Establishment of the analytical system on a fine volume synovial fluid in the human temporomandibular joint

1) TMJ滑液中白细胞介素1 β水平与OA变化呈正相关。软骨退化患者基质溶解素（MMP3）活性显著升高。这些变化可能是tmjs早期骨退化的重要标志，而x线摄影无法检测到。2)同时升高的细胞因子（IL-1和IL-6）和活性形式的MMP_s可能是TMJ软骨降解的潜在分解代谢标志物。3)TMJ滑膜液中PGE_2的水平不能特异性反映疼痛或滑膜炎的强度。但与HA相比，检测到高浓度的C4S和C6S可能是TMJ中蛋白多糖降解的标志。4)TMJ滑膜液中C4S和C6S浓度的比值反映了关节组织，特别是关节软骨和滑膜组织的蛋白多糖代谢。该比值可用于诊断关节疾病，并预测由这些疾病引起的关节软骨破坏或滑膜增生。5)应重复抽吸至少5次，以从滑液中去除高分子量物质。然而，当关节内病理较复杂时，即使重复抽吸9次，也无法充分清除高分子量物质。6)我们改良的直接抽吸技术是合乎逻辑的，并且在尝试直接抽吸TMJ滑液时可以产生最高的成功率。

1) Interleukin 1beta levels in synovial fluid of the TMJ have a positive correlation with OA change. The Stromelysin (MMP3) activity detected was greatly increased in patients with cartilage degradation. These changes may be important markers of early bone deterioration in TMJ_s that are undetectable by radiograph imaging.2) Concomitant increases in the level of cytokines (IL-1 and IL-6) and active forms of MMP_s could be potential catabolic markers for cartilage degradation in the TMJ.3) The PGE_2 level in the TMJ synovial fluid does not specifically reflect the intensity of pain or synovitis, but the detection of high concentrations of C4S and C6S,compared to the amount of HA,is a possible marker of proteoglycan degradation in the TMJ.4) The ratio of concentrations of C4S and C6S in the synovial fluid of the TMJ reflect the proteoglycan metabolism of the joint tissues, particularly of the articular cartilage and synovial tissue. This ratio could be used to diagnose joint diseases and to predict articular cartilage destruction or synovial proliferation due to these diseases.5) Aspiration should be repeated at least 5 times in order to remove high molecular weight substances from synovial fluid. However, when the intraarticular pathology is more complex, adequate removal of high molecular weight substances can not be achieved, even when aspiration is repeated 9 times.6) Our modified direct aspiration technique is both logical and will yield the highest success rate possible when attempting direct aspiration of TMJ synovial fluid.