Objective To determine the intervention of mycophenolate mofetil (MMF) in glial scar formation and learning and memory function in a rat model of diffuse axonal injury (DAI).Methods Ninety-six SD rats were randomly divided into sham group, normal saline (NS) group and mycophenolate mofetil (MMF) group according to the random number table, with 32 rats per group.Immunohistochemistry was used to detect activated microglia cells, activated astrocytes and chondroitin sulphate proteoglycanns (CSPGs) in the hippocampus.Inage-Pro Plus software was used to quantitatively assess the changes of activated microglia cells, activated astrocytes and CSPGs.Morris water maze was applied for testing rat learning and memory function.Integrated absorbance (IA) of major constituents (microglia, astrosyte, chondroitin sulphate proteoglycan) of the glial scar was determined and analyzed for the correlation with the parameters of MWM.Results At 7, 14 and 28 days after injury, MMF group showed decreased IA of activated microglia in the hippocampus compared to sham and NS groups (P ＜ 0.05).At 7-11 days after injury, percent distance and percent time in the target quadrant of Morris water maze did not differ significantly among the three groups and were not related to the IA of glial scar.At 28-32 days after injury, percent distance and percent time in the target quadrant of Morris water maze lowered significantly in MMF group.At 28 days after injury, IA of the glial scar had a positive correlation with mean speed and mean escape latency, but negative correlation with percent distance and time in the target quadrant that measured in Morris water maze at 28-32 days after injury.Conclusion MMF significantly attenuates glial scar formation into the hippocampus and improves learning and memory function in rats during the recovery stage when administered in the early stage after DAI.

OBJECTIVETo find out the clinical and pathological characteristics in acute complicated appendicitis.

METHODSA retrospective clinical analysis was made on 742 cases of acute appendicitis from January 2003 to December 2012. All cases underwent appendectomy. Patients were allocated to the acute complicated appendicitis (ACA) group and the acute uncomplicated appendicitis group based on pathological reports. The χ² test was used to check for differences between proportions. Multivariate analysis was made through the Logistic regression.

RESULTSOf 742 patients, 533 were allocated to the ACA group, including acute suppurative appendicitis 306 patients, acute gangrenous appendicitis 100 patients, appendicitis with perforation 59 patients, appendicitis with abscess formation 6 patients and appendicitis with tumor 5 patients. Statistical result shows that the patients of ACA group usually had higher total WBC count, local or diffuse muscle guarding, intraluminal stercolith or periappendiceal fluid. Logistic regression also indicated that ACA were mathematically related to high level white blood cell count (>20 × 10⁹/L, OR = 2.717, 95%CI: 1.834-4.027, P < 0.05), local or diffuse muscle guarding (OR = 1.649, 95%CI: 1.047-2.597, P < 0.05), intraluminal stercolith (OR = 2.939, 95%CI: 1.607-5.377, P < 0.05) and periappendiceal fluid (OR = 3.273, 95%CI: 1.424-7.525, P < 0.05).

CONCLUSIONSPatients with high level WBC count, local or diffuse muscle guarding, intraluminal stercolith or periappendiceal fluid are likely suffering from acute complicated appendicitis. Appendectomy must be considered as first-line therapy other than conservative antibiotic therapy under these situations.

Acute Disease ; Adult ; Appendectomy ; Appendicitis ; diagnosis ; pathology ; surgery ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective Compare and analyze the clinical efficacy and imaging differences of zero-profile interbody fusion cage and interbody fusion cage combined with titanium plate in anterior cervical discectomy and fusion(ACDF).Methods The clinical data of 40 patients who underwent ACDF in our hospital from February 2017 to November 2021 were retrospectively analyzed.Among them,22 patients were treated with zero-profile interbody fusion cage(zero-profile group),and 18 patients were treated with interbody fusion cage combined with titanium plate(titanium plate group).Record the operation time and intraoperative blood loss of the two groups.Japa-nese Orthopaedic Association(JOA)score,neck disability index(NDI)score and postoperative dysphagia were used to evaluate the clinical efficacy.Measure the cervical Cobb angle(C2-C7),fusion segment Cobb angle,aver-age intervertebral space height,and fusion segment height.Evaluate the fusion and subsidence of the cage by observ-ing the internal and external bone bridging of the cage through postoperative CT.Results There was no significant difference in operation time and intraoperative blood loss between the two groups(P>0.05).The JOA score,NDI score,average intervertebral space height,and fusion segment height of the two groups after operation were signifi-cantly improved compared with those before operation(P<0.05).The incidence of postoperative dysphagia in the zero-profile group was significantly lower than that in the titanium plate group(P<0.05).The Cobb angle of the fusion segment in the zero-profile group at 3 months after operation was significantly improved compared with that before operation(P<0.05).There was no significant difference in the other radiographic parameters between the two groups at each follow-up time point(P>0.05),except for the Cobb angle of the fusion segment at 3 months after operation and at the last follow-up(P<0.05)and the difference in the extra-fusion bone bridge(ExGBB)between the two groups at the last follow-up(P<0.05).Conclusions In ACDF,the clinical efficacy of zero-profile interbody fusion cage and interbody fusion cage combined with titanium plate is similar,both of which can significantly improve cervical function and postoperative imaging indicators.However,the zero-profile interbody fusion cage sig-nificantly reduced the incidence of dysphagia compared with the interbody fusion cage combined with titanium plate.In the end-stage follow-up,the former is better than the latter in improving the Cobb angle of the fusion segment and ExGBB,which is more conducive to promoting bone graft fusion.Both fuses have the risk of sinking.