Ankylosing spondylitis coexisting with Clonorchis sinensis infection: A case report

BACKGROUND Ankylosing spondylitis(AS)is a chronic immune-mediated inflammatory disease.The prevailing theory links AS onset to infections in susceptible individuals.Furthermore,infections may impair the immune responses.Numerous studies have investigated links between AS and various infections-bacterial,viral,fungal,and other microorganism infections.However,limited attention has been given to the association between AS and Clonorchis sinensis(C.sinensis)infection.CASE SUMMARY A 27-year-old male with a 10-yr history of AS presented to our hospital with inflammatory lower back pain as the primary manifestation.Ten years ago,the patient had achieved a stable condition after treatment with biological agents.However,he experienced a recurrence of lumbosacral pain with an unexplained cause 10 d before hospital admission.A lumbosacral magnetic resonance imaging(MRI)scan revealed bone marrow edema in the left sacroiliac joint,and laboratory indicators were elevated.Moreover,the presence of C.sinensis eggs was detected in the stool.The patient was prescribed praziquantel,resulting in the disap-pearance of C.sinensis eggs in subsequent routine stool tests and relief from lumbosacral pain.A follow-up MRI scan performed after 4 months revealed a reduction in bone marrow edema around the left sacroiliac joint.CONCLUSION C.sinensis infections could potentially trigger the exacerbation of AS.Clinicians should pay attention to investigating the presence of infections.INTRODUCTION Ankylosing spondylitis(AS)is a chronic inflammatory and rheumatic disease resulting from an imbalance between innate and acquired immune responses[1].While it can affect any part of the spine,its primary symptoms are persistent back pain and stiffness in the lower back and pelvis.The prevalence of AS per 10000 individuals is 23.8 in Europe,31.9 in North America,16.7 in Asia,10.2 in Latin America,and 7.4 in Africa[2].Infections commonly occur in the first 3 months and may act as potential triggers for the first symptoms of AS,often manifesting as gastrointestinal,urinary tract,and respiratory infections of microbiological origin[3,4].Clonorchis sinensis(C.sinensis)infection is a severe parasitic disease affecting millions globally,especially prevalent in China,South Korea,the Far East of Russia,and Vietnam,with an estimated 15 million cases[5].Transmission occurs through the consumption of undercooked freshwater fish containing metacercariae.Adult C.sinensis parasites then establish themselves within the human hepatobiliary system[6].C.sinensis infection triggers the activation of sphingosine 1-phosphate receptor 2,leading to the injury and fibrosis of the hepatobiliary[7].Recent research in a rat model found that C.sinensis infection increases the risk of hepatocellular carcinoma by stimulating hepatic progenitor cell proliferation[8].Complications of C.sinensis infection include cholestasis,cholangitis,biliary system fibrosis,and in severe cases,the development of cholangiocarcinoma[9].Consequently,the primary preventive measure is to abstain from consuming raw or undercooked freshwater fish.Praziquantel is the recommended and effective treatment for this infection[10].While there is existing literature on the coexistence of AS and parasitic infections,there is limited research specifically addressing the simultaneous presence of AS and C.sinensis infection.This case report details a rare scenario of AS coexisting with C.sinensis infection,underscoring the potential impact of C.sinensis infection on AS disease activity.

Hounsfield units in assessing bone mineral density in ankylosing spondylitis patients with cervical fracture-dislocation

