目的 采用因子分析方法探讨纤维肌痛综合征的中医证候分布特征.方法 采用回顾性研究方法,以102 例纤维肌痛综合征患者为研究对象,从患者的临床病历中提取规范化症状,通过探索性因子分析总结纤维肌痛综合征患者症状、病位证素、病性证素及中医证候分布特点.结果 根据各公因子病位证素、病性证素组合及各患者证素辨证结果,统计102 例纤维肌痛综合征患者证候分布为:肝郁气滞证102 例、阴(血)虚阳亢(扰神)证72 例、寒湿痹阻证63 例、脾肾阳(气)虚证22 例、痰瘀阻络(心)证13 例.结论 纤维肌痛综合征的中医证候以肝郁气滞证最为常见,阴(血)虚阳亢(扰神)证、寒湿痹阻证、脾肾阳(气)虚证、痰瘀阻络(心)证也较为多见,各证可单独存在,亦可相兼出现.该证候特点反映出纤维肌痛综合征属因郁致痹,病位以肝为主涉及多脏,病性具有虚实夹杂、阴阳两伤的特点.

类风湿关节炎(rheumatoid arthritis,RA)是一种以滑膜增生和血管翳形成为主要病理特征的对称性、破坏性自身免疫性结缔组织病,主要患病人群为中老年女性[1],中国大陆RA总患病人群达500万[2].RA因其多关节受累、致残率高、以及多脏器受累[3]等特点,极大影响患者的身心健康和生活质量,目前可通过达标治疗(treat-to-target)有效缓解症状和控制病情[4].中西医治疗RA均强调目标管理下的病情缓解,在缓解短期疼痛和长期获益方面各有优势[5].

目的 观察补肾治尪汤对类风湿关节炎(rheumatoid arthritis,RA)骨侵蚀的临床疗效.方法 纳入50例辨证属肝肾不足证的RA患者,随机分为治疗组和对照组各25例.治疗组患者用补肾治尪汤联合传统改善病情抗风湿药(conventional disease modifying anti-rheumatic drugs,cDMARDs)治疗,对照组患者用cDMARDs治疗,疗程均为12个月.分别收集2个组患者治疗前后双手腕X线片,由2位放射科医师采用盲法以改良Sharp评分(modified total sharp score,mTSS)法对所有X线片进行评分.观察mTSS变化、放射学进展率,以mTSS增加≥0.5分判断为放射学进展,以中医证候积分和有效率为临床疗效评价标准.结果 共42例患者完成研究,其中治疗组22例,对照组20例.2位放射科医师评分一致性高,观察者内相关系数为0.90.2个组患者治疗前后关节间隙狭窄变化值、骨侵蚀变化值及mTSS变化值比较,差异无统计学意义(P＞0.05).治疗组患者放射学进展率低于对照组,差异有显著统计学意义(P＜0.01).2个组患者治疗后中医证候积分均较治疗前显著改善,差异均有统计学意义(P＜0.01);治疗组有效率优于对照组,但差异无统计学意义(P＞0.05).结论 补肾治尪汤中西医结合治疗RA,放射学进展率低于对照组,提示补肾治尪汤具有延缓RA骨侵蚀的作用.

干燥综合征(SS)是常见的风湿免疫病,是中医药治疗的优势病种之一.中华中医药学会组织中医风湿、西医风湿及药学领域专家,深入探讨SS的中医药治疗优势及优选方案.与会专家充分讨论后认为,SS早期诊断率低,缺乏针对性的治疗药物;自身免疫异常是SS发病的关键因素,气阴两虚是核心病机;SS的舌象极具特点,可能成为本病早期诊断及中西医结合诊疗的突破口;中医药治疗SS在改善临床症状和系统受累、个体化治疗、缓解睡眠和情志障碍、疾病早期发挥"治未病"功效及中西药联用增效减毒等方面具有优势,在SS不同阶段均有优势点;中药内服、外治、针刺和针刀均是可选的治疗手段;优选方案应在辨证基础上,结合病情阶段、中医药优势综合制订.应深入研究SS的临床特点和生物标记物对本病患者进行分层,探索建立基于循证证据的SS中医精准治疗方案.基于SS舌象的独特表现,建立疾病早期诊断和不良预后识别模型,实现早期防治,改善预后.未来应大力开展中医、中西医结合治疗SS的高质量循证医学研究,制定相关指南,优化和规范当前的诊疗,为说明白、讲清楚中医药治疗SS的优势提供依据.

