BACKGROUND & AIMS: :Endogenous Pain Modulation (EPM) impairment is a significant contributor to chronic pain. Conditioned pain modulation (CPM) testing assesses EPM function. Osteoarthritic (OA) dogs are good translational models, but CPM has not been explored. Our aim was to assess EPM impairment in OA dogs compared to controls using CPM. We hypothesized that CPM testing would demonstrate EPM impairment in OA dogs compared to controls. Dogs with stifle/hip OA and demographically-matched controls were recruited. The pre-conditioning test stimulus, using mechanical/thermal quantitative sensory testing (MQST or TQST), were performed at the metatarsus. A 22N blunt probe (conditioning stimulus) was applied to the contralateral antebrachium for 2 minutes, followed by MQST or TQST (post-conditioning test stimulus). The threshold changes from pre to post-conditioning (∆MQST and ∆TQST) were compared between OA and control dogs. Twenty-four client-owned dogs (OA, n = 11; controls, n = 13) were recruited. The ∆MQST(p < 0.001) and ∆TQST(p < 0.001) increased in control dogs but not OA dogs (∆MQST p = 0.65; ∆TQST p = 0.76). Both ∆MQST(p < 0.001) and ∆TQST(p < 0.001) were different between the OA and control groups. These are the first data showing that EPM impairment is associated with canine OA pain. The spontaneous OA dog model may be used to test drugs that normalize EPM function.

背景与目标： ：内源性疼痛调节（EPM）损伤是导致慢性疼痛的重要因素。有条件的疼痛调节（CPM）测试可评估EPM功能。骨关节炎（OA）狗是很好的转化模型，但尚未探索CPM。我们的目的是评估与使用CPM的对照组相比，OA狗的EPM损伤。我们假设，与对照组相比，CPM测试将证明OA狗的EPM受损。募集了具有窒息/髋骨OA和人口统计学匹配的对照的狗。使用机械/热定量感官测试（MQST或TQST）对-骨进行预处理测试刺激。在对侧前臂上施加22N钝探针（条件刺激）2分钟，然后进行MQST或TQST（条件后测试刺激）。比较了OA和对照犬从适应前到适应后的阈值变化（ΔMQST和ΔTQST）。招募了二十四只客户拥有的狗（OA，n = 11；对照组，n = 13）。对照犬的∆MQST（p <0.001）和∆TQST（p <0.001）升高，但OA犬却没有（∆MQST p = 0.65; ∆TQST p = 0.76）。 OA组和对照组之间的∆MQST（p <0.001）和∆TQST（p <0.001）均不同。这些是第一个显示EPM损伤与犬OA疼痛相关的数据。自发的OA狗模型可用于测试使EPM功能正常化的药物。

BACKGROUND & AIMS: :Musculoskeletal disorders such as knee osteoarthritis (OA) are the primary cause of chronic pain in older adults. Recommended self-management strategies for knee OA include staying physically active in the face of pain, but many patients avoid activities they are capable of doing. The overall purpose of this study was to examine the extent to which daily pain catastrophizing, a maladaptive coping strategy, could influence OA patients' physical activity and sedentary behavior. The current study used data from 143 older knee OA patients who completed electronic daily diaries for 22 days and wore an accelerometer to capture physical activity and sedentary behavior. At the beginning of each day, patients reported their pain catastrophizing regarding the day ahead. Results from multilevel models demonstrated that on mornings when patients catastrophized more than usual about their pain in the day ahead, they spent more time in sedentary behavior and engaged in fewer minutes of moderate to vigorous physical activity that day. Cross-day lagged analyses further showed that the effect of morning pain catastrophizing on subsequent sedentary behavior extended to the next day. More time spent in sedentary behavior, in turn, contributed to greater pain catastrophizing the next morning. These findings support the mechanistic role of daily pain catastrophizing in the avoidance of physical activity for older OA patients, and suggest that effective interventions for pain catastrophizing may also reduce sedentary behavior and enhance physical activity, with longer-term benefits for pain management, physical function, and overall health.

背景与目标： ：肌肉骨骼疾病，例如膝骨关节炎（OA）是老年人慢性疼痛的主要原因。推荐的膝盖OA自我管理策略包括在面对疼痛时保持身体活动，但许多患者会避免进行自己能做的活动。这项研究的总体目的是研究灾难性的每日疼痛（一种适应不良的应对策略）在多大程度上影响OA患者的身体活动和久坐行为。当前的研究使用了143名年龄较大的膝盖OA患者的数据，这些患者完成了22天的每日电子日记，并佩戴了加速度计来捕捉身体活动和久坐的行为。在每天的开始，患者报告前一天的疼痛是灾难性的。多级模型的结果表明，早晨患者在前一天遭受的痛苦比平常多得多，他们在久坐行为上花费的时间更多，并且当天参加中度到剧烈运动的时间更少。跨日滞后分析进一步表明，早晨疼痛的灾难性后果对随后的久坐行为的影响延续到第二天。反过来，花在久坐行为上的时间更多，则导致第二天早上更大的痛苦成为灾难。这些发现支持了每日疼痛剧烈化在避免老年OA患者身体活动中的机械作用，并表明有效的疼痛剧烈化干预措施还可以减少久坐的行为并增强身体活动，对疼痛管理，身体机能具有长期益处，以及整体健康状况。

