Effects of Home-and-Workplace Combined Exercise for Patients with Ankylosing Spondylitis

PurposeThe purpose of this study was to investigate the effects of home-and-workplace combined exercise on physical function, depression, and work-related disability in patients with ankylosing spondylitis.MethodsThis study adopted a non-randomized quasi-experimental design. Fifty-two patients were recruited: home-and-workplace combined exercise (n = 17), home exercise (n = 18), and control group (n = 17).ResultsThe home-and-workplace combined exercise group showed improvement in spinal mobility and pulmonary function and significantly lower absenteeism and overwork impact than the home-exercise group and control group. The home-and-workplace combined exercise and home exercise groups showed a higher level of activity improvement than the control group.Conclusionhome-and-workplace combined exercise can be recommended to patients with ankylosing spondylitis to enhance their physical function, including spinal mobility and pulmonary function, and reduce work-related disability.     

Perspectiva de género en epidemiología clínica. Aprendiendo con el caso de las espondiloartritis

ObjectiveTo illustrate some gender challenges and contributions which are more frequent in research and health care through a chronic disease such as spondyloarthritis.MethodUsing two of the main identified gender biases in research and health care (de-contextualization of diseases, especially in women, and problem definition and knowledge production in women's health), a cross-sectional study was used with 96 men and 54 women with spondyloarthritis of the Rheumatology Department of the Alicante University General Hospital, whose sources of information were semi-structured patient interviews and clinical records.ResultsWe show how the gender perspective can contribute to contextualise the differences by sex of functional alterations and other social and health indicators, and highlight inequalities in the socioeconomic repercussions between patients of both sexes. It can contribute towards re-conceptualizing diseases, especially of women, specifying the profile of differential diagnosis according to sex, and provide knowledge about methodological challenges related to diagnostic tests.ConclusionsAchieving scientific and professional excellence in health care is also a gender issue. Analysing from a gender perspective the history of the diseases, how their diagnosis criteria were established and the normality and abnormality cut-off points, especially identified diseases of men, such as spondyloarthritis, is a priority to re-conceptualize medicine; as well as providing information on how the gender norms and values of the context interact with the lives of those who suffer these diseases.     

强直性脊柱炎异位骨化机制研究进展

强直性脊柱炎是一种发病机制不明的慢性炎性脊柱关节病,主要侵犯骶髂关节、脊柱关节等,严重者可发生脊柱、关节的畸形和强直。临床表现为炎性腰背痛,夜间及休息后加重,活动后减轻。该病发病率男性高于女性,且男性主要表现为中轴关节改变,而女性大多首发于外周关节。目前生物制剂肿瘤坏死因子抑制剂通过控制炎症,从而改善病情发展,被认为是最前沿的药物,但其在阻断新骨形成方面尚未经循证医学证实有效。本文着眼于新骨形成角度,从基因及细胞因子层面探讨强直性脊柱炎的病因。目前相关研究发现LRP5、ANTXR2、PTGER4、ANKH等基因的异常表达激活骨形成信号通路,在多种细胞因子及相关蛋白(如Noggin蛋白、DKK、转化生长因子-β、骨形态发生蛋白、碳酸酐酶1等)直接或间接作用下将骨形成信号传至靶细胞表面,进而传入细胞核,改变靶细胞正常生理代谢过程,导致过度骨形成,造成异位骨化。近年的临床影像学病例分析也提示了骨赘形成的分布特点,进而推断机械应力是促进其形成的外部因素。本文对强直性脊柱炎异位骨化方面进行了文献综述,以期待能进一步加深对本病的认识,为临床治疗研究提供新的思路。     

An increase of blood squamous cell carcinoma antigen in Pseudomonas aeruginosa spondylitis

Squamous cell carcinoma antigen (SCCA) is traditionally engaged for detecting and following up malignancy from a squamous cell origin. We encountered an unusual increase of blood SCCA but no other cancer markers in a patient associated with an infective lumbar spondylitis due to Pseudomonas aeruginosa. An overshooting of Th1 expression, such as tumor necrosis factor alpha, bumped up by his uremia as a result of P. aeruginosa infection may hasten SCCA. Therefore, SCCA might additionally serve as a serological marker for infection besides squamous cell cancer, and its false-positive increase also highlights the appropriateness of tumor marker screening.     

