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1.
Article in Chinese | WPRIM | ID: wpr-1023366

ABSTRACT

Objective:To explore the effects of workshops combined with problem-based learning (PBL) in clinical teaching of joint surgery.Methods:A total of 60 students who would participate in standardized residency training from September 2019 to June 2021 were randomly divided into traditional lecture-based learning (LBL) group, PBL group, and workshops combined with PBL group, with 20 students in each group. The effects were evaluated by theoretical knowledge and clinical skill assessment and anonymous teaching quality questionnaire surveys. SPSS 25.0 was used to perform the t test and chi-squared test. Results:The workshop+PBL group showed the highest theoretical knowledge score (86.40±9.76), clinical skill score (92.15±4.49), and total score (88.70±5.75), compared with the PBL group (78.45±10.40, 85.80±10.00, and 81.39±7.27, respectively) and the LBL group (80.10±6.77, 85.20±8.12, and 82.14±6.14, respectively). According to the teaching quality questionnaire surveys, the workshop+PBL group was significantly superior to the PBL and LBL groups in self-ability evaluation and the degree of satisfaction with teaching ( P<0.05). Conclusions:Workshops combined with PBL can effectively improve students' scores of theoretical knowledge and clinical skills, with better self-ability evaluation results and higher satisfaction with teaching, which is worthy of application and promotion in clinical teaching of joint surgery.

2.
Chinese Journal of Orthopaedics ; (12): 1601-1609, 2023.
Article in Chinese | WPRIM | ID: wpr-1027673

ABSTRACT

Objective:To explore the effects of mechanical factors on the morphology of the growth plate and proximal femur development, in order to provide a mechanical basis for the mechanism of Cam lesions in femoral acetabular impingement (FAI).Methods:Using CT scan data of hip joint from adolescents, we constructed three-dimensional finite element models of normal and extended proximal femoral epiphyseal growth plates. Dynamic mechanics and position data from daily activities (walk, stand on one and two feet, go upstairs and downstairs, sit and stand up, squat and stand up) and basketball layup drills were collected from five healthy volunteers using the Vicon system. The mean values of femoral head mechanical loads and positions at peak values, movement onset, and termination were selected for finite element analysis to observe the distribution of equivalent stress, normal stress, and shear stress on the two growth plate models under different activity modes.Results:Successful construction of three-dimensional finite element models for normal and extended proximal femoral epiphyseal growth plates was achieved. Mechanical load values and spatial positions of the femoral head during daily activities and layup movements were obtained. In daily activities, peak equivalent stress values for normal and extended growth plates ranged from 1.6 to 11.0 MPa; compressive stress ranged from 1.7 to 12.0 MPa; tensile stress ranged from 0.5 to 10.0 MPa; and shear force ranged from 0.4 to 7.1 MPa. The compressive stress during walking, standing on one or both feet, going up and down stairs, sitting and standing, and squatting was concentrated in the central and lateral areas; tensile stress was concentrated in the central and medial areas; shear force was concentrated in the medial area and the anterior and posterior edges of the growth plate. During a layup, the compressive stress in the center, outer upper side, and medial edge of the growth plate of the normal model was notably concentrated, with peaks fluctuating between 5.5-19.0 MPa, 5.7-11.0 MPa, and 5.4-7.3 MPa respectively; tensile stress and shear force were concentrated at the inner and outer edges as well as in the central area, with peaks fluctuating between 3.0-24.0 MPa and 3.0-26.0 MPa respectively, these values were significantly different from those observed during daily activities. For the elongated growth plate, compressive stress was concentrated at the central and lateral edges with peaks fluctuating between 17.0-41.0 MPa and 17.0-38.0 MPa respectively; simulated shear stress and tensile stress showed significant concentration at peaks fluctuating between 4.9-34.0 MPa, also significantly different from those observed during daily activities.Conclusion:The difference in mechanical distribution between daily activities, basketball layup training, as well as between normal and extended growth plates may be the mechanical initiating factor in the development of extended growth plates and the formation of Cam lesions, it may be the mechanical initiating factor for the development of extended growth plates and the collision of Cam lesions in FAI.

