老年类风湿关节炎患者心功能变化及其相关性研究

目的:研究老年类风湿关节炎(RA)患者心功能变化及与他指标的相关性。方法:将68例类风湿关节炎(RA)患者按年龄分为中青年类风湿关节炎(YMRA)、老年类风湿关节炎(ERA)两组,采用超声心动图(UCG)检测两组RA患者的心功能,并与20例健康对照(NC)组比较;观察两组RA患者的疾病活动度评分(DAS-28)及临床症状、体征及实验室指标的变化。结果:①与NC组相比,两组RA患者舒张早期血流峰值(E峰)、短轴缩短率(FS,%)、E/A比值均显著降低(P<0.05或P<0.01);与YMRA组相比,ERA组患者E峰、E/A比值显著降低(P<0.05或P<0.01),舒张晚期血流峰值(A峰)显著升高(P<0.05)。②与YMRA组相比,ERA组病程、收缩压、DAS-28积分、关节肿胀积分、关节压痛积分、PLT、PCT、UA、α-AGP、hs-CRP、ESR显著升高(P<0.05或P<0.01);双手握力、CD4+CD25+Treg、CD4+CD25+CD127-Treg显著降低(P<0.05)。③Spearman相关分析显示,ERA组心功能参数E峰与年龄、DAS-28、α-AGP、CRP,E/A比值与收缩压,(EF,%)与类风湿因子,ST段压低数与年龄均呈呈显著负相关(P<0.05)。E峰与CD4+CD25+Treg,A峰与舒张压、15m步行时间,E/A比值与CD4+CD25+Treg均呈显著正相关(P<0.05)。结论:RA患者存在心功能下降,ERA患者心功能水平下降更为显著;UCG下表现为E峰、E/A、(EF,%)、(FS,%)的显著降低,A峰显著升高;ERA患者心功能参数与年龄、血压、实验室指标等相关。     

补肾通络汤治疗类风湿关节炎的效果及对骨代谢指标的影响

目的 探究补肾通络汤治疗类风湿关节炎(RA)的效果.方法 采用单双号随机化分组将90例RA患者分为对照组和观察组,每组45例.对照组采用常规西医治疗,观察组在此基础上应用补肾通络汤.比较两组的治疗效果.结果 治疗后,两组BAP、PⅠNP、TNF-α、IL-1β水平及关节肿胀指数、关节压痛指数及关节功能指数均较治疗前降低...     

RNA干扰技术抑制类风湿关节炎成纤维细胞COX-2合成

目的 体外合成针对人环氧化酶-2（hCOX-2）的小分子干扰RNA（siRNA）,并转染人人滑膜成纤维细胞,通过比较不同siRNA抑制COX-2 mRNA表达、COX-2蛋白合成以及下游产物PGE2水平,旨在确定特异性阻断人滑膜成纤维细胞COX-2的siRNA.方法 分离、培养和传代人类风湿关节炎（类风关）滑膜成纤维细胞.设计合成4条针对hCOX-2 mRNA siRNA（1#-4#siRNA）,1条随机序列siRNA.设立1#-4#siRNA和随机序列siRNA组（NC）及未转染对照组（CTL组）.应用Lipofect AMINE 2000将上述siRNA分别转染人滑膜成纤维细胞,4 h后各培养孔加入终浓度为100 nmol/L的佛波酯.转染36 h、48 h后,各组提取蛋白质和总RNA,应用RT-PCR检测hCOX-2 mRNA表达水平,通过Western Blot检测hCOX-2蛋白表达水平.采用ELISA方法检测各组上清液PGE2的水平.结果 转染36 h,PCR结果显示,CTL、NC、1#siRNA、2#RNA、3#RNA、4#siRNA、阳性对照HeLa细胞组hCOX-2 mRNA电泳条带密度值分别为1、0.72、0.3、0.25、0.4、0.04、2.1.Western Blot结果提示上述各组hCOX-2蛋白密度值分别为1、1.04、0.52、0.39、0.9、0和2.48.转染48 h后,各组hCOX-2蛋白条带密度值分别为0.05、0.52、0.51、0.9和0.15.转染24 h、48 h和72 h后,4#siRNA组培养上清液PGE2的水平较其他各组低.结论 4#siRNA能有效抑制人滑膜成纤维细胞COX-2 mRNA表达和COX-2蛋白的合成,且上清液中PGE2水平最低,证实4#siRNA能特异性阻断COX-2在滑膜成纤维细胞表达.     

Further studies on glucametacin in rheumatoid arthritis and in other chronic types of rheumatism

Summary

Twenty-three patients with rheumatoid arthritis and 9 patients with other forms of rheumatic diseases were treated for 20 days with 420?mg glucametacin per day, given as three 140?mg capsules. The treatment produced anti-inflammatory effects which were rated as good in about half the cases, with improvement of the majority of the clinical parameters studied. There were mild digestive side-effects. One patient with gallstones developed biliary colic, but the relationship of this to glucametacin treatment was not clear. The results obtained in the 32 patients treated with 140?mg glucametacin capsules were very similar to those which the same authors had observed in a very extensive case series of patients with rheumatic diseases treated with the same daily dose, but given as 70?mg capsules. It is suggested that the new preparation, which halves the number of capsules taken each day, is to be preferred to the smaller dose capsules.     