BACKGROUND & AIMS: :Nuclear factor-kappaB (NF-κB) proteins constitute a family of transcription factors that are stimulated by pro-inflammatory cytokines, chemokines, stress-related factors and extracellular matrix (ECM) degradation products. Upon stimulation, the activated NF-κB molecules trigger the expression of an array of genes which induce destruction of the articular joint, leading to osteoarthritis (OA) onset and progression. Therefore, targeted strategies that interfere with NF-κB signalling could offer novel potential therapeutic options for OA treatment. In this review, we discuss the involvement of NF-κB in OA pathogenesis and how pharmacological inhibition of the NF-κB signalling pathway affects OA incidence and evolution.

背景与目标： ：核因子-κB（NF-κB）蛋白构成转录因子家族，可被促炎性细胞因子，趋化因子，应激相关因子和细胞外基质（ECM）降解产物刺激。刺激后，活化的NF-κB分子触发一系列基因的表达，这些基因诱导关节的破坏，从而导致骨关节炎（OA）的发作和进展。因此，干扰NF-κB信号传导的靶向策略可以为OA治疗提供新的潜在治疗选择。在这篇综述中，我们讨论了NF-κB在OA发病机理中的参与以及NF-κB信号通路的药理抑制作用如何影响OA的发生和发展。

BACKGROUND & AIMS: :A retrospective review of weight-bearing roentgenograms of 2197 knees in 1894 patients with symptomatic idiopathic osteoarthritis (IOA) revealed six different patterns of tibiofemoral deformity. Five of these patterns expand the taxonomic concepts of Ahlback; the sixth, "nonproliferative," was previously undescribed. It was seen exclusively in patients with varus disease and was characterized by a lack of reactive bony changes. Knees with degenerative changes in the medial compartment constituted the majority of cases (63%). The average age of patients was 72 years for those with varus disease, 79 years for those with valgus disease, and 84 years for those with patellofemoral arthritis (PFA). Bilateral involvement was common only in patients with PFA (79%), suggesting a developmental cause for this subset. There was a female predominance in valgus and patellofemoral disease. The authors report here on a classification system of IOA that has been designed and modified to reflect the unique roentgenographic, epidemiologic, and clinical characterization of the six subsets.

背景与目标： ：回顾性研究了1894例有症状的特发性骨关节炎（IOA）患者的2197膝的负重X线检查，结果显示了6种不同的胫股骨畸形。其中五个模式扩展了Ahlback的分类学概念；第六，“不扩散”，以前没有描述过。仅在内翻性疾病患者中可见，其特征是缺乏反应性骨改变。膝关节内侧腔退行性变的病例占大多数（63％）。内翻疾病患者的平均年龄为72岁，外翻疾病患者的平均年龄为79岁，pa股关节炎（PFA）的患者平均年龄为84岁。双边受累仅在PFA患者中很常见（79％），表明该亚组是发育原因。外翻和pa股病以女性为主。作者在这里报告了IOA的分类系统，该系统已经过设计和修改，以反映这六个子集的独特的X线照相，流行病学和临床特征。

BACKGROUND & AIMS: :Hypertonic saline effectively excites muscle nociceptors. Muscle hyperalgesia was assessed in osteoarthritis (OA) by intramuscular infusion of 0.5 ml hypertonic saline (6%) into the tibialis anterior muscle in humans. Patients (n=14) with OA in the lower extremities were compared with an equal number of age- and sex-matched healthy controls. Ten of the 14 OA patients had pain in the knee joint as the most common presenting complaint. Visual analogue scale (VAS) pain intensity and assessment of pain areas were recorded before infusion and immediately, 2, 5, 10 and 20 min after infusion, and then every 10 min, until the pain vanished. The mean pain offset time in OA patients (11.3+/-7.9 min) was larger as compared with the control subjects (6.04+/-2.1 min) (P=0.025). OA patients had increased pain intensity VAS after the infusion in the right leg compared with controls (P<0.05). Referred and radiating pain areas at 2 min post-infusion increased in OA patients and not in controls as compared with the local pain areas (P<0.05). It is concluded that muscle hyperalgesia and extended pain areas might be due to central sensitization caused by painful osteoarthritis.

