| Although there are many reports on using physical factors to cope with diseases of bone and joint, it has been seldom heard of choosing infrared and magnetic field particularly on injury and disease of bone, joint and soft tissues, whether in clinical or basic research. In order to further investigate what sort of biological effects that combining infrared radiation and magnetic fields will bring about, and offer theoretical gists for clinical correlative diseases, we consider that animal experiment is one of the most reliable methods to assess its value. This research mainly discussed the differences of curative effects between using infrared radiation or magnetic fields alone and associating them as a whole through animal experiment, and probed into whether the united group has cooperating domino offect. We mostly observed the curative effects of simply employing magnetic fields and infrared radiation on osteoarthritis knee of rabbits compared with the effect of applying the two physical factors together, whose goal is to explore whether their combination of magnetic fields and infrared therapy can shorten course of diseases and increase curative effects, and thus to provide experimental references for clinical physiotherapy of bone and joint diseases.1. The etiological mechanism of OA and the research overview of physiotherapyOsteoarthritis(OA) is a kind of chronic recessive bone and joint disease happened mainly on aged people, whose incidence of aged people is above 80% . Its main pathological changes are the destroy of articular cartilage and the form of superfluous bone on the brink of arthrosis, scilicet, the recessive change of articular cartilage and osseous hyperplasia secondarily. It is generally believed that recessive tissue, long period of abrasion and inheritance, metabolizability are the reasons leading to OA. Its main symptoms are the pain in knee joint and function hindrance of walking. Its nosogenesis varies greatly, besides ages, obesity, over-load athletics, heredity, environment, diet and gender difference are all the possible contributing factors. The whole process of this disease influence not only cartilage of joint, but also the whole arthrosis, including the bone under cartilage, ligament, joint theca, synoviurn and the muscles or tendons around arthrosis, etc, which will result in frozen in the joint and function comedown ultimately. The basic objective of treating OA is to decrease symptoms, improve functions, postpone its course and rectify catfaces. Nowadays, there are no effective methods that can cure OA. Its clinical goal is to decrease OA's symptoms and body signs efficiently, thereby, try our best to reduce the deformity degree that is associated with OA. At present, there are many therapeutic methods for treating OA. Generally, these methods can be divided into operation therapy and non-operation therapy. Non-operation therapy includes sound rest and functional exercise, medical therapy, physiotherapy, kinetic therapy, injection and Chinese medicine, etc. Physical therapy depends on using every kind of physical factors(such as force, light, heat, sound, electricity and magnetism, etc) to prevent and treat diseases. Its purpose is detumescence and diminishing inflammation, to make patients calm and ease their pain, to put off convulsion and enhance protective control, so as to eliminate the excitations in the pallium and promote the intensity of injured joints and muscles.Infrared therapy is a kind of therapy which applies the 400~0.76^m section of wavelength in spectrum to treat diseases. The foundation of physiological and therapeutic action of infrared therapy is its tepid domino offect. The hoist of local tissue temperature can make local small blood vessels expand, speed up blood stream, reinforce blood circulation, flourish metabolism and strengthen immune function, which in turn have effect on detumescence, diminishing inflammation and regeneration. Magnetotherapy is a sort of physical therapy which applies magnetic fields on the clay to treat diseases. It has four main effects which are easing pain, calmness, detumescence and diminishing inflammation respectively. When magnetic field operates at organism, it can affect electron's movement directions inside the body, the distributing and concentration of electric ions, the potential of cell membrane and the excitement or restraint of nervous system; it can also boost up membrane's transiting character and accelerate substance exchange inside and outside the cells. Operating on human body, magnetic field can dilate local blood vessels, hasten blood circulation and supply of nutritious ingredients. At the same time, it also reduces blood viscidity, improves the characteristic of blood rheology, weakens the activity and stagnancy of the matter which cause pain in body so as to relieve pain. Combining infrared radiation and magnetic fields together, we apply not only the physical and chemical domino offect of magnetic fields, but also the tepid domino offect of infrared radiation. Their united application can relieve the symptoms of OA patients, improve the function of knee joint, thus increase its curative effects obviously.2. How to set up animal model of OATwenty healthy male-rabbits were randomly divided into two groups: the compared group and the OA model group . The OA model group were duplicated by extended fixation technique, the range of fixation is 1.5cm below groin to 3cmbelow anklebone, and the dorsiflexion of anklebone is 30°~60°. The time