Joint Deformity Research Articles

Effect of Stretching Exercise to Increase Joint Range of Motion and Functional Ability in Post-Burn Shoulder Contracture Patients: A Case Report

Burns are tissue damage or loss caused by contact with high temperatures, such as heat, radiation, electricity, and chemicals. Causes damage to the epidermis and underlying soft tissue, bone, and muscle, placing burn victims at risk for contractures and joint deformities. Upper extremity function is critical to the performance of activities of daily living. Interventions such as surgery, pharmacological therapy, and nutritional support are important in aiding recovery and improving clinical outcomes after severe burns. The aimed to determine the effect of stretching exercises on increasing range of motion and functional ability in post-burn shoulder contracture. This study used the case study method which was conducted on post-shoulder contracture burn patients at Central General Hospital Dr. I.G.N.G Ngoerah Bali in February 2023. Pain measurements were taken using the Numeric Rating Scale (NRS). Measurement of muscle strength using Manual Muscle Testing (MMT). Goniometer to measure the Range of Joint Motion (ROM). Shoulder Pain and Disability Index (SPADI) to measure functional ability. SPADI is a quality of life questionnaire consisting of 13 items to evaluate 5 items for pain and 8 items for impairment. After 3 times of physiotherapy, the results showed a decrease in silent pain at T0 = 2 to T3 = 1. Tenderness at T0 = 4 to T3 = 2. Movement pain T0 = 5 to T3 = 3. Increased muscle strength T0 value 2, that is not full ROM to T3 value 3, namely full ROM and can fight gravity. Increased range of motion in active and passive flexion, extension, abduction, adduction, horizontal, abduction and horizontal adduction, internal and external rotation. The increase in the functional ability of SPADI T0 = 53% then decreased to T3 = 35%. There is a significant decrease in the measurement of functional ability using SPADI, which means the patient's functional ability is increasing. The conclusion is stretching exercises are effective for increasing the range of motion and functional ability of patients with post-burn shoulder contractures. Therefore, stretching exercises should be used to provide proper burn care to patients in hospitals and burn centers.

Charcot arthropathy and acro-osteolysis in a 5-year-old girl with hereditary sensory and autonomic neuropathy type II: A case report

Charcot neuropathic arthropathy is a destructive process that can occur in patients with neuropathy associated with medical diseases such as diabetes. A rare cause of neuropathic arthropathy is congenital insensitivity to pain (CIP) which includes varying degrees of sensory loss and lack of pain perception contributing to absent withdrawal responses. The clinical manifestations of CIP include delayed diagnosis of fractures, joint dislocations, acro-osteolysis, avascular necrosis, osteomyelitis, heterotopic ossification, and Charcot arthropathy. We herein report a case of Charcot arthropathy of ankle joints in a 5-year-old girl with CIP due to underlying hereditary sensory and autonomic neuropathy who had recurrent upper and lower limb fractures with acro-osteolysis. She had an inability to perceive pain from the first year of her life. She also had mild developmental delay. Family history was unremarkable. Blood count, liver and thyroid function tests, erythrocyte sedimentation rate, C-reactive protein, blood electrolytes, blood sugar and other laboratory tests were normal. Charcot neuropathic arthropathy in children is rare and can be a part of congenital diseases like CIP. A high degree of suspicion may lead to early detection and can prevent joint and bone destruction and deformities.

Optimizing welding sequence of TIG cross-joint of Invar steel using residual stresses and deformations

In this paper, a number of welding sequences were designed by numerical simulation to study the welding deformation of Invar steel cross-splicing joint during diagonal welding and adjacent angle welding, and the optimal welding deformation control process was obtained. Results show that segmental welding can control effectively welding deformation. Material on both sides of the weld was under tensile stresses and became compressed along the thickness direction during welding. When segmented welding is studied, irrespective of the welding sequence used in the upper and lower half welds, it is found that it had strong effect on welding deformation control of the joint. When the welding sequence of the upper and lower half welds is opposite, the welding deformation is minimum. When welding a series of welds in an inwards direction from the outside to the inside for large cross-splicing structures, the joint welding deformation is symmetrical, which has the best control effect on the overall joint deformation, but the deformation at the four corners of the large cross-splicing structure is still significant.

