Reproducible metacarpal joint space width measurements using 3D analysis of images acquired with high-resolution peripheral quantitative computed tomography

ObjectiveJoint space narrowing is an important feature of progressive joint damage and functional impairment in rheumatoid arthritis (RA). Methods to provide a continuous measurement of joint space width have not been adopted in research or clinical settings. High-resolution peripheral quantitative computed tomography (HR-pQCT) (Scanco Medical AG, Brüttisellen, Switzerland) accurately and reproducibly images bone microstructure at a nominal isotropic voxel dimension of 82 μm. Given the ability of HR-pQCT to detect bone margins with high precision, we developed methodology to measure a three-dimensional (3D) metacarpophalangeal (MCP) joint space width and tested the reproducibility of the scan protocol with hand repositioning.Materials and methodsConsecutive HR-pQCT scans of the 2nd and 3rd MCP joints of ten subjects with early RA (70% female, mean age 45 years), with repositioning between scans, were obtained. The periosteal edges of the metacarpal head and proximal phalanx base were detected using the μCT Evaluation Program V6.0 (Scanco Medical AG). Using the method of ‘fitting maximal spheres’, the joint space width and distribution of joint space thickness was estimated.ResultsThe mean minimum joint space width of the 2nd MCP was 1.82 mm (SD 0.20) and of the 3rd MCP 1.84 mm (SD 0.23). Reproducibility with repositioning was reliable, with overlapping filtered histograms and a root square mean coefficient of variance of 4.8%.ConclusionsWe provide reproducible methodology for evaluating the joint space width of the MCP joints. When combined with the assessment of erosions and periarticular bone density, HR-pQCT may be the ideal technology to assess disease activity and progression in RA.     

Fuzzy entropy based interactive enhancement of radiographic images

In certain radiographic images, fuzziness exists due to the vague nature of image characteristics and limitations of visual perception. Accordingly, a gap exists between the information content of an image and the information that can be retrieved. In this paper, a new fuzzy logic based intensification operator has been proposed for enhancement of images. For applying the operator effectively, selection of crossover point is critical. In this paper, the concept of fuzzy entropy has been proposed for objective selection of crossover point. Owing to semantic nature of information content, the methodology has a provision to change levels of enhancement interactively, to help in retrieving the information as required. The effectiveness of the methodology has been demonstrated. Comparison of the results with the Zadeh's INT operator and conventional histogram equalization techniques has established its superiority.     

Trainable rule-based algorithm for the measurement of joint space width in digital radiographic images of the knee

The progression of osteoarthritis (OA) can be monitored by measuring the minimum joint space width (mJSW) between the edges of the femoral condyle and the tibial plateau on radiographs of the knee. This is generally performed by a trained physician using a graduated magnifying lens and is prone to the subjectivity and variation associated with observer measurement. We have developed software that performs this measurement automatically on digitized radiographs. The test data consisted of 180 digitized radiographs of the knee (90 duplicate acquisitions) from 18 normal (nonarthritic) subjects and 38 images from 10 subjects with OA. These were digitized and manually cropped so that the images were free of nonanatomical structures and the knee was approximately centered. The software first determined the edge of the femoral condyle on 400 microm pixel subsampled images. Contours marking the location of the tibial plateau in the medial compartment were found on 100 microm images using the femoral edge as a reference. The algorithm was trained using an independent but similar data set and using a jackknife approach with the test data. The results were compared to contours drawn by a trained reader and the duplicate acquisitions were used to measure the reproducibility of the mJSW measurement. The reproducibility was 0.16 mm and 0.18 mm for normal and osteoarthritic knees, respectively, representing an improvement of approximately a factor of 2 over manual measurement. The algorithm also showed excellent agreement with the hand-drawn contours and with mJSW determined by the manual method.     