BACKGROUND Cervical spine fracture-dislocations in patients with ankylosing spondylitis(AS)are mostly unstable and require surgery.However,osteoporosis,one of the comorbidities for AS,could lead to detrimental prognoses.There are few accurate assessments of bone mineral density in AS patients.AIM To analyze Hounsfield units(HUs)for assessing bone mineral density in AS patients with cervical fracture-dislocation.METHODS The HUs from C2 to C7 of 51 patients obtained from computed tomography(CT)scans and three-dimensional reconstruction of the cervical spine were independently assessed by two trained spinal surgeons and statistically analyzed.Inter-reader reliability and agreement were assessed by interclass correlation coefficient.RESULTS The HUs decreased gradually from C2 to C7.The mean values of the left and right levels were significantly higher than those in the middle.Among the 51 patients,25 patients(49.02%)may be diagnosed with osteoporosis,and 16 patients(31.37%)may be diagnosed with osteopenia.CONCLUSION The HUs obtained by cervical spine CT are feasible for assessing bone mineral density with excellent agreement in AS patients with cervical fracture-dislocation.

Effects of serum inflammatory factors,health index and disease activity scores on ankylosing spondylitis patients with sleep disorder

BACKGROUND Patients with ankylosing spondylitis(AS)frequently suffer from comorbid sleep disorders,exacerbating the burden of the disease and affecting their quality of life.AIM To investigate the clinical significance of serum inflammatory factors,health index and disease activity scores in patients with AS complicated by sleep disorders.METHODS A total of 106 AS patients with comorbid sleep disorders were included in the study.The patients were grouped into the desirable and undesirable prognosis groups in accordance with their clinical outcomes.The serum levels of inflammatory factors,including C-reactive protein,erythrocyte sedimentation rate,interleukin(IL)-6,tumour necrosis factor-αand IL-1β,were measured.Disease activity scores,such as the Bath AS functional index,Bath AS disease activity index,Bath AS metrology index and AS disease activity score,were assessed.The health index was obtained through the Short Form-36 questionnaire.RESULTS The study found significant associations amongst serum inflammatory factors,health index and disease activity scores in AS patients with comorbid sleep disorders.Positive correlations were found between serum inflammatory factors and disease activity scores,indicating the influence of heightened systemic inflammation on disease severity and functional impairment.Conversely,negative correlations were found between disease activity scores and health index parameters,highlighting the effect of disease activity on various aspects of healthrelated quality of life.Logistic regression analysis further confirmed the predictive value of these factors on patient outcomes,underscoring their potential utility in risk assessment and prognostication.CONCLUSION The findings demonstrate the intricate interplay amongst disease activity,systemic inflammation and patientreported health outcomes in AS patients complicated by sleep disorders.The results emphasise the need for comprehensive care strategies that address the diverse needs and challenges faced by these patients and underscore the potential relevance of serum inflammatory factors,health index and disease activity scores as prognostic markers in this patient population.

Research Progress in the Treatment of New Bone Formation of Ankylosing Spondylitis

Ankylosing spondylitis(AS)has a very high disability rate.How to effectively inhibit the formation of new bones has become a difficult point in clinical treatment.In recent years,research has shown that different treatment plans can have an impact on inhibiting new bone formation.In this paper,the different effects of new bone formation in the treatment of AS with traditional Chinese and Western medicine are systematically listed.

Ultrasound-guided intra-articular corticosteroid injection in a patient with manubriosternal joint involvement of ankylosing spondylitis:A case report

BACKGROUND Manubriosternal joint(MSJ)disease is a rare cause of anterior chest pain but can be a major sign of systemic arthritic involvement.In patients with ankylosing spondylitis(AS),a type of systemic arthritis,chest pain can be due to MSJ involvement and can be improved by ultrasound-guided corticosteroid injection into the joint.CASE SUMMARY A 64-year-old man visited our pain clinic complaining of anterior chest pain.There were no abnormal findings on lateral sternum X-ray,but arthritic changes in the MSJ were observed on single-photon emission computed tomography-computed tomography.We performed additional laboratory tests,and he was finally diagnosed with AS.For pain relief,we performed ultrasound-guided intra-articular(IA)corticosteroid injections into the MSJ.After the injections,his pain nearly resolved.CONCLUSION For patients complaining of anterior chest pain,AS should be considered,and single-photon emission computed tomography-computed tomography can be helpful in diagnosis.In addition,ultrasound-guided IA corticosteroid injections may be effective for pain relief.