Expression of IL-7 receptor on Th1, Th17 lymphocytes in patients with psoriatic arthritis

Psoriatic arthritis (PsA) is a chronic immune-mediated inflammatory disease of the joints, spine, and entheses that can occur in patients with psoriasis. The prevalence of psoriatic arthritis is high in Russia, in recent years there has been an increase in its incidence rates. The pathogenesis of PsA is based on the activation of Th1, Th17 cells. Pro-inflammatory cytokines produced by the cells are involved in the cascade of reactions leading to the joint deformity and bone destruction. For some autoimmune diseases associated with the Th1/Th17 response, IL-7 has been found to be involved in pathogenetic mechanisms. At the same time, IL-7 is assumed to support autoreactive T lymphocytes. Effect of the cytokine on cells is provided by the binding to a specific receptor thus causing a signal transmission into the cell and inducing the processes of differentiation, proliferation, and production of cytokines. In animal models of autoimmune diseases, usage of blocking antibodies to α-chain of the IL-7 receptor (IL-7R) was shown to cause reduced inflammation in target tissues and decreased number of infiltrating T lymphocytes. Therefore, the aim of this work was to investigate the in vitro effects of IL-7 and blockade of the α-chain of the IL-7 receptor on the contents of Th1, Th17 lymphocytes and expression of IL-7 receptor subunits on these cells in normal subjects and in psoriatic arthritis. The study included nine patients with PsA in the stage of exacerbation of the underlying disease (mean age 44±6.5 years) and 6 healthy individuals (mean age 45±2.7 years). The in vitro effects of IL-7 and specific blocking monoclonal antibodies (aCD127) was evaluated in cultures of mononuclear cells from peripheral blood. Flow cytometry was used to determine the expression of IL-7 receptor subunits (CD127, CD132) and to assess cell phenotypes in peripheral blood and cultured cells. We have shown for the first time that patients with PsA have an increased number of CD127+CD132- and CD127+CD132+ cells among Th17 lymphocytes, as well as CD127+CD132-, CD127+CD132+ and CD127-CD132+ cells among Th1 lymphocytes, which suggests participation of IL-7 in maintaining these cell populations. Upon the in vitro supplement of IL-7, an increase in the Th1 cell contents and a decreased number of Th17 cells were observed, both in donors and PsA patients, and the opposite effect was observed under the conditions of IL-7R of blockade. Under the influence of IL-7, as well as with blocking antibodies, there was a significant decrease in CD127 expression on Th1, Th17 lymphocytes. However, a decrease in the number of CD127-132+ among Th1, Th17 lymphocytes occurred only following blockade with antibodies. That is, despite redistribution of Th1 and Th17 lymphocytes in culture, the cells of these populations were not activated under the IL-7 receptor blockade. The obtained data may serve as a basis for choosing the IL-7 receptor as a target in the development of targeted drugs for the treatment of PsA.

Концепция микромоделирования процесса соединения разнородных материалов пластической деформацией

Introduction. Bond strength between dissimilar materials is the most important characteristic of laminated composites, which determines the success of its development for industrial use. In order to develop the theory of joining materials by plastic deformation, it is proposed to perform computer simulation of joint deformation of representative volumes of dissimilar materials on a microscale and compare the parameters of the stress-strain state with the previously presented theoretical mechanism. The aim of this work is to analyze the stress-strain state of dissimilar materials under plastic deformation on a microscale and to establish the location of the onset of fracture of surface oxide films. To achieve this aim, the following tasks of the work are formulated: 1) to study the surface profiles of dissimilar materials to be bonded by plastic deformation; 2) to simulate by the finite element method (FE) the plastic deformation of contact surfaces of dissimilar materials on a microscale; 3) to study the stages of joint deformation of dissimilar materials on a microscale and verify of the theoretical mechanism. Research methodology. The study of three-dimensional topography and roughness was carried out on a Veeco Wyko NT1100 Optical Profiling System. Deform-3D FE simulation package was chosen as the main research tool. Aluminum alloys AMg3 and D16 were chosen as the materials under study. Results and discussion. In this work, computer FE simulating of the joint deformation of the surface layers of AMg3 and D16 alloys on a microscale was performed, an analysis of the surface profiles of materials after various types of processing was carried out, the parameters of the stress-strain state were studied and compared with the parameters of the theoretical mechanism. Based on the results of the comparison, the adequacy of the proposed theoretical mechanism was assessed, and the practical difficulties of theoretical simulation of the joint deformation of dissimilar materials on the microscale were noted. Microscale FE simulation made it possible to study the flow of plastic deformation in the near-surface layers of materials, as well as to identify areas of the most probable fracture of surface oxide films and, consequently, areas of primary bonding of dissimilar materials.

