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Objective:To observe the application effectiveness and advantages of process-oriented-guided inquiry learning (POGIL) in the clinical practical teaching of rheumatism and immunology.Methods:A total of 120 students of "5+3" clinical medicine from Chongqing Medical University, who interned in the department between May 2019 and May 2021, were randomly selected and divided into control group (60 cases) and experimental group (60 cases). The control group was given conventional clinical teaching model, and the experimental group adopted POGIL theory for clinical teaching design. After one month of implementation through different teaching methods, the mastery of specialized knowledge and self-ability improvement evaluation were compared between the two groups of interns. The scores of fatigue scale (FS-14) and symptom checklist-90 (SCL-90) were used to evaluate the learning stress status of interns. And the satisfaction of interns with different teaching models were compared. SPSS 22.0 was used for t test and chi-square test. Results:①The scores of specialized knowledge assessment of intern students in experimental group were higher than those in control group ( P<0.05). ②The self-evaluation scores of professional abilities were higher in experimental group than those in control group ( P<0.05). ③ The scores of FS-14 and SCL-90 in experimental group were significantly lower than those in control group after POGIL instruction and teaching ( P<0.05). ④In terms of teaching quality, the effective rate of clinical teaching with 96.67%(58/60) in experimental group was significantly higher than that 91.67%(55/60) in control group ( P<0.05). Conclusion:POGIL theory model for clinical practice teaching in department of rheumatism and immunology can improve the professional knowledge and skills of clinical interns, and this teaching model is easier to improve the learning enthusiasm and teaching quality of interns.
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In recent years, with the continuous in-depth research on the pathogenesis of rheumatism and the rapid development of biopharmaceutical technology, the development of targeted drugs for rheumatism is in full swing. In order to better standardize the diagnosis and treatment of rheumatism and the rational application of targeted drugs, the Chinese Rheumatology Association will introduce the targeted drugs for rheumatism that have been approved by the China National Medical Products Administration so far, and provide clinicians with standardized diagnosis and treatment reference.
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We report the case of a 60-years-old man who complained fever and left knee pain. Fever and arthralgia appear once a month, and these symptoms disappear spontaneously in 3 days. The patient came to our hospital to receive Kampo treatment, because the patient experienced improving these symptoms by Kampo medicine about 20 years ago. I judged the arthralgia as kanshippi, because the arthralgia improved when the patient warmed the joint. We prescribed keishikajutsubuto 7.5 g/day. Arthralgia improved after administration of keishikajutsubuto, but the attack appeared every month. We prescribed maobushisaishinto 5 g/day in addition to keishikajutsubuto 5 g/day for further improvement of arthralgia. The frequency of fever and arthralgia attack was dramatically decreased after we prescribed keishikajutsubuto 5 g/day and maobushisaishinto 5 g/day. We considered the possibility of palindromic rheumatism based on clinical symptoms, X-ray in other clinic and blood test results in our hospital. We report an effective case of keishikajutsubuto and maobushisaishinto on arthritis attacks with fever that resolved spontaneously in a short time.
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Celastrus paniculatus is commonly known as “Malkangani”, widely distributed in the Maldives, Australia, China, Cambodia, Malaysia, Taiwan, Nepal, Thailand as well as in the Pacific Islands and all over India mainly Maharashtra, Orissa and Andaman and Nicobar group of Islands on an altitude of 1800m. It climbs up to over 10m. The leaves are ovate or elliptic in shape with dentate margin. Seeds are ellipsoid or ovoid, yellowish-brown in color and grow inside the capsules. Celastrus paniculatus (Malkangni) is used in Ayurveda as a nervine tonic, tranquilizer and diuretic and in rheumatism, gout, leprosy and asthma. Different Parts of Celastrus paniculatus after extraction and fractionation give different active constituents such as sesquiterpene esters-malkanguinol, malkangunin, sesquiterpene alkaloids-celapanin, celapanigin, alkaloids-celastrine, paniculatine, fatty acids-oleic acid, palmittic acid, linoleic acid and stearic acid, crystalline substance tetracasanol and sterol. Different pharmacological activities are anti-rheumatic, anti-fungal, nootropic activity, antimalarial activity, anti spermatogenic effect, anti-anxiety and anti-atherosclerotic effect. In the present review, our target is to search, bring together and compile the data of Celastrus paniculatus, which have less side effects and very valuable for the treatment of rheumatism. Related information is procured from various scientific publications using online, seek out engines such as Google scholar, Pubmed and Science Direct. A total of 200 articles was reviewed out of which 55 articles are selected to review for the description of the plant, parts used, chemical constituents, traditional uses and for reported activities.
