复发性多软骨炎
复发性多软骨炎诊断及治疗现状
医生通常会使用一系列评估工具来评估疾病的严重程度，包括AIMS示关节和骨的损伤情况，但通常不用于诊断复发性 多软骨炎。
CT和MRI
CT和MRI可以更清晰地显示软骨和其他软组织的损伤情况， 有助于诊断和评估病情。
病理学诊断
活检
对于难以诊断的病例，医生可能会建议进行活检，以获取软骨和其他组织的样本 进行病理检查。
THANKS
感谢观看
、平衡训练等，以促进康复。
05
研究进展与挑战
新型生物制剂研究
总结词
新型生物制剂已成为复发性多软骨炎治疗的 最新研究热点，通过调节免疫反应，减轻炎 症，改善病情。
详细描述
近年来，随着生物制剂的快速发展，越来越 多的研究集中于利用新型生物制剂治疗复发 性多软骨炎。这些生物制剂主要包括抗肿瘤 坏死因子抑制剂、抗白细胞介素-1和抗白细 胞介素-6等。这些药物能够特异性地抑制炎 症反应，降低免疫反应，从而减轻复发性多 软骨炎的症状和改善患者的病情。
监测生命体征
监测患者的生命体征，包 括体温、心率、呼吸、血 压等，以发现任何异常情 况。
记录症状变化
患者需要密切关注自身症 状的变化，如疼痛、肿胀 、活动受限等，并及时记 录。
预防措施与生活指导
避免诱发因素
患者需要注意避免诱发疾病复发 的因素，如感染、劳累、精神压
力等。
健康生活方式
鼓励患者保持健康的生活方式，包 括规律作息、合理饮食、适当锻炼 等。
发病机制
01
02
03
自身免疫反应
复发性多软骨炎患者的免 疫系统错误地将自身软骨 组织识别为外来抗原，从 而产生自身免疫反应。
炎症反应
炎症反应在复发性多软骨 炎的发病中扮演重要角色 ，炎症因子刺激软骨组织 引起疼痛和肿胀。
复发性多软骨炎诊断及治疗现状
04
疾病管理
定期随访
患者应定期进行随访，以便医生 密切监测病情变化。
随访频率应根据患者的具体情况 和病情严重程度来定，一般建议 至少每3-6个月进行一次随访。
在随访过程中，医生应评估患者 的关节、呼吸、心血管等系统功 能，及时发现并处理可能出现的
问题。
预防感染
复发性多软骨炎患者由于免疫 系统功能异常，容易感染细菌 和病毒等病原体。
积极配合治疗
患者应积极配合医生的治疗建议，按时服药，定期随访， 以便及时调整治疗方案和保持病情稳定。
保持乐观心态
患者应保持乐观心态，适当进行体育锻炼，避免疲劳和感 染等不良因素刺激，以促进康复和保持良好的生活质量。
THANKS
感谢观看
内分泌系统表现
RP可影响内分泌系统，导致甲 状腺炎、胰腺炎等内分泌疾病
。
02
诊断方法
病史采集
01
询问患者症状出现的时间、频率 和持续时间，以及是否有家族病 史。
02
了解患者的职业、生活习惯、居 住环境等，以寻找可能的诱发因 素。
体格检查
检查患者的皮肤、关节、呼吸系统、 心血管系统等，以寻找病变的迹象。
Hale Waihona Puke 患者应保持良好的个人卫生习 惯，避免接触感染源，注意口 腔和呼吸道卫生。
一旦出现感染症状，患者应及 时就医，接受医生的诊断和治 疗。
功能锻炼
适当的运动可以改善患者的关节 功能，增强肌肉力量和耐力。
推荐进行有氧运动，如散步、游 泳、瑜伽等，以增强心肺功能。
对于受累关节，患者可进行轻度 的伸展和按摩运动，以减轻疼痛
分类
RP可分为原发性和继发性两类，其中 原发性RP较为常见，而继发性RP与系 统性红斑狼疮、类风湿关节炎等其他 自身免疫性疾病相关。
得了复发性多软骨炎怎么办
新世纪大学英语（第二版）视听说教程（3rd Edition）第二册（全）Unit 1 All About MeLesson AVocabulary Link：A1（序号从左至右，自上而下）156324Listening：Activity 1-A1、B2、B3、A4、ABActivity 1-Bbe too interested in things that do not concern them, especially other people's affairsActivity 2-A213Activity 2-B1、B2、CD3、BActivity 2-C1、memories2、it's personalActivity 3-A1、132、To visit his grandparents.3、Yes. He talked to a nice woman.4、He had lots of fun with his grandparents and he saw lots of interesting places. In the end, he didn't even want to go home.Activity 3-B（1）very nervous about traveling so far（2）His grandparents（3）their home（4）twoActivity 4-A1、theme3、other paper keepsakes5、your photos and keepsakesActivity 4-B1、Scrapbooking is making beautiful books to hold special memories.2、Old newspapers clippings, postcards, tickets, report cards, and letters.3、"School days," "Family travel," "Memories of my grandparents, " and "Baby's first year."4、You can use felt pens, paint, and stickers.5、The "5Ws": who, what, where, when and why.Activity 5-A1、Most high schools in the US.2、Because they are graduating soon.3、Yes4、At the end of the year.5、It means a student with a good fashion sense.Activity 5-B1、once a yearspring2、chess3、most likely to succeedcategories4、notesI'll never forget youActivity 5-C（1）record（2）photo（3）seniors（4）sports（5）yearbook（6）titles（7）sign（8）memoriesSpeaking & Communication：Activity 1-A（1）How about you（2）this is（3）Hi（4）Let me introduce myself（5）I'd like you to meet（6）Nice to meet youLesson 4Global Viewpoints：Special People-Before You Watch（1）father（2）sister（3）mother（4）grandfather（5）grandmother（6）brotherSpecial People-While You Watch A1、T2、T3、FThe special person in Kumiko's family is her grandfather.4、FCalum's three friends are the most important people in his life.Special People-While You Watch BsisterbrotherEster80specialsupportivego outmost thingsimportantSpecial People-While You Watch C1、her grandfatherhe's always kind to her and supportive2、he likes to go out with them and he can talk to them about most thingsMemories-Before You Watch1、wise2、collect3、amusement parkMemories-While You Watch（1）Memories（2）collected（3）favorite（4）One of my happiest memories（5）my first day of school（6）I wanted the mostCity Living:Preview-B1、C2、A3、A4、C5、BWhile You Watch-AWhile You