Clinical Analysis of the Frosch Approach in the Treatment of Posterolateral Tibial Plateau Fractures Combined with Lateral Tibial Plateau Fractures.

The treatment of posterolateral tibial plateau fractures is difficult, and providing sufficient exposure and effective fixation is a challenge. There is great controversy regarding the surgical approach for posterolateral tibial plateau fractures. The purpose of the study was to investigate the clinical effects of open reduction and internal fixation using the Frosch approach for the treatment of posterolateral tibial plateau fractures combined with lateral tibial plateau fractures. Data from 19 patients with posterolateral tibial plateau fractures combined with lateral tibial plateau fractures treated from May 2018 to January 2022 were retrospectively analyzed. There were nine men and 10 women, ranging in age from 22 to 62 years, with an average age of 45.6 years. All patients were treated using the Frosch approach. Under direct vision, the posterolateral and lateral fractures were reduced, and full bone grafting was performed. We reshaped the oblique "T" shaped plate for the distal radius and placed it on the posterolateral tibial plateau to fix the posterolateral fractures. The lateral inverted "L" shaped locking plate was placed on the lateral tibial plateau to fix the lateral tibial plateau fractures. Within 2 weeks after the operation, the patients were instructed to perform knee joint function exercises within 90°. At the last follow-up, the Rasmussen radiological criteria were used to evaluate the effectiveness of fracture reduction and fixation. And the knee joint function was evaluated using Rasmussen functional score. The operation time ranged from 100 to 180 min, with an average of 134.2 min; intraoperative blood loss ranged from 20 to 150 mL, with an average of 66.8 mL. The follow-up duration ranged from 14 to 58 months, with an average of 36.2 months. There were no complications, such as vascular or nerve injury or incision infection. Fracture healing was achieved in all patients, and the healing time ranged from 10 to 14 weeks, with an average of 11.2 weeks. During the follow-up period, there was no loosening or breakage of the internal fixation, varus or valgus deformity of the knee joint, re-collapse of the articular surface, or instability of the knee joint. At the last follow-up, the effectiveness of fracture reduction and fixation was excellent in 13 patients and good in six patients. And the knee joint function was excellent in 17 patients and good in two patients. The Frosch approach for open reduction and internal fixation in the treatment of posterolateral tibial plateau fractures combined with lateral tibial plateau fractures has a definite clinical benefit and is worthy of promotion and application.

Childhood-onset rheumatoid arthritis at a tertiary hospital in Senegal, West Africa