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Resumen LA enfermedad de Poncet es una poliartritis aséptica reactiva poco frecuente que ocurre durante cualquier etapa de una infección activa pulmonar o extrapulmonar por Mycobacterium tuberculosis. Existen apenas 200 casos descritos en la bibliografía y hasta el momento permanece como diagnóstico de exclusión sin patogenia bien definida. Suele responder rápida y satisfactoriamente al tratamiento antituberculoso sin dejar secuelas. Este artículo revisa la epidemiología, patogenia, manifestación clínica, diagnóstico, tratamiento y pronóstico de la enfermedad de Poncet.
Abstract Poncet's disease is a rarely reported aseptic reactive polyarthritis associated to active pulmonary or extrapulmonary infection caused by Mycobacterium tuberculosis. There are no more than 200 cases reported in the literature and still remains as a diagnosis of exclusion with unknown pathogenesis. It quickly and remarkably resolves with antituberculous drugs, has usually a good prognosis and does not turn into chronic arthritis. This article reviews the epidemiology, pathogenesis, clinical presentation, diagnosis, treatment options and prognosis of Poncet's disease.
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Due to the definite curative effect,stable drug properties and low incidence of adverse reactions,the external traditional Chinese medicine(TCM) ointment for rheumatism treatment has attracted more and more attention from scholars at home and abroad.Based on the external TCM ointment for the treatment of rheumatism approved by China Food and Drug Administration(CFDA),this paper would comb and analyze their dosage forms,varieties,specifications,etc.On the other hand,this article summarizes the application of the new formulation technology,prescription research,study on the forming process,pharmacodynamics and safety research,etc.The problems existing in this area were pointed out,such as lack of new preparations;less research on the penetration material basis,the penetration enhancing mechanism,and the penetration enhancing law;the selection of detection indicators of quality control standards is not comprehensive enough;qualitative and quantitative studies of pharmacokinetics are relatively scarce and so on.Meanwhile,proper measures and suggestions are put forward.Not only the formulation classification and specification description of external TCM ointment should be standardized,but also new dosage forms such as intelligentized,controlled release and targeted preparations of Chinese medicine should be actively introduced;the study of transdermal activity of transdermal enhancer itself should be strengthened,and investigating the correlation between the transdermal absorption of the agent itself and promoting transdermal absorption;the biological effect index or indicators that combine chemical and biological effects should be used,and learning from the latest research achievements of multidimensional spectroscopy of Chinese herbal medicine,thereby establishing scientific detection indicators and quality control methods that conform to modern transdermal concept.
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[Objective] To explore the experiences of national medical master Professor ZHOU Zhongying treating postpartum rheumatism from Yingwei. [Method]By following Professor ZHOU Zhongying,gathering the cases that are all treated by Professor ZHOU Zhongying treating postpartum rheumatism, analyzing Professor ZHOU Zhongying's understanding of the pathogenesis of postpartum rheumatism and the clinical experience of the treatment of the disease,then give clinical cases to verify.[Results]Professor ZHOU Zhongying believes that the conflict between Ying and Wei is the key to the occurrence of postpartum rheumatism.The treatment should be based on the coordination of Ying and Wei and tonifying Qi and blood,the elimination of the evil and dredging the collaterals as the supplement.By using Huangqi Guizhi Wuwu Tang,the efficacy is determined. [Conclusion]The clinical expericences of Professor ZHOU Zhongying treating postpartum rheumatism from Yingwei is effective and has the value to study,popularization and application.
