玻璃酸钠联合痛点神经阻滞治疗冻结肩的临床疗效分析

目的:观察肩关节腔内注射玻璃酸钠及肩周痛点、肩胛上神经阻滞治疗冻结肩的临床效果.方法将冻结肩患者随机分为3组,每组20例.A组(肩周痛点及肩胛上神经阻滞组),B组(肩关节腔注射玻璃酸钠组),C组(联合治疗组);每周1次,5次为一个疗程;治疗期间行肩关节功能锻炼.观察治疗前后各组的治疗效果.结果:3组患者较治疗前皆取得了满意的效果;C组的治疗效果尤为明显,与A组、B组比较,差异具有显著性(P＜0.05).结论:联合方法治疗冻结肩效果好于单独使用肩周痛点及肩胛上神经阻滞和肩关节腔注射玻璃酸钠法.     

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…     

医用透明质酸钠预防粘连性肠梗阻的疗效观察

目的观察医用透明质酸钠凝胶防治粘连性肠梗阻的疗效.方法1000例腹部手术患者,关腹前于腹腔创面、肠管及腹膜切口部位涂抹医用透明质酸钠凝胶3～15ml,随访期间,23例获再次开腹探查机会,观察腹腔粘连情况,并与同期1 000例未用透明质酸钠凝胶患者及其中的26例2次手术患者作对比分析.结果治疗组未发现粘连性肠梗阻的发生,对照组1 000例患者中40例发生肠梗阻,其中8例采用手术治疗.2次手术治疗组:腹腔粘连Ⅰ级11例,Ⅱ级9例,Ⅲ级3例,Ⅳ级0例;2次手术对照组:Ⅰ级1例,Ⅱ级5例,Ⅲ级17例,Ⅳ级3例.两组轻度粘连分别为87%和23%;重度粘连分别为13%和77%.比较差异有显著意义(P＜0.01).结论医用透明质酸钠凝胶能有效的预防腹部手术后腹腔粘连所致的粘连性肠梗阻.     

玻璃酸钠注射液在骨科临床中的应用

为分析玻璃酸钠在膝关节炎、髌骨固定术后、膝关节僵硬、肌腱手术及腰椎间盘手术的应用特点及作用机理，应用玻璃酸钠于骨科临床71例、五种实例中，结果表明玻璃酸钠在关节、肌腱、神经等术后润滑保护软骨及防粘连等方面很有临床实用价值，可作为某些病种的常规用药。     

Sodium hyaluronate in cataract surgery. II. Report on the use of Healon in extracapsular cataract surgery using phacoemulsification

Healon has been used in a prospective study as a surgical device for extracapsular cataract extraction using Kelman's phacoemulsification technique. The study comprised 38 patients divided into two groups. Healon and balanced salt solution (BSS) were randomly applied and the patients were age-matched. The emulsification was done in the anterior chamber. Healon is shown to have a protective effect on the cornea as judged by corneal thickness measurements and by endothelial cell counts. Healon facilitated the procedure in several ways. In this study no attempt was made to remove Healon from anterior chamber at the end of surgery. It cannot be excluded that Healon may occasionally cause increased intraocular pressure. With regard to postoperative inflammatory reaction and wound healing, no side effects have been observed after use of Healon.     

In vitro effect of hyaluronate on lysosomal enzyme activities in the bovine ciliary body and iris

The effect of hyaluronate on lysosomal enzyme activities in bovine ciliary body and iris was studied in vitro. Hyaluronates from both the human umbilical cord and bovine vitreous inhibited the activities of cathepsin b and acid phosphatase. Cathepsin d, β-N-acetyl-glucosaminidase, β-d-glucuronidase and α-l-fucosidase activities were not affected by the hyaluronate.     

The molecular weight of hyaluronate in the aqueous humour and vitreous body of rabbit and cattle eyes

The molecular weight distribution of hyaluronate in the aqueous humour and vitreous body of rabbit and cattle has been determined by gel chromatography. The eluate from the column was monitored by a radioassay, whereby the molecular weight distribution of 15–20 μg samples could be analysed. Control experiments were carried out with radioactively-labelled hyaluronate added to bovine material to estimate the degradation of the polymer during handling of the ocular fluids. It was shown that in vitro degradation does not appreciably affect the results.The analyses show a considerable polydispersity of the hyaluronate preparations. There is also a marked variation in the degree of polymerization between the two species. Hyaluronate from rabbit vitreous has a weight-average molecular weight ($\text{M}{}_{\mathrm{<mtext>w</mtext>}}$) of 2–3 × 10⁶ while adult bovine vitreous displays a value of about 5–8 × 10⁵. The hyaluronate of bovine vitreous varies with age. In newborn calf, a value of 3 × 10⁶ was registered. This value dropped to about 5 × 10⁵ in old cattle.The hyaluronate in the aqueous humour of rabbit showed a considerably higher molecular weight than that of the vitreous indicating that part of the hyaluronate in the anterior segment originates elsewhere than the vitreous. The differences between hyaluronate from the aqueous humour of adult cattle and that from the vitreous were more complex. As with the rabbit, a relatively large proportion of hyaluronate in the aqueous humour was of high-molecular weight, but, in contrast, the aqueous humour also contained material which had a lower degree of polymerization than the hyaluronate in the vitreous. The proportion of high-molecular weight material in bovine aqueous humour seemed to be lower in the summer than in the winter.     

