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Objective:To investigate the effect of miR-106a on osteoarthritis.Methods:Twenty-four S-D female rats were randomly divided into three groupsaccording to the random number table: the sham operation group, the osteoarthritis (OA) group and the miR-106a mimic group. Eightweeks after operation, all rats were killed and articular cartilage was separated from the medial tibial plateau of each rat. Histopathology was used to observe the morphological changes and denatured quantity of chondrocytes, the level of inflamm-atory cytokines [interleukin (IL)-1, IL-6, tumor necrosis factor (TNF)-β 1], the expression of apoptosis receptor p65, DR6 protein and the expression of mir-106a RNA. The mean between groups was compared by one-way analysis of variance (ANOVA), and the least significant difference (LSD)- t test was used for the comparison between the two groups. Results:Histopathological staining results showed that the articular surface and synovium of rats in the sham operation group were intact, the chondrocytes were arranged horizontally, and the articular cartilage edge was smooth.In the OA group, the articular cartilage edge was seriously damaged and the arrangement of chondrocytes was disordered.In the miR-106a simulation group, the cartilage structure tended to be normal, occasionally uneven, and the articular cartilage surface was not smooth. Compared with sham operation group, the expression of miR-106a in OA group was significantly decreased ( F=918.02, P<0.01); the expression of inflammatory mediators (IL-1, IL-6, TNF-β) in OA group was also signifi-cantly increased ( F=41 914.86, P<0.01; F=64 85.16, P<0.01; F=8 873.31, P<0.01). The expression levels of DR6 and p65 in OA group were higher ( F=2 319.338, P<0.01; F=1 253.882, P<0.01). Compared with OA group, the levels of inflammatory mediators (IL-1, IL-6, TNF-β) in miR-106a mimetic group were significantly decreased (1.270±0.020, 6.040±0.170, 5.690±0.080), and the expressions of DR6 and p65 were decreased (1.53±0.09, 0.41±0.04). Conclusion:miR-106a can reduce the inflammatory changes and the degeneration of chondrocytes in osteoarthritis rats.
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There is a high incidence of venous thrombosis in patients undergoing gynecological surgery, which causes symptoms as limbs swelling, edema and pain. Postoperative recovery of patients is delayed and financial burden is increased More seriously, the obstruction of pulmonary artery by deep venous thrombosis is fatal and always leads to the death of patients. The article provides a theoretical basis for the prevention of venous thrombosis by reviewing the risk factors and risk assessment for venous thrombosis in patients undergoing gynecological surgery and related research progress.
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There is a high incidence of venous thrombosis in patients undergoing gynecological surgery, which causes symptoms as limbs swelling, edema and pain. Postoperative recovery of patients is delayed and financial burden is increased More seriously, the obstruction of pulmonary artery by deep venous thrombosis is fatal and always leads to the death of patients. The article provides a theoretical basis for the prevention of venous thrombosis by reviewing the risk factors and risk assessment for venous thrombosis in patients undergoing gynecological surgery and related research progress.
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Objective To compare the clinical features,ultrasonic imaging manifestations and therapeutic evaluations between elderly onset rheumatoid arthritis (EORA) and EORA with osteoarthritis (OA).Methods Eighty-eight patients with rheumatoid arthritis were divided into two groups:group EORA (n=36)and group EORA+OA (n=52).The onset age of all patients was 60 years or older.General conditions,joint involvement distribution,ultrasonic manifestations and disease activity scores (DAS28-3) of patients in the two groups were analyzed.The x2 test/Fisher's exact probability test and the Student's t test/Mann-Whitney U test were used to analyze data.Results There was no significant difference in the proportion of male and female patients and erythrocyte sedimentation rate (ESR) between the two groups (P＞0.05).The onset age of patients in group EORA+OA [(68±4) years old] was higher than that in group EORA [(65±4) years old],and the difference was statistically significant (t=-3.465,P=0.001).Duration of the disease and body mass index in group EORA+OA were significantly higher respectively than those in group EORA.Joint involvement in the two groups was mainly found in shoulder,wrist,Metacarpophalangeal joint (MCP)2,MCP3,proximal interphalangeal joint (PIP)2,PIP3,PIP4,and knee joint (34.7％-86.5％).The percentage of MCP2 [36.5％(38/104),70.8％ (51/72);x2 =20.02,P ＜0.01],MCP3 [33.7％ (35/100),59.7％ (43/72);x2 =11.72,P =0.001],MCP4 [4.8％ (5/100),22.2％ (16/72);x2 =12.28,P＜0.01],PIP2 [69.2％ (72/104),83.3％ (60/72);x2 =4.51,P=0.034]and PIP3 [53.8％(56/100),70.8％(51/72);x2=5.15,P=0.023] in the EORA+OA group was lower while the percentage of MCP1,DIP 2,DIP3,DIP4 and knee joints were higher than that in the EORA group (P＜0.05).In group EORA+OA,the synovial thickness of the wrist joints [(4.2±0.5) mm] and knee joints [(7.7±0.8) mm]were significantly thicker than those in group EORA [(3.2±0.9) mm;(6.3±0.8) mm,t=-5.82,P＜0.01;t=-7.22,P＜0.01];The proportion (70.0％) of level 2 and 3 of patients' wrist joint synovium pannus blood flow and knee joint synovium pannus in group EORA+OA were increased than group EORA (51.9％;52.3％),the difference between the two groups was statistically significant (x2=4.64,P=0.031;x2=4.43,P=0.035).There was no significant difference in DAS28-3 scores between the two groups before patients received treatment.After 2 weeks and 12 weeks of glucocorticoid treatment,DAS28-3 scores in group EORA [3.62 (2.88,4.03);2.35 (2.26,2.62) points] were significantly lower than group EORA+OA [5.01(4.68,5.26);3.38(2.28,3.83) points](Z=-7.766,P＜0.01;Z=-3.461,P＜0.01).Conclusion Compared with patients of EORA alone,patients of EORA with OA have more obvious joint symptoms,MCP1,DIP and knee joint are susceptible to the coinvolvement among them,longer duration of disease,and were prone to synovial hyperplasia and pannus flow formation.The therapeutic effects of glucocorticoid on joint inflammation in patients of EORA alone are superior to those patients of EORA with OA.
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Objective@#To compare the clinical features, ultrasonic imaging manifestations and therapeutic evaluations between elderly onset rheumatoid arthritis (EORA) and EORA with osteoarthritis (OA).@*Methods@#Eighty-eight patients with rheumatoid arthritis were divided into two groups: group EORA (n=36) and group EORA+OA (n=52). The onset age of all patients was 60 years or older. General conditions, joint involvement distribution, ultrasonic manifestations and disease activity scores (DAS28-3) of patients in the two groups were analyzed. The χ2 test/Fisher's exact probability test and the Student's t test/Mann-Whitney U test were used to analyze data.@*Results@#There was no significant difference in the proportion of male and female patients and erythrocyte sedimentation rate (ESR) between the two groups (P>0.05). The onset age of patients in group EORA+OA [(68±4) years old] was higher than that in group EORA [(65±4) years old], and the difference was statistically significant (t=-3.465, P=0.001). Duration of the disease and body mass index in group EORA+OA were significantly higher respectively than those in group EORA. Joint involvement in the two groups was mainly found in shoulder, wrist, Metacarpophalangeal joint (MCP)2, MCP3, proximal inter-phalangeal joint (PIP)2, PIP3, PIP4, and knee joint (34.7%-86.5%). The percentage of MCP2[36.5%(38/104), 70.8%(51/72); χ2=20.02, P<0.01], MCP3[33.7%(35/104), 59.7%(43/72); χ2=11.72, P=0.001], MCP4[4.8%(5/104), 22.2%(16/72); χ2=12.28, P<0.01], PIP2[69.2%(72/104), 83.3%(60/72); χ2=4.51, P=0.034] and PIP3[53.8%(56/104), 70.8%(51/72); χ2=5.15, P=0.023] in the EORA+OA group was lower while the percentage of MCP1, DIP 2, DIP3, DIP4 and knee joints were higher than that in the EORA group (P<0.05). In group EORA+OA, the synovial thickness of the wrist joints [(4.2±0.5) mm] and knee joints [(7.7±0.8) mm] were significantly thicker than those in group EORA [(3.2±0.9) mm; (6.3±0.8) mm, t=-5.82, P<0.01; t=-7.22, P<0.01]; The proportion (70.0%) of level 2 and 3 of patients' wrist joint synovium pannus blood flow and knee joint synovium pannus in group EORA+OA were increased than group EORA (51.9%; 52.3%), the difference between the two groups was statistically significant (χ2=4.64, P=0.031; χ2=4.43, P=0.035). There was no significant difference in DAS28-3 scores between the two groups before patients received treatment. After 2 weeks and 12 weeks of glucocorticoid treatment, DAS28-3 scores in group EORA [3.62(2.88, 4.03); 2.35(2.26, 2.62) points] were significantly lower than group EORA+OA [5.01(4.68, 5.26); 3.38(2.28, 3.83) points] (Z=-7.766, P<0.01; Z=-3.461, P<0.01).@*Conclusion@#Compared with patients of EORA alone, patients of EORA with OA have more obvious joint symptoms, MCP1, DIP and knee joint are susceptible to the co-involvement among them, longer duration of disease, and were prone to synovial hyperplasia and pannus flow formation. The therapeutic effects of glucocorticoid on joint inflammation in patients of EORA alone are superior to those patients of EORA with OA.
