骨质疏松症(osteoporosis,OP)是一种与增龄相关的骨骼疾患,其起病隐匿,呈渐进性发展,患者初期无明显的临床表现,但随着病情的进展,骨量不断流失及骨组织微结构破坏,进而出现骨痛、脊柱变形,甚至出现骨质疏松性骨折(osteoporotic fracture,OPF)等严重并发症.双能X线吸收法是目前临床诊断OP的金标准,但由于其诊断的准确度受到体重、腰椎退行性改变及主动脉壁钙化等因素的影响,存在假阴性诊断的可能.近年来,人工智能(artificial intelligence,AI)在医学领域快速发展,目前AI已广泛应用于OP的研究中,其在OP筛查、诊断及预测领域的研究已成为一个新的热点.该文从AI应用于OP的早期筛查、医学影像学表现、临床诊疗资料及OPF风险预测等4个方面,阐述AI在OP诊疗过程中的应用现状及优势,为OP的精准诊疗提供新方向.

目的:观察陇中损伤胶囊治疗骨质疏松性椎体压缩骨折(OVCF)经皮椎体后凸成形术(PKP)术后残留疼痛的临床效果.方法:将符合纳入标准的骨质疏松性椎体压缩骨折(OVCF)经皮椎体后凸成形术(PKP)术后患者90例,随机分为两组各45例.对照组行PKP手术,治疗组在对照组基础上予陇中损伤胶囊,疗程6个月.两组患者均予抗骨质疏松治疗.在治疗前后分别动态记录两组患者的视觉模拟疼痛评分(VAS评分)、Oswestry残损指数(ODI评分)和BMD值变化.结果:治疗组、对照组两组治疗总有效率分别为95.6％和82.2％,两组比较,差异有统计学意义(P＜0.05);治疗后,两组患者VAS、ODI评分较治疗前均明显下降,治疗后4周VAS、ODI评分明显低于治疗后1周(P＜0.05).且治疗组在治疗1、4周末VAS、ODI评分均显著低于对照组(P＜0.05).治疗后,治疗组BMD值较对照组均明显升高(P＜0.05).结论:陇中损伤胶囊治疗骨质疏松性椎体压缩骨折PKP术后残留疼痛疗效较好、安全可靠,并一定程度可改善骨代谢.

目的:采用Meta分析方法评价身痛逐瘀汤治疗经皮内窥镜下腰椎间盘切除术(percutaneous endoscopic lumbar discectomy,PELD)后患者残余症状的有效性与安全性.方法:计算机检索2021年9月1日前发表在中国知网、万方数据知识服务平台、维普数据库、中国生物医学文献服务系统、PubMed、Embase、Cochrane Library、Web of Science数据库中所有关于身痛逐瘀汤治疗PELD术后患者残余症状的临床随机对照研究.Meta分析采用Review Manager 5.3软件,并依据Cochrane系统评价纳入文献的质量.结果:共纳入8篇文献,涉及588例患者,其中观察组(身痛逐瘀汤组)292例,对照组(常规药物组)296例.观察组患者视觉模拟疼痛评分(visual analogue scale,VAS)(MD=-0.65,95％CI[-0.77,-0.53],P<0.0000)、Oswestry功能障碍指数(oswestry disability index,ODI)(MD=-3.61,95％CI[-4.07,-3.16],P<0.00001)、日本骨科协会评估治疗分数(Japanese orthopaedic association,JOA)(MD=2.25,95％CI[1.28,3.22],P<0.00001)均优于对照组,差异有统计学意义(P<0.05).结论:身痛逐瘀汤在治疗PELD术后患者残余症状方面具有明显优势,可以缓解患者术后残余腰腿部疼痛、麻木及无力等症状,提高患者生活质量,且具有较高的安全性.但本研究结论仍需大样本、高质量文献验证其真实性与可靠性.