IL-4/IL-10诱导的树突状细胞对类风湿性关节炎的作用

目的:探讨经IL-4/IL-10诱导的树突状细胞(DC)对类风湿性关节炎的作用。方法:用Percoll分层离心法从脾脏细胞分离得到DC后,用IL-4或IL-10或IL-4+IL-10进行诱导。用未经诱导和诱导过的DC对类风湿性关节炎大鼠模型进行干扰。SD鼠设为CIA模型组,DC对照组与DC试验组。用ELISA法检测细胞因子与抗体水平,用MTT法检测细胞增殖情况,对鼠爪关节行病理学检测。结果:DC对照组的临床症状评分,病理改变评分,细胞增殖能力,血清中抗胶原抗体及细胞因子水平与CIA模型组的差异无统计学意义。试验组中,注射IL-10-DC能改善CIA鼠的滑膜炎症情况;在初次免疫后第5天注射IL-4-DC能减轻CIA鼠的滑膜炎程度;注射IL-4+IL-10-DC无明显的保护作用。结论:适时注射IL-4或IL-10诱导的DC,对实验性类风湿性关节炎具有保护作用。     

Morphomechanics of the humero-ulnar joint: I. Joint space width and contact areas as a function of load and flexion angle

Background: Previous studies have shown that the trochlear notch is deeper than necessary for an exact fit with the humerus. However, humero-ulnar joint space width and contact areas have so far not been quantified for variations in the load and angle of flexion. Methods: Six fresh cadaveric specimens were investigated at 30°, 60°, 90°, and 120° of flexion and at loads of 25 and 500 N, simulating resisted elbow extension. The joint space width and contact were determined, using polyether casting material. Results: At 25 N all joints made contact in the ventral and dorsal aspects of the articular surfaces, whereas in the depth of the trochlear notch the joint space was on average between 0.3 and 2.8 mm wide, with some variation between individuals. At 500 N the joint space width was considerably reduced and the contact areas expanded towards the depth of the notch. The size of the dorsal contact areas was significantly smaller at 30° and that of the ventral ones at 120°, their ventro-dorsal ratio decreasing considerably from 30° to 120° (P< 0.01). Conclusion: These results indicate that the size of the contact areas depends to a slight extent on the joint position, but that at all loads and flexion angles a bicentric contact and an important central joint space width emerge because of the concave incongruity of the joint, These data may be used for numerical calculations, analysing the effects of incongruity on the joint stress and on the functional adaptation of the subarticular tissues. © 1995 Wiley-Liss, Inc.     

PTPN22 polymorphisms,but not R620W,were associated with the genetic susceptibility of systemic lupus erythematosus and rheumatoid arthritis in a Chinese Han population

ObjectivesThe present study aimed to detect a possible association between PTPN22 gene polymorphisms and rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in a Chinese Han population.Methods7 PTPN22 SNPs were genotyped in 358 patients with RA and 713 patients with SLE, as well as 564 RA controls and 672 SLE controls by Restriction Fragment Length Polymorphism (RFLP). Association analyses were conducted on the whole data set. Significant relationships were also examined between clinical features and SNPs for both RA and SLE.ResultsRs2476601 was lack of polymorphism with a ⩽0.1% frequency in both SLE and RA patients and healthy controls in our study. The two SNPs rs1217414 and rs3811021 of PTPN22 shown strong association with both SLE (rs1217414T: p_adj = 6.07e−004, OR = 0.57; rs3811021C: p_adj = 4.68e−005, OR = 0.65) and RA (rs1217414T: p_adj = 2.01e−008, OR = 0.26; rs3811021C: p_adj = 0.028, OR = 0.70). And the rs3765598 revealed a strong risk factor for SLE (p = 9.38e−009, p_adj = 6.57e−008, OR = 1.93), but not for RA (p = 0.48, OR = 1.12). Moreover, protective haplotype ACTTC in RA (p = 7.73e−016, p_adj = 5.51−015, OR[95%CI] = 0.02[0.002–0.10]) and SLE (p = 8.29e−018, p_adj = 5.80e−017, OR[95%CI] = 0.11[0.06–0.21]) were observed. In addition, the distribution of risk haplotypes ACGTC and GCTTT in RA (ACGTC: p = 0.0006, p_adj = 0.004, OR[95%CI] = 1.85[1.29–2.63]; GCTTT: p = 2.62e−005, p_adj = 1.85e−004, OR[95%CI] = 2.40[1.57–3.65]) and SLE (ACGTC: p = 0.0006, p_adj = 0.004, OR[95%CI] = 1.85[1.29–2.63]; ACGTC: p = 7.74e−011, p_adj = 6.81e−010, OR[95%CI] = 2.21[1.12–3.34]; GCTTT: p = 2.40[1.57–3.65], p_adj = 2.26e−006, OR[95%CI] = 2.64[1.79–3.87]) were significant different from that in controls. Furthermore, significant association was observed between the PTPN22 rs3765598 and antinuclear antibodies 1 (ANA1) in SLE.ConclusionsOur data provide strong evidence that the rs1217414 and rs3811021 in PTPN22 gene might be common protective factors contributed to SLE and RA susceptibility in the Chinese Han population. While, the rs3765598 might increase the genetic susceptibility of SLE, but not RA.     

