The effects of sodium hyaluronate on mRNA expressions of matrix metalloproteinase-1,-3 and tissue inhibitor of metalloproteinase-1 in cartilage and synovium of traumatic osteoarthritis model

teoarthritis (OA)isadegenerativeprocessofjointscharacterizedbyprogressivedeteriorationanderosionofcartilage .TraumaticOAcausedbyjointsinjuryandoperationiscommonlyobserved .Intra articularinjectionofsodiumhyaluronate (HA )isnowwidelyusedintreatmentofOA .It…     

Intra-articular injection of the cyclooxygenase-2 inhibitor parecoxib attenuates osteoarthritis progression in anterior cruciate ligament-transected knee in rats: role of excitatory amino acids

OBJECTIVE: Our present study examined the effect of intra-articular cyclooxygenase-2 (COX-2) inhibitor parecoxib on osteoarthritis (OA) progression and the concomitant changes in excitatory amino acids' (EAAs) levels of the anterior cruciate ligament-transected (ACLT) knee joint dialysates. METHODS: OA was induced in Wistar rats by anterior cruciate ligament transection of the knee of one hindlimb, the other was left unoperated and untreated. Rats were placed into four groups: Group ACLT/P received intra-articular parecoxib injection (100 microg) in the ACLT knee once a week for 5 consecutive weeks starting at 8 weeks after surgery. Group ACLT/S received the same procedure as group ACLT/P with saline injection instead. Na?ve (Na?ve/P) rats received only intra-articular parecoxib injection in one knee once a week for 5 consecutive weeks without surgery. The sham-operated rats underwent arthrotomy only without treatment. Twenty weeks after surgery, knee joint dialysates were collected and EAAs' concentration was assayed by high-performance liquid chromatography, and gross morphology and histopathology (Mankin and synovitis grading) were examined on the medial femoral condyles and synovia. RESULTS: Parecoxib alone had no effect on cartilage and synovium of normal knees in Na?ve/P rats. In ACLT/P rats, parecoxib treatment showed a significant inhibition of cartilage degeneration of the medial femoral condyle at both the macroscopic level (1.15+/-0.17 vs 2.55+/-0.12, P<0.05) and the Mankin scores (3.03+/-0.28 vs 8.82+/-0.43, P<0.05). Intra-articular parecoxib injection also suppressed the synovial inflammation of ACLT joint compared to the ACLT/S group (3.92+/-0.41 vs 9.25+/-0.32, P<0.05). Moreover, glutamate and aspartate levels were also significantly reduced in the ACLT/P group compared to the ACLT/S group by parecoxib treatment (91.2+/-9.4% vs 189.5+/-17.0%, P<0.05 and 98.2+/-11.6% vs 175.3+/-12.4%, P<0.05, respectively). CONCLUSION: This study shows that intra-articular injection of COX-2 inhibitor parecoxib inhibits the ACLT-induced OA progression; it was accompanied by a reduction of glutamate and aspartate concentration in the ACLT joint dialysates. From our present results, we suggested that intra-articular parecoxib injection, in addition to the anti-inflammatory effect, inhibiting the EAAs' release, may also play a role in inhibiting the traumatic knee injury induced OA progression.     

一氧化氮在骨性关节炎发病机制中的作用

目的 研究一氧化氮与骨性关节炎发病的关系。方法 抽取骨性关节炎和类风湿性关节类患者的关节积液和血清,及关节镜下清理术中切除的骨性关节炎滑膜和退变软骨作为标本,用硝酸还原酶法测定其中的一氧化氮含量并进行比较。结果 骨性关节炎患者的软骨及滑膜中一氧化氮含量明显高于其血清及关节液,且软骨中一氧化氮含量明显高于滑膜。类风湿性关节炎患者关节液中一氧化氮浓度明显高于其血清及骨性关节炎的关节液。结论 骨性关节炎     