3.
Chinese Journal of Trauma ; (12): 961-973, 2023.
Article in Chinese | WPRIM | ID: wpr-1026979

ABSTRACT

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

4.
Chongqing Medicine ; (36): 676-677,680, 2015.
Article in Chinese | WPRIM | ID: wpr-600682

ABSTRACT

Objective The purpose of this study is to investigate extracorporeal shock waves therapy on Achilles tendopathy and evaluate its short‐term effectiveness .Methods The subjects were out‐patients with Achilles tendopathy who came to center for Joint Surgery ,Southwest Hospital ,from Dec .1st 2012 to Dec .1st 2013 .The main symptom of these patients showed pain at the hock site ,while the pain could be released with rest .Before the treatment ,routine checkups were performed including X‐ray of ankle joint with normal side and MRI ,which brought out a definite diagnosis and evacuated other reasons resulting pain .The treatment of blast was 2 000 pulse per time ,once a week and four times in total .During the treatment period ,patients were suggested to prevent from strenuous exercise and had the anodyne on the evening of the first day when they underwent the shock waves .VAS and AO‐FAS was used to evaluate the effectiveness with the records ,before the treatment ,after four‐time treatment ,after three‐month treatment .Patients′complications and follow‐ups were recorded and VAS results were assessed with statistical analysis .Results 32 patients had full follow‐ups .22 of them had insertion tendopathy .10 patients had non‐insertion tendopathy .8 patients had bilat‐eral lesion and 24 patients had unilateral lesion .Part of erythema appeared in five patients and could be relieved after rest .One pa‐tient achieved pain release after four‐time treatment ,but fell down going downstairs and resulted rupture of tendon .All patients had VAS assessment for three times ,with the score 8 .2 ± 1 .5 before the treatment(P0 .05) .The score of AOFAS were 72 .2 ± 5 .1 ,86 .3 ± 5 .2 and 91 .3 ± 3 .5(P<0 .01) .Conclusion When treating on Achilles tendopathy ,extracorporeal shock wave can improve the local symptoms .With minor trauma and reliable outcome ,it brings patients benefits that treat tendon disease without surgery or postponing the surgery .

5.
Article in Chinese | WPRIM | ID: wpr-499853

ABSTRACT

Objective To analyze the features of normal high-frequency ultrasonography of tarsal tunnel. Methods Forty volunteers (20 males and 20 females) were examined with high-frequency ultrasound (12 MHz). The tendons,nerve and blood vessels in tarsal tunnel were observed from short-axis and long-axis views dynamically. The areas of tarsal tunnel and posterior tibial nerve were measured and com-pared between the males and females. Results High-frequency ultrasonography depicted the anatomical structure of tarsal tunnel,and the tendons,nerve and blood vessels presented different sonographic features that were easy to differentiate. The area of tarsal tunnel: male (7.61 ±1.00) cm2,female (6. 61 ± 1. 07) cm2 (P <0. 01). The area of posterior tibial nerve: male (9. 59 ± 0. 75) mm2,female (8.91 ±0.74) mm2(P<0.01). Conclusion High-frequency ultrasonography can clearly show and accurately measure the tarsal tunnel structure. To be familiar with the normal ultrasonographic anatomy of tarsal tunnel will help to improve the efficacy of ultrasound diagnosis of tarsal tunnel abnormalities.

