| Chapter 1: Introduction Chapter 2: Study on the correlation between serum bone metabolic factor and severity of knee joint malformation in primary knee arthritisObjuctive: To retrospectively study the relationship between serum bone metabolism and severity of knee varus deformity in primary knee arthritisMethods: A total of 139 patients with primary knee arthritis were enrolled in this study.The bone metabolism of PTH,OPG and LEPTIN were detected by multichannel immunomagnetic ball flow cytometry.DKK1,TNF-α,OPN,SOST serum concentration,full-length X-ray of the lower limbs,measuring the medial tibial medial angle(MPTA)and HKA angle.The patients were divided into MPTA <85 °varus group and 85-90 ° normal group and> 90 ° valgus group with 87 ° ± 3 ° as normal MPTA angleResults: There were 73 cases with MPTA angle of <85 ° group,66 cases of MPTA angle of 85 °-90 ° and 63 cases of MPTA angle> 90 ° group.The levels of serum DKK1 and TNF-α were lower than those of normal angle group,Serum OPN varus angle group was higher than normal angle group,serum OPG level and MPTA was negatively correlated.Conclusions: In patients with KOA,the levels of serum DKK1 and TNF-α decreased and the OPN concentration increased in patients with more severe tibial varus deformity.Chapter 3: Serum levels of the bone turnover markers dickkopf-1,osteoprotegerin,and TNF-α in knee osteoarthritis patientsObjuctive: The present study compared the serum levels of DKK1,TNF-α,and OPG in patients with KOA and healthy controls to analyze the inter-relationship and the severity of joint destruction.Methods:148 patients with KOA and 101 healthy controls were enrolled in this study.Anteroposterior knee radiographs determined the severity of the disease in the affected knee.The radiographic grading of KOA was performed by the KellgrenLawrence criteria.Serum levels of DKK-1,TNF-α,and OPG were estimated using the multiplex particle-based flow cytometry.Results: Higher serum levels of OPG and TNF-α were observed in KOA than the controls;KOA patients showed a lower serum level of DKK-1,whereas the serum levels of DKK1 correlated with the progression of KOA.The serum levels of TNF-α,OPG,and DKK-1 correlated with incident KOA.In the ROC curve analysis,DKK1levels showed 78.6% sensitivity and 40% specificity,TNF-α levels showed 74.1%sensitivity and 76.0% specificity,and OPG showed 88.1% sensitivity and 81%specificity in predicting severe KOA.In the univariate and multivariate analysis,TNF-α and OPG emerged as independent predictors of severe KOA.Conclusion: This study,for the first time,combined TNF-α,DKK1,and OPG as valuable biological markers in predicting the severity of KOA radiographically in the clinic.This study also supported the inflammation-induced DKK1 and OPG in OA pathogenesis.Chapter 4 Changes of bone turnover factors in OA patients with hypertension before and after primary joint arthroplastyObjuctive: OA patients with metabolic diseases are becoming more and more common.They are also important risk factors for complications such as prosthesis infection and prosthesis loosening after joint replacement surgery in patients with advanced OA.In this study,changes in bone turnover factors were observed in patients with essential OA complicated with hypertension before and after joint replacement surgery to understand the effects of prosthesis implantation and surgical trauma on bone turnover and to explore new ways of postoperative rehabilitation.Methods: We reviewed a total of 122 patients with primary knee and total hip arthroplasty with primary knee and total hip arthroplasty from April 2014 to April2015.Patients underwent reclassification of total knee arthroplasty and total hip arthroplasty.The levels of serum bone turnover factors DKK1,LEPTIN,TNF-α,OPG,OPN,SOST,PTH were observed by Luminex technique and blood routine detection technique respectively.The blood samples were collected before operation,postoperative day 1,postoperative postoperative day 3 and postoperative day 5concentration.The effect of arthroplasty on bone turnover was defined by comparing changes in preoperative and postoperative factors and differences in OA between patients with OA and simple OA.Results: A total of 122 patients with OA were included in the standard.The age was46-86 years(mean age: 66.9 years).The course was 1-25 years,with an average of18.3 years.Among them,32 males and 89 females had hip joint OA 28 Cases,94cases of knee OA;according to history and blood pressure monitoring were included in OA patients with hypertension in 38 cases.The level of Leptin in OA group was lower than that in OA group,while OPN and SOST were significantly increased.The ALB,HCT and HGB of the first day,the third day and the fifth day were lower than those before operation,P <0.05,the difference was statistically significant.Conclusion: The effect of joint replacement surgery on serum bone turnover related factors in OA patients and OA patients with hypertension is different,especially for Leptin,OPN and SOST.Chapter 5 Overview Bone immunology: osteoclasts interact with the immune system... |
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