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MOS 36-Item Short-Form Health Survey has been widely recognized, but the application in the field of traditional Chinese medicine rheumatism was less. This article aimed to summarize the application of MOS 36-Item Short-Form Health Survey in Chinese medicine for rheumatism. This may provide certain reference for the future application.
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Yishen Juanbi Method for Treating Rheumatism began from Mr. ZHANG Ci-gong to the formation and development of Mr. ZHU Liang-chun, and by the evidence-based source, innovation and perfection of the third and fourth generations of successors, has formed the unity of the principle, rule, method, medicine, and the unique diagnosis and treatment of rheumatism of integration of the internal treatment and external treatment. All of these provide original insights for rheumatology of TCM theory and the application of insect medicine, and provide valuable treatment technology for China's young rheumatology disciplines.
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OBJECTIVE:To establish a rapid determination method for 9 kinds of glucocorticoid and 8 kinds of non-steroidal anti-inflammatory drugs illegally added into anti-rheumatic TCM patches. METHODS:UPLC-MS/MS method was adopted. The samples were separated on Acquity UPLC? BEN C18 column with methanol-water(90:10,V/V)as mobile phase at flow rate 0.4 mL/min. The column temperature was set at 30℃,and sample size was 1μL. The ionization mode was electrospray ion source(ESI):spray needle voltage of 5500 V,ion source spray GS1,GS2 pressure of 50,50 psi,ion source temperature of 500 ℃,scanning range of m/z 50-500. The multiple reaction monitoring(MRM)combined with information-dependent acquisition (IDA) and en-hanced product ion scanning(EPI)was used to rapid qualitative analysis. RESULTS:The detection limits for 17 kinds of chemical components were not more than 0.400 μg/mL. RSDs for precision,repeatability,stability tests were not more than 4.93%,7.69%, 9.57%,respectively. Diclofenac sodium was detected in the sample. CONCLUSIONS:The method is selective and sensitive. It is suitable for qualitative analysis of chemicals illegally added into anti-rheumatism TCM patches.
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Yang-palm, through early systematic Zhan-zhuang training to raise qi, pats the affected area to extract pathological product outer surface using the distal of 2-5 fingers in palm dorsal. This therapy emphasizes infusing qi and extract silt. The treatment continues when pathological product scatters and disappears, so the short-term and long-term efficacy is significant, and especially suitable for the treatment of TCM arthralgia. This article introduced the clinical therapy in treating two rheumatism patients by Yang-palm, explained process and study method of Yang-palm therapy, and shared treatment experience and explored the basic principles of treatment, with a purpose to provide a new treatment for rheumatism.
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Objective To establish a UPLC-MS/MS method for determination of 10 anti-rheumatic constituents illegally added in Chinese traditional medicine and health products preparation.Methods The column was ACQUITY UPLC BEHC18 (50 mm× 2.1 mm,1.7 μm),The mobile phase was acetonitrile-Ammonium acetate solution (containing 0.1％ Acetic acid) with gradient elution at a flow rate of 0.3 mL/min.The ion source was electrospray ionization (ESI),Multiple-reaction monitoring (MRM) was performed to identify and quantify 10 anti-rheumatic constituents.Results 10 linear calibration curves were obtained with r ≥ 0.996 1.The recoveries were determinated at three concentration and ranged from 92.5％ to 101.8％.The precision of the method was shown by RSD (n =5) ranged from 0.9％ to 3.1％.The ranges of limit of detection were from 0.001 5 to 0.018 μg,and quantitation were from 0.004 5 to 0.55 μg.The illegally added chemicals were detected with 10 batches of 27 batches of samples.Conclusion The method were simple,sensitivity,accurate,and can be used to detect Anti-rheumatic constituents illegally added in Chinese traditional medicine and health products.