目的 分析纤维肌痛综合征(FMS)患者临床特点和中医证候分布规律,为FMS的中医诊治提供依据.方法 采用前瞻性、横断面研究方法,纳入 2022 年 4 月—2023 年 4 月于中日友好医院中医风湿病科就诊的 148 例FMS患者,观察疼痛诱发和加重因素、疼痛视觉模拟评分法(VAS)评分、疼痛部位、疼痛性质和FMS其他主要症状,分析证候特征.结果 148 例FMS患者中,因劳累、情绪刺激和气候变化诱发疼痛者分别占 52.0%、48.6%和 39.2%,因劳累、情绪刺激和气候变化加重者分别占64.9%、49.3%和54.1%;轻度、中度和重度疼痛分别占11.5%、47.3%和41.2%;左上、右上、左下、右下和中轴部位疼痛分别占89.2%、88.5%、90.5%、86.5%和93.2%,其中,以背部、腰部、右肩胛带区、右上臂和左肩胛带区疼痛较常见,分别占84.5%、81.8%、76.4%、75.0%和75.0%;重痛、酸痛和胀痛分别占69.6%、63.5%和52.7%.常见症状中,有疲劳、睡醒后仍觉疲乏、认知损害、睡眠障碍、情绪障碍、慢性头痛的患者分别占 95.9%、91.2%、67.6%、88.5%、93.2%、71.6%;合并偏头痛、肠易激综合征和骨关节炎的患者分别占29.1%、16.9%和14.2%.使用聚类分析方法将FMS归纳为肝郁化火证(98.6%)、脾虚湿蕴证(95.3%)及肝肾不足证(16.9%)3 类,而且FMS患者常表现为多种证候叠加,肝郁化火合并脾虚湿蕴证最常见(77.7%).结论 FMS患者常出现疲劳和情绪障碍,易受劳累、情绪刺激和气候变化诱发加重,肝郁化火-脾虚湿蕴证是最常见的证候类型.

目的:探讨凝血六项在类风湿关节炎(RA)血瘀证中的诊断价值.方法:采用横断面研究方法,选取2021年4月1日—2023年3月31日于中日友好医院中医风湿病科住院及门诊就诊的RA患者共220例.依据患者是否有血瘀证分为2组,比较2组患者的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原含量(FIB)、纤维蛋白原降解产物(FDP)、D-二聚体(DD)的差异,采用二元Logistic回归分析建立凝血六项在RA血瘀证中的诊断模型,并绘制受试者工作特征(ROC)曲线评价诊断效能.结果:2组患者的性别、体质量指数(BMI)差异无统计学意义(P＞0.05);而血瘀证组患者的年龄、病程均长于非血瘀证组(P＜0.05),疾病活动度高于非血瘀证组(P＜0.05).血瘀证组的FIB、FDP、DD均高于非血瘀证组(P＜0.01).回归分析显示年龄增加、DD水平升高与 RA血瘀证独立相关,OR(95％CI)分别为 1.047(1.024～1.070)、1.382(1.090～1.750).ROC 曲线中,年龄为62.5岁时,预测RA血瘀证的特异性为70.2％,敏感性为54.4％;DD为0.895mg/L时,预测RA血瘀证的特异性为70.2％,敏感性为52.9％.结论:年龄增加、DD升高与RA血瘀证独立相关,临界值参考:年龄≥62.5岁,DD≥0.895mg/L,年龄和DD在RA血瘀证的诊断中具有一定价值.