6.
Chinese Journal of Surgery ; (12): 25-29, 2014.
Article in Chinese | WPRIM | ID: wpr-314749

ABSTRACT

<p><b>OBJECTIVE</b>To observe autograft of femoral head for acetabular reconstruction in total hip arthroplasty(THA)without shortening femoral osteotomy for developmental dysplasia of the hip (DDH) with complicated deformity.</p><p><b>METHODS</b>A case series of 18 Crowe type-III-IV DDH patients (19 hips) with osteoarthritis between December 2004 and October 2010 was reported. There were 2 male and 16 female patients. Mean age was 34.3 years (19-44 years) and limb shortening 4.5 cm (3.0-6.2 cm), and preoperative Harris score was 40 ± 17. All cases were accomplished through posterolateral approach by the same surgeon and underwent the procedure of acetabular reconstruction using a bulk femoral head autograft and periarticular soft tissue releases(dissection of the entire articular capsule, scar tissues and osteophytes), but had no procedure of shortening by subtrochanteric transverse osteotomy. Design data through paired t-test compared the preoperative and postoperative Harris scores, also the radiographic observation, in order to asses the clinical efficacy of acetabular reconstruction, while observing the length of limb lengthening, complications and function.</p><p><b>RESULTS</b>Graft coverage of cases in the group were 16%-47% (mean, 26%), with 17 mm of the socket uncovered during operative evaluation. All patients were followed-up for 14-56 months (mean, 34.6 months). The lengthening of the affected limb was 2.9-4.6 cm (mean, (3.6 ± 0.7)cm). The limb-length discrepancy was 0-1.2 cm (mean, (0.6 ± 0.3)cm) after THA. The offset of the affected limbs was 26.4-34.3 cm(mean, (30.5 ± 1.6)cm). The postoperation radiography showed good position of the prosthetic components and coverage of the socket after bone graft was full. All patients had no static contraction abnormality of muscle in the affected limb. Three patients with numbness in lateral leg after the procedure recovered completely in one months. No other complication was observed except heterotopic ossification in 1 case. At the last follow-up examination, Harris hip score was 86 ± 11. There was statistical significance compared with the preoperative score (t = 5.86, P < 0.01) , and no revision was needed in all patients.</p><p><b>CONCLUSION</b>Autograft of femoral head for acetabular reconstruction in THA without shortening femoral osteotomy for developmental dysplasia of the hip (DDH) is an effective procedure to reconstruct acetabulum and improve the socket bone coverage.</p>


Subject(s)
Adult , Female , Humans , Male , Young Adult , Acetabulum , General Surgery , Arthroplasty, Replacement, Hip , Femur Head , Transplantation , Hip Dislocation, Congenital , General Surgery , Plastic Surgery Procedures , Retrospective Studies
7.
Chinese Journal of Orthopaedics ; (12): 206-213, 2013.
Article in Chinese | WPRIM | ID: wpr-432159

ABSTRACT

Objective To explore the early-term efficacy of the reconstruction ot acetabular bone loss with porous tantalum acetabular components in total hip arthroplasty.Methods Twenty-one patients (21 hips) were included in this study,which had an acetabular replacement with tantalum acetabular components from August 2009 to April 2012.There were 6 males and 15 females,with the mean age of 55.7±16.2 years (range from 24 years to 78 years).The primary total hip arthroplasty in 5 cases,the revision in 16 cases.The acetabular bone defects were classified as Paprosky classification,which included,type Ⅰ in 9 cases,type Ⅱain 4,type Ⅱb in 5,type Ⅱcin 1,type Ⅲa in 1 and type Ⅲb in 1 case.Results The mean follow-up time was 20.1 months (range,6-40 months).In Paprosky Ⅰ,the Harris hip score was 87.2±7.4 postoperatively,which was significant higher than the preoperative score 41.1±6.3.In Paprosky Ⅱ,the Harris hip postoperative score (79.8±11.8) was significant higher than the preoperative score (38.4±12.5).In Paprosky Ⅲ,the Harris hip postoperative score (79) was significant higher than the preoperative score (24).21 Tantalum components were well fixed by the radiograph imaging.No cases suffered aseptic loosening and migration.Bone ingrowths was obviously performed in 21 hips.But 2 hips had a radiolucent line,1 case occurred in zone 3 and the line was filled 4 months later,the other case still existed at last follow-up without any more widen.No infections or mechanical failures.The survivorship of the tantalum acetabular components was 100%.Conclusion Our short-term results suggest this implants may enhance biological fixation in acetabular defect cases.Porous tantalum cup appears to be an ideal material to facilitate biologic ingrowths in these cases.Long-term follow-up still needs to be confirmed.

8.
Chinese Journal of Trauma ; (12): 971-974, 2008.
Article in Chinese | WPRIM | ID: wpr-397343

ABSTRACT

Objective To introduce the experience of improved posterolateral mini-incision total hip urthroplasty(THA)in treatment of femoral neck fractures.Methods Of 199 patients(207 hips)treated with preliminary THA from October2002 to January 2005,them were46 patients(46 hips)with femoral neck fractures including31 fresh fractures and 15 old ones,which were then treated with posterolateral mini-incision THA.An observation was done on length of incision,operation time,volume of blood loss,drainage volume,hospital stays,postoperative complications,functional recovery and Harris score.Results All patients were followed up for 14-26 months(mean 17.2 months).The final Harris score during follow-up was(84.1±8.6)points in the fresh fracture group and(85.8±7.6)points in the old fracture group.Pestoperative X-ray showed sound position of the prosthesis.There was no statistical difference upon length of incision,operation time,blood loss,drainage volume and hospital stays between fresh fracture group and old fracture group(P>0.05).Dislocation occurred in one patient in each group.Conclusion Posterolateral mini-incision THA is proved to be successful in reducing surgical trauma,accelerating rehabilitation and decreasing blood loss and complications for patients with femoral neck fractures.