Watch-B1、blind date2、friend and colleagueBrazilUS office3、excited and a little nervous4、jewelryWhile You Watch-D1、Isn't it beautiful2、too bad3、hanging on to4、keeping it for the memoriesWhile You Watch-E（1）my favorite keepsake（2）pendant（3）things were rough（4）hated（5）make it（6）told（7）helped out（8）as a reminder（9）You know（10）Here goesWhile You Watch-FTara's grandmother's mother.After You Watch-A1、Here goes ...2、It should be OK.3、Too bad ...After You Watch-B（1）is（2）am（3）am living（4）work（5）am volunteering（6）are sending（7）am working（8）are building·She asks Sun-hee to help her choose what jewelry to wear·that her first boyfriend gave to her·that Tara got as a souvenir when she went to the US for the first time·that Tara’s grandmother gave her when she was in her first year of college. At the time, Tara had no friends and she hated her classes. Tara’s grandmother gave her the pendant to remind her to be strong. The story makes Sun-hee decide that the pendant is the perfect jewelry for Tara’s bland date.Unit 2 Express YourselfLesson AVocabulary Link：B2、is laughing3、is crying4、is blushing5、is yelling6、is frowningListening：Activity 1-AActivity 1-B1、bored2、sad3、happyActivity 2-A1、waving to2、shaking hands3、crossing his fingers4、shruggingActivity 2-B1、wallet2、nervous3、studying for a test4、the theaterActivity 3-AThey are both doing great.Activity 3-B（1）That's for sure（2）planning a trip to（3）What about your brothers （4）They're doing great（5）working on a project（6）planning a campaign againstActivity 4-A1、BangladeshIndonesia2、Indonesia3、Indonesia4、Bangladesh5、Bangladesh6、Bangladesh7、Bangladesh8、Indonesia9、NeitherActivity 4-B1、The United Arab Emirates2、Thailand3、Neither4、Thailand5、Neither6、Thailand7、Neither8、The United Arab Emirates9、The United Arab EmiratesActivity 5-A（1）shake hands（2）Japan（3）bow（4）Maori（5）Brazil（6）kiss each other on the cheek（7）in the eyes（8）Japan（9）embarrassedActivity 5-BIn Japan, when meeting for the first time in formal situations, people often exchange business cards. The polite way to give or receive a business card is to hold it with two hands.Pronunciation：B1、Tina's2、sister's3、She is4、When is5、dad is6、How's7、car isSpeaking & Communication：Activity 1-AKaty is stressed and kind of tired.Global Viewpoints：Before You Watch1、bow2、throwing3、stick outWhile You Watch-AWhile You Watch-B（1）doesn't like to feel（2）sad or frustrated（3）to be around other people （4）has stress（5）throw the ball（6）relaxes herWhile You Watch-C（1）have a special way of （2）kissing（3）give them a big hug（4）kiss on the cheek（5）stick my hands out（6）shake handsCity Living：Preview-B1、teachig2、trip3、nervous4、has5、havingWhile You Watch-A1、greetings2、what they are doing3、Tokyo4、nervous5、nothing6、joking7、funWhile You Watch-B1、Takeshi is teaching Claudia how to bow to people when greeting.2、She is preparing for a trip to Japan and this is the traditional Japanese way of greeting people.3、She's going to have a big meeting in Tokyo.While You Watch-C（1）a little nervous about（2）no need to be nervous（3）kind of worried about（4）Everything's going to be fineWhile You Watch-D（1）Let's see（2）like this（3）You're a natural（4）actually rude（5）one more thing（6）for luck（7）come onCome on（8）You guys（9）have a little fun（10）Some teacher you areWhile You Watch-EIt probably means that Takeshi is not a good teacher. Maybe Claudia thinks that a good teacher shouldn't make fun of their students.After You Watch-AAfter You Watch-B1、like this2、Let's see3、a natural4、Come on5、thoughAfter You Watch-C·traditional Japanese greetings. She became immediately interested in knowing what they were doing. Claudia told Tara that she was learning about Japan for her trip to Tokyo·That was why she had asked Takeshi for help. After he had showed Claudia how