OBJECTIVE:To evaluate clinical effect of unilateral approach and bilateral decompression via large channel endoscopic system for the treatment of lumbar spinal stenosis. METHODS:The clinical data of 32 patients with lumbar spinal tenosis treated by unilateral approach and bilateral decompression via large channel endoscopy from February 2018 to February 2019 were retrospectively analyzed. There were 18 males and 14 females, aged 65 to 84 years old with an average of (70.6± 8.4) years. The course of disease was from 1 to 12 years. All 32 cases were accompanied by numbness or pain in the lower limbs, of which 28 cases were accompanied by intermittent claudication. Narrow segments were L3, 4 of 2 cases, L4, 5 of 19 cases, L5S1 of 13 cases, including double segments of 2 cases. Preoperative imaging showed 3 cases of central canal stenosis, 21 cases of bilateral lateral recess stenosis and 8 cases of mixed stenosis. Operation time and complications were recorded. X-ray, CT and MRI were analyzed at 3 days, 3 months and 1 year after operation. Visual analogue scale(VAS), Oswestry Disability Index (ODI), single continuous walking distance(SCWD) were observed before and after operation. Modified Macnab standard were used to evaluate the clinical effect at 1 year after operation. RESULTS:All the patients were followed up for 12-24 (17.68±2.43) months and all operations were successfully completed with the operation time of 70-160(85.64±11.94) min. Spinal dural tear occurred in 1 case during the operation, and sensory disturbance in the other side of lower limb in a short period of time occurred in 2 cases, all improved after corresponding treatment. Postoperative imaging showed that the spinal canal was significantly enlarged and the nerve root was fully released. Before operation and 3 days, 3 months, 1 year after operation, VAS scores of low back pain were 4.62 ±1.41, 2.73 ±1.35, 1.21 ±1.17, 1.11 ±0.34, respectively;VAS scores of leg pain were 6.83 ± 1.71, 3.10±1.50, 1.08±0.19, 0.89±0.24, respectively. VAS scores of low back pain and leg pain each time point after operation were obvious improved (P<0.05); there was significant difference between 3 months and 3 days after operation(P<0.05), and there was no significant difference between 3 months and 1 year after operation (P>0.05). Before operation and 3 days, 3 months, 1 year after operation, ODI scores were 38.40 ±6.48, 18.42 ±2.40, 5.48 ±0.77, 3.05 ±0.28, respectively; SCWD was (47.48±5.32) m, (52.89±11.23) m, (245.43±18.94) m, (468.97±55.87) m, respectively. The differences in ODI score and SCWD postoperative time points were statistically significant compared with those before operation (P<0.05). The difference between 3 months and 3 days after operation was statistically significant (P<0.05). The difference between 1 year and 3 months after operation was statistically significant (P<0.05). According to Macnab standard to evaluate clinical effect at 1 year after operation, 15 cases got excellent results, 14 good, 3 fair. CONCLUSION:It is a safe and effective way to treat lumbar spinal stenosis with unilateral approach and bilateral decompression via large channel endoscopic system. It has the advantages of sufficient decompression, less trauma, fast recovery, high safety and low incidence of postoperative complications. It can minimize the damage to the stable structure of the lumbar spine and is an ideal minimally invasive operation for the treatment of lumbar spinal stenosis.

观察循经通络穴位按摩疗法对缓解膝关节置换术患者围手术期负性情绪的临床疗效.将2018年10月～2019年10月的80例行膝关节置换术并伴有围手术期负性情绪的患者随机分为干预组和对照组,每组40例.对照组采用常规护理,干预组在常规护理的基础上加用循经通络穴位按摩,干预措施持续至术后3d,观察比较两组患者焦虑、疼痛、自理能力及膝关节活动度的情况.干预组焦虑、疼痛、自理能力以及膝关节活动度情况均优于对照组,差异有统计学意义(P＜0.05).循经通络穴位按摩疗法能有效改善膝关节置换术患者围手术期的负性情绪状况,减轻患者疼痛、提高自理能力,有利于麻醉、手术的顺利进行和术后的康复锻炼的实施,同时可以减轻医护人员以及陪护人员的工作量,提高患者住院期间的满意度.

目的 探讨单次及两次静脉滴注氨甲环酸对老年股骨转子间骨折患者围术期隐性失血和凝血功能的影响.方法 老年股骨转子间骨折患者100例根据随机数字表法分为研究组和对照组,两组在术前静脉滴注氨甲环酸;研究组术后7 h再次给药.比较两组手术时间、切口长度、住院时间、失血情况、凝血功能及双下肢深静脉血栓的发生率.结果 两组手术时间、切口长度、住院时间无明显差异(P>0.05),研究组总失血量、隐性出血量及输血率均显著低于对照组(P<0.05);术前、术后3 d,两组凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)水平无明显差异(P>0.05),两组双下肢深静脉血栓发生率无明显差异(P>0.05).结论 术前及术后7 h两次静脉滴注氨甲环酸可更有效减少老年股骨转子间骨折患者隐性失血量,且不会对患者的凝血功能造成明显影响.

