Combination of manual lymphatic drainage and Kinesio taping for treating pigmented villonodular synovitis:A case report

BACKGROUND Pigmented villonodular synovitis(PVNS)is a benign proliferative disorder that affects the synovial joints,bursae,and tendon sheaths.To date,few studies have reported on the treatment of postoperative pain and edema in patients with PVNS.Herein,we present the case of a woman who developed pain and edema in the left lower limb 1 wk after synovectomy and arthroscopic partial meniscectomy and was unable to walk due to limited flexion and extension of the left knee.CASE SUMMARY A 32-year-old woman underwent synovectomy and arthroscopic partial meniscectomy successively and was treated with a combination of manual lymphatic drainage(MLD)and kinesio taping(KT)in our hospital to alleviate postoperative pain and edema.The following parameters were assessed at 2 wk post-treatment and 1 wk post-discharge follow up:suprapatellar circumference,infrapatellar circumference,visual analog scale score,knee range of motion,pittsburgh sleep quality index score,hamilton anxiety rating scale(HAMA)score,and hamilton depression rating scale(HAMD)score.After treatment,the postoperative pain and edema in the patient’s left knee were effectively relieved,resulting in improved sleep quality and remarkably attenuated HAMA and HAMD scores.CONCLUSION Combined MLD and KT may be an effective approach for relieving postoperative pain and edema in patients with PVNS.

Effect of synoviectomy combined with postoperative radiotherapy on pigmented villonodular synovitis in knee:A meta-analysis

Objective:To evaluate the efficacy of synovectomy combined with postoperative radiotherapy in the treatment of pigmented villonodular synovitis compared with only synovectomy in knee. Methods:The related references were searched from SinoMed,CNKI,Wanfang,VIP,PubMed,Embase,Cochrane Library and Web of Science from date of databases establishment to October 2020,and the studies of synovectomy combined with postoperative radiotherapy were screened. According to the type of research,the corresponding evaluation methods were selected for quality evaluation of the literature. RevMan 5.3 software was used for meta-analysis. The primary outcome was recurrence,while the secondary outcomes included complications,excellent and good rate of function of knee,range of motion of knee,Lysholm score,and IKDC score of knee etcetera. Results:A total of 11 articles were included in meta-analysis,with 510 cases,280 in the combined group and 230 in the control group. The results of meta-analysis showed that:(1)The recurrence rate in the combination group was significantly lower than that in the control group,[OR=0.33,95%CI(0.20,0.55),P<0.000 1];(2)The complications in the combined group were higher than that in the control group[OR=2.70,95%CI(1.16,6.31),P=0.02];(3)The excellent and good rate of the combined group was significantly better than that of the control group[OR=2.86,95%CI(1.23,6.64),P=0.01],and it also may be the result of different evaluation criteria of each study;(4)There was no significant difference range of motion[MD=2.96,95%CI(-0.54,6.47),P=0.10],Lysholm score[MD=3.22,95%CI(-0.51,6.96),P=0.09],or IKDC score[MD=2.88,95%CI(-1.07,6.82),P=0.15]in knee between the two groups. Conclusion:The meta-analysis shows that synovectomy combined with radiotherapy can reduce the recurrence rate of pigmented villonodular synovitis in knee,but compared with only operation,there are higher complications. However,the above conclusions need to be verified by long-term follow-up of more high-quality clinical studies.

Therapeutic Effect Analysis of Sodium Aescinate Tablets on Knee Osteoarthritis Combined with Synovitis