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Inflammation is one of the important risk factors of rheumatic diseases. Aconiti Radix is widely used for the treatment of rheumatism, which has significant anti-inflammatory effects. However, its anti-inflammatory mechanism on molecular level is still not clear. The purpose of this study is to illuminate the anti-inflammatory mechanism of Aconiti Radix based on the protein interaction network (PIN) analysis on molecular network level. The main anti-inflammatory components (aconitine, hypaconitine and mesaconitine) were chosen in this study to obtain the targets of the components and protein-protein information though databases retrieval and construct the PIN of Aconiti Radix. By a graph theoretic clustering algorithm molecular complex detection(MCODE), 13 modules were identified and analyzed by gene ontology(GO) enrichment. The results showed that the anti-inflammatory mechanism of Aconiti Radix was mainly associated with prostanoid metabolic process and leukocyte chemotaxis mediated by chemokines. In this study, the anti-inflammatory mechanism of Aconiti Radix was elucidated systematically from molecular network level, which provided the scientific basis for the treatment of rheumatic diseases.
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Stephania Tetrandrae Radix is one of the common traditional Chinese medicines, which has bitter and pungent taste as well as cold properties. It can subside edema, get rid of rheumatism and relieve pain. Therefore, it is mainly used for the treatment of rheumatism arthralgia, edema, dysuria, athlete's foot, swollen wet sores and other diseases in traditional Chinese medicine(TCM). Stephania Tetrandrae Radix is mainly composed of dual-benzyl isoquinoline alkaloids, including tetrandrine, fangchinoline and so on. Modern pharmacology research shows that Stephania Tetrandrae Radix and its main components have a wide range of pharmacological activities in the anti-inflammatory, anti-pathogenic microorganisms, anti-tumor, anti-hypertensive, anti-arrhythmic, anti-myocardial ischemia, anti-fibrosis, anti-silicosis, inhibiting scar and other aspects, with broad application prospect. Stephania Tetrandrae Radix is often applied with compatibility of other Chinese medicines in clinically, and has achieved obvious effects in the treatment of rheumatoid arthritis, cardiovascular disease, cancer, hypertension, liver ascites and other diseases. There are some representative prescriptions, such as Fangji Fuling decoction, Fangji huangqi decoction, Jijiao Lizhuang pill, Xuanbi decoction, and compound Hanfangji granule. In this paper, the pharmacological effects and clinical applications of Stephania Tetrandrae Radix in the past ten years were reviewed, providing reference for its further development and application.
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Objective To explore the relationship between the clinical features,serological markers and European League Against Rheumatism SS Disease Activity Index (ESSDAI) scores of primary Sj(o)gren's syndrome (SS).Methods We enrolled 106 patients,who fulfilled the 2002 classification criteria for primary SS from December 2008 to January 2015,to evaluate the relationship among the clinical characteristics,laboratory features,serological variables and ESSDAI scores.According to serological variables,the prognosis was subdivided into three distinct groups:favourable (no serological markers),intermediate (one serological marker) and poor (two or more serological markers).These data were analyzed by Chi-square test and variance analysis.Results The mean ESSDAI score of 106 pSS patients was (11±7).ESSDAI score was categorized according to the EULAR-SS recommendations as low activity,moderate activity and high activity (scores of 0-4,5-13 and ≥14,respectively),and the positive rate of antinuclear antibody (ANA) 1:100 (6 cases,37.5％;37 cases,66.1％;32 cases,94.1％) in three different ESSDAI levels was statistically different (x2＝18.110,P＜0.01).Those with positive ANA 1:100[positive (13±7) and negative (7±4)],anti-SSA antibody postive (12±7) and negative (9±7),anti-RNP antibody (positive 16±9 and negative 10±6) had higher ESSDAI scores than those with negative ones (F=8.812,P=0.0001;F=3.862,P=0.024;F=5.786,P=0.004).No statistical difference in ESSDAI means were found between patients with positive anti-SSB antibody,rheumatoid factor (RF),FS level,dry mouth,Raynoud's phenomenon and psychosomatic diseases.The ESSDAI scores of favourable group,intermediate group and poor group were significantly different (8±5,10±7,14±7,F=8.715,P=0.000 1).In comparison with the other two groups,the poor pSS patients had a higher frequency of positive ANA 1:100 (15 cases,55.6％;20 cases,57.1％;40 cases,90.9％),anti-SSA antibody(11 cases,0.7％;23 cases,41.1％;36 cases,81.8％),anti-SSB antibody (6 cases,2 2.2％;13 cases,37.1％;23 cases,52.3％),anti-RNP antibody (0 case,0;2 cases,5.7％;9 cases,20.5％) (x2=17.408,P=0.002;x2=14.306,P=0.006;x2=12.330,P=0.015;x2=1 1.482,P=0.022).Conclusion Patients with two or more serological markers may have higher ESSDAI score,and which in turn may associate with poor prognosis.