透明质酸钠治疗膝骨性关节炎的临床效果及分析

目的　观察透明质酸钠 (sodium hyaluronate,SH)关节腔内注射治疗膝骨性关节炎 (osteoarthritis,OA)的临床效果及治疗前后关节液中自由基和炎性介质含量的变化。　方法　 92例 (111膝 ) OA患者 ,其中男 30例 ,女6 2例 ;年龄 2 1～ 71岁 ,平均 4 7.5岁。分轻度组 5 1膝 ,中度组 35膝 ,重度组 2 5膝。关节内每周注射 SH2 0 mg一次 ,共 5次 ,按 L ysholm膝关节功能评分比较治疗前后关节症状和功能的改善情况 ,并测定第 1、2和 5周 SH注射前和注射后 3个月抽取的关节液中一氧化氮 (nitric oxide,NO)、超氧化物歧化酶 (superoxide dismutase,SOD)、丙二醛 (malonicdialodehyde,MDA)和白细胞介素 1β(interlukin1β,IL- 1β)、肿瘤坏死因子 α(tumour necrosis factorα,TNF- α)的含量。　结果　随访 3个月 ,治疗效果优 4 2膝 ,良 38膝 ,可 2 1膝 ,差 10膝 ,优良率 72 .1%。病情越轻 ,治疗见效越早 ,疗效越好。SH治疗后轻、中度组患者关节液中 ,氧自由基含量和 IL- 1β、TNF- α含量明显下降 (P<0 .0 5 ) ,重度组变化不显著 (P>0 .0 5 ) ;SH对 NO含量影响较小 ,只有轻度组治疗后 3个月较治疗前明显减少 (P<0 .0 5 ) ,中、重度组变化不大 (P>0 .0 5 )。　结论　 SH关节腔内注射治疗膝 OA,可缓解临床症状 ,改善     

关节腔注射羧甲基壳聚糖预防膝骨关节炎软骨退变

目的观察羧甲基壳聚糖（CMCTS）关节腔注射对骨关节炎（OA）模型关节软骨退变及软骨基质金属蛋白酶（MMP-1，-3）及其组织抑制物（TIMP-1）mRNA表达的影响。方法32只大耳白兔行单膝前交叉韧带切断术，随机分为A～D组，A、B组分别于术后立即关节腔注射高、低分子量2％CMCTS0．3ml，每2周1次；C组术后立即关节腔注射1％透明质酸钠（SH）0．3ml，每周1次；D组术后不注射任何药物。术后6周处死动物，比较各组股骨内髁关节软骨的大体变化，采用逆转录聚合酶链反应（R-PCR）方法检测软骨MMP-1，-3及TIMP-1 mRNA的表达水平。结果大体评分显示不注射组软骨退变明显重于CMCTS和SH注射组MMP-1，-3在CMCTS注射组软骨中的表达明显低于SH注射组和不注射组，不同分子量CMCTS注射组MMP-1，-3的表达没有显著差异，SH注射组软骨中MMP-1，-3的表达与不注射组比较差异无统计学意义（P〉0．05），TIMP-1在各组中的表达没差异有统计学意义（P〉0．05）。结论CMCTS能明显下调软骨MMP-1，-3的mRNA表达．明显减轻软骨退变的程度。软骨具有保护作用。     

不同浓度木瓜蛋白酶建立兔膝骨关节炎模型的比较研究

目的:比较不同浓度木瓜蛋白酶建立的兔膝骨关节炎模型,为研究骨关节炎病理及诊疗方法提供数据支持。方法:将60只新西兰大耳白兔随机分为4组,分别在1、3、5d右膝关节腔注射2%(低剂量组)、5%(中剂量组)、10%(高剂量组)(w/v)木瓜蛋白酶和0.03mol/L的L-半胱氨酸混合溶液0.1ml/kg(实验组),以及等量生理盐水(对照组)。整个实验过程观察兔状态并记录体重和膝关节宽度。首次注射后第2、4、6周将兔分批处死,取股骨髁、胫骨平台及滑膜做大体及组织病理学观察,并进行评分。结果:实验组均出现关节宽度增大、关节软骨变薄、基质分解破坏、滑膜增生等炎症及退行性改变,严重程度随浓度增高而增高,也随时间延长而发展;对照组无上述改变,二者比较差异有统计学意义。结论:兔膝骨关节腔注射2%、5%、10%木瓜蛋白酶和0.03mol/LL-半胱氨酸混合溶液0.1ml/kg可制备不同严重程度的骨关节炎模型,周期短,可重复且成功率高。     