背景与目标： ：高盐生理盐水可有效刺激肌肉伤害感受器。通过在人的胫骨前肌中肌内注入0.5 ml高渗盐水（6％）来评估骨关节炎（OA）中的肌肉痛觉过敏。将下肢骨关节炎患者（n = 14）与相同数量的年龄和性别匹配的健康对照进行比较。 14例OA患者中有10例最常见的主诉是膝关节疼痛。在输注前以及输注后第2、5、10和20分钟，然后每10分钟立即记录视觉模拟量表（VAS）的疼痛强度和疼痛区域的评估，直至疼痛消失。与对照组相比（6.04 /-2.1分钟），OA患者的平均疼痛抵消时间（11.3 /-7.9分钟）更长（P = 0.025）。与对照组相比，右腿输注后OA患者的疼痛强度VAS增加（P <0.05）。与局部疼痛区域相比，OA患者而非对照组的2分钟输注后疼痛和放射痛区域增加（P <0.05）。结论是，肌肉痛觉过敏和疼痛区域扩大可能是由于疼痛性骨关节炎引起的中枢敏化所致。

BACKGROUND & AIMS: Clinical Question:Are intra-articular corticosteroids associated with improvement in pain and physical function compared with sham injection or no intervention in patients with knee osteoarthritis? Bottom Line:Intra-articular corticosteroids may be associated with moderate improvement in pain and a small improvement in physical function up to 6 weeks after injection. However, the quality of the evidence is low.

背景与目标： 临床问题：与假注射相比，膝关节骨内激素是否与疼痛和身体功能的改善相关或是否没有干预？
底线：注射后长达6周，关节内糖皮质激素可能与疼痛的中度改善和身体机能的轻微改善有关。但是，证据的质量很低。

BACKGROUND & AIMS: UNLABELLED:Peak knee joint contact forces ("loads") in running are much higher than they are in walking, where the peak load has been associated with the initiation and progression of knee osteoarthritis. However, runners do not have an especially high risk of osteoarthritis compared with nonrunners. This paradox suggests that running somehow blunts the effect of very high peak joint contact forces, perhaps to provide a load per unit distance (PUD) traveled that is relatively low. PURPOSE:This study aimed to compare peak and PUD knee joint loads between human walking and running. METHODS:Fourteen healthy adults walked and ran at self-selected speeds. Ground reaction force and motion capture data were measured and combined with inverse dynamics and musculoskeletal modeling to estimate the peak knee joint loads, PUD knee joint loads, and the impulse of the knee joint contact force for each gait with a matched-pair (within-subject) design. RESULTS:The peak load was three times higher in running (8.02 vs 2.72 body weight, P < 0.001), but the PUD load did not differ between running and walking (0.80 vs 0.75 body weight per meter, P = 0.098). The impulse of the joint contact force was greater for running than for walking (1.30 vs 1.04 body weight per second, P < 0.001). The peak load increased with increasing running speed, whereas the PUD load decreased with increasing speed. CONCLUSIONS:Compared with walking, the relatively short duration of ground contact and relatively long length of strides in running seem to blunt the effect of high peak joint loads, such that the PUD loads are no higher than that in walking. Waveform features other than or in addition to the peak value should be considered when studying joint loading and injuries.

背景与目标： 不加标签：跑步中的峰值膝关节接触力（“负荷”）比步行中要高得多，在步行中，峰值负荷与膝骨关节炎的发生和发展有关。但是，与非跑步者相比，跑步者没有特别高的骨关节炎风险。这种悖论表明，运行会以某种方式使非常高的峰值关节接触力的作用变钝，也许是为了提供相对较低的每单位距离（PUD）行驶的负载。
目的：本研究旨在比较人的行走和跑步之间的峰值和PUD膝关节负荷。
方法：十四名健康的成年人以自行选择的速度行走和奔跑。测量地面反作用力和运动捕获数据，并将其与逆动力学和肌肉骨骼模型相结合，以估计每个步态具有匹配对的膝关节峰值负荷，PUD膝关节负荷和膝关节接触力的脉冲（在-主题）设计。
结果：跑步时的峰值负荷高出三倍（8.02对2.72体重，P <0.001），但跑步和步行之间的PUD负荷无差异（每米0.80对0.75体重，P = 0.098）。跑步时，关节接触力的冲动大于行走时的冲动（1.30比1.04体重/秒，P <0.001）。峰值负载随运行速度的增加而增加，而PUD负载随速度的增加而减少。
结论：与行走相比，地面接触持续时间相对较短，步幅相对较长的步伐似乎抑制了高峰值关节负荷的影响，因此PUD负荷不高于行走时的负荷。研究关节负载和损伤时，应考虑除峰值以外或除峰值外的波形特征。

