银屑病关节炎发病的风险因素及其分子细胞机制研究进展

银屑病关节炎(psoriatic arthritis,PsA)是一种与银屑病相关的慢性炎症性关节病,主要表现为外周关节炎、附着点炎、指(趾)炎和脊柱关节炎,其临床表现和治疗反应具有较高的异质性,表现形式多样、复杂,且有一定的致残率,严重影响患者的身心健康、生活质量和工作能力.早期诊断和干预其病程可显著改善PsA临床前阶...     

Factors Associated with Pneumocystis jirovecii Pneumonia in Patients with Rheumatoid Arthritis Receiving Methotrexate: A Single-center Retrospective Study

Objective To investigate the risk factors for the development of Pneumocystis jirovecii pneumonia (PCP) in patients with rheumatoid arthritis (RA) undergoing methotrexate (MTX) therapy. Methods This single-center retrospective cohort study included consecutive patients with RA who received MTX for at least one year. The study population was divided into PCP and non-PCP groups, depending on the development of PCP, and their characteristics were compared. We excluded patients who received biologic disease-modifying anti-rheumatic drugs (DMARDs), Janus kinase inhibitors, and anti-PCP drugs for prophylaxis. Results Thirteen patients developed PCP, and 333 did not develop PCP. At the initiation of MTX therapy, the PCP group had lower serum albumin levels, a higher frequency of pulmonary disease and administration of DMARDs, and received a higher dosage of prednisolone (PSL) than the non-PCP group. A multivariate Cox regression analysis revealed that the concomitant use of PSL [hazard ratio (HR) 5.50, p=0.003], other DMARDs (HR 5.98, p=0.002), and serum albumin <3.5 mg/dL (HR 4.30, p=0.01) were risk factors for the development of PCP during MTX therapy. Patients with these risk factors had a significantly higher cumulative probability of developing PCP than patients who lacked these risk factors. Conclusion Clinicians should pay close attention to patients with RA who possess risk factors for the development of PCP during MTX therapy.     

A Rare Case of Rheumatoid Arthritis with Tocilizumab-induced Intestinal Mucosal Injury

Intestinal mucosal injury that develops as a complication of tocilizumab (TCZ) is usually associated with diverticulosis. We herein report a rare case of TCZ-induced intestinal mucosal injury in the absence of diverticulosis. A 74-year-old woman suffering from rheumatoid arthritis started taking TCZ. Six months later, she complained of hematochezia and abdominal pain. Colonoscopy revealed multiple ulcers spreading from the cecum to the transverse colon but no diverticulosis. These lesions were cured at three months after the discontinuation of TCZ. We should consider TCZ as a risk factor for intestinal mucosal injury, even if patients have no history of intestinal disease associated with diverticulosis.     

艾灸血清对实验性RA滑膜细胞增殖及细胞周期的影响

目的:研究艾灸血清对类风湿关节炎(RA)滑膜细胞增殖及细胞周期的影响,揭示艾灸治疗RA的机制.方法:艾灸刺激实验性RA日本大耳白兔双侧"肾俞"穴,用艾灸血清作用于兔RA滑膜细胞,MTT法检测细胞增殖情况,流式细胞技术检测细胞周期.结果:RA滑膜细胞增殖受到明显抑制(17.8%),艾灸血清作用24 h后艾灸血清组G1期细胞(82.01±1.33)较正常血清对照组百分率(73.99±3.47)明显升高(P<0.05),S期细胞百分率明显减少,G2期细胞变化无显著性差异.结论:艾灸血清作用于RA滑膜细胞可抑制其增殖,并对GI/S转换期有延缓作用.     

类风湿关节炎发病不同时期cDC成熟状态研究

目的 采用hGPI325-339和hGPI469-483混合多肽片段构建类风湿关节炎(rheumatoid arthritis,RA)小鼠模型,观测RA小鼠体内经典树突状细胞(conventional dendritic cells,cDC)的频率及成熟状态.方法 流式细胞术检测RA模型小鼠发病时脾脏、 淋巴结cDC的...     

Treatment Options for Patellofemoral Arthritis

Purpose of ReviewTo present a synthesis of recent literature regarding the treatment of patellofemoral arthritisRecent FindingsRisk factors of PFJ OA include patella malalignment or maltracking, injury to supportive structures including the MPFL, dysfunction of hamstring and quadriceps coordination, lower limb alignment, trochlear dysplasia, patellar trauma, or ACL surgery. Special physical exam maneuvers include patellar grind test, apprehension test, and lateral patellar tilt angle. Radiographs that should be obtained first-line include weight bearing bilateral AP, lateral, and Merchant views. CT and MRI are used to assess trochlear dysplasia, excessive patellar height, and TT-TG distance. Non-operative management options discussed include non-pharmacologic treatment (patient education, self-management, physical therapy, weight loss), ESWT, cold therapy, taping, bracing, and orthotics. Pharmacologic management options discussed include NSAIDs, acetaminophen, oral narcotics, and duloxetine. Injection therapies include glucocorticoids, hyaluronic acid, PRP, and other regenerative therapies (BMAC, adipose, or mesenchymal stem cells). Other treatment options include radiofrequency ablation and botulinum toxin. The algorithm for the surgical treatment of PFJ OA can begin with arthroscopic assessment of the PF articular cartilage to address mechanical symptoms and to evaluate/treat lateral soft tissue with or without overhanging lateral osteophytes. If patients fail to have symptomatic improvement, a TTO can be considered in those patients less than 50 years of age or active patients >50 years old. In patients with severe PFJ OA, refractory to the above treatments, PFA should be considered. While early PFA design and technique were less than encouraging, more recent implant design and surgical technique have demonstrated robust results in the literature.SummaryPatellofemoral osteoarthritis is a challenging orthopedic problem to treat, in that it can often affect younger patients, with otherwise well-functioning knees. It is a unique entity compared to TF OA with distinct epidemiology, biomechanics and risk factors and treatment options.     

水中抗阻训练对类风湿关节炎居家患者手足关节功能康复的影响

目的 探讨水中抗阻训练对类风湿关节炎居家患者手足关节功能康复的影响.方法 将风湿免疫科门诊就诊的类风涅关节炎患者71例根据就诊日期单双日分为观察组(n=35)和对照组(n=36).对照组接受常规护理及关节功能训练;观察组在对照组基础上实施水中抗阻训练,每天训练30～60 min,每周至少训练3d.比较两组干预前后双手握...     

骨质疏松与类风湿关节炎

类风湿关节炎和骨质疏松在我国都属于常见病和多发病,而二者之间又有着非常重要的联系。但是目前临床上还没有一个广泛应用的药物可以同时对两者都产生很好的治疗效果。为了进一步了解骨质疏松和类风湿关节炎的关系,将来能够找到更好的治疗药物,笔者从流行病学、发病机制以及治疗方法等方面分别进行了论述。     

Diabetes and Female Sexuality

Although diabetes plays a significant role in causing impotence in the diabetic male, its effects on female sexuality have only recently been studied. Surprisingly, no demonstrable effect on the capacity for sexual arousal or orgasm has been found in the diabetic female. This paper compares male and female anatomy, physiology, and neurology, and speculates about reasons for this sex difference.