类风湿性关节炎患者关节滑膜液浸润的T细胞表达特性

目的 :为研究类风湿性关节炎 (RA)患者关节滑膜液浸润的淋巴细胞介导自身免疫病的特性 ,分析了 2 2例RA患者滑膜液中淋巴细胞的免疫表型、对II型胶原的反应频率及IL 10、IL 12的分泌格局。方法 :用流式细胞术分别测定滑膜液和外周血淋巴细胞表型 ,并采用国际标准半有限稀释法分析了关节滑膜液中浸润的淋巴细胞对II型胶原 (CII)的反应频率 ,同时用ELISA方法检测了滑膜液与外周血中IL 10与IL 12含量。结果 :滑膜液中的T淋巴细胞的表型分别为CD4 (39 6 %±10 5 % )和CD8细胞 (36 4 %± 16 4 % ) ,CD4 CD8细胞比值显著低于外周血 ,且同时表达CD16和CD5 6的活化NK细胞占15 5 %± 11 1%。T细胞受体谱取用表明仍以αβTCR为主 (6 9 6 %± 15 7% )。有意义的是 :滑膜液中的T细胞对CII的反应频率为 15 2× 10 - 6 ,远远高于外周血 (4 0× 10 - 6 )。IL 12含量为 (4 19 9± 89 2 )pg ml,IL 10含量为 (187 7± 34 5 )pg ml,与外周血中这 2种细胞因子的含量〔分别为IL 12 :(6 5 32± 34 2 )pg ml和IL 10 :(85± 12 7)pg ml〕比较 ,具有显著的统计学差异。结论 :上述实验结果表明这种具有表达特性的浸润T细胞介导了RA患者关节滑膜组织的免疫损伤。     

Low dose methotrexate induces apoptosis with reactive oxygen species involvement in T lymphocytic cell lines to a greater extent than in monocytic lines

Background: The mechanism by which low dose methotrexate (MTX) exerts its anti-inflammatory and immunosuppressive effect in rheumatoid arthritis (RA) patients is still debated. Recently it has been related to the induction of apoptosis.Objective: We investigated the degree of apoptotic induction by MTX in lymphocytic (Jurkat T, EL4 T, and Raji B) and monocytic cell lines (U937 and THP1) and its relation to reactive oxygen species (ROS) generation, as a possible mechanism underlying the apoptotic events.Methods: All cell types were incubated with a range of MTX concentrations (0.001, 0.01, 0.1, 1, and 10 μM) for up to 24 h. Cytotoxicity was assessed by Trypan Blue exclusion and MTT test; cell size and granularity by forward and side scatters (FSC, SSC). Apoptosis was measured by Annexin V test and FDA polarization; and mitochondrial ROS generation by DHR123 probe and by NAC inhibition.Results: MTX significantly reduced cell viability and proliferation in all cell lines, being most effective in the Jurkat T lymphocytic line. The MTX cytotoxicity (at the optimal concentrations corresponding to low dose MTX therapy) was attributed to apoptosis, as suggested by morphological changes (shrinkage, increased granularity) and confirmed by Annexin V binding and FDA hyperpolarization. The apoptotic induction and the ROS generation (statistically correlated to apoptosis) were most pronounced in the Jurkat and EL4 T cell lines, and were partially inhibited by the antioxidant N-acetyl L-cysteine (NAC).Conclusion: According to the present observations, MTX may most likely induce apoptosis through oxidative stress. The high susceptibility of T cell lines to MTX induced apoptosis may account for the beneficial effect of MTX treatment in rheumatoid arthritis, which is characterized by hyperproliferation of T cells.Received 29 June 2004; returned for revision 1 September 2004; returned for final revision 11 February 2005; accepted by M. J. Parnham 7 March 2005This research was supported by the Horowitz Foundation     

