为探讨激光穴位照射联合丹参川芎嗪关节腔内给药治疗膝关节骨性关节炎(KOA)的疗效，将KOA患者96例随机分为对照组（n＝48, 丹参川芎嗪关节注射）和观察组（n＝48, 激光穴位照射＋丹参川芎嗪关节内给药），比较两组临床疗效及治疗前后膝关节疼痛程度、膝关节功能、膝关节活动度及白细胞介素-1β（IL-1β）、C反应蛋白(CRP)、软骨寡聚基质蛋白（COMP）及基质金属蛋白酶-3（MMP-3）血浆水平。结果表明: 观察组治疗总有效率（93.75%）高于对照组（77.08%）（P＜0.05）； 与治疗前比较，两组治疗后VAS评分及IL-1β、CRP、COMP、MMP-3水平降低（P＜0.05），Lysholm评分、膝关节活动度增高（P＜0.05），但观察组以上指标改善优于对照组（P＜0.05）。研究认为激光穴位照射联合丹参川芎嗪关节腔内给药治疗膝关节骨性关节炎的疗效满意。

In this paper, optical coherence tomography (OCT) and surface-enhanced Raman spectroscopy (SERS) were used to characterize normal knee joint (NKJ) tissue and knee osteoarthritis (KOA) tissue ex vivo. OCT images show that there is a clear hierarchical structure in NKJ tissue, including surface layer, transitional layer, radiation layer and cartilage matrix calcification layer tissue structure, while the hierarchical structure of KOA tissue is not clear and unevenly distributed, and the pathological tissues at different stages also show significant differences. SERS shows that NKJ tissue and mild osteoarthritic knee cartilage (MiKOA) tissue have strong characteristic Raman peaks at 964, 1073 (1086), 1271, 1305, 1442, 1660 and 1763cm?1. Compared with the Raman spectrum of NKJ tissue, the Raman characteristic peaks of MiKOA tissue have some shifts, moving from 1073cm?1 to 1086cm?1 and from 1542cm?1 to 1442cm?1. There is a characteristic Raman peak of 1271cm?1 in MiKOA tissue, but not in NKJ tissue. Compared with NKJ tissue, severely degenerated cartilage (SdKOA) tissues show some new SERS peaks at 1008, 1245, 1285, 1311 and 1321cm?1, which are not seen in SERS spectra of NKJ tissue. Principal component analysis (PCA) was used to analyze the Raman spectra of 1245–1345cm?1 region. The results show that PCA can distinguish NKJ, MiKOA and SdKOA tissues and the accuracy is about 90%. These results indicate that OCT can clearly distinguish NKJ, MiKOA, moderate osteoarthritic knee cartilage (MoKOA) and SdKOA tissue, while SERS can provide further judgment basis. The results also prove that the contents of protein and polysaccharide in knee tissue are changed during the pathological process of knee tissue, which is the cause of pain caused by poor friction in knee joint during movement.In this paper, optical coherence tomography (OCT) and surface-enhanced Raman spectroscopy (SERS) were used to characterize normal knee joint (NKJ) tissue and knee osteoarthritis (KOA) tissue ex vivo. OCT images show that there is a clear hierarchical structure in NKJ tissue, including surface layer, transitional layer, radiation layer and cartilage matrix calcification layer tissue structure, while the hierarchical structure of KOA tissue is not clear and unevenly distributed, and the pathological tissues at different stages also show significant differences. SERS shows that NKJ tissue and mild osteoarthritic knee cartilage (MiKOA) tissue have strong characteristic Raman peaks at 964, 1073 (1086), 1271, 1305, 1442, 1660 and 1763cm?1. Compared with the Raman spectrum of NKJ tissue, the Raman characteristic peaks of MiKOA tissue have some shifts, moving from 1073cm?1 to 1086cm?1 and from 1542cm?1 to 1442cm?1. There is a characteristic Raman peak of 1271cm?1 in MiKOA tissue, but not in NKJ tissue. Compared with NKJ tissue, severely degenerated cartilage (SdKOA) tissues show some new SERS peaks at 1008, 1245, 1285, 1311 and 1321cm?1, which are not seen in SERS spectra of NKJ tissue. Principal component analysis (PCA) was used to analyze the Raman spectra of 1245–1345cm?1 region. The results show that PCA can distinguish NKJ, MiKOA and SdKOA tissues and the accuracy is about 90%. These results indicate that OCT can clearly distinguish NKJ, MiKOA, moderate osteoarthritic knee cartilage (MoKOA) and SdKOA tissue, while SERS can provide further judgment basis. The results also prove that the contents of protein and polysaccharide in knee tissue are changed during the pathological process of knee tissue, which is the cause of pain caused by poor friction in knee joint during movement.