BACKGROUND & AIMS: :We assessed the pathological changes of articular cartilage and subchondral bone on different locations of the knee after extracorporeal shockwave therapy (ESWT) in early osteoarthritis (OA). Rat knees under OA model by anterior cruciate ligament transaction (ACLT) and medial meniscectomy (MM) to induce OA changes. Among ESWT groups, ESWT were applied to medial (M) femur (F) and tibia (T) condyles was better than medial tibia condyle, medial femur condyle as well as medial and lateral (L) tibia condyles in gross osteoarthritic areas (p<0.05), osteophyte formation and subchondral sclerotic bone (p<0.05). Using sectional cartilage area, modified Mankin scoring system as well as thickness of calcified and un-calcified cartilage analysis, the results showed that articular cartilage damage was ameliorated and T+F(M) group had the most protection as compared with other locations (p<0.05). Detectable cartilage surface damage and proteoglycan loss were measured and T+F(M) group showed the smallest lesion score among other groups (p<0.05). Micro-CT revealed significantly improved in subchondral bone repair in all ESWT groups compared to OA group (p<0.05). There were no significantly differences in bone remodeling after ESWT groups except F(M) group. In the immunohistochemical analysis, T+F(M) group significant reduced TUNEL activity, promoted cartilage proliferation by observation of PCNA marker and reduced vascular invasion through observation of CD31 marker for angiogenesis compared to OA group (P<0.001). Overall the data suggested that the order of the effective site of ESWT was T+F(M) ≧ T(M) > T(M+L) > F(M) in OA rat knees.

背景与目标： ：我们评估了在早期骨关节炎（OA）中进行体外冲击波治疗（ESWT）后，膝关节不同部位的关节软骨和软骨下骨的病理变化。 OA模型下的大鼠膝盖通过前交叉韧带交易（ACLT）和内侧半月板切除术（MM）诱导OA改变。在ESWT组中，将ESWT应用于大骨关节炎地区的内侧（M）股骨（F）和胫骨（T）dy优于内侧胫骨con，内侧股骨con以及胫骨内侧和外侧（L）（（p < 0.05），骨赘形成和软骨下硬化骨（p <0.05）。使用软骨截面面积，改良的Mankin评分系统以及钙化和非钙化软骨的厚度分析，结果表明，与其他部位相比，TF（M）组对关节软骨的损害得到了最大程度的保护（p <0.05 ）。测量可检测到的软骨表面损伤和蛋白聚糖损失，TF（M）组在其他组中的病变评分最小（p <0.05）。 Micro-CT显示，与OA组相比，所有ESWT组的软骨下骨修复均显着改善（p <0.05）。除F（M）组外，ESWT组的骨重塑没有显着差异。在免疫组织化学分析中，与OA组相比，TF（M）组通过观察PCNA标记显着降低了TUNEL活性，促进了软骨增殖，并且通过观察CD31标记的血管生成降低了血管侵袭（P <0.001）。总体而言，数据表明，OA大鼠膝关节ESWT有效部位的顺序为T F（M）≥T（M）> T（ML）> F（M）。

BACKGROUND & AIMS: :The objective of this study was to identify, on a symptomatic knee osteoarthritis (OA) cohort, the risk factors associated with the progression of the disease. More specifically, we investigated the correlation between knee cartilage volume loss from subregions over the span of 24 months by means of quantitative magnetic resonance imaging (qMRI) with demographic, clinical, radiological, and MRI structural changes. A cohort of 107 patients with knee OA selected from a large trial evaluating the effect of a bisphosphonate underwent x-rays and MRI of the knee at baseline and 24 months. Joint space width (JSW) and joint space narrowing (JSN) and cartilage volume loss over time in subregions of the tibial plateaus and femoral condyles were quantitated. Structural changes in the subchondral bone (hypersignal) and in the menisci (tear and extrusion) were also evaluated. The greatest cartilage volume loss was found in the medial compartment, and risk factors included female gender, JSW, meniscal lesions, and bone changes at baseline. Subregion analysis revealed that the greatest cartilage volume loss at 24 months was found in the central area of the medial tibial plateau (15%; p < 0.0001) and of the medial femoral condyle (12%; p < 0.0001). These findings were associated with the presence at baseline of meniscal extrusion, particularly severe meniscal extrusion, medial and severe meniscal tear, bone hypersignal, high body mass index (BMI), smaller JSW, increases in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and patient global scores over time, and greater JSN. Parameters predicting medial central femoral condyle cartilage volume loss at 24 months were lateral meniscal tear, SF-36 and BMI at baseline, and JSN. At the medial central tibial plateau, the parameters were severe meniscal extrusion, severe lateral meniscal tear, and bone hypersignal in the lateral compartment at baseline, and WOMAC pain change. Meniscal damage and bone changes are the features most closely associated with the greatest subregional cartilage volume loss. Interestingly, for the first time, JSN was strongly associated with cartilage loss in the central areas of plateaus and condyles. This study also further confirms the correlation between cartilage volume loss and JSN and symptomatic changes at 24 months.

