| Objective: Achilles tendon bursitis is a common andfrequently-occurring disease, which is caused by long-term chronic injury. Ifyou do not treat the disease correctly, it will seriously affect the quality ofpatients' life and work. The treatments include electrical stimulation,ultrasound therapy, and the prednisolone closed treatment and so on. For localinjections of drug glucocorticoids really be able to release the adhesion tissues,promote the absorption of inflammation, and accelerate the alleviation ofpatients' symptoms of localized pain, it is widely adopted by many clinicians.This method is simple but results are better. However, it is found thatsome of the Achilles tendon rupture patients have closed treatment history ofAchilles tendon bursitis of varying degrees by clinical observations, and insurgery, the Achilles tendon of those patients show different degrees of darkencolor, local edema, exudation, adhesion with surrounding tissues andother symptoms that the texture of Achilles tendon become harden, brittle, andwith poor flexibility. To explore the rules of pathological changes in differenttime periods generated by the local closed treatment after applying localglucocorticoids to the Achilles tendon, we design and implement thisexperimental study.This study was designed through animal experiments that givingcontinuous injections of normal-dose of prednisolone acetate (injected once aweek) to the rats' Achilles tendons, to simulate closed treatment to theAchilles tendons,so that we can observe pathological changes of Achillestendons at different time points after the injections, and find out the residualeffects to the Achilles tendon tissues, which can guide the clinicalapplications of glucocorticoids, and improve the understandings of the adverse reactions of the local injections of glucocorticoids to Achillestendons. Thereby clinicians will pay more attention to the protection of theAchilles tendon after closed treatment, reducing and avoidingspontaneous ruptures of the Achilles tendon.Methods: Selecting35healthy male Wistar rats, average age:3months,weight:270±10g, injecting normal equivalent to human doses ofprednisolone acetate in the left side Achilles tendons of the rats, the samevolume of saline applies to the right sides as the control groups. Injection sitesare around the Achilles tendon. The injections are given once a week, for threeconsecutive times. After the first week, third week, fourth week, fifth week,sixth week, eighth week, tenth week injections respectively, kill five ratsrandomly and begin to take the specimens. All rats are left in the cage freely,and not given any intervention measures. The author observes the grossmorphology of the Achilles tendon tissues and morphological changes ofbiopsy in different time periods after injections. By observing histologicalmorphology of Achilles tendon tissues though H-E staining, by observingthe morphology of collagen fibers and counting numbers of collagen fibers,collagen type Ⅰ and type Ⅲ though Picric acid-Sirius red staining underpolarized light microscopy, the author reaches conclusion at the end by doingstatistical analysis about the above.Results: All35rats are included in the analysis of results.1,Morphological observation: the Achilles tendon at different time pointsproduce different degrees of damage, such as edema, exudation and adhesionwith surrounding tissues apparently after continuous glucocorticoidsinjections of normal doses(once a week).2,Pathological observation: aftercontinuous glucocorticoids injections of normal doses(once a week), thecollagen fibers of Achilles tendons at different time points show verticalarrangement sparse of varying degrees.The numbers of collagen fibersinterspersed with each other reduces.Beam gaps between collagen fibersincrease. Part of the collagen fibers rupture, and the nuclei decrease.3,Observe under polarizing microscope and calculate collagen fibers: compared with the control groups, the performances of all experimental groups aresignificant (p <0.05) in the quantity of total collagen fibers, collagen type Ⅰ,and type Ⅲ, which is statistically significant. The total collagen fibers ofexperimental groups at the fourth week and the fifth week are of nostatistically significance (p>0.05)and the collagen type Ⅰ of experimentalgroups at the first week, the fifth week and the sixth week are of nostatistically significance (p>0.05). The collagen type Ⅰ of experimentalgroups at the first week, the eighth week are of no statistically significance(p>0.05) but the other experimental groups have differences at different timepoints (p <0.05).4,All the control groups are of no obvious differences in themorphology and optical microscopic observation. No obvious collagen fibersdifferences (p>0.05) are observed under polarized light microscopy.Conclusion:1,Glucocorticoids are influential to the rats' Achilles tendons, they cancause Achilles tendons at different time points after3continuous injectionsvarying degrees of damage, such as edema, exudation and adhesion withsurrounding tissues obviously. Pathological observation: the structure ofcollagen fibers is weak on the ability to resist tension, and easy toproduce the spontaneousrupture of Achilles tendon.2, The influences to the rats' Achilles tendons afterglucocorticoids injections for3times(once a week) can last at least10weeksafter the third injection (a course of treatment). Clinical guidance iswe should take care of Human Achilles tendon to return to normal afterclosed treatment of Achilles tendon bursitis for three times. This method cankeep the Achilles tendon away from spontaneous rupture.3,The collagen fiber structure of the rats' Achilles tendon in the thirdweek is the worst after the third glucocorticoids injection (a course oftreatment), suggesting that in clinical human Achilles tendon collagen fiberstructure have the worst time period, we should pay more attention to theprotection of Achilles tendon in that period. 4,The collagen fiber structures of the rats' Achilles tendon are injuredseriously between the third week and the eighth week after continuousglucocorticoids injections for3times. The risk of spontaneous ruptureof the Achilles tendon is still high, suggesting the presence of aspontaneous rupture time to the clinical human Achilles tendon. |
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