疗前改善（P〈0．05）,但改善程度较12周时下降（P〈0．05）,但仍优于对照组（P〈0．05）,此时影像学表现方面有改善（P〈0．05）;对照组的临床疗效指标、炎性指标和影像学表现等与治疗前比较无明显改善（P〉0．05）。治疗过程中,两组患者均未发生严重不良反应。结论双醋瑞因和硫酸氨基葡萄糖联合透明质酸钠治疗膝骨关节炎是可行、安全、优效、便捷、疗效持久的方案,值得临床推广。     

关节镜清理术联合玻璃酸钠注射治疗膝关节骨性关节炎的临床观察

目的探讨关节镜清理术联合玻璃酸钠药物注射治疗膝关节骨性关节炎的临床效果。方法将2017年6月至2019年3月本院收治的98例膝关节骨性关节炎患者按随机数字表法分为试验组与对照组,各49例。试验组接受关节镜清理术联合玻璃酸钠药物注射治疗,对照组接受单独关节镜清理术治疗。观察两组治疗前后关节疼痛程度、关节液炎症细胞因子表达、膝关节功能及并发症发生率。结果相较于治疗前、治疗后24小时、4个月两组关节疼痛VAS评分均降低,且试验组评分低于对照组,差异有统计学意义(P<0.05)。相较于治疗前,治疗后4个月两组关节液内IL-1β、TNF-α表达均降低,且试验组IL-1β、TNF-α表达分别为(309.64±20.48)pg/ml、(425.37±32.24)pg/ml,低于对照组的(328.76±21.63)pg/ml、(463.31±35.09)pg/ml,差异有统计学意义(P<0.05)。相较于治疗前,治疗后4个月两组膝关节功能均改善,且试验组(79.53±1.57)分高于对照组的(70.36±1.68)分,差异有统计学意义(P<0.05)。两组并发症总发生率对比(14.29%vs 10.20%),差异无统计学意义(P>0.05)。结论关节镜清理术联合玻璃酸钠药物注射治疗膝关节骨性关节炎疗效确切,能减轻或消除关节疼痛等症状,降低炎症反应,改善患者膝关节功能,且并发症少,值得推广。     

软组织贴扎技术对老年膝关节内侧副韧带损伤后的康复疗效观察

目的 观察软组织贴扎技术治疗老年患者膝关节内侧副韧带损伤后膝关节功能障碍的康复疗效果,为治疗该病提供方法.方法 选择2019年5月-2020年12月于上海市仁济医院宝山分院康复治疗科和骨科就诊的老年患者共52例,采用随机数字表随机分为2组:试验组(n=27)和对照组(n=25).对照组采取常规康复治疗,试验组在与对照组...     

Comparison of therapeutic effects of sodium hyaluronate and corticosteroid injections on trapeziometacarpal joint osteoarthritis

This was a randomized, open-label, evaluator-blinded clinical study including 40 women with stage II or III trapeziometacarpal joint osteoarthritis. The steroid group (n?=?20) received one injection of 20 mg triamcinolone acetonide once and the hyaluronate group (n?=?20) received three injections of 5 mg sodium hyaluronate at 1-week intervals. The pain level was assessed using a visual analog scale and grip and pinch strengths were measured using a hand grip dynomemeter and pinch gauge. The Duruöz Hand Index was used to evaluate hand function. Pain level decreased significantly over 12 months for the steroid group and over 6 months for the sodium hyaluronate group. Pinch strength did not improve in either group, but grip strength improved significantly in both groups. Hand function improved in both groups but it was only significant in the steroid group. Our findings showed that both intra-articular injection of steroid and sodium hyalurunate are effective in trapeziometacarpal joint osteoarthritis. However the steroid injection was found to be superior to sodium hyaluronate injection in reducing pain and improving hand function.     

Efficacy of intra-articular sodium hyaluronate in the treatment of knee osteoarthritis

 To assess the efficacy of intra-articular hyaluronic acid in patients with knee osteoarthritis, sixty female patients with knee osteoarthritis were randomised to three weekly intra-articular injections of 30 mg sodium hyaluronate (Na HA) with a high molecular weight (1.0 to 2.9 million Da) or 40 mg 6-methylprednisolone acetate (6-MPA). The clinical assessments included pain at rest, at weight-bearing and on walking, Lequesne Index and active range of knee flexion. Assessments were done at baseline, at week 4, and at months 3 and 6. A significant decrease in VAS scores for pain at rest, at weight-bearing and pain on walking, and in Lequesne index was found in both groups at week 4 when compared to baseline and there was no significant differences between the two groups. However, at 3^rd month improvement in all pain scores and Lequesne index was found in favour of hyaluronic acid. At 6^th, no significant difference was found between the treatment groups. Improvement in pain was accompanied by an increase in joint flexion at week 4 and at month 3 in both groups. Both treatments were well-tolerated. The results showed that both intra-articular hyaluronic acid and 6-MPA treatments provide clinically significant improvement and demonstrated that Na HA has a long-term beneficial effect in patients with knee osteoarthritis. Received: 13 May 2002 / Accepted: 21 November 2002     

