Pyogenic granuloma-like reaction in the necrotic, vessels-deprived femoral head of the rat

Osteonecrosis of the femoral head was produced in rats by cutting the ligamentum teres and incising the cervical periosteum. As of the second postoperative week, fibrous tissue pervaded the necrotic epiphyses, macrophages and osteoclasts removed the debris, osteoblasts deposited lamellar-fibred and woven-fibred intramembranous bone, and remodeling began. In 16% of the rats killed during the 2nd postoperative week, the epiphyses contained big fragments of necrotic bone enclosed by densely packed, capillary-sized vessels. Ingrowth of this hypervascularized, pyogenic granuloma-like tissue is presumably due to the presence of excessive growth factors, reflecting an exaggerated pathophysiological reaction within the framework of organization of the necrotic epiphyses.     

Bilateral deep infrapatellar bursitis associated with tibial tuberosity enthesopathy in a case of juvenile ankylosing spondylitis

Summary A case of bilateral deep infrapatellar bursitis is reported in a 19-year-old man suffering from juvenile ankylosing spondylitis and surgically treated for bilateral tibial tuberosity enthesopathy. In addition to erosive nonspecific bone remodelling the excised specimens showed, in the bursa, synovial layer hyperplasia with mild subintimal inflammatory cell infiltration, i.e. changes similar to those of synovitis in ankylosing spondylitis. The respective roles of the inflammatory terrain and of local shearing stress are discussed.     

女性与男性强直性脊柱炎对比研究

目的：了解不同性别的强直性脊柱炎的临床特点。方法：对比性地分析57例女性AS（FAS）患者和114例病程相同的男性AS（MAS）患者（1：2配对）的临床表现及实验室检查结果。结果：平均发病年龄,首发症状,腰椎的X线受累和病情活动指标在两组无差异（P＞0．05）;贫血,外周关节炎和颈椎的受累在女性明显多于男性（P＜0．05）,而全身症状,虹膜睫状体炎,严重的骶髂关节及髂关节的X线受累和HLA－B27的阳性率在女性明显少于男性（P＜0．05）。结论：FAS患者病情发展较慢,预后较好,这与B27阳性率低有一定的关系。     

类风湿性关节炎与强直性脊柱炎的X线诊断

作者通过复习文献 ,着重从临床和X线角度论述了类风湿性关节炎和强直性脊柱炎。认为两者是完全不同的独立疾病。类风湿性关节炎属胶原系统疾病 ,女性多见 ,常侵及周围小关节 ,X线表现为关节肿胀、骨质疏松、关节间隙早期增宽 ,后期变窄 ,关节脱位、强直、畸形。强直性脊柱炎属关节疾患 ,青年男性多见 ,中轴骨首先受累 ,X线几乎 10 0 %有骶髂关节改变 ,方型椎和韧带骨赘是其特征性X线表现     

强直性脊柱炎并发虹睫炎易感性与LMP2和LMP7基因多态性的探讨

目的　研究LMP基因多态性与强直性脊柱炎并发虹睫炎发病的关系.方法　应用PCR对正常人和病人进行HLA-B27检测以及LMP2和LMP7扩增.CfoI进行限制性酶切图谱分析.结果　强直性脊柱炎有虹睫炎(AS+AAU)病史以及单纯虹睫炎(AAU)患者LMP2基因BB纯合型较正常人以及强直性脊柱炎(AS)患者明显增高(P＜0.05).AS+AAU患者BB型OR＝3.6,AAU患者BB型OR＝5.83.LMP7基因多态性无明显差别.结论　在我国汉人中,LMP2基因多态性与AS+AAU以及AAU发病存在明显相关关系.     

Takayasu’s arteritis occurring under TNF blockers in a patient with spondyloarthritis: is it an association or a paradoxical effect?

Coexistence of spondyloarthritis (SpA) and Takayasu’s arteritis is not a common finding, but such cases have been discussed, particularly in the context of choice of therapy. Inhibition of inflammation by tumor necrosis factor inhibitors (TNFi) is a key aspect of the treatment of SpA and also positive effects of such treatment in concomitant large vessel vasculitis have been reported. However, TNFi is also associated with the possibility of initiating vasculitis.The present article based on a case study and the available literature is an attempt to discuss coexistence of these two diseases and the impact of treatment with biological drugs from the anti-TNF group in the course of SpA with Takayasu’s arteritis.     