Abstract Background Ankylosing spondylitis (AS) is a chronic autoimmune disease that primarily affects the axial joints. Immune cells play a key role in the pathogenesis of AS. This study integrated bioinformatics methods with experimental validation to explore the role of natural killer (NK) cells in AS. Methods Two microarray datasets, GSE25101 and GSE73754, were selected, and the scRNA-seq data were obtained from GSE194315 and Liu’s research. Differentially expressed genes (DEGs) and functional enrichment analysis were performed respectively. weighted gene co-expression network analysis (WGCNA) was conducted to identify key modules of co-expressed genes and genes involved in NK cell function. The diagnostic value of the identified key genes were evaluated using ROC curves, logistic regression analysis, and a nomogram. real-time PCR (RT-PCR) was used to quantified the expression of genes. Statistical analysis was conducted using the R software package, and a P-value of less than 0.05 was considered statistically significant. Results Pathways enrichment analysis revealed the involvement of NK cell-mediated immune pathways and regulation of the innate immune response, indicating the crucial role of innate immunity, especially NK cells, in AS pathogenesis. The construction of a co-expression network revealed that the MElightyellow module was most relevant to the NK cell-mediated immune pathway. IL2RB, CD247, PLEKHF1, EOMES, S1PR5, FGFBP2 from the MElightyellow module were identified as key genes involved in NK cell-mediated immune response and served as potential diagnostic biomarkers for AS, with moderate to high diagnostic values based on AUC values. Further analysis using scRNA-seq profiling revealed the higher expression level of IL2RB, CD247, PLEKHF1, S1PR5, FGFBP2 in NK cells compared to that in other cell types. CD247, PLEKHF1, EOMES, S1PR5, and FGFBP2 were reduced expressed in AS patients as compare to control group verified by scRNA-seq data, CD247, EOMES, FGFBP2, IL2RB and S1PR5 were reduced expressed verified by RT-PCR, and PLEKHF1, S1PR5, and FGFBP2 was upregulated after TNF-α blocker therapy. Conclusion The study revealed the potential role of NK cells in the pathogenesis of AS and identified diagnostic biomarkers and potential treatment targets for AS.

Objective We aimed to explore the delaying effect of Bushen Zhiwang Decoction（a compound prescription for tonifying the kidney and treating arthritis） on bone destruction in rheumatoid arthritis（RA） patients with a pattern of deficiency of both liver and kidney based on the modified total Sharp score（mTSS）.Methods A total of 170 RA patients with a pattern of deficiency of both liver and kidney attending the Department of TCM Rheumatism of the China-Japan Friendship Hospital from September 2020 to September 2021 were prospectively enrolled in this randomized controlled trial. A stochastic grouping method was used to assign patients to the experimental group or the control group. Patients in the experimental group were treated with Bushen Zhiwang Decoction combined with regular doses of conventional synthetic disease-modifying antirheumatic drugs（cDMARDs）, and patients in the control group were treated only with regular doses of cDMARDs. The observation period was 12 months. The mTSS was used as the main index to observe the degree of bone destruction in both groups after treatment.Results A total of 153 patients completed the final observation（76 in the experimental group and 77 in the control group）. There were no significant differences in baseline characteristics between the two groups. After 12 months of treatment, patients in the experimental group showed a more significant improvement in erythrocyte sedimentation rate and traditional Chinese medicine syndrome score compared to patients in the control group（P＜0.05）. Radiographic evaluation revealed an increase in mTSS in both groups, but the increase in mTSS was significantly smaller（P＜0.01） in the experimental group. Radiological progression of bone destruction occurred in 59 patients（77.6%） in the experimental group, a much lower proportion than in the control group（75 patients, 97.4%）（P＜0.01）. Visualization of the proportional distribution showed that mTSS growth values were consistently lower in the experimental group than in the control group.Conclusion Treatment with Bushen Zhiwang Decoction combined with cDMARDs can effectively delay the progression of bone destruction in RA patients with a pattern of deficiency of liver and kidney.