Research progress on the regulation mechanism of non-coding RNA on ankylosing spondylitis

Ankylosing spondylitis(AS)is a chronic progressive inflammatory immune disease,which mainly affects the spine and sacroiliac joints,with a high rate of late disability.At present,because the pathogenesis of the disease is not clear,its treatment targets are not clear,and there is no consensus on intervention measures.Therefore,further exploration of the mechanism of the disease has certain guiding significance for clinical application.At the same time,non-coding RNA can regulate protein translation,participate in the physiological and pathological changes of AS,and is closely related to the progress of AS.Its internal mechanism and potential targets are worthy of in-depth study.This article summarizes the research progress of non-coding RNA involved in AS through the regulation of bone metabolism,inflammation,cell death and autophagy,in order to provide a theoretical basis for exploring potential clinical diagnostic markers and therapeutic targets of AS.

Ankylosing Spondylitis in a West African Hospital

Introduction: Ankylosing spondylitis (AS) is an inflammatory rheumatic disease characterized by predominant axial and peripheral (enthesitis, sacroiliitis) involvement affecting young subjects aged 30 to 40 years, 80% to 98% of cases are associated with HLA-B27. Objective: To determine the epidemiological profile of ankylosing spondylitis in the rheumatology department of the Ignace Deen National Hospital in Conakry (Guinea). Materials and Methods: This was a descriptive cross-sectional study carried out within the said department over a period of 18 months from July 1, 2018 to December 31, 2020, including all patients seen in consultation and/or hospitalized in the department in which the diagnosis of ankylosing spondylitis had been retained according to the modified New York criterion. The parameters studied were sociodemographic, clinical, paraclinical and therapeutic. Result: We collected 73 cases or 4.1% of ankylosing spondylitis out of a total of 1781 patients seen during the study period. The male gender was represented with 54.8% for a sex ratio of 1.2 M/F. The average age of our patients was 32.18 ± 12.44 years with extremes ranging from 17 to 54 years. Axial involvement was present in 89.9% of cases with a lumbar predominance (95.2%), followed by the sacroiliac seat (35.5%), cervical (14.5%) and dorsal at 4.8%. The pain was chronic in 93.2% of cases. The most common drug treatment was taking analgesics and NSAIDs (100%) followed by cortisone infiltration (41.1%), corticosteroids (30%), and physiotherapy (21.9%). Ankylosing spondylitis represents 83% of spondyloarthritis followed by undifferentiated spondyloarthritis (9.1%) and juvenile spondylitis (3.4%) were the most common conditions.

Advances in Research of Ankylosing Spondylitis with Inflammatory Bowel Disease

This paper reviews the advances in research of co-pathogenesis and clinical treatment of ankylosing spondylitis(AS)and inflammatory bowel disease(IBD),in order to offer ideal therapeutic effects for comorbid patients and to provide new ideas for clinical practice.

Overview of Research on the Treatment of Ankylosing Spondylitis in Chinese Medicine

Ankylosing Spondylitis (AS), also known as spondylitis, is a rheumatic disorder that develops gradually in the sacroiliac, lumbar, thoracic and cervical spine and can involve peripheral joints in severe cases. The disease is insidious, starting in the sacroiliac and hip joints and gradually involving the entire spine. AS, also known as seronegative arthritis, is primarily due to a negative response to the susceptibility sheep blood clotting test (RF). Until the 1960s, it was known as “central rheumatoid arthritis” and “rheumatoid spondylitis”. At present, modern medicine has no effective treatment for this disease, but Chinese medicine treatment for ankylosing spondylitis is based on the concept of treating both the symptoms and the underlying cause of the disease, with few side effects and significant clinical effects, and has become a research hotspot in recent years, worthy of further investigation.