Quantification of Joint Space Width Difference on Radiography Via Phase-Only Correlation (POC) Analysis: a Phantom Study Comparing with Various Tomographical Modalities Using Conventional Margin-Contouring

Several visual scoring methods are currently used to assess progression of rheumatoid arthritis (RA) on radiography. However, they are limited by its subjectivity and insufficient sensitivity. We have developed an original measurement system which uses a technique called phase-only correlation (POC). The purpose of this study is to validate the system by using a phantom simulating the joint of RA patients.A micrometer measurement apparatus that can adjust arbitrary joint space width (JSW) in a phantom joint was developed to define true JSW. The phantom was scanned with radiography, 320 multi detector CT (MDCT), high-resolution peripheral quantitative CT (HR-pQCT), cone beam CT (CBCT), and tomosynthesis. The width was adjusted to the average size of a women’s metacarpophalangeal joint, from 1.2 to 2.2 mm with increments of 0.1 mm and 0.01 mm. Radiographical images were analyzed by the POC-based system and manual method, and images from various tomographical modalities were measured via the automatic margin detection method. Correlation coefficients between true JSW difference and measured JSW difference were all strong at 0.1 mm intervals with radiography (POC-based system and manual method), CBCT, 320MDCT, HR-pQCT, and tomosynthesis. At 0.01 mm intervals, radiography (POC-based system), 320MDCT, and HR-pQCT had strong correlations, while radiography (manual method) and CBCT had low correlations, and tomosynthesis had no statistically significant correlation. The smallest detectable changes for radiography (POC-based system), radiography (manual method), 320MDCT, HR-pQCT, CBCT, and tomosynthesis were 0.020 mm, 0.041 mm, 0.076 mm, 0.077 mm, 0.057 mm, and 0.087 mm, respectively. We conclude that radiography analyzed with the POC-based system might sensitively detect minute joint space changes of the finger joint.     

基于显微CT的骨微观三维变形场测量系统的研究

目的初步构建一套集成显微CT与力学加载装置的测试系统,结合数字体相关技术(digital volume correla-tion,DVC)实现骨组织内部微观三维变形场的测量。方法选用微型力学加载装置进行单轴压缩试验,维持载荷不变的同时对试样进行CT扫描;采用DVC方法对连续CT图像序列进行相关匹配和搜索计算,测量载荷变化前后试样内部结构沿三维方向的微观位移值;通过零位移重复扫描和刚体平移评价该系统的测量精度及准确度;利用该系统测试牛松质骨块的三维位移场分布。结果零位移重复扫描结果显示该系统测量加载方向的位移准确度最高,测量精度低于CT扫描分辨率的1/10;刚体平移结果显示计算位移标准差为0.001～0.002μm;松质骨块测试区域在600 N载荷作用下沿加载方向的微观位移范围为100.35～110.25μm,位移场呈现多层逐级分布。结论该系统能够满足数字体相关法测量位移的准确度及精度要求,能够实现骨组织内部微观结构的三维变形场测量,可以作为进一步研究骨组织内部变形分布与结构成分响应关系的测量平台。     

Epstein-Barr virus-positive multiple myeloma developing after immunosuppressant therapy for rheumatoid arthritis: a case report and review of literature

A 61-year-old woman was diagnosed as having rheumatoid arthritis (RA) and began treatment with salazosulfapyridine (SASP) and methotrexate (MTX) in 2008; the administration of concomitant tacrolimus (TAC) was initiated in 2010. She subsequently developed concurrent multiple myeloma (MM), immunoglobulin G (IgG)-κ type, in 2012. A portion of the tumor cells tested positive for Epstein-Barr virus-encoded small RNA (EBER). MTX treatment was discontinued in 2014, and the exacerbation of MM ensued. The patient received two cycles of bortezomib plus dexamethasone (BD) therapy and attained a complete response (CR). She then underwent an autologous peripheral blood stem cell transplantation. The Epstein-Barr (EB) virus infection arising from the increased RA disease activity and immunosuppressant medication might have influenced the development of MM in this case. Most reported patients with EB virus-positive plasmacytoma are in a state of immunosuppression, and this condition may fall within the category of other iatrogenic immunodeficiency-associated lymphoproliferative disorders. No other reports of plasmacytoma occurring in a background of RA or after TAC or MTX therapy have been made, and the present case is the first such report.     