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Las plaquetas o trombocitos son fragmentos citoplasmáticos irregulares, pequeños derivados de los megacariocitos. Poseen un rol fundamental en la hemostasia y en la reparación de tejidos, esta última desarrollada mediante la liberación de factores de crecimiento contenidos en sus gránulos ante estímulos como la injuria tisular. El plasma rico en plaquetas (PRP) consiste en un concentrado de plaquetas obtenido mediante centrifugación de sangre del propio paciente. Se utilizó inicialmente como compactante y sellante de implantes óseos en cirugía maxilofacial y dental. Actualmente, se ha hecho más conocido como alternativa terapéutica en lesiones de deportistas de alto rendimiento. Los exitosos resultados han provocado la expansión de su uso en otras áreas como la dermatología, estética facial y más recientemente la reumatología. El uso de PRP en osteoartritis ha demostrado ser efectiva aliviando el dolor y mejorando la funcionalidad, sin embargo, la diversidad de protocolos utilizados ha dificultado la estandarización del tratamiento.
Platelets or thrombocytes are irregular, small cytoplasmic fragments derived from megakaryocytes. They have a fundamental role in hemostasis and tissue repair, the latter developed by the release of growth factors contained in their granules to stimuli such as tissue injury. Platelet-rich plasma (PRP) consists of a platelet concentrate obtained by centrifugation of the patients own blood. It was initially used as a compactor and sealant of bone implants in maxillofacial and dental surgery. It has now become better known as a therapeutic alternative in high-performance sports injuries. The successful results have led to the expansion of its use in other areas such as dermatology, facial aesthetics and more recently rheumatology. The use of PRP in osteoarthritis has been shown to be effective in relieving pain and improving functionality, however the diversity of protocols used has made difficult the standardization of treatment.
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Humans , Platelet-Rich Plasma/physiology , Rheumatic Diseases/therapy , Osteoarthritis/therapyABSTRACT
Objective: On the basis of formulas derived from Yaotongning (YTN) Capsules to compare the different cellular pharmacological activity of six kinds of Chinese materia medica (CMM) polysaccharides, thus to supply the evidence for the screening of candidate medicines for rheumatoid bone diseases. Methods: Six samples were designed by respectively adding the polysaccharides of Glycyrrhizae Radix, Atractylodis Rhizoma, Cyathulae Radix, Ephedrae Herba, Epimedii Herba, and Taxilli Herba, at 50% into the six mixtures based on the derived formula of YTN. Murine macrophage cells and chondrocytes were exposed to the new recipes, and then the half-inhibitive concentration (IC50) and half-effective concentration (EC50) were applied to evaluating their activity for inhibiting secretion of PGE2 in Ana-1 cells induced by LPS and activities for stimulating the production of IL-6, IL-1β, and TNF-α in Ana-1 cells as well as activity for promoting IL-1β-induced proliferation of chondrocytes by enzyme linked immunosorbent assay. The interactions among the active fractions were evaluated by comparing the experimental EC50/IC50 values to their corresponding additive EC50/IC50 values, which were calculated by the least square method. Results: Among the six formulas derived from YTN, except for one of the two formulas mainly consisted by polysaccharides of Taxilli Herba or Epimedii Herba, whose activities for inhibiting the production of PGE2 in Ana-1 cells induced by LPS, promoting the secretion of IL-6, IL-1β, and TNF-α in Ana-1 cells, and stimulating the secretion of chondrocytes induced by IL-1β were significantly weaker than those of YTN. The activities of other four formulas which were respectively consisted by 50% one of polysaccharides from YTN material medicines were better than those of YTN or statistically equivalent to YTN. The sample mainly composed of polysaccharides of Cyathulae Radix worked well on inhibiting the production of PGE2 in Ana-1 cells induced by LPS, promoting the secretion of IL-6, IL-1β in macrophages, and stimulating the secretion of chondrocytes. Conclusion: The polysaccharides of Cyathulae Radix have the good effect on cellular anti-inflammation, immune regulation, and chondrocytes proliferation. It can be a candidate for the active fraction of polysaccharides in the prescription of rheumatoid disease.