BackgroundChildhood-onset rheumatoid arthritis (CORA), known as rheumatoid factor (RF)-positive juvenile idiopathic arthritis is a type of juvenile idiopathic arthritis that shares the same genetic factors and clinical features as adult-onset rheumatoid arthritis. In Africa, CORA hasn’t been the subject of a specific study.ObjectivesThe aim of this study is to describe the clinical features, disease activity, functional disability, and treatment of CORA at diagnosis in Senegal and compare the findings to other CORA populations.MethodsWe conducted a mixed cohort study by reviewing the medical records of patients diagnosed with CORA with an age of symptom onset < 18 years according to the 2019 PRINTO provisional criteria for RF-positive JIA from January 2020 to December 2022 at rheumatology department of Aristide Le Dantec Hospital in Dakar, Senegal. We collected demographic, clinical, paraclinical and therapeutic data. Disease activity score was assessed by DAS28-ESR and DAS28-CRP. Functional disability was assessed using Health Assessment Questionnaire (HAQ) or Childhood HAQ.ResultsA total of 21 patients were included. Eighteen (85.7%) were Females. The mean age at symptom onset was 13.0 ± 3.0 years, and at diagnosis was 16.4 ± 4.2 years. Morning stiffness, joint swelling, and joint deformities were found in 20, 18 and 13 patients respectively. Four patients had a family history of rheumatoid arthritis. Five patients had extra-articular involvement such as rheumatoid nodules. Two patients had interstitial lung disease. The biological inflammatory syndrome was found in 90% of cases. 16 of 21 (76.2%) patients had positive RF, and 18 of 20 (90%) patients had positive Anti-CCP. Seven of 12 (58.3%) patients had positive anti-nuclear antibodies. The mean DAS28-ESR was 5.7 ± 1.0. Fifteen (71.4%) patients had high disease activity (DAS28-ESR > 5.1). The mean DAS28-CRP was 5.4 ± 1.1. The median HAQ was 2.12 with a mean HAQ of 1.9. Nineteen (90.5%) patients were treated with methotrexate, while 17 (81%) had a combination of methotrexate and hydroxychloroquine. Oral prednisone was used in 17 (81%) cases. Non-steroidal anti-inflammatory drugs were used in 4 cases (19%). After 6 months of treatment, mean DAS28-CRP was 2.9.ConclusionIn our study, CORA mainly affects 13-year-old girls, characterised by high disease activity with joint deformity and significant functional impairment. Treatment is mainly based on methotrexate, prednisone and hydroxychloroquine. Further studies are needed to determine the exact clinical phenotype of this disease.

Acetyl zingerone ameliorates osteoarthritis by inhibiting chondrocyte programmed cell death.

Osteoarthritis (OA) is a degenerative disease that ultimately leads to joint deformity. The pathogenesis of OA is believed to involve abnormal chondrocyte death, with ferroptosis serving a key role in chondrocyte damage. The present study investigated whether acetyl zingerone (AZ), a newly identified antioxidant derived from curcumin, can alleviate the progression of OA. To investigate this, the present study performed various experiments, including crystal violet staining, flow cytometry, immunofluorescence and western blot analysis. In addition, dual validation was performed using invivo and invitro experiments; a mouse OA model was constructed for the invivo experiments, and chondrocytes were used for the invitro experiments. Destabilization of the medial meniscus (DMM) surgery was performed to establish an OA model in mice and IL‑1β was used to induce an OA model invitro. The results indicated that AZ may promote chondrocyte viability and the expression of extracellular matrix components. Furthermore, AZ reduced the occurrence of ferroptosis by promoting the expression of glutathione peroxidase 4, inhibiting cartilage destruction and osteophyte formation, and alleviating damage to articular cartilage caused by DMM surgery. Mechanistically, the activation of nuclear factor erythroid 2‑related factor 2 and heme oxygenase‑1 may be responsible for the anti‑ferroptosis effects of AZ on chondrocytes. These findings indicated that AZ may be considered a promising candidate for OA therapy.

Carbapenem-resistant Klebsiella pneumoniae Osteoarthritis in Two Preterm Infants Treated With Ceftazidime-avibactam.

The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a major threat to global public health. CRKP infections are challenging to treat owing to the limited number of antibiotic species, especially in preterm infants. Ceftazidime-avibactam (CAZ-AVI) is a novel antibiotic with activity against CRKP. At present, there have been no reports of using CAZ-AVI to treat osteoarthritis in premature infants. We describe 2 preterm infants with CRKP osteoarthritis treated with CAZ-AVI in a tertiary children's hospital in China. Clinical characteristics, laboratory and microbiologic data, treatment and follow-up information were retrospectively collected and analyzed. The 2 cases were both premature infants who contracted sepsis and CRKP osteoarthritis. Meropenem and polymyxin B were initially chosen for the first infant. CAZ-AVI was then used due to persistent infection. The second infant was commenced immediately on CAZ-AVI after receipt of antimicrobial susceptibility on the 4th day after admission. Both recovered with CAZ-AVI (50 mg/kg q8h) and surgical incision and drainage. Neither had a joint deformity or limb length discrepancy at 36 and 34 months, respectively. This is the first report on the use of CAZ-AVI to treat CRKP osteoarthritis in premature infants. Successful treatment depends on prompt recognition of the pathogen and treatment with a combination of antibiotics with or without surgery. Further study is needed to determine the pharmacokinetics and pharmacodynamics of CAZ-AVI for treating preterm infants with serious CRKP osteoarthritis.