to give a person her business card in Japan, Takeshi told her that Japanese people would jump and nod their heads for luck—and they would do this three times·she was really trying to learn. While she was jumping and nodding her head, Takeshi and Tara started laughing.As it turned out, Takeshi was joking! He just wanted Claudia to relax and have fun.Unit 3 Let’s EatLesson AListening：Activity 1-ADActivity 1-B1、delicious, crispy, juicy2、bland3、oily, good4、tasty, too sweetActivity 2-AAActivity 2-B1、fast2、life3、farmers4、Europe5、membersActivity 3-A（从左至右，从上而下）butteryspicysweethealthyActivity 3-B1、He wanted to lose weight because he was 20 pounds overweight.2、Because she has spent six months in Thailand and comes to like spicy Thai food.3、It means that Abby likes to eat sweet foods.4、Because Minh is training for a swimming competition and he has to eat healthy foods. And now he prefers healthy foods to sweet or buttery foods.Activity 4-A1、T2、F3、T4、F5、F6、T7、TActivity 4-Bcapsaicin:a chemical in the chili peppers that produces heat andmakes your mouth feel hot. It has no flavor or smell.habanero:the hottest chili pepper in the world. It is bright orange and grows in the Caribbean.Activity 5-AActivity 5-B1、34 centenarians per 100,000 Okinawans.2、The Okinawans' secret: first, they eat a healthy diet;second, they don't do hard exercise; third, the older people have a good attitude about aging.Speaking & Communication：Activity 1-A1、Why don't we go to the pizza place on the corner?2、How about that new Japanese restaurant downtown?Lesson BGlobal Viewpoints：Favorite foods-Before You WatchFavorite foods-While You Watch A2、T3、FDayanne doesn't like rice and beans that are salty and buttery.4、T5、FDan says there's nothing better than juicy steak.6、FJulianna doesn't like to eat bacon.7、FAlejandra enjoys sweet foods like chocolate.International foods-Before You Watch1、some salsa2、tortillaInternational foods-While You Watch（1）I like（2）serve（3）My favorite dish（4）I love that（5）the most popular food（6）You name it（7）deliciousCity Living：Preview-B1、C2、B3、C4、B5、BWhile You Watch-A1、T2、T3、T4、FTakeshi thought Mike added too much hot sauce.5、T6、T7、FChef Dupree liked Mike and Takeshi's chicken because it was very hot.8、FMike and Takeshi won the cooking contest.While You Watch-B1、A2、B3、D4、A5、C6、C7、A8、CWhile You Watch-C1、Mike suggests they make the plate look better because they are attending a cooking contest and they want to win.2、Roberto says that the food looks delicious, and he says "mmm ..."While You Watch-D（1）how about some more hot sauce（2）man（3）Is it hot（4）come on（5）Oh my goshWhile You Watch-E（1）Step away from（2）The taste testing（3）Buttery（4）Quite tasty（5）A little sweet, but still crunchy（6）Try some chicken（7）Hot and spicy（8）Born and raised（9）the winners（10）I told youWhile You Watch-FThe judge, Chef Dupree, liked the food they prepared because he was born and raised in Louisiana where thefood is hot and spicy.After You Watch（1）entered a cooking contest（2）suggested adding some hot sauce to make the chicken spicier（3）wasn't so sure（4）the cover came off the bottle accidentally（5）he tried to remove some of the sauce（6）The judging began（7）her chicken was the oiliest he had ever tasted（8）they became extremely nervous（9）They thought the chef would not like it, but to their surprise, he liked it（10）quite unexpectedlyUnit 4 Today’s TrendsLesson AVocabulary Link：AListening：Activity 1-AActivity 1-B1、T2、T3、T4、FActivity 2Activity 3-A1、f2、c3、bActivity 3-B1、You could look for friends on the Internet.2、You shouldn't wear pants. You definitely ought to wear a dress.3、You'd better get some help or you'll fail the test. You'd better not delay taking the test.Activity 4-A1、b2、aActivity 4-B1、Sorry, but I have to side