目的:探究全膝关节置换术围手术期应用消肿止痛合剂联合氨甲环酸治疗降低出血量的有效性.方法:选取80例全膝关节置换术患者(本院2018年12月-2019年12月收治)为研究对象,随机分为观察组和对照组,各40例.对照组予以消肿止痛合剂治疗,观察组予以消肿止痛合剂联合氨甲环酸治疗,比较两组疗效.结果:观察组围手术期失血量少于于对照组(P＜0.05).观察组在术后48 h和7d静息及活动时VAS评分、膝关节HSS评分明显优于对照组(P＜0.05).结论:全膝关节置换术围手术期出血通过消肿止痛合剂联合氨甲环酸治疗的疗效确切,临床应用价值显著.

目的 探讨脊柱手术患者切口感染病原菌流行特点及相关因子的辅助诊断价值. 方法 选取2016年3月-2018年3月在本院行脊柱外科手术治疗的脊柱损伤患者158例,按术后是否发生感染分为切口感染组(78例)和切口未感染组(80例).同期选择80例体检健康者为健康对照组.采集患者切口处分泌物进行细菌培养并进行药敏试验,同时采集血液标本进行白介素(IL-6、IL-8及IL-18)、碱性磷酸酶(ALP)及肌酸激酶(CK)检测. 结果 78例切口感染患者共分离出184株细菌,其中革兰阴性菌124株(占67.39％),革兰阳性菌54株(占29.35％),真菌6株(占3.26％).分离的革兰阴性菌对亚胺培南100％敏感,对第三代头孢菌素(头孢克肟、头孢他啶、头孢曲松、头孢噻肟)的敏感性为66％～99％;革兰阳性菌对利福平、万古霉素、替考拉宁、呋喃妥因、磺胺甲噁唑/甲氧苄啶等的敏感性在90％左右.检测血白介素、ALP及CK水平,切口感染组患者显著高于切口未感染组和健康组(P＜0.05),切口未感染组患者显著高于健康组(P＜0.05). 结论 脊柱术后切口感染病原菌主要为革兰阴性菌,其对亚胺培南100％敏感.切口感染患者血白介素、ALP及CK水平升高,检测血白介素、ALP及CK水平对脊柱手术切口感染具有辅助诊断价值.

目的 消肿止痛合剂联合氨甲环酸对膝关节置换术患者失血量及纤维蛋白原降解产物(FDP)、D-二聚体(D-D)的影响.方法 选取甘肃省中医院2018年7月至2019年6月收治的60例需行膝关节置换术的膝骨关节炎患者,按照随机数字表法分为观察组和对照组,各30例.对照组给予氨甲环酸治疗,观察组则联合消肿止痛合剂治疗,两组均治疗7 d.比较两组失血及输血情况,术前、术后1 d、3 d、5 d、7 d血红蛋白与红细胞水平,术后1 d、3 d、5 d、7 d血浆FDP、D-D水平以及术后7 d VAS及HSS评分.结果 与对照组相比,观察组的术中出血量、隐性失血量、总失血量及输血比例明显减少(P<0.05);与术前相比,术后1～7 d两组红细胞及血红蛋白水平呈先降低后升高趋势,且术后7 d水平最高,观察组术后1～7 d的红细胞及血红蛋白水平均较高(P<0.05);术后1～7 d两组血清FDP、D-D呈先升后降趋势,术后1 d水平最高,且观察组低于对照组(P<0.05),两组术后3～7d水平无明显差异(P>0.05);与术前1 d相比,术后7 d两组VAS评分均降低,且观察组低于对照组;两组HSS评分均升高,且观察组高于对照组(均P<0.05).结论 消肿止痛合剂联合氨甲环酸可明显减少膝关节置换术患者的术中失血量,改善血红蛋白、红细胞以及凝血和纤溶系统,降低疼痛程度,促进膝关节功能的恢复.