9.
Article in Chinese | WPRIM | ID: wpr-400391

ABSTRACT

Objective To provide clues to diagnosis and treatment for diffuse alveolar hemorrhage (DAH)in patients with diffuse connective tissue diseases(CTD).Method To analyze restropeetively the data of clinical features,pulmonary images and bronchoalveolar lavage(BAL)in 32 patients hospitalized in Peking Union Medical College Hospital from April 2004 to June 2007.Results The data from 1O of the 17 (58.8%)patients with microscopic polyangiitis(MPA),19 of the 1267(1.5%)patients with systemic lupus erythematosus(SLE),2 of the 56(3.6%)patients with Wegener's granulomatosis(WG)and 1 of the 570(0.2%)patients with rheumatoid arthritis(RA)were consistent with the diagnosis of DAH.DAH in SLE occurred in younger patients(mean age at the time of diagnosis 27.3±13.1 years)and early in the course of disease(median duration of SLE from onset was 16.7±18.3 months),while these figures in MPA patients with DAH were 50.1±20.7 years and 10.6±18.7 months.At the time of DAH in SLE.the median systemic lupus erythematosus disease activity index(SLEDAI)score was 17.1±6.7 and anti-ds-DNA antibody titer elevated markedly,while the median C3 level was low.The levels of erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)of patients with DAH in MPA,WG and RA showed marked elevation.The titer of antieutrophil cytoplasmic antibody(ANCA,MPO/PR3)in patients with MPA and WG was highly positive.The main clinical manifestations of DAH were hemoptysis,dyspnea and rapid decrease of hemoglobulin and hematoerit(HCT)in peripheral blood.Most patients presented with difluse alveolar infiltration on chest X-ray and hish resolution CT.DAH could be confirmed by bloody bronchoscopic lavage.20 patients(62.5%)had secondary pulmonary infections at the time of DAH;fungus and combined bacterial infection were most frequently seen.The mortalitv 0f CTD with DAH was 59.4%(19 out of 32).12 patients (63.2%)with SLE,5 patients(50%)with MPA and both of the 2 patients with WG died.12 of the lethal cases(63.2%)died of respiratory failure.Conclusions CTD patients presenting with hemoptysis and dyspnea with rapid decrease of hemoglobulin,and diffuse alveolar infiltration on chest X-ray or high resolution CT should be seriously considered to be suffering from DAH.A bloody BAL may confirm the diagnosis of DAH.DAH in CTD is an acute,serious and frequently life-threatening situation resulting in respiratory hilure and pulmonary infection.It is important for CTD patients with DAH to be diagnosed early and treated vigorously.

10.
Article in Chinese | WPRIM | ID: wpr-543787

ABSTRACT

[Objective]To evaluate the results of arthroscopic capsular release for the treatment of idiopathic frozen shoulder.[Method]From January 2004 to April 2005,7 patients with diagnosis of idiopathic frozea shoulder,who had symptoms for an average of 8.0 months(5 to 13months)with failed conservative treatment for at least 4 months,were treated with arthroscopic capsular release combined with rehabilitaticon exercises after operation.Under general anesthesia,all the patients underwent arthroscopic capsular release and manipulation.All patients were strictly evaluated by Constant score,normalized Constant score and the Visual Analog Scale(VAS 1 to 15 points,1 = no pain),before operation,at 3 weeks after operation,3 months after operation and 17.2 months after operation respectively.[Result]All patients were followed up with a mean of 17.2 months(8 to 23 months).The average in-hospital day was 8.1 days(7 to 10 days).All patients had significant improvement in terms of functional gain and pain relief after operntion.The preoperative pain score improved from(5.2?2.4)points to(11.2?2.0),(14.6?0.4)and(14.7?0.4)points at 3 weeks after operation,3 months after operation end 17.2 months after operation respectively.The Constant score improved from(24.5?14.2)to(47.0?18.8),(68.9?9.4)and(70.1?7.9),and the normalized Constant score improvad from(31.0%?17.3%)to(60.1%?24.9%),(87.1%?14.5%)and(89.7%?12.1%).There was no complication in the treatment procedures.[Conclusion]Arthrosenpic capsular release is a safe and effective surgical procedure in the management of idiopathic frozen shoulder unresponsive to conservative treatment.It has advantages of little invasive,better recovery,less operation time and less complications.