withwant to show offin your free time2、have a serious talkstyle and tastetoo much about appearancesActivity 5-B1、She was nervous and didn't know what to expect.2、She had to report to a recording studio by 10 a.m.3、They had to decide which songs were "Yes -- All the way!", "It's OK.", or "No way!"4、They just talked about the covers they liked.5、They are going to look at some new fashions.Activity 5-C1、The job doesn't pay.2、Brooke works once a week as a trendspotter.3、Brooke saw only six CD covers for "Gifted".4、Brooke held up a "No way" card for the heavy metal music.Pronunciation：B1、Most of2、Some of3、All of4、None ofSpeaking & Communication：Welcome to our debateplease beginWhat do you thinkSoExactlyI don't agreeActivity 2-A开放题型Activity 2-C开放题型Activity 2-E1、All2、A couple3、None4、Most5、Some6、All7、A lot8、MostLesson BGlobal Viewpoints：Family trends-Before You Watch1、full-time2、males3、traditional4、parentsFamily trends-While You Watch APersonal style-Before You WatchPersonal style-While You Watch （1）independent、（2）fashion（3）cowboy boots（4）stylish（5）admire（6）change（7）lose weight（8）appearance（9）instead ofCity Living：Preview-B1、B2、C3、B4、A5、CWhile You Watch-A24135While You Watch-B1、No, Mike didn't think running was enjoyable.2、Roberto said it was good for Mike (good for his health); he also said it was a trend nowadays to exercise.3、No, Mike didn't agree with Roberto. He said that most people he knew didn't exercise.4、None of Roberto's co-workers exercised 5 years ago.5、28 percent or almost one third of Roberto's co-workers go to the gym now.6、They go to the gym three or more times a week.While You Watch-C（1）Just because（2）doesn't make it a trend（3）that means（4）Not necessarily（5）Such as（6）play golf（7）that's true（8）None（9）come on（10）All of（11）most of（12）not this one（13）ought to（14）we'd betterWhile You Watch-D（1）you know what（2）What（3）What（4）You know（5）Yeah, right（6）No, I'm seriousAfter You Watch-A1、Such as2、You know what3、Not necessarily4、more and moreAfter You Watch-B·he should get more exercise. Roberto thought that more and more people were exercising·that most of the people he knew didn’t exercise·the increase in the number of people who exercised at his office·got tired and they stopped to rest·they ought to go home·they had better get Mike something to drink too·they should get some ice cream, too. Why? Because Mike read that thirty-three percent of all athletes recommend eating ice cream after a heavy workout.Roberto, however, didn’t agreeUnit 5 Unsolved MysteriesLesson AVocabulary Link：A1B1、A2、A3、B4、A5、A6、B7、BC(从左至右，从上而下)·The man is breaking a law. He is committing a crime.·The detective is catching a criminal. The detective is arresting the criminal.·The detective is questioning the criminal. The criminal is not making a confession.DWord puzzleListening：Activity 1-Athe most famous detectives ever known imaginary detectivesixtyScottish authormoneyActivity 1-B1、C2、C3、A4、B5、BActivity 2-A41352Activity 2-BABDActivity 2-C1、Mike thinks the lights could be the same as those in a local legend.2、Alexa thinks the lights are a hoax.Activity 3-A1、A young girl standing in the middle of the road.2、Because it was raining heavily.3、He stopped the car quickly.4、She said "I'm fine" and walked away quietly.5、He said the girl was Mary Anne and was killed ina car accident five years ago.Activity 3-B（1）heavily（2）clearly（3）slowly（4）neatly（5）quickly（6）strangely（7）happily（8）quietly（9）Nervously（10）calmlyActivity 4-A1、A terrible explosion.2、In eastern Russia.3、June 30, 1908.Activity 4-B41352Activity 4-C1、lots of damagehuge explosion2、near Eartha part of it broke off3、crashed into the groundits engine exploded 4、destroy the earthset fire to the forest5、used electricitya test of his gunActivity 