Objective:To observe therapeutic effect of sodium aescinate Tablets on knee osteoarthritis complicated with synovitis.Methods:86 patients with knee osteoarthritis combined with synovitis treated in the Honghui Hospital Affiliated to Xi’an Jiaotong University from January 2018 to December 2019 were randomly divided into control group and intervention group,with 43 cases in each group.The control group was given routine treatment,and the intervention group was given sodium aescinate Tablets orally on the basis of routine treatment,twice a day,2 tablets each time.The curative effect was evaluated after 2 weeks of treatment.The knee pain and joint function of the two groups were evaluated by Visual Analogue Scale(VAS)and Western Ontario and McMaster Universities Arthritis Index(WOMAC),and the clinical effects of the two groups were compared.Results:Before treatment,there was no significant difference in general information,VAS and WOMAC scores between the two groups(P>0.05).After treatment,the VAS and WOMAC scores of the two groups were both lower than those before treatment,and the difference was statistically significant(P<0.05).The vas and WOMAC scores of the intervention group were lower than those of the control group(VAS,1.87±0.79 vs 3.38±0.81).In this study,sodium aescinate tablets were applied to the treatment of KOA combined with synovitis.The results showed that the intervention group was better than the control group in alleviating knee pain,improving joint function and improving clinical efficacy,and the difference was statistically significant.The total effective rate of the intervention group was higher than that of the control group(100%vs 86.05%),and the difference was statistically significant(P<0.05).Conclusion:Sodium aescinate tablet in the treatment of knee osteoarthritis combined with synovitis can effectively alleviate knee pain,improve joint function and improve clinical efficacy.

Serum matrix metalloproteinase 3 in detecting remitting seronegative symmetrical synovitis with pitting edema syndrome: A case report

We report a case of remitting seronegative symmetrical synovitis with pitting edema(RS3 PE) syndrome in a 71-year-old woman. She referred to our hospital with finger stiffness, edema of both hands and feet, pain of bilateral shoulder, wrist, metacarpophalangeal, proximal interphalangeal, and ankle joints. Rheumatoid factor was negative, human leukocyte antigen-B7 antigen was positive. Moreover, matrix metalloproteinase 3(MMP-3) was high. She was diagnosed with RS3 PE syndrome, and treatment with prednisolone(15 mg/d) was started. One week after prednisolone treatment initiation, CRP decreased to negative, and joint pain was almost completely resolved. However, hand stiffness persisted, and MMP-3 level was still high. Thus, prednisolone dose was increased to 20 mg/d, and the stiffness resolved. Twenty days after treatment initiation, MMP-3 was normalized. MMP-3 was more indicative of RS3 PE syndrome symptoms than CRP. Thus, MMP-3 seems to be more sensitive to RS3 PE syndrome symptoms.

FABP4 secreted by M1-polarized macrophages promotes synovitis and angiogenesis to exacerbate rheumatoid arthritis

Increasing evidence shows that adipokines play a vital role in the development of rheumatoid arthritis(RA).Fatty acid-binding protein 4(FABP4),a novel adipokine that regulates inflammation and angiogenesis,has been extensively studied in a variety of organs and diseases.However,the effect of FABP4 on RA remains unclear.Here,we found that FABP4 expression was upregulated in synovial M1-polarized macrophages in RA.The increase in FABP4 promoted synovitis,angiogenesis,and cartilage degradation to exacerbate RA progression in vivo and in vitro,whereas BMS309403(a FABP4 inhibitor)and anagliptin(dipeptidyl peptidase 4 inhibitor)inhibited FABP4 expression in serum and synovial M1-polarized macrophages in mice to alleviate RA progression.Further studies showed that constitutive activation of mammalian target of rapamycin complex 1(mTORC1)by TSC1 deletion specifically in the myeloid lineage regulated FABP4 expression in macrophages to exacerbate RA progression in mice.In contrast,inhibition of mTORC1 by ras homolog enriched in brain(Rheb1)disruption specifically in the myeloid lineage reduced FABP4 expression in macrophages to attenuate RA development in mice.Our findings established an essential role of FABP4 that is secreted by M1-polarized macrophages in synovitis,angiogenesis,and cartilage degradation in RA.BMS309403 and anagliptin inhibited FABP4 expression in synovial M1-polarized macrophages to alleviate RA development.Hence,FABP4 may represent a potential target for RA therapy.

Rapid remission of refractory synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome in response to the Janus kinase inhibitor tofacitinib: A case report

