| PART I A SYSTEMATIC REVIEW THE DAMAGE OFOSTEOARTICULAR BRUCELLOSISObjective We conducted a systematic review of related studies published at home and abroad to explore the clinical characteristics of bone and joint damage caused by brucellosis in the world,and to provide ideas for the clinical diagnosis and treatment of the disease.Methods With "brucellosis","bone","joint",and "clinical characteristics" as the main topics,the literatures on the clinical manifestations of bone and joint lesions in patients with brucellosis published in Pub Med,Wanfang data knowledge service platform,Weipu Information Network and other Chinese and English databases were retrieved.The retrieval time was from the establishment of the database to the present.Results A total of 10,763 cases met the selection criteria,and the total number of brucellosis patients with bone and joint damage was 6,098(56.66%),of which 1,124 were eligible for inclusion in the evaluation.There were 532 cases of peripheral joint involvement(47.3%),292 cases of spinal joint involvement(25.7%),and 300 cases of sacroiliac joint involvement(27%).The number of patients with sweating,splenomegaly,increased ESR and increased WBC in the osteoarticular involvement group was higher than that in the non-osteoarticular involvement group,and the number of patients with nausea and vomiting,emaciation,orchitis,decreased HB and decreased PLT was lower than that in the non-osteoarticular involvement group,with statistical significance(P < 0.05).There was no statistical significance in the number of cases with fever,hepatomegaly,lymph node enlargement,CRP increase and WBC decrease between the two groups(P > 0.05).In addition,MRI examination of the affected joint is helpful for early diagnosis.Conclusions1.Bone and joint damage in brucellosis patients was more common in young and middle-aged males;2.most common forms of brucellosis were sacroiliac joint,spinal joint and peripheral joint,especially peripheral joint,followed by sacroiliac joint and spinal joint;3.Brucellosis patients with increased ESR,elevated white blood cells,sweating,spleen enlargement are easy to be associated with bone and joint involvement;4.MRI examination is helpful for early diagnosis.PART II THE LEVELS AND SIGNIFICANCE OF 1,25(OH)2D3 AND ITS SOLUBLE RECEPTOR IN PATIENTS WITH BRUCELLOSIS AND WITH JOINT BONE DAMAGE Objective To determine the level of 1,25(OH)2D3 and its receptor(VDR)in serum of patients with brucellosis and bone and joint damage,and to explore its significance in the disease.Methods In this study,21 patients with brucellosis and 23 healthy controls were selected as subjects.Based on the presence or absence of arthralgia symptoms and joint imaging examinations,the group of brucellosis was further divided into the bone and joint involvement group(14 cases)and the boneless joint involvement group(7 cases).The serum levels of 1,25(OH)2D3 and VDR in 21 patients with brucellosis and 23 healthy controls were determined by ELISA,and their expression changes in bone and joint involvement after brucellosis infection were analyzed.Results 1.The concentration of 1,25(OH)2D3 in serum of patients with brucellosis was significantly lower than that of the control group,and the difference was statistically significant(P<0.05);There was no statistically significant difference in the expression level of 1,25(OH)2D3 between the bone and joint involvement group and the boneless joint involvement group(P>0.05);2.The concentration of VDR in serum of patients with brucellosis was significantly lower than that of the control group,and the difference was statistically significant(P<0.05);There was no statistically significant difference in the expression level of VDR between the bone and joint involvement group and the boneless joint involvement group(P>0.05).Conclusions The expression levels of 1,25(OH)2D3 and VDR in serum of brucellosis group were decreased,suggesting that vitamin D signaling pathway may be involved in the pathological changes of brucellosis. |
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