臭氧液对兔膝骨性关节炎滑膜炎症的影响

目的评价臭氧液对兔膝骨性关节炎滑膜炎症的影响。方法新西兰兔32只,采用随机数字表法分为四组,每组8只。A组不予任何处理;B组仅造模;C组造模成功后,关节腔注射20μg/ml臭氧液2ml,每周1次,连续3周;D组不造模,仅行关节腔注射臭氧液,方法同C组。观察膝关节滑膜形态,检测滑膜组织中IL-6和TNF-α含量。结果 A组滑膜组织无充血水肿,滑膜细胞无增生现象,滑膜组织结构正常;B组滑膜组织正常结构破坏,细胞重度增生,炎性细胞浸润明显,血管增生充血,滑膜厚度较A组明显增加;C组滑膜组织炎症细胞减少,充血水肿减轻,滑膜厚度较B组明显降低;D组滑膜无炎症表现。与A组比较,D组IL-6和TNF-α含量无明显增高,B、C组IL-6和TNF-α含量明显增高(P0.05),但C组明显低于B组(P0.05)。结论关节腔注射20μg/ml臭氧液2ml可以减轻滑膜炎症,降低滑膜中IL-6和TNF-α含量,且对正常关节滑膜组织无明显损害。     

Overexpression of active TGF-beta-1 in the murine knee joint: evidence for synovial-layer-dependent chondro-osteophyte formation

OBJECTIVE: To investigate the impact of a prolonged and constant active TGF-beta expression by the synovial lining cells on cartilage and ligamentous joint structures in vivo. DESIGN: An adenoviral vector (AdTGF-beta1(223,225)) was used for the overexpression of active TGF-beta1 in knee joints of C57Bl/6 mice. RESULTS: It was found that physiological relevant levels of active TGF-beta1 produced by the synovial lining layer resulted in histopathological changes: hyperplasia of synovium and chondro-osteophyte formation at the so-called chondro-synovial junctions. No histological changes were seen after intra-articular injection of an empty control vector (AdDL70-3) or by overexpression of latent TGF-beta1 (AdTGF-beta1). The predominant site of TGF-beta production in osteoarthritis (OA) and rheumatoid arthritis (RA) is the synovial lining layer. To address the question whether the TGF-beta-induced changes were related to the expression site in the synovial lining, the synovial lining layer was depleted by local treatment with liposomes encapsulating clodronate. Depletion of the lining resulted in a dramatic change of TGF-beta1-induced pathology: markedly reduced chondro-osteophyte formation and increased accumulation of extracellular matrix in the synovium. CONCLUSION: This study shows that overexpression of active TGF-beta1 in the knee joint results in OA-like changes and suggests the synovial lining cells contribute to the chondro-osteophyte formation.     