Direct anti-proliferative effect of adipose-derived mesenchymal stem cells of ankylosing spondylitis patients on allogenic CD4+ cells

ObjectivesT-cell-mediated adaptive immunity contributes to the development and persistence of ankylosing spondylitis (AS). Mesenchymal stromal/stem cells (MSCs) have immunomodulatory potential and are able to inhibit T-cell proliferation, but their functionality in AS patients is relatively unknown. The aim of the study was to assess the direct anti-proliferative effects of MSCs isolated from subcutaneous abdominal adipose tissue of AS patients (AS/ASCs) on allogeneic T lymphocytes, using commercially available ASC lines from healthy donors (HD/ASCs) as a control.Material and methodsCD3+CD4+ T-cells were isolated from peripheral blood of healthy blood donors, activated with anti-CD3/CD28 beads, and co-cultured for 5 days with untreated and TNF+IFN-γ pre-stimulated HD/ASCs (5 cell lines) and AS/ASCs, obtained from 11 patients (6F/5M). The proliferative response of T-cells was analysed by flow cytometry, while the concentrations of kynurenines, prostaglandin E2 (PGE-2), interleukin 10 (IL-10), and interleukin 1 receptor antagonist (IL-1Ra) were measured spectrophotometrically or using a specific enzyme-linked immunosorbent assay (ELISA).ResultsHD/ASCs and AS/ASCs similarly reduced the T-cell proliferation response, i.e. the percentage of proliferating cells, the proliferation, and replication indices, and these effects were dependent mostly on soluble factors. In the co-cultures of activated CD4+ T-cells with HD/ASCs and AS/ASCs significant increases of kynurenines, PGE-2, and IL-1Ra, but not IL-10, production were observed. The release of these factors was dependent either on cell-to-cell contact (IL-10, IL-1Ra) or soluble factors (kynurenines, PGE-2). There was a moderate to strong negative correlation between T-cell proliferative response, and the concentrations of kynurenines, PGE-2, and IL-10, but not IL-1Ra. This association was more evident in the case of TI-treated AS/ASCs than HD/ASCs.ConclusionsAS/ASCs, similar to HD/ASCs, exert a direct effective anti-proliferative impact on CD4+ T cells, acting via soluble factors that are released in cell contact-dependent (IL-10) and independent (kynurenines, PGE-2) pathways. Thus, our results suggest that AS/ASCs are potentially useful for therapeutic application.     

80例强直性脊柱炎临床X线分析

目的：分析和研究强直性脊柱炎的临床Ｘ线检查诊断方法,Ｘ线分级、分期的表现及在诊断中的重要性,方法：对８０例强直性脊柱炎患者进行Ｘ摄片分级,分期,结合血沉（ＥＳＲ）,Ｃ－反应蛋白（ＣＲＰ）和ＨＬＡ－Ｂ２检查诊断。并进行统计学分析。结果：９０％患者ＨＬＡ－Ｂ２阳性,６０％血沉增快,骶髂关节和髋关节片以２级改变为主,腰椎病变以早、中期Ｘ线病变者较多。结论：强直性脊柱炎以青壮年男性为多见,ＨＬＡ－Ｂ２阳性     

联合给药法治疗强直性脊柱炎

目的 采用氨甲喋呤（ＭＴＸ）、抑氮磺胺吡啶（ＳＡＳＰ） 非甾体类药（ＮＳＡＩＤｓ）“递减法”联合给药治疗７８例强直性脊柱炎（ＡＳ的临床疗效观察。方法 ＳＡＳＰ０．５ｇ,２次／日,服１周后改为０．７５ｇ,２次／日,第２周后改为１．０ｇ,２次／日,以后每周１．０ｇ,２次／日,疗程２年,ＭＴＳ５ｍｇ,１次／周,每周递增５ｍｇ,加量至１５～２０ｍｇ／周时维持０．５～１年,ＮＳＡＩＤｓ疗程为３个月左右减半量     

儿童胸椎化脓性脊柱炎误诊分析（附1例报告）

<正>化脓性脊柱炎（Pyogenic spondylitis）是一种相对少见的脊柱感染性疾病,主要包括化脓性椎间盘炎、脊柱骨髓炎、椎间盘炎合并椎体骨髓炎以及硬膜外脓肿。有证据表明,近年来,化脓性脊柱炎的发病率和致死率正逐渐升高。化脓性脊柱炎好发于老年人和有慢性疾病患者[1],儿童化脓性脊柱炎患者十分罕见,因而容易漏诊误诊。本文回顾2017年9月6日我院收治1例10岁化脓性脊柱炎患者,对其误诊及漏诊原因进行分析,报道如下：