BACKGROUND Synovitis,acne,pustulosis,hyperostosis,and osteitis(SAPHO)syndrome is a rare autoinflammatory disease for which clinical treatment has not been standardized.Janus kinase(JAK)inhibitors represent a novel therapeutic option for rheumatoid arthritis,psoriatic arthritis,and some other autoinflammatory diseases.However,the clinical utility of JAK inhibitors in treating SAPHO syndrome has not been thoroughly investigated.In this study,we describe a patient with SAPHO syndrome who failed to respond to conventional treatment but demonstrated a remarkable and rapid response to the JAK inhibitor tofacitinib.CASE SUMMARY A 62-year-old female patient presented with swelling and pain at the sternoclavicular joints,back pain that limited her activities,arthralgia in the right knee,and cutaneous lesions.Her symptoms were unresponsive to nonsteroidal anti-inflammatory drugs,disease-modifying antirheumatic drugs,Tripterygium wilfordii hook f,and bisphosphonates.SAPHO syndrome was diagnosed in accordance with dermatological and osteoarticular manifestations and abnormal inflammatory factors.Multiple image studies have illustrated bone lesions and pathological fractures of vertebral bodies.Oral treatment with tofacitinib at 5 mg twice daily with methotrexate and bisphosphonates was initiated.The patient reported that her pain symptoms were relieved after 3 d and her cutaneous lesions were reduced after 4 wk of treatment.Vertebral lesions were improved after 6 mo on tofacitinib.No serious adverse effects were noted.CONCLUSION JAK inhibitor therapy may be a promising strategy to treat SAPHO syndrome.

New scoring system in assessment of Hoffa's fat pad synovitis: A comparative study with established scoring systems

AIM To investigate the reliability of the established and new scoring methods for Hoffa's fat pad synovitis using magnetic resonance imaging(MRI).METHODS A total of 139 knees of 115 patients who underwent MRI of the knee with and without gadolinium contrast were enrolled in this study. Proton density(PD)-weighted, PD-weighted fat-suppressed(PD-FS), and postcontrast T1-weighted fat-suppressed(T1CE) images were used for evaluation. Using contrast and noncontrast images, our grading method for synovitis was performed to measure synovial thickness and signal intensity changes of the fat pad [Synovial membrane(SM) score], which was compared with the established methods,including MRI Osteoarthritis Knee Score(MOAKS), parapatellar synovitis score,Whole-Organ Magnetic Resonance Imaging Score(WORMS), and suprapatellar effusion diameter. Intraclass correlation coefficients(ICC) for intra and interobserver reproducibility and Spearman correlation coefficients(r) were calculated for the parapatellar synovitis score and each scoring method.RESULTS All of the scores presented substantial to almost perfect intrareliability. Among three readers, effusion diameter had substantial to almost perfect interreliability(ICC = 0.68-0.81) and WORMS had substantial interreliability(ICC = 0.61-0.70).For two out of three readers, there was substantial interreliability for the thickness score in T1CE(ICC = 0.55-0.69), SM scores in T1CE(ICC = 0.56-0.78)and PD-FS(ICC = 0.51-0.79), and parapatellar synovitis score in T1CE(ICC =0.53-0.72). The parapatellar synovitis score was significantly correlated with the thickness score in T1CE(r = 0.70) and the SM score in T1CE(r = 0.81) and PD-FS(r = 0.65).CONCLUSION The newly proposed quantitative thickness score on T1CE and the semiquantitative SM score on T1CE and PD-FS can be useful for Hoffa's fat pad synovitis.

Subtalar joint pigmented villonodular synovitis misdiagnosed at the first visit:A case report

BACKGROUND Pigmented villonodular synovitis(PVNS)is an uncommon disease that usually occurs in large joints,and involvement of the subtalar joint is rare.The lack of comprehensive knowledge of subtalar joint PVNS could lead to misdiagnosis.CASE SUMMARY We present a 64-year-old woman who,at her first visit,complained of discomfort in the right ankle when she walked.Based on the physical signs and X-ray report,the physician failed to make the suspected diagnosis of PVNS.Eighteen months later,the patient returned with a complaint of a mass in her right lateral malleolus with intermittent blunt pain.The X-ray presented an osteophyte formation and soft tissue calcification at the margin of the subtalar joint.The laboratory tests were normal,whereas magnetic resonance imaging(MRI)showed a low-intensity area on both T1-and T2-weighted images.A suspected diagnosis of PVNS was made and later confirmed by postoperative pathology.Subsequently,the patient received radiotherapy with 32 Gy in 16 fractions.At 6 mo postoperatively,the patient only complained of discomfort after walking three blocks.The American Orthopedic Foot and Ankle Society Ankle-Hindfoot score was 97.CONCLUSION MRI is necessary for the diagnosis of PVNS.Early soft tissue calcification and painless joint swelling should be of concern.