背景与目标： ：这项研究的目的是在有症状的膝骨关节炎（OA）队列中确定与疾病进展相关的危险因素。更具体地说，我们通过定量磁共振成像（qMRI）结合人口统计学，临床，放射学和MRI结构变化，研究了24个月跨区域膝关节软骨体积损失之间的相关性。从一项大型试验中选择的107名膝OA患者队列评估了双磷酸盐的疗效，并在基线和24个月对膝关节进行了MRI检查。定量分析了胫骨平台和股骨sub子区域的关节间隙宽度（JSW）和关节间隙变窄（JSN）以及软骨体积损失随时间的变化。还评估了软骨下骨（高信号）和半月板（撕裂和挤压）的结构变化。最大的软骨体积损失发生在内侧腔室，其危险因素包括女性，JSW，半月板病变和基线骨质改变。次区域分析显示，在胫骨平台内侧中央区域（15％； p <0.0001）和股骨内侧fe中央区域（12％； p <0.0001）发现了24个月时最大的软骨体积损失。这些发现与半月板挤压的基线存在有关，特别是严重的半月板挤压，内侧和严重的半月板撕裂，骨信号亢进，高体重指数（BMI），较小的JSW，西安大略省和麦克马斯特大学骨关节炎指数（WOMAC）升高随着时间的流逝，疼痛和患者的整体评分会提高，并且JSN也会更高。预测24个月时内侧中枢股骨con突软骨体积减少的参数是外侧半月板撕裂，基线时的SF-36和BMI以及JSN。在胫骨内侧中央高原，这些参数包括严重的半月板挤压，严重的半月板撕裂和基线时外侧室的骨高信号，以及WOMAC疼痛变化。半月板损伤和骨骼变化是与最大的次区域软骨体积损失最密切相关的特征。有趣的是，JSN首次与高原和con突中心区域的软骨损失密切相关。这项研究还进一步证实了24个月时软骨体积损失与JSN和症状变化之间的相关性。

BACKGROUND & AIMS: OBJECTIVE:To determine the influence of comorbidity on physical function in osteoarthritis (OA) consulters aged 50 years and over in family practice. METHODS:The study design linked morbidity consultations during an 18-month period to self-reported physical function status measured at the end of the period. Clinical comorbidity was compared between consulters with (n = 1026) and without (n = 8160) OA. Comorbidity was defined by morbidity counts (1-2 low, 3-4 medium,> 5 high) and by a measure of severity of individual morbidities based on chronicity. Associations between comorbidity and physical function were assessed using unconditional logistic regression, adjusting for age, sex, and socioeconomic deprivation. RESULTS:Of the 1026 OA consulters, 38 (3.7%) had an OA consultation only, 260 (25.3%) had low, 288 (28.1%) medium, and 440 (42.9%) high morbidity counts. Higher OA comorbid counts were associated with poorer physical function, after adjusting for age, sex, and socioeconomic deprivation. Associations between OA comorbidity severity and poor physical function showed estimates that were in excess of simply multiplying the individual effects of OA and comorbidity severity separately. Comorbidity, however, did not explain all of the association between OA and poor physical function. CONCLUSION:Comorbidity increases the likelihood of poor physical function in patients with OA in population-based family practice. The combined influence is greater than would be expected from the influence of either OA or the comorbid conditions alone. Treating comorbidity in patients with OA is likely to be crucial in preventing or reducing the related physical decline.

背景与目标： 目的：确定合并症对50岁及以上的家庭实践中骨关节炎（OA）咨询员身体功能的影响。
方法：本研究设计将18个月期间的发病率咨询与该阶段结束时测得的自我报告的身体功能状态联系起来。比较了有（n = 1026）和没有（n = 8160）OA的顾问之间的临床合并症。合并症的定义是发病率计数（1-2低，3-4中，> 5高）和根据慢性病对个体发病严重程度的度量。使用无条件逻辑回归评估合并症和身体机能之间的关联，并根据年龄，性别和社会经济剥夺情况进行调整。
结果：在1026名OA顾问中，仅进行OA咨询的有38名（3.7％），低（260）（25.3％）低，288（28.1％）中，440（42.9％）高发病率。在调整了年龄，性别和社会经济剥夺之后，较高的OA合并症计数与较差的身体机能相关。 OA合并症严重程度与身体机能不良之间的关联表明，估计值超过了简单地将OA和合并症严重程度的单独影响相乘的程度。然而，合并症并不能解释OA与身体机能不良之间的所有关联。
结论：合并症增加了以人群为基础的家庭实践中OA患者身体机能不良的可能性。合并的影响大于从OA或单独的合并症的影响所预期的影响。在OA患者中治疗合并症可能对于预防或减少相关的体力下降至关重要。

BACKGROUND & AIMS: BACKGROUND:Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic synovitis that progresses to destruction of cartilage and bone. AIM:The purpose of this study was to employ microarray analysis combined with bioinformatics techniques to evaluate differential gene expression in BM-derived mononuclear cells obtained from patients with rheumatoid arthritis (RA) or osteoarthritis (OA) to study the pathogenesis of this disease. MATERIALS AND METHODS:Gene expression profiles in BM-derived mononuclear cells from 9 RA and 10 OA patients were obtained from GEO. RESULTS:The bone marrow (BM) mononuclear cells showed 2581 up-regulated and 649 down-regulated genes in RA patients relative to the OA group: Our analysis indicated that several differentially expressed genes might play crucial roles in RA development, including SP1, RARA, ETS1, ETS2, FOS and ESR1. CONCLUSIONS:Further analysis predicted these genes might be involved in RA through cancer related pathways and immunity related pathways. Furthermore, these genes may serve as novel therapeutic targets for the treatment of RA.