Use of Ilizarov technique for bilateral knees flexion contracture in Juvenile-onset ankylosing spondylitis: A case report

BACKGROUND Ankylosing spondylitis(AS)is a chronic rheumatic disease that primarily affects the spine and the sacroiliac and peripheral joints.Juvenile-onset AS(JoAS)patients will likely present with peripheral joint symptoms.Knee flexion contracture(KFC)and hip flexion contracture(HFC)are common in these patients due to subchondral bone inflammation.The Ilizarov technique is the most commonly used technique for treating KFC.However,its use to treat JoAS-associated KFC has not been reported.CASE SUMMARY This report presents a case study of a 31-year-old male patient with a squatting gait due to severe bilateral KFC and HFC.The patient had a normal walking pattern until the age of eight,after which he experienced knee and hip pain,leading to the gradual development of KFC and HFC.The patient’s primary complaint was an inability to walk upright.The patient was diagnosed with JoAS and under-went hip dissection and release,limited soft tissue release of the hamstring,and gradual traction using the Ilizarov method.Ultimately,the patient was able to walk upright.CONCLUSION The incidence of squatting gait due to KFC in individuals diagnosed with JoAS was low.Utilizing the Ilizarov technique has proven to be a secure and effective method for managing KFC in JoAS patients.Although the Ilizarov technique cannot substitute for total knee arthroplasty(TKA),its application can delay the need for primary TKA in JoAS patients and alleviate the intricacy and potential complications associated with the procedure.

平台转移设计的Ankylos种植系统进行种植修复的效果

目的观察平台转移设计的Ankylos种植系统种植体颈部骨吸收情况,评价其临床效果。方法 196例患者共植入Ankylos种植体344颗,并行种植修复。观察随访3～48个月,进行临床及X线检查,并对其进行评价。结果 344颗种植体骨结合良好,种植体成功率100%,患者均对种植体功能及修复效果感到满意。结论 Ankylos种植体基台莫氏锥度的连接设计可以取得满意的临床修复效果。

两种不同直径Ankylos种植体边缘骨吸收的比较研究

目的:比较3.5mm和4.5mm两种不同直径的Ankylos种植体用于修复单牙缺失的边缘骨吸收量。方法:临床选择50例单牙缺失患者,采用3.5mm和4.5mm Ankylos种植体各25例,行潜入式种植手术,Ⅱ期手术2周后,按照常规方法完成金钯合金烤瓷冠修复。术后随访,通过X线检查骨组织的吸收情况。比较3.5mm种植体和4.5mm种植体X线检查结果。义齿修复后的临床观察期为12个月。结果:全冠修复后,两组植体及修复体均未发生严重并发症,初期稳定性好,3.5mm种植体在修复即刻及修复后3、6、12个月的边缘骨吸收量分别为(0.53±0.46)、(0.58±0.42)、(0.64±0.40)、(0.78±0.35)mm,4.5mm种植体在修复即刻及修复后3、6、12个月的边缘骨吸收量分别为(0.33±0.24)、(0.35±0.26)、(0.41±0.28)、(0.51±0.29)mm。两组骨吸收量经检验存在显著性差异(P<0.05),均数排列为:3.5mm组(0.66mm)>4.5mm组(0.42mm)结论:在Ankylos平台转换结构中,肩台的宽度越大,即种植体的直径越大,种植体边缘骨吸收量越少。在牙槽骨宽度足够的情况下,尽可能选择宽径种植体。

