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Osteoarthritis (OA) is the most common form of arthritis and the leading cause of old age disability, affecting an estimated 302 million people worldwide. OA is seriously overlooked in the world. The awareness of OA and the popularization of standardized diagnosis and treatment are all lacking. Knees, hips, and hands are the most commonly affected joints in OA. Based on the experience of diagnosis and treatment, consensus and guidelines, we formulated this diagnosis and treatment standard in order to standardize the diagnosis and treatment of OA. We hope that our standard can reduce misdiagnosis and mistreatment and improve the prognosis of OA.
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ObjectiveIn order to confirm the value of high resolution frequency(HFUS) ultrasonography in the early diagnosis of psoriatic arthritis(PsA).MethodsTwenty-nine patients with psoriatic arthritis reporting sixty-nine finger pain and 30 patients with rheumatoid arthritis reporting seventy finger pain and 20 healthy volunteers underwent X-ray and US evaluation.The ultrasonographic characteristics and blood flows in the joints were checked with high resolution ultrasonography.Bilateraljoints were compared each other in every patient.Comparisons between groups were tested by x2 test.ResultsSonographic positive signs were found in all the involved joints in 29 PsA patients,joint effusion in 42 fingers (61％).Synovial thickening was found in 38 fingers (55％).Bone erosions were found in 28 fingers(41％),tenosynovitis were found in 40 fingers (58％),soft tissue inflammation was revealed in 29 fingers (42％).Enthesitis were foundin 30 fingers (43％).In RA patients,joint effusion was found in 52 fingers (74％) and synovial thickening in 48 fingers (69％).Bone erosions were found in 33 fingers (47％).Tenosynovitis,soft tissue inflammation and enthesitis were not found in RA patients.ConclusionHigh resolution ultrasonography is an easy,safe and effective method for the early diagnosis of pathological changes of small joints in psoriatic arthritis.
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Objective To explore the role of intracranial electrode EEG monitoring for localizing epileptogenic zone in epilepsy.Methods 20 patients with refractory temporal lobe epilepsy,whose seizure onsets were unable to be localized by MRI、routine EEG and clinical characteristic,accepted long-term intracranial electrode EEG monitoring.Bitemporal lobe subdural implanted trip electrode were used to perform the ictal and interictal EEG monitoring under the guiding of the stereotactic technique.The results routine of EEG,MRI and intracranial electrode EEG were combined.The accuracy for localization of epilepitogenic zone was evaluated based on the followed-up.Results The intracranial electrode EEG monitoring was implanted within 1～5 d.Each patient was recorded the ictal and interictal discharge and was detected clinical onsets at least twice.All patients could be localized by ictal EEG.The consistency between interical EEG and ictal EEG were observated in 15 cases,the inconsistency in 3 cases,and 2 cases were bilateral discharge in interictal.The clinical outcome showed that patients were seizure-free in 13 cases(65%),improved significantly in 3 cases(15%),improved in 3 cases(15%),unimproved in 1 case(5%)according to Engel's criteria after surgery.No significant complication was found in all patients.Conclusion The intracranial electrode EEG monitoring can localize epileptogenic zone and offer reliable evidence for epilepsy surgery.
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Objective To analyze the prognostic factors and evaluate the effect of stereotactic radiosurgery for patients with multiple brain metastases. Methods Comparison was made in 53 such patients treated by stereotactic radiosurgery plus radiotherapy and 53 treated by radiotherapy alone. Patients were matched paired according to the following criteria: age, Karnofsky performance scale(KPS) before treatment, extent of systemic cancer and number of brain metastasis.Fourty patients had stereotactic radiosurgery, 13 patients stereotactic fractionated radiosurgery. In the stereotactic radiosurgery group, the patients were given a mean marginal dose of 20?Gy. Methods of stereotactic fractionated radiosurgery was 4 12?Gy per fraction, twice a week to a total dose of 15 30?Gy. Whole brain radiotherapy was given immediately after stereotactic radiosurgery. For patients treated by radiotherapy alone, the entire brain was treated by 30 40?Gy in 3 4 weeks. Results The median survival was 11.6 months in stereotactic radiosurgery plus radiotherapy and 6.7 months in radiotherapy alone. The one year survival rate and one year local control rate were 44.3%,17.1% and 50.9%,13.2%. Those with KPS increased after treatment gave 1 year survivals of 69.8% and 30.2%, respectively. The validity rates in CT or MRI three months after treatment were 82.0% and 55.0%.The difference in the two groups was found to be statistically significant (P