Moment-Rotation Calculation Method and Parameter Analysis for Loose Continuous-Tenon Joint in Column-And-Tie Timber Structure

ABSTRACT To quantitatively calculate the moment-rotation relationship of loose continuous-tenon joints in traditional column-and-tie timber frame, the rotational deformation of loose joints is divided into two stages: free sliding and contact compression. Using constitutive, geometric, and equilibrium equations, a theoretical formula for moment-rotation is derived. The calculated values are then compared with experimental results to validate the accuracy of the theoretical calculation method. A sensitivity analysis is conducted on typical parameters, such as beam height, column diameter, joint clearance, and perpendicular compression modulus of wood, to explore their effects on the moment-rotation relationship of tenon joints. The results show that increasing the perpendicular compression modulus of wood leads to greater bending stiffness and load carrying capacity of tenon joints, with the latter increasing more significantly. In the elastic stage, the rotational stiffness of the joint increases with beam height or column diameter, while after entering the elastoplastic stage, the joint stiffness is less influenced by these factors. The initial rotational stiffness and load carrying capacity of the joint both decrease with joint clearance, and the effect of joint clearance on load carrying capacity decreases as the clearance increases when the joint enters the yielding stage.

A Method to Evaluate the Reduction Difficulty of Atlantoaxial Dislocation Based on Computed Tomography Quantitative Analysis

To evaluate the difficulty of reduction of congenital atlantoaxial dislocation with or without os odontoideum or basilar invagination based on computed tomography (CT) quantitative analysis. From March 2018 to December 2022, the CT features of 108 patients with atlantoaxial dislocation with or without os odontoideum or basilar invagination were analyzed. Quantitative scores were defined according to imaging features, including sloping of the lateral mass; osteophyte between the lateral mass joint; ball-and-socket deformity of the lateral mass joint; vertical interlocking of the lateral mass joint; callus between the lateral mass joint; and atlanto-odontoid joint hyperplasia, blocking, or fusion. Grades were calculated according to the sum of points of the atlanto-odontoid joint and lateral mass joints, as follows: I, 0-1 points; Ⅱ, 2-3 points; Ⅲ, 4-6 points; IV, 7-10 points. After 1 week of bidirectional cervical traction, CT scans were performed, and atlantodens interval and vertical distance from dens to Chamberlain line were measured. The vertical reduction rate, horizontal reduction rate, and overall reduction rate of atlantoaxial dislocation were calculated. The vertical distance from dens to Chamberlain line values after traction were significantly reduced compared with before traction, including grades I, II, III, and IV. The overall reduction rates were 85.1% ± 11.8%, 65.8% ± 8.3%, 45.0% ± 8.5%, and 38.4% ± 13.0% respectively, after 1 week of bidirectional cervical traction. The CT quantitative score system is an effective noninvasive evaluation to judge the reduction difficulty of atlantoaxial dislocation with or without os odontoideum or basilar invagination.

Three-dimensional analysis of the morphological changes of the craniofacial jaw and condyle in patients with idiopathic condylar resorption

In this study we aim to describe the three-dimensional analysis of condylar deformation of the temporomandibular joint (TMJ) and morphological changes of the craniofacial jaw in patients with idiopathic condylar resorption (ICR). We also compare those with a control group that is healthy and matched for age and gender. Cone-beam computed tomography (CBCT) and cephalometric radiograph (X-ray) were conducted and analysis of craniofacial measurement, condylar width, length, height, and condylar axial angle changes were done three-dimensionally using ProPlan CMF™ 3.0 software (Materialise). The craniofacial jaw measurements of the ICR patients were significantly different than the control group and the significant changes in the mandible can be seen in ICR patients according to the results of this study. The results of smaller condylar width and height in the ICR group reflect the smaller size of the condyle compared with an unaffected condyle. Also, both right and left sagittal condylar angles (p = 0.001 and p = 0.003), respectively, and axial condylar angles (p = 0.01 and p = 0.02), respectively, displayed significant differences between the two groups. In conclusion, the vertical development of the condyle decreased along with reduced measurements in the width and height of the condyle in ICR patients, and differences in the morphology of the craniofacial jaw and condylar angles were observed between study groups.