Pigmented Villonodular Tenosynovitis of the Temporomandibular Joint—A Case Report

Background: Pigmented villonodular synovitis is a rare condition typically affecting the major joints and the involvement of the temporomandibular joint is rare. Although, it is histologically benign, it can be locally aggressive, capable of extensive bone destruction. The disease has aggressive behavior and a high incidence of recurrence (40% - 60%). Case report: A 35 years old male presented with history of unilateral hearing loss and otalgia of six month duration. On examination, there was a soft bulge in the superior wall of external auditory canal. Contrast enhanced CT scan showed soft tissue density occupying the right external auditory canal and bulging into the middle ear cavity, displacing the intact ossicular chain medially with evidence of destruction of the posterior wall of the external auditory canal, glenoid fossa, mastoid bone and the scutum. The squamous part of the right temporal bone showed evidence of lateral bowing with discontinuity. Surgical resection was done through post aural approach. Histopathological examination revealed pigmented villonodular tenosynovitis which stained positive for CD 68. Post operatively patient was evaluated clinically and with radiological modalities which showed healthy mastoid cavity and no increase in post operative granulations on magnetic resonance imaging. Conclusion: Pigmented villonodular tenosynovitis of temporomandibular joint is a rare entity. Due to the aggressive behavior of the lesion, radical or aggressive surgical resection should be done. Long term follow up with radiological modality should be done due to the high recurrence rate.

Potential mechanism of Simiao powder in treatment of synovitis based on network pharmacology

Objective:Based on the technology and method of network pharmacology,to explore the active components and specific mechanism of Simiao powder in the treatment of synovitis.Methods:by using tcmsp database,the potential active components and related target proteins of Simiao powder were screened.Genecards and digenet database were used to predict the target of synovitis.UniProt database was used to query the corresponding gene names.The compound synovitis target network and protein of Simiao powder were constructed by using Cytoscape and string software In R language,bio conductor data package was used to analyze the enrichment of go biological function and KEGG pathway,and the effective components and targets of Simiao powder in the treatment of synovitis were obtained.Results:64 key active components of Simiao powder were screened out from tcmsp database,71 of them were involved in the interaction of main chemical components of Simiao powder-chemical components and synovitis treatment target-synovitis.95 PPI core genes were obtained,and 90 go biological enrichment processes were obtained by go enrichment analysis.The results of network pharmacology indicate that Simiaosan can regulate 32 signaling pathways in the treatment of synovitis,including IL-17 signaling pathway,TNF signaling pathway,T cell receptor signaling pathway and toll like receptor signaling pathway.Conclusion:the treatment of synovitis with Simiao powder is a complex process of multi-component,multi-target and multi-channel,which is related to the coordinated regulation of multiple targets and signal pathways.

坚骨胶囊对气滞血瘀型肘关节骨关节炎的影响

目的 探讨坚骨胶囊治疗气滞血瘀型肘关节骨关节炎的临床效果。方法 选择2018年1月至2021年6月河北省沧州中西医结合医院收治的气滞血瘀型肘关节骨关节炎患者90例,按照随机数字表法将其分成两组,每组45例。观察组采用坚骨胶囊联合玻璃酸钠治疗,对照组单用玻璃酸钠治疗,两组连续治疗5周。比较两组临床疗效,比较治疗前后Mayo肘关节功能评分(MEPS)、患侧肘关节关节活动度(ROM)、视觉模拟评分法(VAS)评分,以及关节滑液中基质金属蛋白酶-3(MMP-3)、白细胞介素-1β(IL-1β)、软骨寡聚基质蛋白(COMP)、转化生长因子-β_(1)(TGF-β_(1))水平。比较两组不良反应发生情况。结果 观察组临床疗效优于对照组(P<0.05)。治疗后,两组MEPS评分、肘关节ROM高于治疗前,VAS评分低于治疗前,且观察组MEPS评分、肘关节ROM高于对照组,VAS评分低于对照组(P<0.05)。治疗后,两组关节滑液中MMP-3、IL-1β、COMP水平低于治疗前,关节滑液中TGF-β_(1)水平高于治疗前,且观察组关节滑液中MMP-3、IL-1β、COMP水平低于对照组,关节滑液中TGF-β_(1)水平高于对照组(P<0.05)。两组治疗过程中均无明显不良反应发生。结论 联合坚骨胶囊治疗能更有效地调控气滞血瘀型肘关节骨关节炎患者关节滑液中MMP-3、IL-1β、COMP和TGF-β_(1)的表达水平,促进关节软骨修复。