Ankylos种植系统单牙修复临床应用

目的:评价Ankylos种植体用于修复单牙缺失的临床应用效果。方法:临床选择90例单牙缺失患者,采用Ankylos种植体进行潜入式种植手术,部分骨量不足的患者,同期使用膜引导骨再生术、上颌窦内提升术及上颌窦外提升术。Ⅱ期手术2周后,按照常规方法完成金钯合金烤瓷冠修复。术后随访,检查修复体与基台的稳定性以及种植体周围牙龈组织的健康状况;通过X线检查观察种植体周骨组织的吸收情况及基台的密合程度;调查患者对种植义齿咀嚼、美观、功能的主观满意度。种植后及义齿修复后的临床观察期为1～2.5年。结果:全冠修复后,除1枚植体发生种植体周围炎、1颗烤瓷冠崩瓷外,其余植体稳定度好,短期追踪未发现松动问题;基台植体界面密合,未发现有上部基台松动情况;牙龈组织健康;术后1年内骨吸收小于1mm;患者主观满意率高,为98.9%(89/90)。按种植成功标准,修复成功88枚,累积成功率97.8%;失败2枚,占2.2%。结论:Ankylos种植体用于单牙修复具有良好的临床效果。

Xive和Ankylos 2种种植系统单牙修复的临床疗效评价

目的评价Xive和Ankylos 2种种植系统在临床应用中的优缺点。方法选择527例采用Xive种植系统和82例采用Ankylos种植系统的单冠种植体患者,进行潜入式种植手术,Ⅰ期术后4~6个月,Ⅱ期术后2周,全部采用金钯合金烤瓷冠修复。结果取印模修复时,Xive、Ankylos种植体成功率分别为98.5%、97.6%。修复后1年Xive、Ankylos的修复成功率分别为98.8%、100.0%。Xive种植体牙槽骨边缘骨吸收在修复即刻和修复后1年时分别为-0.32（-0.40~0.00）mm和-0.12（-0.18~0.00）mm,Ankylos分别为0.08（-0.15~0.12）mm和0.40（0.10~0.62）mm。结论 2种种植系统各有优缺点,根据患者的临床特点选择合适的系统可取得满意的疗效。

Ankylos种植系统在上颌窦外提升术同期牙种植中的应用

目的:对Ankylos种植系统在上颌窦提升术同期牙种植中的临床效果进行评价。方法:收集2008年1月至2010年1月期间,对46例上颌后牙区牙齿缺失要求种植的患者,于58侧上颌窦行外提升术,同期植入Ankylos种植体142枚,修复后随访观察1～3年。结果:观察期内142颗种植体,均无松动或脱落,曲面断层片检查种植体周围未见明显骨吸收阴影。结论:Ankylos种植系统应用于上颌窦提升术同期牙种植可获得满意的临床效果。

Ankylos种植系统多牙固定修复短期临床疗效评价

目的评价Ankylos种植体用于固定修复多牙缺失的临床应用效果。方法临床选择21例多牙缺失患者完成An-kylos 68枚种植体进行潜入式种植手术,部分骨量不足的患者,同期使用膜引导骨再生术、上颌窦内提升术或上颌窦外提升术。Ⅱ期手术两周后,按照常规方法完成金钯合金烤瓷冠修复。术后随访,检查修复体与基台的稳定性,种植体周围牙龈组织的健康状况;通过X线检查观察骨组织的吸收情况及基台的密合程度;调查患者对种植义齿咀嚼、美观功能的主观满意度。种植后及义齿修复后的临床观察期为1～2.5年。结果冠桥修复后,1例患者的1枚种植体在种植修复后1个月时,发生种植体周围炎;1例在修复后1年烤瓷冠崩瓷;其余种植体均稳定,无明显骨吸收,种植体基台界面密合,牙龈组织健康。按种植成功标准,修复成功66枚,成功率97.1%;失败2枚,占2.9%。结论 Ankylos种植体用于多牙缺失的固定修复具有良好的临床效果。

Ankylos种植体中央螺丝杆折断取出1例

目的:探讨种植体中央螺丝杆折断原因及取出方法。方法:Ankylos种植体植入时中央螺丝杆折断患者一例,二期手术时使用超声洁牙机头,利用其超声震动,将折断部分震松,配合使用手机和小球钻成功将折断螺丝杆部件从种植体内取出。结果:术后种植体结构未破坏,种植体无松动,修复6个月后全景片检查种植体周围无明显骨吸收。结论:因术者操作原因及种植体结构设计的特殊性而发生中央螺栓折断,超声器械配合手机使用是取出种植体折断螺栓的是一种安全有效的处理办法。

