Objective To compare effects of intra-articular injection of corticosteroid or viscoelastic agent alone or a combination of the two drugs for treatment of temporomandibular joint disorders. Methods A prospective quasirandomized controlled trial was conducted to compare 3 treatment protocols of intra-articular injections in the upper compartment of the joint immediately following arthrocentesis repeatedly every 10 days: ① triamcinolone 8 mg alone for 3 times, ② 1% hyaluronate 1 ml alone for 4 times, and ③ triamcinolone 8 mg for 2 times then 1% hyaluronate 1 ml for 2 times. Clinical examinations were done at baseline, 1, 12, and 24 months after end of the treatments. According to improvement of the symptoms and clinical signs, the effectiveness was graded in 3 classes: excellent, better, no change, or worse. The first two were classified as effective. Effective rates of the treatments and subgroups were compared statistically. Results Five hundred and sixty four patients with temporomandibular disorders were included and randomly allocated to 3 groups with 188 patients in each group. The rate of lost follow up at 24 months was 6.9% to 10.1%. At one month after treatment, the triamcinolone group had a better effective rate at 92.0%. At 12 and 24 months of follow up, effective rates of the hyaluronate group were better than those in the triamcinolone alone group (84.6% vs. 54.1% and 83.4% vs. 40.4%). Effective rates of combining triamcinolone and hyaluronate group at 12 and 24 months were 90.4% and 66.3% respectively. Conclusion Intra-articular injection of corticosteroid has better results in a short term and hyaluronate has better results in a long term in the treatment of temporomandibular joint disorders.
目的 探讨盐酸氨基葡萄糖胶囊联合透明质酸钠注射液治疗髋骨关节炎的临床疗效。 方法 纳入疼痛门诊2010年7月－2011年7月收治的髋骨关节炎患者60例，随机分为透明质酸钠关节腔内注射联合口服盐酸氨基葡萄糖胶囊组（A组）和单独透明质酸钠关节腔内注射组（B组），每组30例。透明质酸钠关节腔内注射均为2.5 mL/次，每周1次，连续5周为1疗程。盐酸氨基葡萄糖胶囊口服，0.75 g/次，2次/d，6周为1个疗程。评估两组患者治疗后6周后髋关节疼痛视觉模拟评分（VAS评分）及Lequesne指数评定髋关节休息痛、运动痛、局部压痛、关节活动度、晨僵及行走能力，并观察两组不良反应发生情况。 结果 治疗6周后A组Lequesne功能指数及VAS评分较B组显著降低（P＜0.05），两组不良反应比较差异无统计学意义（P＞0.05）。 结论 治疗髋骨关节炎患者时，联合应用透明质酸钠及盐酸氨基葡萄糖胶囊疗效优于单独应用透明质酸钠者，且并未增加不良反应的发生。
ObjectiveTo review the registration and technical data for sodium hyaluronate facial derma fillers. MethodsRecent literature concerning registration for sodium hyaluronate facial derma fillers was reviewed and analyzed. ResultsThe aspects on registration for sodium hyaluronate facial derma fillers include nominating the product, dividing registration unit, filling in a registration application form, preparing the technical data, developing the standard, and developing a registration specification. ConclusionThe main difficulty in registration is how to prepare the research data of that product, so the manufacturers need to enhance their basic research ability and work out a scientific technique routing which could ensure the safety and effectiveness of the product, also help to set up the supportive documents to medical device registration.
Objective To study the effect of sodium hyaluronate hydrogel in treating residual cavity on body surface after abscess drainage so as to provide new method to speed up the heal ing of residual cavity after body surface abscess drainageand reduce the frequency of dressing change and cl inic nursing workload. Methods From June 2007 to March 2008, 60 outpatients with body surface abscess drainage were randomly divided into hydrogel group (group A, 30 cases) and the control group (group B, 30 cases). In group A, there were 16 males and 14 females aged (49.5 ± 6.1) years, the disease course was (3.8 ± 0.6) days, and the volume of residual cavity was (4.19 ± 1.31) mL. In group B, there were 18 males and 12 females aged (50.2 ± 7.6) years, the disease course was (4.3 ± 0.5) days, and the volume of residual cavity was (4.04 ± 1.22) mL. There was no significant difference between two groups in gender, age, disease course and volume of residual cavity (P gt; 0.05). Residual cavity was smeared with 1 mL/cm2 sodium hyaluronate hydrogel in group A and drained by sal ine gauze in group B, the dressing was changed every two to three days. Residual cavity volume was recorded every four days, and the residual cavity volume, the frequency of out-patient dressing and the heal ing time residual of cavity were compared. Results The volume of residual cavity was (3.11 ± 1.12), (1.75 ± 0.95) and (0.55 ± 0.56) mL in group A, and was (3.39 ± 1.12), (2.64 ± 0.99) and (1.81 ± 0.81) mL in group B at 4, 8 and 12 days after treatment respectively, showing no significant differences at 4 days (P gt; 0. 05), but significant difference at 8 and 12 days (P lt; 0.01). Residual cavity heal ing time was (12.70 ± 2.78) days in group A and (20.27 ± 3.89) days in group B, and the frequency of dressing change was 5.53 ± 1.33 in group A and 9.13 ± 1.81 in group B, indicating significant differences between two groups (P lt; 0.01). Conclusion Sodium hyaluronate hydrogel can promote residual cavity heal ing, reduce the frequency of dressing change of out-patient and decrease the cl inic nursing care workload.