鸡滑液囊支原体病及其诊断与防治的研究进展

滑液囊支原体(Mycoplasma synoviae,MS)可引起鸡的急性或慢性呼吸道疾病、传染性滑膜炎、空气传染病和蛋壳顶端异常等疾病,对家禽业造成了巨大的经济损失。文章就鸡滑液囊支原体病的流行病学、致病特点、临床症状、诊断方法和防控措施进行综述,对鸡滑液囊支原体病的诊断技术及疫苗的研发及应用前景进行展望,以期为该病的临床防控提供参考。

加味桂枝芍药知母汤对急性创伤性膝关节滑膜炎患者炎性因子和膝关节症状分级量化的影响

目的 观察加味桂枝芍药知母汤口服配合关节穿刺抽液倍他米松、利多卡因关节腔注射对急性创伤性膝关节滑膜炎患者的炎性因子和膝关节肿痛症状改善情况。方法 选70例急性创伤性膝关节滑膜炎患者随机分为两组,治疗组口服加味桂枝芍药知母汤,并配合关节穿刺抽液倍他米松、利多卡因关节腔注射,对照组仅行关节穿刺抽液倍他米松、利多卡因关节腔注射;比较两组患者膝关节肿痛症状及血清炎性因子改善情况。结果 治疗组总有效率为91.43%,高于对照组的74.29%(P <0.05);治疗后两组患者Lysholm膝关节评分及症状分级量化(疼痛、肿胀、活动度、压痛和功能)评分均较治疗前增高(P <0.05),且治疗组高于对照组(P <0.05);两组患者血清白细胞介素-1(IL-1)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平均较治疗前下降,但治疗组下降更明显(P <0.05)。结论 加味桂枝芍药知母汤口服,并配合关节穿刺抽吸积液并行倍他米松、利多卡因关节腔注射治疗急性创伤性膝关节滑膜炎可明显减轻膝关节肿痛、改善关节功能,并降低血清中IL-1、IL-6和TNF-α的水平;疗效优于单纯的关节穿刺抽吸积液并行倍他米松、利多卡因关节腔注射。

谷胱甘肽过氧化物酶4介导铁死亡在膝骨关节炎滑膜炎发生发展中的作用

背景:滑膜炎在膝骨关节炎早期进展中起主导作用,是潜在的早期治疗靶点,但滑膜炎发生机制尚不清楚。在动物模型中,全身铁含量增加和细胞内铁摄取升高可诱发和加剧骨关节炎,但滑膜炎与铁死亡的关系仍不清楚,因此探讨铁死亡在骨关节炎滑膜炎发生发展中的作用需进一步研究。目的:探讨谷胱甘肽过氧化物酶4(glutathione peroxidase4,GPX4)介导的铁死亡在膝骨关节炎滑膜炎发生发展过程中的作用。方法:入选行膝关节镜或关节置换手术的骨关节炎患者43例以及行关节镜治疗半月板损伤或韧带撕裂患者10例,根据患者术前X射线平片Kellgren-Lawrence分级分为3组:对照组(KLG 0)10例,早期膝骨关节炎组(KLG 1,2)20例和晚期膝骨关节炎组(KLG 3,4)23例。采用苏木精-伊红染色观察各组滑膜炎的严重程度,普鲁士蓝染色评估各组滑膜组织中的铁沉积情况,免疫组化法检测ACSL4、GPX4、环氧化酶2、肿瘤坏死因子α在滑膜组织中的表达,Western blot和免疫荧光分别检测ACSL4、GPX4蛋白的表达。结果与结论:①与对照组相比,骨关节炎组滑膜组织中铁含量增加,且晚期膝骨关节炎组铁沉积多于早期膝骨关节炎组;②与对照组相比,ACSL4在骨关节炎滑膜组织中高表达(P<0.01),GPX4在骨关节炎滑膜组织中低表达(P<0.01),且ACSL4表达量随着骨关节炎的进展呈现增高趋势,GPX4表达量随着骨关节炎的进展呈现降低趋势;③环氧化酶2在骨关节炎滑膜组织中的表达明显高于正常滑膜组织,其中早期骨关节炎组表达最高,与晚期骨关节炎组比较差异有显著性意义(P<0.01);④肿瘤坏死因子α在骨关节炎滑膜组织中的表达明显高于正常滑膜组织,早期骨关节炎组与晚期骨关节炎组比较差异无显著性意义(P>0.05);⑤结果表明,骨关节炎滑膜组织中有铁的沉积,铁死亡参与了膝骨关节炎滑膜炎的发生及病情进展。