Effects of different friction stir welding processes on residual stress and deformation of Ti62A alloy joints

Residual stress induced by welding easily causes deformation and even fracture failure in welded structures. In this paper, a three-dimensional thermal-mechanical coupling finite element model of friction stir welding (FSW) was developed. The effects of different welding processes, namely conventional friction stir welding (C-FSW), stationary shoulder friction stir welding (SS-FSW), and bobbin tool friction stir welding (BT-FSW), on the temperature, residual stress, and deformation of welded joints were investigated by employing a heat source model and a force model to the welding analysis. The results reveal that a discernible disparity in temperature gradient is observed in the region ahead of the tool and behind it among various welding processes. The peak values of longitudinal residual stress along the surface and bottom paths of SS-FSW are reduced by 35.7% and 34.1%, respectively. In addition, the deformation at the initial end of the weld is slightly larger than that at the final end along the welding direction in three welding processes. Compared with other FSW processes, SS-FSW exhibits the smallest deformation, which is advantageous for improving assembly accuracy and enhancing the load-bearing capacity of weldments. The above results provide an important theoretical reference for the FSW process optimization of Ti62A alloy.

I‐beam to RHS‐column joints with welded studs under cyclic loading

AbstractThe design of removable beam‐column joints between open structural steel beams and rectangular hollow section (RHS) columns is not easy because of the inaccessibility to the tube interior from outside. I‐beam to RHS‐column joints with threaded welded studs are of great interest due to their low‐cost assembling technique and easy on‐site execution. This study examines the cyclic performance of these joints with welded studs. A quasi‐static experimental study on the cyclic response of eight joint specimens is described. The strength of the joint and the failure modes were revealed. The ductility of the joints was also evaluated according to the rotation capacity after yielding, classifying all of them as having intermediate ductility and, therefore, implying some capacity to withstand limited plastic deformations when subjected to seismic forces. Some equations were also used to classify the joints according to the components that mainly govern the deformation of the full joint. In addition, the energy dissipation rate was assessed for all the specimens, finding the highest energy dissipation rates in the most rigid joints.

Study of Association of Chromosomal Region 1Q21-23 with Rheumatoid Arthritis and Their Correlation with Severity of Disease.

The understanding of the pathophysiology of rheumatoid arthritis (RA) has taken a major step forward with the research of new illness-related genes and further deciphering the involved molecular. Gene variants like human leukocyte antigen (HLA)-DRB1 and PTPN22 1858T act as individual risk factors for RA. It also serves as a risk factor for the rate of progression of joint destruction and clinical manifestations in autoimmune diseases like RA. The focus of this study is to find out the association of chromosomal region 1q21-23 with RA and its connection with disease severity using the disease activity score (DAS) and distribution frequency of the prevalent alleles of such genes in an already recruited group of patients/controls of India, specifically Northwest Rajasthan. This was a case-control study wherein every patient of RA aged 16 years and above diagnosed with RA as per the 2010 American College of Rheumatology (ACR) and the European League against Rheumatism (EULAR) revised criteria for RA in Outpatient Department (OPD) and Inpatient Department (IPD) patients were included. Blood samples of the study population were drawn at Sardar Patel Medical College (SPMC), Bikaner (rheumatology OPD), along with the cooperation of Birla Institute of Technology and Science (BITS), Hyderabad (Department of Biological Sciences) from July 2009 to January 2012. A total of 100 controls (without any previous history of disease) and 135 cases were selected considering inclusion and exclusion criteria. Clinical data along with laboratory parameters like complete blood count, serum electrolytes (sodium, potassium, calcium, and chlorine ions), blood sugar, blood urea with serum creatinine, lactate dehydrogenase (LDH) isoenzymes assay, serum glutamic-oxaloacetic transaminase (SGOT)/serum glutamic pyruvic transaminase (SGPT) ratio, serum γ-glutamyl transferase (GGT) level, serum amylase, arterial blood gas (ABG), total serum proteins were evaluated and recorded from the patients. Our study showed control group has a mean age of 45.11 + 4.12 years. The case and control groups did not have significant differences in any of the clinical variables. 59% of cases show joint deformity. Allelic frequencies of the D1S498 polymorphism in cases were found significant in sizes 198, 204, 208, and 210, while it was found insignificant in sizes 192, 196, 200, 202, and 206. No correlation was found in allelic frequencies of the D1S318 polymorphism in cases and controls. Bigger cohort studies will allow better genomic elucidation of clinically defined intermediate phenotypes evaluated in RA patients by virtue of the autoimmune origin of the disease and its diverse symptoms in patients. Genetic-molecular studies can be a milestone for adopting effective personalized treatment for such progressively debilitating diseases. How to cite this article: Gauri LA, Meena MK, Singh U, et al. Study of Association of Chromosomal Region 1Q21-23 with Rheumatoid Arthritis and Their Correlation with Severity of Disease. J Assoc Physicians India 2023;71(9):28-32.

