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Chondrogenesis mediates progression of ankylosing spondylitis through heterotopic ossification

Bone Research 2021年第2期9卷 166-177页

作者： Tao Yu Jianguo Zhang Wei Zhu Xiao Wang Yun Bai Bin Feng Qianyu Zhuang Chang Han Shengru Wang Qimiao Hu Senbo An Mei Wan Shiwu Dong Jianzhong Xu Xisheng Weng Xu Cao Department of Orthopedic Surgery Johns Hopkins University School of MedicineBaltimoreMD 21205USA Department of Orthopedics Southwest HospitalThird Military Medical UniversityChongqing 400038China Department of Orthopedics Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical College100730 BeijingChina State Key Laboratory of Complex Severe and Rare Diseases Peking Union Medical College HospitalChinese Academy of Medical Science&Peking Union Medical College100730 BeijingChina

Ankylosing spondylitis(AS)is chronic inflammatory arthritis with a progressive fusion of axial ***-inflammatory treatments such as anti-TNF-αantibody therapy suppress inflammation but do not effectively halt the progression of spine fusion in AS *** we report that the autoimmune inflammation of AS generates a microenvironment that promotes chondrogenesis in spine ligaments as the process of spine *** differentiation was observed in the ligaments of patients with earlystage AS,and cartilage formation was followed by ***,a large number of giant osteoclasts were found in the inflammatory environment of ligaments and on bony surfaces of calcified *** activity by these giant osteoclasts generated marrow with high levels of active TGF-β,which induced new bone formation in the ***,no Osterix+osteoprogenitors were found in osteoclast resorption areas,indicating uncoupled bone resorption and *** at the late and maturation stages,the uncoupled osteoclast resorption in bony interspinous ligament activates TGF-βto induce the progression of ossification in AS *** resorption of calcified cartilage-initiated ossification in the progression of AS is a similar pathologic process of acquired heterotopic ossification(HO).Our finding of cartilage formation in the ligaments of AS patients revealed that the pathogenesis of spinal fusion is a process of HO and explained why anti-inflammatory treatments do not slow ankylosing once there is new bone formation in spinal soft ***,inhibition of HO formation,such as osteoclast activity,cartilage formation,or TGF-βactivity could be a potential therapy for AS.

关键词： ossification inflammation spondylitis

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Clinical significance and prognostic value of tumor necrosis factor-α and dickkopf related protein-1 in ankylosing spondylitis

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World Journal of Clinical Cases 2020年第7期8卷 1213-1222页

作者： Jun-Hui Xiong Jian Liu Jian Chen Department of Rheumatology Lishui People’s HospitalLishui 323000Zhejiang ProvinceChina

BACKGROUND Ankylosing spondylitis(AS)frequently occurs in people aged 30-45 years,and its prevalence is generally believed to be between 0.1%and 1.4%*** present,the“gold standard”for diagnosis of AS requires the provision of pelvic X-rays,which makes it more difficult to perform in population-based epidemiological ***,the identification of serological indicators related to the diagnosis,treatment,and prognosis of AS patients is of great *** To analyze the therapeutic,diagnostic significance and prognostic value of dickkopf-related protein-1(DKK-1)and tumor necrosis factor-α(TNF-α)in *** A total of 113 patients with active AS were selected as the research group,and 100 healthy subjects who underwent physical examination were selected as the control *** levels of DKK-1 and TNF-α in peripheral blood in the two groups were *** diagnostic and predictive values of DKK-1 and TNF-α for AS were analyzed with ROC curves,and the factors influencing AS recurrence were analyzed with COX *** Before treatment,the research group showed lower DKK-1 levels but higher TNF-αlevels than the control group(both aPspondylitis Disease Activity Index,DKK-1,and TNF-αwere risk factors for AS recurrence(aP<0.05).CONCLUSION DKK-1 and TNF-αare effective in the diagnosis and treatment of AS and are risk f

关键词： Dickkopf-related protein-1 Tumor necrosis factor-α Ankylosing spondylitis Diagnosis Prognosis Peripheral blood

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Thoracic pyogenic infectious spondylitis presented as pneumothorax:A case report

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World Journal of Clinical Cases 2021年第6期9卷 1402-1407页

作者： Mi-Kyung Cho Byeong-Ju Lee Jae-Hyeok Chang Young-Mo Kim Department of Rehabilitation Medicine Pusan National University HospitalBusan 49241South Korea