5-A27846153Activity 5-B1、Different people see different lights.2、Robert Ellison saw the lights in 1883.3、The Native Americans thought the lights were stars falling to Earth.4、A team from Japan studied the lights, but couldn't solve the mystery.Activity 5-C1、Ball lightning is lightning in the shape of circle. It often appears after a rainstorm.2、Some people call the lights "ghost lights".3、No, they aren't. Actually, they hold a town festival every September to celebrate the mystery lights. PronunciationA1、B2、A3、A4、C5、C6、BLesson BGlobal Viewpoints：Before You WatchWhile You Watch AWhile You Watch B1、fall2、a strong3、sneaky4、real5、how6、offWhile You Watch C（1）witnessed a very strange event （2）make the rain fall（3）was haunted（4）late at night（5）turned off（6）very strange and quite scary City LivingPreview B1、A2、B3、B4、B5、AWhile You Watch-A421653While You Watch-B1、Tara asked them to come because she wanted to solvea crime.2、Someone stole and ate Sun-hee's yogurt.3、Sun-hee thinks it's OK, because it's only yogurt.4、Tara feels it's serious, because if the thief is not caught more things are likely to go missing.While You Watch-C（1）It's very likely（2）for emergencies（3）besides（4）Now（5）calmly（6）netly（7）Note the weapon（8）I have an alibi（9）you are a friend ofWhile You Watch-D（1）What（2）Confess（3）too busy to go shopping （4）went to bed（5）made sure（6）carefully took this spoon （7）No! No! It's not true!（8）Hey（9）What's upAfter You Watch-A1、Who knows2、go on3、Note4、It's very likelyAfter You Watch-B（1）without notice（2）solve this "crime"（3）it was very likely（4）Tara got serious about the matter（5）if it were not checked at the start（6）though in a humorous way（7）he had an alibi and hadn't done it（8）Just as Claudia was protesting that it wasn't true（9）Finally everyone came to know who the "thief"really wasUnit 6 The MindLesson AVocabulary Link：B11、My memories of school are mostly happy/unhappybecause ...2、My favorite song is ..., it reminds me of ...3、I didn't believe it when ...4、I usually remember/forget things such as ...5、I find it helpful to ... when I am trying tomemorize new English wordsListening：Activity 1-ArememberActivity 1-BActivity 1-C1、Two tips. One is to label things in English. The other is to make a note of related words.2、You can rent a film and see it at home.Activity 2-A231Activity 2-B1、no one2、couldn't run3、can't swimActivity 3-A1、pink2、pillars3、living room4、large5、stereo system6、wasn‘tActivity 3-B1、T2、F My best friends were all there. They spoke to me and smiled didn't speak or smile.3、F There were a few all kinds of kitchen equipment in the kitchen.4、F The whole family was standing sitting around the table, waiting for a meal to be served.5、TActivity 3-C1、The storyteller heard a voice saying: "welcome home." and she realized the dream house was hers.2、She thought her dream was turning into a nightmare because her friends suddenly disappeared and it was scary.3、She liked the food processor most because it makes life much easier.4、She saw the stove was broken and that there was no electricity. She also saw the children were cryingbecause they were hungry. She felt bad and wanted to help prepare a meal but began to despair when she found the refrigerator was empty.Activity 4-A2513 and 4Activity 4-B1、Four or five times.2、Stages 3 and 4.3、Fifteen to sixteen hours a day.4、Sleep is very important for learning.Activity 5-A1、many times2、don't remember3、very active4、gods5、Greeks and RomansActivity 5-B1、T2、F3、FActivity 5-C（1）definite answers（2）Why do you dream（3）a person’s mind（4）husband or wife（5）start a business（6）thoughts and feelings（7）strange or confusing（8）think about the events in the dream （9）feel free or want freedom（10）feel afraidPronunciation：BSpeaking & Communication：Activity 1-A1、Yes, they're here in my pocket.2、They're not in my pocket.3、I don't think so.4、Maybe they're in your backpack. Global Viewpoints：How's your memory?