2014年 · 第94卷第39期

Inflammatory demyelinating disease of the central nervous system (CNS) refers to a class of immune-mediated demyelination-dominated diseases. The most common are multiple sclerosis (MS) and neuromyelitis optica (NMO). In recent years, it is believed that the incidence of NMO in Asian population is more than that of MS, and both of them are different in pathogenesis, pathological injury and clinical treatment. Therefore, it will be of great significance to master the similarities and differences between the two pathogenesis and clinical treatment and the research progress.

As early as 1870, researchers found that optic neuritis (ON) and spinal cord disease have a co-incidence relationship. In 1894, Devic first proposed the concept of neuromyelitis optica (NMO). NMO is an inflammatory demyelinating disease of the central nervous system (CNS) that selectively involves the optic nerve and spinal cord. It is a disease characterized by severe optic neuritis and long-segment (>3 vertical segments) transverse spinal cord damage, also known as Devic's disease.

The child was a girl, 29 days after birth. Admission due to abdominal mass found on prenatal B-ultrasound. The child is the first birth, full-term birth, there is no asphyxia after birth, no vomiting after feeding, and the fetus has been discharged. Immediately after birth, he came to the Second Affiliated Hospital of Wenzhou Medical University for diagnosis and treatment. Physical examination: body temperature 37 ℃, heart rate 128 beats/min, breathing 36 beats/min, body weight 4.2 kg. The anterior fontanel was 2.0 cm ×1.0 cm, flat and soft, with clear respiratory sounds in both lungs and heart (–). Abdominal distension was slightly obvious, no gastrointestinal shape and peristaltic wave, no tenderness and rebound pain, and mobile voiced sound (–). Blood routine: white blood cells 6.86×10⁹/L, red blood cells 4.31×10¹²/L, platelets 479×10⁹/L. After admission, feeding and defecation were normal. Abdominal B-ultrasound showed (Figure 1): A cystic fluid dark area with a size of about 7.5 cm ×5.1 cm ×6.4 cm in the abdominal cavity, with clear boundaries, good sound transmission, and pressure and displacement of the surrounding intestine, was diagnosed as a cystic mass in the abdominal cavity. Abdominal CT showed (Figure 2): A large cystic-solid mass occupied in the left abdominal cavity of about 6.5 cm ×4.6 cm with clear boundaries, and a high-density shadow of about 2.0 cm ×1.4 cm was seen behind it. It was diagnosed as a huge cystic-solid mass occupied in the abdominal cavity with cystic mass occupied with bleeding? MRI showed (Figure 3，Figure 4): The size of the left lower abdomen is about 4.3 cm ×6.3 cm ×7.5 cm, the huge cystic occupies the space, the border is clear, and the signal is high on both T1WI and T2WI. The fluid-fluid level is seen in the lesion, and the patchy hemorrhage is seen in the posterior part of the lesion. The diagnosis was a large occupation of the left abdominal cavity, and cystic teratoma was considered first. An exploratory laparotomy was performed, and a cystic solid mass was found in the abdominal cavity during the operation. There were no abnormalities in the liver, spleen, stomach, omentum and large and small intestines. A cystic mass was seen in the middle and lower abdomen, about 8 cm ×7 cm ×6 cm in size, with thin wall. 80 ml of cystic fluid coffee solution was withdrawn, and the mass was pulled out. The left ovary where the cyst originated was seen. Careful observation found that the cystic pedicle was twisted 360° clockwise and was necrotic, so pedicle resection was given. Postoperative pathological diagnosis: ovarian cyst with pedicle torsion.

The characteristic lumbar lordosis and continuous curvature of the spine, the extension of the hip and knee joints, the changes of the arch and muscle dynamic system, which form the characteristic shape and position relationship of the spine and pelvis^[1]。 Evolution from stable quadruped supports to human bipedal mechanisms with smaller supporting surfaces, balance must be maintained to conserve energy conforms to power science^[2]。 The center of gravity and the line of gravity (GL) of the human body are the result of the interaction between the ground and the chains of the trunk, pelvis and lower limbs. When normal people stand quietly on the force measuring platform, GL is projected on the support surface between the two feet including the soles of the two feet, and GL is projected on the full-length lateral X-ray film of the spine, generally passing through the center of the femoral head slightly behind and the sacrum slightly forward^[3,4]。 The sagittal balance of the spine and pelvis has an important influence on spinal diseases. For the convenience of measurement, the full-length X-ray of the spine in standing position is generally measured to evaluate the sagittal balance^[5]。

Rheumatoid arthritis (RA) is a chronic, destructive, autoimmune disease characterized by synovial inflammation and joint destruction, and may also have systemic manifestations such as fatigue, anemia, and osteoporosis. Currently, there are a variety of cytokines involved in the pathogenesis of RA, among which interleukin (IL) – 6 plays a key role.