葡萄糖-6-磷酸异构酶对类风湿关节炎诊断价值的系统评价

为了评价血清中葡萄糖-6-磷酸异构酶(glucose-6-phosphate isomerase,GPI)诊断类风湿关节炎(rheumatoidarthritis,RA)的价值,检索1990~2007年相关数据库,关于酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测血清中GPI诊断RA的诊断性试验文献,提取四格表资料,利用RevMan软件分析。15个研究对GPI检测异质性较大:χ2=191.65,P0.00001,使用已知浓度血清作为标准品的5篇文献,具有同质性(χ2=6.97,P=0.14),合并OR=1.93(95%CI:1.40,2.67),有效性检验Z=4.00(P0.0001)。15个研究合并诊断敏感性为38%,合并特异性为87%,曲线下面积为0.7846;5个使用相同标准品的研究合并诊断敏感性为25%,合并特异性为80%,曲线下面积为0.6279。GPI在RA诊断中的特异性较高而敏感性较差,可与高敏感性的其他标志物联合检测。     

基于肌电信号层级分类的手部动作识别方法

目的 利用肌电信号对手部动作进行识别,是控制现代康复假手的关键,其中使用少量电极识别出较多手势又是一难点。为更加充分利用所获得的肌电信息,本文提出一种层级分类方法。方法 首先提出一种基于层级分类的手部肌电信号动作识别方法,该方法首先根据被分类对象的多侧面属性,利用肌电积分值作为特征值,并通过线性判别函数实施预分类;其次建立肌电信号的自回归模型,将模型系数作为特征值,将人工神经网络作为分类器进行细分类;最后进行了对比实验论证。结果 实验结果表明,可以利用2个表面肌电电极以较高的识别率识别出8个常用手部动作。结论 该方法能够以较少的肌电电极识别出较多的动作,比未采用分层方法具有更好的分类效果。     

Associations of killer cell immunoglobulin like receptors with rheumatoid arthritis among North Indian population

Introduction

Rheumatoid arthritis (RA) is an autoimmune and chronic inflammatory disease of unknown etiology. Killer cell immunoglobulin-like receptors (KIR) expressed on surface of natural killer cells and CD28 null T-cells which are present in synovial membrane of RA. The present study has evaluated associations of KIR genes with RA among North Indian population from Uttar Pradesh.

Materials and methods

KIR genotypes were determined in 100 RA cases and 100 healthy controls using sequence specific primer polymerase chain reaction (PCR-SSP) method.

Results

RA cases positive for KIR3DS1 (OR = 1.17, p-value = 0.0498) and KIR2DS2 (OR = 2.21, p-value = 0.0120) showed risk associations. While, KIR2DL2 (OR = 0.40, p-value = 0.0026), KIR2DL3 (OR = 0.44, p-value = 0.0283) and KIR3DL1 (OR = 0.32, p-value = 0.0012) showed protective associations. Increased incidence of BB genotype (45%) was revealed among cases. Risk association was noted against telomeric region (OR = 2.12, p = 0.0120) genes for RA. Pair-wise linkage disequilibrium (LD) analysis among RA cases revealed KIR2DS1-2DL1 (D′ = 0.83, r² = 0.36), KIR3DL1-3DS1 (D′ = 1, r² = 0.58) and KIR2DL1-2DL2 (D′ = 1, r² = 0.61) to be in significant LD. KIR3DS1 and KIR2DS3 genes showed significant risk associations among RA patients with extra-articular manifestations (OR = 5.14, p-value = 0.0018; OR = 3.79, p-value = 0.0106) and in limited range of motion in affected joints (OR = 14.91, p-value = 0.0001; OR = 2.95, p-value = 0.0126).

Conclusion

The KIR activating genes have risk association with RA in the present study.     