-Before You Watch1、code2、characteristic3、memory4、imageHow's your memory?-While You Watch-A1、imagesnumbers2、numbers3、numberslanguages4、names5、namesStrange dreams-While You Watch A1、T2、F Malinda had a nightmare that she was lost in a city forest.3、T4、F Woo Sung had a dream that birds dinosaurs were chasing him.5、F Dan dreamed that a dinosaur bird ate him. Strange dreams-While You Watch BLast night I had a dream about a friend who's living very far away from me. When I woke up I felt sadbecause I miss her.City Living：Preview-B1、night2、pajamas3、a man4、liked5、understandsWhile You Watch-A51342While You Watch-BWhile You Watch-C1、Roberto was not sure about what happened in hisdream.2、He thought it was weird because he was wearing pajamas in the daytime.3、Claudia encouraged Roberto to recall his dream. She said "Come on! Try!"While You Watch-D（1）I'm not sure（2）He reminded me of（3）and then（4）No! Really（5）Do you remember（6）I'm sure of it（7）thinkWhile You Watch-E（1）I got it（2）shook my hand（3）like this（4）ballet dancer（5）I woke up（6）Why（7）They were a surpriseWhile You Watch-F1、I am surprised by the ending. It is a real coincidence that Roberto dreamed about tickets and ballet dancing when, unknown to him, Claudia had got two tickets to the New York City Ballet.2、I think Claudio and Roberto will go to the Ballet together.After You Watch-A1、B2、A3、B4、AAfter You Watch-B·It was daytime but he was in the street in his pajamas. He stopped a man and asked him where to buy a ticket. He and the man talked and laughed a lot. The man reminded him of Mike. Then the man hugged Roberto, shook Roberto's hand, and began to dance like a ballet dancer. Roberto thought the dream was really weird·Claudia said, "This is so scary." Then she showedRoberto a surprise she had for him —two tickets for the New York City BalletUnit 7 Let’s Celebrate！Lesson AVocabulary LinkA21、before2、manbe3、live near each other4、gifts5、on a warm, sunny day6、your family and relatives7、stay overnight8、keep a secretListening：Activity 1-ABActivity 1-B1、B2、A3、CActivity 1-C1、Another company.2、A bachelor party and a big family reunion.3、He's excited about it and he likes the job. Activity 2-A2413Activity 2-B（1）it was a lot of fun（2）to rent（3）loud and beautiful（4）The only bad part for him（5）from too much dancing（6）some beautiful floats go down the river Activity 2-C2431Activity 2-D（1）traveling through India （2）best memories（3）water pistol（4）shot everyone（5）a mess（6）come out ofActivity 3-A1、C2、AActivity 3-BMDMMDActivity 3-C（1）gets very crowded（2）after you arrive（3）The most important event（4）be sure to find a good place to sit（5）just relax and have fun（6）before（7）after the parade finishesActivity 4-A1、F2、F3、T4、T5、F6、TActivity 4-B1、Before Mardi Gras even begins, there are over 70 parades of dazzling floats.2、Start making reservations in August. Don't wait until January.3、Many streets are closed to cars, and bus and streetcar schedules are often changed.4、Get there early, about four hours ahead of any bigparades. For the Sunday night parade, find a space in the morning.5、You might need a jacket, sunglasses, an umbrella, or all three.6、People ride on floats in the parades and give "throws" to the crowd.Activity 5-ABActivity 5-B1、T2、F A movie about Pete came out in 1995 1993.3、T4、F Pete rarely sees usually sees his shadow. Activity 5-C1、A groundhog is a small animal covered with brown fur. It lives in a hole in the ground and stays underground during the winter2、Every February 2, local people and sightseers in the town of Punxsutawney watch for Pete, a groundhog, to come out of its hole. If it comes out, GroundhogDay is celebrated with a barbecue, a colorful festival in the park, a souvenir show and sale and even a storytelling festival.3、People think it means the weather will continue tobe cold for at least six weeks.4、The weather in February in Punxsutawney isgenerally cold and will continue to be cold for another six to eight weeks.5、People would be disappointed if Pete didn't appear.PronunciationB1、Do you want to2、Would you like to3、Would you like to4、Do you want toLesson BGlobal Viewpoints：What a party!