Exogenous bone marrow mesenchymal stem cells (MSCs) can regulate osteogenic differentiation. MicroRNA-21 has been shown to target SMAD7. This study explored the mechanism by which miR-21/SMAD7 inhibits osteogenic differentiation from exosomes secreted by osteoporosis patients-derived MSCs. Exosomes were obtained from MSCs and miR-21 expression was detected. Normal MSCs were treated with exosomes secreted by MSCs from different sources for osteogenic differentiation followed by detection of ALP, Bglap and Runx2 level and ALP activity. Normal MSCs were divided into three groups, which were treated with exosomes from normal adult MSCs, osteoporosis patients-derived MSCs and osteoporosis patients-derived MSCs + SMAD7 overexpression followed by analysis of the mRNA expression of ALP, Bglap and Runx2 by qRT-PCR and ALP activity. miR-21 expression in exosomes from osteoporosis patients-derived MSCs was significantly higher than that from normal adults MSCs. After treatment with exosomes from osteoporosis patients-derived MSCs, Runx2 expression and ALP activity was significantly decreased. SMAD7 expression in osteoporosis patients was significantly lower than that in normal adults. The expression of ALP, Bglap and Runx2 is significantly decreased after overexpression of SMAD7. SMAD7 is a target gene of miR-21 and plays a role in inhibiting osteogenic differentiation induced by exosomes from osteoporosis-derived MSCs.

Purpose: Liquiritin is an extract from Glycyrrhiza Radix, one of the oldest traditional Chinese herbal medicines, which is commonly used to treat various injuries and swellings. This study is aimed to determine whether liquiritin can protect spinal cord injuries (SCIs) from secondary injuries. Methods: A rat SCI model was established. After liquiritin treatment, the neural-function of Rats was determined by Basso, Beattie and Bresnahan (BBB) scores, paw withdrawal threshold (PWT), and thermal withdrawal latency (PWL). The effects of anti-inflammation, anti-oxidation, and anti-apoptosis of liquiritin were also examined in the rats with SCI. Moreover, the activities of several signaling elements, such as, inflammation-associated nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kappa B), toll-like receptor 4 (TLR4), proliferative-related p38 mitogen-activated protein kinases (MAPK) and myeloid differentiation primary response 88 (MyD88) which was involved in the TLR4 signaling, were used for further investigation of the underlying molecular mechanisms. Results: Liquiritin improved locomotor function recovery, alleviated allodynia and hyperalgesia, and decreased water content of spinal cord in SCI rats. Also, liquiritin reduced SCI-induced inflammatory responses by decreasing the levels of tumor necrosis factor alpha (TNF-alpha), interleukin 1 beta (IL-1 beta), and IL-6. Liquiritin inhibited SCI-induced oxidative stress by decreasing malondialdehyde (MDA) level and increasing the levels of uperoxide dismutase (SOD) (p < 0.05), glutathione (GSH) (p < 0.01), and GSH-PX (p < 0.001). In addition, liquiritin alleviated spinal cord injury (SCI) -induced apoptosis of neural cells by decreasing the expression of cleaved caspase-9, -3 and cleaved poly ADP-ribose polymerase (PARP). Finally, liquiritin decreased spinal cord injury (SCI) -induced up-regulation of TLR4/MyD88/NF(Sic)-kappa B and p38 MAPK signaling cascades. Conclusion: Liquiritin exerts protective role in SCI by reducing excessive inflammation, suppressing oxidative stress, and inhibiting neural cell apoptosis in a rat model of SCI. Thus, the agent can potentially be used for the management of SCI

Objective:To observe the curative effect of Bushen Huoxue prescription for vertebral compression fracture of senile osteoporosis in perioperative period. Methods:Divided 90 cases of patients into two groups randomly,45 cases in each group. The control group adopted percutaneous kyphoplasty (PKP) for treatment,while the treatment group was additionally given Bushen Huoxue prescription before and after the operation for one week respectively based on the treatment of the control group. Observed the scores of the visual analogue scale (VAS) of pain and the scores of the Oswestry disability index (ODI) at the first,second and fourth weeks before and after the operation. Results:At the first,second and fourth weeks after the operation,VAS scores in the two groups were decreased when compared with those before treatment (P ＜ 0.05);at the second and fourth weeks after the operation,VAS score in the treatment group was decreased more significantly than that in the control group (P ＜ 0.05). At the first,second and fourth weeks after the operation,ODI scores in the two groups were decreased when compared with those before treatment (P ＜ 0.05);at the second and fourth weeks after the operation,ODI score in the treatment group was decreased more significantly than that in the control group (P ＜ 0.05). Conclusion:Bushen Huoxue prescription can alleviate postoperative pain of patients with vertebral compression fracture of senile osteoporosis after PKP and improve the spine function of patients.

