BACKGROUND:The narrowing of intervertebral space induced by the intervertebral disc degeneration is mainly characterized by the expression of proteoglycan in nucleus pulposus cells and the reduction of col agen type II. OBJECTIVE:To quantitatively observe col agen type II protein in adult normal and degenerative intervertebral disc nucleus pulposus cells by immunofluorescence staining and safranin O staining.
METHODS:The nucleus pulposus specimens were col ected from adult scoliosis patients and patients with intervertebral disc protrusion, who were al volunteers. After culture, 26 cells in each patient were measured. There were 78 cells in both normal group and degeneration group. The normal and degenerative intervertebral disc nucleus pulposus cells were subjected to safranin“O”staining, and gray values were determined;intracellular col agen type II was detected by immunofluorescence staining.
RESULTS AND CONCLUSION:Immunofluorescence staining revealed that, degenerative intervertebral disc nucleus pulposus cells were only mildly stained, with the fuzzy staining, the shape was round, spindle, fusiform and irregular. There were a very smal amount of fluorescent particles within cells. The expression of col agen type II was decreased significantly compared with normal cells (P<0.05). Safranin O staining showed that, degenerative nucleus pulposus cells began to swel , the nuclei swel ed and were stained slightly, cellprocesses were prolonged, cytoplasmic dyeing was uneven accompanying with vacuole, celldisruption, scattered and chaotic distribution were visible, patches of necrosis were observed. The image gray value showed no significant difference compared with normal nucleus pulposus cells (P>0.05). The degenerative intervertebral disc nucleus pulposus cells have a smal quantity and partial y become apoptotic, the content of col egen type II protein is decreased significantly compared with normal nucleus pulposus cells.

Objective To investigate the clinical value of a newly designed surgical therapy for familial polyposis coli by severing the superior mesenteric artery&vein in order to make a complete lysis of the mesentery and an ileum pouch and the anal anastomosis within the entire muscular sheath of the rectum.Methods Six patients with familial polyposis coli(5 males and 1 female,aged 24-36 years)were admitted and underwent the procedure which was consisted of:(1)An incision was made in the left middle and lower parts of the rectus abdominis;(2)The greater omentum was retained and the large intestine was removed;(3)At the juncture of the sigmoid colon and the rectum,the muscular sheath was dissociated 0.5cm,the mucous membrane of the rectum was stripped in a revolving manner,the nourishing artery and vein in the membrane were exposed,and clamped and cut in sequence up to the anocutaneoue line;(4)The rectal mucous membrane was completely removed;(5)Under the right colonic artery,the superior mesenteric artery and vein were severed;(6)An N-,J-or W-shaped pouch was made in the ileum accordingly:(7)An anastomosis of the ileum pouch and the anal canal was made within the entire muscular sheath of the rectum,and a drainage was placed;(8)The mesostenium was fixed on the fight posterior abdomen,the small intestines were spread out to the right side,and the mesostenium was covered on the coarse surface of the colon bed:(9)A tube was placed in the left lower abdomen for a vacuum aspiration for 2 days after operation,combined with the suction drainage,to eliminate the pelvic effusions;and(10)The abdomen was closed.Results Patients were able to discriminate stools and flatus 3-7 days after operation.and the formed stools occurred 7-10 days after operation.Five patients were followed-up for 3-17 years,with averagely one defecation a day,with no night defecation and seepage.Urination was normal;In another one patient who underwent the procedure 4 months ago the defecation was twice a day,with no night defecation.All the 6 patients had normal autonomic nerve function and sexual function as well as normal defecation and urination,with no recurrence of polyposis coli or infection.The small bowel functions well with no ischemia related symptoms.Conclusion Cutting the superior mesenteric artery and vein and then making anastomosis of the ileum pouch and the anal canal within the muscular sheath of the rectum is a new surgical approach to familial polyposis coli.It is safe and significantly improves the patients' life quality.