肺泡巨噬细胞活化在急性坏死性胰腺炎大鼠肺损伤中的作用

目的　探讨肺泡巨噬细胞活化在急性坏死性胰腺炎 (ANP)肺损伤中的作用。　方法30只成年SD大鼠随机分为正常对照组、ANP后 1、3、6、12h组 ,每组 6只。逆行性胰胆管注射 3%牛磺酸钠建立ANP大鼠模型 ,正常对照组大鼠自胆胰管内逆行注入生理盐水。经支气管肺泡灌洗获取肺泡巨噬细胞 ,检测支气管肺泡灌洗液中蛋白含量、肺组织髓过氧化物酶 (MPO)水平、肺泡巨噬细胞分泌肿瘤坏死因子α(TNFα)及一氧化氮 (NO)水平。以反转录聚合酶链反应 (RT PCR)法测定肺泡巨噬细胞TNFαmRNA、诱导型一氧化氮合酶 (iNOS)mRNA表达情况。行肺、胰腺组织病理学检查并评分。结果　ANP大鼠肺损伤随着病情进展而逐渐加重 ;肺组织MPO及支气管肺泡灌洗液中蛋白含量逐渐升高 ,12h达最高值 ,分别为 (10 78± 0 5 8)U/g和 (2 0 11 0± 10 5 5 ) μg/ml;肺泡巨噬细胞分泌TNFα、NO水平逐渐升高 ,至 6h达到高峰 ,分别为 (16 2 4 2± 149 2 )pg/ml和 (88 8± 6 5 ) μmol/L ,12h又回落。ANP发生后 ,肺泡巨噬细胞TNFαmRNA、iNOSmRNA的表达情况与TNFα、NO的变化趋势相似。ANP大鼠各组指标与正常对照组相比差异均有显著性意义 (P <0 0 5 )。组织学评分结果表明 ,随着胰腺损伤的加重肺损伤也逐渐加重。肺泡巨噬细胞TNFαmRNA、iNOSmRNA     

补肾活血中药对膝骨性关节炎家兔血清、滑膜及关节软骨一氧化氮水平的影响

目的探讨补肾活血中药对膝骨性关节炎家兔血清、关节软骨及滑膜一氧化氮(NO)水平的影响.方法 48只6～10个月龄新西兰大白兔,雌雄各半,随机分为正常组(18只),空白对照组(18只),中药组(12只).采用Hulth造模法建立OA模型.造模6周后分别给正常组和空白对照组、中药组每日灌服生理盐水、中药煎剂.分别于造模后6周、8周、12周测定各组血清、关节软骨及滑膜NO水平.结果空白对照组血清、关节软骨及滑膜NO水平均高于正常组,以关节软骨最为显著,而在灌服中药煎剂后,上述各项指标均有明显下降,与空白对照组比较有显著性差异(P＜0.05).结论补肾活血中药能够降低血清、关节软骨及滑膜NO水平,延缓OA的组织学改变进程,抑制本病的发生发展.     

一氧化氮在急性坏死性胰腺炎大鼠肺损伤中的作用

目的　探讨一氧化氮 (NO)在急性坏死性胰腺炎 (ANP)肺损伤中的作用。　方法12 0只成年SD大鼠随机分为正常对照组、ANP组、精氨酸 (L Arg)组、N 硝基 L 精氨酸甲酯 (L NAME)组、混合预处理组 ,每组 2 4只。逆行性胰胆管注射 3%牛磺酸钠建立ANP大鼠模型。经支气管肺泡灌洗获取肺泡巨噬细胞 (AM) ,检测支气管肺泡灌洗液 (BALF)中蛋白含量、肺组织髓过氧化物酶 (MPO)水平、AM分泌肿瘤坏死因子α(TNFα) ,NO水平及TNFαmRNA、诱导型一氧化氮合酶(iNOS)mRNA表达情况。　结果　ANP大鼠肺损伤随着病情进展而逐渐加重 ;肺组织MPO及BALF蛋白含量逐渐升高 ,12h达最高值 ,分别为 (10 8± 0 6 )U/g和 (2 0 11 0± 10 5 5 ) μg/ml;AM分泌TNFα ,NO水平逐渐升高 ,至 6h达到高峰 ,分别为 (16 2 4 2± 14 9 2 ) pg/ml和 (88 8± 6 5 )μmol/L ,12h又回落。AMTNFαmRNA、iNOSmRNA的表达情况与TNFα,NO的变化趋势相似。L Arg、L NAME、混合预处理三组各指标变化趋势与ANP组相似 ,各组与正常对照组相比 ,均有显著性差异 (P <0 0 5 )。L Arg、L NAME组与ANP组相比 ,L Arg组各指标均升高 ,L NAME组各指标均降低 ,差异亦有显著性 (P <0 0 5 )。　结论　由iNOS介导产生的NO的过量生成促进了ANP所致的肺损伤。加入外源性     