11.
Article in Chinese | WPRIM | ID: wpr-592189

ABSTRACT

Objective To investigate the value of microsurgical management for the diagnosis and treatment of pigmented villonodular synovitis(PVNS)of the knee.Methods Thirty-eight patients with PVNS of the knee that were confirmed by arthroscopy were treated in our unit between January 2002 and April 2006.Among the patients,5 were referred from other hospitals because of postoperative recurrence.Villusectomy was performed in each of the patients by using arthroscopy.In the cases with larage extra-articular lesions,small auxiliary incision was made for complete resection.All the resected masses were examined pathologically after the surgery,and the patients received intra-anticular drainage,local ice therapy,and functional exercises afterwards.Results Unilateral surgery was performed on this group of patients.Under an arthroscope,the synovium showed characteristic yellow-brown color.Patholgocial examination confirmed PVNS in all the cases,including 20 cases of local PVNS and 18 diffused lesions.Open surgery was performed on 6 patients owing to large lesion at the popliteal fossa.According to the International Knee Documentation Committee(IKDC)Scoring Forms,the mean IKDC score increased from 60.4?6.1 to 89.3?7.2 in one year after the operation.The 38 patients were followed up for 1 to 4 years(mean 2.1 years),none of them had recurrence during this period.Two of the patients,who had been treated by open surgery and then were referred to our hospital,could not flex their knees to 90? after the microsurgery.Whereas,all the others achieved normal knee flexion.Conclusions Arthroscopy is reliable for the diagnosis and treatment of PVNS.For large extra-articular lesions,open surgery using small auxiliary incision is necessary for complete resection and avoidance of recurrence.

12.
Article in Chinese | WPRIM | ID: wpr-565338

ABSTRACT

Objective: The study was to reveal the inhibition of neovascularization by Tongbiling. Methods: Rat model were established by injecting CFA at the root of the tail and divided into model control group, Indomethacin group and Tongbiling group at random. The serum and paws were collected after seven days treatment. 10ng/L VEGF solution was added I into CAM to stimulate the neovascularization, and to observe the influence of each group of serum on the first and second order new vessels. RT-PCR method was taken to determine the expression of mRNA of VEGF and VEGFR-1 of paws in different groups. Results: The number of vessels in the model control group was significantly more than that in the Indomethacin group and the Tongbiling group (P

13.
Article in Chinese | WPRIM | ID: wpr-408961

ABSTRACT

BACKGROUND: Rapid development of tissue engineering is the new hope of repairing bone defect so as to obtain complete bone regeneration,and rapid proliferation of seed cells is one of the important factors in it.OBJECTIVE: To evaluate the proliferation and osteogenic differentiation of human mesenchymal stem cells (MSCs) plated at different cell density during subculturing period.DESIGN: Repetitive measurement.PARTICIPANTS: The experiment was conducted in the Trauma, Burn and Combined Injury Laboratory of the Third Military Medical University of Chinese PLA between January 2003 and March 2004. MSCs were obtained from iliac bone bone marrow of the 5 healthy male volunteers by separation and proliferation.METHODS: The MSCs of second generation were inoculated at 8×103/cm2,3×103/cm2, and 8×102/cm2, respectively, and then the growth curve was drawn and analyzed. After 18 days of proliferation and culture, the increased amount of MSCs was recorded to analyze the post-proliferation growth curve and osteogenic ability.MAIN OUTCOME MEASURES: ①Growth curve of cells plated at different cell density; ②Results of alkaline phosphatase(ALP) staining and immunohistochemical staining of osteocalcin.RESULTS: Human MSCs from bone marrow were CD34 negative and expressed low level of ALP. Population doubling time was 40 hours after MSCs were plated at 8×103/cm2 and the number of the cells was expanded (51±13) times after 18 days. MSCs were expanded (28±6) times 18 days after plated at 3×103/cm2. While plated at 8×102/cm2, the number of the cells was only expanded (5±3) times. Proliferative ability of cells cultured at a low density was stronger that that at a high density. MSCs could be induced to differentiate into the osteocytic lineages after plated at not only 8×103/cm2 but also 8×102/cm2.CONCLUSION: Cell density plays an evident role in the proliferation of MSCs. Cell density of 8×103/cm2 is proper to the rapid proliferation of MSCs as seed cells in bone tissue engineering.