退行性脊柱侧凸(Degenerative Scoliosis,DS)是指骨骼发育成熟之后的成人,主要由于椎间盘不对称性楔形变,相对应的小关节突关节退变及脊柱其他附件退行性变等原因,引起的脊柱失衡并侧凸.常伴有冠状位移位Cobb角＞10°、旋转性半脱位和椎体矢状位滑脱即脊柱的三维旋转畸形.不仅影响形体美观,还带来了以腰背疼痛、神经根性症状及间歇性跛行等为主的诸多临床症状,严重影响患者的生活质量[1].近些年随着社会老龄化的加重,老年人作为DS的高发人群,DS的发病率随年龄增加也明显增加[2].由于人们的生活水平逐渐提高,同时人们对生活质量的要求也在提高,使解决DS的问题成为社会问题[3].

目的:探讨消定膏治疗膝骨关节炎的机制.方法:将膝骨关节炎106例分为2组各53例,治疗组给予消定膏治疗,对照组给予奇正消痛贴膏治疗,疗程2周.采用酶联免疫吸附测定法(ELISA)检测膝关节液标本中白细胞介素-1β (IL-1β)和肿瘤坏死因子-α(TNF-α)的含量.结果:治疗前以及治疗后2组间IL-1β、TNF-α比较,差异无统计学意义(P＞0.05).经治疗,2组关节液IL-1β、TNF-α浓度均下降(P＜0.05).结论:消定膏可能是通过降低关节液中IL-1β、TNF-α的含量来发挥对膝骨关节炎的治疗作用.

目的:探讨中药洗剂对兔膝骨性关节炎(OA)模型组织形态学及关节液中基质金属蛋白酶-3(MMP-3)的影响.方法:将新西兰大白兔40只,雌雄不限,体质量(2.50±0.10) kg,随机分为4组:A组(正常对照组)、B组(模型对照组)、C组(中药洗剂组)、D组(扶他林软膏组),每组10只.适应性喂养7天后,B、C、D组兔膝关节腔内注入木瓜蛋白酶造成OA及滑膜炎病变模型.术中注意不刺激关节软骨及滑膜;A、B组造模成功后每天用热水袋热敷膝关节,早晚各1次,C组造模成功后用中药洗剂热敷膝关节,早晚各1次,D组造模成功后用扶他林软膏涂抹后每天用热水袋热敷膝关节,早晚各1次,以上各组均外敷右膝关节表面,每次均为40分钟,治疗8周后,测关节液中MMP-3的含量.结果:1)中药洗剂、扶他林软膏都能明显改善兔膝关节功能活动;2)模型对照组血清MMP-3含量高于正常对照组(P＜0.05),中药洗剂可降低关节液MMP-3水平;中药洗剂组、扶他林软膏组与模型对照组比较差异有统计学意义(P＜0.05),但中药洗剂组与扶他林软膏组比较差异无统计学意义(P＞0.05).结论:1)中药洗剂外敷与扶他林软膏外擦对兔膝骨性关节炎均有治疗作用;2)中药洗剂可降低关节滑液中MMP-3含量,对骨性关节炎具有治疗作用.

目的:探讨当归注射液对椎板切除术后硬膜外粘连及瘢痕形成兔动物模型的预防作用和干预机制,为临床预防和治疗腰椎手术失败综合症(FBSS)提供理论依据.方法:选取成年健康新西兰大白兔45只分为3组,每组15只,分别为模型组(生理盐水组)、对照组(玻璃酸钠组)、实验组(当归注射液组).于术后2周、4周、6周分3批处死白兔,从组织学观察硬膜外粘连和测定瘢痕中血小板衍化因子(PDGF)含量.结果:第2周,3组比较,各组间比较差异无统计学意义(P＞0.05).第4周,模型组与对照组比较,P＜0.05,模型组与实验组比较,P＜0.05,差异均有统计学意义.而对照组与实验组比较差异无统计学意义(P＞0.05).第6周,模型组与对照组比较,P＜0.05,模型组与实验组比较,P＜0.05,差异均有统计学意义,而对照组与实验组比较差异无统计学意义(P＞0.05).说明当归注射液对预防硬膜外粘连有一定的效果,但与玻璃酸钠相比却无明显优势.结论:当归注射液可以减少FBSS兔局部成纤维细胞计数及PDGF含量的增加.