Objective To investigate the MRI features of pleomorphic xanthoastrocytoma (PXA).Methods 1 5 pathologically confirmed PXA cases were analyzed retrospectively.Clinical history and imaging features including location,size,shape,signal intensi-ty,enhancement and surrounding changes of those lesions were analyzed.Results All 1 5 cases were supratentorial and solitary le-sions,of which 9 lesions located in temporal lobe(60%).14 lesions contacted with the leptomeninges,and 1 lesion contacted with lat-eral ventricle wall.All lesions were solid-cystic,with different proportion of solid/cystic components.8 large lesions were predomi-nantly cystic(53.3%),3 small lesions were predominantly solid(20%),and 4 lesions had roughly equal cystic and solid proportions (26.7%).Solid components showed iso-intense or mild hypo-intense on T1 WI,iso-intense or mild hyper-intense on T2 WI,and signif-icant enhancement with contrast.Cyst fluid showed slightly hyper-intense in some cases.Cyst wall or septa enhancement was seen in 7 cases,and leptomeningeal enhancement was seen in 8 cases.Conclusion The MRI features of PXA are the characteristic of suprat-entorial solid-cystic lesions commonly seen in temporal lobe and contacting with leptomeninges.The typical features include “cyst with mural nodule”and “multiple cysts with irregular eccentric nodule”with significant enhancement of solid component and some cyst wall.MRI features of PXA is valuable in diagnosis and differential diagnosis of PXA.

Objective To observe the efficacy ofHuayu Kangyou Formula combined with Western medicine for Hp-related peptic ulcer disease;To discuss the mechanism of action.Methods Totally 152 patients were randomly divided into treatment group and control group, 76 cases in each group. Control group was given standard triple therapy, while treatment group was givenHuayu Kangyou Formula based on the standard triple therapy. The treatment lasted for 6 weeks. The clincal symptom scores and gastroscopy were observed to evaluate the therapeutic effect, adverse reactions were recorded, and relapse of ulcer was followed-up.Results The total effective rates of clinical symptoms in the treatment group and the control group were 94.74% (72/76) and 84.21% (64/76), respectively;the excellent rates were 78.95% (60/76) and 55.26% (42/76), respectively;the incidences of adverse reactions were 5.26% (4/76) and 13.16% (10/76), respectively;the relapse rates after 1 year of follow-up visit were 13.63% (6/44) and 41.67% (10/24), respectively, with statistical significant difference between the two groups (P<0.05).ConclusionHuayu Kangyou Formula combined with Western medicine can effectively improve the efficacy of Hp-relative peptic ulcer disease, reduce adverse reaction rate and relapse rate.

The attenuated Chinese equine infectious anemia virus (EIAV) vaccine is the first lentiviral vaccine that provides solid protective immunities to vaccinated horses. To investigate properties of EIAV vaccine, especially the relationship between its replication and the immunity, viral plasma loads of an EIAV vaccine strain EIAVFDDV in immune suppressed horses were detected. Three horses, which were immunized with EIAVFDDV for 16 months, were treated with dexamethasone for 14 days to suppress their immunities. Reduced immune response in these animals was confirmed by significantly declined lymphocyte proliferation rate detected after 10 days of the drug treatment. The plasma viral loads of EIAVFDDV, which was indicated by the genomic RNA copy numbers, in horses before and after the treatment of dexamethasone were monitored by real time RT-PCR. Results revealed that the viral plasma loads in two of three immune-suppressed horses were kept a steady low level around 103～ 104 copies/ml. The load was increased by 10 folds in the third horse, but was still among the standard levels for EIAVFDDV vaccinated horses. As a positive control, the viral copy number of an asymptomatic carrier of EIAV virulent strain EIAVLiao was jumped nearly 25 000-fold higher after being treated with dexamethasone. The typical clinical symptoms of EIA, characterized by febrile episodes and thrombocytopenia, were also appeared in this horse. These results clearly indicate that it is the unique biological feature of the attenuated EIAV vaccine, but not the immunity, resulted in EIAVFDDV remaining in low levels in the body harmlessly. In addition, the steady low level of viremia and the inability to cause clinical symptoms of EIAVFDDV in immune-suppressed hosts further demonstrated the safety of attenuated Chinese EIAV vaccines. The data provide a new sight for studies on the immunity to lentiviruses.