背景与目标： 背景：类风湿关节炎（RA）是一种全身性自身免疫性疾病，其特征在于慢性滑膜炎，其发展为软骨和骨骼的破坏。
目的：本研究的目的是将微阵列分析与生物信息学技术结合使用，以评估类风湿关节炎（RA）或骨关节炎（OA）患者获得的BM来源的单核细胞中的差异基因表达，以研究该疾病的发病机理。
材料与方法：从GEO获得了9名RA和10名OA患者的BM来源的单核细胞的基因表达谱。
结果：相对于OA组，RA患者的骨髓（BM）单核细胞显示2581个上调基因和649个下调基因：我们的分析表明，几个差异表达基因可能在RA发育中起关键作用，包括SP1，RARA ，ETS1，ETS2，FOS和ESR1。
结论：进一步的分析预测这些基因可能通过癌症相关途径和免疫相关途径参与RA。此外，这些基因可以作为RA的新治疗靶标。

BACKGROUND & AIMS: BACKGROUND:Evidence suggests that both selective cyclooxygenase (COX)-2 inhibitors and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) increase the risk of cardiovascular events. However, evidence from prospective studies of currently available COX-2 inhibitors and non-selective NSAIDs is lacking in patients at high cardiovascular risk who are taking aspirin. OBJECTIVE:To determine the cardiovascular outcomes in high risk patients with osteoarthritis treated with ibuprofen, naproxen or lumiracoxib. METHODS:The Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET) of 18 325 patients with osteoarthritis comprised two parallel substudies, comparing lumiracoxib (COX-2 inhibitor) with either ibuprofen or naproxen. A post hoc analysis by baseline cardiovascular risk, treatment assignment, and low-dose aspirin use was performed. The primary composite end point was cardiovascular mortality, non-fatal myocardial infarction, and stroke at 1 year; a secondary end point was the development of congestive heart failure (CHF). RESULTS:In high risk patients among aspirin users, patients in the ibuprofen substudy had more primary events with ibuprofen than lumiracoxib (2.14% vs 0.25%, p = 0.038), whereas in the naproxen substudy rates were similar for naproxen and lumiracoxib (1.58% vs 1.48%, p = 0.899). High risk patients not taking aspirin had fewer primary events with naproxen than with lumiracoxib (0% vs 1.57%, p = 0.027), but not for ibuprofen versus lumiracoxib (0.92% vs 0.80%, p = 0.920). Overall, CHF developed more often with ibuprofen than lumiracoxib (1.28% vs 0.14%; p = 0.031), whereas no difference existed between naproxen and lumiracoxib. CONCLUSIONS:These data suggest that ibuprofen may confer an increased risk of thrombotic and CHF events relative to lumiracoxib among aspirin users at high cardiovascular risk. The study indicates that naproxen may be associated with lower risk relative to lumiracoxib among non-aspirin users. This study is subject to inherent limitations, and therefore should be interpreted as a hypothesis-generating study.

背景与目标： 背景：证据表明，选择性环氧合酶（COX）-2抑制剂和非选择性非甾体类抗炎药（NSAIDs）均可增加发生心血管事件的风险。但是，在服用阿司匹林的心血管高危患者中，缺乏对目前可用的COX-2抑制剂和非选择性NSAIDs的前瞻性研究证据。
目的：确定布洛芬，萘普生或鲁美昔布治疗的高危骨关节炎患者的心血管结局。
方法：治疗性关节炎研究和胃肠道事件试验（TARGET）对18 325例骨关节炎患者进行了两项平行研究，比较了lumiracoxib（COX-2抑制剂）与布洛芬或萘普生的疗效。通过基线心血管风险，治疗分配和小剂量阿司匹林进行事后分析。主要的复合终点是心血管疾病死亡率，非致命性心肌梗塞和1年时的卒中。次要终点是充血性心力衰竭（CHF）的发展。
结果：在阿司匹林使用者中的高危患者中，布洛芬亚组患者的布洛芬原发事件多于卢拉昔布（2.14％vs 0.25％，p = 0.038），而在萘普生亚组中，萘普生和卢拉昔布的亚组发生率相似（1.58％）对比1.48％，p = 0.899）。不服用阿司匹林的高危患者与萘米普生相比，萘普生的原发事件较少（0％比1.57％，p = 0.027），但布洛芬和lumiracoxib相比则没有（0.92％比0.80％，p = 0.920）。总体而言，布洛芬组的CHF发生率高于卢美昔布（1.28％vs 0.14％； p = 0.031），而萘普生和卢美昔布之间无差异。
结论：这些数据表明，与具有较高心血管风险的阿司匹林使用者相比，布洛芬相对于lumiracoxib可能增加血栓和CHF事件的风险。该研究表明，与非阿司匹林使用者相比，萘普生相对于lumiracoxib的风险较低。这项研究受到固有限制，因此应解释为产生假设的研究。

