Exercise Therapy in Addition to an Orthosis Reduces Pain More Than an Orthosis Alone in Patients With Thumb Base Osteoarthritis: A Propensity Score Matching Study

ObjectiveTo compare the effect of exercises and orthotics with orthotics alone on pain and hand function in patients with first carpometacarpal joint (CMC-1) osteoarthritis (OA) and to predict outcomes on pain and hand function of exercises and orthotics.DesignProspective cohort study with propensity score matching.SettingData collection took place in 13 outpatient clinics for hand surgery and hand therapy in The Netherlands.ParticipantsA consecutive, population-based sample of patients with CMC-1 OA (N=173) was included in this study, of which 84 were matched on baseline demographics and baseline primary outcomes.InterventionsExercises and orthotics versus orthotics alone.Main Outcome MeasuresPrimary outcomes included pain and hand function at 3 months, measured using visual analog scale (VAS, 0-100) and the Michigan Hand Outcomes Questionnaire (MHQ, 0-100).ResultsA larger decrease in VAS pain at rest (11.1 points difference; 95% confidence interval, 1.9-20.3; P=.002) and during physical load (22.7 points difference; 95% confidence interval, 13.6-31.0; P<.001) was found in the exercise + orthotic group compared to the orthotic group. In addition, larger improvement was found for the MHQ subscales pain, work performance, aesthetics, and satisfaction in the exercise + orthotic group. No differences were found on other outcomes. Baseline scores of metacarpophalangeal flexion, presence of scaphotrapeziotrapezoid OA, VAS pain at rest, heavy physical labor, and MHQ total predicted primary outcomes for the total exercise + orthotic group (N=131).ConclusionsNon-surgical treatment of patients with CMC-1 OA should include exercises, since there is a relatively large treatment effect compared to using an orthosis alone. Future research should study exercises and predictors in a more standardized setting to confirm this finding.     

基于asp的医院办公自动化系统的研究与实现

办公自动化系统提供了交流和协作的平台,在医院组建并推广有着重要的意义,方便了医务工作人员之间的交流,规范化了工作流程,在办公自动化系统平台上,可以了解每项业务的进度和状态,了解哪些地方、哪个环节有改善的余地,它促进了医院工作的协作效率和办公效率。     

协同办公平台设计与实现

分析协同办公平台应用现状与发展趋势,阐述中国疾病预防控制中心协同办公平台功能及架构设计,包括认证管理、权限管理、LDAP目录服务、工作流引擎、网络拓扑等方面,指出该平台有助于实现信息共享,充分利用各种资源提高工作效率和管理水平。     

移动医疗APP现状与展望

介绍当前移动医疗APP应用现状,包括手机挂号、医疗咨询、医师随身工具箱、慢性病远程会诊、移动医疗OA等,分析优缺点,对未来应用如居民电子健康档案建立、在线医院、智慧医疗系统等进行展望。     

老年医学开放获取资源调查分析

利用开放获取期刊目录提供的有代表性的开放获取数据库,对老年医学开放获取资源开展调查分析,介绍检索结果的总体情况和各OA资源库的具体情况,指出老年医学开放获取资源具备较大的利用空间。     

Expression of membrane-type matrix metalloproteinases in synovial tissue from patients with rheumatoid arthritis or osteoarthritis

We investigated the expression of membrane-type matrix metalloproteinase (MT-MMP) and matrix metalloproteinase (MMP) mRNAs in synovial tissue from patients with rheumatoid arthritis (RA, n = 5) or osteoarthritis (OA, n = 5) by Northern blot analysis. Northern analysis demonstrated strong expression of MT1-MMP, MT3-MMP, MMP-1, and MMP-3 and weak expression of MT2-MMP and MMP-8 in synovial tissue from patients with RA or OA. MT4-MMP was not detected. No significant difference was shown in the expression of MT-MMP mRNAs between RA and OA. Synovial tissue of RA or OA patients expressed MT-MMPs as well as MMPs. These results indicate that, in addition to MMPs, MT1-MMP, MT3-MMP, and probably MT2-MMP may play a role in the degradation of bone and cartilage matrix in RA and OA. Such information may provide a clue to the development of a novel therapeutic approach targeted on the prevention of joint destruction. Received: April 30, 2000 / Accepted: September 19, 2000     

虾青素胶囊治疗膝关节骨性关节炎疗效观察

目的观察虾青素胶囊治疗膝关节骨性关节炎的疗效。方法将60例膝关节骨性关节炎患者随机分为治疗组(30例)和对照组(30例)。治疗组给予虾青素胶囊治疗,对照组给予芬必得治疗。比较两组治疗前后膝关节功能评分,观察主要症状缓解情况和治疗效果。结果 (1)治疗组的疼痛缓解持续时间较对照组缩短,而疼痛缓解时间较对照组延长(P均0.01);(2)两组治疗后关节功能较治疗前均有提高(P均0.01),而治疗组比对照组更优(P0.05);(3)总有效率治疗组为66.67%,对照组为83.33%,两组疗效比较差异无统计学意义(P0.05)。结论虾青素胶囊治疗骨性关节炎有一定的疗效。     

阿仑磷酸盐治疗老年性OA患者临床研究

目的：探讨阿仑磷酸盐在治疗老年性OA患者中的作用及可能机制。方法：用双能X线骨密度仪测定使用阿仑磷酸盐治疗的OA患者前后的骨密度，应用ELISA法检测患者前后血清中护骨素、破骨细胞分化因子（ODF）的水平。结果：应用双磷酸盐治疗的患者骨密度显著高于未使用者和使用前（P〈0.05）;血清中OPG/ODF水平，双磷酸盐治疗的患者高于未治疗的患者和治疗前（P〈0.05）。绪论双磷酸盐可以提高OA患者的骨密度，并可能通过改变OPG/ODF水平对骨代谢进行调节的。