Synergistic chemotherapy/PTT/oxygen enrichment by multifunctional liposomal polydopamine nanoparticles for rheumatoid arthritis treatment

Amultifunctional liposomal polydopamine nanoparticle(MPM@Lipo)was designed in this study,to combine chemotherapy,photothermal therapy(PTT)and oxygen enrichment to clear hyperproliferating inflammatory cells and improve the hypoxic microenvironment for rheumatoid arthritis(RA)treatment.MPM@Lipo significantly scavenged intracellular reactive oxygen species and relieved joint hypoxia,thus contributing to the repolarization of M1 macrophages into M2 phenotype.Furthermore,MPM@Lipo could accumulate at inflammatory joints,inhibit the production of inflammatory factors,and protect cartilage in vivo,effectively alleviating RA progression in a rat adjuvant-induced arthritis model.Moreover,upon laser irradiation,MPM@Lipo can elevate the temperature to not only significantly obliterate excessively proliferating inflammatory cells but also accelerate the production of methotrexate and oxygen,resulting in excellent RA treatment effects.Overall,the use of synergistic chemotherapy/PTT/oxygen enrichment therapy to treat RA is a powerful potential strategy.

Application of Wax Therapy in Pain Care of Patients with Rheumatoid Arthritis

Objective: To investigate the effect of wax therapy in pain care of patients with rheumatoid arthritis. Methods: Convenience sampling method was used to select inpatients with rheumatoid arthritis admitted to the rheumatology and immunology department of a 3A hospital in Jingzhou City. 75 patients from January 2021 to June 2021 were selected as the control group, and 75 patients from January 2022 to June 2022 were selected as the observation group. The control group was given routine nursing, and the observation group was implemented wax therapy nursing on the basis of the control group. The relief of clinical symptoms (morning stiffness time, pain score) and quality of life score of the two groups were observed. Results: After intervention, there was statistical significance between the two groups (P Conclusion: Wax therapy can improve the time of morning stiffness, the degree of pain and the quality of life of patients with rheumatoid arthritis.

Difficult-to-treat rheumatoid arthritis treated with Abatacept combined with Baricitinib:A case report

BACKGROUND Sporadic cases of rheumatoid arthritis(RA)due to unsatisfactory responses to Abatacept(ABT)have been reported;however,the rescue therapy has not been finalized.Here,we present a case with difficult-to-treat RA(D2T RA)that was resistant to either a single ABT or a Janus kinase(JAK)inhibitor(Tofacitinib),but improved with a combination of ABT and JAK inhibitor(Baricitinib,BAT).CASE SUMMARY A 46-year-old Chinese woman who had RA for ten years that was resistant to Tocilizumab,Etanercept,Adalimumab,and ABT.According to the European League Against Rheumatism definition,the patient was diagnosed with D2T RA.It was then improved with a combination of ABT and a JAK inhibitor BAT.CONCLUSION ABT combined with BAT may be an acceptable strategy for treating D2T RA.

Traditional Chinese Medicine as a Treatment for Rheumatoid Arthritis:From Empirical Practice to Evidence-Based Therapy

Rheumatoid arthritis(RA)is a common autoimmune condition with an elusive etiology.Conventional and biological disease-modifying drugs sometimes fail or produce only partial responses.Traditional Chinese medicine(TCM)has long been used in China as a treatment for RA and is achieving everincreasing acceptance worldwide.TCM treatments are traditionally guided by the theory of treatment based on TCM syndrome differentiation;however,they remain a matter of empirical practice relying on TCM theories and doctors’own experience,which places severe restrictions on worldwide TCM application.Nevertheless,TCM is a treasure trove for drug discovery,particularly as a treatment for complicated human conditions.The discoveries of artemisinin as a treatment for malaria and of TCM–arsenic trioxide(As2O3)combination therapy as a treatment for acute promyelocytic leukemia(APL)are excellent examples of the great value of TCM.Regarding RA treatments,many Chinese medicinal herbs and their formulas,extracts,ingredients,and even single compounds have been used in clinical applications.Several Chinese proprietary medicines(CPMs)derived from TCM formulas or herbal bioactive components,such as the controlled-release ZhengQingFengTongNing(ZQFTN)Tablets,Tripterygium Glycoside Tablets,and Total Glucosides of Peony(TGP)Capsules,have been included in the National Health Insurance Directory of China,and show comparable therapeutic efficacies to those of western chemical drugs with fewer side effects.As TCM research has advanced,particularly in the use of multidisciplinary technologies,the scientific foundations and characteristics of the use of TCM to treat RA have been revealed,and the quality of TCM treatments have been increasingly enhanced.However,TCM generally lacks sufficient clinical and laboratory data to be consistent with international standards for quality,safety,and efficacy in order to support its application worldwide.Therefore,intensive basic and clinical studies on TCM are required.In particular,investigations that use cutting-edge technologies in analytical chemistry,biology,and biomedical sciences,and the development of randomized clinical trials(RCTs)and personalized pragmatic randomized controlled trials(PPRCTs)are necessary.Researchers should also collaborate to advance TCM from empirical practice to evidence-based therapy,thus consistently promoting TCM development and globalization in a vital,beneficial,and contributable manner.