Rheumatoid arthritis (RA) is a chronic, progressive inflammatory and systemic autoimmune disease resulting in severe joint destruction, lifelong suffering and considerable disability. Diverse prescriptions of traditional Chinese medicine (TCM) containing Epimedii Herba (EH) achieve greatly curative effects against RA. The present review aims to systemically summarize the therapeutic effect, pharmacological mechanism, bioavailability and safety assessment of EH to provide a novel insight for subsequent studies. The search terms included were "Epimedii Herba", "yinyanghuo", "arthritis, rheumatoid" and "Rheumatoid Arthritis", and relevant literatures were collected on the database such as Google Scholar, Pubmed, Web of Science and CNKI. In this review, 15 compounds from EH for the treatment of RA were summarized from the aspects of anti-inflammatory, immunoregulatory, cartilage and bone protective, antiangiogenic and antioxidant activities. Although EH has been frequently used to treat RA in clinical practice, studies on mechanisms of these activities are still scarce. Various compounds of EH have the multifunctional traits in the treatment of RA, so EH may be a great complementary medicine option and it is necessary to pay more attention to further research and development.

OBJECTIVESTo investigate the clinical characteristics and relevant factors of secondary immune thrombocytopenia (ITP) in patients with primary Sjögren's syndrome (pSS).METHODSPatients with pSS being treated between 2013 and 2020 in China-Japan Friendship Hospital were retrospectively analysed. Clinical characteristics were compared between pSS patients with and without secondary ITP. Logistic regression analysis was performed to identify factors associated with secondary ITP in patients with pSS.RESULTS639 patients with pSS were included in this study, among which 566 (88.6%) were women. The prevalence of secondary ITP in patients with pSS were 12.4%. Among pSS patients with secondary ITP, 55.7% had mucocutaneous bleeding and 8.9% experienced visceral bleeding. Lymphopenia (OR=3.154, 95% CI 1.185-8.395, p=0.021), anaemia (OR=2.416, 95% CI 1.250-4.668, p=0.009), low C4 (OR=2.904, 95% CI 1.563-5.394, p=0.001), and positive anti-RNP (OR=2.777, 95% CI 1.070-7.202, p=0.036) were significantly related to secondary ITP, while interstitial lung disease (ILD, OR=0.429, 95% CI 0.203-0.907, p=0.027), ANA ≥1:320 (OR=0.469, 95% CI 0.221-0.996, p=0.049) and positive anti-SSB (OR=0.288, 95% CI 0.126-0.685, p=0.003) were negatively associated with secondary ITP in patients with pSS.CONCLUSIONSOver 10% of patients with pSS had secondary ITP, among whom visceral bleeding was comparatively rare. Lymphopenia and anaemia were positively related to secondary ITP, while ILD was negatively associated with secondary ITP. Low C4 and positive anti-RNP seem to be two potential risk factors for secondary ITP in patients with pSS, while ANA ≥1:320 and positive anti-SSB may be two potential protective factors.

目的:探究治尪汤联合甲氨蝶呤改善胶原诱导关节炎模型(CIA)大鼠的骨破坏作用及机制.方法:SD雄性大鼠随机分为正常组,模型组,甲氨蝶呤组(1.5 mg·kg-1),甲氨蝶呤+治尪汤低(40.8 g·kg-1),高(102.0 g·kg-1)剂量组.除正常组外,其余大鼠分别于第1,7天尾部注射浓度为2 g·L-1的Ⅱ型胶原乳剂50μL建立CIA模型;第8天开始连续给药21d,每7d检测1次体质量、足趾厚度,进行关节炎指数(AI)评分,酶联免疫吸附测定法检测血清肿瘤坏死因子-α(TNF-α),白细胞介素-6(IL-6),白细胞介素-1β(IL-1β)含量,抗酒石酸酸性磷酸酶染色法检测踝关节破骨细胞的数量,免疫组化(IHC),实时荧光定量聚合酶链式反应(Real-time PCR),蛋白免疫印迹法(Western blot)检测踝关节核转录因子-κB受体活化因子配体(RANKL),骨保护素(OPG)的表达.结果:与正常组比较,模型组大鼠体质量显著降低(P＜0.01),足趾厚度显著增加(P＜0.01),踝关节AI评分显著增加(P＜0.01),血清TNF-α,IL-6,IL-1β含量显著升高(P＜0.01),踝关节破骨细胞数量显著增加(P＜0.01),踝关节RANKL mRNA和蛋白表达显著升高(P＜0.01),OPG mRNA和蛋白表达明显降低(P＜0.05),RANKL/OPG显著升高(P＜0.01).与模型组比较,甲氨蝶呤+治旭汤低、高剂量可改善大鼠体质量,降低足趾厚度,AI评分,RANKL mRNA和蛋白表达并增加OPG mRNA和蛋白表达,使RANKL/OPG降低(P＜0.05,P＜0.01),且甲氨蝶呤+治旭汤高剂量效果最好,甲氨蝶呤+治尪汤低剂量次之,甲氨蝶呤再次之.结论:治尪汤联合甲氨蝶呤能更好地改善类风湿关节炎的骨破坏,可能是通过抑制RANKL/OPG通路实现的,本研究为中西医结合方案治疗类风湿关节炎骨破坏提供了实验基础.