降钙素对兔膝骨关节炎发病过程中细胞因子及关节软骨细胞凋亡的试验研究

目的探讨降钙素(CT)对兔膝骨关节炎发病过程中细胞因子及关节软骨细胞凋亡情况的影响。方法将36只健康大耳白兔随机分为空白对照组(A组)、模型组(B组)和CT治疗组(C组),B、C两组采用改良Hulth法复制膝骨关节炎模型,A组除切开皮肤和关节腔外,不做其他处理,从术后第6周开始C组每天皮下注射CT 5u/kg,A、B组给与等量生理盐水皮下注射,连续注射20 d后处死动物。观察膝骨关节炎(KOA)发病过程中关节软骨病理组织学的变化,关节液中细胞因子IL-1、TNF-α、NO的变化。关节软骨Ⅱ型胶原及基质金属蛋白酶-1(MMP-1)的变化,以及CT对上述指标的影响。结果与A组相比,B组JP和Mankin’s评分明显升高,关节软骨损伤明显加重,关节液中IL-1、TNF-α、NO含量明显升高(P<0.05),关节软骨Ⅱ型胶原含量明显降低,MMP-1活性和软骨细胞凋亡百分数明显升高(P<0.05);与B组相比,C组关节液中IL-1、TNF-α、NO含量明显降低(P<0.05),关节软骨损伤减轻、Ⅱ型胶原含量明显升高,MMP-1活性和软骨细胞凋亡百分数明显降低(P<0.05)。结论 CT对KOA的治疗作用与细胞因子及细胞外基质合成与分解代谢失衡的恢复有关。     

关节内注射复方倍他米松对兔佐剂性关节炎的效果

目的评价关节内注射复方倍他米松对兔佐剂性关节炎的效果。方法日本大耳白兔，雌雄各半，体重2～3kg，6～8月龄。采用皮内注射卵清蛋白＋非完全弗氏佐剂的方法制备佐剂性关节炎模型。佐剂性关节炎模型制备成功的48只免随机分为2组（n=24），C组双膝关节内各注射生理盐水1ml；D组注射复方倍他米松0．5mg／kg。每组各随机取6只兔，持续观察膝关节外观，分别于治疗前、治疗后2周测量髌骨上缘处双膝周径，并测定膝关节灌洗液中一氧化氮（NO）浓度，治疗后2周处死兔，打开膝关节，观察关节腔内改变，取髌上囊处滑膜，光镜下观察病理学改变。2组分别于治疗后1、2、3d各随机处死6只兔，取髌上囊滑膜，观察细胞凋亡情况。结果与c组比较，治疗后D组关节滑膜炎性反应较轻，NO浓度降低（P〈0．01）；治疗后2、3d滑膜细胞凋亡率升高（P〈0．05或0．01）。结论膝关节内注射复方倍他米松0．5mg／kg对免佐剂性关节炎有抗炎作用，可能与抑制NO的合成及促进滑膜细胞凋亡有关。     

Hyaluronan suppressed nitric oxide production in the meniscus and synovium of rabbit osteoarthritis model.

Nitric oxide (NO) plays an important role in cartilage degeneration, and NO donors induce meniscus degeneration and synovium inflammation. This study evaluated the effect of intraarticular injections of hyaluronan (HA) on NO production in meniscus and synovium using an experimental osteoarthritis (OA) model. Thirty-six New Zealand white rabbits underwent unilateral anterior cruciate ligament transection (ACLT), and were divided into three groups. Four weeks after ACLT, the HA group started to receive intraarticular HA injections once a week for 5 weeks; the vehicle group started to receive the carrier of HA; and the no injection group, no treatment. All ACLT knees were harvested at the 9th week. Meniscus and synovium sections were examined by immunohistochemistry for nitrotyrosine. The pieces of these two tissues were cultured for 24 h. Culture supernatants were analyzed for nitrite concentration. The amount of NO produced by the meniscus was much larger than that produced by the synovium. NO productions in the meniscus and synovium of the HA group were significantly lower than those of the other groups. The results suggest that the inhibition of NO production in meniscus and synovium might be a part of the mechanism of the therapeutic effect of HA on OA.     

