The Ankylosing Spondylitis Disease Activity Score is a highly discriminatory measure of disease activity and efficacy following tumour necrosis factor-α inhibitor therapies in ankylosing spondylitis and undifferentiated spondyloarthropathies in China.

OBJECTIVE: To validate the clinical value of the new Ankylosing Spondylitis Disease Activity Scores (ASDASs) in assessing the disease activity and efficacy of TNF-α inhibitor in AS and uSpA patients in China. METHODS: Two hundred and thirty patients were included in our study. They consisted of patients with active AS (n = 87) and uSpA (n = 30) participating in a double-blind placebo-controlled randomized clinical trial of etanercept and patients with active AS (n = 58) and uSpA (n = 55) treated with infliximab. The disease activity and treatment effects were assessed by ASDAS, BASDAI, patient global and the acute inflammation score of lumbar and SI joints by MRI. Discriminatory ability of all the measures was analysed by standardized mean difference and t-score. RESULTS: In both the AS and uSpA groups, ASDAS correlated well with patient global score (AS group: r = 0.65-0.72; uSpA group: r = 0.52-0.62), ESR (AS group: r = 0.57-0.81; uSpA group: r = 0.63-0.85) and CRP (AS group: r = 0.51-0.70; uSpA group: r = 0.61-0.76) both at baseline and in changes from baseline to 6 weeks after TNF-α inhibitor treatment. The ASDAS scores outperformed BASDAI, patient global score, ESR, CRP and the acute inflammation score by MRI in differentiating patients with different levels of disease activity and patients with different levels of change in both AS and uSpA groups. There was little difference in performance between the two versions of the ASDAS. CONCLUSION: The new ASDAS is a highly effective measure in assessing disease activity and a great discriminatory measurement to assess the efficacy of TNF-α inhibitor in Chinese AS patients and uSpA patients.

[The application of spiral CT in diagnosing the otitis media with cholesteatoma].

OBJECTIVE: To discuss the application of spiral CT imaging of temporal bone in diagnosing the chronic otitis media with cholesteatoma. METHOD: The clinical data and spiral CT manifestation of 104 cases of chronic otitis media with cholesteatoma were retrospectively analyzed. All the diagnoses were confirmed by operation and pathology. RESULT: Spiral CT imaging could accurately show the signs of soft-tissue occupancy and bony-erosion of by cholesteatoma in middle ear which originated from various sites and of various sizes. Comparing the CT imaging before surgery and the findings during the operation, the consistency in bone erosion was 89.1%, in soft-tissue occupancy was 94.4% and in invasion of ossicle chain was 89.3%. CONCLUSION: Spiral CT imaging plays an important role in diagnosing cholesteatoma and especially the bony-erosion and the soft-tissue occupancy, which can provide crucial information for the surgery.