Anti-and non-tumor necrosis factor-α-targeted therapies effects on insulin resistance in rheumatoid arthritis,psoriatic arthritis and ankylosing spondylitis

In addition toβ-cell failure with inadequate insulin secretion,the crucial mechanism leading to establishment of diabetes mellitus(DM)is the resistance of target cells to insulin,i.e.insulin resistance(IR),indicating a requirement of beyond-normal insulin concentrations to maintain euglycemic status and an ineffective strength of transduction signaling from the receptor,downstream to the substrates of insulin action.IR is a common feature of most metabolic disorders,particularly type II DM as well as some cases of type I DM.A variety of human inammatory disorders with increased levels of proinflammatory cytokines,including tumor necrosis factor(TNF)-α,interleukin(IL)-6 and IL-1β,have been reported to be associated with an increased risk of IR.Autoimmunemediated arthritis conditions,including rheumatoid arthritis(RA),psoriatic arthritis(PsA)and ankylosing spondylitis(AS),with the involvement of proinflammatory cytokines as their central pathogenesis,have been demonstrated to be associated with IR,especially during the active disease state.There is an increasing trend towards using biologic agents and small molecule-targeted drugs to treat such disorders.In this review,we focus on the effects of anti-TNF-α-and non-TNF-α-targeted therapies on IR in patients with RA,PsA and AS.Anti-TNF-αtherapy,IL-1 blockade,IL-6 antagonist,Janus kinase inhibitor and phosphodiesterase type 4 blocker can reduce IR and improve diabetic hyper-glycemia in autoimmune-mediated arthritis.

Effect of Stereoscopic Comprehensive Therapy of Zhuang Medicine on Inflammatory Factor IL-6 in Patients with Rheumatoid Arthritis

Objective:To study the effect of Stereoscopic Comprehensive of Therapy Zhuang Medicine on IL-6 in serum of patients with rheumatoid arthritis.Methods:Sixty rheumatoid arthritis patients who met the inclusion criteria were selected and randomly divided into a control group and a treatment group using a random number table.Among them,30 cases in the control group were treated with Western medicine,and 30 cases in the treatment group were treated with Western medical and Stereoscopic Comprehensive Therapy of Zhuang Medicine.The observation period was 8 weeks.Results:After 8 weeks of treatment,the level of IL-6 in the treatment group and the control group decreased,and the treatment group was better than the control group(P<0.05).Conclusion:The Stereoscopic Comprehensive of Zhuang Medicine can reduce the level of IL-6 in the serum of patients with rheumatoid arthritis,and has a good regulating effect on the inflammation of rheumatoid arthritis.

Interleukins and interleukin receptors in rheumatoid arthritis: Research, diagnostics and clinical implications

Rheumatoid arthritis(RA) is an autoimmune disease, resulting in a chronic, systemic inflammatory disorder. It may affect many tissues and organs, but it primarily affects the flexible joints. In clinical practice patient care generates many questions about diagnosis, prognosis, and treatment. It is challenging for health care specialists to keep up to date with the medical literature. This review summarizes the pathogenesis, the polymorphisms of interleukin and interleukin genes and the standard available and possible future immunologictargets for RA treatment. The identification of diseaseassociated interleukin and interleukin receptor genes can provide precious insight into the genetic variations prior to disease onset in order to identify the pathways important for RA pathogenesis. The knowledge of the complex genetic background may prove useful for developing novel therapies and making personalized medicine based on the individual's genetics.