BACKGROUND Pyogenic infectious spondylitis(PIS)is a rare condition,with an incidence between 0.2 and 2 cases per 100000 per ***’s most common symptom-back or neck pain-occurs in more than 90%of ***,we reported a case of thoracic PIS accompanied by pneumothorax in a 65-year-old male *** SUMMARY A 65-year-old man presented with right chest pain and *** initial erect posteroanterior chest radiography revealed pneumothorax,which was further evaluated by chest computed tomography,revealing pleural effusion in the right lung and a paravertebral abscess with bony destruction of vertebral *** on magnetic resonance imaging,the patient was diagnosed with thoracic infectious spondylitis with an anterior paravertebral *** was prescribed antibiotics and underwent neurosurgery due to aggravated symptoms and neurologic *** examination revealed that the cause of pleural effusion and pneumothorax was Staphylococcus aureus infection contiguously spread to lung *** several surgical treatments with intravenous antibiotic therapy for two months and transition to oral antibiotics(rifampin 600 mg qd and ciprofloxacin 500 mg bid),the patient received physical therapy to recover *** month after discharge,the patient had no chest pain or dyspnea,and exhibited no elevation in inflammatory markers or new thoracic *** To our knowledge,this is the very first report of a case of thoracic PIS with pneumothorax.

关键词： Chest pain Pneumothorax Pleural effusion Neurologic deficits spondylitis Case report

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Factors affecting the path ogenesis of ankylosing spondylitis

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Chinese Medical Journal 2001年第2期114卷 99-100页

作者：周昌德 Division of Allergy-Immunology Rheumatology Department of Medicine Veterans General Hospital Taipei 11217 China

Ankylosing spondylitis (AS) occurs more frequently in young males than in females. The prevalence of AS in Taiwan, according to our previous study, is about 0.3%.1 AS mainly affects the spine, however, it can also result in peripheral arthritis that occurs in the toes, ankles, knees, hip joints and the tendon and ligaments around those joints.2 In addition, the spine of some AS patients may develop kyphoscoliosis due to late diagnosis or failure to cooperate in following the routine medication and exercises prescribed by their doctors.

关键词： spondylitis affecting

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Significance of Sacroiliac Joint Aerocele in Diagnosis of Ankylosing spondylitis

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Journal of Shanghai Jiaotong university(Science) 2011年第5期16卷 636-640页

作者：王锋赵炳辉汪年松 Department of Nephrology and Rheumatology the Sixth People's Hospital Affiliated to Shanghai Jiaotong University Department of Radiology the Tenth People's Hospital Affiliated to Tongji University

To explore the significance of sacroiliac joint aerocele in the diagnosis of ankylosing spondylitis, the data of 196 patients with ankylosing spondylitis (AS) were collected during December of 2008 to May of 2009. And 50 patients with osteoarthritis (OA), 15 patients with sclerosing osteitis (SO) and 47 patients with sacroiliac joint tumors were investigated as the control groups. The feature of sacroiliac joint aerocele in computed tomography (CT) images was observed carefully. In AS group there were 130 patients (66.3%) diagnosed as AS according to CT results, and 32 of them (24.6%) were observed with aerocele within sacroiliac joint cavity, majority of whom were earlier AS patients with slight bone destruction. Other 66 patients were diagnosed as early AS according to magnetic resonance imaging (MRI) and ultrasonography. CT examination showed that the 66 patients did not have apparent bone destruction, of whom, 26 (39.4%) patients had aerocele within sacroiliac joint cavity. Among the control groups of 15 (15/50, 30.0%) patients with OA, 5 (5/15, 33.3%) patients with SO were observed sacroiliac joint aerocele. The 47 patients with sacroiliac joint tumors were observed with bone or cartilage destruction, but without signs of sacroiliac joint aerocele. The sacroiliac joint aerocele in CT images of AS patients usually appeared as spots, streaks, small or larger round blocks, and it often happened in patients with earlier stage of diseases. Sacroiliac joint aerocele may be useful to early diagnosis of AS.

关键词： ankylosing spondylitis sacroiliac joint aerocele

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Total spinal involvement due to delayed diagnosis and treatment of noncontiguous brucellar spondylitis

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Asian Pacific Journal of Tropical Medicine 2021年第1期14卷 44-46页

作者： Jie He Qiang Zhang Department of Orthopedics Beijing Ditan HospitalCapital Medical University100015China

