Objective To study the pathophysiology of ankylosing spondylitis (AS)-related osteoporosis by investigating the relation between bone mineral density (BMD) and bone turnover markers.Methods Fortysix AS patients were included in this study,including 35 male and 11 female patients.Twenty-five gender and age matched healthy subjects were served as the healthy control group.Informed consents were obtained from all subjects.BMD of lumbar spine (L2-4),fermoral neck and radius were tested using dual-energy X-ray absorption method.Data about BASDAi,ESR,Ig was collected.Bone formation markers including procollagen type Ⅰ N-terminal peptide (PINP) and osteocalcin (OC) were included for analysis,the formal was measured by radioimmunoassay and the later was measured by immunoradiometric assay and bone resorption marker.β-Crosslaps was measured by electrochemiluminescence immunoassay.Independent-samples t test was used to compare normal distributed data between the two groups.Analysis of variance was used to compare the data between the three groups.For those data which were not normally distributed,Rank sum test was performed.Correlations were determined by Pearson or Spearman's ranking.Results ① 48％ of AS patients had bone loss,while the percentage in the healthy control group was 20％ (x2=5.32,P=0.021).BMD of lumbar spine,fermoral neck and radius of the AS patients were lower than the controls (t=-3.73,-3.68,-5.24; P＜0.05).② Bone density (BMD) of lumbar spine in patients at the late stage was higher than patients at early disease stage (t=2.26,P=0.034),however,the BMD in the femoral neck was not.③ The procollagen (PINP),OC and β-CrossLaps were not significantly different in patients at different stage of diseases (P＞0.05).④BMD of lumbar spine was negatively correlated with the β-CrossLaps and ESR(r=-0.325,P=0.047; r=-0.314,P=0.046),The BMD in fermoral neck was negatively correlated with β-CrossLaps and OC (r=-0.387,P=0.024; r=-0.371,P=0.034),but they were not correlated with disease duration and BADSAI.Conclusion Osteoporosis is common in AS.Bone turnover markers including bone formation and bone resorption are increased in AS.β-CrossLaps is likely to predict bone loss in AS.

Objective:To observe the clinical and imaging features of infiltrative optic neuropathy (ION) secondary to extraocular malignant tumors.Methods:A retrospective case study. From January 2017 to October 2022, 26 eyes of 20 patients with ION secondary to extraocular malignancies and 32 eyes of 16 patients with early papilloedema (EP) secondary to intracranial metastatic carcinoma were included in the study. All eyes underwent best corrected visual acuity (BCVA), fundus color photography, orbital and/or craniocerebral magnetic resonance imaging (MRI). A total of 54 eyes were examined by visual field examination, among which ION and EP were 22 and 32 eyes, respectively. Clinical and imaging features of the affected eye were retrospectively analyzed.Results:Among 26 eyes of 20 ION patients, there were 13 males and 7 females, with the mean age of (52.8±16.9) years. There were 10 patients of hematologic malignancy, 7 patients of periorbital malignancy, 2 patients of lung cancer, 1 patient of gastric cancer, 1 patient of breast cancer and 1 patient of prostate cancer. Two patients of nasal lymphoma were recorded as hematologic malignancies and periorbital malignancies. Sixteen patients had a history of systemic or periorbital malignancy, among which 4 patients reported that they had been "clinically cured". Optic neuritis was diagnosed in 15 patients. Among the 16 patients with EP, 5 were males and 11 were females, with the mean age of (47.9±12.3) years. The primary malignant tumors were lung cancer, breast cancer, leukemia, gastric cancer, ovarian cancer, colon cancer and rectal cancer in 7, 2, 2, 2, 1, 1, 1, respectively. In 26 eyes of ION, 20 eyes complained of blurred vision or peripheral vision occlusion and progressive aggravation; no obvious visual symptoms in 6 eyes. BCVA was light sensing to 1.0 with a median of 0.3, including light sensing and light sensing in 4 eyes. Optic disc edema was observed in 19 eyes; no obvious abnormality in 7 eyes. Visual field examination showed that in 22 eyes, normal or mild enlargement of blind spot in 3 eyes, arcuate scotoma in 4 eyes, annular scotoma in 6 eyes, tubular visual field or concentric contraction of visual field in 6 eyes, and diffuse depression in 3 eyes. MRI showed optic nerve enlargement with sheath enhancement in all ION eyes. Among 32 eyes of EP, 28 eyes showed recurrent transient amaurosis, and the other 4 eyes showed horizontal diplopia. BCVA ranged from 0.8 to 1.5, with a median of 1.0. All EP patients showed different degrees of optic disc hyperemia and edema by fundus examination. The visual field examination showed normal or mild enlargement of the physiological blind spot. MRI showed thickening of the optic nerve and widening of the intrathecal space, but no obvious enhancement of the optic nerve and its intrathecal membrane, and obviously enhanced space-occupying lesions in the brain parenchyma, accompanied by compression and edema of the surrounding brain tissue and midline displacement.Conclusions:ION secondary to extrocular malignant tumors mainly manifested as mild visual symptoms and obvious optic disc edema. MRI showed thickened optic nerve and strengthened sheath, and no obvious abnormality in optic nerve parenchyma.

Objective:To analyze the changes of thyroid volume before and after supplementation with lipiodol pills in children with goiter, and to evaluate the recovery effect of lipiodol pills supplementation on children with goiter in the short term.Methods:In October 2018, 4 townships and towns in Linxia Hui Autonomous Prefecture with relatively serious historical conditions and high goiter rate of children aged 8 to 10 were selected for thyroid examination in 19 primary schools within the jurisdiction. Sixty children with goiter were selected as research subjects; at the same time, 138 children of the same age with normal thyroid B-ultrasound examination results were selected as control in the same period. Under the condition of normal diet, children with goiter were intervened by taking 200 mg lipiodol pills at one time. After 6 months, the thyroid volume of children with goiter and control children was measured by B-ultrasound.Results:Fifty-three children with goiter were finally included, with a sex ratio of 1.00 ∶ 1.04 (26 ∶ 27). There were 138 control children in the same period, with a sex ratio of 1.00 ∶ 1.30 (60 ∶ 78). Six months after taking lipiodol pills, the median thyroid volume of children with goiter was 3.7 ml, which was significantly different from that before supplementing with lipidol pills (5.8 ml, Z = - 7.95, P < 0.001), and not significantly different from that of control children (4.1 ml) in the same period ( Z = - 0.91, P = 0.365). Among them, 90.6% (48/53) of children with goiter recovered to the normal range, and 100.0% (15/15), 81.8% (18/22) and 93.8% (15/16) children's thyroid recovered returned to the normal range in the 8-, 9-, and 10-year-old age groups, respectively, and the highest proportion was in the 8-year-old age group. Stratified by age and gender, the thyroid volume of children with goiter in all age groups and gender after supplementation with lipiodol pills was lower than that before supplementation with lipiodol pills ( P < 0.001), but there was no difference compared with the control children in the same period ( P > 0.05). After supplementing with lipiodol pills, the diameters of thyroid in children with goiter were significantly lower than those before supplementing with lipiodol pills ( P < 0.001). Compared with the control children in the same period, there were significant differences in the right width, left length and right long diameter of the thyroid ( P < 0.05). Conclusion:Supplementing lipiodol pills can restore the thyroid volume of 8 - 10 year old children with goiter to normal range in a short term, and can effectively treat simple goiter.