Objective To study clinical application value of sacral and epidural block in treating lumbar intervertehral disc protrusion (LIDP), and explore technical operation methods, indications and con-traindications of sacral block. Methods Sacral block was adopted in 120 patients with LIDP(sacral group), they were injected triamcinolone acetonide 40 mg, vitamin B1 100 mg, vitamin B12 1 mg, 2% lidocaine 100 mg, added physiological saline 20-30 ml, twice a week, three times as a period. Compared therapy effect with epidural block (120 cases, epidural group). Results The achievement ratio of once puncture was 93.3% (112/120) in sacral group and 82.5% (99/120) in epidural group, P < 0.05. After treatment, the excellent and good rate of sacral group and epidural group were 85.0%(102/120) and 93.3%(112/120), there was not obvious difference, P>0.05, but the fair and bad rate were 15.0%(18/120) and 6.7%(8/120), there was ob-vious difference, P<0.05. Conclusions Sacral block and epidural block are effective methods to treat LIDP. They can relieve the stress at nerve root, especially sacral block, which has the advantages of easily operation, less pain, less side effect and safety.

Objective　Lipoxin A4 (LXA4) has been proved to have a good protective effect on spinal cord ischemia-reperfusion injury in rats, but whether autophagy is one of the protective mechanisms remains unclear. This study aims to investigate the effects of lipoxin A4 on rat spinal cord ischemia-reperfusion injury.　Methods　48 rats were randomly divided into LXA4 group, ischemia-reperfusion group (SCII group) and sham group with 16 rats in each, and the models of each group were built accordingly. The rats in LXA4 group received intrathecal injection of 10μl LXA4 (300 pmol) 30 minutes after clamping the abdominal aorta. Three groups of rats were sacrificed by cervical dislocation 24 hours after reperfusion and the apoptosis-positive cells were then obtained. The spinal cord tissues of three groups of rats were stained and counted by LC3B fluorescence staining, and the expressions of LC3-II/LC3-I and GABARAP protein were detected by Western blot.　Results　There were few LC3B positive cells in the sham group. Compared to those in the sham group (73.40±19.42), the number of LC3B positive cells in SCII group (399.80±18.46) and LXA4 group (240.80±12.76) significantly increased (P<0.05), and the number in LXA4 group was significantly lower than that in SCII group (P<0.05). The ratio of LC3-II/LC3-I and the expression of GABARAP in SCII group and LXA4 group was significantly higher than those in sham group (P<0.05). The ratio of LC3-II/LC3-I in spinal cord tissue significantly declined compared with that of SCII group (P<0.05).　Conclusion　The autophagy is activated when SCII occurs, indicating that the autophagy is involved in SCII. After LXA4 is administered, autophagy is inhibited and SCII is alleviated.

Objective:To investigate the pathological characteristics and the clinical significance of novel coronavirus (2019-nCoV)-infected pneumonia (termed by WHO as coronavirus disease 2019, COVID-19).Methods:Minimally invasive autopsies from lung, heart, kidney, spleen, bone marrow, liver, pancreas, stomach, intestine, thyroid and skin were performed on three patients died of novel coronavirus pneumonia in Chongqing, China. Hematoxylin and eosin staining (HE), transmission electron microcopy, and histochemical staining were performed to investigate the pathological changes of indicated organs or tissues. Immunohistochemical staining was conducted to evaluate the infiltration of immune cells as well as the expression of 2019-nCoV proteins. Real time PCR was carried out to detect the RNA of 2019-nCoV.Results:Various damages were observed in the alveolar structure, with minor serous exudation and fibrin exudation. Hyaline membrane formation was observed in some alveoli. The infiltrated immune cells in alveoli were majorly macrophages and monocytes. Moderate multinucleated giant cells, minimal lymphocytes, eosinophils and neutrophils were also observed. Most of infiltrated lymphocytes were CD4-positive T cells. Significant proliferation of type Ⅱ alveolar epithelia and focal desquamation of alveolar epithelia were also indicated. The blood vessels of alveolar septum were congested, edematous and widened, with modest infiltration of monocytes and lymphocytes. Hyaline thrombi were found in a minority of microvessels. Focal hemorrhage in lung tissue, organization of exudates in some alveolar cavities, and pulmonary interstitial fibrosis were observed. Part of the bronchial epithelia were exfoliated. Coronavirus particles in bronchial mucosal epithelia and type Ⅱ alveolar epithelia were observed under electron microscope. Immunohistochemical staining showed that part of the alveolar epithelia and macrophages were positive for 2019-nCoV antigen. Real time PCR analyses identified positive signals for 2019-nCoV nucleic acid. Decreased numbers of lymphocyte, cell degeneration and necrosis were observed in spleen. Furthermore, degeneration and necrosis of parenchymal cells, formation of hyaline thrombus in small vessels, and pathological changes of chronic diseases were observed in other organs and tissues, while no evidence of coronavirus infection was observed in these organs.Conclusions:The lungs from novel coronavirus pneumonia patients manifest significant pathological lesions, including the alveolar exudative inflammation and interstitial inflammation, alveolar epithelium proliferation and hyaline membrane formation. While the 2019-nCoV is mainly distributed in lung, the infection also involves in the damages of heart, vessels, liver, kidney and other organs. Further studies are warranted to investigate the mechanism underlying pathological changes of this disease.