Establishment Of An Animal Model Of Hemorrhagic Arthritis And Observation On The Therapeutic Effect Of Hemophilia Arthritis

Objective:The pathogenesis of Hemophilia arthritis(Ha)is unknown,and no relevant gene knockout animal model has been established.Therefore,this experiment explores the physiological and pathological mechanisms of hemorrhagic arthritis by constructing the model of animal hemorrhagic arthritis to simulate the process of hemophilia arthritis.From another perspective,the mechanism of arthritis caused by hemophilia hemorrhage is simulated.The degree of synovial lesions and related imaging and pathological results were used as the main evaluation indicators for the success of animal models,and the physiological changes of experimental animals were also monitored.In the clinical efficacy observation,the individualized rehabilitation treatment was compared with the changes of the joint function and the daily living ability(ADL)of Ha patients,which laid a theoretical foundation for the rehabilitation of hemophilia arthritis.Methods:Three male thoroughbred beagle dogs were selected,aged 1 year and 8 months,and weighed 12±0.4Kg.Statistics From September 2018 to March 2019,after feeding natural hirudin,the blood coagulation function of the experimental dog was increased to simulate the high bleeding risk of hemophilia,and the blood coagulation function activated partial coagulation under different coagulation functions during the monitoring experiment.The values of Activated Partial Thromboplastin Time(APTT),Prothrombin Time(PT),and Vascular Endothelial Growth Factor(VEGF).In the experimental group,2 dogs were injected with autologous blood in the knee joint for 3 days/time,PRICE principle protection after injection,and appropriate outdoor running rehabilitation training after 72 hours.After a total of 20 injections,the animal model was established.After the embolization of the experimental dogs,the knees,ankle synovium,cartilage were observed for the degree of joint damage,and related hematoxylin-Eosin staining(HE staining)and iron staining were used to examine the pathological changes.Ten patients with Ha were enrolled in the clinical trial.According to the FITT(training frequency,training intensity Intensity,training type Type,training time Time)training principle,the joints were loosened and muscle strength were given to patients 5 days a week,once a day,under moderate exercise intensity.Rehabilitation treatments such as training,posture correction and balance training,ADL functional training,through the Functional Independence Score in Haemophilia(FISH)and Haemophilia Joint Health Score(HJHS)Compare treatment effects before and after the score.Results:The results showed that the level of coagulation function had a significant effect on the expression of VEGF in experimental dogs(P<0.05).When APTT reached the clotting function of canine hemophilia,VEGF was highly expressed.In normal coagulation state,VEGF returned to normal.And a large number of repeated autologous blood injections in the joint cavity does not cause it to rise.There was only a small amount of mild hyperplasia and villus-like changes in the synovial membrane of the joints in the joints of the experimental dogs.There was no obvious vascular remodeling.HE staining showed mild synovial and cartilage hyperplasia,and mild knee synovial inflammation.Iron staining showed no macrophage inflammatory response and hemosiderin deposition.The animal model of hemorrhagic arthritis was successfully established but did not achieve the expected results.Clinical rehabilitation effect observation After the individualized rehabilitation training,there was no obvious bleeding symptoms in the course of the disease,and the affected joint function and daily living ability were significantly improved(P<0.05).Conclusion:(1)The animal model of hemorrhagic arthritis was successfully established,but did not achieve the expected pathological effect.(2)The level of coagulation function in dogs has an effect on the concentration of VEGF.When APTT is significantly elevated to a high risk of hemorrhage,VEGF expression is highly expressed;when coagulation function is normal,VEGF also returns to normal.(3)Multiple interventions in the canine joints under the intervention of rehabilitation means only cause mild synovial inflammation and hyperplasia of the joints.(4)Canine autologous blood joint injection did not cause significant changes in VEGF,but it was not directly inferred that blood had no associated effect on VEGF and arthritic factors.(5)After the individualized rehabilitation training of Ha patients,the joint function and daily living ability were greatly improved.During the treatment,the patient had no bleeding,which is a relatively safe and effective Ha treatment method.