BACKGROUND & AIMS: :Being overweight is a major risk factor for developing knee osteoarthritis (OA). The purpose of the current study was to: (a) determine participant adherence to a quadriceps exercise and weight management program after completion of the intervention; and (b) examine whether a quadriceps exercise and weight management program can reduce knee pain and improve knee function and weight loss in 40 community-dwelling overweight Thai older adults with knee OA at 6- and 12-month follow up. Twenty-nine (76.3%) participants completed at least 75% of the program. Two (5%) participants did not complete the program. In the intervention group, significant improvement was noted in knee range of motion at 6 and 12 months compared with baseline, and a significant reduction was noted in knee pain, time spent in the Timed Up and Go test, and body weight compared with baseline. These study variables, except for body weight, between the intervention group and control group were significantly different. This study highlights the benefit of long-term adherence to the multicomponent intervention for community-dwelling overweight Thai older adults with knee OA. [Journal of Gerontological Nursing, 43(4), 40-48.].

背景与目标： ：超重是发展膝关节骨关节炎（OA）的主要危险因素。本研究的目的是：（a）在干预完成后确定参与者是否遵守了股四头肌锻炼和体重管理计划； （b）在40个社区居住的泰国超重老年人中，在6个月和12个月的随访中，检查股四头肌锻炼和体重管理计划是否可以减轻膝关节疼痛并改善膝关节功能和减轻体重。 29名（76.3％）的参与者至少完成了该计划的75％。两名（5％）参与者未完成该计划。在干预组中，与基线相比，在6和12个月时膝关节运动范围得到了显着改善，并且与基线相比，膝关节疼痛，Timed Up and Go测试所花费的时间以及体重均得到了显着降低。除体重外，干预组与对照组之间的这些研究变量存在显着差异。这项研究凸显了长期坚持对社区居住的泰国超重膝关节OA老年人的多组分干预的益处。 [老年护理杂志，43（4），40-48。]。

BACKGROUND & AIMS: BACKGROUND:Quantitative MR, including T1ρ mapping, has been extensively used to probe early biochemical changes in knee articular cartilage of subjects with osteoarthritis (OA) and others at risk for cartilage degeneration, such as those with anterior cruciate ligament (ACL) injury and reconstruction. However, limited studies have been performed aimed to assess the spatial location and patterns of T1ρ. In this study we used a novel voxel-based relaxometry (VBR) technique coupled with principal component analysis (PCA) to extract relevant features so as to describe regional patterns and to investigate their similarities and differences in T1ρ maps in subjects with OA and subjects six months after ACL reconstruction (ACLR). METHODS:T1ρ quantitative MRI images were collected for 180 subjects from two separate cohorts. The OA cohort included 93 osteoarthritic patients and 25 age-matched controls. The ACLR-6M cohort included 52 patients with unilateral ACL tears who were imaged 6 months after ACL reconstruction, and 10 age-matched controls. Non-rigid registration on a single template and local Z-score conversion were adopted for T1ρ spatial and intensity normalization of all the images in the dataset. PCA was used as a data dimensionality reduction to obtain a description of all subjects in a 10-dimensional feature space. Logistic linear regression was used to identify distinctive features of OA and ACL subjects. RESULTS:Global prolongation of the Z-score was observed in both OA and ACL subjects compared to controls [higher values in 1st principal component (PC1); P=0.01]. In addition, relaxation time differences between superficial and deep cartilage layers of the lateral tibia and trochlea were observed to be significant distinctive features between OA and ACL subjects. OA subjects demonstrated similar values between the two cartilage layers [higher value in 2nd principal component (PC2); P=0.008], while ACL reconstructed subjects showed T1ρ prolongation specifically in the cartilage superficial layer (lower values in PC2; P<0.0001). T1ρ elevation located outside of the weight-bearing area, located in the posterior and anterior aspects of the lateral femoral compartment, was also observed to be a key feature in distinguishing OA subjects from controls [higher value in 6th principal component (PC6); P=0.007]. CONCLUSIONS:This study is the first example of T1ρ local/regional pattern analysis and data-driven feature extraction in knees with cartilage degeneration. Our results revealed similarities and differences between OA and ACL relaxation patterns that could be potentially useful to better understand the pathogenesis of post-traumatic cartilage degeneration and the identification of imaging biomarkers for the early stratification of subjects at risk for developing post-traumatic OA.