骨关节炎是由多种因素引起的慢性退行性关节疾病, 严重影响患者的肢体功能和日常生活, 是影响人类健康最常见的关节疾患之一。 当骨关节炎发展到一定程度时, 形成不可逆疾病。 因此, 骨关节炎的及时检测和诊断是至关重要的。 拉曼光谱在分子水平上显示出微创、 无标记和客观诊断的潜力, 因此越来越多的被用于骨关节炎的研究。 在目前本领域流行研究的基础上综述了拉曼光谱在关节软骨和骨关节炎研究中的创新性研究成果和进展, 并简要分析了目前国内外拉曼光谱技术应用的部分局限性以及未来的发展方向。 全文所述分别基于不同拉曼测量模式即宏观拉曼、 显微拉曼、 光纤拉曼三种拉曼光谱技术, 检测在骨关节炎发展中关节软骨等组织中的细胞外基质、 细胞周围基质、 以及软骨细胞中蛋白质、 脂质、 核酸成分等的变化, 甚至关联的软骨下骨和滑液的主要成分变化及其对应的部分骨关节炎特征或生理功能的变化。 该综述表明拉曼光谱检测骨关节炎组织成分变化的有效性和可行性, 可为骨关节炎的后续研究提供参考。 另一方面, 拉曼光谱技术诸多的检测和诊断优势, 特别是不受水影响的特征, 使其非常有潜力发展为本领域临床早期诊断和康复监测的有力的分子光谱技术和临床工具。

通过比较分析正常大鼠与膝骨关节炎模型（KOA）大鼠血清、 膝关节肌肉和滑膜组织的表面增强拉曼光谱(SERS), 为KOA生物学改变提供实验基础。 同条件下饲养普通级健康雄性SD大鼠20只, 随机分为正常对照组（简称“正常组”）和KOA模型组（简称“模型组”）, 每组10只。 采用左膝关节腔内注射0.03 mol·L-1的L-半胱氨酸与4%木瓜蛋白酶混合物方法制备KOA模型, 并于复制成功4周后取材。 采用银纳米基底液检测大鼠血清和膝关节肌肉、 滑膜组织中的表面增强拉曼谱峰, 应用NGLabSpec软件比较两组拉曼频移和特征峰的差异, 应用OriginPro 8.5软件分析拉曼光谱图。 结果: 在血清中, 拉曼频移400～2 000 cm-1区间内, 正常组特征峰有12个, 模型组有14个, 且模型组大部分特征峰强度低于正常组, 两组在495, 883和1 447 cm-1等处出现较为显著的差异性特征峰; 在膝关节肌肉组织中, 正常组特征峰有12个, 模型组有13个, 二者的同质性特征峰的拉曼强度存在显著差异, 模型组以950和1 237 cm-1为代表的多处同质性特征峰的峰强显著升高; 在滑膜组织中, 正常组特征峰有10个, 模型组有15个, 两组共性特征峰的峰强变化多不明显, 但在655, 950, 1 335和1 447 cm-1处的同质性特征峰表现出峰强的明显差异, 在655和950 cm-1峰为模型组显著升高, 而1 335和1 447 cm-1两峰相对强度为模型组显著降低。 结果表明: KOA模型导致血清、 膝关节肌肉和滑膜组织的同质性特征峰数量显著减少, 差异性物质增多, 物质代谢平衡被严重打破, SERS是一种快速准确的检测方法, 可以用于KOA模型的检测。