Rational:Brucellosis is a globally prevalent zoonotic *** part of the body can be affected by active brucellosis but osteoarticular involvement are the most common symptoms which was reported to vary from 10%to 85%.The spine is the most common site of brucellosis in the ***,noncontiguous brucellar spondylitis is rare,only few cases have been reported in the *** concerns:A 62-year-old woman with brucellar spondylitis presented with lower back pain and pain in the right lower extremity for six ***:Brucella agglutination test(1:320)and the result of polymerase chain reaction(PCR)confirmed the diagnosis of noncontiguous brucellar ***:During hospital stay,the women received intravenous treatment for brucellosis(A combination of doxycycline 200 mg/d,rifampicin 900 mg/d,levofloxacin 0.5 g/QD,and ceftriaxone 2 g/QD was administered for 1 week),The L4-S1 vertebral body was fixed by posterior lumbar ***:Six months after discharge,the follow-up radiographic images showed stable vertebral height and good lumbar *** complained no ***:Multi-level involvement is an exceptional form of brucellar *** the best of our knowledge,only few similar cases have been *** and bacterial culture is necessary for confirmed diagnosis.

关键词： Brucella spondylitis Tuberculosis Polymerase chain reaction Radiology

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Single-stage anterior debridement and reconstruction with tantalum mesh cage for complicated infectious spondylitis

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World Journal of Orthopedics 2017年第9期8卷 710-718页

作者： Shih-Chieh Yang Hung-Shu Chen Yu-Hsien Kao Yuan-Kun Tu Department of Orthopedic Surgery E-Da Hospital I-Shou University

AIM To evaluate the clinical and radiographic results of patients with complicated infectious spondylitis treated with single-stage anterior debridement and reconstruction using tantalum mesh cage(TaMC) followed by immediate *** Single-stage radical debridement and subsequent reconstruction with TaMC instead of autograft or allograft were performed to treat 20 patients with spinal deformity or instability due to complicated infectious spondylitis. Clinical outcomes were assessed by careful physical examination and regular serological tests to determine the infection control. In addition, the visual analog score(VAS), neurologic status, length of vertebral body reconstruction, and the correction of sagittal Cobb angle on radiography were recorded and compared before and after surgery. The conditions of the patients were evaluated based on the modified Brodsky's *** The average VAS score significantly decreased after the surgery(from 7.4 ± 0.8 to 3.3 ± 0.8, P spondylitis.

关键词： Anterior reconstruction Complicated infectious spondylitis Instrumentation Spinal deformity Tantalum mesh cage

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A modified posterior wedge osteotomy with interbody fusion for the treatment of thoracolumbar kyphosis with Andersson lesions in ankylosing spondylitis:a 5-year follow-up study

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Chinese Medical Journal 2020年第2期133卷 165-173页

作者： Hong-Yu Wei Chun-Ke Dong Yu-Ting Zhu Jun Zhou Ping Yi Feng Yang Ming-Sheng Tan Department of Orthopaedic Surgery China-Japan Friendship HospitalBeijing 100029China Graduate School Beijing University of Chinese MedicineBeijing 100029China Department of Education China-Japan Friendship HospitalBeijing 100029China

Background:Andersson lesions(ALs),also known as spondylodiscities,destructive vertebral lesions and spinal pseudarthrosis,usually occur in patients with ankylosing spondylitis(AS).Inflammatory and traumatic causes have been proposed to define this *** surgical approaches including anterior,posterior,and combined anterior and posterior procedure have been used to address the complications,consisting of mechanical pain,kyphotic deformity,and neurologic ***,the preferred surgical procedure remains *** aim of this study was to illustrate the safety,efficacy,and feasibility of a modified posterior wedge osteotomy for the ALs with kyphotic deformity in ***:From June 2008 to January 2013,23 patients(18 males,5 females)at an average age of 44.8 years(range 25–69 years)were surgically treated for thoracolumbar kyphosis with ALs in AS via a modified posterior wedge osteotomy in our *** sagittal balance parameters were assessed by standing lateral radiography of the whole spine before surgery and during the followup *** of radiologic fusion at follow-up was based on the Bridwell interbody fusion grading *** spondylitis quality of life(ASQoL)and visual analog scale(VAS)scores were performed to evaluate improvements in daily life function and back pain pre-operatively and *** t tests were used to compare clinical data change in parametric values before and after surgery and the Mann-Whitney U test was employed for non-parametric *** radiographic data change was evaluated by repeated measure analysis of ***:The mean operative duration was 205.4 min(range 115–375 min),with an average blood loss of 488.5 mL(range 215–880 mL).Radiographical and clinical outcomes were assessed after a mean of 61.4 months of *** VAS back pain and ASQoL scores improved significantly in all patients(7.52±1.31 vs.1.70±0.70,t=18.30,P<0.001;13.87±1.89 vs.7.22±1.24,t=1