Objective To investigate the feasibility and efficiency of a technique of "eggshell" technology and percutaneous balloon kyphoplasty in treating senile severe osteoporotic vertebral compression fractures.Methods Data from June 2009 to December 2013 who suffered from senile severe osteoporotic thoracolumbar vertebral compression fractures,using the posterior invasive percutaneous balloon kyphoplasty for 43 patients with 46 vertebral bodies.Under local/general anesthesia in posterior unilateral pedicle vertebral puncture into disease body,first the use of distraction with balloon slowly,then injected low dose(from 0.5 to 1 mL) bone cement into the distraction of vertebral body,inserted balloon again and increased vertebral height,and it become the bone cement "eggshell",pull out ballon,at last injection of bone cement filling into the spreading disease vertebral body.The clinical effects by observing the changes of visual analog scale,locomotive activity scale,height of vertebral bodies and the Cobb' s angle.Results All the patients were successfully treated and no severe complication occurred.Visual analog scale decreased from (7.9 ± 0.8) preoperatively to (3.5 ± 0.8) postoperatively(P ＜ 0.05).Locomotor activity scale improved from (3.5 ± 0.6) preoperatively to (1.3 ± 0.4) postopcratively (P ＜ 0.05).The height of vertebral body increased from (13.5 ± 2.0) mm preoperatively to (31.2 ± 1.5) mm (P ＜ 0.05).The Cobb's angle improved from (31.8 ± 6.9) ° preoperatively to 18.2° ± 5.8° (P ＜ 0.05) postoperatively (P ＜ 0.05).There were statistically significant differences between each other.All patients were followed up for 1 to 5 months,with an average of 3.8 months,in the outpatient service,and haven't found vertebral compression,new and adjacent segment fracture,clinical manifestation were significant improved.Conclusion "Eggshell" technology and posterior percutaneous balloon kyphoplasty is a fast,effective and feasible method for senile severe osteoporotic vertebral compression fractures.

<正>骨质疏松症最常见、最严重的并发症是骨折,不仅影响中老年人的身体健康与生活质量,也是中老年人致残、致死的主要原因之一[1]。骨质疏松性骨折属病理性骨折,常累积的部位是脊柱、髋部、桡骨远端和肱骨近端。其主要特征为轻微创伤即可导致的脆性骨折,且反复、多部位发生。目前,随着我国社会老龄化速度的

目的:探讨“蛋壳”技术应用于手术治疗脊柱结核的临床疗效.方法:对2008年1月~2011年12月间收治的36例运用“蛋壳”技术经后路病灶清除、植骨融合、钉棒系统内固定术[1]的脊柱结核病人回顾性分析.结果:36例脊柱结核患者,手术均顺利完成,钉棒系统位置及稳定性良好,术后0.5~3年随访,术后未出现脊髓神经症状加重.随访中术后1年植骨骨性融合率为70%,术后2年植骨融合率为99%,断钉及内固定失效发生率为0.其中仅1例出现切口延期愈合.结论“:蛋壳”技术应用于后路病灶清除、植骨融合、钉棒系统内固定术治疗脊柱结核中,病灶清除彻底,脊髓减压显著,能较好的纠正后凸畸形,结合钉棒系统,具有更好的稳定性.此术式有利于病灶的清除、愈合和植骨的融合,能更好的促进神经损伤的修复.联合抗结核药物治疗脊柱结核疗效显著,唯有彻底清除病灶加全程、足量抗结核治疗,才能有效减少结核致瘫的机率,提高患者的生活质量.

Objective: To explore the effect of Xiaoding cream on expression of TNF-αin the synovial fluid of osteoarthritis rabbits.Methods:Forty New Zealand white rabbits,body weight(2.50±0.10)kg,were randomly divided into A group(blank group),B group(model group),C group(control group),and D group(treatment group),10 cases in each group.The knee of rabbits in B,C,and D group were injected papain(according to Japanese Yasuhiko Kito) to established stable model of osteoarthritis synovitis 7 days after adaptive feeding.It should be careful not to stimulate the articular cartilage and synovial membrane in surgery.After the model was successfully established,the blank group was not treated,while,the control group treated with Voltaren ointment,the treatment group was administrated with Xiaoding cream,and the model group was given Vaseline.Results:The expression of TNF-αin model group,control group,and treatment group were significantly different to blank group(P0.05).And the expression of TNF-αin control group and treatment group were significantly different to model group(P0.05).There was no significant difference between control group and treatment group(P0.05).It suggested that Xiaoding cream and Voltaren ointment can reduce the content of TNF-αin synovial fluid of osteoarthritis rabbits.Conclusion: 1.Xiaoding cream and Voltaren ointment both have obviously therapeutic effect on osteoarthritis rabbits.2.Traditional Chinese medicine,Xiaoding cream,can reduce content of TNF-αin synovial fluid of osteoarthritis rabbits,and relieved degeneration of knee cartilage,so to play a role in the prevention and control of osteoarthritis.