纤维状结构是生物组织的一种基本结构形式。疾病的发生和演化常常伴随着纤维状结构空间取向的相应变化。对生物组织内纤维状结构空间取向的定量表征方法和主要应用进行了简单综述,着重介绍了空间取向信息在几种重要疾病模型中的研究进展,包括伤口愈合、骨关节炎、乳腺癌、腹膜癌扩散、脑损伤等,并在特定的人工组织模型中探究了组织结构与功能的关系。对生物组织纤维状结构的高灵敏、高精度描述,为研究疾病的发生和演化提供了新思路和手段,有望实现特定疾病的早期诊断和病理机制的深入理解。最后,对该方法的应用前景进行了展望。

Two discriminant methods, partial least squares-discriminant analysis (PLS-DA) and Fisher's discriminant analysis (FDA), were combined with Fourier transform infrared imaging (FTIRI) to differentiate healthy and osteoarthritic articular cartilage in a canine model. Osteoarthritic cartilage had been developed for up to two years after the anterior cruciate ligament (ACL) transection in one knee. Cartilage specimens were sectioned into 10 μm thickness for FTIRI. A PLS-DA model was developed after spectral pre-processing. All IR spectra extracted from FTIR images were calculated by PLS-DA with the discriminant accuracy of 90%. Prior to FDA, principal component analysis (PCA) was performed to decompose the IR spectral matrix into informative principal component matrices. Based on the di?erent discriminant mechanism, the discriminant accuracy (96%) of PCA-FDA with high convenience was higher than that of PLSDA. No healthy cartilage sample was mis-assigned by these two methods. The above mentioned suggested that both integrated technologies of FTIRI-PLS-DA and, especially, FTIRI-PCA-FDA could become a promising tool for the discrimination of healthy and osteoarthritic cartilage specimen as well as the diagnosis of cartilage lesion at microscopic level. The results of the study would be helpful for better understanding the pathology of osteoarthritics.

探讨了红外热成像与骨关节炎中医证型之间的关系。采用前瞻性研究方法观察了90例骨关节炎患者，按肾虚髓亏、阳虚寒凝、瘀血阻滞将患者分为3组，每组30例。以30例健康人为对照组，使用HIR-2000A型红外热像仪对四组人进行扫描检查。扫描位置为手掌、手背、膝部和腘窝，并对相应区域的体表温度值进行记录。阳虚寒凝患者与健康人对照组之间的体表温度值差有显著的统计学意义(P<0.01)，瘀血阻滞患者与对照组之间的体表温度值差有统计学意义(P<0.05)；而肾虚髓亏患者的体表温度值与对照组相比，差异无统计学意义(P>0.05)。结果表明，红外热成像可用于骨关节炎中医证型的辅助诊断，对骨关节炎的早诊断、早治疗有重要的临床意义。

Fourier transform infrared imaging (FTIRI) was used to examine the depth-dependent content variations of macromolecular components, collagen and proteoglycan (PG), in osteoarthritic and healthy cartilages. Dried 6 μm thick sections of canine knee cartilages were imaged at 6.25 μm pixel-size in FTIRI. By analyzing the infrared (IR) images and spectra, the depth dependence of characteristic band (sugar) intensity of PG show obvious difference between the cartilage sections of (OA) and health. The result confirms that PG content decreases in the osteoarthritic cartilage. However, no clear change occurs to collagen, suggesting that the OA influences little on the collagen content at early stage of OA. This observation will be helpful to further understand PG loss associated with pathological conditions in OA, and demonstrates that FTIRI has the potential to become an important analytical tool to identify early clinical signs of tissue degradation, such as PG loss even collagen disruption.