中医药治疗风湿免疫疾病的优势病种、中西医结合切人点仍不明确,制订中医、西医普遍认可、融合的诊疗方案是亟待解决的问题.为明确中医、中西医结合风湿病优势病种和优势环节,由中华中医药学会发起风湿领域中医优势病种青年沙龙研讨会(以下简称风湿优势病种青年沙龙),以广泛涵盖中医、西医风湿领域专家的研讨小组为主体,采用问卷调查和现场研讨两种形式,充分探讨中医药治疗风湿免疫疾病的优势,明确中西医结合切入点,初步形成一致意见,为制订出中医西医普遍认可、融合的诊疗方案提供基础.风湿优势病种青年沙龙与会专家一致认为,应结合现代医学方法、现代科技手段开展循证医学研究,为践行"宜中则中、宜西则西"的指导思想提供客观临床证据;要以"四个互"为要求,即语境互通、学理互释、标准互证、手段互融,要着重解决难治性风湿病;在优势病种和优势点上,本文介绍达成广泛共识的类风湿关节炎、强直性脊柱炎、干燥综合征、高尿酸血症与痛风、系统性红斑狼疮、纤维肌痛综合征等6种优势疾病的21个优势环节.本研究为风湿病中医、中西医结合诊疗方案提供参考,为临床实际诊疗和科学研究提供参考依据和有益借鉴.

Objective To study the clinical characteristics of primary Sjogren's syndrome (pSS) with different onset age, and perform a review of the literature to confirm if the clinical phenotypes are affected by onset age in patients with pSS. Methods Data of 742 patients with pSS were retrospectively analysed. Patients were divided into three groups according to onset age: young-onset pSS (YopSS, <35 years), adult-onset pSS (AopSS, = 35 and =65 years), and elderly-onset pSS (EopSS, >65 years). Clinical characteristics were compared among three groups and further multiple comparisons were conducted by Bonferroni adjustment. The Chi-squared test for linear-by-linear association was used to explore variation tendency. Results This study included 105 (14.2%), 533 (71.8%), and 104 (14.0%) cases of YopSS, AopSS, and EopSS, respectively. YopSS demonstrated lower prevalence of dry mouth, abnormal Schirmer I tests, and interstitial lung disease (ILD), but higher proportions of low C3 and C4 levels, and ANA, anti-SSA, anti-SSB, and rheumatoid factor (RF) positivity than AopSS and EopSS. The proportions of dry mouth (p= 0.004), abnormal Schirmer I tests (p=0.002), and ILD (p<0.001) tended to increase with the increase of onset age, while the prevalence of leukopenia (p=0.011), low C3 (p=0.001), low C4 (p=0.001), and ANA (p<0.001), anti-SSA (p<0.001), anti-SSB (p<0.001) and RF (p<0.001) positivity tended to decrease with an increase in onset age. Conclusion YopSS demonstrated less dryness and ILD, but more immunologic disorders. ILD prevalence were directly proportional to onset age of pSS; however, leukopenia, hypocomplementaemia,

为评价案例教学(Case-Based Learning,CBL)在"中医内科学"教学中的效果,通过建立"中医内科学"课程《痹证》和《鼓胀》两个章节的传统教学教案和CBL教案,选取北京中医药大学本科三年级"中医内科学"两个平行班级的授课学生,经随机分组抽签,A班开展CBL授课+传统授课,B班开展传统课堂教学授课,教学任务完成后要求学生采用教学效果自评量表进行评估.分析发现,与传统教学组相比,CBL教学法在知识掌握维度、创新中医思维维度、兴趣爱好维度等3个维度9个方面均明显提高,差异有显著性(p<0.05).结果表明,CBL教学法有助于提高"中医内科学"教学知识掌握程度、中医创新能力和兴趣爱好,值得进一步推广应用.