The potential of intra-articular injection of chondrogenic-induced bone marrow stem cells to retard the progression of osteoarthritis in a sheep model

In recent years, the use of bone marrow mesenchymal stem cell (BMSC) implantation has provided an alternative treatment for osteoarthritis. The objective of this study is to determine whether or not an intra-articular injection of a single dose of autologous chondrogenic induced BMSC could retard the progressive destruction of cartilage in a surgically induced osteoarthritis in sheep. Sheep BMSCs were isolated and divided into two groups. One group was cultured in chondrogenic media containing (Ham's F12:DMEM, 1:1) FD+1% FBS+5 ng/ml TGFβ3+50 ng/ml IGF-1 (CM), and the other group was cultured in the basal media, FD+10% FBS (BM). The procedure for surgically induced osteoarthritis was performed on the donor sheep 6 weeks prior to intra-articular injection into the knee joint of a single dose of BMSC from either group, suspended in 5 ml FD at density of 2 million cells/ml. The control groups were injected with basal media, without cells. Six weeks after injection, gross evidence of retardation of cartilage destruction was seen in the osteoarthritic knee joints treated with CM as well as BM. No significant ICRS (International Cartilage Repair Society) scoring was detected between the two groups with cells. However macroscopically, meniscus repair was observed in the knee joint treated with CM. Severe osteoarthritis and meniscal injury was observed in the control group. Interestingly, histologically the CM group demonstrated good cartilage histoarchitecture, thickness and quality, comparable to normal knee joint cartilage. As a conclusion, intra-articular injection of a single dose of BMSC either chondrogenically induced or not, could retard the progression of osteoarthritis (OA) in a sheep model, but the induced cells indicated better results especially in meniscus regeneration.     

Comparing the efficacy of different intra-articular injections for knee osteoarthritis: A network analysis

Background:The findings on the effectiveness of platelet-rich plasma, ozone, and hyaluronic acid in the treatment of osteoarthritis of the knee are controversial, and the existing original studies and meta-analyses are mostly comparisons of a single joint cavity injection method, lacking direct and indirect comparisons of different drugs in the joint cavity. The lack of direct and indirect comparisons of different drugs in the joint cavity makes it difficult to have a clearer and more comprehensive understanding of joint cavity injection methods. In this study, the efficacy of platelet-rich, ozone, sodium hyaluronate, and combined knee cavity injections were compared directly or indirectly using a reticulated meta-analysis in this field, and the efficacy of treatment measures was ranked to provide more comprehensive and reliable evidence-based clinical evidence for the selection of knee cavity injections in osteoarthritis of the knee.Objective:To compare the effects of platelet-rich plasma, ozone, and sodium glassate injection interventions on the efficacy of osteoarthritis of the knee through reticulated Meta-analysis, and to comprehensively compare the clinical effectiveness of platelet-rich plasma, ozone, and sodium glassate injection joint cavity injection for the treatment of osteoarthritis of the knee.Methods:The PubMed, CBM, CNKI, VIP, and Wan-Fang databases were searched for information on the effectiveness of platelet-rich plasma, ozone, and sodium vitrate injection for the comparative treatment of osteoarthritis of the knee, with a search time frame of each database from the date of creation to July 20, 2021. Two investigators independently screened the literature, extracted data according to inclusion and exclusion criteria, and evaluated the quality of the literature in parallel. Statistical analysis was performed using Stata 16.0 software to compare the differences in the efficacy of each treatment measure using the ratio and 95% confidence interval as effect indicators and to rank the efficacy.Results:Thirty-three RCTs with 7003 patients with osteoarthritis of the knee were included, involving 5 therapeutic measures. Meta-analysis showed that the efficacy of platelet-rich plasma injection was superior to both ozone and hyaluronic acid therapies. Hyaluronic acid+ozone and platelet-rich plasma+hyaluronic acid were both superior to ozone and hyaluronic acid monotherapy. The differences in efficacy between hyaluronic acid and ozone compared with platelet-rich plasma were statistically significant, and the differences in efficacy between the 2 combination therapies (platelet-rich plasma+hyaluronic acid, hyaluronic acid+ozone) and the 3 monotherapies (platelet-rich plasma, ozone, hyaluronic acid) were statistically significant. Platelet-rich plasma+hyaluronic acid, hyaluronic acid+ozone compared with 3 monotherapies (platelet-rich plasma, ozone, hyaluronic acid) were statistically significant, except for the difference in efficacy with platelet-rich plasma, which was not statistically significant, indicating that this platelet-rich plasma+hyaluronic acid and Hyaluronic acid+ozone combination therapy was superior to monotherapy. Also, the efficacy of platelet-rich plasma was better than hyaluronic acid and ozone and the difference was statistically significant, indicating that platelet-rich plasma was more effective than ozone and sodium glass in the treatment of osteoarthritis of the knee in monotherapy.Conclusion:It is believed that in the course of clinical practice, hyaluronic acid+ozone or platelet-rich plasma+hyaluronic acid combination therapy or platelet-rich plasma therapy can be preferred for patients with osteoarthritis of the knee.     