Melittin acupoint injection in attenuating bone erosion in collagen-induced arthritis mice via inhibition of the RANKL/NF-κB signaling pathway.

Rheumatoid arthritis (RA) is an autoimmune disease leading to chronic joint inflammation. Bone erosion is the most serious pathological condition of RA and the main cause of joint deformities and disability. Melittin acupoint injection (MAI) is an effective traditional Chinese medicine (TCM) method for RA treatment. This study aimed to investigate the effect of MAI on RA bone erosion and to elucidate the underlying mechanism. A collagen-induced arthritis (CIA) mouse model was established as the experimental subject. MAI was administrated once every other day for 28 days to mice with CIA. The effects of MAI on joint diseases were assessed by body weight, arthritis index (AI) score, swollen joint count (SJC) score, and hind paw thickness. Ankle radiological changes were captured by micro-computed tomography (micro-CT) and histological changes were observed by pathological staining. Organ histological changes, spleen index, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatinine (Crea) levels of serum were tested to evaluate the toxicity of MAI. Cytokine expression levels were confirmed by enzyme-linked immunosorbent assay (ELISA) to evaluate the immunity of CIA mice. MAI administration markedly improved the clinical signs of CIA in mice, including hind paw thickness, AI, and the number of swollen paw joints (most of them P<0.05 or even <0.01). According to histopathological analysis, MAI ameliorated inflammatory cell infiltration, synovial hyperplasia, pannus formation, and bone erosion (all P<0.01). Micro-CT and tartrate-resistant acid phosphatase (TRAP) staining (P<0.01) also revealed that MAI could relieve bone erosion via reducing the formation of osteoclasts. Not only could MAI relieve the immunological boost [P<0.05 for the high-dose MAI (HM) group], but also it had no liver or kidney side effects (P>0.05). In addition, it decreased the serum levels of interleukin (IL)-6 and tumor necrosis factor-α (TNF-α) and increased the serum levels of IL-4 and IL-10 (the majority of P<0.05 or even <0.01). Transcriptome sequencing results indicated that MAI affected the expression of osteoclast differentiation pathway genes, which was connected with the receptor activator of the nuclear factor κB ligand/nuclear factor kappa B (RANKL/NF-κB) pathway. Based on our findings, MAI could suppress joint inflammation and inhibit RANKL/NF-κB-mediated osteoclast differentiation to rescue bone erosion in CIA mice, suggesting that MAI can be a potentially therapeutic substance for RA.

A novel solution for the patient with knee ankylosing spondylitis: a case report

Link of Video Abstract: https://youtu.be/wskQdvBx0c0 Background: Knee ankylosis is a joint condition that causes functional limitation that becomes more severe when accompanied by pain. Arthroplasty is a complex and intricate reconstruction procedure that is more challenging when there is a structural limitation that requires a technique modification. In this report, we presented a rare case of a young patient with knee ankylosis and flexion contracture treated with arthroplasty. Case Presentation: A 20-year-old young woman came to the hospital with stiffness in her left knee, inability to sit well and crouch, and difficulty getting up from sitting. Based on the physical examination and X-ray of the left knee, the patient showed bone ankylosis on the femorotibial joint with a 100 flexion, which confirmed knee ankylosis. Arthroplasty was performed with a parapatellar medial approach. After eight months of supervision, the patient was able to perform an active flexion within 1050 and a full extension on the left knee. In our patient, arthroplasty brought a satisfying functional outcome and pain reduction, which was also supported by previous studies with the same procedure on ankylosis patients. Conclusion: Arthroplasty can be considered the main therapy option for joint deformities due to its more satisfying outcomes.

