消痛汤配合消肿膏外敷治疗急性痛风性关节炎53例

[目的]观察消痛汤配合外敷消肿膏治疗急性痛风性关节炎的临床疗效。[方法]53例均采用中医分期辨证给予消痛汤加减配合外敷消肿膏治疗。[结果]总有效率达到96.2%。[结论]消肿膏外敷在缓解急性炎性疼痛、肿胀等方面具有良好的疗效,而中药内服与外敷相结合可达到标本兼治的作用,临床效果显著。     

云克治疗类风湿性关节炎62例护理浅识

[目的]探讨类风湿性关节炎患者使用锝[99TC]亚甲基二磷酸盐（商品名：云克）静脉滴注治疗类风湿性关节炎患者的护理措施。[方法]对62例类风湿性关节炎患者进行心理状况、药物观察、运动指导、生活保健、健康教育等措施的综合运用进行调查分析。[结论]提示云克治疗类风湿性关节炎疗效好,不良反应少,密切的临床观察及周密细致的护理是减少不良反应、保证用药安全、提高病人生活质量的重要因素。     

UK temporomandibular joint replacement database: report on baseline data

Our goal is to establish the long-term collection of data on temporomandibular joint replacement from all centres in the UK where this is done. Currently, 16 surgeons have been identified, and 13 of them had entered data when this paper was being prepared. Data are entered online through the Snap Survey and then analysed annually. We report on 402 patients (332 (83%) female and 70 (17%) male) who had 577 joints inserted between 1994 and 2012. The main diagnoses that resulted in total joint replacement were osteoarthritis, failed operation, ankylosis, and seronegative arthritis. Preoperatively, the median (IQR) maximal incisal opening was 20 (15–26) mm (mean 20) and the median pain scores on the visual analogue scale (VAS 0–10) were 8 for both joints. The median (IQR) baseline dietary score (liquid 0 – solid 10) was 4 (3–6). A total of 173 (43%) patients had had one or more open procedure(s) before total replacement, 177 (44%) had not had open operation, and 52 (13%) had no data entered. The 3 primary systems used were the TMJ Concepts System (Ventura, USA), the Biomet System (Biomet/Lorenz Microfixation, Jacksonville, USA), and the Christensen System (TMJ Implants, Golden, USA). The median (IQR) duration of inpatient stay was 3 (2–4) days (mean 3). Follow-up data will be collected to assess patient recorded outcome measures (PROM) and objective measurements of total joint replacements in the UK from 1994 onwards.     

抗环瓜氨酸肽抗体和类风湿因子联合检测对类风湿关节炎的临床价值

目的探讨抗环瓜氨酸肽(CCP)抗体和类风湿因子(RF)联合检测对类风湿关节炎(RA)诊治的临床价值。方法收集2013年11月至2014年12月该院182例风湿性疾病患者血清,采用ELISA方法检测CCP抗体,使用免疫透射比浊终点法检测RF。结果 (1)182例患者中RA 99例,CCP中位数是4.20,RF是392,非类风湿疾病患者83例,CCP中位数是2.30,RF是20.1,健康对照者106例,CCP中位数是1.23,RF是12.3。健康对照者与非风湿性疾病患者比较,差异无统计学意义(P0.05);与RA患者比较,差异有统计学意义(P0.01)。(2)CCP抗体诊断RA的特异度是90.5%,RF是79.2%,CCP抗体高于RF,差异有统计学意义(P0.05);CCP抗体和RF联合检测诊断RA的灵敏度是71.4%,特异度是96.2%,高于单项检测(P0.01)。CCP抗体和RF的灵敏度比较,差异无统计学意义(P0.05)。CCP抗体特异度高于RF。结论 CCP抗体和RF联合检测有助于RA的诊断和疗效监测,具有较高的临床意义。     

检测抗聚丝蛋白抗体在类风湿关节炎诊断中的意义

目的探讨抗聚丝蛋白抗体(AFA)对类风湿关节炎(RA)诊断的价值,并比较与RA的其他早期诊断指标的相关性。方法从人表皮细胞中提取并部分纯化聚丝蛋白(filaggrin)抗原,用于免疫印迹检测(Western blot)103例RA血清标本和140例对照血清,包括系统性红斑狼疮(SLE)、干燥综合征(SS)、骨性关节炎(OA)95份及正常人45份。APF和AKA用间接免疫荧光法检测。结果103例RA病人的AFA阳性率、特异性分别为35.9%,93.7%,显著高于疾病对照组和正常人(P<0.001)。在AFA阳性的37例中,AKA也阳性的为26例,重叠率为70.3%;APF亦阳性的为31例,重叠率为83.8%,AFA与AKA、APF之间存在相关性。结论AFA对RA具有很高的特异性。AFA的检测可用于RA的临床诊断。AFA与APF及AKA有相关性,但不能完全取代它们的检测。     