14.
Article in Chinese | WPRIM | ID: wpr-409522

ABSTRACT

BACKGROUND: Tongbiling is the modified guizhi shaoyao zhimu tang (Decoction of Cinnamon Twig, Peony and Anemarrhena) recorded in Synopsis of Prescriptions of the Golden Chamber. It has been used for rheumatoid arthritis(RA) for more than ten years. Here is the experimental study on effects of tongbiling on interleukin 2(IL-2) and its α-chain, IL-2Rα(CD25), to explain the mechanism of tongbiling in regulating the cellular immunity and resisting RA From the aspects of in vivo and in vitro.OBJECTIVE: To study the effect of tongbiling on IL-2 in collagen introduced arthritis of rats and the influence of total base of tongbiling on expression of IL2-Rα (CD25).DESIGN: A totally randomized and controlled experimental study based on the experimental animalsSETTING: Department of Jinkui of a university and the center of organ transplantation and immunity of another university.MATERIALS: The experiment was carried out from April to July 2001 in the Central Laboratory of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine. The 36 Wistar rats, clean degree, male,bought from the Animal Experimental Center of Medical College of Sun Yat-sen University, certificate No. 2000A050, weighted(110 ± 20) g, were divided into 6 groups with 6 in each: normal group, model group, methotrexate (MTX) high dosage group, MTX low dosage group, tongbiling high dosage group, and tongbiling small dosage group.METHODS: The experiment in vivo was done with the modeled rats of collagen-induced arthritis. The foot swelling was measured with volume method, the cells of primary synovium cultured, and the upper clear fluid of culture fluid tested with radioimmunoassay to observe the effect of tongbiling on synovial IL-2. The experiment in vitro was done in the way of separating the lymphocytes, giving extraneous stimulation with phorbol 12, 13-dibutyrate (PDB) or concanavalin A(ConA), using bicolor immunofluorescence labeling, testing with flow cytometer to observe the influence of total base of tongbiling on the expression of CD3 +, CD25 +.MAIN OUTCOME MEASURES: The influence of tongbiling on the foot swelling and synovial IL-2 of rats with collagen-induced arthritis.RESULTS: In the experiment in vivo, the high dosage of tongbiling could relieve obviously the foot swelling, compared with MTX, there was no remarkable difference ( P > 0.05) . Both high and low dosage of tongbiling could inhibit the synthesis of synovial IL-2 ( P < 0.01 ). In the experiment in vitro, the total base of tongbiling could extremely inhibit the expression of CD3 +, CD25 + stimulated by ConA, but not effective for that stimulated by PDB plus ionomycin.CONCLUSION: Tongbiling can inhibit the IL-2 synthesis and the signal transduction of IL-2Rα (CD25) activated by ConA, relieving the inflammation of local joint. It provides an experimental evidence for the application of tongbiling in the treatment of RA.