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OBJECTIVE:To establish a method for the content determination of ephedrine hydrochloride in Luofu mountain rheumatism plaster. METHODS:HPLC was performed on the column of Eclipse XDB-C18 with the mobile phase of acetoni-trile-0.1%phosphoric acid(9∶91,V/V),at the flow rate of 1.0 ml/min. The detection wavelength was 207 nm,the column tempera-ture was 40 ℃,and the volume was 5 μl. RESULTS:The linear range of ephedrine hydrochloride was 81.6-408 ng(r=0.999 7);RSDs of precision,stability and repeatability tests were lower than 2%;and the average recovery rate was 96.73%(RSD=1.9%, n=6). CONCLUSIONS:The method is fast and accurate,and can be used for the content determination of ephedrine hydrochlo-ride in Luofu mountain rheumatism plaster.
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Objective: To investigate the various body ailments both communicable and non communicable diseases in conjunction with nutritional status of elderly in Ondo state, Nigeria. Methods: This was a random sampling of 400 elderly individuals (>60 years) living in Ondo State, Nigeria. By means of Open ended and structured questionnaire, data were collected on health, diet and Sociodemographic characteristics. There was anthropometric measurement to assess nutritional status. Results: Most of the elderly aged 60-69 years were married and have no formal education. Most of them were from monogamy and polygamy family structure. The body ailment reported consist of body pain (28%) respiratory related complications (14%) eye ailments (11%), hypertension (8%) diabetes (3%) and musculoskeletal problems (24%) such as rheumatism, cramps and arthritis. The prevalence of self reported hypertension was 26% less in male respondents than in female respondents. The dietary pattern revealed that elderly ate from major food groups with animal protein foods (74% ate daily) but low dairy products (7% ate daily). The food habit related significantly with body ailments such as skipping meals ((c=19.2; P<0.05) and eating three times a day ((c=8.4; P<0.05). The body Mass index classification showed more than half were in normal nutritional status (58%), but 20% underweight, 15% overweight and 7% were obese. The body ailments associated significantly with nutritional status (c=55.1; P<0.05).
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Objective To explore the clinical effect of treating rheumatism arthritis with pure traditional Chinese medicine preparation of Tongluoshu Liquid.Methods The study of single-blind method was adopted.60 patients were recruited randomly into 2 groups,with 30 patients in each group.The patients in treatment group were administered with Tongluoshu Liquid,150ml each time,twice a day.Those in the control group were given diclofenac sodium sustained release tablets,one tablet each time,twice a day,and methotrexate,7.5 mg for each time,once a week.Results Compared with the control group,the symptoms of joint pain,joint swelling,joint tenderness,bend to stretch disadvantage and soreness and weakness of waist and knees were significantly improved( U=1.20、1.36、1.01、1.78、1.46,P＜0.05)in the treatment group.Conclusion Tongluoshu Liquid is a kind of economical,safe and effective medicine to treat rheumatism arthritis.