Hyaluronic acid in the treatment of osteoarthritis of the knee.

OBJECTIVES: We examined the efficacy, safety and patient satisfaction of intra-articular hyaluronic acid (HA) in patients with osteoarthritis of the knee. METHODS: One hundred patients with mild to moderate osteoarthritis of the knee entered a randomized blind-observer trial of 6 months HA vs placebo. Primary efficacy criteria were pain on walking, measured with a visual analogue scale, and the Lequesne Index. RESULTS: For pain on walking, a significant difference in favour of HA was found for completed patients at week 5, the end of the course of injections, and at month 6, the end of the study (P = 0.0087 and P = 0.0049, respectively). Further analysis using the Last Observation Carried Forward (LOCF) also showed a significant benefit favouring HA at month 6 (P = 0.0010). For the Lequesne Index, a significant difference in favour of HA was found at week 5 (P = 0.030) and at month 2 (P = 0.0431), but this was only of borderline significance at month 4 (P = 0.0528). Patients' global assessment of efficacy favoured HA at month 6 (P = 0.012). Improvement in other secondary criteria was generally superior in the HA group compared to placebo both at week 5 and month 6. Adverse events, mainly local injection site reactions, occurred in both groups with equal frequency. CONCLUSIONS: The study demonstrated that five weekly intra-articular injections of sodium hyaluronate (Hyalgan) were superior to placebo and well tolerated in patients with osteoarthritis of the knee with a symptomatic benefit which persisted for 6 months.     

体外冲击波联合中药独活寄生汤治疗膝关节骨性关节炎的临床研究

目的探讨体外冲击波(ESW)联合中药独活寄生汤治疗早中期膝关节骨性关节炎(KOA)的疗效和安全性。方法将360例(445膝)按患者治疗意愿分为中药独活寄生汤治疗组(A组)、单纯ESW治疗组(B组)、ESW联合中药独活寄生汤综合治疗组(C组),每组120例。分别对三组患者治疗前和治疗后2周、6周、12周、24周行VAS疼痛评分及Lysholm功能评分检查,以及膝关节液中一氧化氮(NO)、超氧化物歧化酶(SOD)等含量检测,并进行对比。结果与治疗前比较,治疗后2周、6周、12周、24周,三组VAS疼痛评分均降低,Lysholm功能评分均提高,C组VAS疼痛评分、Lysholm功能评分与其他两组比较差异均有统计学意义(P<0.05)。三组患者治疗后2周、6周、12周、24周膝关节液中NO含量较治疗前降低,SOD含量较治疗前增高,差异有统计学意义(P<0.05);C组与其他两组比较差异有统计学意义(P<0.05)。结论ESW联合中药独活寄生汤综合治疗早中期KOA是一种具有多方面优越性的无创性可行技术,临床疗效确切,值得推广应用。     

Intra-articular methylprednisolone acetate injection at the knee joint and the hypothalamic–pituitary–adrenal axis: a randomized controlled study

The objective of this study was to evaluate the effect of intra-articular corticosteroid injection (IACI) of methylprednisolone acetate (MPA) on the hypothalamic–pituitary–adrenal (HPA) axis in patients with osteoarthritis of the knee. Patients with symptomatic osteoarthritis of the knee who failed to respond to nonsteroidal anti-inflammatory medications and physical therapy were randomized between group 1 and group 2. Group 1 patients had an IACI of 80 mg of MPA at the knee joint and group 2 patients had an intra-articular injection (IAI) of 6 ml (60 mg) of sodium hyaluronate (control group). Immediately prior to the IAI and on weeks 1, 2, 3, 4, and 8 following IAI, patients from both groups underwent a low-dose (1 μg) adrenocorticotropin hormone (ACTH) stimulation test. Demographic, clinical, laboratory, and radiologic variables were documented in all patients. Both criteria of <7 μg/dl increase in the serum cortisol level and absolute levels of <18 μg/dl 30 min following the ACTH stimulation test were used to define secondary adrenal insufficiency (SAI). Twenty patients were randomized in each group. In group 1, 25 % of patients had SAI vs. none in group 2 (p?=?0.0471). The earliest SAI was observed at week 2, and latest SAI was observed at week 4. SAI was observed at one time point, two consecutive time points, or two separate time points in the same patient. There was no correlation between SAI and any of the demographic, clinical, or laboratory variables. An IACI of 80 mg MPA at the knee joint induced a transient SAI in 25 % of the patients, an effect that was observed between week 2 and week 4 following the IACI.