Targeting the resolution pathway of inflammation using Ac2–26 peptide-loaded PEGylated lipid nanoparticles for the remission of rheumatoid arthritis

Rheumatoid arthritis(RA)is a common autoimmune disease characterized by joint inflammation and immune dysfunction.Although various therapeutic approaches have been utilized for the treatment of RA in clinical applications,the low responsiveness of RA patients and undesired systemic toxicity are still unresolved problems.Targeting the resolution pathway of inflammation with pro-resolving mediators would evoke the protective actions of patient for combating the inflammation.Ac2–26,a 25-amino acid peptide derived from Annexin A(a pro-resolving mediator),has shown good efficacy in the treatment of inflammatory disorders.However,the low bioavailability of Ac2–26 peptides hinders their efficacy in vivo.In this paper,we formed PEGylated lipid nanoparticles(LDNPs)by the co-assembly of l-ascorbyl palmitate(L-AP)and N-(carbonyl methoxypolyethylene glycol-2000)-1,2-distearoyl-sn–glycero-3-phosphoethanolamine(DSPE-PEG 2 k)to encapsulate and deliver Ac2–26 peptides to the arthritic rats.They showed good stability and biocompatibility.After being intravenously administrated,Ac2–26 peptide-loaded PEGylated lipid nanoparticles(ADNPs)showed the prolonged in vivo circulation time and enhanced accumulation in inflamed sites.In vivo therapeutic evaluations revealed that ADNPs could attenuate synovial inflammation and improve joint pathology.Therefore,the pro-resolving therapeutic strategy using ADNPs is effective in RA treatment.

THERAPEUTIC EFFECT OF NEEDLE WARMING THROUGH MOXIBUSTION AT TWELVE SHU POINTS ON RHEUMATOID ARTHRITIS

Rheumatoid arthritis is a chronic andgeneral immunologic disease,mainlyinvolving the joints.Clinically,it is manifestedby morning ankylosis,arthroncus,jointdeformity and dysfunction.It falls into thecategory of arthralgia syndrome in traditionalChinese medicine(TCM).The authors havetreated 55 cases of rheumatoid arthritis byneedle warming through moxibustion

A Clinical Study of Suogudan Granule (索骨丹颗粒) in the Treat ment of Rheumatoid Arthritis

Objective： To study the clinical efficacy of Suogudan Granule （SGDG, 索骨丹颗粒） in the treatment of rheumatoid arthritis （RA）. Methods： Ninety patients with RA were randomly divided into the treated group and the control group. The treated group was administered orally with SGDG 6 g each time, thrice a day, while the control group with the combined therapy of Fenbid Oapsules 0.3 g each time, twice a day and Tripterygium tablet 20 mg each time, thrice a day. The treatment course for both groups was 6 weeks. The changes of clinical symptoms and signs, and laboratory indices such as erythrocyte sedimentation rate （ESR）, rheumatoid factor （RF）, antistreptolysin O （ASO）, routine examination of blood and urine, liver and kidney function, etc. before and after treatment were observed. Results： （1） The total effective rate in the treated group （88.0 %） was obviously higher than that in the control group （67.5 %） with significant difference （P〈0.05）. （2） The improvement in arthralgia, joint swelling, time of morning stiffness, 15-meter walking, analgesia initiation and persistence in the treated group was better than that in the control group （P〈0.05, P〈0.01）, but there was no obvious difference in improvement of joint tenderness, range of joint motion, grip strength, and initiating detumescence time （P〉0.05）. （3） The improvement in ESR and RF in the treated group was better than that in the control group with significant difference （P〈0.05）. The negative-conversion rate of ASO in the treated group was also higher than that in the control group （P〈0.01）. （4） No evident abnormality in blood, urine, liver or kidney function was found in either group. Conclusion： SGDG is effective and safe for the treatment of RA.

