老年人膝关节X线平片测量研究

选择90例老年人和120例中青年的正常膝关节X线平片进行了测量对照。测量结果表明:两侧膝关节内侧间隙宽度,两侧胫骨髁间隆突内外侧高度老年组与中青年组比较有显著性差异(P<0.01或P<0.05)。两膝关节间隙外侧宽度,两侧胫骨近端横径两组之间无显著性差异(P>0.05)。文中还对差异的原因及意义作了简要的讨论。

Influencing factors analysis of spontaneous knee joint osteoarthritis among middle aged and old aged pople in Xi'an

Objective:To explore the prevalence rate of knee joint osteoarthritis and its pathogenetic fea- tures among the middle-aged and old aged people in the urban and rural area of Xi'an.Methods:From May to October 2005,1538 Han nationality above 40 years in Xi'an were investigated according to strati- fied and cluster random sampling.The same questionnaire was delivered to subjects who had been given normotopia and lateral position radiographic examination in both knees.Excluded from etiological arthri- tis,some subjects with clinical symptoms and a radiographic grade (beyond Kellgren & Lawrence gradeⅡ) were finally diagnosed as spontaneous knee joint osteoarthritis.All analyses were performed with SPSS 13.0 and t test,U test.Single factor analysis and multiple logistic regression analysis were used to analyze dates.Results:The total prevalence of spontaneous knee joint osteoarthritis was 12.1% with 2.5% and 2.1% for right and left knees,respectively.The prevalence of knee joint osteoarthritis in wom- en was 2.5 times of that in men (17.2% vs 6.8%,P=0.000).the osteophyte prevalence in women was 2.3 times of that in men (26.5% vs 11.4%,P=0.000).The prevalence of knee joint osteoarthritis and osteophyte increased with the growth of age.So did the symptomatic knee,except for the age group of 56- 60 years and 66-70 years.The prevalence of symptomatic knee joint for urban area was significantly higher than that for rural area (56.3% vs 45.3%,P=0.003).In women,the prevalence of knee joint os- teoarthritis increased significantly with the increasing of body mass index,which had not been observed in men.Female and obesity are the risk factors for osteoarthritis,but bean and its products and meat could prevent the osteoarthritis.Conclusion:Old age,female and obesity serve as risk factors for knee joint os- teoarthritis.

ARTHRALGIA TREATED BY ACUPUNCTURE WITHIN "CHIFU" AREA

Chifu refers to the skin covering the areafrom the wrist joint to the elbow joint, about 1chi (1/3 meter) in length in adults.Acupuncture with filiform needle at certainpoints within Chifu area exhibits quitesatisfactory therapeutic results for treatment ofsprain and contusion of the four extremities.The following are some examples.

The effect of electroacupuncture preconditioning on cognitive impairments following knee replacement among elderly:A randomized controlled trial

Objective: To investigate if electroacupuncture(EA) preconditioning can mitigate cognitive impairments and reduce the incidence of postoperative cognitive dysfunction(POCD) following knee replacement and its safety among elderly.Methods: Totally 60 participants met the inclusion criteria were enrolled in a randomized controlled trial a ratio of 1:1, with 30 cases allocated to the treatment group and 30 cases allocated to the control group, respectively. The participants in the treatment group were provided with real-EA therapy whereas participants in control group were provided with placebo-EA therapy(Streitberger Placebo-needle). In both groups, Tou sanshen(头三神)acupoints, including Sìshéncōng(四神聪EX-HN1), Sh6 ntíng(神庭 GV24),and bilateral Běnsh6 n(本神GB13) were adopted as the main acupoints, while Bǎihui(百会GV20), bilateral Hégǔ(合谷Ll4), and bilateral Tàich6 ng(太冲LR3) were adopted as matching acupoints. Interventions were offered 5 days prior to the surgery, once daily, and continued for total 5 days. The global scores of MiniMental State Examination(MMSE), and levels of serum inflammatory cytokines including interleukin 1β(IL-1β) and tumor necrosis factor-α(TNF-α), and S100-β protein were observed at 24 h prior to the surgery, and postoperative 24 and 72 h respectively for assessing the incidence of POCD and the severity of cognitive impairments among patients. Meanwhile, adverse effects were monitored and recorded.Results:(1) Compared with baseline, MMSE global scores in both treatment and control groups markedly decreased at postoperative 24 h. MMSE global scores in treatment group decreased from 29.43 ±0.97 to27.10 ±1.95 while that in control group decreased from 29.27 ± 1.01 to 26.83 ± 2.25(all ?P< 0.05), and this trend continued until postoperative 72 h(at postoperative 72 h, MMSE global scores in treatment group was 26.53 ±2.26 versus 24.79 ±3.03 in control group). Moreover, decline in control group was more significant than that in treatment group at postoperative 72 h(P<0.05).(2) Compared with baseline, levels of serum IL-1β, TNF-α and S100-β in both groups increased markedly at postoperative 24 and 72 h. IL-1β in treatment group increased from 43.13 ±5.51 to 73.13 ±2.32 at postoperative 24 h and reached 83.17 士 5.95 at postoperative 72 h, while IL-1β in control group increased from 44.87 土 5.83 to91.10 ±3.55 at postoperative 24 h and reached 111.93 ±9.18 at postoperative 72 h;TNF-α in treatment group increased from 51.27 士 6.48 to 88.80 ± 3.55 at postoperative 24 h and reached 94.37 ± 5.22 at postoperative 72 h, while TNF-α in control group increased from 52.07 ±7.48 to 116.37 ±3.14 at postoperative24 h and reached 121.40 ±3.68 at postoperative 72 h(both ?P< 0.05), furthermore, increases of IL-1β and TNF-α levels in control group were more significant(P<0.05). Statistical difference in level of S100-β was not observed(P>0.05).(3) There was no statistical difference in POCD incidence at postoperative 24 h and postoperative 72 h between two groups(P> 0.05), though the incidence of POCD in patients receiving real-EA therapy was indeed much lower than that in patients receiving placebo-EA therapy, particularly at postoperative 72 h(POCD incidence rate at postoperative 24 h in treatment group was 26.67%, 30.00%in control group;POCD incidence rate at postoperative 72 h in treatment group was 30.00%, 46.67% in control group).(4) No serious adverse events were reported in this trial. No one dropped out from this trial.Conclusion: EA preconditioning can mitigate cognitive impairments at post-knee replacement surgery 24 and 72 h in elderly through inhibiting expression of inflammation. However, there is insufficient evidence to support that EA pretreatment can reduce the incidence of POCD.