自拟补肾活血温经通络汤治疗膝骨性关节炎临床观察

目的：观察评价自拟补肾活血温经通络汤治疗膝骨性关节炎的临床疗效．并与筋骨痛消丸作比较。方法：将283例患者随机分为治疗组152例,治疗组给予补肾活血温经通络汤治疗。对照组131例,给予筋骨痛消丸治疗,疗程均为3个月,观测对膝关节疼痛,活动范围及可行走距离等。结果：治疗组有效率及优良率优于对照组。结论：补肾活血温经通络汤可以有效治疗膝骨性关节炎,显示了中医整体观辨证论治理念的优势。     

关节软骨的微摩擦接触力学特性

目的使用修饰后的原子力显微镜(atomic force microscopy,AFM)探针研究关节软骨的微摩擦接触力学性能。方法使用微操作器对AFM氮化硅探针进行修饰处理,具体操作为在探针上粘贴玻璃微球作为针尖,然后使用修饰后的探针研究人体和牛关节软骨的微摩擦接触力学性能。结果人体和牛软骨的粗糙度分别为(68.63±6.22)、(50.16±6.47)nm,随着载荷的增大,人体和牛软骨的摩擦力逐渐增大。当探针滑动速度从0增加到100μm/s时,试样与探针之间的摩擦力增速很快;当速度从100μm/s增加到300μm/s时,摩擦力上升缓慢。结论软骨表面具有明显的纤维状结构,软骨的粗糙度与测量范围直接相关。随着速度或载荷的增大,人体和牛软骨的摩擦力增大,变化范围相同。探讨关节软骨在微摩擦试验中的力学和摩擦学性能表现,对于认识软骨损伤机制和医用人工关节抗磨材料的开发具有重要意义。     

Disparate response of articular- and auricular-derived chondrocytes to oxygen tension

Purpose/Aim: To determine the effect of reduced (5%) oxygen tension on chondrogenesis of auricular-derived chondrocytes. Currently, many cell and tissue culture experiments are performed at 20% oxygen with 5% carbon dioxide. Few cells in the body are subjected to this supra-physiological oxygen tension. Chondrocytes and their mesenchymal progenitors are widely reported to have greater chondrogenic expression when cultured at low, more physiological, oxygen tension (1–7%). Although generally accepted, there is still some controversy, and different culture methods, species, and outcome metrics cloud the field. These results are, however, articular chondrocyte biased and have not been reported for auricular-derived chondrocytes. Materials and Methods: Auricular and articular chondrocytes were isolated from skeletally mature New Zealand White rabbits, expanded in culture and differentiated in high density cultures with serum-free chondrogenic media. Cartilage tissue derived from aggregate cultures or from the tissue engineered sheets were assessed for biomechanical, glycosaminoglycan, collagen, collagen cross-links, and lysyl oxidase activity and expression. Results: Our studies show increased proliferation rates for both auricular and articular chondrocytes at low (5%) O₂ versus standard (20%) O₂. In our scaffold-free chondrogenic cultures, low O₂ was found to increase articular chondrocyte accumulation of glycosaminoglycan, but not cross-linked type II collagen, or total collagen. Conversely, auricular chondrocytes accumulated less glycosaminoglycan, cross-linked type II collagen and total collagen under low oxygen tension. Conclusions: This study highlights the dramatic difference in response to low O₂ of chondrocytes isolated from different anatomical sites. Low O₂ is beneficial for articular-derived chondrogenesis but detrimental for auricular-derived chondrogenesis.     

Synthesis,characterizations, in vitro and in vivo evaluation of Etoricoxib-loaded Poly (Caprolactone) microparticles – a potential Intra-articular drug delivery system for the treatment of Osteoarthritis

Intra-articular Drug delivery systems (IA-DDS) deliver the drug directly to the diseased joint space with significantly lowered systemic toxicities. In this work, we explored Etoricoxib (COX-2 inhibitor)-loaded Poly caprolactone (PCL) microparticles (MPs) as a potential IA-DDS. MPs were prepared by Oil/Water (O/W) emulsion-solvent evaporation method. Formulation parameters like polymer to drug ratio, stabilizer concentration were optimized to get the maximum encapsulation efficiency. The prepared particles were characterized using Scanning Electron Microscopy (SEM), Fourier Transform Infrared Spectroscopy (FTIR), X-ray Diffraction studies (XRD), and Differential Scanning Calorimetry (DSC). The particles were found to be spherical and smooth-surfaced using SEM. FTIR studies proved that there was no chemical interaction between the drug and the polymer. XRD and DSC studies confirmed that Etoricoxib existed in its amorphous form while PCL had retained its semi-crystalline phase during the micro-encapsulation process. In vitro drug release studies proved that there was controlled release of the drug from the MPs for nearly 28 days. In vivo synovial drug clearance studies on SD rats proved that drug leach out rate from the joint region to the systemic circulation was slow which indicated that MPs had a good drug retention capacity. In vivo fluorescence imaging results confirmed that MPs could stay longer in the joint region for almost a month. Thus, PCL microparticles could be a potential IA-DDS for the treatment of the diseased joint regions especially for Osteoarthritis.     