Use of biological drugs in patients with psoriasis and psoriatic arthritis in Italy: Results from the PSONG survey

This Italian multicenter retrospective study compared the drug survival and efficacy of different anti‐TNF agents in psoriasis (PsO) and psoriatic arthritis (PsA) patients. A database of PsO/PsA patients treated with adalimumab, etanercept, and infliximab from May 2013 to May 2014 was analyzed. PASI 75, 90, and 100 was calculated at each time point to evaluate efficacy. Drug survival rate and probability of maintaining PASI response were evaluated. The impact of dependent variables on probability of PASI 75 loss was evaluated by logistic regression. 1,235 patients were included, 577 with PsO and 658 with PsA. Highest survival rates were observed with adalimumab followed by etanercept and infliximab in PsO and PsA patients. The probability of maintaining PASI response was significantly higher for adalimumab followed by infliximab. For PsO patients, the odds of losing PASI 75 was higher in etanercept‐treated patients (OR: 8.1; 95% CI: 4.2–15.6, p < .001) or infliximab (OR: 6.6; 95% CI: 2.6–16.3, p < .001) vs. adalimumab. Likewise, for PsA patients the odds of losing PASI 75 was higher in etanercept‐treated patients (OR: 2.3; 95% CI: 1.4–3.8, p = .01) or infliximab (OR: 2.2; 95% CI: 1.1–4.1, p = .018) vs. adalimumab. Adalimumab could be the best therapeutic option over other anti‐TNF agents for the treatment of PsO and PsA patients.     

A case of acute septic arthritis of the hip joint caused by Panton-Valentine leukocidin-positive ST772 community-acquired methicillin-resistant Staphylococcus aureus

Acute septic arthritis (ASA) caused by Staphylococcus aureus can lead to fulminant arthritis and cause permanent joint destruction. In particular, infection caused by methicillin-resistant Staphylococcus aureus (MRSA) becomes intractable and severe owing to limitation of therapeutic drugs. Here, we report the case of a young patient with ASA without any record of overseas travel, who was infected by the Panton-Valentine leukocidin-positive Bengal-Bay clone, which is a predominant community-acquired MRSA in India.     

抗氨基甲酰化蛋白抗体对类风湿关节炎诊断价值的Meta分析

目的采用Meta分析方法综合评价抗氨基甲酰化蛋白(CarP)抗体诊断类风湿关节炎(RA)的效果。方法通过检索Pubmed、万方、维普、CNKI 4个数据库,获得有价值的CarP抗体诊断RA的文献,直接或间接提取真阳性数(TP)、假阳性数(NP)、假阴性数(FN)、真阴性数(TN);采用Revman 5.3、Meta-Disc 1.4、Stata 14.0软件进行诊断试验Meta分析,采用加权法、非加权法及稳健法分别拟合筛查方法的受试者工作特征(ROC)曲线。采用QUADAS-2的方法学质量评价体系进行总结。结果血清CarP抗体诊断RA灵敏度为0.43、特异度为0.92,阳性似然比为6.07,阴性似然比为0.65,AUC为9.43。结论CarP抗体对RA具有中等的诊断价值,特异度较高,但对RA诊断的灵敏度较低。     

血清葡萄糖-6-磷酸异构酶在类风湿关节炎疾病活动及骨侵蚀中的作用

目的 探讨类风湿关节炎(RA)患者血清中葡萄糖-6-磷酸异构酶(GPI)与疾病活动的关系及其在骨侵蚀中的作用。方法 选择2019-08至2021-02在山西省汾阳医院风湿免疫科就诊的RA患者105例,采用酶联免疫吸附法(ELISA)检测血清GPI值,根据GPI滴度分为GPI阳性组和GPI阴性组,比较两组患者临床资料、实验室指标,如关节肿胀数(SJC)、关节压痛数(TJC)、抗环瓜氨酸肽(CCP)抗体、类风湿因子(RF)、红细胞沉降率(ESR)、C-反应蛋白(CRP)等,计算28个关节计数法疾病活动度评分即DAS28评分;同时完善影像学检查,包括双手X线正位片和骨密度,计算Sharp评分。给予所有患者规范治疗并定期随访,在治疗3、6、9、12个月后评估疾病活动度,记录DAS28评分,于治疗1年后复查双手正位片和骨密度。结果 GPI阳性组SJC[5.00(4.00, 6.00)]、TJC[6.00(5.00, 8.75)]、ESR[(58.70±23.40) mm/h)]、CRP[21.82(13.55, 31.90) mg/L]、 DAS28评分(5.44±0.69)高于GPI阴性组[4...