膜关节

Material and MethodsRA Rabbit Model group: 15 early RA rabbits of the same weight and variety Control group:10 normal rabbits of the same weight and varietyMethods of making RA rabbit model:elect 15 normal rabbits of the same weight and variety, dissolve Ovalbumin in 0.9% sodium chloride solution, to make the solution of 20mg/ml concengtration, blend the same quantity of complete Freund′s Adjuvant equably ,inject the mixed solution into endermic tissue of the rabbit′s scapular section, making the rabbits allergic, inject 1 ml of the mixed solution to one rabbit every time, inject 1 ml of the mixed solution in 5 different places of the rabbit′s scapular section, inject the rabbit one time every week,inject 3 weeks continuously,it turned out to be that the rabbits will be allergic, inject Ovalbumin blent with the 0.9% sodium chloride solution into the knee joint cavity of the rabbits in the fourth week, 5 mg Ovalbumin every knee joint cavity,two knees of every rabbit of the 15 rabbits are both injected,the arthrosis diameter and the exterior temperature of the knees will be added obviously in 24 hours,and they will drop gradually,at the time of the 14th or 21th day, the arthrosis diameter and the exterior temperature of the knees will get to the balance time,the incidence rate of RA is 100%.after the RA model succeeds,it is the early time of RA from the first week to the fourth week,after the fourth week,it is the late time of RA, the cartilage of the femoral condyle and the subchondral bone cortices will be changed unrecoverily.

资料与方法RA模型组：早期RA家兔模型15只，品种及体重接近。对照组：正常家兔10只，品种及体重接近。RA家兔模型制作方法：选取15只成年家兔，体重、品种接近，将卵蛋白溶解于生理盐水，配成浓度为20mg/ml的溶液，与等量完全弗氏佐剂混匀，注入家兔肩胛区皮下致敏，每只家兔每次注射1ml，于肩胛区5个不同区域注射，每周一次，连续注射3周而致敏，第4周向膝关节腔注射卵蛋白生理盐水溶液，每只关节腔注射5mg卵蛋白，15只家兔膝关节全部注射，24h内此关节直径和表面温度大幅度上升，以后缓慢下降，至14～21d达到平台期，发病率达100%。造模成功后第1～4周为早期改变，第4周以后出现不可逆的关节软骨及骨破坏。采用高频超声对RA模型组与对照组的膝关节髌上囊液体厚度、滑膜及股骨髁软骨厚度及软骨下骨皮质的回声情况进行对比观察。结果RA组模型组膝关节髌上囊积液及滑膜的厚度明显厚于对照组，其股骨髁软骨的厚度与对照组相比无明显差异，其软骨下骨皮质与对照组相比无明显改变。

The right and left TMJ were removed from the animals, and all the specimens were observed. 3 days later, we could find that all TMJ components showed signs of injury. The synovial membrane was torn up and the cartilage of the condylar process and glenoid fossa was destructed.

伤后3天可出现关节滑膜撕裂、颞骨和髁突骨质破坏、关节腔内积血，关节盘以及关节附着的断裂等改变；7天后，关节积血少见。2周后可见关节内明显的破坏性改变，关节腔内还可有渗出液存在。

Objective: 1）Observe the feasibility of the model of egg protein induced leporid rheumatoid arthritis. 2）By pathology observation of pathological synovium, find out the transformation of AIA leporid arthral synovium after urea injection and the infection to local and general disease. 3）Find out if urea has obvious side-effect to arthral cartilage. 4）Mensurate the VEGF expression of synovium, investigate the effect of VEGF on rheumatoid arthritis and the effect of urea on VEGF expression.

研究目的：（1）观察鸡卵蛋白诱导性兔类风湿性关节炎模型实验方法的可行性；（2）通过病变滑膜组织病理学观察，了解注射尿素后AIA兔关节滑膜病理形态的变化；以及对局部及全身病情的影响；（3）观察尿素对关节软骨是否有明显毒副作用；（4）测定滑膜VEGF表达，初步探讨VEGF在RA病变发展中的作用及注射尿素对VEGF表达的影响。

Current application for hip arthroscopy include management of labral tears, osteoplasty for femoroacetabular impingement, thermal capsulorrhaphy and capsular plication for subtle rotational instability and capsular laxity, lateral impact injury and chondral lesions, osteochondritis dissecans, ligamentum teres injuries, internal and external snapping hip, removal of loose bodies, synovial biopsy, subtotal synovectomy, synovial chondromatosis, infection, and certain cases of mild to moderate osteoarthritis with associated mechanical symptoms.

目前髋关节镜主要应用于盂唇撕裂的处理、股骨髋臼的撞击症的骨成形、隐匿性髋关节旋转不稳的热关节囊紧缩或关节囊皱折术，治疗软骨损伤、剥脱性骨软骨炎、圆韧带损伤、内源性或外源性弹响髋，清除游离体、滑膜活检、滑膜次全切、滑膜软骨瘤病、感染和某些伴有机械症状的轻度至中度骨性关节炎。

The pathological findings showed that ZBT could alliviate the synovial tissues inflammatory congestion, edema, remit the inflammatory cell infiltration and inhibit the proliferation of synovial cells, therefore reduce the degree of destruction of the articular cartilage and subcartilaginous bone tissue. Inhibited the disablement of the woulded limbs.