周期性机械拉伸对类风湿关节炎和骨关节炎成纤维样滑膜细胞BMP-2表达的影响

目的 研究周期性拉伸对类风湿关节炎(rheumatoid arthritis, RA)和骨关节炎(osteoarthritis,OA)成纤维样滑膜细胞(fibroblast-like synoviocytes, FLS)中骨形态发生蛋白-2 (bone morphogenetic protein2,BMP2)表达的影响,探讨力学刺激在不同病理过程中对滑膜组织的作用。方法 在正常条件和炎症条件下使用Flex cell 4000周期性力学加载系统,分别对正常、RA、OA来源的人膝关节FLS施加连续2 h和6 h的6%、0.5 Hz的拉应力,比较测定BMP-2 mRNA表达的差异性。结果 2 h的机械拉伸对3种FLS中BMP-2 mRNA的水平均无显著性影响,6 h的机械拉伸能够显著升高RA FLS中BMP-2 mRNA的水平。炎症因子(IL-1β)作用2 h对正常FLS无显著影响,作用6 h使其中BMP-2 mRNA的水平显著升高; IL-1β作用2 h和6 h均使RA FLS中BMP-2 mRNA的水平显著升高,但只有作用2 h才使OA FLS中BMP-2 mRNA的水平显著升高,作用6 h对OA FLS中BMP-2 mRNA的水平无显著影响;炎症因子和力学刺激共同作用2 h使正常和RA FLS中BMP-2 mRNA的水平显著升高,作用6 h使正常、RA、OA FLS中BMP-2 mRNA水平均显著升高。结论 正常、RA、OA FLS中BMP-2 mRNA对于力学刺激和炎症因子的响应不同,结果提示在RA和OA发病机制中,炎症因子的影响可能比力学刺激更强;力学刺激和IL-1β共同作用6 h后对OA FLS中BMP-2 mRNA产生协同效应,提示两者联合作用对OA病情发展具有一定作用。     

Kinetic Modeling of Contrast-Enhanced MRI: An Automated Technique for Assessing Inflammation in the Rheumatoid Arthritis Wrist

In recent years, development of rheumatoid arthritis (RA) drug therapy has been more directly targeted to counteract specific mechanisms of inflammation, and it is now believed that early aggressive treatment with disease modifying drugs is important to inhibit future structural joint damage. The development of these new treatments has increased the need for methodologies to assess disease activity in RA and monitor the effectiveness of drug therapy. Unlike X-ray, which shows only structural bone damage, magnetic resonance imaging (MRI) can depict soft tissue damage and synovitis, the primary pathology of RA. Recent studies have also indicated that MRI is sensitive to pathophysiologic changes that may predate radiographic erosions and may predict future joint damage. In this study, we have developed a computer automated analysis technique for MR wrist images that provides an objective measure of RA synovitis. This method applies a two-compartment pharmacokinetic model to every voxel of a dynamic contrast-enhanced MRI (DCE-MRI) dataset and outputs resulting parametric images. The aim of this technique is to not only objectively quantify the severity of rheumatoid synovitis, but to also locally determine where areas of serious disease activity are situated through kinetic modeling of blood-tissue exchange. Preliminary results show good correlation to early enhancement rate, which has previously been shown to be a useful clinical marker of RA activity. However, the use of tracer kinetic modeling methods potentially provides more specific information regarding underlying RA physiology. This approach could provide a useful new tool in RA patient management and could substantially improve RA therapeutic studies by calculating objective biomarkers of the disease state.     

Effects of bisphosphonates on joint damage and bone loss in rat adjuvant-induced arthritis

Objective and design: Examination of the effects of bisphosphonates on joint damage and generalized bone loss.Materials: Adjuvant-arthritis was induced by injection of Mycobacterium butyricum into the footpad of the right hind paw of Lewis rats (8 animals/group) on day 0.Treatment: Arthritic rats were treated with the vehicle (saline), etidronate or alendronate (subcutaneously, daily 5 times a week for 3 weeks from day 1 to day 21). Experiment-1: Etidronate (0.1, 0.5, 2.5, 12.5 mg/kg) or alendronate (0.02, 0.1, 0.5, 2.5 mg/kg), Experiment-2: Etidronate (2.5, 5, 10mg/ kg) or alendronate (0.001, 0.01, 0.1 mg/kg).Methods: In the adjuvant-injected side of the hind limbs, paw swelling was evaluated at 1-week intervals, and bone mineral density (BMD) in the proximal tibia, histopathology and radiographical findings in the tibio-tarsal region were evaluated at the time of sacrifice (on day 21).Results: In all treatment schedules, both bisphosphonates significantly prevented paw swelling and bone loss. Alendronate reduced paw swelling at higher doses (over 0.1 mg/ kg) compared with its effect on BMD decrease (over 0.001 mg/kg). In contrast, etidronate reduced paw swelling and joint damage at doses similar to those (over 2.5 mg/kg) prevented BMD decrease.Conclusions: Both etidronate and alendronate are effective in reducing arthritic damage, but their effective dose ranges for inflammatory responses and BMD decrease clearly differ; i.e., the etidronate dose ranges for anti-inflammatory and anti-resorptive effects are similar, whereas the dose range for anti-inflammatory effects of alendronate is 100-fold higher than that for its anti-resorptive effects.Received 21 January 2003; returned for revision 14 July 2003; accepted by M. Katori 15 August 2003     