-Before You WatchWhat a party!-While You Watch A1、T2、FAt the party Alejandra went to, everyone wore formal summer or casual clothes.3、FThere were 28 38 people at Dennis's birthday party.4、T5、FDennis's friends Dennis cooked the food for his birthday party.。
第22章-复发性多软骨炎210-215
第二十二章复发性多软骨炎新疆维吾尔自治区人民医院滕玉芬复发性多软骨炎（Relapsing Polychondritis，RP）是一种较少见的炎性破坏性自身免疫病，其特点是软骨组织炎性破坏呈反复发作和缓解的进展性病变。
表现为耳、鼻、喉、气管、眼、关节、心脏瓣膜等器官及血管等结缔组织受累。
本病好发于白种人，国外报告，发病率约为3.5/百万人。
任何年龄均可发病，但多数发病年龄为30～60岁。
无性别及家族性发病的倾向。
第一节病因和发病机理至今病因和发病机理不明，可能是软骨基质受外伤、炎症、过敏等因素的影响暴露出抗原性，导致机体对软骨局部或有共同基质成分的组织的免疫反应，也有人认为与中胚层合成障碍或蛋白水解酶异常有关，通过多年来对临床特点，实验室检查和病理的研究，越来越多的资料提示它是一种免疫介导的疾病。
包括体液免疫和细胞免疫。
1.25％～30％RP病例合并其他自身免疫性疾病。
2.血清学检查可见Ⅱ型胶原抗体，部分RP病例抗ANA、类风湿因子（RF），循环免疫复合物（CIC）阳性。
3.用Ⅱ型胶原免疫啮齿类动物可见到耳部软骨和多关节软骨的炎性改变。
4.观察到RP病例对软骨抗原的细胞介导的特异性免疫增强。
5.通过直接免疫荧光检查观察到在受累的软骨有免疫球蛋白和补体的沉积。
6.RP与HLA-DR4相关。
7.Buker等最近报道，Matrilin-1的抗原可能参与了RP的发病机制。
它是一种软骨机制蛋白，为成年人气管、耳和鼻软骨所特有。
8.糖皮质激素或免疫抑制剂治疗有效。
总之，RP患者机体产生了针对Ⅱ型胶原的自身免疫反应，造成软骨破坏。
另外，软骨糖蛋白、弹性蛋白及其它胶原也可诱发自身免疫反应。
软骨糖蛋白抗原广泛存在与巩膜、虹膜睫状体、气管、视神经、内皮细胞、主动脉血管中层结缔组织，心脏瓣膜、心肌纤维、肾小球基底膜，滑膜等。
临床上这些器官、组织均可受累，可以证明软骨糖蛋白抗体可诱发软骨变性，滑膜炎和软骨炎。
第二节病理1.软骨早期表现为基质呈局灶性或弥漫性丧失，伴软骨组织周围炎细胞浸润；晚期表现为软骨变性、坏死、溶解、液化并出现肉芽组织，最后残余的软骨组织消失，肉芽组织纤维化，疤痕形成收缩，组织塌陷变形。
复发性多软骨炎(多发性软骨病,复发性多发软骨炎)
复发性多软骨炎（多发性软骨病，复发性多发软骨炎）
复发性多软骨炎（Rheumatoid Arthritis）是一种常见的慢性自身免疫性疾病，
主要侵犯滑膜和软骨。
它通常以手、腕、膝关节的对称性关节炎为特征，但也可影响其他关节，如踝、肩、肘和髋关节。
本文将探讨复发性多软骨炎的病因、症状、诊断和治疗。
病因
复发性多软骨炎的病因尚不清楚，但在其发病过程中，免疫系统起着至关重要
的作用。
免疫系统误认自身的滑膜组织和软骨组织为外来物质进行攻击，导致关节炎的发生。
遗传因素、环境因素以及生活方式等都可能对复发性多软骨炎的发病有影响。
症状
复发性多软骨炎的症状多样化，包括但不限于关节疼痛、肿胀、僵硬、运动障
碍等。
早期的症状常常被忽视，但随着病情的进展，患者的关节功能会逐渐受到限制，甚至丧失劳动能力。
诊断
复发性多软骨炎的诊断主要依靠临床表现、体格检查和影像学检查。
医生会根
据患者的症状、体征以及实验室检查结果来做出诊断。
常用的诊断方法包括血常规、血沉、类风湿因子等检测。
治疗
针对复发性多软骨炎的治疗主要是缓解症状、控制炎症以及保护关节功能。
常
用的治疗方法包括非甾体类抗炎药、糖皮质激素、免疫调节剂、物理疗法等。
对于部分患者来说，手术治疗也是一种有效的选择，如关节置换手术等。
结语
复发性多软骨炎是一种慢性疾病，给患者的生活带来了很大的困扰。
及早发现
并进行有效的治疗对于提高生活质量具有重要意义。
希望本文能够帮助读者更深入了解复发性多软骨炎的相关知识，并能够更好地预防和治疗这一疾病。
复发性多软骨炎的病因与病理
复发性多软骨炎的病因与病理
一、概述
在医学上很多的疾病都是大家很少听过的，其中复发性多软骨炎就是一个很少见的疾病，他经常涉及到全身多个系统，如果疾病的发生，就全身很多系统都会造成损害，而且十分具有反复性，经常反复性的发作，他经常会危及全身的缘故以及其他组织，包括耳朵鼻子眼睛身体上的关节，还有心血管系统等，这些都是常见的。
那么你知道复发性多软骨炎的一个病理吗？
二、步骤/方法：
1、其实对于复发性多软骨炎等一个发病原因并没有一个科学的
解释，有的人认为他可能是因为外部受伤，再受伤的期间受到了感染，从而患上了疾病，还有一种原因是因为过敏或者是因为酗酒也会造成。
2、还有一种人认为这个疾病与中胚层合成障碍有关，还有可能
与蛋白水解酶异常有关，但是这些都没有一个具体的说明，对于这个疾病的病因也没有一个完全的解释，一切都还在研究当中。
3、但是通过医生对于病者临床的特点的研究，表明了这种疾病
是一种免疫介导的疾病，包括了两种免疫方式，一种是体液免疫，还有一种是细胞免疫，对此事有比较统一的说法，但对于病因还没有一个具体的说明。
三、注意事项：
对于这项疾病的研究还在不断地进行，其发病原因有很多，可能
与外伤感染过敏这些因素都有关系，对此不同的研究学者也有不同的看法，以前还在研究之中。
复发性多软骨炎的诊断与鉴别诊断
复发性多软骨炎的诊断与鉴别诊断
一、概述
大家对于复发性多软骨炎并不是十分的了解，这是一种非常少见的能够累积到全身多系统的一种疾病，而且还会反复的发作，也会形成一种缓解的进展性，炎症性的破坏性的病变，会直接的累及到耳，眼，鼻，关节呼吸道以及心血管系统。
出现复发性多，软骨炎一定要在临床上进行诊断和鉴别。
因为早期复发性多，软骨炎在临床上和其他疾病都会有相似的症状。
二、步骤/方法：
1、耳廓在出现急慢性感染的时候，包括外伤和冻伤以及化学物质的刺激，再加上昆虫的咬伤和日晒，都需要和软骨皮炎进行鉴别，主要是因为血管功能出现失调所引起的，局部会发生浆液性的渗出。
2、眼睛出现的疾病的表现是比较多的，所以一定要注意引起的原因，包括坏死性的骨膜炎或者是角膜炎以及关节炎中耳炎伴听力和前庭功能出现的损伤，结合临床上的症状表现以及疾病经活组织检查明确进行诊断。
3、主动脉炎和主动脉病的病变和病毒以及动脉粥样硬化进行鉴别，还包括肋软骨炎的病变和良性的胸廓综合征的鉴别，听力和前庭功能出现障碍，也是首发的症状表现，一定要和脑基底动脉病变和脑卒中进行鉴别。
三、注意事项：
造成复发性多软骨炎的原因是比较多的，包括自身免疫性的疾病，或者是细胞出现浸润，以及生活当中过度饮酒，加上感染和外伤等等这些因素，所以在生活当中一定要避免这些因素的发生。
复发性多软骨炎诊断及治疗现状
疾病定期检查与评估
定期检查
患者应定期进行全面的身体检查，包括各项生命体征、心肺 功能、肝肾功能等方面的检查，以及必要的影像学和实验室 检查，以便及时发现并处理可能出现的并发症和病情变化。
评估病情
医生应对患者的病情进行定期评估，了解患者的病情发展趋 势、治疗效果、生活质量等方面的情况，以便及时调整治疗 方案和提供更全面的治疗支持。