结果：止痹痛药酒能轻模型鼠关节肿胀度，对免疫注射后继发病变具有良好的治疗作用，说明该药具有抗炎免疫作用，病理学观察证实该药能减轻关节滑膜的充血水肿和炎细胞浸润、抑制滑膜细胞增生，减轻关节软骨和软骨下骨组织的破坏程度，抑制模型鼠患肢的致残。

Infections of 3 cases were controled after treatment with the wound dressing and compression bandaging after local inflammation organic resection, oral Xinhuang Tablets of proprietary Chinese medicines and antibiotics; 9 cases were treated with arthroscopic joint clean-up washing , 2 case of them were treated with incision debridement combined by synovectomy arthroscopic due to inability to complete debridement ; 3 case of them were treated with temporary prosthesis replacement surgery on the infection after total knee debridement due to recurring knee swelling and rupture , filling bone cement containing sensitive antibiotics, convection to wash on the articular cavity, and second phase renovation in stable condition, finally they recoveried postoperatively and discharged.

结果：对22例出现炎症性反应的TKA术后患者，经抗感染、关节腔对流冲洗、清创和Ⅱ期再置换并配合口服中成药新癀片等处理。10例轻微肿痛病人经单纯药物治疗，症状改善。12例患者应用外科干预， 3例行局部炎症组织切除后伤口换药并加压包扎，口服中成药新癀片及抗生素治疗后控制感染；9例在关节镜下行关节清理冲洗，其中2例在行关节镜下手术时因无法彻底清创行切开清创合并滑膜切除； 3例因反复出现膝关节红肿、疼痛、甚至破溃予全膝置换术后感染清创临时假体置换术，用含敏感抗生素骨水泥填充，对关节腔进行对流冲洗，待关节情况稳定后行Ⅱ期翻修，术后痊愈出院。

Arthroscopic examination is useful in diagnosing the anterior disc displacement and perforation of temporomandibular joint and in finding the pathologic changes including synovitis,synovial hyperplasia,fibrillation, chondromalacia and adhision.

关节内窥镜检查可诊断关节盘前移位与关节盘穿孔，并能发现病理性改变，如滑膜炎，滑膜增生，纤维变性，软骨软化，关节内粘连等。

Fascia lata grafts and periarticular soft tissues were used extensiely in the United States and Europe. Sir Robert Jones used gold foil as an interpositional layer in 1912. Results remained unpredictable, with residual pain and stiffness being the primary causes of failure. In 1923, Smith-Petersen introduced the concept of "mould arthroplasty" as an alternatie to the interpositional membrane.

当时在美国和欧洲，阔筋膜瓣移植物和关节周围软组织被广泛使用。1912年Robert Jones 爵士曾采用金箔作为间置物，其结果很不稳定，遗留疼痛和关节僵硬是其失败的主要原因。1923年，Smith-Petersen引入&铸模关节成形术&的概念，替代了在关节面间放置衬膜的方法。

Estrogen deficiency can increase the mRNA expression of MMP-1、MMP-3 and IL-1β in OA synovia tissue. Estrogen could inhibit the mRNA expression of MMP-1、 MMP-3 and IL-1β in OA synovia tissue. Progestin could even decrease this expression. Estrogen could slightly increase the mRNA expression of TIMP-1. It is suggested that low dose of estrogen supplement play a protective effect on OA cartilage, and progestin could increase this protective effect.

雌激素缺乏可使OA关节滑膜中MMP-1、MMP-3和IL-1β mRNA表达增加，雌激素对关节滑膜组织中MMP-1、MMP-3和IL-1β mRNA表达有抑制作用，孕激素可增强雌激素的这一抑制作用，雌激素对TIMP-1有轻度升高作用，提示低剂量雌激素对OA关节软骨有一定保护作用，而加用孕激素这一保护作用增强。

Cases with linear or reticular enhancement, 4 cases with multiple bony erosions, while one patient with invasion of extra-articular structures. Conclusion: The feathers of nodular synovial proliferation, articular cartilage erosion, involement of subchondral bone, intra-and extra-articular invasion can all be detected presicely by MRI. MRI is the most valuable method for diagnosing PVNS.

MRI能准确反映PVNS中滑膜的绒毛结节状增生、增生滑膜及其对关节软骨的破坏以及增生滑膜对软骨下骨质及软骨下远部骨质侵蚀的不同时期绒毛结节的影像学特征，并可以准确评价病变对关节内外累及的范围，是诊断PVNS最佳检查方法。

On the other hand, the more important thing is because the urban housing is a kind of heterogeneity products.

另一方面，更重要的是由于城市住房是一种异质性产品。

Climate histogram is the fall that collects place measure calm value, cent serves as cross axle for a few equal interval, the area that the frequency that the value appears according to place is accumulated and becomes will be determined inside each interval, discharge the graph that rise with post, also be called histogram.

气候直方图是将所收集的降水量测定值，分为几个相等的区间作为横轴，并将各区间内所测定值依所出现的次数累积而成的面积，用柱子排起来的图形，也叫做柱状图。