Correlation of finger-to-floor distance with the spinal mobility, spinal function indices and initial determination of its optimal cutoff value: a multicentre case-control study.

Objective: To identify the correlation between finger-to-floor distance(FFD) and the spinal function indices and disease activity scores of ankylosing spondylitis (AS) via a multicentre case-control study, and to calculate the optimal cutoff value of FFD using statistical methods. Methods: Patients with AS and healthy individuals were recruited, and the FFD and other spinal mobility values were measured. The correlation between the FFD and the Bath Ankylosing Spondylitis Metric Index (BASMI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) was analyzed using Spearman rank correlation analysis. Receiver operating characteristic (ROC) curves of FFD stratified by gender and age were drawn and their optimal cutoff values were determined. Results: A total of 246 patients with AS and 246 healthy subjects were recruited. The FFD was strongly correlated with BASMI (r = 0.72, p < 0.001), moderately correlated with BASFI (r = 0.50, p < 0.001) and weakly correlated with BASDAI (r = 0.36, p < 0.001). The lowest cutoff value of the FFD was 2.6 cm while the highest was 18.4 cm. Moreover, the FFD was significantly correlated with sex and age. Conclusion: There exists a strong correlation between the FFD and spinal mobility, a moderately correlation and function, which provides reliable data for the evaluation of patients with AS in clinical settings and the rapid screening of low back pain-related diseases in the general population. Furthermore, these findings have clinical potential in improving the missed diagnosis or delayed diagnosis of low back pain.

Symptomatic femoral head necrosis in patients with rheumatoid arthritis: A retrospective case-control study.

OBJECTIVE: We conducted a retrospective case-control study to investigate the risk factors for osteonecrosis of the femoral head (ONFH) in rheumatoid arthritis (RA) patients. METHODS: The clinical data of patients diagnosed with RA at Fujian Provincial Hospital from January 2013 to December 2020 were retrospectively collected and evaluated. Twenty-two patients with ONFH were identified. Eighty-eight age-, sex-, and disease duration-matched RA patients without symptomatic ONFH were randomly selected as controls in a ratio of 1:4. Logistic regression analysis was used to analyze the risk factors. RESULTS: The anticardiolipin (ACL)-immunoglobulin G (IgG) concentration, clinical disease activity index, simplified disease activity index, incidence of hyperlipidemia in the case group were higher than those in the control group. Multivariate logistic regression analysis did not find the independent risk factor in ONFH patients with RA. CONCLUSION: The pathogenesis of ONFH in RA is related to many factors such as ACL IgG, disease activity index, and hyperlipidemia. While, we went to great lengths to explore the relationship between antiphospholipid antibodies and ONFH, but it plays a very small role.

Epigallocatechin gallate regulates inflammatory responses and new bone formation through Wnt/ß-Catenin/COX-2 pathway in spondyloarthritis.

OBJECTIVE: Spondyloarthritis (SpA) is mainly characterized by bone erosion, new bone formation, inflammation and potential disability. Epigallocatechin gallate (EGCG) has been proved to be closely related with the regulation of inflammation and bone metabolism. However, whether EGCG could improve SpA remains unclear. METHODS: SpA animal model was established using proteoglycan. Cell proliferation were measured by CCK-8 assay. The mRNA expression levels of genes were detected using qRT-PCR, protein levels were assessed via western blotting and immunohistochemistry. ELISA assay was performed to examined the inflammatory cytokine release. Lesions in spine cartilage tissues were observed using hematoxylin-eosin (HE) and Safranin O staining. Alkaline phosphatase (ALP) assay and Alizarin Red S staining was used to investigate osteoblast mineralization. RESULTS: We found that EGCG could inhibit inflammation and new bone formation in SpA mice. Besides, inflammatory factor expression and osteogenic differentiation in osteoblasts isolated from SpA mice were also decreased by EGCG. Further, EGCG treatment suppressed the activation of Wnt/ß-Catenin/COX-2 pathway and the activator of this pathway partially reversed the effects of EGCG on inflammation and osteoblast differentiation. CONCLUSIONS: EGCG repressed inflammatory responses and new bone formation, and further improved SpA through Wnt/ß-Catenin/COX-2 pathway. Our findings may provide a new thought for the prevention and treatment of SpA.

Efficacy and safety of thalidomide on psychological symptoms and sleep disturbances in the patient with refractory ankylosing spondylitis.

BACKGROUND: Thalidomide has been used to treat ankylosing spondylitis (AS) patients, but the efficacy and safety of thalidomide on psychological symptoms and sleep disturbances in the patient with refractory AS has not been evaluated. METHODS: In this 6-month open study, 35 cases of patients with refractory AS were recruited, using thalidomide at a dose of 150 mg/d before sleep. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), fingertip-to-floor distance, nocturnal pain, total back pain, psychological symptoms, and sleep were assessed at baseline, 3 months and 6 months respectively. RESULTS: Clinical parameters, included BASDAI, BASFI, fingertip-to-floor distance, nocturnal pain, total back pain, ESR, CRP, SAS, SDS and PSQI lower levels of month 3 were found when compared to initial levels (P<0.05). In the 6th month, the levels of BASDAI, fingertip-to-floor, nocturnal pain, total back pain, SDS were further lower than those in the 3rd month (P<0.05). The levels of BASMI were lower than this at baseline (P<0.05). The most tolerable common adverse reactions were drowsiness (10/35), dry mouth (8/35), constipation (8/35), dandruff (7/35), dizziness (4/35). CONCLUSIONS: Thalidomide can improve effectiveness and safety in the treatment of physical, as well as psychological symptoms and sleep disturbances accompanying refractory AS.