目的 比较分析类风湿关节炎(RA)患者寒、热证候间外周血淋巴细胞亚群与相关细胞因子的差异.方法 纳入RA患者115例,其中寒证58例,热证57例.采集中医证候数据,检测血沉(ESR)、C-反应蛋白(CRP)、免疫球蛋白及补体、类风湿因子(RF)、抗环瓜氨酸肽(CCP)抗体、外周血淋巴细胞亚群及相关细胞因子水平,分析淋巴细胞亚群数量及细胞因子在RA寒、热证候中的差异.结果 与寒证组比较,热证组CD4+T细胞、B2细胞、B1细胞、NK细胞数量降低,IL-1β、IL-8、IL-6、干扰素(IFN)-γ升高(P＜0.05,P＜0.01).ROC曲线结果显示:CD4+T/IL-6＜30时,判断RA热证的敏感性为82.1％,特异性为82.4％;CD4+T/IFN-α ＜205时,热证可能性大,其敏感性为60.7％,特异性为91.2％.结论 寒、热证候间淋巴细胞数量及细胞因子有显著差异,CD4+T/IL-6＜30和CD4+T/IFN-α＜205是RA热证的特征性表现.

目的 研究胃饥饿素/生长激素促分泌性受体/γ-氨基丁酸(Ghrelin/GHSR-1a/GABA)通路的关键因子在胃食管反流病肝郁证大鼠模型中的表达情况,建立相关病证结合动物模型.方法 将55只雄性SD大鼠随机分为正常组、假手术组、胃食管反流病组、肝郁证组、胃食管反流病肝郁证组,每组11只.以食管十二指肠侧吻合术制备胃食管反流病模型,以慢性不可预见性刺激制备中医肝郁证模型,以食管十二指肠侧吻合术联合慢性不可预见性刺激制备胃食管反流病肝郁证模型.进行糖水偏爱实验、旷场实验、食管上皮HE病理观察,检测血清及胃组织Ghrelin、下丘脑GABA和GHSR-1a表达.结果 分别与正常组、胃食管反流病组比较,胃食管反流病肝郁证组大鼠糖水偏好比和旷场实验总穿格数降低(P<0.01)、中央区持续停留时间缩短(P<0.01),血清中Ghrelin含量增高(P<0.01),胃组织中Ghrelin阳性细胞表达数及下丘脑GHSR-1 a蛋白表达增加(P<0.01).与假手术组比较,胃食管反流病肝郁证组大鼠下丘脑中GABA含量降低(P<0.05).结论 食管十二指肠侧吻合术联合慢性不可预见性刺激可以制备胃食管反流病肝郁证模型,该病证结合大鼠模型血清及胃Ghrelin表达增高,下丘脑GHSR-1 a蛋白表达增高、GABA含量降低.

RA是一种发病率高、致残率高的常见自身免疫病，延缓骨破坏始终是RA治疗的目标和难点。近年来，Wnt/β-连环蛋白（β-catenin）信号通路在RA骨破坏过程中的作用逐渐被证实。本文从分子生物学、蛋白、细胞水平综述Wnt/β-catenin信号通路在RA骨破坏中的作用，以期为RA骨破坏发病机制的深入研究提供新的思路。