Objective To explore the efficacy and safety of bioactive material(combest) which is combinated with bioglass and hyaluronan on burn wound healing．Methods From March to September 2006, 20 patients were treated; including 16 males and 4 females, aging 18-58 years(40 years on average)．The wounds were classified as deep degrees Ⅱ in 7 cases, granulated wounds in 9 cases and graft site wounds in 4 cases. Twenty wounds in one side were repaired with Combest as the test group and 20 wounds in the other side with blank cream as the control group. The wounds in size ranged from 2.0 cm×1.5 cm to 40.0 cm×20.0 cm. The wound healing rate was observed, and the blood test and the indices of hepatic and renal function were determined on the 1st, 3 rd,6 th, 11 th, 16 th and 21 st days of treatment．Results Wound healed within 3 weeks in 11 cases of the test group (3 cases on the 11 st day, 4 on the 16 th day, and 4 on the 21 st day) , but no wound healing was observed within 3 weeks in the control group. The healing size accounted for 2/3 of wounds in 18 cases of the test group and in 1 case of the control group. The excellent and good rates were 95%(18 cases and 1 case) in the test group and 50% (1 case and 9 cases) in the control group, showing significant difference (Plt;0.01). For all patients, no obvious changes were found in the blood test and hepatic or renal function indices. Conclusion Combest combinated with bioglass and hyaluronan is beneficial to the proliferation of the granulation and wound healing with good safety.
Objective To investigate whether the implanted myoblasts with the soluble carriers can improve the repairing efficiency for theseverelycryodamaged tibialis anterior muscles. Methods The skeletal myoblasts were isolated from the newborn SD rats by the use of the enzyme digestion. They were purified and serially subcultivated; the subcultivated myoblasts of the 3rd generation were marked with BrdU. The severelycryodamaged tibialis anterior muscle models were established from 84 SD rats aged 5 months. They were randomly divided into 4 groups, including Group A1 (the implanted myoblasts with the carriersF12 containing 0.1% sodium hyaluronate), Group A2 (the implanted myoblasts, with the carriersF12 that did not contain 0.1% sodiumhyaluronate), Group B1 (the implanted carrier solution containing 0.1% sodium hyaluronate, but with no myoblasts), and Group B2 (with no carrier solution or myoblasts). Six rats were killed at the following time points: at 2, 5 and 9 days,and 2, 4, 8 and 12 weeks after operation; the immunohistochemical and the Mallory staining studies were performed for an evaluation on the repairing efficiencyfor the severelycryodamaged tibialis anterior muscles. By the imaging analysis, the number of the survived cells in each group was compared at 2 days, and the area ratio of the collagen fiber in each group was also compared at 8 weeks. Results The BrdU immunohistochemical staining showed that the number of the remaining implanted cells was significantly greater in Groups A1 than in Group A2, the migrating area of the myoblasts was greater, the distribution of the cells was more uniform, the cell differentiating potential was undestroyed, the repairing efficiency for the severelycryodamaged tibialis anterior muscles was significantly improved. There was no bluestained nucleus at each time point in Group B. The Mallory staining showed that the fibrous degeneration inthe tissue repairing process was significantly inhibited in Groups A1, A2 and B1; the inhibition was most obvious in Group A1, and next in Group A2. The imaging analysis indicated that at 2 days after operation, the number of the survived cells was significantly-greater in Group A1 than in Group A2 (Plt;0.05). At 8 weeks after operation, the collagen fiber was the least in Group A1, less in Group A2, more in Group B1,and the most in Group B2 (Plt;0.05). Conclusion The implanted myoblasts can significantly improve the repairing efficiency for the severelycryodamaged muscle tissues, and the implanted carrier solution containing 0.1% sodium hyaluronate can improve the implanting efficiency for the myoblasts.
Objective To explore effective substances and methods for prevention of peridural adhesion. Methods Laminectomy was performed on the 5th lumbar segment in 64 rabbits, which were equally divided into 4 groups. The duramater (12 mm×6 mm) was exposed. The exposed duramater was left uncovered in Group A; the exposed dura mater was covered with sodium hyaluronate jel (high molecular weight, 1 ml) in Group B; the lamina repair was performed with the autologous spinous process in Group C; the lamina repair was performed with the sodium hyaluronate jel filling and the autologous spinousprocess in Group D. The specimens were observed grossly and histologically at 2, 4, 6 and 8 weeks postoperatively. The computed imaging analysis on the epidural adhesion was also performed at 6 weeks postoperatively. Results ①The gross anatomical evaluation: Severe peridural adhesion was formed in Group A, less adhesion formed in Groups B and C, but no obvious adhesion formed in Group D. ②The area percentage of the epidural scar: The area percentage ofthe epidural scar was 15.89%±1.88% and 13.94%±1.89% in Groups C and D respectively, which were significantly lower than those in Groups A and B (22.66%±2.89% and 20.70%±2.82%,Plt;0.05). ③The density of epidural scar: Thedensity of the epidural scars were 42.03%±7.36% and 36.50%±9.08% in Groups B and D, which were significantly lower than those in Groups A and C (63.73%±6.06% and 52.11%±4.10%，Plt;0.05). Conclusion The high molecular weight sodium hyaluronate jel filling combined with the lamina repair using the autologous spinous process has the best preventive effect on the peridural adhesion after laminectomy.