Comparative Clinical Trial of Antibodies to Interferon-Gamma (IFN-γ) and Tumor Necrosis Factor-Alpha (TNF-α) in the Treatment of Rheumatoid Arthritis

In 1974, in Nature, one of us has proposed a radically new idea that led to the development of anticytokine therapy which is now used around the world for the treatment of autoimmune diseases. We were the first to use antibodies to IFN-γ and were some of the first to suggest using antagonists of TNF-α in the treatment of autoimmune and inflammatory diseases as well. Our method suppresses one of the main pathogenetic mechanisms of these diseases. Antibodies to IFN-γ and TNF-α exhibit dramatic effects on clinical manifestations of rheumatoid arthritis (RA). However, in our trial ultrasound assessment of the synovial membrane thickness in RA patients showed that only anti-IFN-γ exerted pronounced anti-inflammatory effect. Some patients who underwent treatment with antibodies to TNF-α developed a number of complications. Anticytokine therapy (mono- and poly-) alone or in combination with other drugs can possibly be used not only in the treatment of autoimmune diseases, but also in other pathologies with cytokine synthesis disturbances (a number of neurological, psychiatric, endocrine, and other diseases).

The Influence of Health Qigong on the Subjectively Expressed Psychophysical State of Patients with Rheumatoid Arthritis,Rheum,Osteoporosis,Osteopenia

This study assesses the impact of exercise on the health of the Qigong(Jibengong,Health Qigong Ba Duan Jin and Health Qigong Yi Jin Jing)in patients with rheumatoid arthritis,rheumatism,osteoporosis,osteopenia.Through the given questionnaire we have come up with data showing how and how much health qigong affects the patients with rheumatoid arthritis,rheumatism,osteoporosis,osteopenia according to the subjective assessment.

Remission is not maintained over 2 years with hematopoietic stem cell transplantation for rheumatoid arthritis:A systematic review with meta-analysis

BACKGROUND Hematopoietic stem cell(HSC)transplantation(HSCT)is being accepted as a standard of care in various inflammatory diseases.The treatment of rheumatoid arthritis(RA)has been closely evolving with the understanding of disease pathogenesis.With the rising resistance to the traditional disease-modifying antirheumatic drugs and targeted biological therapy,researchers are in pursuit of other methods for disease management.Since the ultimate goal of the ideal treatment of RA is to restore immune tolerance,HSCT attracts much attention considering its reparative,paracrine,and anti-inflammatory effects.However,a systematic review of studies on HSCT in RA is lacking.AIM To investigate the role of HSCT in the management of RA.METHODS A detailed search of PubMed,Scopus,EMBASE,Cochrane,and the Web of Science databases was made to identify the relevant articles till September 2020 following Cochrane and PRISMA guidelines.We extracted data including the number of patients,source of hematopoietic stem cells,their mobilization and conditioning regimens,results,and complications from the eligible studies.Results were dichotomized into success(ACR 50/70)and failure(ACR 20)based on the improvement from baseline characteristics.The methodological quality of the included studies was also assessed.Analysis was performed using OpenMeta[Analysis]software.RESULTS We included 17 studies(1 randomized controlled trial,11 prospective,and 5 retrospective studies)with 233 patients for analysis.HSCT provided a significantly beneficial overall improvement in the clinical grades of ACR criteria(Z=11.309,P<0.001).However,the remission was noted only till 24 mo and later on the significance of the result was lost(Z=1.737,P=0.082).A less than 1%treatmentrelated mortality was noted from the included studies.No major drug-related toxicities were noted in any of the included studies.All patients who underwent allogeneic HSCT received immunosuppression in the conditioning regimen to counteract the graft-vs-host reaction which made them vulnerable to infections.It is noted that the source of hematopoietic stem cells did not play a role in altering the functional outcome and both autologous(Z=9.972,P<0.001)and allogenic(Z=6.978,P<0.001)sources produced significant improvement in the outcome compared to the pre-operative state despite having a significant heterogeneity among the studies reporting them(I2=99.4,P<0.001).CONCLUSION Although the available literature is encouraging towards the use of HSCT in refractory cases with significant improvement from baseline till 2 years,the inclusion of HSCT into the standard of care of RA needs further exploration.