透明质酸钠关节内注射配合三花膏外敷治疗膝骨性关节炎的临床观察

目的观察透明质酸钠(SH)关节内注射配合中药三花膏外敷治疗膝骨性关节炎的临床疗效。方法将112例膝骨性关节炎患者随机分为两组,Ⅰ组(54例)采用单纯膝关节内注射SH治疗,Ⅱ组(58例)采用关节内注射SH配合三花膏外敷治疗,对两组患者治疗前后膝关节整体情况按照Lvsholm功能评分标准作评分比较。结果治疗第2周、第5周、治疗后3个月及1年的膝关节功能评分结果显示,两组膝关节评分值均较治疗前显著升高(P<0．05),且3个月内随时间的延长而不断增高,两组同期比较,Ⅱ组的评分值明显高于工组(P<0．05);治疗后1年,Ⅰ组总有效率为81．5％,Ⅱ组总有效率为96．6％,Ⅱ组高于Ⅰ组(P<0．05);Ⅱ组患者症状、体征初次改善时间明显早于Ⅰ组,不良反应症状消退速度亦快于Ⅰ组。结论关节内注射SH配合三花膏外敷治疗膝骨性关节炎的,临床疗效优于单用膝关节内注射SH者。     

Efficacy and safety of 0.18% sodium hyaluronate in patients with moderate dry eye syndrome and superficial keratitis

Background Sodium hyaluronate (SH) is used in patients with dry eye. We evaluated the efficacy and safety of SH and carboxymethylcellulose (CMC) in the treatment of dry eye syndrome with superficial keratitis.Methods A total of 22 patients with moderate dry eye and superficial keratitis were enrolled in a prospective, randomised, masked-observer, parallel-group, single-centre study. Patients were randomly assigned to a 0.18% SH or 1% CMC solution for a 2-month period. In addition to the commonly assessed parameters in patients with dry eye (among others symptoms and corneal staining with fluorescein), flow cytometry analysis of CD44, HLA DR expressions in impression cytology was investigated as a potential efficacy parameter.Results Both treatments improved the symptoms and ocular surface and were well tolerated. SH significantly (p<0.05) decreased CD44 values compared with CMC. Comfort was significantly (P<0.05) better in the SH group than that in the CMC group throughout the study. Recovery in keratitis (type, extent and depth) and symptoms were faster in the SH group than in the CMC group. Blurred vision was reported by patients in the CMC group only.Conclusions SH was well tolerated and tended to show a faster efficacy than did the CMC-based formulation in patients with moderate dry eye and superficial keratitis. SH could therefore advantageously be prescribed from the early stages of dry eye disease. This study also showed that flow cytometry in impression cytology specimens is a reliable tool for exploring the ocular surface at the epithelial level and that CD44, in addition to HLA DR, could be an interesting endpoint for future trials in dry eye syndrome with products based on SH.     

Safety and efficacy of retreatment with a bioengineered hyaluronate for painful osteoarthritis of the knee: results of the open-label Extension Study of the FLEXX Trial

Objective

To evaluate the safety of repeated intra-articular (IA) injections of Euflexxa^® (1% sodium hyaluronate; IA--BioHA) for painful knee osteoarthritis (OA).

Design

Participants who completed the randomized, double-blind, 26-week FLEXX Trial comparing IA-BioHA to IA saline (IA-SA) for knee OA¹ received three weekly IA-BioHA injections in a 26-week Extension Study. Adverse events (AEs) were recorded and the effect of treatment on knee pain was measured immediately following a 50-foot walk test using a 100 mm visual analog scale (VAS). Responder rate, Medical Outcomes Study Short Form 36 scores, Patient’s Global Assessment, and intake of rescue medication were also evaluated.

Results

The Extension Study included 433 subjects, 219 who received IA-BioHA and 214 who received IA-SA during the FLEXX Trial. Safety results from the Extension Study indicated that 43.4% (188/433) of subjects had AEs, of which 4.8% (21/433) were deemed treatment-related AEs. Two AEs in the Extension Study led to discontinuation, and no joint effusion was reported. Patients who continued with IA-BioHA in the Extension Study maintained their improvement from baseline, with an average reduction in pain in the VAS score of −3.5 mm. Patients initially treated with IA-SA in the FLEXX Trial also had a reduction in VAS score of −9.0 mm. Secondary efficacy variables also improved during the Extension Study.

Conclusions

Repeat injections of IA-BioHA were effective, safe, well tolerated, and not associated with an increase in AEs, such as synovial effusions. Additional symptom improvements were noted for subjects who received either IA-BioHA or IA-SA in the FLEXX Trial.Clinical Trial Registration Number: NCT00379236