胰岛素干预对严重烧伤后早期大鼠血管内皮细胞的保护效应

目的了解胰岛素对严重烧伤后早期大鼠血管内皮细胞的保护效应，并分析相关机制。方法将sD大鼠分成假伤组（7只）、烧伤组（7只）和处理组（7只）。后2组制成30％TBSAⅢ度烧伤（用94℃水浴烫伤）模型，假伤组37℃水浴模拟致伤过程。伤后即刻，各组经腹腔注射等渗盐水（40ml／kg）抗休克，同时处理组皮下注射胰岛素3U／kg、另2组同法注射等体积等渗盐水。伤后24h透射电镜下观察各组大鼠主动脉内皮细胞形态及结构，检测其血糖、血清一氧化氮（NO）及各型一氧化氮合酶（NOS）水平。结果镜下可见，处理组较烧伤组主动脉内皮细胞受损程度明显减轻。伤后24h，假伤组、烧伤组、处理组大鼠血糖分别为（4．9±0.8）、（8．2±1.0）、（7．1±0.．7）mmol/L，后2组均显著高于假伤组（P〈0．01），但处理组明显低于烧伤组（P〈0．05）。处理组血清NO、总NOS和结构型NOS（cNOS）水平均明显高于烧伤组（P〈0．01），但2组血清诱导型NOS水平比较，差异无统计学意义（P〉0、05）。结论胰岛素干预可保护严重烧伤后早期大鼠的血管内皮细胞，其机制可能与促cNOS水平升高从而使生理态NO合成增加有关。     

The short-term therapeutic effect of recombinant human bone morphogenetic protein-2 on collagenase-induced lumbar facet joint osteoarthritis in rats

OBJECTIVE: To determine whether an intra-articular injection of recombinant human bone morphogenetic protein-2 (rhBMP-2) alleviates cartilage degradation in a rat model of osteoarthritis (OA) of the lumbar facet joint. METHOD: The right-side facet joint OA model was created by an intra-articular injection of collagenase (type II) 2 weeks before treatment. The OA rats were divided into four groups: (1) no treatment, or intra-articular injection of either (2) saline, (3) rhBMP-2 10 ng, or (4) rhBMP-2 100 ng. The left-side facet joint served as the normal control. At 3 and 6 weeks after treatment, histological analyses were performed on the cartilage, synovium, subchondral bone and bone marrow. The cartilage and synovium were graded using a modified Mankin score and a synovium score system. Extracellular type II collagen was evaluated by immunohistochemistry. RESULTS: Intra-articular injection of collagenase causes OA-like changes in the facet joint. OA rats treated with rhBMP-2 at both dosages tested showed reduced severity of their cartilage lesions compared with untreated and saline-treated groups. There was a statistically significant difference in the modified Mankin score compared to the untreated and saline-treated groups. However, some rhBMP-2-treated rats at the higher dose (100 ng) showed, as a side effect, joint space obliteration caused by cartilage overgrowth. Also OA rats treated with 100 ng of rhBMP-2 displayed a significant synovium reaction at 3 weeks compared with that in other groups. Immunohistochemical analysis showed that treatment with rhBMP-2 significantly increased the content of type II collagen. CONCLUSION: This study demonstrates the potential efficacy of rhBMP-2 in the alleviation of arthritic changes in a rat model of OA of the lumbar facet joint. However, treatment with a high dosage of rhBMP-2 caused adverse side effects in some animals.     

