铍针治疗腰椎退行性骨关节病(K-L3、4级)的病例对照研究

目的:观察铍针治疗腰椎退行性骨关节病(Kellgren-Lawrence分型3、4级)的早期临床疗效。方法:选取2014年5月至2015年5月中国中医科学院望京医院收治的腰椎退行性骨关节病患者108例作为研究对象,按照随机数字表法随机分为观察组和对照组,每组54例。观察组使用铍针松解1次/周;对照组口服醋氯芬酸肠溶胶囊,1粒/次,2次/d,3周为1个疗程,如果症状在疗程内消失则停止治疗。分别于治疗前、治疗1周后、治疗2周后、随访1个月、随访3个月,采用VAS及ODI评价治疗效果。结果:2组在治疗第1周后VAS评分比较差异无统计学意义,在第2周后及2次随访时,观察组效果优于对照组,差异均有统计学意义(P0.05)。2组间ODI分数在前2周无统计学意义,在2次随访时观察组ODI分数与对照组之间差异有统计学意义(P0.05)。结论:使用铍针治疗腰椎退行性骨关节炎(K-L3、4级)符合微创理念,具有定位精准、操作简便、疗效显著、不影响脊柱的稳定性及小关节正常功能优点,治疗效果优于口服醋氯芬酸肠溶胶囊,为治疗腰椎退行性骨关节炎痛提供了新选择。     

Phenolsulfonphthalein as a surrogate substrate to assess altered function of the prostaglandin transporter SLCO2A1

The prostaglandin (PG) transporter SLCO2A1 regulates PGE₂ signaling and interacts with many drugs, and SLCO2A1 defects is associated with PG metabolic disorders. This study aimed to characterize a non-metabolic phenolsulfonphthalein (PSP) transport mediated by SLCO2A1. PSP uptake by HEK293 cells expressing human SLCO2A1 (HEK/2A1 cells) was pH-independent and saturable with a K_m value of 54.5 ± 9.5 μM PGE₂ competitively inhibited PSP uptake with a K_i of 257.3 ± 22.8 nM. When PSP was intravenously (i.v.) injected, concentration-time curve showed a biphasic response. In Slco2a1-deficient (−/−) mice, AUC_inf tented to decrease and the central distribution volume (V₁) significantly increased, compared to wild-type (wt) counterparts. Intriguingly, Slco2a1-deficiency significantly reduced a ratio of tissue-to-plasma concentration in the lungs at 15 min after i.v. injection, suggesting that SLCO2A1 limits tissue distribution of PSP. In conclusion, these results prove that PSP is a potential surrogate for monitoring SLCO2A1 function, providing a new concept for diagnostics for the genetic diseases caused by defects in SLCO2A1 gene.     

36例以杵状指为首发症状的肺癌临床分析

目的探讨杵状指作为肺癌首发症状时的临床特征。方法回顾分析3584例经病理证实的肺癌中36例以杵状指为首发症状者的临床资料。结果以杵状指为首发症状者占全部病例的1．00％;36例中吸烟者占83．3％,鳞癌12例（33．3％）,腺癌21例（58．3％）;7例合并肥大性骨关节病其他表现,占19．4％;根治切除30例,占83．3％;术后杵状指开始消退,可完全恢复正常。结论杵状指可单独或合并肥大性骨关节病其他表现出现作为肺癌的首发症状,应在全面考虑和详尽检查后作出诊断。     

A case of pachydermoperiostosis treated by oral administration of a bisphosphonate and arthroscopic synovectomy

Pachydermoperiostosis (PDP) is a rare hereditary disorder characterized by pachydermia, digital clubbing, and periosteal hypertrophy. Here, we report a case of PDP showing symptoms consistent with arthritis, which was treated by oral administration of risedronate sodium and arthroscopic synovectomy.     

退行性骨关节病患者膝关节液中一氧化氮含量的变化及其意义

对１８例膝关节退行性骨关节病（ＤＯＡ）患者膝关节液中一氧化氮（ＮＯ）含量进行测定。结果发现ＤＯＡ关节液中ＮＯ含量明显高于对照组（Ｐ＜０．０１）。提示ＮＯ在该病的发生发展中起一定作用。     

两种超高频波型治疗退行性骨关节病的对比观察：附120例临床应用报告

本文应用脉冲式超短波和连续式超短波（以下简称脉冲式，连续式）两种超高频电场疗法分别治疗退行性骨关节病各６０例。结果是脉冲式治疗的显效率、有效率分别为３６．７％、９１．７％；连续式治疗的显效率，有效率分别为１８．３％、７８．３％。脉冲式治疗的疗效优于连续式。二者的显效率差异有非常显著性（Ｐ＜０．０１）。二者有效率亦有显著性差异（Ｐ＜０．０５）。     

Genetic diagnosis history and osteoarticular phenotype of a non-transfusion secondary hemochromatosis

BACKGROUNDIt is not easy to identify the cause of various iron overload diseases because the phenotypes overlap. Therefore, it is important to perform genetic testing to determine the genetic background of patients.AIMTo investigate the genetic background of a patient with hemochromatosis complicated by psoriasis on both lower extremities.METHODSTen years ago, a 61-year-old male presented with iron overload, jaundice, hemolytic anemia and microcytic hypochromic anemia. Computed tomography of the left knee joint showed enlargement of the tibial medullary cavity and thinned bone cortices. Magnetic resonance imaging showed hepatic hemochromatosis, extensive abnormal signals from bone marrow cavities and nodular lesions in the lateral medullary cavity of the upper left lateral tibia. Single photon emission computed tomography showed radial dots of abnormal concentration in the upper end of the left tibia and radial symmetry of abnormal concentrations in joints of the extremities. The patient showed several hot spot mutations of the HFE and G6PD genes detected by next-generation sequencing, but no responsible gene mutation was found. The thalassemia gene was detected by gap-PCR.RESULTSThe patient was found to carry the -α^4.2 and --^SEA deletion mutations of the globin gene. These two mutations are common causes of Southeast Asian α-thalassemia, but rarely cause severe widespread non-transfusion secondary hemochromatosis osteoarthropathy. The simultaneous presence of an auxiliary superposition effect of a rare missense mutation of the PIEZO1 gene ({"type":"entrez-nucleotide","attrs":{"text":"NM_001142864","term_id":"1388742761"}}NM_001142864, c.C4748T, p.A1583V) was considered. Moreover, several rare mutations of the IFIH1, KRT8, POFUT1, FLG, KRT2, and TGM5 genes may be involved in the pathogenesis of psoriasis.CONCLUSIONThe selection of genetic detection methods for hemochromatosis still needs to be based on an in-depth study of the clinical manifestations of the disease.