电针辅助治疗类风湿关节炎的疗效观察及对血清类风湿因子和炎症因子的影响

目的观察电针足三里和关元穴辅助治疗类风湿关节炎(rheumatoid arthritis,RA)的临床疗效及对患者关节功能、关节压痛指数、红细胞沉降率、类风湿因子和炎症因子的影响。方法将112例RA患者用随机数字表法分为对照组和观察组,每组56例。对照组采用常规西医治疗,观察组在对照组治疗基础上予电针足三里和关元穴治疗。比较两组临床疗效和不良反应发生情况,观察两组治疗前后关节功能、关节肿胀指数、关节压痛指数、RA患者病情评价(disease activity score 28,DAS28)评分以及红细胞沉降率、类风湿因子、炎症因子[C-反应蛋白(C-reactive protein,CRP)、白介素-1β(interleukin-1β,IL-1β)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]水平的变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,两组关节功能(关节僵硬、疼痛和日常活动)评分、DAS28评分、关节肿胀指数和关节压痛指数以及红细胞沉降率、类风湿因子、CRP、TNF-α和IL-1β水平均低于治疗前(P<0.05),且观察组上述观察指标均低于对照组(P<0.05)。对照组1例出现咽部梗阻感,疑为甲氨蝶呤所致;有2例出现消化道不适症状。观察组2例出现针刺后皮下血肿,1例出现消化道不适症状。结论在常规西医治疗基础上,电针足三里和关元穴辅助治疗RA可提高临床疗效,有助于改善患者关节功能和关节压痛,降低红细胞沉降率、类风湿因子和炎症因子水平。

红外光疼痛治疗仪结合甲氨蝶呤治疗类风湿关节炎患者疼痛、焦虑抑郁的对照研究

目的 对于红外光疼痛治疗仪联合甲氨蝶呤对类风湿关节炎患者的治疗效果和安全性进行评估,同时观察其对患者焦虑、抑郁状况的改善能力。方法 选取76名存在焦虑或抑郁病症的类风湿性关节炎患者,随机分为对照组和治疗组,各38名。两组均进行常规药物治疗,治疗组的患者另加红外光疼痛治疗仪的附加治疗,疗程为10d。采用ACR50、多项临床观察指标、焦虑自评量表(SAS)、抑郁自评量表(SDS)对干预前后进行比较。结果治疗10d后,治疗组ACR50有效率高于对照组,但差异无显著性(P>0.05)。治疗组自我VAS评定、医生评定评分均降低,晨僵情况改善,疼痛关节及肿胀关节缓解数目优于对照组,差异有统计学意义(P<0.05)。治疗组SAS、SDS评分改善程度优于对照组,差异有统计学意义(P<0.05)。结论 使用红外光疼痛治疗仪对改善类风湿关节炎症状、控制疾病活动度有积极效果,同时也能减少患者焦虑、抑郁等不良情绪。