Self-assembled monolayers of phosphonates promote primary chondrocyte adhesion to silicon dioxide and polyvinyl alcohol materials

The optimal solution for articular cartilage repair has not yet been identified, in part because of the challenges in achieving integration with the host. Coatings have the potential to transform the adhesive features of surfaces, but their application to cartilage repair has been limited. Self-assembled monolayer of phosphonates (SAMPs) have been demonstrated to increase the adhesion of various immortalized cell types to metal and polymer surfaces, but their effect on primary chondrocyte adhesion has not been studied. The objective of this study was to investigate the response of primary chondrocytes to SAMP coatings. We hypothesized a SAMP terminated with an α,ω-bisphosphonic acid, in particular butane-1,4-diphosphonic acid, would increase the number of adherent primary chondrocytes to polyvinyl alcohol (PVA). To test our hypothesis, we first established our ability to successfully modify silicon dioxide (SiO₂) surfaces to enable chondrocytes to attach to the surface, without substantial changes in gene expression. Secondly, we applied identical chemistry to PVA, and quantified chondrocyte adhesion. SAMP modification to SiO₂ increased chondrocyte adhesion by ×3 after 4?hr and ×4.5 after 24?hr. PVA modification with SAMPs increased chondrocyte adhesion by at least ×31 after 4 and 24?hours. Changes in cell morphology indicated that SAMP modification led to improved chondrocyte adhesion and spreading, without changes in gene expression. In summary, we modified SiO₂ and PVA with SAMPs and observed an increase in the number of adherent primary bovine chondrocytes at 4 and 24?hr post-seeding. Mechanisms of chondrocyte interaction with SAMP-modified surfaces require further investigation.     

Disconnecting bones within the jaw‐otic network modules underlies mammalian middle ear evolution

The origin of the mammalian middle ear ossicles from the craniomandibular articulation of their synapsid ancestors is a key event in the evolution of vertebrates. The richness of the fossil record and the multitude of developmental studies have provided a stepwise reconstruction of this evolutionary innovation, highlighting the homology between the quadrate, articular, pre‐articular and angular bones of early synapsids with the incus, malleus, gonial and ectotympanic bones of derived mammals, respectively. There are several aspects involved in this functional exaptation: (i) an increase of the masticatory musculature; (ii) the separation of the quadrate bone from the cranium; and (iii) the disconnection of the post‐dentary bones from the dentary. Here, we compared the jaw‐otic complex for 43 synapsid taxa using anatomical network analysis, showing that the disconnection of mandibular bones was a key step in the mammalian middle ear evolution, changing the skull anatomical modularity concomitant to the acquisition of new functions. Furthermore, our analysis allows the identification of three types of anatomical modules evolving through five evolutionary stages during the anatomical transformation of the jawbones into middle ear bones, with the ossification and degradation of Meckel's cartilage in mammals as the key ontogenetic event leading the change of anatomical modularity.     

山羊颞下颌关节腔内压测定及其意义

目的　研究山羊颞下颌关节上腔内压在5种运动状态下的变化规律。方法　采用Mingograf7型多道生理记录仪对15只健康成年雌性山羊颞下颌关节测量在休息位、小开口位、大开口位、咀嚼及侧向运动时关节内压的值。结果　在休息位时,颞下颌关节上腔内压为负值,开口过程中负压值下降,在咀嚼、侧向运动等周期性运动中,关节上腔内压处于负压与正压交替的周期性变化中。结论　关节上腔内压可用于反映颞下颌关节的功能运动状态。     

自体耳廓软骨瓣置换或重建颞下颌关节盘MRI评价

目的　通过磁共振成像 ( MRI)对自体耳廓软骨瓣修复关节盘的术后情况进行评估 ,以观察软骨生长情况。方法　对 11例关节病患者 13侧关节进行自体耳廓软骨瓣移植修复关节盘手术 ,所有患者均经临床检查和信访答卷进行随访 ,症状均得到缓解 ,并对其中 5例患者 (滑膜软骨瘤病和关节强直各 1例 ,结构紊乱 2例 ,骨关节病 1例 )行 MRI检查。结果　 MRI矢状位、张闭口位及冠状位扫描均显示移植软骨无明显破碎或吸收。结论　 MRI可作为检测软骨生长情况的指标之一 ,自体耳廓软骨瓣置换 /重建关节盘是可行的手术方式     

人组织工程软骨的实验研究

目的　了解组织工程研究的基本原理 ,完善制作组织工程化人软骨的技术方法 ,探讨天然可吸收材料组织 ,引导再生胶原膜作为人软骨细胞体外培养支架的可行性 ,为广泛开展组织工程的研究与应用开辟新的途径。方法　利用组织工程技术制作人组织工程化软骨 ,并应用组织学方法 ,对获得的人组织工程化组织形态和功能进行表征。结果　培养的软骨细胞均匀沉降于医用组织引导再生胶原膜上 ,1周后形成一层乳白色软骨样组织 ;植入 8周后从裸鼠体内获得软骨样组织 ,组织学检测证实软骨细胞的存在 ,软骨细胞可以分泌硫酸软骨素。结论　医用组织引导再生胶原膜以其特有的三维结构和细胞网结功能 ,可以作为组织工程技术应用研究中软骨细胞培养的支架 ;利用组织工程技术 ,能够完成人组织工程化软骨的制作。