关键词： Ankylosing spondylitis Andersson lesions Kyphosis Modified posterior wedge osteotomy

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Effect of Icariin on apoptosis and expression of Fas,Fas ligand,B cell lymphoma,and Bcl-2-associated X protein in CD4＋ T lymphocytes from patients with ankylosing spondylitis

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Journal of Traditional Chinese Medicine 2017年第2期37卷 207-213页

作者： Wang Hailong Jiang Quan Feng Xinghua Division of Rheumatology Guang'anmenHospital China Academy of Chinese Medical Science Beijing 100053 China Basic Medical School Guiyang University of Chinese Medicine Guiyang 550025 China The SecondAffiliated Hospital Guiyang University of Chinese MedicineGuiyang 550003 China Division of Rheurnatology Guang'anrnen Hospital China Academy of Chinese MedicalScience Beijing 100053 China

OBJECTIVE:To investigate the effects of icariin on apoptosis and the expression of Fas, Fas ligand(Fas L), B cell lymphoma(Bcl-2), and Bcl-2-associated X protein(Bax) in CD4+ T lymphocytes from patients with ankylosing ***:Primary cultures of peripheral blood CD4+ T lymphocytes were established and treated with icariin at high, medium, and low doses(0.5,0.25, and 0.125 mg/mL).Sulfasalazine treated and helthy cells were used as *** of treated cells was determined by flow *** transcription polymerase chain reaction and enzyme-linked immunosorbent assays were used to determine the effects of icariin on the expression of Fas, Fas L, Bcl-2, and *** activity of caspase 8 and caspase 3 was determined by a colorimetric ***:The m RNA and protein expression of Fas,and activity of caspase 8 and caspase 3 in CD4+ T lymphocytes were increased by icariin(P < 0.05).Conversely, the m RNA and protein expression of Bcl-2 was decreased(P < 0.05).The expression of Fas L and Bax were not significantly different between *** proapoptotic effects of icariin were ***:Icariin induces the apoptosis of CD4 + T cells from patients with AS comparing to normal ***, the induction of apoptosis may be the likely mechanism of action of icariin's antirheumatics activities.

关键词： spondylitis ankylosing Fas Fas Ligand protein Lymphoma B-Cell Bcl-2-associated X protein CD4-positive T-lymphocytes Apoptosis Icariin

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Moxibustion on Governor Vessel for ankylosing spondylitis due to kidney yang deficiency:a clinical controlled study

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Journal of Acupuncture and Tuina Science 2015年第6期13卷 361-367页

作者：冯辉马迎辉王晓梅黄国琪 Shanghai Guanghua Integrative Medicine Hospital Shanghai University of Traditional Chinese Medicine Shanghai Research Institute of Acupuncture and Meridian

Objective： To observe the clinical effect of moxibustion on Governor Vessel for ankylosing spondylitis（AS） due to kidney yang ***： A total of 60 patients of AS due to kidney yang deficiency were randomly divided into a treatment group and a control group by random digital table, 30 cases in each group. Both of the two groups were treated by oral administration of Sulfasalazine tablets. Additionally, the treatment group was given moxibustion on Governor Vessel, and the control group was given sham moxibustion. The treatment was given once every other day, 4 weeks constituted one course, 2 courses in total. Before treatment, after 1-course and 2-course treatments, the quantified scores of traditional Chinese medicine（TCM） syndromes and the symptoms scores recommended by AS International Society [including Bath ankylosing spondylitis disease activity index（BASDAI）, visual analogue scale（VAS）, Bath ankylosing spondylitis functional index（BASFI） and Bath ankylosing spondylitis metrology index（BASMI）] were respectively observed and recorded, and the change of safety item was monitored. Results： After 1-course and 2-course treatments, the quantified scores of TCM syndromes were obviously improved than those before treatment in the two groups（P〈0.05）, and the score was improved better in the treatment group than that in the control group（P〈0.05）. In comparison within the group, there were no statistical differences between the scores after 1-course treatment and 2-course treatment in the two groups（P〈0.05）. After 1-course treatment, the items of the symptoms scores were improved than those before treatment in the two groups（P〉0.05）. After 2-course treatment, the therapeutic effect was more remarkable in the treatment group, with a statistical difference between the two groups（P〈0.05）. During treatment, no obvious abnormality in all safety items was noticed in the two groups. Conclusion： Moxibustion on Governor Vessel can effectively relieve the clinical sympt

关键词： Moxibustion Therapy Indirect Moxibustion Garlic-partitioned Moxibustion spondylitis Ankylosing

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