15.
Article in Chinese | WPRIM | ID: wpr-409580

ABSTRACT

BACKGROUND: Researches on the pathogenesis and pathological changes of rheumatoid arthritis(RA) have achieved significant progress in recent years. But traditional Chinese medicine(TCM) has unique advantage in RA therapy.OBJECTIVE: To study effects of overall alkali in tongbiling(TBL) on the proliferation of lymphocytes and the transferrin receptor of T lymphocytes (CD71) to explore the mechanism of TBL on the modulation of cell immunity.DESIGN: A completely randomized grouping design and an explorative study by employing cells as subjects.SETTING: Sixth internal medicine department of a TCM university,center of tissue transplantation and immunology college of life science of a university PARTICIPANTS: The study was conducted in the central laboratory (tertiary laboratory of National TCM Administrator) of the first affiliated hospital of Guangzhou TCM medical university between July 2002 and August 2003. Ten clean male SD rats were selected.METHODS: Lymphocyte was separated from rat inguinal lymph node for culture. Concanavalin(ConA) was used for 72-hour stimulation. The impacts of overall alkali TBL on lymphocyte proliferation were tested by MTT.The expression of T lymphocyte CD71 was tested by flow cytometer after 48-hour stimulation of phorbol 12,13 -dibutyrate(PDB) or ConA.MAIN OUTCOME MEASURES: The impacts of overall alkali TBL on lymphocyte proliferation and T cell activation.RESULTS: Different concentration of overall alkali TBL could significantly inhibit the proliferation of lymphocytes under ConA stimulation. PDB and ConA-activated T lymphocyte CD71 + expressions were significantly higher than that of blank control group(P<0.01) . CD3+ CD71 + expressions [(62.03±1.51) %,(25.28±1.57) %,(20. 29±1.72)%] activated by ConA under different concentration of overall alkali TBL(50,100,200 mg/L)were significantly lower than(72.03±1.28)% of BPS-positive control group (P<0. 05). CD3 + CD71 + expressions activated by PDB under 100 mg/Land 200 mg/L of overall alkali TBL were significantly lower than that of phosphate buffer solution (PBS-)positive control group(P<0.05). Different concentration of overall alkali TBL had significant down-regulated effects on CD71 expression in T lymphocyte activated by PDB or ConA and there was also a significant dose-effect relationship(P<0. 05). The inhibition on ConA-activated CD71 expression was stronger than that of PDB.CONCLUSION: Overall alkali TBL can inhibit the abnormal proliferation of T lymphocyte and its mechanism might be realized through its inhibition on transferrin receptor.

16.
Article in Chinese | WPRIM | ID: wpr-409587

ABSTRACT

BACKGROUND: Chinese medicine is rich in recognition and treatment for rheumatoid arthritis(RA) and has achieved attractable progression in researches of recent several years,characterized by variable therapeutic methods, definite therapeutic effects and few toxic side effects. Therefore, it is important scientifically and socially to further search for the effective drugs and methods for the treatment of RA in the field of Chinese medicine. There are few reports on whether Chinese herbs inhibit or block the destruction of cartilage and bone and promote their metabolism and repair for damage or not by variable approaches,targets and links in RA occurrence.OBJECTIVE: To probe into the mechanism of Chinese herbal tongbiling on cartilage destruction.DESIGN: Complete random design and control experimental study based on the experimental animals.SETTING: Golden Chamber teaching and research room of guangzhou university of traditional Chinese medicine.MATERIALS: The experiment was performed in Comprehensive Experimental Room of First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from August 2002 to December 2003,in which,35female Wistar rats were employed,clean grade,weighted(110±20) g,provided by Animal Experimental Room of First Military Medical University of Chinese PLA, with qualified animal No. 2002A041.After 3 days adaptive breeding,Wistar rats were randomized into normal group,model group and total alkaloidal of tongbiling group(TBL group). TBL was extracted in Phytochemistry Room of Tropical Disease Institute of Guangzhou University of Traditional Chinese Medicine.METHODS: The animal model was prepared on rats with collagen-induced arthritis. After treated with gastric infusion in groups,the pathological sections were done on phalangeal joint of rat and chondropathy was observed after routine HE staining. The chondrocytes were cultured. The chondrocytes were stimulated with rrIL-1β in vitro and resulted in matrix decomposition of chondrycyte to prepare pharmaceutical model,TBL of various concentrations added and dexamethasone(DXM) was applied in the control. After 48 hours culture,the upper clear solution if cell was collected and glycosaminoglycan (GAG) content was measured with alcian blue method,and nitric oxygen (NO) content was assayed with method of aqua fortis reduction.MAIN OUTCOME MEASURES:①Primary results: Effect of TBL on phalangeal chondropathy in rats with collagen-induced arthritis and on matrix decomposition of chondrocyte induced by rrIL-1β.②Secondary results: Effect of TBL on induction of NO synthesis from chondrocytes by rrIL-1β.RESULTS:①It was indicated in evaluation on HE pathological section of phalangeal joint: The severity of cartilage destruction in TBL group was less than that in model group(P<0.05).②TBL of various concentrations and DXM inhibited remarkably the decomposition of choncrocyte proteoglycan (P<0.01) and NO synthesis (P<0.01).CONCLUSION: TBL inhibits phalangeal cartilage destruction of rats with collagen-induced arthritis. It is indicated in the results of experiment in vitro that TBL is against the decomposition of choncrocyte proteoglycan,which is probably achieved by inhibiting NO synthesis.