广义估计方程评估调督通脉针灸法治疗不同年龄临床前类风湿关节炎的效果

背景:针灸在类风湿关节炎中的治疗效果尚存在争议。因此,该研究旨在通过广义估计方程评估调督通脉针灸法治疗不同年龄临床前类风湿关节炎患者的效果,为针灸在类风湿关节炎中的应用提供依据。目的:基于广义估计方程探讨调督通脉针灸法对不同年龄临床前类风湿关节炎患者的影响。方法:选取2023年1-9月收治的123例临床前类风湿关节炎患者为研究对象,根据治疗方法不同分为研究组(n=64)和对照组(n=59),研究组给予调督通脉针灸治疗,对照组给予乙酰氨基酚片治疗。采用倾向性评分匹配法调整基线均衡性,比较两组患者临床疗效和治疗前后细胞因子水平,建立广义估计方程模型评估调督通脉针灸法治疗不同年龄临床前类风湿关节炎患者的效果。结果与结论:(1)治疗0 d,研究组和对照组在关节疼痛、C-反应蛋白方面存在显著差异(P<0.05);治疗4周,两组患者在目测类比评分、关节疼痛、C-反应蛋白、红细胞沉降率方面存在显著差异(P<0.05);治疗8周,两组患者在目测类比评分、C-反应蛋白、红细胞沉降率方面存在显著差异(P<0.05);治疗12周,两组患者在目测类比评分、C-反应蛋白、红细胞沉降率方面存在显著差异(P<0.05)。(2)研究组治疗后总有效率为93.75%,对照组为79.17%,研究组患者临床疗效显著优于对照组(P<0.05)。(3)研究组治疗后在白细胞介素6、干扰素γ、巨噬细胞迁移抑制因子、类风湿因子IgA、类风湿因子IgM、基质金属蛋白酶3、基质金属蛋白酶9、抗环状瓜氨酸抗体方面与治疗前相比差异显著(P<0.05);对照组治疗后在白细胞介素6、干扰素γ、类风湿因子IgA、类风湿因子IgM、基质金属蛋白酶3、基质金属蛋白酶9、抗环状瓜氨酸抗体方面与治疗前相比差异显著(P<0.05);研究组治疗后在白细胞介素6、干扰素γ、巨噬细胞迁移抑制因子、类风湿因子IgA、类风湿因子IgM、基质金属蛋白酶3、抗环状瓜氨酸抗体方面与对照组治疗后相比差异显著(P<0.05)。(4)治疗12周,研究组各年龄段患者综合疗效优于对照组(P<0.05);治疗8周,研究组23-35岁、36-50岁、51-60岁患者的综合疗效优于对照组(P<0.05),两组18-22岁患者综合疗效相当;治疗4周,研究组36-50岁、51-60岁患者综合疗效优于对照组(P<0.05),两组18-22岁、23-35岁患者综合疗效相当。结果表明,调督通脉针灸法治疗36-50岁、51-60岁临床前类风湿关节炎患者具有一定优势。

调督通脉针灸法辅助甲氨蝶呤及对乙酰氨基酚治疗类风湿性关节炎患者的疗效观察

目的探究调督通脉针灸法辅助甲氨蝶呤、对乙酰氨基酚在类风湿性关节炎(Rheumatoid arthritis,RA)中的应用效果。方法选取2022年1月—2022年12月期间黑龙江中医药大学附属第四医院RA患者100例,按照随机数字表法分为对照组和研究组,每组各50例。对照组口服甲氨蝶呤,针对疼痛难忍者临时给予对乙酰氨基酚片,研究组在对照组基础上采取调督通脉针灸法。治疗3个月后,观察比较两组患者临床疗效、安全性,治疗前后中医证候积分、疼痛程度(Visual Analogue Scale/Score,VAS)及疾病活动度(Disease Activity Score 28,DAS28)评分、实验室指标[类风湿因子(Rheumatoid factor,RF)、C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(Tumor necrosis factor-alpha,TNF-α)、抗环瓜氨酸肽抗体(Anti-cyclic citrulline peptide antibody,抗CCP抗体)、血沉(Erythrocyte sedimentation rate,ESR)]水平。结果(1)中医证候积分:治疗后两组患者晨僵、屈伸不利、关节疼痛、关节肿胀积分均较治疗前降低,差异有统计学意义(P<0.05);且研究组低于对照组,差异有统计学意义(P<0.05)。(2)临床疗效:治疗后研究组临床总有效率94.00%(47/50)高于对照组80.00%(40/50),差异有统计学意义(P<0.05)。(3)疼痛程度及疾病活动度:治疗后两组患者VAS、DAS28分值较治疗前降低,差异有统计学意义(P<0.05);且研究组低于对照组,差异有统计学意义(P<0.05)。(4)实验室指标:治疗后两组患者RF、CRP、TNF-α、抗CCP抗体、ESR水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组低于对照组,差异有统计学意义(P<0.05)。(5)安全性:治疗期间,两组患者均未发生血尿常规、肝肾功能异常,且研究组不良反应发生率8.00%(4/50)与对照组4.00%(2/50)比较,差异无统计学意义(P>0.05)。结论采取调督通脉针灸法辅助甲氨蝶呤、对乙酰氨基酚对RA患者实施干预,可减轻患者临床症状,缓解疼痛程度及疾病活动度,调节相关生化指标水平,提升疾病治疗效果,且具有安全性。