for fixation is six weeks. There was no treatment for the compared group. All the rabbits were fed under the same conditions: a cage for a rabbit. We check the fixation of plaster everyday.3. The experimental material, methods and targets of observation Twenty-four rabbits were duplicated by extended fixation technique, and after 6months, all the rabbits were unchained from fixation. Then, the 24 rabbits were randomly divided into four groups: namely the model group, the infrared group, the magnetotherapy group and the combined therapy group. At the same time, we used different physical factors to treat different groups. There was no treatment for the model group. At the end of the first, second and third weeks, 2 rabbits were killed from every group per week. Before killing them, we firstly measured its range of knee joint's motion. Then we observed the general change of its cartilage, and excised the synovium and condylar cartilage of femur for the measurement of histopathology(HE, IHC and ISH) and for the observation of microscope and electron microscope. Each case was recorded according to Mankin's index. At the end of the experiment, the serum and douche fluid of the diseased joints were obtained for the testing of superoxide dismutase(SOD) and malondialdehyde(MDA).4. Outcome of the experiment4.1 The outcome of the animal model's pathologyThe knee joint's synovium of the model group were found adhesion, swelling and over growth. Obviously degenerative changes were found in the OA model group by microscope and electron microscope. The model group's scores(7.89±1.52) were significantly higher than the compared group(1.28±0.46) according to Mankin's index(P<0.05). The activity of SOD in the model group(110.67±14.62 nu./ml) were significantly decreased than the compared group(t=-9.669, P=0.001),while the quantity of MDA(13.70±4.75nmol/ml) increased dramatically (t=3.478,P=0.007).4.2 The outcomes after physiotherapy4.2.1 The change of the joint's ROMAt the end of three weeks after treatment, the joint's ROM of combined group(136.50±2.12° ) have changed significantly than the infrared group(66.50±0.71°) , the magnetotherapy group(73.00±2.83°) and the model group(43.50±4.95°) . We can see that F=9.060, PO.01.4.2.2 The change of synovium and cartilage of the kneeIn the combined group, the severity of cartilage damage (including various injuries on the surface of cartilage, the proliferation and disarrangement of the chondrocytes) Outerbridge score(4.50±0.71) and synovitis damage (including the synovium line cells proliferation, the invading of granulation and blood vessels in the underlayer of synovium, the infiltration of inflammatory cells) Ayral's score(0.25) declined significantly(P<0.05). The Mankin scores of the combined group's(l .25±0.71) were much lower than the other three groups(P<0.05).4.2.3 The outcome of IHC of synovium PCNA and cartilage MMP-13At the end of three weeks of combining therapy, the proliferating index (13.25±0.36) of synovium PCNA of IHC in combined group were significantly higher than the infrared group(9.50), and the magnetotherapy group(9.75±0.35), and the difference between them are significant(P<0.05).The dying grade of cartilage MMP-13 of IHC of the combined group(including the number of dying cells, 11.00±1.41;and the dying intensity is 0.50) is much lower than the other groups at the end of three weeks(P<0.05),4.2.4 The signal intensity of ISH of II type collagenThe joint cartilage in combined group took on a better look after therapy, whilethat of the model group always looked like OA from beginning to end. At the end of three weeks, the signal intensity of combined group(2.75±0.35) are significantly higher than the other three groups(F=4.33, P<0.05) .4.2.5 The change of SOD and MDA in serum and lavement fluid of jointIn combined group, the SOD (256.53±30.08 U/mgprot) in articular douche fluid increased significantly and the content of MDA(5.71±1.18 nmol/ml) in articular douche fluid declined quickly. The combined group's scores were significantly different than the other groups(P<0.05).5. DiscussionThrough experiment of the first part, we duplicated the OA model by extended fixation technique successfully, and proved that it is truthful and credible to duplicate the OA model by extended fixation technique on knee joint. What's more, we also have a good cognition and understanding on the etiological mechanism and histopathological basis of OA. The inflammation of synovium, the degeneration of articular cartilage and the change of free-radicals are the pathological basis of OA.The outcome of physiotherapy shows the curative effects on rabbit model of experimental OA on the knee. The treatment effectiveness of combining infrared radiation and magnetic field together on cartilage trauma of rabbit's OA of the knee is much significant than the other three groups; The therapeutic investigation of infrared radiation and magnetic field on rabbit's synovitis of OA of the knee also indicated that, combining infrared radiation and magnetic fields together, we apply not only the physical and chemical domino offect of magnetic fields, but also the tepid domino offect of infrared radiation. Their united application can not only relieve the symptoms of OA patients, but also improve the function of knee joint, thus increase its curative effects obviously. The influence of infrared radiation and magnetic fields on oxidation process of rabbit's OA of the knee. All the outcomes...
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