Ankylos种植系统在前牙区的临床应用及效果评价

目的观察Ankylos种植系统对前牙缺失患者修复的临床效果,探索其在临床上的应用。方法选取2009年6月至2011年4月来我院口腔科治疗的前牙部分缺损的患者共有81例,对所有的患者采用Ankylos种植系统进行种植手术,同时还对一些牙槽骨量较少的患者合用膜引导的骨再生性手术、以及上颌内、外提升术进行辅助修复,总共修复有96颗牙齿,然后再采用合金或者金属烤瓷冠再行予以修复。手术之后要按时进行随访（随访期一般为1~2年）,同时要做好临床检查及X光线的检查,并观察种植体与基台之间的稳定性及密合度,以及种植体周围骨组织的吸收情况和牙龈组织的健康情况,还要对种植体的修复后的功能进行考察,再对其临床疗效进行分析与评价。结果 Ankylos种植系统修复后,经过随访期的检查,观察到只有1例前牙缺失患者的2颗种植体的周围发生炎症,其余94颗种植体与基台稳定性及密合度都比较好,可以很好地发挥其正常的咀嚼功能,成功率高达97.92%。结论 Ankylos种植系统用于治疗前牙缺失临床效果非常满意,成功率也比较高,还能够很好的保持牙龈的健康状况,值得在临床上继续推广和应用。

Ankylos种植系统在前牙美学区种植修复体会

目的：应用Ankylos系统种植修复于前牙，观察其临床疗效。方法：选取36例前牙缺失的患者，采用直径为3.5mm标准A型Ankylos植体种植牙齿48颗，钴铬合金烤瓷冠修复。术后随访1周~18月，通过临床及X线检查，观察种植体周围牙龈组织的健康状况以及修复体与基台的稳定性，调查患者主观满意度，进行分析与评价。结果：全冠修复后，1枚植体上部基台因角度较大而转动、1颗烤瓷冠崩瓷外，其余均稳定牢固，无种植体周围炎及基台松动情况，术后1年内骨吸收小于1mm，患者主观满意率高，成功率97．8％。结论： Ankylos 种植系统应用于治疗前牙缺失成功率较高，并可获得较好的修复及美学效果。

Nobel Replace系统与AnKylos系统对前牙修复种植体周围组织影响的临床比较

目的:比较Nobel Replace系统与粗糙水平平台转化技术(AnKylos系统)对前牙种植修复患者红色美学指数、种植体周围骨水平及3年累积存留率的影响。方法:选取笔者医院2014年6月-2015年6月收治的前牙缺失患者40例,按照随机数字表法分为Nobel Replace组和AnKylos组,每组20例。比较两组患者采用不同方式修复后红色美学指数、种植体周围骨水平、3年累积存留率,以及修复期间并发症发生情况。结果:两组患者经修复后红色美学指数均显著增加,且修复后2年内AnKylos组的红色美学指数显著高于Nobel Replace组(P<0.05)。两组患者经修复后种植体周围骨吸收量均显著增加,且AnKylos组负重6个月、12个月种植体周围骨吸收量显著低于Nobel Replace组(P<0.05)。经治疗后,AnKylos系统的3年累积存留率为100%,显著高于Nobel Replace系统(86.67%),差异具有统计学意义(P<0.05)。主要并发症为种植体松动、折断以及修复体松动和崩瓷,两组并发症发生率无显著性差异(P>0.05)。结论:AnKylos系统对于前牙种植修复的效果显著优于Nobel Replace系统,AnKylos系统可有效提高红色美学指数,改善种植体周围骨水平,并增加3年累积存留率。