Protective effects of thymoquinone and methotrexate on the renal injury in collagen-induced arthritis

The goal of this investigation was to study the protective effects of thymoquinone (TQ) and methotrexate (MTX) on collagen-induced arthritis (CIA) in rats. On day 0 under ether anesthesia, the experimental groups were immunized with 0.5 mg native chick collagen II (CII) solubilized in 0.1 M acetic acid and emulsified in Freund's incomplete adjuvant. Control rats were gavaged with vehicle, whereas CII was administered intradermally. In addition, arthritis treated with TQ group received TQ (10 mg kg(-1) bw by gavage once a week for 3 weeks starting on day 0); and arthritis treated with MTX group received MTX (MTX was suspended in corn oil and administered by gavage at 1 mg kg (-1) bw once a week for 3 weeks starting on day 0). A significant decrease in the incidence and severity of arthritis by clinical and radiographic assessments was found in recipients of therapy, compared with that of controls. The MTX treatment significantly (P<0.01) decreased the elevated serum NO, urea and creatinine in arthritic rats. Likewise, TQ treatment was also able to reduce significantly (P<0.05) serum NO, urea and creatinine levels, but to lesser extent than MTX. The histopathologic abnormalities are consistent with the hydropic epithelial cell degenerations and moderate tubular dilatation in the some proximal and distal tubules. The severity of the degenerative changes in most of the shrunken glomerules and vascular congestion were also observed in arthritic animals. Preventive treatment of TQ and especially MTX significantly inhibited kidney dysfunction and this histopathologic alterations. These studies indicate that TQ can be used similar to MTX as a safe and effective therapy for CIA and may be useful in the treatment of rheumatoid arthritis.     

红花如意丸联合秦氏风湿灵治疗女性风湿性关节炎临床研究

目的:观察红花如意丸联合秦氏风湿灵治疗女性风湿性关节炎的临床疗效。方法:选择2012年5月—2014年9月就诊于本院的1 166例风湿痹证患者,随机分为对照组378例,治疗1组390例和治疗2组398例。对照组进行西医常规治疗,治疗1组采用秦氏风湿灵加减治疗,治疗2组在治疗1组的基础上加用红花如意丸治疗。比较三组患者临床症状、膝关节功能、实验室指标急临床疗效。结果:对照组有效率为73.02%,治疗1组有效率为84.36%,治疗2组为有效率95.23%,组间比较,差异具有统计学意义(P0.05);治疗2组晨僵时间、肿胀关节数、疼痛关节数明显低于对照组和治疗1组,Lysholm评分、Tenger评分明显高于对照组和治疗1组,差异具有统计学意义(P0.05);治疗2组血清TNF-α、IL-1β、CRP、ESR均明显低于对照组和治疗1组差异具有统计学意义(P0.05)。结论:红花如意丸联合秦氏风湿灵有助于缓解女性风湿性关节患者临床症状,改善膝关节功能,减轻炎症反应,提高临床疗效。     

Effects of TGFbeta1 and extracts from Cervus korean TEMMINCK var. mantchuricus Swinhoe on acute and chronic arthritis in rats

AIM OF THE STUDY: To elucidate the pharmacological activities of deer antler acupuncture and TGF61538;1 on the acute and chronic phases of rheumatoid arthritis diseases. MATERIALS AND METHODS: Polyarthritis rats were administered with TGF61538;1 and water extract of deer antler acupunture (DAA), prepared from the pilose antler of Cervus korean TEMMINCK var. mantchuricus Swinhoe. TGF61538; (0.1 to 2 61549;g/animal) and DAA (5-100 61549;g/kg animal) were initiated 1 day before an arthritogenic dose of streptococcal cell wall fragments to see the effects on the joint swelling and distortion during the acute phase and the chronic phase of the disease. Arthritic index suppression of rat arthritis model was examined by TGF61538; and DAA administrations. RESULTS: TGF61538;1 and DAA diminished the polyarthritis development in rats. TGF61538; and DAA eliminated the joint swelling and distortion observed during the acute phase and the chronic phase of the disease. The TGF61538; and DAA suppressed the arthritis progress when administration was begun after acute phase of arthritis. DISCUSSION: Consistent with the inhibition of inflammatory cell recruitment into the synovium, TGF61538;1 and DAA reversed the leukocytosis associated with the chronic phase of the arthritis, respectively.     

Effects of bee venom on the maturation of murine dendritic cells stimulated by LPS

Aim of study

This study was performed to elicit the effectiveness of bee venom (BV), a traditional immunosuppressive Korean acupuncture agent, on the maturation of dendrtic cells (DCs).

Materials and methods

Immature dendritic cells (iDCs) were generated from mouse bone marrow cells with GM-CSF. After 10 days of initial differentiation, DCs were activated with lipopolysaccharides (LPS) for another 48h in the presence or absence of BV. Surface molecule analysis, intracytoplasmic staining of cytokines, FITC-conjugated antigen uptake, and transwell migration assays were conducted with iDCs and activated DCs.

Results

Up-regulation of costimulatory molecules, typical of mature DCs (mDCs) was inhibited by addition of BV. Pro-inflammatory cytokines were also found to be reduced with BV treatment in LPS-stimulated DC. A decrease in antigen uptake upon the maturation of DC was reversed in low dose BV treated mDC. In addition, BV treated mDC demonstrated reduced directional migration in response to CCL21, a lymphoid chemokine which directs mDC.

Conclusions

BV may have a therapeutic effect an on abnormally activated immune status, such as autoimmune rheumatoid arthritis, through an immune-modulatory effect on DC.     

脾实热证与类风湿关节炎热痹证的关系

类风湿性关节炎属于中医"痹病"范畴。辨证大体分为寒热两类,而类风湿关节炎热痹证临床上较为多见。现代实验研究表明,中医脾气虚时机体免疫系统功能低下。试以探讨脾实热证时机体的免疫功能是否亢进,经研究中医古典医籍,发现脾实热证具有某些热痹证候,而类风湿关节炎热痹证在急性活动期常可见体液免疫亢进,现就脾实热证与类风湿关节炎热痹的关系加以探讨,为清热泻脾法治疗免疫疾病提供理论依据。