CT和MRI
对于显示软骨和软组织病变更敏感，有助于发现病变部位
病理学诊断
活检
对于复发性多软骨炎的诊断具有重要意义，通过活检可以观察到软骨基质中免疫 细胞的浸润和软骨细胞的破坏
免疫病理学检查
可发现细胞间质中免疫细胞和炎症细胞的浸润，以及细胞内抗原抗体复合物的沉 积
03
复发性多软骨炎治疗现状
药物治疗
05
复发性多软骨炎临床研究及 展望
临床研究现状
临床表现
复发性多软骨炎患者多表现为 气道、鼻、喉、耳等部位的软 骨炎，伴有发热、关节痛、体
重减轻等症状。
诊断标准
目前复发性多软骨炎的诊断主 要基于临床表现、实验室检查
和影像学检查。
疾病进展
疾病早期常出现呼吸道受累， 随着病情进展，可累及全身多
器官。
研究热点及挑战
需要开展多中心临床试验，以评估现有治疗方案的疗 效和安全性，并探索新的治疗方案。
需要加强国际合作和交流，共同推进复发性多软骨炎 的研究和治疗水平的提高。
THANKS
感谢观看
复发性
• 引言 • 复发性多软骨炎诊断现状 • 复发性多软骨炎治疗现状 • 复发性多软骨炎疾病管理 • 复发性多软骨炎临床研究及展望 • 结论
01
引言
疾病背景介绍
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▪ 反复发作可引起鼻软骨局 限性塌陷，发展成鞍鼻畸 形。
▪ 患者常有鼻塞、流涕、鼻 衄、鼻粘膜糜烂及鼻硬结 等。
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临床表现
4、眼部病变
主要表现为眼的附件炎症,可单侧性，也可为对称性，最常 见为结膜炎、角膜炎、虹膜睫状体炎、巩膜炎和色素膜炎。
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临床表现
▪ 10.神经系统病变
▪ 少数患者可有中枢神经系统受损和周围神经受损的症状, 如头痛、外展神经麻痹、面神经麻痹、癫痫、器质性脑病 和痴呆，也可发生多发性单神经炎。
巩膜炎反复发作可导致角膜外周变薄，甚至造成眼球穿孔。 视网膜病变如视网膜微小动脉瘤、出血、渗出，静脉闭塞、
动脉栓塞也常有发生。 视网膜血管炎或视神经炎可导致失明。 随着病情的反复发作，患者常可同时有几种眼疾。
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临床表现
▪ 5.关节损害
▪ 特点是:外周关节非侵蚀性非畸形性多关节炎。 ▪ 大小关节均可受累,呈非对称性分布，多为间歇性发作，
慢性持续性者较少。 ▪ 肋软骨和胸锁关节以及骶髂关节也可受累。 ▪ 当合并类风湿关节炎时可出现对称性侵蚀性畸形性关节炎。
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临床表现
▪ 6.呼吸系统病变
▪ 约半数患者累及喉、气管及支气管软骨。 ▪ 表现为声音嘶哑、刺激性咳嗽、呼吸困难和吸气性喘鸣。 ▪ 喉和会厌软/11
15
临床表现
▪ 9.皮肤损害
▪ 25%患者有皮肤损害。 ▪ 皮损无特征性,形态多样，可表现为结节性红斑、紫癜、
网状青斑、结节、皮肤角化、溢脓、色素沉着等。 ▪ 活检常呈白细胞破碎性血管炎的组织学改变。 ▪ 也可发生指（趾）甲生长迟缓、脱发及脂膜炎、口腔溃疡
及生殖器溃疡。 ▪ 有些病例和白塞病重叠存在。
软骨糖蛋白抗原广泛存在于巩膜、虹膜、睫状体、气 管、视神经内皮细胞、主动脉血管中层、结缔组织、心脏 瓣膜、心肌纤维膜、肾小球基底膜、滑膜等。
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临床表现
1、耳廓软骨炎
耳廓软骨炎是最常见的临床表现,以外耳轮突发的疼痛、肿 胀、发红发烫为特征，炎症可以自行消退或经治疗消退。反复 发作可导致软骨的破坏、外耳廓松弛、塌陷、畸形和局部色素 沉着称为菜花耳。
骨压痛。 ▪ 喉和会厌软骨炎症可导致上呼吸道塌陷,造成窒息，需急
症行气管切开术。 ▪ 在疾病晚期支气管也可发生类似病变，炎症、水肿及瘢痕
形成可导致严重的局灶性或弥漫性的气道狭窄，气管切开 术不能有效纠正呼吸困难。 ▪ 由于呼吸道分泌物不能咳出，继发肺部感染，可导致患者 死亡。
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临床表现
引起猝死。 ▪ 还可因血管炎而导致血栓形成，可累及降主动脉及腹主动脉、锁骨下、
脑内、肝、肠系膜及周围动脉。 ▪ 可伴发结节性多动脉炎、魏格纳肉芽肿及大动脉炎等。
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临床表现
▪ 8.血液系统异常
▪ 半数患者出现贫血、血小板减少。 ▪ 活动期的患者多有轻度正细胞正色素性贫血,白细胞增高。 ▪ 有些患者脾脏肿大，还可并发骨髓异常增生综合征。 ▪ 少数患者发生溶血性贫血。
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概述
复发性多软骨炎是一少见的累及全身多系统的疾病,具 有反复发作和缓解的进展性炎性破坏性病变，累及软骨和 其他全身结缔组织，包括耳、鼻、眼、关节、呼吸道和心 血管系统等。
复发性多软骨炎
据统计，截止到2001年，国外报道600多例，截止到 2003年，国内240例。发病年龄为5-84岁，诊断时的平均 年龄为30～60岁。RP发病男女大致相等，比例约为l:l一1 ：1．3。本病的病因及发病机制尚不明确，但越来越多的 证据表明本病有自身免疫的机制参与 。
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概述
▪ 该疾病可与类风湿关节炎、系统性血管炎、 系统性红斑狼疮以及其他结缔组织病并发。
▪ 病初常为急性炎症,经数周至数月好转，以 后呈慢性反复发作。
▪ 晚期因起支撑作用的软骨组织遭破坏，出 现松软耳、鞍鼻以及嗅觉、视觉、听觉和 前庭功能障碍。
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流行病学
本病好发于白种人,但世界各地均有本病的报 告，发病率约为3.5/100万人。本病可发生于各 个年龄段，而以40～50岁为发病高峰。男女均可 受累，但女性以呼吸道受累较多而较重。
复发性多软骨炎
(Relapsing polychondritis,RP)
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概述
▪ 最早Jaksch—Wartenhost于1923年以多发性软骨 病的名称来描述,以后曾被称为弥漫性软骨膜炎、 软骨软化、慢性萎缩性多软骨炎、弥漫性软骨溶 解和软骨发育障碍等。
▪ 1960年由Pearson等命名为“复发性多软骨炎”， 该名称逐渐被广泛接受。
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临床表现
2、听觉及(或)前庭功能受累
▪ 外耳道狭窄、中耳炎症、咽鼓管阻塞可导致传导性耳聋。 ▪ 后期可累及内耳,表现为听觉或前庭功能损伤。 ▪ 病变累及迷路可导致旋转性头晕、眼球震颤、共济失调、
恶心及呕吐等。
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临床表现
▪ 3.鼻软骨炎
▪ 约3/4患者有鼻软骨炎。 ▪ 急性期表现为局部红肿、
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病因
病因至今不明
中胚层合成障碍或蛋白水解酶异常可能是关 键,但通过对临床特点、实验室检查和病理的多年 研究，越来越多资料提示它是一种免疫介导的疾 病，包括体液免疫和细胞免疫。
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发病机制
目前普遍认为是由于自身免疫反应异常引起的疾病。 推测其发病机制是各种原因引起的细胞和体液免疫功能异 常并攻击自身的软骨组织,导致含有软骨组织器官的结构 破坏，从而导致本病的发生。机体产生了主要针对Ⅱ型胶 原的自身免疫反应，造成软骨破坏,此外软骨糖蛋白、弹 性蛋白及其他胶原也可诱发自身免疫反应。
▪ 7.心血管病变
▪ 约30%的患者可累及心血管系统,表现为心肌炎、心内膜炎或心脏传导 阻滞、主动脉瓣关闭不全，大、中、小血管炎。
▪ 主动脉瓣关闭不全是常见而严重的心血管并发症，通常是由于主动脉 炎、主动脉瓣环和主动脉进行性扩张所致，而非主动脉瓣膜病变。
▪ 在主动脉瓣听诊区可闻及不同程度的舒张期杂音。 ▪ 其他表现包括升主动脉、降主动脉动脉瘤，及其他大血管动脉瘤破裂