RESUMO
Rheumatoid arthritis （RA） is a systemic chronic auto-inflammatory disease， characterized by infiltration of inflammatory cells， pannus formation， articular cartilage destruction， and bone matrix destruction. Therefore， improving articular cartilage destruction has an important impact on the treatment of RA. Chinese medicine has a good application effect in improving cartilage destruction of RA due to its characteristics of multiple components， multiple targets， high activity and low side effects. Based on this， the author reviewed relevant literature to summarize the relevant research and mechanism of Chinese medicine and its active components in improving RA cartilage destruction. The results showed that Chinese medicine and its active components can improve RA cartilage destruction by regulating inflammatory factors， phosphatidylinositol 3-kinase/protein kinase B， Wnt/β- catenin， nuclear factor-κB， mitogen-activated protein kinase， Janus kinase 2/signal transduction and activator of transcription 3/ vascular endothelial growth factor， microRNAs， fibroblastic synovial cells.
RESUMO
Total hip arthroplasty (THA) has been one of the most successful orthopaedic surgery in the last 50 years, with an excellent survival rate of more than 20 years. However, hip instability, impingement, dislocation, and liner wear remain common causes of THA failure and revision after THA. To minimize the risk of postoperative complications, abnormal spine-pelvic-hip mobility and its impact on THA outcomes have received increasing attention. According to the concept, the patient's pelvic mobility should be fully considered when making preoperative plans for THA. Individualized anteversion and inclination angles should be set according to the patient's sagittal balance and pelvic mobility to reduce the incidence of postoperative adverse events and prolong the life of the prosthesis. In the literature, recent studies have shown that patient aging, postural changes in daily life, high body mass index (BMI), and different surgical approaches and positions can impact spinopelvic mobility. Because changes in pelvic mobility translate into changes in acetabular orientation, excessive intraoperative or postoperative changes in pelvic mobility may result in poor intraoperative prosthesis orientation, postoperative impingement, dislocation, and accelerated liner wear, ultimately shortening the life of the prosthesis. Therefore, it is vital to evaluate and measure spinopelvic mobility preoperatively, investigate the factors that influence intraoperative pelvic mobility changes and the use of assisted positioning devices for accurate cup placement, and observe postoperative changes in pelvic mobility and the resulting adverse outcomes. This review takes the current literature on the spine-pelvic-hip interrelationship as a starting point and presents studies on the factors influencing spinopelvic mobility and the strategies for perioperative management of THA.