Synovial lining macrophages mediate osteophyte formation during experimental osteoarthritis

OBJECTIVE: In human osteoarthritis (OA), various forms of pathology are observed. Besides cartilage damage and fibrosis, neogenesis of bone, osteophyte formation, also occurs. Osteophytes are thought to limit joint movement and cause pain. The objective of this study was to investigate whether synovial macrophages are involved in osteophyte formation in experimental OA, and if they are, to study which mechanism may be involved. DESIGN: Experimental OA was induced by two intra-articular injections of collagenase on alternate days into murine knee joints. The role of synovial lining macrophages in this model was studied by selective removal of these cells prior to OA induction using clodronate liposomes. After 1 and 2 weeks, knee joints were dissected and examined (immuno)histologically. RESULTS: At days 7 and 14 after induction of OA, osteophyte formation and fibrosis were observed. Depletion of synovial macrophages resulted in spectacular reduction of osteophyte formation, 84% and 66%, respectively, at days 7 and 14. Fibrosis and synovial activation, measured by MRP8/14 expression, were also ameliorated (40-60%). In addition, production of growth factors (TGFbeta, BMP-2 and BMP-4) in the lining was largely prevented but production of these growth factors in deeper layers of the synovium and the periosteum did not differ from controls. CONCLUSIONS: These results indicate the synovial macrophage to be a pivotal cell in the synovium mediating osteophyte formation and other OA-related pathology, like fibrosis, during experimental OA. Production of growth factors and induction of synovial activation by these cells may play a crucial role in this event.     

风湿骨痛药酒药槌外治法防治关节软骨退变的实验研究

目的 探讨风湿骨痛药酒药槌外治法防治关节软骨退变的作用机理。方法 选用日本大耳白兔18只，随机将12只通过结扎右股静脉造成膝关节骨性关节炎模型。未造模兔6只为正常组，12只造模兔随机分为造模组和治疗组。造模8周后，治疗组施以风湿骨痛药酒槌外治法进行治疗。造模11周后，观察软骨病理组织形态学、滑膜中NO浓度、软骨中PA及PAI活性和关节液中HA含量变化。结果 治疗组滑膜中NO浓度、软骨中PA及PAI活性和关节液中HA含量与正常组相比有显著性差异。造模组所测各项指标与治疗组相比有显著性差异。治疗组滑膜中NO浓度及软骨中PA含量明显低于造模组，而软骨中PAI含量及关节液中HA含量明显高于造模组。治疗组关节软骨退变不明显，类似正常组，而造模组关节软骨退行性变明显。结论 风湿骨痛药酒药槌外治法能通过改善骨内及周围组织的微循环，抑制滑膜组织中NO的过度产生，降低软骨中PA的活性，提高PAI的活性，消除导致关节软骨退变的内在因素，提高关节液中HA的含量，从而达到保护关节软骨、抗关节软骨退变的目的。     

DDH合并OA患者血清及其滑膜组织中SP、S100A12的表达特点及意义

目的探讨髋关节发育不良(developmental dysplasia of the hip,DDH)患者血清及其滑膜组织中的P物质(substance P,SP)、钙结合蛋白(S100 calcium binding protein A12,S100A12)表达及其意义。方法本研究采取回顾性研究方法,选取我院2013年4月至2018年4月收治的182例DDH患者,其中单纯的DDH患者114例(DDH组)、DDH合并骨关节炎(osteoarthritis,OA)的患者68例(OA组),同时选取髋部外伤骨折实施手术的40例患者作为对照组,分别采用ELISA法、免疫组化法检测三组的血清及滑膜组织中的SP、S100A12表达情况并进行比较。结果OA组患者的血清SP、S100A12表达水平显著高于DDH组和对照组(P<0.05),DDH组患者的血清SP、S100A12表达水平显著高于对照组(P<0.05);采用ELISA方法检查,OA组患者的髋关节滑膜组织中SP、S100A12表达水平显著高于DDH组和对照组(P<0.05),DDH组患者的髋关节滑膜组织中SP、S100A12表达水平显著高于对照组(P<0.05);采用免疫组化方法检查,OA组患者的髋关节滑膜组织中SP、S100A12表达的OD值高于DDH组和对照组(P<0.05),DDH组患者的髋关节滑膜组织中SP、S100A12表达OD值显著高于对照组(P<0.05)。结论DDH患者血清及髋关节滑膜组织中SP、S100A12表达较正常髋关节滑膜组织显著增高,合并OA的DDH患者SP、S100A12表达的升高更显著,可能与关节退变及关节的炎性改变有关。