背景与目标： 背景：定量MR（包括T1ρ作图）已广泛用于探查患有骨关节炎（OA）和其他具有软骨退化风险的受试者（例如前交叉韧带（ACL）损伤和重建的受试者）的膝关节软骨的早期生化变化。但是，已经进行了旨在评估T1ρ的空间位置和样式的有限研究。在这项研究中，我们使用了一种新颖的基于体素的弛豫法（VBR）技术和主成分分析（PCA）来提取相关特征，以便描述区域模式并研究OA受试者和受试者6中T1ρ图的相似性和差异性ACL重建（ACLR）后的几个月。
方法：从两个独立的队列中收集180例受试者的T1ρ定量MRI图像。 OA队列包括93例骨关节炎患者和25例年龄匹配的对照。 ACLR-6M队列包括52例ACL重建后6个月成像的单侧ACL眼泪患者和10个年龄匹配的对照。对数据集中所有图像的T1ρ空间和强度归一化采用单个模板上的非刚性配准和局部Z分数转换。 PCA用作数据降维，以获取10维特征空间中所有主题的描述。 Logistic线性回归用于确定OA和ACL受试者的显着特征。
结果：与对照组相比，在OA和ACL受试者中均观察到Z分数的整体延长[第一主成分（PC1）值较高； P ＝ 0.01]。此外，观察到胫骨外侧外侧和滑车的浅层和深层软骨之间的松弛时间差异是OA和ACL受试者之间的显着特征。 OA受试者在两个软骨层之间表现出相似的值[第二主成分（PC2）的值较高； P = 0.008]，而经ACL重建的受试者在软骨表层特异显示T1ρ延长（PC2值较低； P <0.0001）。 T1ρ升高位于承重区域之外，位于股外侧厢室的后部和前部，也被认为是区分OA受试者与对照组的关键特征[第6个主要成分（PC6）较高； P = 0.007]。
结论：本研究是T1ρ局部/区域模式分析和数据驱动的特征性膝关节软骨变性的特征提取的第一个例子。我们的研究结果揭示了OA和ACL放松模式之间的相似性和差异性，可能有助于更好地了解创伤后软骨变性的发病机理，并为可能发展为创伤后OA的受试者的早期分层识别成像生物标记物。

BACKGROUND & AIMS: :Kashin-Beck disease (KBD) is a chronic osteochondropathy with unclear pathogeny. In this study, we compared the microRNA expression profiles of 16 KBD patients, 16 osteoarthritis (OA) patients and 16 rheumatoid arthritis (RA) patients and 16 healthy controls in their blood specimens. miRNAs expression profiling was performed using Exiqon miRCURY LNATM miRNAs Array. miRNAs target genes were predicted using miRror suite. Another independent mRNA expression profile dataset of 20 KBD patients and 15 healthy controls were integrated with the miRNA expression profiles of KBD. We identified 140 differently expressed miRNAs in KBD vs. CONTROLS:GO enrichment analysis found that hypoxia, Wnt receptor signaling pathway and vitamin B6 biosynthesis related GO terms were significantly overrepresented in the target genes of differently expressed miRNAs in KBD vs. CONTROL:18 differently expressed common miRNAs were identified in KBD vs. Control, KBD vs. OA and KBD vs. RA. Integrating the lists of differently expressed miRNA target genes and mRNA differently expressed genes detected 6 common genes for KBD. Our results demonstrated the altered miRNAs expression profiles of KBD comparing to healthy controls, OA and RA, which provide novel clues for clarifying the mechanism of KBD.

背景与目标： ：Kashin-Beck病（KBD）是一种慢性骨软骨病，病因尚不明确。在这项研究中，我们比较了血液样本中16位KBD患者，16位骨关节炎（OA）患者和16位类风湿关节炎（RA）患者和16位健康对照者的microRNA表达谱。使用Exiqon miRCURY LNATM miRNA Array进行miRNA表达谱分析。使用miRror套件可预测miRNA靶基因。将20位KBD患者和15位健康对照的另一个独立的mRNA表达谱数据集与KBD的miRNA表达谱整合在一起。我们在KBD与cDNA中鉴定了140种不同表达的miRNA。
对照组：GO富集分析发现，与KBD相比，KBD中不同表达的miRNA的靶基因中缺氧，Wnt受体信号传导途径和维生素B6生物合成相关的GO术语显着过量表达。
对照：在KBD与对照，KBD与OA以及KBD与RA中鉴定出18种不同表达的常见miRNA。整合不同表达的miRNA靶基因和mRNA不同表达的基因的列表，检测到KBD的6个常见基因。我们的结果表明，与健康对照，OA和RA相比，KBD的miRNA表达谱发生了变化，这为阐明KBD的机理提供了新的线索。