miR-29a对类风湿关节炎成纤维样滑膜细胞增殖和凋亡的影响

目的探讨miR-29a对类风湿关节炎(RA)成纤维样滑膜细胞(FLS)活力和凋亡的影响。方法分离培养健康人FLS(n-FLS)和RA患者FLS(RA-FLS);Western blot检测n-FLS和RA-FLS中标志物CHI3L1蛋白表达;将miR-29a mimics、si-NFAT5及miR-29a+NFAT5转染RA-FLSs,转染48 h后,RT-qPCR检测miR-29a和NFAT5 mRNA表达;MTT法及流式细胞计量术分别检测各组细胞活力和凋亡率;Western blot检测p38、p-p38、cleaved-caspase3蛋白表达;通过双荧光报告基因检测系统检测过表达或抑制miR-29a后NFAT5表达,验证miR-29a和NFAT5的靶向关系。结果与n-FLS比较,RA-FLS中CHI3L1蛋白表达明显升高(P<0.05);过表达miR-29a或抑制NFAT5后,RA-FLS细胞活力明显降低,凋亡率明显升高,p-p38表达明显降低,cleaved-caspase3表达明显升高(P<0.05)。miR-29a与野生型NFAT5 3′UTR共转染组RA-F...     

Impact of joint line orientation on clinical outcomes in bilateral Oxford mobile-bearing unicompartmental knee arthroplasty

BackgroundJoint line orientation angle (JLOA) is the angle between the knee joint line and the floor. It has been reported to be related to postoperative outcome after TKA. Regarding unicompartmental knee arthroplasty (UKA), although it can be horizontal after UKA because it is a resurfacing surgery, there are few reports about the JLOA after UKA and its impact on clinical outcomes.PurposeThe purpose of this study was to reveal the relationship between JLOA and clinical outcome after UKA.MethodsThis study included 106 knees in 53 consecutive patients with osteoarthritis who underwent simultaneous bilateral mobile-bearing UKA. Their pre- and postoperative JLOAs were measured by full-leg-length standing coronal radiographs. We also evaluated the tibial component height (TCH) as the factor which we assumed could influence JLOA. We analyzed the patients’ JLOAs, TCHs and clinical outcomes.ResultsPre- and postoperative JLOA were 0.4 ± 2.4° and 2.7 ± 2.6°, respectively. The JLOA significantly tilted medially (P < 0.0001). The JLOA significantly negatively correlated with the improvement of the clinical outcomes (Oxford Knee Score (OKS): r = 0.40, P < 0.0001, Knee Society Knee Score (KSKS): r = 0.25, P < 0.01, Knee Society Function Score (KSFS): r = 0.22, P = 0.02). The TCH showed a positive correlation with postoperative JLOA and with the postoperative JLOA change (r = 0.45, P < 0.001; r = 0.25, P < 0.01, respectively).ConclusionThe JLOA significantly tilted medially after UKA. An excessive medial tilt of the JLOA was associated with poorer postoperative outcomes of UKA. It is therefore recommended to keep the JLOA horizontal and to avoid a lower tibial cut.     

便携式大功率LED黄疸光疗仪的研制

提出一种基于发光二极管(LED)开发的便携式光强可调黄疸光疗仪。仪器选用蓝色LED实现特殊阵列排布,并基于芯片MAX5035构建恒流驱动电路,驱动电流受单片机ATmega16L程序控制,可实现对仪器光照强度的线性调节,并将其对应光强值显示在液晶12864。与传统黄疸光疗仪相比,仪器体积小,光照强度强,并能实现一定范围光强调节。