一期后路病灶清除植骨融合内固定闭式冲洗治疗原发性腰椎间隙感染

目的探讨一期后路病灶清除植骨融合内固定闭式冲洗治疗原发性腰椎间隙感染的有效性。方法回顾性分析2010年6月至2013年6月广州军区广州总医院收治的17例原发性腰椎间隙感染患者的临床资料,其中男10例,女7例;年龄12-77岁,平均年龄51岁。均为单一间隙感染,感染部位包括L2/32例、L3/45例、L4/58例、L5/S12例。均行一期后路病灶清除＋自体髂骨植骨融合内固定术,术中留取病灶组织标本进行细菌培养及病理学检查,术后持续闭式冲洗椎间隙2-3周。结果 17例患者均成功施行手术,术中失血量200-700mL,平均失血量（425±50）mL。病灶组织细菌培养结果：铜绿假单孢菌2例、金黄色葡萄球菌1例、粘质沙雷菌1例,余13例均为阴性;病理检查结果符合急慢性炎症表现。术后3周,降钙素原恢复正常,血常规、血沉、C反应蛋白均明显下降,3个月复查时恢复正常。切口均甲级愈合。术后随访6-42个月（平均28个月）,患者腰痛症状明显缓解,无感染复发病例。术后3-12个月（平均6.5个月）植骨均获骨性融合。结论一期后路病灶清除植骨融合内固定闭式冲洗治疗原发性腰椎间隙感染具有病灶清除彻底、固定可靠、操作简便可行、效果满意的特点,可使清除病灶、植骨、固定、冲洗一步到位,避免二次手术。     

应用微量淋巴细胞毒与流式细胞仪检测HLA-B27的比较

目的 :探讨不同 HL A- B2 7检测方法之间的差异及各自的优缺点 ,为临床检验提供参考。方法 :分别采用微量淋巴细胞毒法及流式细胞仪法检测 134例血标本的 HL A- B2 7抗原 ,将两者结果进行比较分析。结果 :两种检测方法结果符合率为 94 .8%。微量淋巴细胞毒法检测强直性脊柱炎者 HL A- B2 7阳性率为 89.5 % ,对照组阳性率 11.0 % ,符合国内外大样本调查结果。结论 :两种检测方法均准确可靠 ,适合于有条件的医院开展。     

维族与汉族强直性脊柱炎患者炎性指标的差异性分析

目的初步探讨维族与汉族强直性脊柱炎患者炎性指标间的差异性。方法对49例维族和87例汉族强直性脊柱炎患者进行外周血炎性指标检测。结果分析显示维族和汉族AS患者性别构成存在统计学差异(x2=8.36,P=0.0038),维族患者男性比率(93.88%)明显高于汉族(73.56%),而不同年龄段性别构成均无统计学差异(x2维族=0.65,P=0.7214;x2汉族=3.38,P=0.1836);维族与汉族儿童青少年(20.41%,10.34%)和青壮年(67.35%,80.46%)患者比率均无统计学差异(x2=2.64,P=0.1041;x2=2.93,P=0.0868);血清超敏C反应蛋白(hsCRP)和CRP存在统计学显著性差异(thsCRP=2.36,P=0.0193;tCRP=4.08,P=0.0001),均表现为维族患者检测水平明显高于汉族,ASO检测水平在正常值范围内表现出维族患者高于汉族(t=8.13,P=0.0000)。白细胞计数(WBC)在正常值范围内民族间无差异(t=0.97,P=0.3323),而单核细胞水平(#MONO)维族患者明显高于汉族(t=2.23,P=0.0255),且其单核细胞升高...     

Diagnostic value of FDG-PET versus magnetic resonance imaging for detecting spondylitis: a systematic review and meta-analysis

BACKGROUND CONTEXT

Spondylitis is a rare infection in bone requiring multiple diagnostic strategies for verification.