Objective To investigate the effects of sodium hyaluronate solution on the proliferation and differentiation of myoblasts. Methods The 3rd subculture myoblasts from muscle of infant SD rat were cultured in four growth media, in which the concentrations of sodium hyaluronate were 0.05% (group A) , 0.1%( group B), 0.2% (group C)and 0 (group D, control group), respectively. The proliferation rate of myoblasts in each medium was observed through growth curves by means of count and MTT. At the same time, the subculture myoblasts were cultured in differentiated media in which the concentrations of sodium hyaluronate were 0 and 0.1%. The capacity of fusion of myoblasts was compared between two kinds of differentiated media. Results There were the nearly same proliferation curse in Groups A, B and C: increasing by logarithm at 2 days and reaching peak value at 4 days. The myoblasts in Group D increased slowly: increasing by logarithm at 3 days, doubling at 5 days and reaching peak value at 6 days. MTT has the similar curse to counting. The myoblast proliferation of Group B was more than that of the other groups. The peak value of myoblast fusion was 35% at 6 days in common differentiated media; slowly reached 11.7% at 7 days in the differentiated media in which the concentrations of sodiumhyaluronate was 0.1%.Conclusion Sodium hyaluronate at certain concentration can be a decent media for myoblasts, it can accelerate proliferation and differentiation of myoblasts.
Objective To investigate the effect of sodium hyaluronate (SH) intra-articular injection on the treatment of knee osteoarthritis (OA), andto compare the contents of free radicals and inflammatory factors in joint fluids of pre-and pro-treatment as to explore the treatment mechanism of SH. Methods Ninety-two patients (111 knees) with mild(51)，moderate(35) and serious(25) knee OA were treated with intra-articular injections of SH (20 mg once a week for 5 weeks). According to Lysholm scoring, clinical signs such aspain, swelling,and the ability to walk, squat, run, go upstairs and downstairs were assessed before and after the treatment, and the contents of nitric oxide (NO), superoxide dismutase(SOD), malonic dialdehyde(MDA) and IL-1β、TNF-α in joint fluids from the OA joints before 1st,2nd, and 5th injection and 3 months after each injection were observed. Results All cases were followed up for 3 months. The improvements in the signs and function of knees were excellent in 42 knees, good in 38 knees, fair in 21 knees and poor in 10 knees, with 72.1% excellent and good results. The lighter the illness was, the better the improvement was: the rate of the excellent and good was 92.1% in mild group, 68.6% in moderate group and 42.9% in serious group. The contents of oxygen free radicals and IL-1β、TNF-α of the patients with mild and moderate OA decreasedmarkedly after being treated with SH（Plt;0.05）, but these decreased lightlyin serious OA group（Pgt;0.05）. SH had mild effect on the contents of NO. Three months after treatment, only in mild OA group the contents of NO significantly decreased（Plt;0.05）, and no significant change in moderate and serious groups was observed（Pgt;0.05）. Conclusion SH intraarticular injection has a positive effect on the relief of clinical symptoms and on the improvement of articular function of knee OA. The therapeutical effect of SH on OA is achieved possibly by decreasing the contents of free radicals especially oxygen free radicals and inflammatory factors in joint fluids.
Objective To explore the relationship of the limited resource of the autologous bone marrow mesenchymal stem cells (MSCs) in articularcavity to the treatment results of full-thickness articular cartilage defect, and to investigate whether the extrogenous sodium hyaluronate(SH) promotes the migration of MSCs cultured in vitro tothe articular defect in vivo. Methods Sixty-six Japan rabbits were made the model of the full-thickness articular cartilage defect (5 mm width and 4 mm depth).The autologous MSCs were extracted from the rabbit femur, cultured in vitro, labeledby Brdu, and injected into the injured articular cavity with or without SH. Theexperiment was divided into 4 groups; group A (MSCs and SH, n=15); group B (MSCs, n=15); group C (SH, n=18); and group D (non-treatment, n=18). The morphologic observation was made by HE staining, Mallory staining and immunohistochemical staining after 5 weeks, 8 weeks and 12 weeks of operation. Results There were significant differences in the thickness of repairing tissue between group A and group B(Plt;0.01); but there were no significant differences between group A and group C, and between group B and group D(P＞0.05). Thehistological observation showed that the main repairing tissue was fibrocartilage in group A and fiber tissue in group B. Conclusion MSCs cultured in vitro and injected into the articular cavity can not improve the treatment results of the articular cartilage defect. Extrogenous SH has effect on repairing cartilage defect. The extrogenous SH has no effect on the chemotaxis of the MSCs, and on the collection of MSCs into the joint defect.