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Objective To investigate the causes of misdiagnosis related to rheumatism diseasecases.Methods A search was performed in database WanFang to identify the misdiagnosed clinical cases reports which were published in Chinese Journal and a retrospective analysis was conducted.All data were analyzed by chi-square test and Fisher's exact test.Results We screened 705 citations and identified 215 articles on the rheumatic diseases,finally,187 reports and 195 cases in total with definite diagnosis were included,accounting for 25.5％ of the total number of misdiagnosed cases.Primary vasculitis (72 cases),rheumatoid arthritis (25 cases),spondyloarthropathy (17 cases),polymyositis (14 cases),systemic lupus erythematosus (13 cases) and Sj(o)gren's syndrome (SS) (12 cases) were amongst the top misdiagnosed rheumatic diseases.There was no difference between 1998-2006 and 2007-2015 in the overall misdiagnosis cases.Single disease comparison,polymyositis,spondyloarthropathy and IgG4 related disease were increased (P=0.002;P=0.034;P=0.060;respectively),while polymyositis was delayed (P=0.002).Rheumatism misdiagnosed cases reported mainly came from tertiary hospitals and the department of rheumatology.Conclusion Misdiagnosed rheumatism are common in clinic.Strengthen the physicians' continuous education,the validity of clinical thinking mode and rational use of diagnostic criteria are important to make correct diagnosis.
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Objective Idiopathic pulmonary fibrosis, the fibrosis score (i.e., the combined extent of reticulation and honeycombing) is associated with worse survival. The aim of this study was to identify high-resolution computed tomography (HRCT) patterns and patient characteristics that could predict poor prognosis in rheumatoid arthritis-related ILD (RA-ILD). Methods We retrospectively analyzed 130 patients with newly diagnosed RA-ILD from 2011 to 2017 at Shanxi People's Hospital. The Pearson correlation analysis was used for the correlation between the fibrosis score and the worse survival of RA-ILD, and Using Cox regression analysis was used to identify the associations with mortality. A value of P less than 0.05 was considered statistically significant. Results During a median follow-up of 65 months, 32/130 (24.6％) patients died. Univariate analysis identified 6 significant poor prognostic factors: lower baseline ％ predicted forced vital capacity [HR=0.97, 95％CI(0.94, 0.99);P=0.008], total interstitial disease score [HR=1.06, 95％CI(1.03, 1.08);P<0.01], reticulation score [HR=1.07, 95％CI (1.04, 1.09); P<0.01], traction bronchiectasis score [HR=2.04, 95％CI (1.21, 3.40);P=0.008], fibrosis score [HR=1.07, 95％CI (1.01, 1.13);P<0.01], and definite UIP pattern [HR=4.18, 95％CI (1.40, 12.51); P=0.010]. Fibrosis score remained to be an independent significant poor prognostic factor of survival on bivariate analysis [HR=8.136, 95％CI (2.87, 28.35); P=0.001]. Patients with a fibrosis score>20％ had high mortality. Conclusion This study has shown that fibrosis score is strongly associated with worse survival in RA-ILD, and patients with fibrosis score>20％ have a 8.136-fold increased risk of mortality.
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Objective To observe the effect of intermedin on renal interstitial fibrosis of unilateral ureteral obstruction rats. Methods Forty male Wistar rats were randomly divided into two groups:the sham-operation group (n=10) underwent the left ureteral dissection,the other 30 rats were made as unilateral ureteral obstruction models and divided into the model group (UUO),the losartan group,the IMD group (each group n=10).At the day 14,21 after operation,randomly 5 rats from each group were blooded by abdominal arotic and obstructive kidneys were taken out.The renal histopathological changes were observed by HE and Masson staining.The BUN,Scr,and hydroxyproline (Pro) of the obstructive kideys were measured by colorimetry. The expression of TGF-β1 and intermedin was observed by immunohistochemisty staining. Results Compared with the sham-operated group,the levels of BUN,Scr,Pro,TGF-β1 and IMD in the model group increased (P＜0.05).Compared with the UUO group,the levels of Scr,BUN,Pro,TGF-β1 and IMD in the losartan group were lower (P＜0.05).However,IMD in the IMD group was significantly up-regulated (P＜ 0.05),the others were down-regulated (P＜0.05). Conclusion IMD can improve the renal interstitial fibrosis,and the mechanism maybe antagonizes the TGF-β1.