目的:探究类风湿关节炎(RA)患者寒证和热证患者临床特征的差异,为RA的寒热辨证客观化提供依据.方法:将符合RA诊断标准的134例RA患者分为寒证组与热证组.收集患者一般资料、免疫指标、抗体水平、疾病活动度评估及临床常规指标等41项指标,探究两组间相关指标的差异.进一步结合临床选取具有代表性的因素,使用多因素Logistic回归模型进行分析,明确RA寒热证候的临床特征因素.结果:热证组较之于寒证组28关节压痛数目、28关节肿胀数目、VAS、类风湿因子、超声下28关节的滑膜炎数目、超声下28关节多普勒血流信号数目、超声下28关节骨侵蚀关节数目、红细胞沉降率、C-反应蛋白、白细胞计数、血免疫球蛋白A、血免疫球蛋白G、谷氨酰转肽酶、28关节疾病活动度评分指标更高,差异具有统计学意义(P＜0.01,P＜0.05);血红蛋白、高密度脂蛋白胆固醇指标更低,差异具有统计学意义(P＜0.01,P＜0.05).多因素Logistic回归结果表明28关节疾病活动度(DAS28)、28关节超声下多普勒血流信号数是RA寒热证候的独立预测因子,RA患者随着28关节疾病活动度数值增高及28关节超声下多普勒血流信号数目增多,其热证概率明显升高.结论:RA患者寒证、热证与临床指标间存在一定差异,28关节多普勒超声下血流信号数目与DAS28数值是预测寒热证型的独立预测因子.

Apart from the treatment potential of micro-fragmented adipose tissue (MF) in joint diseases, what's less clear is the mechanism of MF on Osteoarthritis (OA). Synoviocytes isolated from synovium tissues of 11 knee joint OA patients were identified and co-cultured with MF collected by Lipogems®. Cytokines and mRNA levels in synoviocytes were detected by enzyme-linked immunosorbent assay (ELISA) and quantitative reverse transcription polymerase chain reaction (qRT-PCR). Cell viability, apoptosis and apoptosis-related protein expression of Tumor Necrosis Factor-α (TNF-α)-activated synoviocytes were detected by cell counting kit-8, flow cytometry and western blot, respectively. The rescue experiments were conducted to verify the causal relationship of MF and miR-92a-3p. The relationship between miR-92a-3p and KLHL29 was verified by bioinformatics analysis, qRT-PCR, dual-luciferase reporter assay and western blot. OA synoviocytes were composed of synovial fibroblasts and synovial macrophages. After co-cultivation of synoviocytes and TNF-α, the levels of Interleukin (IL)-8 and hyaluronic acid (HA) appeared a few changes, and those of chemotactic cytokine ligand (CCL) 2, CCL3, CCL5 and matrix metalloproteinases (MMP)-9 were downregulated, while the levels of Tissue Inhibitor of Metalloproteinases (TIMP)-1, IL-10 and Prostaglandin E2 (PGE2) were up-regulated. Co-culture of MF and activated synoviocytes reversed the above-mentioned effects regulated by TNF-α and reduced the mRNA levels of inflammatory factors. However, miR-92a-3p inhibitor overturned the reversal. KLHL29 was the target gene of miR-92a-3p and its expression was suppressed in activated synoviocytes co-cultured with MF, which was reversed by down-regulated miR-92a-3p. Collectively, MF regulated the biological functions of OA synoviocytes by upregulating miR-92a-3p expression.

目的:系统评价中医补肾法治疗类风湿关节炎(rheumatoid arthritis,RA)的有效性与安全性.方法:计算机检索中国知网、中国生物医学文献、万方、维普、PubMed等数据库自建库至2021年1月收录的运用补肾法治疗RA的随机对照试验,制定相应的纳排标准筛选文献并提取数据,Meta分析使用RevMan5.3软件.结果:共纳入23个研究总计2338名患者,Meta分析结果显示与对照组比较,补肾治疗组可以显著提高有效率[危险度比(relative risk,RR)=1.22,95％置信区间(confidence interval,CI)(1.18,1.27),P<0.00001],降低RA患者血沉[均数差(mean difference,MD)=-7.31,95％CI(-9.03,-5.58),P<0.00001]、C-反应蛋白[MD=-5.92,95％CI(-7.47,-4.37),P<0.00001],提高25羟基维生素D水平[标准化均数差(standard mean difference,SMD)=0.74,95％CI(0.17,1.31),P=0.01],降低不良反应发生率[RR=0.43,95％CI(0.33,0.54),P<0.00001],差异有统计学意义,2组在血清破骨细胞分化因子、核因子κB受体活化因子配体方面比较无明显差异.结论:目前现有证据可以证明,较单纯西药相比补肾方药联合西药治疗RA可以提高有效率,减轻炎症程度,延迟骨破坏进展并降低不良反应发生率.