BMS电路板多模块协同热-力耦合建模及仿真分析

针对现有电动汽车电池管理系统(BMS)电路板研究仅仅考虑单一功能模块的温度场及其散热效果,缺乏考虑BMS多个功能模块在温度场和力场下的相互影响及协同效应的研究的情况,以某商用BMS电路板为研究对象,采用ANSYS构建了表征BMS多模块协同作用下的热-力耦合数值仿真分析模型并验证了其有效性.在此基础上,针对BMS电路板各功能模块温度场及热变形行为开展了数值仿真研究.结果表明:BMS电路板温度分布不均,最大温差达20.5℃.均衡模块存在积热,温度高达54.4℃.高温导致电路板组件发生热膨胀变形,同时电路板约束诱发均衡模块及供电模块边缘的贴片电阻出现热应力集中,两者共同作用致使BMS均衡模块、供电模块产生凸起翘曲变形,且Z轴热变形量随着温度升高而增大,最大变形量达9.5μm,应针对BMS电路板上积热模块开展散热优化设计.

巨噬细胞靶向的纳米载药平台治疗RA滑膜炎研究新进展

类风湿关节炎(RA)是一种以慢性侵蚀性多关节炎为特征的全身性自身免疫性疾病。其核心病理改变是关节滑膜的持续炎症和血管翳形成,进而引起关节软骨和骨的破坏。RA的病因和发病机制仍不明确且复杂,尽管在过去的几十年里已经积累了大量关于RA的治疗证据和经验,但目前尚没有明确的方法可以逆转RA关节组织损伤。纳米载药平台作为一种基于纳米材料的药物递送系统,旨在改善药物分布、增强疗效及减少药物不良反应。该文重点分析RA滑膜炎的发病机制,并探讨巨噬细胞靶向的纳米载药平台在RA的预防和治疗中的应用和潜力。

Multi-scale Distribution Pattern of Natural Ramet Population in the Rhizomatous Herb ,Thermopsis lanceolata

Thedistributionpatternofnaturalrametpopulationintherhizomatousherb ,Thermopsislanceolata R .Br.,at 5scales (0 .2m ,0 .4m ,0 .6m ,0 .8mand 1.0m)wasinvestigatedusinggridsamplingand spatialauto_correlationanalysis (Moran’sI)inMaowususandlandofInnerMongoliaofChina .Theresult showedthattherametpopulationhadnon_randomdistributionpatternatfourscales (0 .2m ,0 .4m ,0 .6m and 1.0m) .Themostfrequentlyobservedpatternwascontagiousatthescaleof 0 .2m .Thegenethadsym podialgrowthandnearlyphalanxarchitecture .Thebranchingangleoftherhizomeswasfrom 10°to 30° .The densityoftherametpopulationwasfrom 35to 131ramets·m- 2 .Themeanheightoframetswasbetween 11.0 cmand 2 5.9cm .Thebiomassoftherametpopulationwas 2 6 3.6 3g·m- 2 and 30 6 .19g·m- 2 inthetwo plots,respectively .33.71%and 4 4 .97%ofthebiomassallocationtorhizomeswereobservedandthe biomassallocationtorootswas 2 9.91%and 2 9.95%andthattoleaveswas 2 5.12 %and 36 .35%inthetwo plots ,respectively .Theratioofroottoshootwas 0 .4 4inbothplotswhiletheratioofbelow_toabove_ground biomasswas 2 .12and 3.59,respectively .