Objective To explore the diagnoses of spontaneous intracranial hypotension,and discuss the therapeutic efficacy of epidural blood patch therapy in spontaneous intracranial hypotension patients.Methods The clinical data of 12 patients with spontaneous intracranial hypotension,admitted to our hospital from January 2013 to December 2018,were retrospectively analyzed.The lumbar puncture results,MR imaging features of the skull and spine,and CT myelography (CTM) features of these patients were analyzed.The treatment efficacies of epidural blood patch,which included blind epidural blood patch and targeted epidural blood patch,were compared.Results The cerebrospinal fluid pressure of 12 patients was ≤ 60 mmH2O.Ten patients (83.3％) showed subdural fluid collections,enhancement of the pachymeninges,engorgement of venous structures,pituitary hyperemia,and sagging of the brain on brain MR imaging,and one of the patient showed pituitary hemorrhage.Seven patients (63.3％) showed spinal dural epithelial fluid accumulation and venous plexus expansion on spine MR imaging,and one of the patient showed dorsolateral dural discontinuous thickening of T6 and forward movement of the spinal cord caused by massive dorsal epidural effusion.Twelve patients in this group underwent CTM,and were found cerebrospinal fluid leakage.Twelve patients applied 14-times epidural blood tests;4 responded well to one-time targeted epidural blood patch therapy,with success rate of 100％;8 patients used blind epidural blood patch therapy,and 6 patients responded well to one-time therapy,with success rate of 75％,one patient improved with blind epidural blood stick twice,and one patient was ineffective twice.Conclusions Head MR imaging combined with spinal MR imaging is a non-invasive method to diagnose spontaneous intracranial hypotension.Myelogram can determine whether there is a leakage of spinal cerebrospinal fluid and accurately locate the leakage site.Epidural blood patch therapy is an effective method for treatment of patients with spontaneous intracranial hypotension.With the precise location of leak points by myelography,targeted epidural blood patch is more effective.

Objective To investigate the application of myelography including digital subtraction angiography myelogram (DSM) and computed tomography myelogram (CTM) in patients with spontaneous intracranial hypotension.Methods The myelography results including DSM and CTM of 10 patients with spontaneous intracranial hypotension form Guangzhou First People's Hospital between January 2013 and June 2018 were retrospectively analyzed.Some patients were treated with targeted epidural blood patch on the basis of myelography.Results Myelography (including DSM and CTM) showed cerebrospinal fluid leakages in all the 10 patients.There were one to 16 leak sites with an average of nine sites (totally 90 leak sites).Forty-two sites (47％) were located in cervical vertebra,19 sites (21％) in thoracic vertebra,22 sites (24％) in lumbar vertebra,and seven sites (8％) in sacral vertebra.On DSM and CTM,cerebrospinal fluid leakage was characterized by the diffusion of contrast agent along one side or the bilateral sides of nerve root,enlargement of the nerve sleeves and paraspinal collections of hyper-demity contrast medium.Two patients whose cerebrospinal fluid leakage occurred in long sections showed more cerebrospinal fluid leakage on CTM than on DSM.Two patients responded well to targeted epidural blood patch on the basis of myelography.The cerebrospinal fluid leakage was completely settled on myelography after the treatment of epidural blood patches.Conclusions Myelography has been shown to assist the diagnosis of spontaneous intracranial hypotension and accurately define the location and extent of cerebrospinal fluid leakages.Myelography can be used to guide targeted epidural blood patch and applied in the reexamination of cerebrospinal fluid leakages after treatment.More cerebrospinal fluid leakages are detected by CTM than by DSM.