17.
Article in Chinese | WPRIM | ID: wpr-543588

ABSTRACT

Objective To evaluate the indication, clinical results, and prognosis after arthroscopic release for treatment of the limitation of elbow joint motion. Methods From December 2003 to May 2005, 17 elbows in 17 patients were treated with an arthroscopic procedure for elbow contracture. All patients had trauma as the cause of limitation of elbow joint motion. Previous injuries included fixation after fracture of the olecranon (7 cases), elbow dislocation (5 cases), fracture of the radial head (2 case), and braking after skin graft for burn of elbow (2 cases), one patient underwent a open synovectomy for synovitis. All patients with elbow contractures underwent the arthroscopic capsular release and arthroscopic debridement. The osteophytes in the olecranon and medial or lateral epicondyle and loose bodies were removed, and full debridement of fibrous tissue in elbow were performed. Complete release of the capsule was necessary to regain good functional motion. Postoperative care began from gentle active and passive range of motion of the elbow under patient controlled analgesia(PCA). All elbows were assessed for increase in range of motion(ROM) and Mayo assessment before and after surgery. Score assessment: ≥90 points,excellent; 75-89 points, good; 60-74 points, fair;

18.
Article in Chinese | WPRIM | ID: wpr-580937

ABSTRACT

Objective To observe the chondroprotective mechanism of Tongbi Compound(TC) on adjuvant arthritis(AA) rats.Methods Wistar rats were randomized into the normal group,model group,indomethacin group(2.6 mg?kg-1?d-1),sulfasalazine group(825 mg?kg-1?d-1) and TC group(30 g?kg-1?d-1).Except the normal group,the rats in other groups were given pedal injection of Freund's complete adjuvant(FCA,0.2mg for each rat)to induce AA.After gastric gavage of corresponding medicine for 2 weeks,the pathological changes of the cartilage in the rat ankles and their scores were observed,and the expression of matrix metalloproteinases 3(MMP-3) and tissue inhibitor of metalloproteinase(TIMP-3) in rat cartilage was detected by immunohistochemical method.Results In the model group,pathological score was increased(P0.05),but had less toxic and side effects.Conclusion The therapeutic mechanism of Tongbi Compound for the treatment of ankylosing spondylitis is probably related with the regulation of the balance between MMP-3 and TIMP-3.

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Article in Chinese | WPRIM | ID: wpr-570972

ABSTRACT

[Objective] To observe the effects of Tongbiling (TBL) prescription in counteracting cartilage destruction in rats with rheumatoid arthritis (RA). [Methods] Collagen-induced arthritis (CIA) rat models were established to observe the therapeutic effects of TBL. After a short-term treatment, expressions of tumor necrosis factor (TNF - a) and transforming growth factor (TGF- P) in cartilage tissue of model group, methotrenxate (MTX) tablets group and Radix Tripterygii Wilfordii (RTW) preparation group were examined by immunohistochemical semi-quantitative assessment method. [ Results ] The number of chondrocytes with positive TNF - a expression was lower and the chondrocytes were stained lighter in normal group than those in model group and low-dose MTX group ( P

20.
Article in Chinese | WPRIM | ID: wpr-570973

ABSTRACT

[ObjectivejTo explore the therapeutic mechanism of Tongbiling (TBL) prescription for rheumatoid arthritis (RA) by observing the effects of TBL on inflammation and expression of vascular endothelial growth factor (VEGF) in synovium of rats with collagen-induced arthritis (CIA) .[Methods]CIA rat models were established by subcutaneous injection of type II collagen. Pathological sections of synovium in knee joint were made after medication for 37 days and then stained by HE method and immunohistochemical method respectively. Infiltration of inflammatory cells and hyperplasia of macrophages A and fibrous tissue in HE-stained pathological sections were observed under microscope and expression of VEGF was observed by semi-quantitative immunohistochemical method. [ Results ] Infiltration of inflammatory cells and hyperplasia of macrophages A and fibrous tissue in high-dose TBL group were inferior to those in model group (P 0.05); both TBL and Radix Tripterygii Wilfordii at high dose decreased the expression of VEGF (P

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