基于共轭梯度法的晶闸管电热耦合模型快速求解方法研究

为解决传统求解技术在处理效率和计算成本上的局限问题,针对晶闸管电热应力耦合交互模型,提出一种基于共轭梯度法的高效解析方法。通过优化迭代过程和收敛条件来显著提升求解效率和精度。新的参数选择策略被引入以自动调整算法迭代步长,加快收敛速度,减少计算资源消耗。相比传统求解方法,所提优化方法在求解时间上平均减少10%,求解精度提高8%。这一进展证明自适应共轭梯度法在电热应力耦合模型快速求解中的有效性,可为电力电子设备热管理提供高效、可靠的计算工具。所提方法在多种测试条件下均表现出显著的提升效率和良好的精确度,为晶闸管电热耦合模型的高效求解提供了创新方案,同时对电力电子领域的相关研究具有重要的实践意义。

超声评估类风湿关节炎患者手和前足滑膜炎的相关性

目的:通过对类风湿关节炎患者手部及足部关节进行超声检查,结合临床指标,预测类风湿关节炎患者前足滑膜炎存在的相关因素,便于临床医师关注病情变化,及时调整治疗方案。方法:收集类风湿关节炎患者69例,对其均行二维和能量多普勒(PDUS)检查,并收集其临床指标。根据二维超声跖趾关节滑膜是否增厚将患者分为前足受累组19例和前足未受累组50例,对比2组之间临床指标和超声结果的差异,评估临床指标及手部关节超声结果与足部关节超声结果之间的相关性。结果:①前足受累组关节肿胀数(SJC)、患者的总体评估(PGA)、医师的总体评估(EGA)、DAS28评分、临床疾病活动度评分(CDAI)、手PDUS总分、手PDUS阳性关节数均明显高于前足未受累组,差异有统计学意义(P<0.05)。②前足PDUS阳性关节数与SJC、DAS28评分、CDAI间存在低度相关,与手PDUS总分之间存在显著相关(P<0.05)。③单因素变量回归分析显示,SJC、PGA、EGA、DAS28评分、手PDUS总分、手PDUS阳性关节数均是前足滑膜炎的危险因素(P<0.05)。多因素变量回归分析显示,只有手PDUS总分是前足滑膜炎的独立危险因素(P<0.05)。④类风湿关节炎患者手PDUS评分的受试者工作特征曲线(ROC)提示,当手总PDUS评分>5分时与跖趾关节滑膜炎有关,敏感性为90%,特异性为78%,提示手部PDUS评分与跖趾关节滑膜炎存在相关性。结论:手PDUS总分对于提示类风湿关节炎患者跖趾关节滑膜炎的存在具有很好的价值。

益气蠲痹方治疗脾失健运型膝骨关节炎性滑膜炎临床研究

目的:观察益气蠲痹方治疗脾失健运型膝骨关节炎性滑膜炎(knee synovitis,KS)的临床疗效。方法:将70例患者随机分为试验组(35例,后脱落3例,纳入32例)和对照组(35例,后脱落5例,纳入30例)。对照组给予塞来昔布胶囊口服,试验组予以益气蠲痹方口服,两组连续治疗3周。评价治疗前后症状评分、视觉模拟评分法(visual analogue scale,VAS)、西安大略和麦克马斯特大学骨关节炎指数(Western Ontario and McMaster Universities Osteoarthritis Index,WOMAC)评分、膝关节肿胀程度评分等情况,评估不良反应发生情况。结果:治疗后试验组总有效率[93.75%(30/32)]高于对照组[83.33%(25/30)](P<0.01);两组治疗后VAS评分、WOMAC评分及关节肿胀程度评分相比治疗前均降低(P<0.05),且试验组下降幅度大于对照组(P<0.05)。治疗后对照组症状总评分及关节肿胀、关节疼痛、关节活动不利及乏力等症状评分较治疗前降低(P<0.05),但腹胀纳呆、便溏、面黄肌瘦症状评分变化不明显(P>0.05);试验组症状总评分及各症状评分均较治疗前降低(P<0.05);两组在关节活动不利症状评分的改善方面效果相当(P>0.05),但试验组在关节肿胀、关节疼痛、腹胀纳呆、便溏、面黄肌瘦、乏力症状评分的改善方面优于对照组(P<0.01)。结论:益气蠲痹方治疗脾失健运型KS患者,在改善患者腹胀纳呆、便溏、面黄肌瘦等伴随症状上优势明显,并且在治疗期间未出现明显不良反应。