Objective To discuss MRI diagnositic value and evaluation of the treatment of cervical Brucella spondylitis(BS).Meth-ods MRI data of 39 cases with cervical BS in our hospital were collected.Non-operative treatment,minimal invasive surgery and the open surgery were selected according to the MRI manifestations.The correlation was analyzed by consistensy check,imaging score and clinical effect evaluation.The data were analyzed by SPSS15.0.Results 39 cases of patients were examined by MRI before the treatment.37 cases were reviewed after 6 months treatment and 33 cases were reviewed after 12 months treatment.All of the Kappa values were more than 0.75 by imaging consistency check.MRI of cervical BS possessed characteristic expressions.The treatment effect according to MRI classification before the treatment:(1)drug therapy was performed in 14 cases (Group A);(2)minimal inva-sive surgery was performed in 7 cases (Group B);(3)focus clearance and bone graft were performed in 18 cases (Group C);(4)the clinical effects showed the healing rate in every group at different time point was different and the difference had statistical signifi-cance(P<0.05).The healing rate in Group C was higher than it in other group at 6 months after treatment.There was no significant difference among 3 groups or among different method group(Group C1,C2 and C3)in Group C at 12 months after treatment(P>0.05). Conclusion MRI classification for cervical BS has important value and guiding significance in the selection of clinical conservative treatment,minimal invasive surgery or the open surgery.

Objective:To investigate the correlation of 25-hydroxyvitamin D [25(OH)D], parathyroid hormone(PTH)and bone turnover markers with the glomerular filtration rate(GFR)in elderly male patients with type 2 diabetes mellitus.Methods:The study included a total of 426 non-dialyzed male T2DM patients with a disease course of more than 10 years, of whom 206 aged 60-86 years(the elderly group, 69.8±5.7 years old)and 220 aged 40-59 years(the middle-aged group, 50.1±5.3 years old). According to the estimated GFR(eGFR)calculated using the CKD-EPI formula, patients in each group were divided into four subgroups: Group 1(at CKD1 stage), Group 2(at CKD2 stage), Group 3(at CKD3 stage)and Group 4(at CKD4/5 stage). Levels of 25(OH)D, parathyroid hormone(PTH), procollagen type 1 N-terminal propeptide(P1NP), and C-terminal telopeptide of type Ⅰ collagen(β-CTX)in each group were measured.Results:The median level of 25(OH)D was 17.10(11.30-21.60) μg/L in 426 patients, of whom 292(68.5%)showed vitamin D deficiency.The level of 25(OH)D decreased significantly in the elderly group compared with the middle-aged group(15.10 μg/L vs. 17.15 μg/L, Z=-2.165, P=0.030), while the proportions of patients with vitamin D deficiency were similar in the two groups(68.4% vs. 68.6%, χ2=0.002, P=0.966). With decreasing eGFR, the proportion of patients with vitamin D deficiency gradually increased in the elderly.In the elderly cases, compared with the Group 1 and Group 2, the level of 25(OH)D in Group 3 dropped significantly (10.85 μg/L vs. 16.80 μg/L, Z=-2.808, P=0.005; 10.85 μg/L vs. 15.60 μg/L, Z=-2.099, P=0.044), and Group 4 showed an even more pronounced decrease than Group 3(6.65 μg/L vs. 10.85 μg/L, Z=-1.956, P=0.048). The level of 25(OH)D decreased significantly in the middle-aged patients at the CKD4/5 stage.The levels of PTH and β-CTX were negatively correlated with the 25(OH)D level( r=-0.348 and -0.263, P<0.001), and the level of negative correlation was affected by eGFR. Conclusions:In non-dialysis elderly male patients with T2DM, PTH and bone turnover marker β-CTX levels are negatively correlated with the 25(OH)D level, and the negative correlations are affected by eGFR.