针刺联合甲氨蝶呤治疗类风湿关节炎的疗效观察及对关节功能及ESR、CRP水平的影响

目的 观察针刺联合甲氨蝶呤治疗类风湿关节炎(rheumatoid arthritis, RA)的临床疗效及对关节功能及红细胞沉降率(erythrocyte sedimentation rate, ESR)、C反应蛋白(C-reactive protein, CRP)水平的影响。方法 将86例RA患者随机分为观察组与对照组,每组43例。两组均予甲氨蝶呤治疗,观察组另予针刺治疗。观察两组治疗前后视觉模拟量表(visual analog scale, VAS)评分、28个关节疾病活动度评分(disease activity score-28, DAS-28)评分、关节功能[晨僵时间、28个关节肿胀数(28-swollen joint count, SJC28)、28个关节压痛数(28-tender joint count, TJC28)及双手握力]、炎性细胞因子CRP、抗环瓜氨酸肽(anti-cyclic citrullinated peptide antibody, anti-CCP)抗体及类风湿因子(rheumatoid factor, RF)]水平、血液流变学[ESR、D-二聚体(D-Dimer, D-D)和纤维蛋白原(fibrinogen, FBG)]的变化,并比较两组临床疗效和不良事件情况。结果 观察组的总有效率为95.4%,高于对照组的79.1%(P<0.05)。两组治疗后VAS评分、DAS-28评分、晨僵时间、SJC28、TJC28、CRP、anti-CCP抗体、RF、ESR、D-D及FBG水平均较治疗前降低(P<0.05),观察组低于对照组(P<0.05);两组治疗后双手握力较治疗前升高(P<0.05),观察组高于对照组(P<0.05);两组不良事件发生率比较差异无统计学意义(P>0.05)。结论 针刺联合甲氨蝶呤对RA患者疗效确切,能显著改善关节功能和疼痛程度,降低炎症反应和血液流变学,安全性较高。

类风湿关节炎细胞疗法的文献计量学分析

目的通过文献计量学分析细胞疗法与类风湿关节炎(RA)相关文献的知识结构、研究现状及热点趋势。方法使用科学网络核心合集(WoSCC)数据库检索2003—2022年间细胞疗法与RA相关的文献。VOSviewer、CiteSpace和R包“bi-bliometrix”(版本3.2.1)(https:www.bibliometrix.org)用于文献计量学分析。结果共纳入8822篇文献,来自107个国家或地区,7556个机构的41982位作者。细胞疗法与RA相关研究逐步发展,Arthritis Res Ther是该领域最受欢迎的期刊。阿姆斯特丹大学、哈佛大学、卡罗林斯卡学院和斯坦福大学为主要研究机构,美国和中国是高产国家,多个国家已经形成国际合作网络;发文量最多的作者是Tak PP,被引次数最多的是Emery P。细胞疗法在RA相关文献主要聚焦于RA、免疫、肿瘤坏死因子α拮抗剂、疗法、单克隆抗体5个主要方向。结论细胞疗法应用于RA治疗已成为多学科关注的重要研究领域,中美两国是开展细胞疗法与RA相关的主要国家,相关研究处于基础逐步向临床发展阶段。

干细胞治疗类风湿性关节炎的研究进展

目的类风湿性关节炎(rheumatoid arthritis,RA)是一种发病机制复杂的免疫性疾病,近年来干细胞因其强大的免疫调节和抗炎能力成为治疗免疫性疾病的研究热点,本文作者综述了干细胞疗法在RA治疗中的研究进展,为后续研究作参考。方法通过Pubmed和知网等平台,检索国内外相关文献,对干细胞疗法对RA的治疗进展进行总结分析。结果干细胞通过“免疫重置”或抑制自身免疫有效对抗RA,目前间充质干细胞和造血干细胞移植治疗可明显改善RA患者的临床症状,降低类风湿因子(rheumatoid factor,RF)、抗环瓜氨酸肽抗体(抗CCP抗体)以及C反应蛋白(C-reactive protein,CRP)等指标,减轻疾病活动度,治疗过程安全可行且无明显的不良反应。结论干细胞疗法安全有效,但仍存在一些局限性,今后可通过大量临床试验进一步探究,为RA患者带来更大的获益。