Deformation and failure mechanism of metro shield tunnel subjected to buried fault dislocation

Numerous studies have shown that tunnels are vulnerable to damage due to fault dislocation. To investigate the deformation response and structural failure mechanism of the metro shield tunnel subjected to faulting, model tests with a geometric similarity ratio of 1:25 were carried out to analyze the influence of fault dislocation on the tunnel. The deformation of segmental lining and circumferential joints, earth pressure, and strain evolution were investigated. Combined with numerical simulations, the deformation and failure pattern of the shield tunnel after normal and reverse faulting were revealed. The failure criterion of segmental lining was discussed thoroughly. The results show that after faulting, the differential settlement, convergence deformation, strain response, and the soil pressure near the interface between the shield tunnel and the path line of fault increase remarkably. A horizontal duck egg-shaped deformation profile of segments is presented. The longitudinal cracks are distributed inside the tunnel vault and outside the tunnel haunch. The circumferential joint of shield tunnel is damaged severely under normal faulting, and the opening between segment rings exceeds the deformation limit of joint waterproofing. While tensile damage of the circumferential joint under reverse faulting is less evident, and the opening between segment rings is slight. The numerical simulation results have consistency with the consequence of the experiments. In addition, no circumferential crushing or oblique shear failure occurred in the model segment, and the deformation and tensile fracture damage of the circumferential joint should be deemed as the failure criterion of shield tunnels under faulting. Finally, countermeasures and suggestions are proposed for the structural design of metro shield tunnels overcrossing buried faults.

Investigating the failure behaviour of aluminium alloy gusset joints under impact loading: An experimental and numerical study

The AAG joint, also known as the Temcor joint, is a well-established method for constructing long-span spatial grid structures using aluminium alloys. This joint system has been widely used and tested is considered a mature technology in the field. This paper investigates the tensile properties of 15 stainless-steel bolt connections for aluminium alloy plates at room temperature. Through testing, the load–displacement curve was obtained and two failure modes of the connection were identified. Test results show that the increase in the number of bolts and the thickness of aluminium alloy plate increases the ultimate bearing capacity of the connection. The thickness of the aluminium alloy plate was found to have a significant impact on the slippage effect of the bolts and the warping deformation of the contact surface. Based on the test results of the connection, three specimens of AAG joints were designed to study their dynamic behaviour under different impact loads. Our findings detail the dynamic response behaviour of joints subjected to varying impact times, including stress, acceleration, and displacement, as well as the resultant joint failure phenomenon. The test results show that AAG joints have good impact resistance. The refined FE model of the AAG joint was established using ANSYS/LS-DYNA, and its effectiveness was verified by comparing the stress, displacement, and acceleration between the numerical model and the experimental model. By comparing and analysing the final deformation of AAG joints obtained through test and numerical simulation, three distinct failure modes of AAG joints under impact load were identified. Finally, based on the stress nephogram and impact force time-history curve obtained by numerical simulation, the stiffness degradation law of AAG joints is discussed. This paper also discuss the energy dissipation mechanism of AAG joints during impact load, based on the strain energy time-history curve of each component.

Study of mechanical properties of H-shaped beam-column joints considering panel zone

In order to clarify the influence of panel zone (PZ) strength on the mechanical properties of each component (column, beam and PZ) of H-shaped steel beam-column joint, the equations of mathematical physics for the mechanical relationship of framing member end considering panel zone were established, and five groups of T-shaped beam-column joint specimens with different strength are tested to study the influence of panel zone to beam strength ratio (PBSR) on the deformation performance, bearing capacity and stiffness of the specimens. Through the finite element analysis, the effect of PBSR and weld access hole on the deformation of joints, the shear and flexural capacity of beams is discussed. Finally, based on the analysis of deformation and bearing capacity of the specimens and models, the reasonable value of PBSR is proposed.